ENHANCE MEMORY

BACKGROUND

Mild cognitive impairment is a condition characterized by poor memory, mild memory loss, forgetfulness, and difficulty concentrating or focusing. Mild cognitive impairment may be caused by many factors, including stress, lack of sleep, lack of exercise, overeating, insufficient intake of vitamin B₁₂, headache, head injury, stroke, and seizures. Mild cases of cognitive impairment can be reversed with lifestyle changes or diet modifications. However, moderate cases of cognitive impairment will require herbal treatment.

FORMULA EXPLANATION

According to traditional Chinese medicine, the Kidney produces marrow and the brain is the sea of marrow. Strong Kidney jing (essence) is vital to the nourishment of the brain, memory, concentration and alertness. The Kidney is also essential in helping the Heart house the shen (spirit) and maintain clear mental activity, consciousness, memory and thinking.

Forgetfulness and inability to concentrate or focus are usually the result of deficiency and lack of nourishment due to overwork, lack of rest, or aging. Enhance Memory contains herbs that tonify the Kidney and Heart, invigorate blood circulation to the head, and open orifices to improve alertness. Di Huang (Radix Rehmanniae), Xuan Shen (Radix Scrophulariae), Mai Dong (Radix Ophiopogonis) and Tian Dong (Radix Asparagi) nourish Kidney yin and jing (essence). Ren Shen (Radix et Rhizoma Ginseng) and Fu Ling (Poria) tonify Heart qi. Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) and Dang Gui (Radix Angelicae Sinensis) invigorate the blood, and Yin Xing Ye (Folium Ginkgo) acts as a channel-guiding herb to the brain. Furthermore, the flavonoids in Yin Xing Ye (Folium Ginkgo) provide antioxidant protection to the brain and its related vascular structure. These blood-moving herbs keep adequate amounts of oxygenated blood to the brain cells to ensure healthy brain functions. Yuan Zhi (Radix Polygalae) and Shi Chang Pu (Rhizoma Acori Tatarinowii) improve mental alertness because they have aromatic dispelling functions to clear phlegm obstructing the orifices. Bai Zi Ren (Semen Platycladi), Suan Zao Ren (Semen Ziziphi Spinosae) and Wu Wei Zi (Fructus Schisandrae Chinensis) tranquilize the shen (spirit) and prevent the leakage of Heart qi. Jie Geng (Radix Platycodonis) acts as a channel-guiding herb to bring other herbs to the Heart.

In conclusion, Enhance Memory is a well-balanced formula to improve memory and increase cognition. Enhance Memory contains herbs that nourish the Heart, tonify the Kidney jing (essence), and invigorate blood circulation to the head.

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated in cases of excess heat or existing exterior pathogenic conditions.

* This formula is contraindicated during pregnancy and nursing.

* This herbal formula contains herbs that invigorate blood circulation, such as Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) and Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]^,[2],[3]

CLINICAL NOTES

* It is important to note that the maximum benefit of Enhance Memory is derived from continuous use, not from one excessive dose. In other words, use the normal dose continuously for three to six months for optimal effect. Increasing the dose exponentially will not necessarily accelerate the desired effect.

* This formula is safe for long-term use.

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Poor memory and concentration due to Heart blood deficiency: small pulse, a thin and weak pulse on the left cun

SUPPLEMENTARY FORMULAS

* With Alzheimer’s disease, add Neuro Plus.

* With Kidney yang deficiency, add Kidney Tonic (Yang).

* With Kidney yin deficiency, add Kidney Tonic (Yin).

* With patients who are “burned out,” add Adrenal +.

* With stress or Liver qi stagnation, add Calm.

* With stress and insomnia in patients with excess heat, fire and shen (spirit) disturbance, add Calm (ES).

* With stress and insomnia in patients with deficiency, add Calm ZZZ.

* With ADD/ADHD and poor memory, add Calm (Jr).

* With blood stagnation, add Circulation (SJ).

* For visual disturbances, blurriness, redness or pain, add Lycium Support.

ACUPUNCTURE TREATMENT

Traditional Points:

* Si Shen Cong, scalp points.

* Taichong (LR 3), Xingjian (LR 2), Yinlingquan (SP 9), Yanglingquan (GB 34), Renzhong (GV 26), Baihui (GV 20).

Classic Master Tung's Points:

* Dizong (T 44.09), Tianhuangfu [Shenguan] (T 77.18), Zhenghui (T 1010.01), Piyi (T 88.35)*, Pier (T 88.36)*

Master Tung’s Points by Dr. Chuan-Min Wang:

* Forgetfulness, poor memory: Bleed Huosan (T 66.12), Chongxiao (T DT.17). Needle Shuixiang (T 66.14), Shuixian (T 66.15).

Balance Method by Dr. Richard Tan:

* Left side: Shenmen (HT 7), Shaohai (HT 3), Zulinqi (GB 41), Yanglingquan (GB 34), Weizhong (BL 40), Shugu (BL 65)

* Right side: Zhongzhu (TH 3), Tianjing (TH 10), Houxi (SI 3), Xiaohai (SI 8), Taixi (KI 3), Yingu (KI 10), ear Shenmen

* Alternate sides from treatment to treatment.

Auricular Medicine by Dr. Li-Chun Huang:

* Invigorating the brain function: Brain, Thalamus, Pituitary, Forehead, Heart, Kidney, Smart, Nervous Subcortex, Groove of Brain Posterior

NUTRITION

* Make sure the diet contains an adequate amount of lecithin, which is essential for transmission of nerve impulses that control memory. Good sources of lecithin include flax seed oil, walnut oil, sesame oil, egg yolk, soybean, and raw wheat germ.

* Do not overeat. Adults who consume between 2,100 and 6,000 calories each day are twice as likely to develop memory problems, according to American Academy of Neurology.[4]

* The B vitamins are also important for energy and proper brain function.

* Ensure adequate intake of vitamin B₁₂. Brain shrinkage and age-related memory declines have been linked with vitamin B₁₂ deficiency, according to a report done by researchers at Chicago's Rush University Medical Center and published in Neurology. Foods rich in vitamin B₁₂ include meat, fish, poultry, milk, eggs, and fortified breakfast cereals.

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Poor concentration: Incorporate 1/4 cup of either fresh or frozen blueberries into breakfast daily for two to four weeks.

* Memory decline: Make trail mix of equal portions of dried blueberries, walnuts, pine nuts, goji berries, and pumpkin seeds.

* Memory decline: Make a brain tonic bean soup by cooking equal portions of navy beans, black beans, and kidney beans seasoned with rosemary, thyme, and turmeric. Eat a bowl daily.

* Memory and focus issues: Eat hardboiled quail eggs regularly.

LIFESTYLE INSTRUCTIONS

* Patients are recommended to have a good balance between exercise, rest, and relaxation.

* Encourage patients to continuously stay mentally active. Go back to school, take a part time job, solve crossword puzzles, play chess, and engage in other mentally-fulfilling activities.

* Encourage patients to stay physically active. Exercises that are good for the heart are also good for the brain.

* Avoid a stressful and hectic lifestyle. A poor memory is often related to an excessive amount of stress on a daily basis.

* Avoid physical activities or contact sports that cause direct injuries to the brain, such as boxing.

* Stay away from environments with dramatic and sudden change of temperature, from hot to cold and vice versa.

* Develop healthy sleeping habit. Sleep is necessary to consolidate memories so that they can be recalled in the future. Lack of sleep impairs a person's ability to focus and learn.

* Smoking and alcoholic beverages are not recommended.

CASE STUDIES

* J.H., a 35-year-old female, presented with memory loss due to trauma from a car accident. Her blood pressure was 120/70 mmHg and the heart rate was 72 beats per minute. Additional symptoms included heart flutters and night sweats. The patient was diagnosed with Kidney yin deficiency and Heart qi and jing (essence) deficiencies. Enhance Memory was prescribed for eight weeks, at 3 capsules three times daily for the first four weeks followed by a reduction to 2 capsules three times daily the next four weeks. After nine days her heart flutters and night sweats resolved. In conjunction with acupuncture treatments the patient’s healing process was positive on many levels. Submitted by B.S., Albuquerque, New Mexico.

* A professional singer in her early 70's years of age had been complaining of memory loss. She was prescribed Enhance Memory. After taking this formula for two weeks, she exclaimed that "she was able to recall lyrics and felt mentally confident again." Submitted by K.F., Honolulu, Hawaii.

PHARMACOLOGICAL AND CLINICAL RESEARCH

Enhance Memory is carefully crafted with herbs that have shown marked ability to enhance cognitive functions. Herbs in Enhance Memory have been shown to improve blood circulation to deliver oxygen and essential nutrients to the brain. Furthermore, herbs in Enhance Memory have a positive cognitive effect to improve mental functions and a neuroprotective effect to prevent damages to the neurons. Lastly, many herbs in Enhance Memory have been found to be effective in treating neurodegenerative disorders and drug-induced memory impairments.

Dang Gui (Radix Angelicae Sinensis) and Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) are two herbs in Enhance Memory that have shown pronounced ability to improve blood circulation. Dang Gui (Radix Angelicae Sinensis) improves overall blood circulation by decreasing blood viscosity, or improving the hemorrheological changes in "blood stagnation."[5] Administration of Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) is associated with marked vasodilation of the coronary arteries, a negative chronotropic and an inotropic effect, and a reduction of blood pressure.[6] In addition to improving blood circulation to the brain, Enhance Memory contains Shi Chang Pu (Rhizoma Acori Tatarinowii) to help guide the herbs into the brain. Administration of Shi Chang Pu (Rhizoma Acori Tatarinowii) is associated with an increased permeability of the blood-brain barrier by opening the tight junctions of the endothelial cells.[7] This action helps to enhance the overall effect of the formula. Overall, these three herbs act to improve microcirculation, thus delivering oxygen and essential nutrients to the brain to ensure the health and optimal performance of brain cells.

Enhance Memory contains many herbs with positive cognitive effects to improve memory. Administration of Ren Shen (Radix et Rhizoma Ginseng) for three days has demonstrated marked impact in improving memory and learning ability.[8] Another study shows that administration of Ren Shen (Radix et Rhizoma Ginseng) enhances cognitive performance and ameliorates the increase in subjective feelings of mental fatigue experienced by participants during the later stages of sustained, cognitively demanding task performance.[9] Ren Shen (Radix et Rhizoma Ginseng) has also been used successfully to improve classroom performance in a clinical trial of 30 children with low IQ and mental retardation.[10] In addition, Shi Chang Pu (Rhizoma Acori Tatarinowii) has a dose-dependent effect on improving cognition and memory.[11] Furthermore, a preparation of Wu Wei Zi (Fructus Schisandrae Chinensis) has a stimulating effect on the central nervous system to increase mental alertness, improve work efficiency, and quicken reflexes.[12] Wu Wei Zi (Fructus Schisandrae Chinensis) has also been shown to significantly reduce memory impairment in laboratory studies.[13] Lastly, Yin Xing Ye (Folium Ginkgo) has shown a positive cognitive effect to improve attention and memory in 52 young, healthy volunteers.[14]

Enhance Memory also contains many herbs with neuroprotective effects to prevent damages to the neurons. Yuan Zhi (Radix Polygalae) has potential as a drug to treat dementia and Alzheimer's disease via several mechanisms of actions. It has a dose-dependent effect to protect the neurons from Abeta-induced neuronal damage.[15] It also inhibits acetylcholinesterase (AChE) activity in a dose-dependent and non-competitive manner.[16] Shi Chang Pu (Rhizoma Acori Tatarinowii) shows a neuroprotective effect by attenuating neuronal apoptosis in hippocampus induced by beta-amyloid (Abeta), and helps to manage cognitive impairment associated with conditions such as Alzheimer's disease.[17] Dang Gui (Radix Angelicae Sinensis) reduces the neurotoxicity induced by amyloid beta-peptide in a dose-dependent manner and has potential to prevent Alzheimer's disease. Di Huang (Radix Rehmanniae) contains catapol, a compound with potential to treat senescence or neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases, by ameliorating cognitive deficits and attenuating oxidative damage in the brain.[18] Finally, Jie Geng (Radix Platycodonis) demonstrates a marked neuroprotective effect by rescuing the neurons in the hippocampal region from ischemic damage.[19]

In addition to having a direct cognitive effect to improve brain functions and an indirect neuroprotective effect to prevent damage, Enhance Memory has many herbs to treat various neurodegenerative disorders. Yin Xing Ye (Folium Ginkgo) has been used in China and Europe for treatment of dementia. Pharmacologically, it has an antiplatelet effect to reduce blood viscosity and a vasodilative effect to increase perfusion to peripheral parts of the body, including the brain.[20]^,[21] Clinically, numerous studies have shown Yin Xing Ye (Folium Ginkgo) to be safe and effective in treating various types of neurodegenerative disorders. According to a placebo-controlled, double-blind, randomized clinical trial with 309 patients over 52 weeks, Yin Xing Ye (Folium Ginkgo) was concluded to be “safe” and capable of “improving the cognitive performance and the social functioning of demented patients for six months to one year.” The study was published by JAMA in October 1997.[22] According to another randomized, placebo-controlled, double-blind clinical trial, 400 patients aged 50 years or older with dementia with neuropsychiatric features were treated with Yin Xing Ye (Folium Ginkgo) extract or placebo for 22 weeks. The results showed that Yin Xing Ye (Folium Ginkgo) extract was significantly superior to placebo on all secondary outcome measures, including the Neuropsychiatric Inventory and an activities-of-daily-living scale. Furthermore, Yin Xing Ye (Folium Ginkgo) extract was well tolerated. Incidence of adverse effects was comparable to placebo.[23] Another study conducted at the University of Southern California Keck School of Medicine also showed that use of Yin Xing Ye (Folium Ginkgo) was significantly better than placebo to improve cognitive performance and global assessment scores in patients with dementia accompanied by neuropsychiatric symptoms.[24]

Lastly, the use of herbs in Enhance Memory has also been found to be effective in preventing and treating drug-induced memory impairment. Jie Geng (Radix Platycodonis) ameliorates scopolamine-induced amnesia via inhibition of acetylcholinesterase (AChE) activity and inhibition of thiobarbituric acid-reactive substance in the serum and brain.[25] Dang Gui (Radix Angelicae Sinensis) is effective in treating scopolamine- and cycloheximide-induced amnesia in laboratory subjects.[26] Yuan Zhi (Radix Polygalae) is beneficial in treating memory impairment caused by scopolamine or dysfunction of the cholinergic system in the brain.[27] Finally, in an in vitro study, a traditional Chinese medicinal preparation [composed of Ren Shen (Radix et Rhizoma Ginseng), Yuan Zhi (Radix Polygalae), Shi Chang Pu (Rhizoma Acori Tatarinowii), and Fu Ling (Poria)] reduced the ethanol-induced impairment of memory registration. It also ameliorated the scopolamine-induced memory registration deficit. These results suggest that the herbal preparation ameliorates the impairing effect of ethanol on learning and memory processes.[28]

In summary, Enhance Memory is an excellent formula to improve cognition and treat memory-related disorders such as memory impairment, dementia, and Alzheimer’s disease.

COMPARATIVE ANALYSIS

One striking difference between Western and traditional Chinese medicine is that Western medicine focuses and excels in crisis management, while traditional Chinese medicine emphasizes and shines in holistic and preventative treatments. Therefore, in emergencies, such as gunshot wounds or surgery, Western medicine is generally the treatment of choice. However, for treatment of chronic idiopathic illness of unknown origins, where all lab tests are normal and a clear diagnosis cannot be made, traditional Chinese medicine is distinctly superior.

In cases of gradual deterioration of mental acuity (with forgetfulness and poor memory), there are no diagnostic signs or symptoms, no laboratory abnormalities, and no functional or anatomical disorders. Under these circumstances, Western medicine struggles to identify a specific diagnosis and offers no drug treatments. On the other hand, traditional Chinese medicine is beneficial as it excels in maintenance and preventative therapies. Herbs can be used to improve blood circulation to the brain, nourish underlying deficiencies, and improve cognitive functions. In comparison with Western medicine, traditional Chinese medicine offers safe and effective treatment options. Therefore, herbal therapy should definitely be employed to prevent deterioration of this condition, and to restore optimal health.

[1] Chan K, Lo AC, Yeung JH, Woo KS. Journal of Pharmacy and Pharmacology 1995 May;47(5)::402-6.

[2] Pharmacotherapy 1999 July;19(7)::870-876.

[3] European Journal of Drug Metabolism and Pharmacokinetics 1995; 20(1)::55-60.

[4] American Academy of Neurology. Annual meeting report in February, 2012.

[5] Xue, JX. et al. Effects of the combination of astragalus membranaceus (Fisch.) Bge. (AM), angelica sinensis (Oliv.) Diels (TAS), cyperus rotundus L. (CR), ligusticum chuanxiong Hort (LC) and paeonia veitchii lynch (PV) on the hemorrheological changes in "blood stagnating" rats. Chung Kuo Chung Yao Tsa Chih; 19(2):: Feb 1994; 108-10, 128.

[6] Shang Hai Di Yi Xue Yuan Xue Bao (Journal of First Shanghai Medical College), 1980; 7(5)::347.

[7] Hu Y, Yuan M, Liu P, Mu L, Wang H. Effect of Acorus tatarinowii schott on ultrastructure and permeability of blood-brain barrier. Department of Clinical Pharmacology and Pharmacy, Chinese PLA General Hospital, Beijing 100853, China. Zhongguo Zhong Yao Za Zhi. 2009 Feb;34(3)::349-51.

[8] Zhong Yao Ci Hai (Encyclopedia of Chinese Herbs), 1994.

[9] Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks. Human Cognitive Neuroscience Unit, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK. J Psychopharmacol. 2006 Nov;20(6)::771-81.

[10] Zhong Cheng Yao Yan Jiu (Research of Chinese Patent Medicine), 1982; 6::22.

[11] Zhong Yi Xue (Chinese Herbal Medicine), 1992; 23(8)::417.

[12] Zhong Yao Xue (Chinese Herbology), 1998; 878::881.

[13] Kang S.Y., Lee K.Y., Koo K.A., Yoon J.S., Lim S.W., Kim Y.C. & Sung S.H. ESP-102, a standardized combined extract of Angelica gigas , Saururus chinensis and Schizandra chinensis , significantly improved scopolamine-induced memory impairment in mice. Life Sci. 2005, 76(15):: 1691-1705.

[14] Elsabagh S, Hartley DE, Ali O, Williamson EM, File SE. Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology Research Unit, Centre for Neuroscience, Hodgkin Building, King's College London, Guy's Campus, London, SE1 1UL, UK. Psychopharmacology (Berl). 2005 May;179(2)::437-46.

[15] Naito R, Tohda C. Characterization of anti-neurodegenerative effects of Polygala tenuifolia in Abeta(25-35)-treated cortical neurons. Division of Biofunctional Evaluation, Research Center for Ethnomedicine, Institute of Natural Medicine, University of Toyama, Toyoma, Japan. Biol Pharm Bull. 2006 Sep;29(9)::1892-6.

[16] Park CH, Choi SH, Koo JW, Seo JH, Kim HS, Jeong SJ, Suh YH. Novel cognitive improving and neuroprotective activities of Polygala tenuifolia Willdenow extract, BT-11. Department of Pharmacology, College of Medicine, National Creative Research Initiative Center for Alzheimer's Dementia and Neuroscience Research Institute, MRC, Seoul National University, Seoul, South Korea. J Neurosci Res. 2002 Nov 1;70(3)::484-92.

[17] Geng Y, Li C, Liu J, Xing G, Zhou L, Dong M, Li X, Niu Y. Beta-asarone improves cognitive function by suppressing neuronal apoptosis in the beta-amyloid hippocampus injection rats. The Institute of Medicine, Qiqihar Medical University, Qiqihar 161006, China. Biol Pharm Bull. 2010;33(5)::836-43.

[18] Zhang X, Zhang A, Jiang B, Bao Y, Wang J, An L. Further pharmacological evidence of the neuroprotective effect of catalpol from Rehmannia glutinosa. School of Environmental and Biological Science & Technology, Dalian University of Technology, Dalian 116024, China. Phytomedicine. 2008 Jun;15(6-7)::484-90.

[19] Choi JH, Yoo KY, Park OK, Lee CH, Won MH, Hwang IK, Ryu SY, Kim YS, Yi JS, Bae YS, Kang IJ. Platycodin D and 2''-O-acetyl-polygalacin D2 isolated from Platycodon grandiflorum protect ischemia/reperfusion injury in the gerbil hippocampus. Department of Anatomy and Neurobiology, Institute of Neurodegeneration and Neuroregeneration, College of Medicine, Hallym University, Chuncheon, South Korea. Brain Res. 2009 Jul 7;1279::197-208.

[20] Kudolo GB, Wang W, Barrientos J, Elrod R, Blodgett J. The ingestion of Ginkgo biloba extract (EGb 761) inhibits arachidonic acid-mediated platelet aggregation and thromboxane B2 production in healthy volunteers. Department of Clinical Laboratory Sciences, MSC 6246, University of Texas HSC at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA. J Herb Pharmacother. 2004;4(4)::13-26.

[21] Guo Wai Yi Xue Zhong Yi Zhong Yao Fen Ce (Monograph of Chinese Herbology from Foreign Medicine), 1979; 4::200.

[22] Le Bars, P. et al. A placebo-controlled, double-blind, randomized trial of an extract of ginkgo biloba for dementia. JAMA (Journal of American Medical Association);278::1327-1332. October 22, 1997.

[23] Napryeyenko O, Borzenko I; GINDEM-NP Study Group. Ginkgo biloba special extract in dementia with neuropsychiatric features. A randomised, placebo-controlled, double-blind clinical trial. Psychiatry Department, National Medical University, Kyiv, Ukraine. Arzneimittelforschung. 2007;57(1)::4-11.

[24] Schneider LS, DeKosky ST, Farlow MR, Tariot PN, Hoerr R, Kieser M. A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer's type. Curr Alzheimer Res. 2005 Dec;2(5)::541-51.

[25] Moon MK, Ahn JY, Kim S, Ryu SY, Kim YS, Ha TY. Ethanol extract and saponin of Platycodon grandiflorum ameliorate scopolamine-induced amnesia in mice. Functional Food Technology Research Group, Korea Food Research Institute, Sungnam-Si, Republic of Korea. J Med Food. 2010 Jun;13(3)::584-8.

[26] Hsieh MT, et al. Radix Angelica Sinensis extracts ameliorate scopolamine- and cycloheximide-induced amnesia, but not p-chloroamphetamine-induced amnesia in rats. American Journal of Chinese Medicine 2000;28(2)::263-72.

[27] Sun XL, Ito H, Masuoka T, Kamei C, Hatano T. Effect of Polygala tenuifolia root extract on scopolamine-induced impairment of rat spatial cognition in an eight-arm radial maze task. Department of Pharmacognosy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Tsushima, Okayama 700-8530, Japan. Biol Pharm Bull. 2007 Sep;30(9)::1727-31.

[28] Biological and Pharmaceutical Bulletin. 1994 Nov.; 17(11)::1472-6,

CLINICAL APPLICATIONS

WESTERN THERAPEUTIC ACTIONS

CHINESE THERAPEUTIC ACTIONS

DOSAGE

INGREDIENTS

Yin Xing Ye (Folium Ginkgo)