IN HERBAL PREPARATIONS
MEDICINAL QUALITIES OF CHANCA PIEDRA
by Melody Elaine Thomas
It is little wonder that Chanca Piedra is used for so many purposes in herbal medicine systems: in clinical research over the years, the plant has demonstrated liver protective, antilithic (expelling stones), pain-relieving, hypotensive, antispasmodic, antiviral, antibacterial, diuretic, antimutagenic, and hypoglycemic activities. Since the 1960’s there has been a growing body of scientific studies published on Chanca Piedra, to date over 300 studies have been carried out. Indian and Brazilian research groups were the first to conduct these studies since the plant was indigenous to their areas, with a long history of use by their inhabitants. The Brazilian researchers have summarized their research stating, “Pre-clinical and clinical studied carried out with the extracts and purified compounds from these plants support most of their reported uses in folk medicine for the treatment of a wide variety of pathological conditions.”
Kidney, Gall Stones & Cholesterol
Research done in Brazil at the Federal University of Santa Catarina in 1984 on Chanca Piedra revealed an alkaloid (phyllanthoside) in the leaves and stem with strong antispasmodic activity. It served as a relaxing agent for smooth muscles and they concluded that its spasmolytic action probably accounted for the efficacy of Chanca Piedra in expelling stones.
TABLE 1. Chemical Constituents and Pharmacological Activities in Phyllanthus species.
Species |
Compound |
Pharmacological Activity |
|
P. urinaria,
P. niruri,
P. amarus
|
Rutin
|
Anti-inflammatory and analgesic
|
|
P. urinaria
|
B-amyrin
|
Analgesic, antilipoxignease
|
|
P. urinaria,
P. niruri
|
Ellagic acid
|
Aldose reductase inhibitor
|
|
P. urinaria
|
Geraniin
|
ACE inhibitor, antiallergic, diuretic hypertensive and analgesic
|
|
P. urinaria,
P. niruri
|
Quercetin,
Dibencylbutirolactone |
Mitocondrial ATPace inhibitor, phosphodiesterase inhibitor, mutagenic effect in bacterial, cycloocigenase inhibitor, analgesic, phosphorilase and tyrosine kinase inhibitor, phopholipase A2 inhibitor
|
|
P. niruri
|
Niruside
|
HIV-1 Reverse transcriptase inhibitor
|
|
P. niruri
|
Repandusinic acid A, Phillanthin, Hypophillantin, hirtetralin, triacontanal
|
HIV-1 reverse transcriptase inhibitor, antihepatoxic, endothelin antagonists
|
|
P. urinaria
|
B-sitosterol, gallic acid, ethyl ester, & stigmasterol -sitosterol
|
Analgesic and anti-inflammatory
|
|
|
|
Alkaloid phyllanthoside
|
Antispasmodic activity
|
|
Gallstones and kidney stones are a major health problem in the United States. In fact, 20,000,000 in the U.S. suffer from gallstones and medical doctors treat 600,000 each year for this condition. With the introduction of Chanca Piedra, health care practitioners have acquired a powerful plant ally in helping their patients to maintain optimal kidney, gall bladder, liver, and bladder health. Kidney stones are formed when urine becomes too concentrated-usually due to chronic dehydration, infection, various kidney disorders, deficiencies in magnesium, and excess purines or oxalates in the diet.
Kidney stones form when certain substances, calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid or cystine-become so concentrated in the urine that they precipitate out as hard, solid lumps. The main symptom of kidney stones is pain in the left or right lower back or pelvic area that becomes excruciating as the stone attempts to leave the kidney through narrow tubes called ureters.
The first notable area of study of Chanca Piedra for kidney stones was conducted in 1990, at the Paulista School of Medicine in Sao Paulo, Brazil. This study was conducted using humans and rats with kidney stones. They were given a simple tea of Chanca Piedra for 1-3 months and it was reported that the tea promoted the elimination of stones. They also reported a significant increase in urine output as well as sodium and creatine excretion.
In a 1999 study, researchers confirmed that Chanca Piedra has a potent and effective inhibitory effect on the formation of calcium-oxalate crystals and decreases the size of existing stones. Not only that, but also this effect was found even at very high levels of calcium oxalate, which indicates that it might be a useful preventative aid for people with a history of kidney stones.
In a 2002 in vivo study, researchers seeded the bladders of rats with calcium oxalate crystals and treated them for 42 days with a water extract of Chanca Piedra. Their results indicated that Chanca Piedra strongly inhibited the growth and number of stones formed over the control group. Several of the animals even passed the stones that did form. More recently (in 2003), scientists studied the inhibition of calcium oxalate crystal formation in urine samples to which sodium oxalate had been added. These researchers again confirmed in vitro that Chanca Piedra could help prevent the formation of kidney stones stating, “…that it may interfere with the early stages of stone formation and may represent an alternative form of treatment and/or prevention of urolithiasis.”
Chanca Piedra is also used in herbal medicine for gallstones and one study indicates that Chanca Piedra has an effect on gallbladder processes. Gallstones form when cholesterol and bile pigments become so concentrated that they form lumps inside the gallbladder. These lumps may be as small as a pinhead or as large as a golf ball. Gallstones that remain in the gallbladder rarely cause symptoms. But you can expect major problems if a stone blocks either the cystic duct (the tube that leads from the gallbladder to the bile duct) or the bile duct (the tube running from the liver and gallbladder into the intestine). In a 2002 study, Indian researchers reported that Chanca Piedra increased bile acid secretion in the gallbladder and significantly lowered blood cholesterol levels in rats. The beneficial effects of lowering cholesterol and triglyceride levels was also confirmed by another in vivo (rat) study in 1985.
Dr. Wolfram Wiemann of Nuremburg, Germany has used Chanca Piedra in his medical practice in Germany. He reported 94% of all the cases he encountered among his patients of gallstones and kidney stones were “completely eliminated” within one or two weeks. Another Amazon physician interviewed by Nicole Maxwell, about the use of Chanca Piedra for his patients said that the plant worked 100% of the time without any side effects. While not characterized as a side effect, it is noted that for several hours during the actual process of elimination of the stones, some patients experienced stomach cramps.
In France, Chanca Piedra has been used for some time to treat gall and kidney stones. It is part of a pharmaceutical product called Pilosuryl, which is sold as a diuretic.
Antinociceptive Effects
Brazilian researchers have also discovered powerful, long-lasting pain-blocking activity in the roots, stems and leaves of several different species of Phyllanthus, including P. niruri. In a book called “Cat’s Claw: Healing Vine of Peru”, Kenneth Jones, in a section of the book devoted to Chanca Piedra, states:
“In the test system used, the extract of Phyllanthus urinaria showed about four times more potent activity than indomethacin and three times the strength of morphine against the second phase of pain which models the stage of “inflammatory” pain. The pain model used in these tests (formalin-induced persistent pain) appears to provide a state similar to that of post-operative pain in people…the pain blockers in Phyllanthus have been identified by the Brazilians as gallic acid, ethyl ester and the steroidal compounds as beta-sitosterol and stigmasterol.”
Calixto, et al. have pointed out that different kinds of compounds isolated from plants belonging to the genus Phyllanthus, eg., flavonoids such as quercetin and rutin, tannins, such as geraniin and furosin, benzenoids, such as ethyl gallate and methyl gallate, and the phytosterols, exhibited antinocieptive effects in mice. With so many different pain-relieving active compounds present in these plants, the Brazilian researchers have indicated the possibility of the existence of synergistic effects between some molecules present in the extracts, and suggest future investigations of such effects.
Diuretic, Hypotensive, and Hypoglycemic
The diuretic, hypotensive and hypoglycemic effects of Phyllanthus niruri were documented in a 1995 human study. Indian researchers gave human subjects with high blood pressure Chanca Piedra leaf powder in capsules and reported a significant reduction in systolic blood pressure, a significant increase in urine volume and sodium excretion. Chanca Piedra’s diuretic effect in humans was recorded as far back as 1929 and, in India a tablet of Chanca Piedra is sold as a diuretic there. This significant diuretic effect, and a significant reduction in systolic blood pressure in non-diabetic hypertensive individuals were attributed to a specific phytochemical in Chanca Piedra called geraniin in a 1988 study. In the above 1995 study, researchers also reported that blood sugar levels were reduced significantly in human subjects studied, with blood glucose in diabetic patients taking Chanca Piedra for 10 days.
Two other studies with rabbits and rats document the hypoglycemic effect of Chanca Piedra in diabetic animals. In dealing with diabetic neuropathy and macular degeneration, a study documented Chanca Piedra with aldose reductase inhibition (ARI) properties. Aldose reductases are substances that act on nerve endings exposed to high blood sugar concentration, resulting in neuropathy and macular degeneration. Substances that inhibit these substances can prevent some of the chemical imbalances that occur and thus protect the nerve. This ARI effect of Chanca Piedra was attributed, in part, to a plant chemical called ellagic acid. This well-studied plant chemical has been documented with many other beneficial effects in over 300 clinical studies. It is also considered an immune system stimulator.
Hepatitis
Of particular note, break-stone gained worldwide attention in the late 1980’s due to the plant’s antiviral activity against Hepatitis B. Preliminary clinical trials with P. niruri on children with infective hepatitis using an Indian drug containing Phyllanthus amarus as the main ingredient showed promising results, which fueled the subsequent in vitro and in vivo studies. The in vitro inactivation of Hepatitis B by break-stone was reported in India in 1982. A study that followed indicated that in vivo, break-stone eliminated hepatitis B in mammals within 3-6 weeks. Several subsequent studies in the late 1980’s and early 1990’s failed to produce any effect against hepatitis, but other research conducted form 1990 to 1995 has indicated that Chanca Piedra does demonstrate antiviral activity against Hepatitis B.
Phyllanthus niruri / amarus is considered, based on accumulated research, as the most effective natural, non-toxic remedy for the Hepatitis B virus, a pathogen now carried by more than 350 million people in the world. Statistics on HBV are staggering: one out of every 250 Americans is an HBV carrier! The Center for Disease Control (CDC) estimates that 73,000 new U.S. cases of HBV infection per year are added to the current estimate of 1.25 million carriers in the U.S. In the U.S., the CDC also reports that 3,000-4,000 annual deaths from cirrhosis and 1,000 deaths from liver cancer are HBV-related. Hepatitis B is not only disabling in its acute phase, but it can remain in the body and contribute decades later to the development of liver cancer. Liver cancer to date is reported to be 100% fatal.
Many people who contract HBV become chronic (and, often, asymptomatic) carriers of the disease while still being contagious to others. HBV is reported to be 100 times more infectious than HIV, and, like HIV, is transmitted through blood transfusions, needles, sexual contact, and in utero (from mother to child in the womb).
In 1988, Dr. Baruch Blumberg reported that Chanca Piedra could clear up the chronic carrier state of Hepatitis B. This was big news for Herbalists as Dr. Blumberg was the winner of the 1963 Nobel Prize for discovering the HBV antigen. This led to the discovery that HBV was the primary cause of liver cancer and initiated the development of HBV vaccines. Most of Blumberg’s early research on Chanca Piedra was carried out in India in collaboration with an Indian research group. Blumberg was employed with the Fox Chase Cancer Center in Philadelphia, and it was with this group and the Indian research group that filed two patents on the plant’s ability to treat HBV and its antiviral properties in 1985 and1988. The fist patent was specific to HBV; the second stated that the plant’s antiviral properties were achieved in part through a strong inhibition of reverse trancriptase, necessary for many types of viruses to grow. This made it possible to treat such retroviruses as HIV, sarcoma and leukemia viruses. Their first human study reported that a water extract of Phyllantus amarus and niruri cleared the HBV surface antigen from 22 of 37 chronic HBV patients in only 30 days and continued to test negative for nine months. This same group had published several earlier in vitro studies as well as animal studies. They chose to use woodchucks in the animal tests because woodchucks respond to chronic HBV infection in much the same manner as do humans. All reported similar and effective anti-HBV effects.
After these studies, at the Fox Chase Cancer Center, they asked the question: Could an herbal medicine help? Since it was at this research center where a massive search of the world’s herbal literature was initiated for plants used against jaundice (acute hepatitis) and other liver diseases and Phyllanthus turned up as one of the most promising. The hope for Phyllanthus is to provide an abundantly available nontoxic alternative not only to treat the disease, but ideally to render carriers Sero-negative for the virus so they won’t pass it on to others. Combined with vaccines, Phyllanthus, or perhaps other herbs combined, might make a significant contribution to the eradication of viral hepatitis.
Research in Japan and India in the 1980’s has demonstrated the liver-healing properties of Chanca Piedra. The primary compounds responsible are phyllanthin, hypophyllanthin and triacontanal. Glycosides found in Chanca Piedra demonstrated aldose reductase (AR) inhibitory activity in studies conducted by a Japanese research group in 1988 and 1989.
HIV
The most recent research on break-stone reveals that its antiviral activity extends to human immunodeficiency virus (HIV). A Japanese research group discovered Phyllanthus niruri’s HIV-1 reverse transcriptase inhibition properties in 1992 with a simple water extract of the plant. Scientists from Bristol-Myers Squibb’s Pharmaceutical Research Institute isolated at least one of the constituents in the plant responsible for this activity—a novel compound that they named “niruside” and described in a 1996 study. A German research organization published their first study on Chanca Piedra and its application with HIV therapy (reporting a 70-75% inhibition of virus) in 2003.
Arthritis
Preliminary studies in chronic arthritis indicate a clear anti-inflammatory activity, anti-tumoral effects in mice have been detected and there are some evidences that relate this property to one of its phytochemicals: dibencylbutirolactone.
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Anticancer
In several animal studies (as well as within cell cultures), extracts of Chanca Piedra have stopped or inhibited cells (including liver cells) from mutating in the presence of chemical substances known to create cellular mutations and DNA strand breaks (which can lead to the creation of cancerous cells). It may well be that Chanca Piedra’s documented ability to stop cells from mutating plays an important factor in this reported anticancerous activity. Again, one of these studies indicated that Chanca Piedra inhibited several enzyme processes peculiar to cancer cells replication and growth-rather than a direct toxic effect of killing the cancer cell (sarcoma, carcinoma, and lymphoma cells were studied). This cellular-protective quality was evidenced in other research, which indicated that Chanca Piedra protected against chemically induced bone marrow damage in mice, as well as against radiation-induced damage in mice.
Future Studies
Researchers have suggested that another promising area for future study would be the use of Chanca Piedra in treatment of Lyme’s Disease. Since syphilis is caused by a spirochete and Chanca Piedra has traditionally been used for this illness, it would be a good study for the epidemic of Lyme’s Disease, which we are experiencing the northeastern United States, since Lyme’s is also caused by a spirochete. Some herbalists have used Chanca Piedra traditionally for gonorrhea and syphilis.
Chanca Piedra is a perfect example of a highly beneficial medicinal plant, which is deserving of much more research. Unfortunately, because of its complicated myriad of chemical constituents, there isn’t enough grant monies available. Major funding would have to be had for a pharmaceutical or research company to isolate a single, patentable chemical to justify the high cost of research.