Artemisia annua
Image courtesy of Franz Eugen Köhler’s Medizinal-Pflanzen, or ‘Medicinal Plants’ published in 1887
Artemisia annua, also known as White Wormwood or Sweet Annie, is a common type of Wormwood native to temperate Asia, but naturalized throughout the world. It has fern-like leaves, bright yellow flowers, and a camphor-like scent. It has long been used in the treatment of the reoccurring fevers of malaria; indeed, for centuries before man knew about the potentially fatal parasite responsible for these. Medicinally, the aerial parts of the plant are used.
Artemisinin is a phyto-chemical component of Wormwood, which in 2006 was recommended by the World Health Organization (WHO) as part of a combination therapy for cases of uncomplicated Plasmodium falciparum malaria (a very drug resistant strain), worldwide. Artemisinin and its metabolites (essentially its break-down products in the body) have additionally been shown to have wide-ranging antibiotic and anti-parasitic effects. Studies are also now validating its traditional use in autoimmune disease, and exciting anti-cancer potential is slowly being revealed.
What Do We Know?
Antibiotic: Artemisinin has been found to have antibacterial activity against Staph aureus, Bacillus, Salmonella, and E coli, suggesting that it may be most useful as a gastro-intestinal antibiotic. It has also demonstrated remarkably strong activity against Helicobacter pylori (which causes ‘stomach ulcers’).
Parasites: Artemisinin and its metabolites have been shown to have activity against maleria, Schistosoma, Pneumocystis, Toxoplasma, Trichomonas and Giardia. In 2006, the World Health Organization (WHO) recommended Artemisinin combination therapy for uncomplicated Plasmodium falciparum malaria (a very drug resistant strain) worldwide.
Immunosuppressant: In Traditional Chinese Medicine, Wormwood has been widely used to treat autoimmune diseases such as SLE (Lupus) and Rheumatoid Arthritis. Research in small animals has also demonstrated that the activity of Artemisinin as an immunosuppressive agent is more than cyclosporin A (a very powerful, often last-line, immunosuppressant drug). Other studies have indicated that Artemisinin has potential in the treatment of T-cell related inflammatory (autoimmune) diseases.
Cancer: Artemisinin has been shown to be toxic to many types of cancer cells, particularly liver, breast and brain. In this capacity, it has been shown to destroy abnormal cells leaving normal cells unaffected (in contrast to chemotherapy, which does not discriminate). While there have been few clinical trials to date, there is gathering interest based on numerous case reports suggesting that Artemisinin works in both animals and humans with far advanced cancer.
Contraception: Interestingly enough, Wormwood has been used historically as a contraceptive and abortificant (hence, not for use in the first trimester of pregnancy). Recent studies in animals support this, showing that Wormwood can both delay ovulation and prevent implantation. However, little is known about which phyto-chemical constituents of Wormwood are responsible for these effects, or appropriate dosing in women.
My Experience
Currently there is a trend towards using antimalarials as whole herbs, rather than as isolated compounds like Artemisinin. It is believed, in malaria treatment at least, that other phyto-chemicals in Wormwood have a synergistic effect with Artemisinin. Infact, some authors have reported whole herb extracts of Wormwood to be as much as 3 times more effective than Artemisinin by itself.
Presumably, this is the case in other conditions too, such as autoimmune disease and cancer; personally, I have a preference for whole herb (in medicinal herbs of any kind) over isolated compounds for these very reasons. Indeed, it is my lack of faith in the efficacy and safety of the purified (while mostly plant-derived) compounds that conventional medicine terms ‘drugs’ and the monopolies of pharmaceutical companies, that steered me away from continuing towards a career in conventional medicine in the first place. Regardlessly however, the fact is, that even if Wormwood is 3 times as effective as Artemisinin alone, a comparative dose of Wormwood (ie 3 times lower) still costs significantly more than purified Artemisinin. Given that this is the case, and the fact that research has shown purified Artemisinin to be staggeringly effective and remarkably safe (in experienced hands), I tend to prescribe pure Artemisinin. I most often use it in one of three ways:
A. Artemisinin is one of my most potent weapons in systemic autoimmune diseases such as SLE (Lupus) and Rheumatoid Arthritis, especially at times when these potentially devastating diseases are most active. In these situations, I commonly use it alongside other immunosuppressant herbals such as Bupleurum, Salvia, or Rehmannia (depending on the disease pattern). I have had some very startling success treating resistant autoimmune disease in this way, even when conventional drugs have failed to have adequate effect or need to be avoided due to their potential to significantly increase the risk of infection or impact on the liver.
B. Artemisinin is also a very powerful topical immunosuppressant. I often prescribe Artemisinin salve in autoimmune skin conditions such as lichen sclerosis and stubborn psoriasis. I have seen its effects rival the strongest steroid creams available on prescription.
C. Artemisinin can be very effective in parasitic diseases, including recurrent Giardia infection, which can be quite prevalent in New Zealand’s very rural populations, including our gold-miners, trappers, and trampers. It seems to compare very favourably with the antibiotic drug metronidazole, without the tummy upsets and alcohol intolerance the drug brings.
Artemisinin treatment typically costs around $16-33NZ per month, depending on the indication (doses in Maleria are much higher again, but only recommended for a few days at a time). The equivalent dose of Wormwood typically costs around $75-150 per month. It may be possible for me to access Artemisinin for you for as little as $3 a month, if you are prepared to put the powder in capsules (provided) yourself.
Trouble-shooting
Take on an empty stomach. Taking Artemisinin with 350mls of grapefruit juice has been shown to increase absorption (but be aware that other drugs you are taking may interact with grapefruit juice; a large number do).
As the intestine builds up resistance to absorbing Artemisinin, it is best to only take it for a few days at a time, before stopping for a few days then restarting again, as this way the resistance is reversible.
In pregnancy, Artemisinin may be used after the first trimester.
Drug-induced fever may occur in Malaria treatment, although the dose recommended by WHO is significantly higher than I would use for other indications.
References
Appalasamy et al. Antimicrobial activity of artemisinin and precursor derived from in vitro plantlets of Artemisia annua L. Biomed Res Int. 2014;Epub 2014 Jan 19
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Ferreira. Artemisia annua L.: The hope against maleria and cancer. Medicinal and Aromatic Plants: Production, Business and Applications. Proceedings of the Jan 15-17/2004 meeting. http://www.ars.usda.gov/SP2UserFiles/person/34667/Ferreira-ArtemisiavsMalariaandCancer.pdf
Goswami et al. Anti-Helicobacter pylori potential of artemisinin and its derivatives. Antimicrob Agents Chemother. 2012 Sep;56(9):4594-607
Li et al. [Advances in research of dihydroartemisinin against parasitic diseases]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2011 Aug;23(4):460-4
Li et al. Anti-inflammatory and immunomodulatory mechanisms of artemisinin on contact hypersensitivity. Int Immunopharmacol. 2012 Jan;12(1):144-50
Noori et al. Immunosuppressive activity of a molecule isolated from Artemisia annua on DTH responses compared with cyclosporin A. Int Immunopharmacol. 2004 Oct;4(10-11):1301-6
Rahimi-Esboei et al. Effect of Hydroalcoholic extract of Artemisia annua on cysts of Giardia lamblia In vitro. Journal of Mazandaran University of Medical Sciences (JMUMS); July 2012
Saputo. Artemisinin: A cancer smart bomb. http://www.naturalnews.com/033182_artemisinin_cancer.html
Tian et al. The effects of dihydroartemisinin on Giardia lamblia morphology and cell cycle in vitro. Parasitol Res. 2010 Jul;107(2):369-75
White. Cancer smart bomb: Part I and II Artemisinin Follow-Up. New Horizons newsletter, published by the Brewer Science Library, 2002.http://www.mwt.net/~drbrewer/canart2.htm
World Health Organisation (1995). WHO Model Prescribing Information: Drugs Used In Parasitic Diseases, second edition. Geneva: World Health Organization.
World Health Organization (2006) Guidelines for the treatment of malaria, first edition. Geneva: World Health Organization.
Zhang et al. Dihydroartemisinin exhibits antitumor activity toward hepatocellular carcinoma in vitro and in vivo. Biochem Pharmacol. 2012 May 1;83(9):1278-89
Zhu et al. Artemisinin reduces cell proliferation and induces apoptosis in neuroblastoma. Oncol Rep. 2014 Jul 11
Healing Herbals 