1. Valerian Kelly Hughey Nutrition Update 547

2. What Is Valerian? Botanical Name: Valeriana officinalis Other Names: Heliotrope, Fragrant Valerian and European Valerian. Valerian grows wild over many parts of Europe and Asia. However, most of the valerian used for medicinal extracts is cultivated. Parts used for extract: Root and rhizome.. Valerian is a popular herb used as a sedative to promote sleep and as a calmative agent.

3. History and Traditional Uses Valerian: from the Latin word valere, which means to be in good health. The herb was first discovered and used by Greek physicians, who recommended it for a host of medicinal uses: –Insomnia –Digestive problems –Anxiety –Epilepsy??

4. Current Valerian Claims Valerian is currently recommended for the following: »Insomnia »Anxiety »Pain Valerian is used in combination with many other herbs for a list of purposes.

5. Insomnia Even losing sleep a few nights a week can significantly impair your ability to function and decrease the quality of your life. Lack of Sleep can cause: 1. Depression and Anxiety 2. Delayed Reflexes 3. Mental and Physical Exhaustion 4. Weight Gain 5. Slow recovery from infections and diseases 6. Depressed immune system 7. Decreased attention span 8. Irritability

6. Insomnia cont.. Many who suffer from sleeping problems seek out help. Options available: Relaxation techniques, prescription drugs and herbal remedies (like valerian). Herbal remedies may be chosen due to the high cost and addictive properties of prescription medications.

7. Chemical Constituants Valerian extract is composed of many chemical constituents that are suggested to have medicinal properties »Valerenic acid »Valeoptriates »Amino acids Valerenic acid; suggested in several studies to be one of the active compounds of valerian.

8. How it Works GABA receptors, melatonin, serotonin and dopamine play a big part in controlling sleep (circadian rhythm, sleep latency, and duration) Valerian may decrease the degradation of GABA, therefore increasing GABA concentration at the synapse (similar to Rx drugs like barbituates and benzodiazepine) resulting in a calming or sedative effect. There are also studies testing valerians effect on serotonin and melatonin receptors as well, but the mechanism of this reaction is unknown.

9. Abourashed, E. and Koetter, U. In Vitro Binding Experiments with a Valerian, Hops and Their Fixed Combination Extract to Selected CNS Receptors. Phytomedicine. 2004. Vol 11 _____________________________________________________ Several central receptors were selected for screening the binding affinity of valerian extracts. (serotonin, dopamine, melatonin) Valerian dry extract was prepared for the dried roots of the plant and paired with hops dried extract. The binding assays were performed using human cloned receptors.

10. Findings: –The tested extracts showed considerable affinities towards the serotonin and melatonin receptors. –the nature of affinity for the valerian product to the respective receptors is yet to be determined. –Partially due to the in vitro tests (bioavailability is an essential parameter to be considered). –Identification of the active constituents of any herbal product is important for full understanding of its pharmacological use and risks.

11. Analyzed 3 studies of uses and effectiveness of valerian. 1. Double blind, placebo controlled trial, 128 participants. Evaluating the effects of a single dose (400mg) on sleep latency, quality, night awakenings and sleepiness upon wake. –Valerian extract demonstrated significant improvement over placebo in latency and quality, but no differences in the other two parameters. –Examination of the study showed that the positive effects of valerian extract on sleep were most significant in those who considered themselves very poor sleepers and smokers. Subjects who rated themselves as good sleepers where largely unaffected by the herb. Hadley, S., Petery, J. Valerian. American Family Physician. 2003. Vol 67. pg 1755-1760. ________________________________________________________

12. 2.Another double blind study of 58 subjects who were described as and having lengthy sleep latency: Single doses of 450 and 900mg for comparison Wriest activity meter Provided sleep rating surveys They also found the single does to be effective for sleep latency and achieving “better rest”, however no effect on total sleep time. The 900mg dose produced increased sleepiness on awakening, compared with placebo.

13. 3. The last study focused on pts with confirmed insomnia. –Design: Placebo-controlled, double blind –600mg single dose –Doses given over 14 days –Each monitored with a polysomnograph (measures sleep waves) Findings: –The 600mg single dose of valerian extract demonstrated no effect on sleep efficiency. –While multiple doses over the 14 days resulted in significant improvement in parameters of slow- wave seep. –There was a slight trend toward reduced sleep latency after the long-term valerian Tx.

14. Summary of article Most studies reviewed suggested that valerian is more effective when used continuously rather than as an acute sleep aid. More rigorous studies are needed to confirm these results. A potential advantage of valerian over prescription meds is the lack of sleepiness upon awaking when using recommended doses.

15. Other Research reviewed: Evidence indicates that valerian may be beneficial and safe for persons with Rheumatoid Arthritis, and possibly may be superior to other sleep aids. –RA can be used as an example of problems that people may have that inhibit good sleep (others found include child developmental delay, anxiety and fibromyalsia,,, the list can go on) One article suggested that valerian is just as, if not more effective as Kava in treating insomnia. In pre-op pts: Valerian, and other herbs should be tapered off within a week of most surgeries or when anticipating a major medication change. But may be useful post- surgery for pts with sleep difficulty. (check with MD)

16. Dosages and Effectiveness Many people take 300-500mg of valerian root extract in capsules or tablets, 30 minutes to 2 hours prior to bedtime. Another common preparation is to create a tea-like tincture, by soaking 2-3g of dried root in warm water. It has been found that taking valerian for single time use is questionable effectiveness. Valerian is recommended to be used longer periods of time or for chronic conditions. Valerian is most effective after taking it nightly for 5 to 7 days. Several clinical studies have shown that valerian is effective in the treatment of insomnia, most often by reducing sleep latency.

17. Side Effects and Herb-Drug Interactions According to several studies, there are no contraindications with valerian. Reported adverse effects are rare, but include dizziness, headache and GI distress. Valerian may potentate the sedative effects of barbiturates, anesthetics or other CNS depressants. Use with other sedative medications is not advised. No evidence of averse effects have been found in studies combining the use of valerian and alcohol consumption. But is still not advised. Contradictory information was found regarding the operation of heavy machinery or motor vehicles.

18. Quality Considerations Quality standards generally relate to the level of essential oil. The European Pharmacopia defines valerian root as containing at least 5ml of essential oil/kg. Higher quality is considered to be associated with roots bred to have higher concentrations of oil. Neither the FDA nor any other federal or state agency routinely tests valerian products, or other supplements, for their quality.

19. Quality Considerations cont.. ConsumerLabs.com: Products were tested for: the quality and quantity of their valerian; potency, contamination, and dissolution. What CL Found: Among the 13 products tested by ConsumerLab.com, 5 failed. Low potency was the primary reason for failure.

20. Summary and Key Points Efficacy: Appears effective in mild to moderate insomnia. Adverse Effects: Rare GI disturbance and headache. Interactions: None have been reported, however may increase sedative effects of barbiturates, anesthetics and CNS depressants. Dosage: Varies. Usually 300 to 600mg capsules 30 minutes to 2 hours before bed. Or 2 to 3g of dried root (tea form). Cost: $0.08 to $0.30 per capsule, depends on brand. Bottom line: If the brand is tested to provide adequate amounts of active ingredients, it is a safe and effective treatment of mild to moderate insomnia.

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22. References Abourashed, E. and Koetter, U. In Vitro Binding Experiments with a Valerian, Hops and Their Fixed Combination Extract to Selected CNS Receptors. Phytomedicine. 2004. Vol 11. American Academy of Family Physicians. http://www.aafp.org/afp/20030415/1755.html. retrieved July, 2006. http://www.aafp.org/afp/20030415/1755.html Hadley, S., Petery, J. Valerian. American Family Physician. 2003. Vol 67. pg 1755-1760. Herb Almanac. http://www.1001herbs.com/valerian/. retrieved July, 2006.http://www.1001herbs.com/valerian/ McCabe, S. Complementary Herbal and Alternative Drugs in Clinical Practice. Perspectives in Psychiatric Care. 2002. Vol 38. pg 98-109. Mischoulon, D. The Herbal Anxiolytics Kava and Valerian for Anxiety and Insomnia. Psychiatric Annals. 2002. Vol 32. pg 55-66. Muller, D., Pfeil, T., et all. Treating Depression Comorbid with Anxiety Results of an Open, Practice-oriented Study with St.Johns Wort and Valerian Extract in High Doses. Phytomedican. 2003. Vol 10. pg 25. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/Valerian.asp. retrieved July, 2006.http://ods.od.nih.gov/factsheets/Valerian.asp Taibi, D., Bourguignon, C., Taylor, A. Valerian Use for Sleep Disturbances Related to Rheumatoid Arthritis. Holistic Nursing Practice. 2004. Vol 18. pg 120-127. Wills, R., Bone, K., Morgan,M. Herbal Products: Active Constitualnt, Modes of Action and Quality Control. Nutrition Society. 2000. Vol 13.

23. A side Note… Valerian has shown to have a similar effect on cats as cat-nip.