Dr. W. M. Bortz II

Q: Have you ever heard that natural medicines (herbs) could help or even possibly reverse the symptoms of Alzheimer’s disease? If so, what are your views on this and would you be open to discussion on this subject?

A: I would bet that some herb or another has been proposed for every ailment from which the human family suffers. In one way this is natural. Since prehistory, mankind has sought remedies for every bruise and misery that came its way. Before scientific medicine made its legitimate entry only a little over a century ago with Louis Pasteur’s demonstration of the bacterial origin of illness, all the medicines available were assorted ground roots, berries, powdered animal horns and the like — much like the Chinese apothecary shops of today.

      Progress by chemical science has allowed us now to isolate and purify the exact pure compounds intended for therapeutic use. Certainly the modern pharmaceutical industry is an immense advance. It provides thousands of specific drugs for specific purposes.
      But modern pharmacy certainly is not the whole answer to illness, although some people would like it to be. It is a constant truth that prevention is far better than cure, even when the possibility of one exists. Polio comes immediately to mind. There never was, is, or will be a cure for polio — but, thankfully, we no longer need to search for one since polio is now only seen largely in the history books.
      Alzheimer’s disease is polio's cousin. This horrible condition maims millions of people and lacks a cure — but we’re searching. No cure is found in the drugstore, so it is logical to see if Mother Nature may offer something of value that has not been suspected. Enter Ginkgo biloba. This herbal compound, derived from the ancient ginkgo tree has been extensively employed in Europe — Germany, in particular — for dementia. Many positive results have been reported, but close reading of these reports reveals the poor nature of the studies, made worse by the lack of standardization of the ginkgo extract itself. The active ingredients are possibly flavonoids and isoprenoids, chemical substances common to many plants. Experts say these act as anti-oxidants, but this is not established. Ginkgo conceivably could increase blood flow to the brain.
      Ginkgo’s use for Alzheimer’s disease receives support by an article published in 1999 in the Journal of the American Medical Association which showed a mild improvement in the symptoms of a group of patients with Alzheimer's.
      Besides ginkgo, experimenters have tried ginseng, the hormone DHEA, Vitamin E and superoxide dismutase (SOD) in an effort to slow or reverse the awful progress of Alzheimer’s disease. To date, no enthusiasm for any of these approaches has occurred, which leaves G. biloba as the herbal choice. I am aware that greatly expanded research efforts are under way, including one at my parent institution, Stanford University, to see whether ginkgo helps or not. This will involve recruiting a large number of Alzheimer's patients and conducting a double-blind study to see whether it helps.
      Certainly, the pharmaceutical industry has not found any magic bullet. Knowing that Alzheimer’s disease brain tissue has low levels of the neurotransmitter acetylcholine, efforts have been instituted trying to increase this substance by giving a drug. Tacrine and Aricept have been marketed in this effort with very little medical enthusiasm. Other nonspecific medicines including estrogens and the anti-inflammatory drugs are employed.
      To me, the fact that we have not found “the answer,” no miracle drug, is not at all surprising. As you look at brain specimens from people who died with Alzheimer’s disease and witness the awful gummy mess that burdens the delicate brain tissue, it is simply unrealistic to think that taking a pill could prove effective in restoring the original circuitry. Again, reference to polio is appropriate. Polio is the destruction of the anterior portion of the spinal cord by the polio virus. Looking at the spinal cord of a polio victim reveals what looks like a frazzled telephone cable. What pill could you imagine that would serve to untangle that mess? It's impossible.
      So, we confront the awful disease of Alzheimer’s unarmed with the likelihood of a cure anytime soon, if ever. But that should not make us lose heart. To the contrary, in my view our understanding of Alzheimer’s disease is exploding. What I am hoping for so desperately is a vaccine, a preventive that once universally applied will make Alzheimer’s disease a historical relic too. That will be a joyous day for all humanity.
      But in the meantime, we wait. There is no good reason not to try G. biloba, but it is inappropriate to hold out great hope for much improvement from it. The positive placebo effect is strong, particularly when a person is so eager to find improvement.
      For me, I would advocate taking the money you would spend for the ginkgo and give it instead to the Alzheimer’s Disease and Related Diseases Association for their research. It is a cause worthy of all our constant support.

                                                                                                  
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