What if phytotherapy benefits were in fact microbiotic

The history of medicinal plants is inseparable from the one of Humanity. We think about Antiquity, but this link goes back to much longer since we find traces of medicinal plants in prehistoric skeletons’ teeth. Given the taste of those plants and their low nutritional value, the most likely hypothesis is that prehistoric men ingested it for “health purposes.” Regardless, the ingestion of medicinal plants is deeply rooted in the traditions of various human cultures.

Even if this practice has long taken empirical or even esoteric forms, the advent of pharmacognosy has made it possible to shed light on the active compounds present in these plants and their potential action mechanisms. Nowadays, many of these plant compounds are drugs. As for other medicinal plants, the links between tradition and molecular mechanisms are better and better identified. Today, Phytotherapy and Aromatherapy can claim to have become Sciences.


However, a bias exists: attempting to explain the efficacy perceived empirically by exclusively pharmacological data. Based on this paradigm, medicinal plants would be sources of various active molecules acting on several pharmacological targets but with less intensity than a purified molecule (thus giving several nudges rather than a punch effect). In other words, Phytotherapy could be summed up as a form of “gentle polypharmacology.” As Science progress, another explanation seems to emerge.

1. MEDICINAL PLANTS & MICROBIOTA

As scientific discoveries progress, we observe three particularly fascinating elements:

  • We discover more and more plants with multiple health benefits going beyond the usual properties recognized by tradition. Thus, more and more medicinal plants are identified as playing on stress, blood sugar, memory, immunity, and digestive disorders.
  • The intestinal microbiota is at the heart of numerous studies highlighting its multiple virtues. Particularly on stress, blood sugar, memory, immunity, and digestive disorders.
  • We also know that several ingested phytomolecules have a significant positive impact on the intestinal microbiota. Polyphenols, triterpenoids, and other secondary metabolites are increasingly identified as influencing the relationship between the body and the microbiota.
This triple perspective obviously opens the way to many opportunities for medicinal plants in the context of health. It also invites us to take a new look at what herbal medicine is truly about and how it differs from classic pharmacology. What if phytotherapy would be far from a simple direct action on human physiology? What if it also played a role, even more important, of mediator between the body and its intestinal microbiota?

1.1. The case of adaptogenic plants

Adaptogenic plants are considered to stimulate resilience to the environment (immunity, stress, fatigue, cognition, etc.) in a global and non-specific way. However, we have to consider that this definition remains exceptionally vague on the molecular mechanisms which lead to this result.

It is fascinating to note that most adaptogenic plants are characterized by the presence of main active molecules (ginsenosides for ginseng, salidroside for Rhodiola, withanolides for Ashwagandha, etc.) but also specific and beneficial polysaccharides (ginsans for ginseng, turmerosaccharides for turmeric, etc.) which could well play a role of prebiotics. Many adaptogenic plants are also roots (part of the plant classically rich in polysaccharides).

Finally, we also need to add that when an adaptogen is extremely qualitative, its “health potential” extends from the immune sphere to the neurological sphere, including the metabolism of sugars and lipids. These primary health areas are reminiscent of health themes related to the microbiota (Immunobiotics, Neurobiotics, Metabiotics, etc.).

Therefore, it is quite realistic to think that adaptogenic plants are actually medicinal plants whose molecular profile is particularly effective at the microbiota level. This synergy between direct physiological activity and microbiotic activity leads to an overall and lasting health potential, incredibly beneficial.

1.2. The case of medicinal mushrooms

Medicinal mushrooms have been treasured in Asia for millennia. The Western world seems to be behind on this aspect of “Natural health.” However, the interest in fungi and their active molecules continues to grow (some are even now considered adaptogens). However, medicinal mushrooms like Reishi (Ganoderma lucidum), Hydne hedgehog (Hericium erinaceus) or Cordyceps (Cordyceps militaris or sinensis) are characterized by their richness in polysaccharides, as well as by the presence of other secondary metabolites (just like adaptogenic plants). It is thus evident that medicinal mushrooms are not only adaptogens but that they could also be microbiotic regulators. Moreover, they are identified as having immune, nootropic, or even metabolic properties.

Once again, everything seems to indicate that herbal medicine, or rather mycotherapy in this case, has everything a microbiotic approach to health.

2. ANSWER TO MANY QUESTIONS?

The growing number of indications for microbiotic herbal medicine is not the only striking element. Thus, many questions could well find their answer in this perspective.

2.1. Less frequent side effects

For a long time, the idea that medicinal plants can provide significant health benefits without inducing any side effects appeared to be counter-intuitive. Later, it has been realized that side effects are possible, but at every large doses and in particular contexts (weakened and/or multiple-medicated person).

On a microbiotic angle, this paradox is not really one. As a matter of fact, if a major part of the influence of the medicinal plant is on the microbiota and not directly on the organism, the latter will mitigate the potentially problematic impact by “buffering.”

2.2. A “normalizing” activity

Another aspect of herbal medicine that has long been considered atypical is the “normalizing” activity. In other words, medicinal plants would have a physiological effect that would be more significant in people prone to an imbalance (glycemic, hormonal, etc.) than in people without any apparent problem.

Once again, the microbiotic hypothesis comes here to provide a simple explanation: if the main target is not pharmacological but microbiotic, it will be rebalanced in the event of a health problem. So the plant will only strengthen this balance if the microbiota did not present a problem.

2.3. Pharmacological action vs Physiological benefits

Many European experts consider that the regulatory boundary between plant nutraceuticals and traditional pharmacology is tenuous. Indeed, European legislation specifies that, unlike a drug which acts through pharmacological activity, the food supplement can only have a physiological effect. It can neither prevent pathologies nor cure them, but can on the other hand, “maintain good health” (note that between “prevent pathologies” and “maintain good health,” the difference appears more semantic than anything else).

However, seeing the data showing the positive impact of many phytomolecules on the intestinal microbiota, we can say that the explanation may lie in this “indirect” activity on health. Indeed, just like our food, medicinal plants can influence our microbiotic balance and thus act more globally and diffusely on our physiology. Therefore, we are in the Healthy Food (certainly particularly active) rather than in the alternative medicine.

2.4. An explanation of the “detox effect”?

Many plant extracts are presented as “detoxifying.” This empirical application is widely recognized in the world of naturopathy. However, the scientific explanation underlying this hypothetical detoxifying action remains unknown. Even worse, the very concept of a toxic accumulation in the body that would be released by a modulation of liver activity remains more than uncertain.

However, in the light of the microbiotic balance, this “detoxifying” dimension takes on its full meaning. Indeed, it has been shown that the microbiota and its interactions with the body could play on the hepatic metabolism, on the amount of bile and its bile acid composition, as well as on most of the symptoms that the detox effect intends to “resolve.”

It should also be noted that many detoxifying plants (like adaptogenic plants) show roots rich in polysaccharides (Burdock, Dandelion, Black radish, etc.) and that those not showing interesting roots are known to be rich in bitter compounds. Those compounds will, in particular, modulate the content of gastric juice and / or intestinal mucus and thus have a significant impact on the microbiota.

3. WHAT IMPACT FOR TOMORROW’S PHYTOTHERAPY?

3.1. The “best” is sometimes the enemy of the good

By taking the pharmacological approach as a benchmark, nutraceutical innovation has recently focused on 2 specific aspects to determine the potential of a product formulated with medicinal plants: the concentration of active molecules of the ingredients and the bioavailability of the active molecules.

To obtain a particularly effective plant extract, there will be a tendency to identify the molecule considered active and concentrate it to the maximum or even purify it. According to this postulate, the selected molecule is considered the only active ingredient, and the rest of the composition is viewed as an excipient, a plant matrix. Yet this matrix very often contains polysaccharides, which, when you take the trouble to study them, also carry a “health potential.” This bias reminds us of fruit juices, which were said to be “rich in vitamins” before realizing that the fibers lost during pressing played a significant role in the fruit’s health benefits.

As for the question of bioavailability, it often comes down to a desire to absorb the active molecules as quickly as possible. However, the latter could well have maximum activity when they come into contact with the microbiota. A glaring example is that of the pomegranate punicalagin. These molecules, which are more massive than their ellagic equivalent, are too big to have a high absorption rate. But this apparent disadvantage gives them increased efficiency. They have a beneficial action on the microbiota and are converted into Urolithin A (active metabolic agent of punicalagins and elagic acid) to act more directly on the body.

In microbiotic phytotherapy, the terms “full-spectrum” or “totum” take on their full meaning. It also invites us to rethink the way galenic and matrices are designed.

3.2. The holistic approach is a microbiotic approach

At a time of ever more extensive personalization of care, it appears, however, that many natural methods act globally on health, rather than being confined to a targeted curative or anti-symptomatic effect. The holistic approach is thus increasingly popular, especially for chronic health problems. Examined through the prism of microbiotic herbal medicine, this phenomenon takes on a whole new dimension.

Naturopaths are probably the first microbiotherapists in the health landscape of tomorrow. When they refer to considering the whole patient, they also (and perhaps most importantly) consider the relationship between the body and its microbial alter ego. The holistic approach by acting at all possible levels to harmonize this relationship (food, micronutrition, herbal medicine, etc.) would then be a source of overall health rather than a therapeutic approach. Knowledge about the microbiota in the context of health and tomorrow’s diagnostic tools could well propel these holistic approaches to the level of cutting-edge therapeutic support.

3.3. Nutraceuticals & Nutrition are intimately linked

The first source of microbiotic balance is probably food. In doing so, a synergy between Nutrition and Phytotherapy could well lead to more than promising results when medicinal plants are selected based on their microbiotic benefits rather than by a conventional approach. Thus, medicinal plants could prove to be of great use to nutritionists. Conversely, phytotherapists could probably significantly amplify the impact of their recommendations. The Nutrition / Nutraceutical duo could well represent the foundation of tomorrow’s health, part of a sustainable approach.

The pharmacological properties of phytomolecules are now proven and pharmacognosy becomes todays’ scientific basis on which modern phytotherapy relies on. Therefore, this article does not aim to question whether plants have a direct action on the body. Instead, it is an invitation to change perspective to embrace medicinal plants’ use as a whole. In doing so, some experts might realize that many of their beliefs and experiences have a surprising scientific basis, far removed from classical pharmacology.