<i>Ashwagandha</i>root in the treatment of non-classical adrenal hyperplasia

Kalani, Amir; Bahtiyar, Gül; Sacerdote, Alan

doi:10.1136/bcr-2012-006989

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…Ashwagandha root (Withania somnifera) has been used for millennia in Aryuvedic medicine, where it has proven effective in treating a number of specific conditions as well as being used as a general "tonic". We recently reported a patient who complained of excessive scalp hair shedding who was investigated and found to have both non-classic 3-β-ol-dehydrogenase deficiency and aldosterone synthase deficiency with elevated baseline levels of both serum 17-OH-pregnenolone and corticosterone [26]. The patient had been able to reduce her rate of scalp hair loss and normalized her serum levels of both steroid metabolites while taking pioglitazone 15 mg/day.…”

Section: Contemporary Gynecologic Practicementioning

confidence: 99%

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Sacerdote¹,

Bahtiyar²

2015

Contemporary Gynecologic Practice

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Among the most common causes of female infertility, anovulation, menstrual irregularity, hirsutism, acne, and alopecia are congenital adrenal hyperplasia (CAH) and polycystic ovarian syndrome (PCOS). These two conditions resemble one another quite a bit, especially the nonclassic forms of CAH (NCAH). Another common cause of such problems is hyperprolactinemia, which results in increased androgen synthesis by both the ovaries and the adrenal cortex, while suppressing gonadotrophin-releasing hormone, gonadotrophin, and estrogen synthesis. Hyperprolactinemia, in turn, may be caused by primary hypothyroidism, prolactinomas, stalk effects of other pituitary and hypothalamic neoplasia, as well as a host of prescription and recreational drugs; it may also be idiopathic. Other, less frequently encountered causes of these problems include Cushing's syndrome and virilizing tumors (ovarian, adrenal, or ectopic). A growing worldwide problem in this sphere is androgen doping to improve athletic performance. Additional causes of menstrual irregularity include uterine leiomyomata, puberty, perimenopause, chronic illnesses eg. poorly controlled diabetes mellitus and sickle cell disease, elite athletics and dancing, eating disorders, endometriosis, and Asherman's syndrome. Infertility may also be caused by stress, tubal factors, Asherman's syndrome, immune response to spermatozoa, luteal phase inadequacy, and male factors. In this chapter we shall focus on 3 novel concepts: • The treatment of the congenital adrenal hyperplasias and the acquired/unmasked adrenal hyperplasias by interventions which reduce insulin resistance.

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Section: Contemporary Gynecologic Practicementioning

confidence: 99%

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Sacerdote¹,

Bahtiyar²

2015

Contemporary Gynecologic Practice

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“…In traditional home medicine, Ashwagandha roots have been commonly used for several kinds of herbal formulations, wherein predominant bioactives are Withaferin A, Withanolide A and Withanone [5,6,8,21]. We initiated to explore bioactivities in Ashwagandha leaves for the reasons, such as (i) to obtain ample supply without sacrificing the plants, (ii) to rule out soil contaminants, (iii) easy distinction of the healthy versus diseased plants, (iv) ease of cleaning and extraction processes and (v) avoid strong unpleasant odor of roots.…”

Section: Introductionmentioning

confidence: 99%

Novel Methods to Generate Active Ingredients-Enriched Ashwagandha Leaves and Extracts

Kaul

Ishida²,

Tamura³

et al. 2016

PLoS ONE

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Ashwagandha (Withania somnifera) is an Ayurvedic herb commonly used in world-renowned traditional Indian home medicine system. Roots of Ashwagandha have been traditionally known to possess a variety of therapeutic and health promoting potentials that have not been sufficiently supported by laboratory studies. Nevertheless, most, if not all, of the preventive and therapeutic potentials have been assigned to its bioactive components, steroidal alkaloids and lactones. In contrast to the traditional use of roots, we have been exploring bioactivities in leaves of Ashwagandha. Here, we report that the leaves possess higher content of active Withanolides, Withaferin-A (Wi-A) and Withanone (Wi-N), as compared to the roots. We also established, for the first time, hydroponic cultivation of Ashwagandha and investigated the effect of various cultivation conditions on the content of Wi-A and Wi-N by chemical analysis and bioassays. We report that the Withanone/Withaferin A-rich leaves could be obtained by manipulating light condition during hydroponic cultivation. Furthermore, we recruited cyclodextrins to prepare extracts with desired ratio of Wi-N and Wi-A. Hydroponically grown Ashwagandha and its extracts with high ratio of withanolides are valuable for cancer treatment.

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“…Although glucocorticoid treatment (sometimes combined with fludrocortisone) continues to be the mainstay of conventional treatment of CAH and has been very helpful and lifesaving in that capacity, its use, even with recent refinements, continues to be plagued with issues regarding over-and under-treatment, growth inhibition, hypertension, obesity, low bone density, testicular adrenal rest tumors, and diabetes [58][59][60]. Our group has been focusing on insulin sensitizing interventions to reduce IR, which is a consistent feature of CAH, as it is with PCOS [61][62][63][64][65].…”

Section: Discussionmentioning

confidence: 99%

Effect of Vitamin D in a Patient With Classical Adrenal Hyperplasia due to 11-Hydroxylase Deficiency

Thomas

2013

J Med Cases

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Both classical and non-classical CAH, like PCOS, are characterized by insulin resistance (IR) and are also ameliorated by measures which reduce IR. Vitamin D supplementation reduces IR and ameliorates PCOS in Vitamin D deficient/insufficient (VDDI) patientsraising the question: would Vitamin D replacement also ameliorate CAH? Our patient is a 47 year old man with Type 2 diabetes (Type 2 DM) and hypertension hospitalized for cellulitis, abscess, osteomyelitis, and gangrene of the left foot. He was not taking any known insulin sensitizers, and denied any history of acne or hyperpigmentation. The patient has no progeny and never had intercourse due to issues concerning his phallus size. He had hypospadias and micropenis at birth. The former was surgically corrected in childhood. His BMI = 36.45 kg/m 2 with a central fat distribution. On physical examination there was no acanthosis nigricans or hyperpigmentation. He had a stage IVa Hamilton male pattern alopecia that started during his early 20s. He had micropenis (or clitoromegaly), measuring 1.5 -2cm when flaccid; scrotum (or scrotalized labia majora) was normal in size. Testes is measured 3.4 cm in their long diameter and were firm. On 12-4-2012 his serum 11-deoxycortisol by liquid chromatography tandem mass spectrometry (LC MS/MS) was 2024 ng/dL ( ≤ 76) while his serum 25-OH-vitamin D by LC MS/ MS was 12 ng/mL( ≥ 30), and his 1,25 (OH)2-Vitamin D3 by LC MS/MS was ≤ 8 pg/mL (18 -72). Supplementation was begun with ergocalciferol 50,000 units orally weekly. Nine days later his serum 11-deoxycortisol fell to 425 ng/dL, while serum 25-OH-Vitamin D rose to 23 ng/mL, and serum 1,25-(OH)2-Vitamin D3 remained ≤8 pg/mL. Seventeen days later his serum 11-deoxycortisol was 194 ng/dL, while his serum 25-OH-Vitamin D was 27 ng/mL, and his 1,25-(OH)2-vitamin D3 remained ≤ 8 pg/mL. 28 days after starting supplementation with ergocalciferol the 11-deoxycortisol was < 20ng/dL. The laboratory lost the corresponding sample for Vitamin D metabolites. His lymphocyte karyotype was XY. He refused any biopsies, which might have disclosed mosaicism.Vitamin D might be a means of treating classical 11-hydroxylasedeficiency in patients with a VDDI co-morbidity and suggest that it may work by reducing IR.

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Ashwagandharoot in the treatment of non-classical adrenal hyperplasia

Cited by 7 publications

References 29 publications

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Treatment of Congenital Adrenal Hyperplasia by ReducingInsulin Resistance and Cysticercosis Induced Polycystic Ovarian Syndrome

Novel Methods to Generate Active Ingredients-Enriched Ashwagandha Leaves and Extracts

Effect of Vitamin D in a Patient With Classical Adrenal Hyperplasia due to 11-Hydroxylase Deficiency

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