Macular degeneration and diabetic retinopathy have something in common. Although the indirect causes may be different, a consequence of untreated AMD or untreated diabetes is similar. Untreated, both conditions may result in macular microbleeding, in which abnormal capillaries develop (angiogenesis) that leak fluid or blood into the retina. A holistic approach may reduce the risk of the development of abnormal blood vessels bleeding into the retina and destroying vision
Why Angiogenesis is a Problem
Let’s consider dry and wet (advanced) macular degeneration. AMD is basically a form of “starvation of the retina,” particularly the age-related form, in which essential nutrients are not reaching their target. Insufficient delivery can be due to some combination of a poor diet, lack of exercise, issues with absorption, poor circulation, candida, or chronic inflammatory conditions such as rheumatoid arthritis.
Since the function of blood is to deliver oxygen and nutrients, one might reasonably think that growing new blood vessels would improve the ‘starvation’ issue, and that would be the intention of angiogenesis, but it’s not quite that simple. Angiogenesis occurs in an effort to deliver deficient nutrients to the retina, but unfortunately, these blood vessels are poor in quality and end up leaking. They also distort the delicate structure of the macula.
Few Options for Abnormal Retinal Bleeding
Patients with diabetic eye disease or advanced AMD have few options. Doctors can sometimes zap the eye with lasers in an attempt to reduce the rate of future blood vessel growth. Oral drugs such as ranibizumab can help stop tiny new blood vessels from developing. Injectable drugs, such as Lucentis (ranibizumab), Avastin (bevacizumab), or Eylea (aflibercept), are also aimed at stopping the extra capillary growth and dry up existing excess blood vessels. All these options carry potential side effects and damage. However, they are important for preserving vision by controlling acute active bleeding or leakage.
The long term approach to preserving vision is to deal with any underlying health condition, pay attention to lifestyle, and take targeted supplements to strengthen circulation in the eyes and provide essential nutrients that, when deficient, can lead to AMD and bleeding.
Angiogenesis Factors
The process that leads to angiogenesis is controlled in normal tissues by biochemical activity sequences. Vascular endothelial growth factor (VEGF) refers to the biochemical that promotes blood vessel growth through regulation of the lining (endothelial) of blood vessels. Drugs like bevacizumab block the signaling receptor for VEGF, and thus, angiogenesis. Angiopoietins are a type of VEGF which most directly correspond with angiogenesis.
Synergistic Potential
In the case of cancers, the evidence is that single anti-angiogenic compounds are of limited value, but acting synergistically, combinations of these compounds have better potential. In a much-cited 2006 study,1 scientists examined the fact that cancerous tumors thrive because angiogenesis creates new blood vessels to feed them. They looked at herbal approaches that avoid the side effects of conventional cancer drugs. They identified specific traditional herbal medicines that have potential directly and indirectly against angiogenesis. Since they may have merit with respect to diabetic retinopathy and macular degeneration, let’s discuss them.
Key Anti-Angiogenesis Medicinal Herbs
Artemisia Annua (Chinese Wormwood)
Artemisia contains 95% artemisinin and other related terpenes and flavonoids. Known for its antimalaria qualities, Artemisia has potential direct and indirect anti-angiogenic activity.2 It contains many antioxidant compounds3 and reduces oxidative stress, cell death, and promotes DNA repair.4 One of the vehicles for reducing angiogenesis may through inhibiting immune mediators of angiogenesis.5 Immune mediators are those biochemicals that stimulate or overstimulate the immune system, sometimes to attack itself.
Scutellaria Baicalensis (Chinese Skullcap)
Scutellaria contains 95% baicalin and flavonoids. It is a potent anti-angiogenic compound, and inhibits VEGF.6 Scutellaria also displays strong anti-inflammatory, anti-viral, and anti-tumor activities, and is protective against diabetes-induced oxidative damage and dysfunction to the lining of blood vessels.7 It is the flavonoids contained in Scutellaria that appear to reduce inflammatory-induced angiogenesis.8
Vitis Vinifera (Grape Seed Extract)
With its 95% content of proanthocyanidins (dark blue pigments) grape seed extract is a potent antioxidant that also has direct activity against angiogenesis.9 It appears to do so by suppressing the receptor pathway of VEGF.10 11 Grape seed extract has been recognized for its healthful benefits for many years. They include vascular capillary integrity, anti-inflammation, antioxidant action, blood pressure normalization, neuro-protection, and much more.
Magnolia Seed Cones
Magnolia, containing 90% the active ingredient honokiol, directly and indirectly suppresses angiogenesis. It accomplishes this through regulating blood platelet-derived endothelial cell growth factor and changing how signaling influences angiogenesis. 12 13 In addition, magnolia extract offers neuroprotection,14 and protects mitochondria (energy producers in cells).15
Curcuma Longa (Turmeric)
Turmeric, which contains 95% curcumin, specifically inhibits VEGF and has direct activity against angiogenesis. It inhibits VEGF directly as well as down regulating the genes that control VEGF.1617 Curcumin is not new to the holistic eye doctor as it has been noted for its helpfulness in many different vision conditions, including “glaucoma, cataract, age-related macular degeneration, diabetic retinopathy, corneal neovascularization, corneal wound healing, dry eye disease, conjunctivitis, pterygium, and anterior uveitis.”18
Other Important Medicinal Herbs
There are several other traditional medicinal herbs that are valuable specifically against angiogenesis: Angelica sinensis (dong quai), Camellia sinensis (green tea), and Silybum marianum (milk thistle). Other important herbs for the visual system include Ginkgo biloba, Poria cocos, Zingiber officinalis (ginger), Panax ginseng, and cinnamon.
Dr. Grossman has combined these herbs into a synergistically balanced combination with the following goals:
- Promote blood vessel control support and thereby reduce the risk of angiogenesis developing in the retina – a serious complication of advanced macular degeneration or diabetic retinopathy.
- Improve circulation and delivery of nutrients to the eye
- Strengthen the integrity of blood vessels and capillaries
- Support liver health and detoxify the liver, which, in traditional Chinese medical is connected to the eye.
- Provide potent antioxidants to reduce oxidative stress.
- Provide anti-inflammatory herbs to help reduce inflammation and swelling
- Strengthen bones.
- Possibly provide some anticancer properties.
- Stimulate physical and mental activity.
- Help balance sugar.
A Holistic Approach to Angiogenesis from Macular Denegeration or Diabetic Retinopathy
We feel that by taking advantage of the anti-angiogenic qualities of these key medicinal herbs, we may reduce the risk of the development of abnormal blood vessels bleeding into the retina and destroying vision. A synergistic approach to protecting vision could be a combination of these key herbs with others known to be supportive of the visual system.
Dr. Grossman’s Blood Vessel Control Formula includes many of the medicinal herbs described in Dr. Sagar’s study (replicated in later research), as well as other antioxidant- and nutrient-rich herbs to support vision health.
The Blood Control Formula is also included in some discounted packages:
For the macula: AMD Package 4G (3 months) and AMD Package 4G2 (1 month supply). These packages help reduce angiogenesis but also supply essential nutrients to the macula such as omega-3, vitamin D3, and antioxidants to combat oxidative stress and inflammation.
For sugar balance and the macula: Sugar Balance & Blood Vessel Support Package 1. This package contains nutrients that retard angiogenesis but also help balance blood sugar, strengthen blood vessels, and reduce inflammation.
For vascular support: Vascular Support Package 2. This 3-month supply includes nutrients to support optic nerve health, supply essential fatty acids, and support blood vessel strength, while reducing angiogenesis.
For inflammation: Anti-Inflammatory Eye and Whole Body Package 1, antioxidants and herbs to help reduce eye and overall inflammation and well as helping to nourish eye and body health.
If you have questions about which package might be most appropriate for you, give us a call at 845-875-4158 or email us at info@naturaleyecare.com
Footnotes:
- Sagar SM, Yance D, Wong RK. (2006). Natural health products that inhibit angiogenesis: a potential source for investigational new agents to treat cancer – Part 1. Curr Oncol. Feb;13(1):14-26). ↩
- Ibid. Sagar. (2006). ↩
- Messaili S, Colas C, Fougere L, Destandau E. (2020). Combination of molecular network and centrifugal partition chromatography fractionation for targeting and identifying Artemisia annua L. antioxidant compounds. J Chromatogr A. Mar 29;1615:460785. ↩
- Efferth T. (2017). From ancient herb to modern drug: Artemisia annua and artemisinin for cancer therapy. Semin Cancer Biol. Oct;46:65-83. ↩
- Zhu XX, Yang LY, Li YJ, Zhang D, Chen Y, et al. (2013). Effects of sesquiterpene, flavonoid and coumarin types of compounds from Artemisia annua L. on production of mediators of angiogenesis. Pharmacol Rep. 2013;65(2):410-20. ↩
- Ibid. Sagar. (2006). ↩
- Chen G, Chen X, Niu C, Huang X, An N, et al. (2018). Baicalin alleviates hyperglycemia-induced endothelial impairment 1 via Nrf2. J Endocrinol. Oct 1;JOE-18-0457.R1. ↩
- Gong G, Wang H, Kong X, Duan R, Dong TTX, et al. (2018). Flavonoids are identified from the extract of Scutellariae Radix to suppress inflammatory-induced angiogenic responses in cultured RAW 264.7 macrophages. Sci Rep. Nov 27;8(1):17412. ↩
- Ibid. Sagar. (2006). ↩
- Wen W, Lu J, Zhang K, Chen S. (2008). Grape seed extract inhibits angiogenesis via suppression of the vascular endothelial growth factor receptor signaling pathway. Cancer Prev Res (Phila). Dec;1(7):554-61. ↩
- Huang S. Yang N, Liu Y, Hu L, Zhao J, et al. (2012). Grape seed proanthocyanidins inhibit angiogenesis via the downregulation of both vascular endothelial growth factor and angiopoietin signaling. Nutr Res. Jul;32(7):530-6. ↩
- Ibid. Sagar. (2006). ↩
- Ong CP, Lee WL, Tang YQ, Yap WH. (2019). Honokiol: A Review of Its Anticancer Potential Mechanisms. Cancers (Basel). Dec 22;12(1):48. ↩
- Woodbury A, Yu SP, Wei L, Garcia P. (2013). Neuro-modulating effects of honokiol: a review. Front Neurol. Sep 11;4:130. ↩
- Pillai VB, Kanwal A, Fang HY, Sharp WW, Samat S, et al. (2017). Honokiol, an activator of sirtuin-3 (SIRT3) preserves mitochondria and the heart from doxorubicin-induced cardiomyopathy in mice. Oncotarget. May 23;8(21):34082-34098. ↩
- Ibid. Sagar. (2006). ↩
- Fu Z, Chen X, Guan S, Yan Y, Lin H, et al. (2015). Curcumin inhibits angiogenesis and improves defective hematopoiesis induced by tumor-derived VEGF in tumor model through modulating VEGF-VEFGR2 signaling pathway. Oncotarget. Aug 14;6(23):19469-19482. ↩
- Radomska-Lesniewska DR, Osiecka-Iwan A, Hyc A, Gozdz A, Dabrowska AM, et al. (2019). Therapeutic potential of curcumin in eye disease. Cent Eur J Immunol. 2019;44(2):181-189. ↩