Red Raspberry Leaf in Pregnancy

Red Raspberry Leaf (Rubus idaeus): Myths & Facts, Safety & Efficacy, Mechanism of Action

Red raspberry leaf tea is perhaps the best-known herbal medicine used in pregnancy. It has a long

Red Raspberry Leaf & Berries

Red Raspberry Leaf & Berries

tradition of use in both Europe and North America.  Many women have heard it is “good for you” and so they drink it.

Did your mom drink it when she was pregnant? Mine did. It is an excellent choice of herbal ally during pregnancy. Considering how useful it is, and how popular, I think it should be better understood.

MYTH: Red raspberry leaf induces labor.

NOT TRUE! NOT TRUE!

Fact: Red raspberry leaf is safe and useful throughout pregnancy, especially in the second and third trimesters. It does not induce labor.

This misunderstanding stems from the fact that Rubus ideaus is used to prepare for labor. The herb is a wonderfully effective uterine tonic, meaning it has a toning, strengthening, and nourishing effect on the tissue and function of female reproductive tract (Hoffman, 2003).

Via its mineral content (especially calcium) and various polypeptides, it enhances the ability of the uterus to contract when labor begins, and can make labor more efficient.

The herb affects smooth muscles, meaning it has gentle action beyond the uterus in the smooth muscles lining the digestive tract. As a herb for digestion, it is most often used when stool is loose, but can also be part of a formula to address constipation.

Red raspberry leaf is also rich in tannins, lending it a whole other realm of actions. Tannins astringe,

Rubus idaeus

Rubus idaeus

or pull together tissue. Think of the feeling of black tea – also rich in tannins – in your mouth. It is a little bit drying, but also toning & tightening, making it great for skin and mucous membranes. Tannins are a good fit when there is excess fluid, as in diarrhea or certain kinds of gut inflammation, and can also be used to address bleeding. Indeed, a red raspberry leaf mouthwash is used for bleeding gums. Further down in the body, Rubus idaeus tea is used for postpartum uterine bleeding as well as bleeding in the gastrointestinal tract.

Red raspberry leaf plays a role in supporting fertility as well, as it is thought to help thicken the uterine lining (Gilbert, 2015).

Actions

Uterine Tonic (also tones pelvic floor); Partus preparator; Astringent; Nutritive

Uses

Pregnancy; Fertility; Painful periods; Diarrhea; Constipation (mild); Decreasing excess bleeding (eg postpartum, but also gastrointestinal, as a mouthwash for bleeding gums)

Note: some references list Red Raspberry leaf as a galactagogue, aka promoter of lactation, but this is not a primary action of the herb, and for most folks, not the best herb for this action. The herb is also listed as a nausea treatment in pregnancy, but clinically, nausea would not be my reason to choose Rubus ideaus. The herb may also lower blood sugar if it is elevated, but, again, this is not a primary action of the herb.

What is a partus preparator?

An herbal combination used traditionally to help someone prepare to give birth, usually taken in the last 4-6 weeks of pregnancy. The combination is designed to tonify the uterus, encouraging efficient contractions, as well as being mildly soothing and astringent. While the herbs used vary considerably, common choices include Red Raspberry Leaf, Blue Cohosh, Black Cohosh, Partridge Berry, Cotton Root and Spikenard.

Blue Cohosh in particular does not have a good safety profile. There have been case reports of infants with bleeding in the brain or heart attacks (Romm, 2010) – and this herb should be used only with the advice of a trained herbal clinician.

In fact, modern herbal medicine practitioners are now divided as to the efficacy or necessity of a partus preparator formula, and may prefer to select specific herbs to meet the needs of the individual pregnant client. Many practitioners will use homeopathics and acupuncture rather than a partus preparator formula.

Constituents of Red Raspberry Leaf

Flavonoids, tannins (8-14 %), polypeptides, minerals (eg calcium, iron, phophorus).

Some sources reference an alkaloid, fragrine, but recent research has not confirmed its presence.

Dose

Most commonly taken as a tea: 1 tsp to 2 tbsp per cup, steeped 10 min to overnight depending on desired action. (Longer steeping will result in a stronger medicinal action, as well as higher mineral content). 1-4 cups per day.

Studies have found efficacy with certain extracts in tablet form as well.

Tincture: 2-4 ml (1:5 in 40% alcohol), 3 times per day.

Preparations

Check out this Pregnancy Tonic Tea featuring Red Raspberry & Nettle Leaves.

Or become a kitchen herbalist with this fancy/simple Red Raspberry Leaf Vinegar.

Research

I will refer below only studies on pregnant women, leaving out studies on rats, guinea pigs, cats, rabbits, and isolated uterine muscle as these do not replicate the complex physiology of a pregnant human drinking a herbal infusion.

It is worth noting that from the studies on isolated uterine muscle, red raspberry leaf appears to have a tonic effect – that is, it increases tone of relaxed smooth muscle, and induces relaxation where muscle tone is already high (Mills & Bone, 2005; Mills, Duguoa et al 2006). It is also noteworthy that Rubus ideaus has an apparent relaxing effect on the muscle of the small intestine (specifically the ileum), at least in Guinea pigs (Rojas-Vera J1Patel AVDacke CG, 2002).

Although nearly two thirds of US midwives report prescribing Red Raspberry leaf to their clients red raspberry leaf with teapot(McFarlin et al 1999), and many, many women self prescribe the tea, there have been relatively few human studies.

One randomized controlled trial of 192 women with low-risk single pregnancies compared red raspberry leaf tablets (2 x 1.2 g per day) to placebo from 32 weeks gestation onwards. There were no adverse effects for either mothers or babies.

Those who took the herbal tablets had a shorter second stage of labor, as well as lower rates of forceps delivery (Simpson et al, 2001).

Another study involving 108 women (57 in treatment group, 51 in control group) confirmed that the herb is safe. They also noted lower rates of pre and post-term gestation – meaning fewer babies were born too early or late – as well as less likelihood of obstetric interventions, including caesarian section, and vacuum or forceps delivery (Parsons et al 1999).

Safety & Concerns

Considered safe in pregnancy and while breast-feeding.

Due to the high tannin content, the herb may interfere with absorption of iron and other minerals, similar to black tea. So, take supplemental iron at a different time than you drink your tea. Note that the herb itself contains iron along with other minerals. In balance as they occur in nature, this mineral content is considered well-absorbed.

 

References

 

Boon, Heather & Smith, Michael. 2004. The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs. Toronto, ON: Robert Rose, Inc.

 

Gilbert, Cyndi. 2015. The Essential Guide to Women’s Herbal Medicine. Toronto, ON: Robert Rose, Inc.

 

Gladstar, Rosemary. 1993. Herbal Healing for Women. New York, NY: Simon & Schuster, Inc.

 

Hoffmann, David. 2003. Medical Herbalism: The Science & Practice of Herbal Medicine. Rochester, VT: Healing Arts Press, a division of Inner Traditions International.

 

McFarlin B, Gibson M, O’Rear J, Harman P. 1999. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery, 44:205-216.

 

Mills, Simon & Bone, Kerry. 2005. The Essential Guide to Herbal Safety. St Louis, MO: Elsevier – Churchill Livingstone.

 

Mills, Edward, Dugoa, Jean-Jacques, Perri, Dan, Koren, Gideon. 2006. Herbal Medicines in Pregnancy & Lactation: An Evidence-Based Approach. London & New York: Taylor & Francis Group.

 

Rojas-Vera J1, Patel AVDacke CG. 2002. Relaxant activity of raspberry (Rubus idaeus) leaf extract in guinea-pig ileum in vitro. Phytother Res. Nov;16(7):665-8.

 

Romm, Aviva. 2010. Botanical Medicine for Women’s Health. St Louis, MO: Elsevier – Churchill Livingstone.

 

Simpson M, Parsons M, Greenwood J, Wade K. 2001. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Women’s Health, 46:51-59.

 

Weed, Susun. 1986. Wise Woman Herbal for the Childbearing Year. Woodstock, NY: Ash Tree Publishing.

 

Wood, Matthew. 2009. The Earthwise Herbal: A Complete Guide to New World Medicinal Plants. Berkeley, CA: North Atlantic Books.

Pregnancy Tonic Tea: nettle & raspberry edition

 

Red Raspberry & Nettle Pregnancy Tonic Tea

Red Raspberry & Nettle Pregnancy Tonic Tea

Starting at 20 weeks or so:

  • Place ¼ cup (8 g) dried red raspberry leaf (Rubus idaeus) and 1 cup (8-9 g) dried nettle leaf (Urtica dioica) in a large French press (eg Bodum) or sturdy jar. Add (~1 – 1.5 L) boiling water.
  • Let steep 4 hours or up to overnight.
  • Strain and enjoy at room temp or chilled.
  • Drink within 24-36 hours. So, 3-4 cups daily.

For extra calming and nerve nourishment: consider adding 1-2 tbsp of oatstraw (Avena sativa).

For extra digestive support (especially for gas and bloating), consider adding 1 tsp fennel seeds.
 
Benefits: see Red Raspberry Monograph for the specifics of this wonderful herbal ally in pregnancy. Nettle is another highly nutritive herb supporting a healthy gestation. Additionally, it is a natural anti-histamine, and can help with allergies. 

If your period is kicking your ass, kick back

No More Painful Periods

So, it turns out that menstruating doesn’t have to hurt. Is this hard to imagine?

In this instalment of the Natural Medicine for Painful Periods series, I share some stats and underlying causes, and present evidence for another way to minimize period pain, naturally. In other words, If your period kicks your ass every month, kick back!
 
Dysmenorrhea – difficult/painful menstruation – affects more than half of all menstruating women (estimates range from 45-95%). 7-15% of women experience debilitating to incapacitating dysmenorrhea monthly. Symptoms commonly include painful uterine cramps, pelvic heaviness, aching, and/or uterine spasms, and may be accompanied by low back pain or pain down the backs of the thighs. The pain may begin with the start of menstrual flow, or a couple days before. Diarrhea, nausea, vomiting, headaches and migraines can also occur as part of dysmenorrhea. What a party, every month!
 
Treat the cause
Endometriosis, ovarian cysts, fibroids, adenomyosis, IUD use, pelvic inflammatory disease (PID), irritable bowel syndrome (IBS), inflammatory bowel diseases (IBDs), and interstitial cystitis (IC) can all cause dysmenorrhea. If your symptoms are related to an underlying condition such as these, it is called Secondary Dysmenorrhea. In order to truly resolve your painful periods, a naturopathic physician will not only address your immediate discomfort but will also work with you to uncover and address the cause(s).
 
On the other hand, primary dysmenorrhea refers to painful periods without any of the above conditions. Note that primary dysmenorrhea may still be aggravated by food allergies or sensitivities, which will also be addressed in treatment. 
 

Tip #2 in Natural Medicine for Painful Periods:


living room dance party cat on couchMove your body. Regularly. Have you noticed that this advice shows up for the prevention or treatment of virtually every chronic condition? Regular aerobic exercise (the sort that gets your heart rate up) decreases stagnation of liver qi in the pelvis. And stagnant qi is a major cause of dysmenorrhea according to the Traditional Chinese Medicine paradigm. Of course, there are studies to back this up in western science terms.  Regular yoga practice, and specific yoga poses have both been studied and found to reduce pain during menstruation. Yoga-on-the-Mountain-You know, given that yoga and other forms of movement also improve mood, and oh, decrease your risk of heart disease and cancer, the top two causes of death, I really can’t see why you wouldn’t try it. Move your body, please. If you don’t feel comfortable going to a gym or studio, and you can’t imagine doing yoga as instructed in a youtube video, start with a daily 3 song dance party in your living room and build from there. Or take up hula hooping. Or volunteer to walk a dog. Move. Kick back.

If PMS has you down, see my 10 Tips for a Happy Menstrual Cycle.

For more, personalized, strategies to ease your monthly cycle (including energy medicine, herbal medicine, homeopathy, acupuncture and therapeutic nutrition),contact Mahalia for an appointment. 

PMS Prevention Plan: 10 Tips For a Happy Menstrual Cycle

by Dr. Mahalia Freed, ND


Umm, happy? Isn’t that taking things a bit far? No, no it is entirely possible and reasonable. Read on. Premenstrual Syndrome (PMS) is not inevitable or unavoidable. PMS is common, but it is not “normal”.
 
Did you know that PMS can include over 100-300 different symptoms? While mood changes like anxiety, depression, irritability and lability (moodiness) are the most recognized, other common symptoms include breast pain or swelling, bloating, bowel changes (e.g. constipation, diarrhea), insomnia, headaches, migraines, food cravings, acne, back pain, fluid retention in the legs, and fatigue. For some people, PMS takes the form of increased clumsiness and brain fog. For others, it means less vocal range (an issue if you are a professional vocalist!), or even seizures. Finally, many women notice that their immunity is decreased at this time of the month. It is a time when cold sores or genital herpes might erupt, when asthma symptoms may flare, or when a yeast infection could make itself known. It is considered PMS if the symptoms occur in a cyclical pattern, related to the menstrual cycle, over several months. Symptoms may begin at ovulation (around day 14), or 1-2 days before the period begins.
 
The majority of women will experience PMS symptoms at some point in their lives.
 
So, shouldn’t we all know how to stay healthy, happy and stable in the face of Premenstrual Syndrome?  

Here are my Top 10 Tips for PMS Prevention:

 

  1. Nourish yourself with food. Eat lots of vegetables, eat home-made, eat clean protein. Eat organic whenever possible (in this case because xenoestrogens in pesticides impact your hormone balance). Remember that organic junk food is still junk food. Enjoy your treats.

Careful with caffeine. Most of us have figured out the therapeutic power of good chocolate, and I won’t be the one to take this away, but caffeine does make breast tenderness worse, and it can destabilize mood and worsen digestive symptoms. Consider cutting down on coffee.

  1. Cut the sugar. Refined sugar and processed foods aggravate pain and mood issues, even though they seem like a good idea in the moment. (Except a bit of good, dark chocolate).

 

  1. Move your body. Regular movement of any kind is effective, but yoga stands out in its efficacy in the clinical trials.

 

  1. Increase target micronutrients with supplementation:
  • B6: especially helpful for mood symptoms, B6 is essential for the metabolism of estrogen. Take it as part of a good-quality B complex.
  • Cal-Mag: Both calcium and magnesium are proven effective for managing premenstrual symptoms, from fatigue to depression to cramps. Consider supplementing with one or both.
  • Fish Oil (especially EPA): while more researched for other health concerns, fish oil is known to be effective for mood balance, and for shifting physiology to decrease inflammation. Thus, it is a good choice for certain types of PMS.

 
5. Work with an herbal ally or few

  • Herbs to consider for PMS include: St John’s Wort, Vitex agnus-castus, gingko, black cohosh, kava, motherwort, skullcap, passionflower. The specific herbs best for you will depend on your particular symptoms. Some people use combination formulas, while others see great results with only one or two herbs. Ask me for a personalized herbal prescription.

 

  1. Regulate your sleep schedule. Women with a regular sleep routine have more stable hormone levels than those whose sleep patterns are all over the place. Go to bed at the same time every night. For maximum benefit, go to sleep well before midnight, and sleep in total darkness (see melatonin, below).

 

  1. Increase your melatonin. You know how it feels like your hormones are crazy when you have PMS? Well, in fact the only hormonal difference scientists have found between women with severe PMS and controls is melatonin levels. That’s right, no estrogen excess or deficiency, no progesterone excess or deficiency. The other hormone issues are believed to stem from changes in hormone receptor sensitivity. But, this is still theory. In the meantime, you can increase your melatonin naturally:
  1. Sleep in complete darkness (blackout curtains, an eye mask if light is unavoidable)
  2. Start sleeping sooner. Melatonin production is higher before midnight.
  3. Ensure you give your body the building blocks. Pumpkin seed is a great source of tryptophan, the amino acid precursor to serotonin and melatonin. The reaction requires B6 (see above).
  4. Alternate nostril breathing can stimulate the pineal gland to increase melatonin production (and generally promotes calm when done before sleep).
  5. If you have been diagnosed with Premenstrual Dysphoric Disorder (PMDD), consider supplementing with melatonin. Start with 3 mg per day before bed. And, contact me for more (nonprescription) options.

 

  1. Honor the wisdom within you. If you are exhausted and feel irritated by anyone talking to you, maybe this is the time of the month to carve out a couple hours to curl up with a novel, or journal, rather than pushing yourself to maintain your usual pace. For those who experience intense shifts in mood, think of PMS as the time when the tide is out, and all the feelings and nagging thoughts that you can push down (under the water) the rest of the month are exposed. Sometimes PMS emotionality is just PMS, but often there are important nuggets of truth buried in the sad or mad or irritable state. Look for these truths and give them space at other times in the month. If the nagging thought is “this (job/relationship/etc.) doesn’t feel right”, then make space to explore that. Make changes. As things in your life shift in response to you listening to your inner voice, watch your PMS symptoms abate.

 

  1. Cultivate a happy microbial community:
  • Eat fermented or cultured foods regularly (e.g. unpasteurized sauerkraut, kimchi, kosher-style dill pickles).
  • Consider reseeding your flora with a quality probiotic supplement, especially if you have taken antibiotics.
  • (Good gut flora are associated with better mood, and good gut flora are also important for hormone balance)

 

  1. As always, I highly encourage you to seek out personalized naturopathic care to help map out the big picture, and tunnel down to the right supports for you. Constitutional homeopathy, acupuncture, flower essences, therapeutic nutrition and custom formulated herbal medicines can all offer incredible healing & resolution for PMS symptoms. With professional guidance and the advantage of an outside eye, meet your health goals faster, with less time lost to the contradictory information offered by Dr Google.

Contact me for information on becoming a client/patient.

Polycystic Ovarian Syndrome (PCOS) and Heart Health

By Mahalia Freed ND

This article highlights a common women’s health concern seen in my practice. Polycystic ovarian syndrome, or PCOS, affects not only reproductive health and fertility, but also cardiovascular health.

Definition and Clinical Consequences

Polycystic ovarian syndrome is a label referring to a complex and broad health picture. PCOS is diagnosed by presence of two of the following three things: (i) irregular ovulation or absence of ovulation, (ii) clinical and/or biochemical signs of high testosterone, and/or (iii) polycystic ovaries seen on ultrasound. While presentation varies, the most common clinical manifestations are infertility, male pattern hair growth, obesity, and absent or infrequent menses. However, these concerns represent only the tip of the iceberg with respect to the PCOS picture. Less obvious consequence of PCOS lie below the surface. Women and transgendered men who have PCOS are at risk for hypertension, insulin resistance, impaired glucose tolerance, type II diabetes, and abnormalities in blood lipids such as elevated triglycerides and oxidized cholesterol. Additional complications include increased risk of endometrial (uterine) cancer, an altered (increased) stress response, and difficulty maintaining or attaining desired body weight compared to people who do not have PCOS. Finally, there is an increased risk of cardiovascular disease.

Continue reading

Vitamin D and Pregnancy: Research Findings & Recommendations

Trying to conceive? Higher concentrations of Vitamin D in follicular fluid are an independent predictor of the success of IVF treatment. Vitamin D is hypothesized to support ovarian/uterine hormone production.

Pregnant? Women given adequate supplemental Vitamin D during pregnancy are less likely to develop high blood pressure or preeclampsia. Their babies are less likely to develop type I diabetes. Vitamin D helps support healthy immunity, and prevents autoimmune conditions like type I diabetes from developing.

How much do I take? Current Canadian guidelines vary between organizations, and what you need to take will depend on (i) your blood levels; (ii) the amount of sun exposure without sunscreen you get; (iii) your skin colour; and, (iv) the season. Please consult your ND for an individual prescription.

Babies: 400 IU per day, with more (800 – 1200 IU per day) in winter months, and after 1 year (as weight increases, so does necessary dose).

Breast Feeding: Current study recommendations are for supplementing as high as 6400 IU, though common prescriptions are for 2000-4000 IU per day.

Adults, non-pregnant: Recommendations range, as do individual needs. *Get your blood levels checked first. Common supplemental doses range from 2000- 5000 IU per day, although some people do not require supplementation.

(Study References Available Upon Request)