Ryan Bradley, ND, MPH is a doctor of naturopathic medicine in San Diego, CA. Diabetes is an area of both research and clinical specialization for Dr. Bradley. He practices integrative care for diabetes and heart health as the Director of the Center for Diabetes & Cardiovascular Wellness at the Bastyr University California.
Goji: The Newest Old Medical Miracle?
Recently I had a patient with diabetes in my office complaining of arthritis pain in her and knees limiting her ability to be active and exercise - elements of a health lifestyle critical to long-term health in diabetes. We talked at great length about physical therapy, massage, and other possible treatments that may reduce her pain. However our focus for the appointment was improving her blood sugar. A month or so later she returned for a follow up appointment looking brighter, more energetic, and stating that all her pain was gone! She attributed the change to Goji Juice and had starting to sell the product. I was skeptical, but supportive because she was more active and feeling better. The next visit she brought me my very own bottle! I felt it my duty to look deeper into the product, so here is the summary of what I learned:
Is there substance behind the hype?
There is currently an explosion of attention on Goji Juice and other Goji berry products in the marketplace. There are websites riddled with testimonials stating the miraculous health benefits people have gained from their trials with Goji juice ranging from reduced arthritis pain and improved sex drive to dramatic reductions in blood sugar. Is Goji truly a miracle product? Is Goji juice the panacea we have all been waiting for? Where did it come from and why did it take so long to find it?
Goji juice is the juice of Lycium barbarum, a Himalyan species of a fruiting tree that produces small, red, semi-sweet berries. Berries from other Lycium species have been used in Traditional Chinese Medicine (TCM) for hundreds of years. In Chinese, Lycium is known as Gou Qi Zi, or commonly as Wolfberry. Wolfberry is described in Chinese herbal texts as a Yin tonic, used for Yin/blood deficiency. Yin lies opposite of Yang in TCM. Generally, Yin suggests a more restful state and Yang a more excited state when applied to organ function.
Its medical indications in TCM include: diabetes, hypertension, cancer, renal compromise, fever, and eye disorders including blurred vision and macular degeneration. Wolfberry is often combined with other herbal ingredients in individualized formulas each with its own indications based on the diagnosis of a TCM practitioner. In my experience, wolfberry fruit can be purchased from most Chinese groceries or pharmacies.
Does the Science Parallel the Hype?
The short answer is - maybe. There have been few clinical studies of Lycium and hardly any on particular products. However, there is a lot of supportive research that suggests Lycium may have health benefits. Lycium is known to be a rich source of antioxidants-specifically zeaxanthin. Zeaxanthin is well-absorbed from Lycium (Cheng et al. 2005). Zeaxanthin absorbs blue light and therefore, like the pigment lutein, is thought to be beneficial to the human eye.
There is also research suggesting that plant-based pigments may protect the vascular system from inflammation and atherosclerosis. A large study called the Los Angeles Atherosclerosis Study showed that people with higher levels of zeaxanthin and lutein in their blood seemed to have a slower progression of blood vessel disease (Dwyer et al. 2004).
There have only been preliminary animal studies in diabetes, but the results are promising. Wu et al. demonstrated Lycium protects the DNA (our genetic code) from damage in animal models of type 2 diabetes (Wu et al. 2006). Similarly research published by Zhao et al. showed Lycium increases the transporters necessary to get sugar (glucose) out of the blood stream and into the tissues (Zhao et al. 2005); this research suggests Lycium may lower blood sugar by reducing the dependency on insulin. These studies are very preliminary, but also very interesting.
Once again, traditional remedies are proving to have scientific merit! Could the same little berry (and pigment) protect against and improve all these health concerns?
Are There Any Concerns about Trying Goji or Lycium?
As is the case with most fruit berries, Lycium itself is very safe and appears to contain healthful pigments. My only concerns relate more the other factors than to the fruit (or juice) itself. My concerns are:
- Watch ingredients! There are many preparations that contain Lycium, however many also have other ingredients, including herbal stimulants like caffeine. While the “juice” products with other additives may give you energy, this energy is temporary, not sustainable and may reduce the possible benefits of Lycium itself in conditions like high blood pressure.
- Medication interactions? One published case report suggests Lycium may interact with the anticoagulant medication coumadin (warfarin). If you are taking coumadin, I highly recommend discussing your decision to try Lyicum with your physician before starting so that your bleeding times can be carefully monitored. Otherwise dangerous increases in bleeding time may occur!
- Cheaper alternatives? As I mentioned above, Lycium fruit is available dried in many Chinese groceries and pharmacies and is available for much less cost than many of the products currently being sold. At my last check, you could purchase a one-pound bag of Lycium fruit for around $4.00.
- Sustainable harvest? I believe it is very important to know where the products are coming from and to ensure natural products are produced in a sustainable manner. As Himalayan herbal products are becoming more popular and market demand encourages their harvest, many Himalayan plants are also becoming endangered. The high-altitude Himalayan environment is one of a kind. Please inquiry about the origin of the product before you purchase. Chinese Lycium may be just as good (and what is advertised as “Himalayan” may be actually by made in China or elsewhere in Asia.
- Sugar content! Fruit juices do contain sugar and therefore require consideration as a part of your overall carbohydrate and caloric intake. Although most of the products I reviewed are quite low in sugar, some are not. One fluid once (30 mL) of a pure Lycium juice is approximately 2/3 of a fruit exchange, according to some websites advertising the product, but you should check each product and talk with your physician or nutritionist about its sugar content before trying.
- Greater benefit from Whole System Traditional Chinese Medicine? As mentioned, Lycium has been used for centuries by practitioners of TCM. It is becoming obvious they were on to something with their medical uses of Lycium - perhaps it is also true that the traditional formulas used in TCM for different conditions have health benefits above and beyond the Lycium content. A whole system of medicine that has been around as long as TCM likely has something to offer all of us in our quests for optimal health!
Natural products are exciting and interesting and I am a firm believer in the health benefits of naturally occurring substances…yet I also chose my products very carefully based on objective information when available. Goji juice and Lycium are likely to continue gaining popularity and likely do have health benefits yet to be discovered. I continue to support my patients who have elected to try Lycium and Goji products and monitor them closely when needed. As always, I recommend discussing your choices with your physician, and in the meantime, continue with your current treatment plan! Sometimes reports that are too good to be true are in fact too good to be true.
Hawthorn (Crataegus oxycantha) has been long used in Western herbal medicine as a cardiovascular tonic. Reported uses include improving oxygenation of the heart muscle, reduction in blood pressure, and improving the force of contraction of the heart.
Recently Walker et al. published a placebo-controlled trial of hawthorn extract in patients with Type 2 diabetes using medications for their blood pressure. At the end of the 16-week study significant reductions in diastolic (the “bottom number”) blood pressure were observed (85.6 mmHg at the beginning vs. 83.0 mmHg at the end).
While not a large reduction, any and all reductions in blood pressure improve health - especially in people with diabetes.
The findings are published in the British Journal of General Practice this month. Other studies have shown hawthorn may improve exercise tolerance in congestive heart failure!