Plants with Dissociated Corticosteroids for Long Covid and Autoimmune Disorders
A potential route of therapy for the underlying inflammation?
Corticosteroid medications are really great. And really terrible. They do an amazing job of pulling down inflammation. And they have serious side effects that soon emerge and limit their overall usefulness.
Other posts at the Long Covid 411 review the evidence that many of the symptoms of Long Covid may be due to persistent inflammation (via mechanisms like Mast Cell Activation) and to persistent autoimmune activation. Glucocortisteroids like prednisone and dexamethasone are great for that… until a person gains 20 pounds, sees their blood pressure rise, gets high blood sugar and triglycerides, has dramatic mood swings, and develops bone or liver issues.
What if there were compounds that had most of the anti-inflammatory properties of corticosteroids, but few or none of the nasty side effects? That is one Holy Grail of the pharmaceutical industry. Some progress is being made in developing these “Dissociated Corticosteroids” that don’t quickly make a person very sick with side effects… but it may be another decade until anything is available from a pharmacy. But medical research shows that at least two plants have this dissociated corticosteroid effect.
This type of medicine might be very useful not only for people with Long Covid, but for anyone dealing with autoimmune conditions like lupus, rheumatoid arthritis, Hashimoto’s disease, or scleroderma.
In this article, those two plants will be briefly introduced, along with pointers to the evidence. In future posts, each will be considered in greater depth. You have probably heard of one of the plants: ginseng. The other is more obscure; it’s called saltwort.
Ginseng as a Dissociated Corticosteroid
I was first introduced to ginseng in the mid-1980s, and have used it off and on since then. It’s a useful herb. And it is poorly understood.
It’s common to see ginseng portrayed as an ‘energy booster’ in the west. If the reputation is to be believed, it is somewhere between caffeine and amphetamine in terms of its stimulating capacity. But that is mostly non-sense. Ginseng can sometimes increase energy levels or attention/mental focus - but it does so indirectly, by a number of disparate mechanisms.
Ginseng is also portrayed as an herbal version of Viagra. And again, the evidence shows that ginseng can sometimes help with male issues, but it does so indirectly, by improving underlying metabolic issues.
Here is the key research on ginseng having dissociated corticosteroid properties:
“Ginsenoside Rg1, a novel glucocorticoid receptor agonist of plant origin, maintains glucocorticoid efficacy with reduced side effects.” Journal of Immunology, 15 Jul 2011. PMID 21666059
The researchers detail that Rg1, a compound unique to ginseng behaves like corticosteroids, without the side effects. “ … Rg1 can effectively inhibit acute and chronic inflammation in vivo, but it does not cause hyperglycemia or osteoporosis as seen with dexamethasone. These results suggest that ginsenoside Rg1 may serve as a novel anti-inflammatory agent and may exhibit a potential profile for therapeutic intervention in inflammatory diseases.”
Several other studies support the idea that ginseng can reduce overactive immune activity, “ … primarily through glucocorticosteroid-like anti-inflammatory activity.” 1
Ginseng and the ginsenosides it contains have been shown to reduce mast cell activity and IgE signalling a variety of diseases. 2 3 4
One traditional idea about ginseng in Asia is that it should not be taken when fighting off a chest cold, as it can ‘drive it deeper.’ This is consistent with the idea that the herb may reduce immune activity, which sometimes is desirable, and sometimes excessive.
Salsola Saltwort as a Dissociated Corticosteroid
A second plant shown to work like corticosteroids without the side effects is Salsola komarovii. This plant is eaten as a seasonal vegetable in parts of Asia and is also used there as an herbal remedy. A closely related species with the common name of Agretti is eaten in the spring in Italy. Another nickname for this plant is “Monk’s Beard” due to the frilly, scraggily nature of the vegetable when it is cooked. These plants grow in salt marshes, but don’t need the salt - they can be cultivated in ordinary gardens.
Here is the key research:
“Anti-inflammatory effect of Salsola komarovii extract with dissociated glucocorticoid activity.” BMC Complementary Medicine and Therapies, 5 Jun 2020. PMID 32503533.
“Discovery of Compound A--a selective activator of the glucocorticoid receptor with anti-inflammatory and anti-cancer activity.” Oncotarget, 13 Jul 2015. PMID 26436695.
The Downshot?
So how much ginseng or saltwort is needed to bring inflammation down to a tolerable level and allow healing to take place? There’s no clear answer to that question. It has been shown that these plants contain valuable compounds, but the research did not provide clear clues as to whether normal consumption can provide enough to make a clear difference.
Ginseng is notable for having a variety of ginsenosides - Rg1 is only one of them. We don’t know if the other ginsenosides also have dissociated activity, or how much is needed. There is evidence that other compounds in ginseng also work in other ways to reduce excess inflammation, and that hasn’t been studied to the nth degree. If I had to make a prediction as to whether consuming a gram or three of ginseng per day is going to have a noticeable effect, it would be a clear ‘maybe, probably, possibly.’ The research does show an anti-inflammatory response from normal doses of ginseng, but it is not clear how much of it is from this mechanism and how much is from other actions in the body.
I have grown Salsola komarovii saltwort, and it is a delicious side dish that looks very nice on a plate next to cod and potatoes. Even if it doesn’t help with my family’s autoimmune conditions, I will keep growing a patch of it between the collards and celery. The recently described ‘Compound A’ in this species of saltwort is not incredibly complicated, I would not be surprised to see Compound A supplements come on the market in the near future if additional research shows that it indeed is helpful in inflammatory and immune/autoimmune issues.
Note: I don’t profit in any way from herbs, supplements, prescription medicines, or other potential therapies discussed in the Long Covid 411... I am not trying to steer anyone to buy any product. My goal is to present an accurate, unbiased analysis of the options for living with a challenging condition. This is the information I would give to my friends and family.
References
“Ginsenoside F1 Attenuates Eosinophilic Inflammation in Chronic Rhinosinusitis by Promoting NK Cell Function.” Journal of Ginseng Research, Nov 2021. PMID
“Fermented red ginseng and ginsenoside Rd alleviate ovalbumin-induced allergic rhinitis in mice by suppressing IgE, interleukin-4, and interleukin-5 expression.” Journal of Ginseng Research, 2019. PMID 34764724
“Gamma-irradiated black ginseng extract inhibits mast cell degranulation and suppresses atopic dermatitis-like skin lesions in mice.” Food and Chemical Toxicology, Jan 2018. PMID 29126802
“20(S)-Protopanaxatriol inhibits release of inflammatory mediators in immunoglobulin E-mediated mast cell activation.” Journal of Ginseng Research, Jun 2015. PMID 26199549