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"Give with a free hand, but give only your own."
 -- J.R.R. Tolkien The Children of Hurin
- Aroma Therapy
-







 
- Peppermint

- Rosemary

- Lemon balm (Melissa officinalis)

- Rosemary and lemon mix in the morning, and lavender and orange mix in the evening


A discussion of this topic can be found at:
http://alzheimers.infopop.cc/eve/forums/a/tpc/f/762104261/m/3394080708


Aromatherapy in the Treatment of Alzheimer's Disease

In 1997, the late Mark Smith and colleagues discovered that peroxynitrte-mediated damage is widespread in Alzheimer's disease. This damage includes the oxidation of g proteins coupled to receptors involved in short-term memory, mood, sleep, alertness, and smell. Peroxynitrite scavengers have partially reversed Alzheimer's disease in animal studies, clinical trials (see especially Jimbo's study with armoatherapy and Akhondzadeh's study with tinctures of essential oils), and case studies. The list of peroxynitrite scavengers is quite long but they include ketones from coconut oil, minocycline and other tetracycline antibiotics, and a variety of phenolic compounds such as rosmarinic acid, grape seed extract, cinnamon extract, Cinnamomum zeylanicum essential oil, and rosemary essential oil. For my mother, we (my sisters and I) use rosemary, sage, cinnamon leaf, clove, thyme, oregano, and sweet orange. She smells each from a bottle for a couple of seconds each day. Here are the some of the results of this treatment (which we began four years ago with rosemary essential oil): she recognizes her home again, sleeps through the night, can remember her name and sometimes spell it, and is much more alert and aware then before. The evidence that aromatherapy can be used to treat Alzheimer's disease is quite strong and it would be a pleasure if the Alzheimer's Association would begin to distribute this research to caregivers and researchers.


Here are some links that relate to aromatherapy and AD:

Effect of aromatherapy on patients with Alzheimer’s disease
PSYCHOGERIATRICS 2009; 9: 173–179
Daiki JIMBO, Yuki KIMURA, Miyako TANIGUCHI, Masashi INOUE and Katsuya URAKAMI
http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8301.2009.00299.x/pdf


Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double blind, randomised, placebo controlled trial
J Neurol Neurosurg Psychiatry 2003;74:863-866 doi:10.1136/jnnp.74.7.863
S Akhondzadeh, M Noroozian1, M Mohammadi1, S Ohadinia, A H Jamshidi, M Khani
http://jnnp.bmj.com/content/74/7/863.abstract


Another angle that might be of interest is possible help from vitamin E for a peroxynitrite problem:

Dietary vitamin E and selenium and toxicity of nitrite and nitrate

Toxicology. 2002 Nov 15;180(2):195-207.
Chow CK, Hong CB.
Graduate Center for Nutritional Sciences, University of Kentucky, Lexington, KY 40506-0054, USA.

Abstract

Nitrites and nitrates are important antimicrobial and flavoring/coloring agents in meat and fish products. However, nitrites and nitrates may cause methemoglobinemia and other illness, and may react with certain amines to form carcinogenic nitrosamines.

The nutritional status of vitamin E and selenium has long been associated with nitrite and nitrate toxicity, although the mechanism involved is not yet clear.

Information available recently shows that nitrites and nitrates are both oxidation products and ready sources of nitric oxide (NO√), that NO√ reacts rapidly with superoxide to form highly reactive peroxynitrite (ONOO−), and that vitamin E may mediate the generation and availability of superoxide and NO√.

Increased formation of ONOO− resulting from nitrite treatment and low intake of vitamin E and selenium may thus be the critical event leading to tissue damage and animal mortality observed previously.

The protection against the adverse effects of nitrites/nitrates by vitamin E is attributed to its ability to reduce ONOO− formation, while selenium exerts its protective effects via seleno-enzymes/compounds, which reduce ONOO− formed.

http://www.ncbi.nlm.nih.gov/pubmed/12324194


Thanks very much for the links. The other Akhondzadeh study is entitled "Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial." Based on your post, I did a little more research on Vitamin E and peroxynitrites. According to a Life Extension Vitamin web page, gamma tocopherol E is the form of Vitamin E that strongly inhibits peroxynitrite formation, but most Vitamin E supplements only contain alpha tocopherol which at high levels can displace gamma tocopherol. Supplementation with gamma tocopherol may indeed help in the treatment of Alzheimer's disease by lowering the formation of peroxynitrites. Thank you for your insights.



Supplementation with gamma tocopherol may indeed help in the treatment of Alzheimer's disease by lowering the formation of peroxynitrites. According to a Life Extension Vitamin web page, gamma tocopherol E is the form of Vitamin E that strongly inhibits peroxynitrite formation.  It appears that most Vitamin E supplements only contain alpha tocopherol, which at high levels can displace gamma tocopherol.
 

A related discussion about Vitamin E on a message board:

High levels of several Vitamin E components lower Alzheimer's risk by 50 percent
http://alzheimers.infopop.cc/eve/forums/a/tpc/f/762104261/m/534309014

Inhibiting tyrosine phosphorylation appears to be the key to preventing and slowing the progression of Alzheimer's disease. Peroxynitrite scavengers appear to be the key to reversing Alzheimer's disease. Tyrosine phosphorylation activates one of the two enzymes which likely triggers Alzheimer's disease (phospholipase C gamma; the other being phospholipase C beta). These two enzymes trigger a pathway that leads to the processing of amyloid precursor protein and the cleaving of this protein to form plaques, the hyperphosphorylation and nitration of tau proteins, and inflammation. Both phospholipase C gamma and beta eventually activate nuclear factor kappa b (via tumor necrosis factor alpha) which produces superoxide anions and inducible nitric oxide that combine to form peroxynitrites. Phenolic compounds in various vegetables, fruits, spices, and essential oils and Omega 3-fatty acids inhibit tyrosine phosphorylation thus inhibiting both the activation of phospholipase C gamma and the activation of nuclear factor kappa b. They thus should help delay the onset of Alzheimer's disease. It appears that various forms of Vitamin E also inhibit tyrosine phosphorylation, although one study by Ahn suggests that gamma-toctrienol at lower doses is more effective at inhibiting the activation of Nuclear Factor-kappa b than gamma-tocopherol. On the other hand, both appear to be good peroxynitrite scavengers (whereas alpha tocopherol is not) and if that is the case then both would provide an effective treatment for Alzheimer's disease (finding the right diet or the proper supplement to produce the maximum effect still needs to be determined). One of the interesting aspects of Alzheimer's disease is that many of the compounds which inhibit the formation of peroxynitrites are also peroxynitrite scavengers. Thus, you may be able to delay and treat Alzheimer's disease using the same compounds.
 
How do you perform Aroma Therapy? Do you just open a bottle and breathe deeply directly from the bottle? Or, does one need a "
diffuser"?

Some people just open the bottle of essential oil and have the person breathe it for a few seconds.  Some people have
seen progess using a diffuser. Jimbo [NEED LINK] et al used a diffuser. An aromatherapist would probably recommend that the oil be diluted somewhat when using a diffuser, otherwise it is too much of an assault on the senses.  I don't know if the method of delivery of the essential oils makes a difference. The bottles are replced about once a year as the phenolic compounds in them get degraded over time. They should probably be kept out of sunlight to prevent degradation.

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Thanks again for posting your ideas and experiences. As I said before, I know nothing about aromatherapy.

First I'd like to include in this thread a link to your other thread which contains related information:

A unifying hypothesis for Alzheimer's disease
http://alzheimers.infopop.cc/eve/forums/a/tpc/f/762104261/m/2494061808?r=2494061808#2494061808

Second, I'd appreciate input from you (and anyone else) about the pros and cons of two ways of ingesting essential oils -

(1) aromatherapy (inhalation of essential oil aromas)

vs.

(2) oral ingestion of supplements of diluted (NOT full strength) essential oils.

In an earlier thread, there was a brief discussion of oral ingestion of essential oils as a possible treatment for AD as a neurospirochetosis.

Alzheimer's disease - a neurospirochetosis?
http://alzheimers.infopop.cc/eve/forums/a/tpc/f/762104261/m/9014064208?r=9014064208#9014064208

That thread's brief discussion of essential oils starts here:

http://alzheimers.infopop.cc/eve/forums/a/tpc/f/762104261/m/9014064208?r=9044066208#9044066208

Any input from you (and others) will be appreciated, especially regarding very practical, safe things that we can try with our cognitively impaired loved ones.

Thank you very much for the link to my other post. I found your comments on natural antibiotics quite interesting and useful. Phenolic compounds (as contained in various essential oils and spices) inhibit the activation of phospholipase C-gamma by bacteria and viruses and thus limit part of their damage--this is the same enzyme implicated in Alzheimer's disease. Whether a long-standing bacterial infection or viral infection (in combination perhaps with other risk factors) could trigger Alzheimer's disease is still an open question.

You ask a great question about the safety of essential oils. I prefer using aromatherapy over oral administration of essential oils because I believe it is safer (in clinical trials both appear to be equally effective). Finding the right dilution for essential oils is tricky and if not done properly can be toxic (to the liver, for example). Constantly breathing of essential oils can also be toxic--perhaps even leading to a coma. Some antioxidants can become oxidants at how levels. Some outlying studies have linked eugenol (a component of cinnamon leaf, sage, and rosemary essential oils, for instance) to cancer and have warned aromatherapists about the constant breathing of essential oils high in eugenol. Phenolic compounds also inhibit the break down of adrenaline (and other catecholamines) which could theoretically lead to higher blood pressure. People suffering from seizures probably should not take essential oils. Allergic reactions are possible (although probably in most cases these reactions are mild). These are all the contradictions that I know of.

In the Jimbo study, they gave the participants four essential oils (lemon, orange, lavender, and rosemary) to smell through a diffuser (the oils were placed on a gauze) for twice a day--two hours in the morning and one and a half hours in the evening(.04 milliliters of lemon and orange and .08 milliliters of rosemary and lavender) without any adverse effects after 28 days. We have given my mother rosemary to smell from a bottle every morning for the past four years and have added sage, oregano, sweet orange, oregano,thyme, and cinnamon leaf this year (and most recently Ylang Ylang) without any adverse effects. Except for some of the caveats added above, to the best of my knowledge, the intermittent use of essential oils via aromatherapy (or with the correct dilution when taken orally) is quite safe.


Lane, thanks for your comments above.

If you don't mind, a few more questions...

These are with regard to the essential oils you've used that you believe have helped your mother.

- After beginning each new oil, how long has it taken before you've seen a positive response?

- Can you link specific oils to specific types of positive responses? If so, which oils have brought which improvements?

- Which oil(s) have done the most to improve memory?

Thanks again.


Keep asking the questions. I like answering them. I have been meaning to answer the first one. It took about one month from the time I first began administering rosemary essential oil for me to notice some difference in my mother. She noticed that I had moved something on her bookshelf and she asked me why I had been giving it to her every day for a month. Her improvement after that was gradual but steady. She began to sleep better at night, she recongized her home again, she was no longer anxious when we took her to visit her brother (she used to think he was an impostor), she no longer asked why her parents were being left out in the cold in the forest (although she still occasionally asks for her parents), she started to show some improvements in various forms of memory (recalling taking a walk, whether she had recently been to a place before, spelling her name, remembering the order of days and months, reciting the alphabet, and completing phrases like "I scream, you scream, we all scream for...ice cream" and "April showers bring... May flowers"), and she began to be more lucid, alert, and aware (these changes took place over the next three years). I began giving the next set of essential oils earlier this year en masse so I was not able to figure out if any particular one was more effective than the other. Together, though, they seemed to have made a signficance diffence over a period of weeks (I have a harder time pinpointing this because she was so far gone when I began giving her rosemary essential oil that when she started to make improvements it stood out in my mind; this time the changes were more subtle, but in a way just as significant). Just a few days ago, I began to give my mother Ylang Ylang essential oil, and have noticed improvements in regards to energy (she isn't sleeping as much during the day) and clarity of thought.

Essential oils high in methoxyphenols (eugenol, carvacrol, and thymol) appear to work best for treating Alzheimer's disease (cinnamon leaf/true cinnamon, clove, oregano, thyme, rosemary, sage, Ylang Ylang, sweet basil, holy basil, bay leaf, and lemon balm among others). I think limonene in citrus-based essential oils (orange, lemon, and grapefruit, for instance) may be the compound responsible for helping people with Alzheimer's disease. In short, probably a combination of a few of the essential oils listed above (you probably wouldn't want someone smelling a dozen or more oils at a time due to the contraindications listed in my previous post)should be effective for patients with Alzheimer's disease.


Thanks for posting, Lane. If you know of other anecdotal reports that you think might be helpful, please post. And I wonder if there's a safe way to speed up the response time for those who are just starting.


I am not adept at posting links, but here are the other anecdotal accounts that I have and which can be found with the following google searches: Texas State Research on aromatherapy, rosemary for Alzheimer's treatment (how the rosemary was taken is not specified), and ECU therapist studies links between scent and memory.

Unfortunately, I do not know how to speed up the process. It may be that it takes awhile for the chemicals in the essential oil to begin to restore the sense of smell (although others believe the chemicals can enter the hippocampus even with a greatly impaired sense of smell). Perhaps, if several essential oils are given at once that speeds up the process, but since I just started with one essential oil, I am not certain of this. I had one person who attended a talk that I had given on aromatherapy and Alzheimer's disease. The nursing staff used a diffuser to deliver rosemary essential oil to his wife and after about three weeks he called me to tell me that his wife had said that she loved him for the first time in months. I don't know if the diffuser had speed up the process or not. If as time goes by, others could share their experiences with me in terms of the time needed to see results, how they administered the essential oil, and the effects of the aromatherapy (or oral administration) that would be wonderful.


Lane, after reading about the progress your mother has made with aromatherapy, I've started my stage 5-6 DH on essential oils. Here's my MO: after breakfast each morning I have him inhale deeply, three times, from each of rosemary, cinnamon leaf, sage, and oregano essential oils. Does this seem like a reasonable way to proceed? He can smell some of them; others he says don't seem to have much odor.

The very first day I tried this was a day when he woke up disoriented (usually that doesn't happen until late afternoon or evening). Whether it was breakfast or the essential oils or just inhaling deeply, after breakfast he was oriented again, and even undertook chores that usually he has [claimed to have] forgotten how to do. (I don't discount the possibility of malingering, because it's a life-long habit of his to get out of things he doesn't want to do.)

I'm inhaling the essential oils also, because I know I'm at risk. My mother died of some form of dementia (never clearly diagnosed), and so did her father. Then there's the elevated risk statistic for caregivers, and the recently raised possibility of contagion.



This is about what I do for my mother, so I think you should be fine (just as a side note, it's only been about a week since she started smelling Ylang Ylang essential oil, but she seems to be improving further with it). If you notice any adverse effects, you can cut back on the time that he inhales the oils but I don't expect that to happen (both from personal experience and from what I have read about aromatherapy).

Cases of people returning to past "activities" such as carrying on a conversation or playing an instrument (or in this case maybe returning to doing chores) is something that a few researchers have noted in their studies on the use of aromatherapy in the treatment of Alzheimer's dieases. An almost intangible improvement in personal orientation is another.

Some oils seem to stimulate smell better than others and the reaction to the smells varies not only from oil to oil but sometimes from day to day. On some days earlier on my mother would like the smell of rosemary essential oil and some days she recoiled at the smell. Now her reaction to the oils that I give her is on the whole positive and when I ask her if she can smell them, she says yes.

I smell the essential oils along with my mother on most days (because I know my high glucose levels are a risk factor for the disease). The evidence that essential oils (via aromatherapy) can prevent Alzheimer's disease is not as strong as the evidence that aromatherapy can be used to treat the disease. However, many essential oils do appear to inhibit the likely pathway that leads to Alzheimer's disease. The possibility that aromatherapy can prevent or delay Alzheimer's disease certainly exists.

I think for the great majority of people with Alzheimer's disease (and those at risk for the disease), the benefit of aromatherapy far outweighs the small amount of risk.


For anyone interested, a couple more studies on how essential oils may affect memory (in healthy people):


Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang
Int J Neurosci. 2008 Jan;118(1):59-77.

"... Peppermint was found to enhance memory whereas ylang-ylang impaired it, and lengthened processing speed. In terms of subjective mood peppermint increased alertness and ylang-ylang decreased it, but significantly increased calmness..."

http://www.ncbi.nlm.nih.gov/pubmed/18041606

________



Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults.
Int J Neurosci. 2003 Jan;113(1):15-38.

"... Analysis of performance revealed that lavender produced a significant decrement in performance of working memory, and impaired reaction times for both memory and attention based tasks compared to controls. In contrast, rosemary produced a significant enhancement of performance for overall quality of memory and secondary memory factors, but also produced an impairment of speed of memory compared to controls. With regard to mood, comparisons of the change in ratings from baseline to post-test revealed that following the completion of the cognitive assessment battery, both the control and lavender groups were significantly less alert than the rosemary condition; however, the control group was significantly less content than both rosemary and lavender conditions. These findings indicate that the olfactory properties of these essential oils can produce objective effects on cognitive performance, as well as subjective effects on mood..."

http://www.ncbi.nlm.nih.gov/pubmed/12690999


Articles on aromatherapy:

From University of Maryland Medical Center:
Aromatherapy

http://www.umm.edu/altmed/articles/aromatherapy-000347.htm

Also see:

Aromatherapy for Memory Loss

http://www.tangledneuron.info/the_tangled_neuron/aromatherapy-for-memory-loss.html



Here are a few more quotes from some of the studies mentioned earlier in this thread:


Effect of aromatherapy on patients with Alzheimer’s disease

PSYCHOGERIATRICS 2009; 9: 173–179
Daiki JIMBO, Yuki KIMURA, Miyako TANIGUCHI, Masashi INOUE and Katsuya URAKAMI

... Aromatherapy consisted of the use of rosemary and lemon essential oils in the morning, and lavender and orange in the evening...

... All patients showed significant improvement in personal orientation related to cognitive function...

... The lemon and rosemary mix activates the sympathetic nervous system to strengthen concentration and memory, whereas the lavender and orange fragrance activates the parasympathetic nervous system to calm patients’ nerves...

... this method is known, through experience, to synchronize the autonomic nervous system to the circadian rhythm: the sympathetic nerve system works predominantly after stimulation by rosemary–lemon oil in the morning, whereas the parasympathetic nerve system works predominantly after activation by the lavender–orange oil at night...

http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8301.2009.00299.x/pdf

____________________________________



Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double blind, randomised, placebo controlled trial

J Neurol Neurosurg Psychiatry 2003;74:863-866 doi:10.1136/jnnp.74.7.863
S Akhondzadeh, M Noroozian, M Mohammadi, S Ohadinia, A H Jamshidi, M Khani

... At four months, Melissa officinalis extract produced a significantly better outcome on cognitive function than placebo...

http://jnnp.bmj.com/content/74/7/863.abstract



I've been trying to get a handle on exactly which essential oils have allegedly been shown - in any scientific studies - to have specifically aided memory and cognition (in either healthy people or those with dementia).

Based on the quotes in my earlier posts above, here's what seems, in these four studies anyway, to have helped memory and cognition:

- Peppermint

- Rosemary

- Lemon balm (Melissa officinalis)

- Rosemary and lemon mix in the morning, and lavender and orange mix in the evening

Am I understanding right? And are there any other essential oils to add to the list?

In addition to the actual scientific studies, of course I appreciate very much any anecdotal reports such as those posted by Lane.

And do I understand correctly that "lemon" and "lemon balm" are two different kinds of essential oils and should not be confused with each other? Can Lane or anyone else clarify this? Thanks.


Thanks, Onward, for the additional links. You are right, lemon and lemon balm are different kinds of essential oils. Lemon balm comes from the Lamiaceae family (the mint family). Other plants in this family include rosemary, oregano, peppermint, thyme, and sage. Akhondzadeh's other clinical trial involved the use of sage (Salvia officinalis) and produced similar results as lemon balm. Methoxyphenols in essential oils may be particulary effective at scavenging peroxynitrites and in reversing part of the damage done by peroxynitrites in Alzheimer's disease (limonene in various citrus-based essential oils may also scavenge peroxynitrites to some extent and ketones in some essential oils may help decompose peroxynitrites). Methoxyphenols (eugenol, thymol, and carvacrol) can be found in several essential oils, such as cinnamon leaf, clove, basil, laurel (bay leaf), nutmeg, peppermint, thyme, oregano, rosemary, and sage (there are lists for the constituents of essential oils used in aromatherapy on the internet, but they vary to some degree ). Irie postulates that eugenol may provide an effective treatment for Alzheimer's disease: Y Irie. Effects of eugenol on the Central Nervous System: Its possible application to the treatment of Alzheimer's disease, depression, and Parkinson's disease. Curr. Bioactive Compounds 2(2008): 57-68. As far as I know, a similar study does not exist for thymol and carvacrol.

You ask very important questions. To slightly rephrase them: What essential oils are most likely to have a positive effect on the treatment of Alzheimer's disease and how long should they be breathed in aromatherapy? The information above partially answers the first question. I don't have a precise answer to the second question.


Thanks very much for the helpful information, Lane.

If you don't mind my asking... is there any special reason why you haven't been using peppermint, lemon balm, or lemon? I'm just curious since these are all said to have been shown helpful for memory and cognition (in studies cited above).

I didn't know about the positive effects of peppermint essential oil on memory until I read your post (or the negative effects of Ylang Ylang essential oil). Thank you. It's not clear at this point whether the results would be the same for people with Alzheimer's disease, but I think there is enough evidence to at least give peppermint essential oil a try. The other two are more a feeling of equivalency (sweet orange and lemon; sage and lemon balm). I figure the two that I am giving to my mother are similar to the two that I am not giving to her, although this might not be correct thinking on my part. Based on the handful of studies that do exist, I believe that lemon, orange, lemon balm, and peppermint essential oils should be effective essential oils to use in the treatment of Alzheimer's disease, along with rosemary and sage essential oils (the scientific evidence that I have for all the other essential oils that I mention is indirect--their ability to scavenge peroxynitrites).


In vitro and in vivo effects of Laurus nobilis L. leaf extracts.
Kaurinovic B, Popovic M, Vlaisavljevic S.

Molecules. 2010 May 7;15(5):3378-90.
Source: Department of Chemistry, Faculty of Science, University of Novi Sad, Trg Dositeja Obradovica 3, 21000 Novi Sad, Serbia. biljana.kaurinovic@dh.uns.ac.rs
Abstract

The in vitro and in vivo antioxidant activities of different extracts of laurel leaves were studied. Free radical scavenging capacity (RSC) was evaluated measuring the scavenging activity on the DPPH, NO, O(2)(.-) and OH radicals. The effects on lipid peroxidation (LP) were also evaluated. Experimental results indicate that ethyl acetate extract of leaves has exhibited the largest RSC capacity in neutralization of DPPH, NO, O(2)(.-) and OH radicals. The same result was obtained in investigation of extracts impact on LP. The in vivo effects were evaluated on some antioxidant systems (activities of GSHPx, LPx, Px, CAT and XOD, and GSH content) in the mice liver and blood-hemolysate after treatment with the examined laurel extracts, or in combination with carbon tetrachloride (CCl(4)). On the basis of the results obtained it can be concluded that the examined extracts exhibited a certain protective effect, which is more pronounced on the liver than on blood-hemolysate parameters. The results obtained indicate toxicity of CCl(4), probably due to the radicals involved in its metabolism. Combined treatments with CCl(4) and the examined extracts showed both positive and negative synergism. Based on the experimental results, the strongest protective effect was shown by the EtOAc extract.
PMID: 20657487 [PubMed]
http://www.ncbi.nlm.nih.gov/pubmed/20657487

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