herbs for stroke recovery
the general approach for stroke recovery involves reducing cell death, improving resilience to reduced oxygen, improving neuronal re-growth, improving circulation to the brain, as well as secondarily supporting emotions and psychological distress
there are two main types of stroke,
ischemic : meaning that generally a clot has blocked a blood vessel and lead to reduced oxygen flow. Depending on how long the clot remains, there could be damage on the other side of the pathway of the blood vessel from hypoxia, And hemorrhagic : this meaning that the wall of a blood vessel has burst and caused bleeding.
Before we begin on the herbs, some key parts of adult neurogenesis include; acetylcholine (essential for memory and learning); aerobic exercise has the potential to double new neuronal cells in the hippocampus (learning region); flavonoids and resveratrol are plant compounds that have been associated with nerve regwroth, as well as B-vitamins which support myelin sheath regrowth, and alpha-lipoic acid. This is not an exhaustive list and neurogenesis is extremely complex.
NGF (nerve growth factor) obviously increases nerve growth, and it has an apparent symbiosis with neurogenic substances as listed above. It’s an endogenous hormone, but how do we increase it? Through adequate protein and fat intake qnd B-vitamins. There is such thing as an oral nerve growth factor, but it’s ineffective as it’s a large protein and does not cross the blood brain barrier. Don’t waste your money on this supplement.
One tricky part of choosing the right herbs for post-stroke recovery is the fact that most people will be put straight onto anticoagulants to thin the blood and prevent further clots, and/or anti-hypertensives to reduce the chance of a haemorrhage.
These class of drugs notoriously interact with a large amount of herbs, including the most effective at nerve regrowth and blood vessel protection.
what I found is that saponins in plants are the most important compound associated with neurorptection and vascular-protection, unfortunately, this is also the compound that directly interacts with anticoagulant and blood pressure medications - that’s the reason for such a big list of stroke-herb and stroke-drug interactions
The following herbs do not interact with (or have a very low interaction with) anticoagulants / blood pressure medications. You should ALWAYS double check with your doctor.
rosemary - suggested to be able to improve electrophysiological function in nerves and accelerate nerve regrowth https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11068989/
cenetella - has been shown to enhance neurogenesis, up-regulate brain-derived neurotrophic factor, and can protect neuronal cells against injury from hypoxia. Studies show that treatment with centella is related to longer neurite length.
lavender - an antagonist to AMPA receptor. In ischemic stroke, the restricted blood supply leads to an ‘energy failure’ message that activates excessive glutamate to be produced (which is an excitatory neurotransmitter and is tying to excite the brain into functioning) , this glutamate triggers a prolonged and large amount of AMPA receptors which in turn makes them more permeable to calcium, and this increased calcium influx into the cells causes damage. AMPA receptor antagonists reduce the excitation of the AMPA receptors, and the thus the damage of inter-cellular calcium
parthenolide isolated from feverfew - interestingly, parthenolide, an alkoid from feverfew has shown to be effective at inhibiting apoptosis and nerve degeneration. It has been researched in sciatic and spinal cord injuries.
bacopa - can increase acetylcholine (ssocicated with learning and memory, and often deficient in cognitive decline), and improve signalling molecules at the synapses. It has a great effect on general memory and cognition and can also improve functional markers like amount of neuronal stem cells.
Next, lets quickly look at the role of essential oils - they’re one of the few compounds that can cross the blood brain barrier nasally.
Lavender and bergamot have shown to reduce neural death and damage.
Ok, now lets look at the herbs I WISH i could give to everyone post-stroke, the strongest herbs for neurogenesis and neuroprotection, but which are CONTRAINDICATED WITH ANTICOAGULANTS;
bilberry / blueberry - contains flavonoids and anthocyanins that, as we’ve already covered, are very protective to blood vessel integrity. Mainly through reducing things that damage them like oxidation and inflammation. These compounds can also enhance endogenous production of brain-derived neurotrophic factor.
gingko - delivered intravenously in Chinese hospitals for its strong anti-platelet activity. It can prevent blood platelets from binding and creating clots. It’s a strong anti-apoptosis and stops cell-death. It improves circulation to the brain and expands brain-blood vessels, and it improve brain cell tolerance to hypoxia. Patents who received intravenous gingko in 48hrs post-stroke saw cognitive improvements over 90 days compared to placebo.
scutellaria baicalensis - has been shown to regulate necropolis (programmed cell death) and mitigate ischemic injury as well as reduce hippocampal neuronal damage post-stroke, this was all in acute, controlled intervention of a stroke though.
dan shen - appears to have a strong reputation in post-stroke and theoretically could work well as it improves the integrity of capillaries, however, two literature reviews of the current RCT’s both show that most of the studies done on dan shen are unreliable, and the jury’s still out https://pubmed.ncbi.nlm.nih.gov/15644072/
lions mane - is very well studied to show it can increase nerve-growth factor and support neurogenesis. It’s been shown to decrease neuronal death and in a pre-treatment for 5 days before ischemic stroke, it reduced total neuronal death by 44%. Overall, lion’s mane is the most well studied and the most promising at supporting nerve regrowth post-stroke.
paeonia lactiflora - shown to improve nerve regeneration in a severed sciatic nerve model https://www.researchgate.net/publication/352144308_Effect_of_herbal_extracts_on_peripheral_nerve_regeneration_after_microsurgery_of_the_sciatic_nerve_in_rats moderate antagonist of anticoagulants
Panax notoginseng - shown to repair and improve damaged neurones and increase quantity and quality of surviving cells. The saponins induce neurogenesis, improve cell proliferation and differentiation ,and up regulates brain-derived noeurotrophic factor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236302/ . It’s from the same panax family as ginseng, but contains more saponins and volatile oils, whereas the more famous pan ginseng contains more polysaccharides and amino acids. Technically no studies to show that it does interact and warfarin is often combined with panax saponins as a cardiovascular treatment.
and a final comment on COQ10 - it’s an essential nutrient that is often depleted in both elderly and post-stroke / chronic disease states. It’s safe to combine with statins and has a good amount of evidence to show it improves oxidative stress and neurodegenration as associated with stroke.
