Has anyone tried lemon balm?
Melissa Officinalis, known as lemon balm has long been used by herbalists as a mild sedative. It has calming and anti-stress properties.

Lemon balm has also has been used to improve memory. It is believed that lemon balm enhances activity of the neuro transmitter acetylcholine by binding to it.

Research into Lemon Balm and Memory
A small study using lemon balm for Alzheimer's disease was caried out in Iran in 2003. People taking lemon balm achieved better memory test scores than the group taking a placebo.

In 2003 Dr Andrew Scholey and Dr David Kennedy from Northumbria University in England gave 20 people capsules of dried lemon balm. When they carried out memory tests at one, three and six hour intervals they found the research subjects ability to learn, store and retrieve information had improved.

Lemon Balm Side Effects
There are no significant side effects from lemon balm.

Both studies were very small so further research is required before lemon balm is a recommended alternative treatment for Alzheimer's disease.

http://alzheimers.about.com/od...nts/a/Lemon_balm.htm

A few more things I read about lemon balm- it can interfere with thyroid meds and can interfere with anesthesia. There could definitely be other side effects.

An interesting fact is that it can be used to treat Herpes. And, we know that herpes can be linked to AD maybe.

Anyway, if anyone has any experience or knowledge about this, I'd be so appreciative if you would post. One thing I'm wondering is if it should or could be given at the same time as Aricept. From reading other stuff that I googled, it seems to work similarly to Aricept.
I'm kinda guessing that my Grandma's doctor would say he has no clue about it and not to try it, but it's over the counter and I think I might "override" his opinion this time.

Thanks for this info, jellybeans. Maybe JAB will see this and come by with her insight. I hope we see some opinions on this.

No problem.
The study was really small, but it seemed like the results were good. I'm hoping JAB or someone in the know will come by. I would like some input about what the "p values" mean exactly and also whether it would be ok to take this with Aricept or not.
My Grandma can't take most of the alternative treatments because of the interactions (either that or the side effects just freak me out). She can't even try cinnamon or cumin because she takes Coumadin. But this, I think would be safe to try based on the side effects. She does take thyroid meds, but I am thinking we could just test her thyroid function more often. And we're supposed to go to the neurologist this week about Axona. Try one first? Both?

It's an intriguing little study. The design is good (double-blind, placebo-controlled) but as jellybeans notes, the number of participants is extremely small -- only 35 finished the study, 20 in the treatment group and 15 in the placebo group -- and it was also pretty short.

ADAS-cog is one of the "gold standards" used as outcomes, the CDR-SB not so much. One paper I have notes that "...many of the reliability and validity studies used inappropriate correlation coefficients and/or included only a small number of subjects. Therefore, further assessments of reliability and validity are needed before it can be concluded that the psychometric properties of the CDR are sufficient for the scale to be used in AD drug trials."

In fact, more and more researchers are questioning the validity of both tests for use in evaluating drug efficacy, e.g., this excerpt from another paper I have: "Why have so many programs yielded discouraging efficacy data in phase II and III clinical trials? In phase II, the problem may be primarily one of statistical power. Most programs seek to be able to demonstrate a 25% to 33% slowing of progression of mild or mild to moderate AD. But in view of substantial inter-subject and inter-site variance issues, a large and long trial is necessary. Estimates using preliminary data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) [15] suggest that to demonstrate a 33% reduction in progression rate (as measured by change in Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) or Clinical Dementia Rating 'sum of boxes' (CDR-SB)) in an 18 month trial in mild AD, approximately 300 subjects per group are required (M Donohue et al., unpublished)."

Aside from that ... there are reasonably impressive differences between treatment and control groups, on both tests, in this study, reaching p < 0.001 at week 6 for ADAS-cog and week 8 for CDR-SB.

Frankly, the standard deviations at each data point for each test were so small that they appear to be almost too good to be true...


Like jellybeans, I would question the claim that lemon balm has no side effects. Purported mechanisms of action would indicate that it must have side effects. That should be looked into further, especially possible drug interactions, before considering whether to give lemon balm a try.

Other points of interest: Not all lemon balm preparations have the same pharmacological profile. The results can vary depending on the strain of the plant used, and also on the extraction method. E.g.,

http://www.ncbi.nlm.nih.gov/pubmed/17168769

http://wholehealthmedia.com/Me...inalis%20article.pdf

(It is always a red flag if lower doses appear to be more effective -- something strange is going on here.)

One "practitioner" experienced in the use of alternative medicines warned that some of the constituents of lemon balm extracts are very volatile, and it would be advisable to use only fresh extracts from fresh lemonbalm leaves.

So ... you'd probably want to make your own, following the method described in the original "clinical trial" paper. The method is very vague, so you'd want to do some more checking into methods commonly used for preparing alcohol extracts of the leaves.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738567

And when evaluating potential side effects, you'd want to take into account whether the lemon balm product found to have "x" side effect or drug interaction was prepared in the same way. Various lemon balm preparations have been used for a number of applications, for quite a few years, but how many of them were the same as the one that appeared to show some efficacy against AD?

JAB, you must have used your ESP to know that I was hoping you'd read my posts and add your input. I've been sending you telepathic messages.

As far as the preparation, I found this on webmd (which was the same as what was in the article)
For mild to moderate Alzheimer's disease: 60 drops per day of a standardized lemon balm extract, prepared 1:1 in 45% alcohol. So, here's my idiotic question- Does this mean that I take say one liter of lemon balm extract and one liter of 45% alcohol and mix them together? Where would one buy 45% alcohol?

Because this is made with alcohol, would this be bad for someone who isn't supposed to drink alcohol? My Grandma's cardiologist said years ago "no alcohol", I think because of the medications she's taking. Does the alcohol kinda go away in the two weeks it takes to make this stuff like it does with say cooking wine?
I was actually thinking of taking the lazy way and just doing "eenie meeny miney moe" and picking one of the lemon balm extracts at the vitamin store. So, I'm glad you mentioned that JAB.
They sell this in a capsule form. Is there some sort of mathematical formula that would correlate to the liquid 1:1 formula of drops?
http://www.iherb.com/Nature-s-...0-Capsules/2015?at=0 That's one capsule that I found which has 1.47grams in three capsules.
As far as the liquid drops, I have so far found the ratios to range from 1:4 to to 1:1.5. That would mean that the 1:1.5 is stronger than the 1:4? Would you just take four times as much of the 1:4 ratio or 1/4 as much of the 1:4 ratio?
One more question, I found one preparation of this lemon balm that is alcohol free. Would that be as effective? (hypothetically, of course).

The only other safety issue I've come across so far is that in cats, it can increase eye pressure so it shouldn't be used in people with glaucoma, though they (according to one site) haven't had any issues in people with glaucoma, at least not reported according to a site.

I found this about dosages:
For difficulty sleeping, or to reduce stomach complaints, flatulence, or bloating, choose from the following:

Tea: 1.5 - 4.5 grams (1/4 - 1 teaspoonful) of dried lemon balm herb in hot water. Steep and drink up to 4 times daily.
Tincture: 2 - 3 mL (40 - 90 drops), 3 times daily
Capsules: Take 300 - 500 mg dried lemon balm, 3 times daily or as needed
http://www.umm.edu/altmed/arti...emon-balm-000261.htm
So, then it would be roughly 40 drops equals 300 mg? It's times like this I wish I was a brainiac.

I'm definitely positively going to try this. I'll probably wait about two months if the Axona goes ok. I did ask the neurologist about it today at my Grandma's appointment and she said she'd look it up, but with or without her blessing, I'm going to try it.
Lemon balm is on the GRAS list. I did find a few more side effects, nothing huge. The biggest thing with my Grandma is that she'll need frequent thyroid tests for the first several months and she gets a monthly blood test to monitor her coumadin, so they'll just draw a little more blood, it's not even an extra needle poke.
I've read that it's really hard to grow and we have cats and one of the cats eats everything(kleenex, paper, wood, plastic, etc), so I don't think that I'd be able to grow it due to both the cat and my missing green thumb.
The amount of alcohol is really small, so I think that'd be ok too.
I'm going to go with a brand that claims to use fresh leaves and a 1:1 ratio.
I think that there's probably a lot of "natural cures or treatments" out there for many diseases, but most of them will probably become the standard of practice because there's no one to pay for the research. Drug companies developing a new drug spend tons of money to create and test new drugs and their payoff is a patent that pays them back. With existing drugs and herbal therapy, there's no payoff at the end, there's no patent protecting profits.

OOps, that was supposed to say most alternative treatments will probably NOT become the standard of care.

quote:

I think that there's probably a lot of "natural cures or treatments" out there for many diseases, but most of them will probably not become the standard of practice because there's no one to pay for the research.

People who want to sell you untested (and worthless) natural supplement concoctions claim that, to justify the fact their brews haven't undergone clinical trials, but it's not true -- NIH will pay for the trial, if a well-written proposal with solid underlying theory is submitted by a qualified team of researchers. That's how cinnamon is getting studied for treating diabetes, how gingko biloba got studied for preventing AD, how vitamin E got studied, omega-3's, alpha-lipoic acid, the list goes on and on.

The one thing that makes me a little leery of the lemon balm study is that, with such apparently promising results, they never followed up with a larger study. That was an academic group, not a commercial one.


To make the extract (aka tincture):

Harvest the lemon balm, rinse it well and dry it.

Chop the dried lemon balm leaves and stems using a food processor, coffee grinder, spice grinder or mortar and pestle.

Fill a clean glass jar about half full with the chopped lemon balm leaves.

Cover the dried, chopped lemon balm with 45% alcohol, filling the jar to the top. (Half full of leaves and hypothetically half full of the diluted alcohol is the "1:1" they're talking about.) To make the 45% alcohol, mix equal parts of vodka and water. I've seen recipes that call for rum, brandy, etc.

Shake the jar, label (esp with the date) and allow it to sit in a cool, dark location for one month. (I've seen recipes that only call for two weeks.) Shake the brewing tincture at least once each day.

After one month, strain the tincture and pour it into smaller, dark-colored glass bottles with dropper tops for ease of use.

1 milliliter (1 cc) equals 20 drops. So 60 drops is 3 mL (3 cc's). At ~45% alcohol, there's very little alcohol per dose.



This lady thinks lemon balm is easy to grow:

http://oldfashionedliving.com/lemonbalm.html

JAB,
I don't know if it's universally true, but I have heard that a lot of American doctors (and one was definitely an attending physician in an academic group )prefer to participate in research projects that are affiliated with a pharmaceutical company because it's more profitable, they make a lot of cash doing lectures that promote the drug in the study.

The study about antibiotics and AD showed promising results and it took 5 years after an initial publication to start a larger research study (as far as I can tell). That's a long time. With drugs that can be patented, things seem to move much more quickly.

I looked up SHAHIN AKHONDZADEH-BASTI (one of the researchers) and I found his CV online. He's written several articles that are in respected journals. My question to you (and I'm not being snarky or anything, so please don't take it that way) is what specifically is suspicious to you about the fact that there were promising results with no follow-up study so far? Do you think that it means that this researcher knew that he was fudging the figures and decided that it would be found out if he did pursue a larger study? Or do you think he played around with the statistics to get an article that would be worthy of being published? A lot of his studies seem to be pilot studies. If he purposely skewed the results just to get published, wouldn't that be career ending for him? Would respected journals continue to publish his articles?
(Again, my questions aren't meant to be sarcastic or argumentative, I know it would make sense to do a bigger study, but it would also seem to me that he wouldn't continue to get published if he was doing something unethical repeatedly.)

If you have to go to a Government agency for funding, sure it takes longer than if you're a pharmaceutical company with deep pockets. I'm just saying that one cannot claim that unpatentable treatments never get into clinical trials. If the evidence is compelling, the money is there.

If we're talking about the same antibiotic study, I can think of a number of reasons why the researchers may not have pursued the follow-on study vigorously and/or may have had trouble attracting funding. For one, the results did not support the original hypothesis. That's disconcerting at best. And it's more than enough to make a good scientist wonder whether he wants to spend more time and effort on the approach ... because a good scientist always has a number of very exciting projects to work on.

Looking up the author of the lemon balm study is a good thing to do -- I have no problem at all with you probing into my reasoning. He does appear to have reasonable credentials (caveat: maybe it's different in Iran, but that seems to be a long time to still be an associate professor), and as you noted, he does appear to be a bit of a dilettante. (Maybe that's why he's still an associate professor.) I would have thought, though, that results that good would have gotten some serious attention, by someone. Mind you, researchers have their own areas of interest, and maybe lemon balm as a treatment for AD doesn't turn anybody else on. On the other hand, you and I don't know his reputation. Some researchers look okay in a CV, but their peers have little to no respect for them. Off the top of my head, I can think of several in my areas of expertise where the mere mention of the name is enough to have me turning purple. They have all sorts of publications in their fields, but I wouldn't trust a single word they wrote.

You're right, if a professor is caught deliberately falsifying data, that can certainly be career-ending. But who is going to "catch" him? It's all too common for one researcher to come to a conclusion based on his experiments, and another to come to the exact opposite conclusion based on his. Neither one is "wrong" or deliberately falsifying their results. And it's all too common for one study to turn out a given way, and other researchers to be totally unable to reproduce the results. Again, it may not have anything to do with the first guy deliberately falsifying anything. Heck, I've had that happen in my labs, quite a few times, and we've gone crazy trying to figure out what was different. Sometimes, it's a tiny thing that you'd never suspect in a million years. For example, one time, we were using exactly the same type, size, and shape of vials, made out of exactly the same material, for a single incubation in a long and complicated process ... but we'd switched to a different supplier. We never did figure out why the one vendor's vials created one effect, and the other's didn't. But we tested both often enough to be sure that was the problem.

What I'm saying is that sometimes a given scientist may not be rigorous enough or quite logical enough in his experimental design or in the way he actually conducts the study or in the way he does the data analysis, or he may indeed fudge just a wee bit to make things look better. It might be something as simple as eliminating a few data points that don't quite fit the way the researcher wants. After a while, his peers pay scant attention to his work, because it just isn't very high caliber. But it's very rare for anyone to go to the extreme of checking into his laboratory notebooks etc etc to see if he's "dry labbing" and/or make an accusation of falsifying data.

The thing that bothers me the most, is that the data look just a little bit too good. There is very little scatter, but you would expect quite a bit of scatter in a very small clinical trial involving something as subjective as testing the cognitive status of AD patients. We all know that their symptoms can bounce around all over the place.

Well, that and the fact he has published another study, on Salvia officinalis extract, which had similarly amazing results. Maybe it's because they're both herbs that belong to the same family ... maybe it's the researcher.

Anyway, lemon balm appears reasonably innocuous, it is easy to make, and it's dirt cheap if you make your own -- and not all that pricey even if you decide to buy, given how low the recommended dose is. And although I haven't looked into this in detail, there appears to be a reasonable amount of evidence that lemon balm can be helpful in treating some behavioral problems, which might be effective in helping our ADLOs who have those problems.

JAB, thank you so much for your very thoughtful answer. I know that you are/were in the research field, and I knew you'd have reasons, I just didn't understand what they were. I remember hearing about some research a few years back and the researcher got totally busted for doing something unethical and the medical journal published some sort of retraction and it was on the news. (LOL, I guess I couldn't be any more vague about this if I tried).

I'm sure I sound like a broken record about lemon balm, but I do want to try it for my Grandma. I don't know about getting any of her doctors to agree to it and I would need someone to follow her thyroid tests for awhile. I think my best bet would be a naturopathic doctor, they aren't covered by Medicare, but I wouldn't have to take her there all that often, I assume.
Thank you again, JAB. You are such a huge asset to this board and I appreciate all of the time and energy you put into your posts as well as the effort and time that you put into reading and researching.

It is big news when a researcher is busted for deliberately falsifying data. It just doesn't happen as often as might be justified.


We will all, of course, expect you to keep us up to date on how your Grandma does on the lemon balm!

quote:

Originally posted by JAB:


We will all, of course, expect you to keep us up to date on how your Grandma does on the lemon balm!

I promise. Of course, it will be after the increased exelon dose and axona. And, being that it's me, I'll be my usually verbose self.