How Botanical Medicine Supports Harmony in the Body

For five years or so I have been guided by my intuition’s telling me to seek harmony. I remember exactly where I was when this knowing first became a conscious thought: standing by the counter on the third floor of the neuroscience nonprofit where I used to work, probably refilling my water bottle. I didn’t know what it meant then, but it’s stayed with me all this time.

I’m participating in a joy coaching program called JOY Revolution, life coaching intended to help you to grow awareness of your sensations and emotions and use them as information, and to turn down the volume of your brain and turn up the volume of your inner voice. Two weeks ago, the weekly workbook gave a long list of values, one of which was harmony. I realized it still means something to me. Then, two days ago, I was making myself a double pot of echinacea tea when I turned over the tags to read the aphorisms. One of them read, “Nature teaches us harmony.”

One part of my mission is to cultivate a harmonious relationship between humans and nature. By this I don’t only mean protecting the health of the planet, although I mean that too, because human and planetary health are intertwined. What I mean more directly is integrating nature into our lives and showing people that nature can be used, either directly (as in botanical medicine) or as inspiration (as in plant science), to heal.

This knowledge has existed as wisdom for thousands of years as naturopathic medicine. The most well-known may be the Ayurvedic and Taoist (Chinese) traditions, although it even has Grecian and other roots as well. As a scientist-at-heart whose mind is also open to naturopathic medicine, I am thrilled that science is beginning to give a scientific foundation to this wisdom, which will increase acceptance of its practice.

It's not widely known as a practice, so as context, I’ll note that naturopathic medicine is founded on six principles:

• First Do No Harm, primum non nocere

• The Healing Power of Nature, vis medicatrix naturae

• Discover and Treat the Cause, tolle causam

• Treat the Whole Person, tolle totum

• The Physician as Teacher, docere

• Prevention Is the Best Medicine, praevenire

The simplest definition I can give of naturopathic medicine is that it recognizes the body’s innate wisdom to heal. It seeks to restore balance in the body by giving the body what it needs (micronutrients, as an example).

Of course, it’s more complex than giving the body micronutrients (it is medicine, after all). It draws on sciences including biomedical sciences (e.g., biochemistry), clinical sciences (the “-ologies”), nutrition, physical medicine, and behavioral medicine. Where it differs from conventional medicine is its integrative approach that recognizes the interconnectedness present within our body and environment and its inclusion of homeopathic and botanical medicine.

Much, though not all, of my experience with naturopathic medicine has been botanical. I have truly come to love herbs. This is all of the ways in which I have used them:

Foundational mineral support — For the first month I drank nettle tea 3-4 times a day, from an herbal shop near me at first and then from Mountain Rose Herbs. I still drink it often as a bedtime tea. Nettle is a very grounding tea, earthy in flavor; my favorite way to prepare it is with fresh peppermint leaves from my plant.

A note on mineral support: I also took an unpleasant supplement called BioSil (Natural Factors) that gives your body the ingredients it needs to make collagen (silicon and choline). A throughline of naturopathic medicine is giving your body the ingredients it needs to make the target compound naturally in the body. As another example, the first supplement my primary care ND gave me (and which I ended up taking again later) was Deproloft-HF (Thorne), because it contains 5-hydroxytryptophan, which can be converted to serotonin, a neurotransmitter that helps you to feel peace, optimism, and confidence.

Antimicrobial support — This is the reason I sought care from naturopathic doctors: the UTIs (and vaginal infections that came with them). I tried Bio Vegetarian (Priority One) first, a powerful complex of herbs that wasn’t powerful enough for me, because I still got a UTI while taking them. Later, I switched to Urinary Defense (Priority One), taken both as a prophylactic and in higher doses when I felt a UTI coming on. (Truthfully, I wonder if I took too much of it in my desperation to not get those UTIs. It did work, though.)

Gut support — While the UTI supplements contained berberines, I took additional berberines in the form of Berberine-500 (Allergy Research). Berberine is a strong antibacterial compound found in many plants such as juniper berry and barberry (Herbal Antibiotics by Stephan Harrod Buhner).

Lymphatic system support — The lymphatic system supports natural detoxification processes by moving lymph through the body. I took LymphActiv (CellCore), which also supports adrenal and liver function and immunity.

There is a world of ways in which to use and prepare herbs. You could get very scientific about which herbs to use in treating a given condition, and how. If you're interested in learning more about medicinal plants, I recommend a title I spotted within a floor-to-ceiling stack of books in an ND’s office, the most engaging autobiography I have ever read: Of People & Plants by Maurice Mességué, a French healer.

On Ureaplasma and Becoming Your Own Health Advocate

In starting this blog, it’s hard to know where to start. So I’ll start at what feels like the beginning, a natural place, which for me was a diagnosis of ureaplasma.

I was at my grandmother’s house when my doctor (the first in a line of many) called. I took the call in the backyard. In addition to the standard culture for a urinary tract infection, she had ordered a lab test for ureaplasma (looking back, I feel grateful to have had a doctor who thought to do this). It was the first time I’d heard of this bacteria called ureaplasma, although afterwards, many times, I would wonder with well-intentioned frustration why it’s not more widely talked about.

She explained that the medical community is divided over whether to treat it or not, because it lives naturally in the body as “commensal” bacteria and is in fact present in up to 80% of American women’s vaginal microbiomes. It’s thought to only become a problem when there is dysbiosis (imbalance) in the vaginal microbiome and/or when it is present with other, harmful bacteria. In my case, she thought the ureaplasma may have been contributing to the three UTIs I managed to develop within the span of a month. Given I was symptomatic, we treated with a single 1g dose of azithromycin.

Note: Two strains of ureaplasma exist: Ureaplasma urealyticum and Ureaplasma parvum. Some lab tests only test for “Ureaplasma spp.,” in which case a positive result would indicate you have one of the two. More nuanced tests can tell you which one. (I had ureaplasma urealyticum.)

The treatment must not have worked because two months later, I got an even worse UTI after hiking. This was before I’d learned to pee immediately after a sweaty workout, but all the same, I’m almost certain the Lululemon leggings had something to do with it. (I recommend wearing only 100% cotton underwear, polyester if you plan on getting sweaty, and not wearing lingerie for more than an hour or two at a time. If sensuality is important to you, you don’t have to give it up, even if you suffer from vaginal infections!)

On June 10 of that year, I came down with the worst UTI I’ve had to date and hope never to have again. It wasn’t responding to treatment, my doctor was out of town, and it was the only time in my life I recall begging. Seriously. I pleaded with the doctor on-call to prescribe a Z-pack, explaining that I was certain this UTI was caused by ureaplasma. He must have taken pity on me, because eventually he relented and did.

This is the part in the story in which I say that ureaplasma, as almost any doctor will look at you with sympathy and tell you, is one of the most hard-to-get-rid-of infections out there. Ureaplasmas belong to a class of bacteria called Mollicutes, which also includes the mycoplasmas. When people say “mycoplasmas,” they’re often talking about ureaplasmas, too. As with other species of bacteria that include some beneficial and other harmful strains (I’m looking at you, E. coli), while there are over 200 kinds of mycoplasmas, only a few of them — Mycoplasma pneumoniae, which causes respiratory tract infections, and Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma spp., which are implicated in genitourinary infections — are harmful. (I never tested positive for any of the mycoplasmas.)

Mollicutes are Gram-negative; they lack a cell wall, which means they don’t show up under a microscope and can’t be treated with antibiotics that target cell wall synthesis. They are notoriously hard to get rid of because they form biofilms (as many bacteria do), matrixed structures of synergistic bacteria that confer resistance to antibiotics due to the fact that the bacteria aren’t floating around where antibiotics can get at them. (In the case of chronic infections, a naturopathic or integrative practitioner may recommend breaking up the biofilm, during which time your symptoms will worsen, in order to effectively treat with antibiotics. Thankfully, I never had to do this.)

The last day of the Z-pack was only the first I really started to feel better; ordinarily, you continue taking antibiotics for several days after you begin to feel better, so this wasn’t a good sign. The antibiotics calmed the storm but didn’t knock out the infection, leaving in their wake a low-lying cloud in the form of low-grade burning that hung around for two months.

Those were a very anxious two months. My brain has blurred a lot of this time in my life, but I distinctly remember practicing gentle yoga, which felt like the only exercise I could do, in thin cotton pajama shorts, which felt like the only pants I could wear. Any amount of sugar made my symptoms flare up, too.

In July, I saw an infectious diseases specialist. Ureaplasma is considered an infectious disease, and I strongly believe it should be included in STI education. Even if most of the time it lives incongruously and harmlessly in the body, it’s spread through sex (i.e., sex without a condom). Even if you asked your partner to get tested before having sex, he/she wouldn’t be able to tell you if they had ureaplasma, because it’s not included on STI panels. It should be. So you know.

The infectious diseases doctor was not of much help regarding the UTIs; he said I had to be actively having an infection for a urine culture to show anything (ahem, as a gynecologist later told me, constant low-grade burning IS an active infection). He did say the IUD I had in place could be colonized. In retrospect, because my strings were cut short, this was unlikely, but not impossible. I had it removed, but my symptoms didn’t resolve. Which was when I truly took matters into my own hands.

I researched. I researched antimicrobial susceptibility patterns of antibiotic classes prescribed to treat ureaplasma: macrolides, tetracyclines (to which I am allergic), and fluoroquinolones. My goal in reading the literature was to identify the antibiotic with the highest success rate and to which the ureaplasmas circulating in the universe have the lowest resistance, on average. I found a paper that I shared with my doctor indicating that moxifloxacin might be the antibiotic I was looking for. (I wish I still had the paper saved, but I deleted all of my bookmarks from that time, and I can’t dig it out of my messages with my provider because the clinic changed its patient portal.) She read the paper and, out of kindness and wanting to help me, I think, and probably openness to trying anything that could, she prescribed the moxifloxacin, 400mg tablets for 7 days. She also prescribed a single dose of azithromycin for my partner, which I was able to pick up at the pharmacy for him, a small miracle.

Fluoroquinolones are terrifying to take. I do not recommend taking them unless you absolutely have to. They come with a long list of side effects, the most dangerous of which is joint damage. During the week I took them (and for some time after) I was careful not to do high-impact workouts or anything that could damage my joints, because fluoroquinolones (anything that ends in -floxacin) increase your risk of permanent joint damage and even tendon rupture.

To this day I am grateful to this doctor for prescribing the moxifloxacin, and to myself. A month after finishing the antibiotic, my retest for ureaplasma was negative. A year later, it is still negative. It’s totally possible that it is hiding out in a biofilm, where it can go undetected, but if so, it’s not giving me any trouble.

This story shows what tiny intuitions and the kindness of providers — and your luck and initiative to find the providers who can and will help you — can do. I love reading scientific journal articles, but when it came to my health, looking for research to find new leads and inform experimental care pathways felt too personal, so many negative emotions wrapped up in it. It was worth it, though. I’ve become a passionate advocate for bridging the gap between research and care, because for me, it worked. None of the above is intended as medical advice; draw what connections you will to your health journey. The medical advice I will share is this:

Be your own advocate.

COVID-19 Effects on the Female Reproductive System and Thyroid

In my last post, I alluded to my and others’ questions around the effects of COVID-19 and the vaccines on reproductive health. In my research to discover whether or not the latest booster was right for me, I wanted to go deeper into an article I read by Aviva Romm, MD, an integrative women’s health practitioner, trained first as an herbalist and midwife, who has written multiple books I adore (Hormone Intelligence, The Adrenal Thyroid Revolution). This article focuses on changes in women’s menstrual cycles, which in my observations took some time to receive validation and attention (and then, all of a sudden, did). Anyway, as someone with a family history of hypothyroidism, it was this paragraph about the thyroid that stood out to me:

“We also know that COVID-19 infection can have some impact on thyroid function, and there’s a relationship between your thyroid and your menstrual cycles. The authors of one study found that abnormal thyroid function – especially low TSH – is common in patients with COVID-19. (In fact, about 15-30% of hospitalized COVID-19 patients will have detectable new-onset thyroid dysfunction.) They concluded that although more research is needed, it’s possible that COVID triggers systemic immune activation that can cause inflammation in the thyroid, subacute hyperthyroidism, or acute hypothyroidism. Thyroid conditions like these are known contributors to menstrual cycle issues. The thyroid not only affects metabolism and weight, but it also interferes with the production of other hormones, including estrogen and progesterone, and can cause infertility, miscarriage, irregular cycles, skipped periods, heavy periods, cognitive problems, and much more.”

The second link is to an article published by the Baylor College of Medicine that explains that infection with COVID-19 can lead to acute hypothyroidism in something called “non-thyroidal illness syndrome,” characterized by low T3 or TSH and triggered by the release of pro-inflammatory cytokines. Alternatively, infection can lead to acute subclinical hyperthyroidism. Several cases have also reported subacute thyroiditis, or inflammation and pain in the thyroid that is thought to be autoimmune and possibly caused by invasion of the ACE2 receptor by the virus. Which led me to… What is the ACE2 receptor?

A quick Google search taught me that ACE2 stands for angiotensin-converting enzyme 2 and that these receptors are located in the heart, lungs, and other parts of the body, including those involved in the female reproductive system (notably, ovaries, although it turns out these receptors are also located in the male reproductive system — not trying to leave anyone out!). Frontiers in Physiology (I do love Frontiers — they have a journal for everything) dedicates an entire research topic to the impact of COVID-19 on the human reproductive system. One article serves as the most comprehensive review of literature on this topic to date that I’ve found. It explains that ACE2 regulates the expression of several peptides, including angiotensin II and Ang(1-7), which are involved in maturation of oocytes, ovulation, and “all stages of follicular development, suggesting a role in fertility.” Notably, the vagina and cervix do not express ACE2. Infection with COVID-19 has also been implicated indirectly in obstetric outcomes including pregnancy loss, preterm birth, neonatal NICU admission, and more, at least in part through a mechanism compromising the placenta.

Interestingly, there is also a body of research around the immunomodulatory effects of estrogen, supporting a stronger immune response in females than in males. Women are known to have “a stronger innate and adaptive immune response to viral infection,” as this article explains in detail, although it also notes that “While androgens like testosterone are known to be immunosuppressive, oestrogen tends to be more versatile in its character, and may enhance or deplete immune response, based on its concentration, distribution, and expression of its receptors.”

This one is worth a read, but I’ll call out two points:

· Women appear to experience higher phagocytic activity (from white blood cells calls neutrophils and macrophages), more robust responses from T cells (CD4+ and CD8+), and increased production of antibodies that remain in circulation longer, too.

· Estrogen has been shown to dampen production of pro-inflammatory cytokines, preventing cytokine storm syndrome.

More research is needed into gender-specific responses to COVID-19, the effects of COVID-19 on pregnancy (the research is limited and divided), and the effects of COVID-19 vaccines on reproductive health (so far, I have only read that the vaccines do not compromise fertility).

Tell me what you’re seeing and link me to any research you’re reading!