The Coptis Triad: Anti-Inflammatory, Metabolic Remediating, and Anxiolytic Actions
Written by Marc Wasserman Ph.D. L.Ac. Dipl.O.M.
Introduction
Coptis chinensis (HuangLian) is a powerful heat-clearing medicinal. It is effective against a variety of bacterial, fungal and viral infections; and its anti-inflammatory action can be used to combat inflammation from either infection or auto-immune conditions.
It is especially effective in cases of diarrhea, nausea, fever, and swelling or abscess formation. Thus it is a go-to selection for inflammatory conditions of the lower and upper digestive tract.
It is also a strong anxiolytic, useful for its calming effects--leveraging the reciprocal pathway between the gut microbiome and neurochemical secretions in the brain.
And coptis is frequently used for metabolic disorders–it has a hypoglycemic, insulin-sensitizing action.
Coptis chinensis is the most commonly used variety, others native to Asia are Coptis deltoidea, and Coptis teeta. And in North America, Coptis laciniata and Coptis occidentalis. All of these have common (place + goldthread) names: Chinese, Yunan, Japanese, Oregon, and Idaho goldthreads…
Research
With over 1700 articles in the Pubmed database and more than 20 NIH-grant studies, coptis is one of the more heavily researched plant medicinals.
15 phytochemical extracts have so far been identified. Berberine is the most looked into for explanations of coptis’ pharmacological effects.
Here are some of the highlights of berberine research:
Berberine restores and supports enteric glial cells and intestinal epithelial cells. This restructuring of the intestinal lining protects from further injury and prevents a perpetual cycle of inflammation.
A phase I trial of berberine showed decreased inflammation of tissues in the colons of mesalamine-treated ulcerative colitis patients.
And for metabolic conditions, compared against standard treatment metformin, berberine was equally effective in all measures of glucose control (A1c, fasting and post-prandial glucose and insulin) and superiorly effective on lipid markers(triglycerides and cholesterol).
Likewise, berberine promotes GLP-1 release, an increasingly popular target for treating metabolic syndrome and obesity.
However clinical effects cannot solely be credited to berberine. Here are some research findings on coptis’ other phytochemicals:
The isoquinolone alkaloid palamatine controlled inflammatory cytokines and increased glutathione and superoxide dismutase, simultaneously minimizing inflammation and accelerating healing. It also protects against atherosclerosis via modifications to gut microbiota and metabolism.
Another coptis alkaloid, jatrorrhizine restored gastric emptying and intestinal transit in post-operative ileus.
And the alkaloid coptisine, helped lower inflammatory cytokines, healing psoriatic skin lesions and reducing anxiety behavior in animal models.
These studies show some of the mechanisms, the gears that turn down overactive inflammatory pathways; nonetheless, it is the full entourage of all phytochemicals that is most powerful.
Innovative research demonstrates how the full array of Coptis alkaloids work via multiple pathways, synergizing into a powerful anti-inflammatory in the treatment of multiple types of arthritis.
And there are other studies, showing how full spectrum extraction of HuangLian was superior in restructuring the gut microbiome and regulating hepatobiliary metabolism, lowering glucose, and decreasing hyperlipidemia.
Prescription Formulas
In East Asian medicine, preferring whole plant materials over isolated ingredients is taken even a step further by forming multi-ingredient plant medicinal compounds. Thus increasing efficacy, maximizing safety, and avoiding resistance.
Three well-known compound formulas that include coptis are:
ZuoJinWan from the physician Zhu DanXi (1281-1358CE). It is a two-ingredient combination, Coptis and Evodia. Described in classical texts as “clearing and draining liver fire;” the current understanding is that it relieves nausea, reduces inflammation of the upper and lower GI tract, clears out harmful bacteria, and improves gastrointestinal function and motility. In recent years, multiple studies have looked at its anticancer mechanisms and usage in colon cancer treatment(1, 2).
An even more ancient formula, Huang Lian Tang from the foundational text “Discourse on Damage Due to Cold” (ShangHanLun) by Zhang ZhongJing (150-219CE) is the combination of Coptis and six other medicinals to enhance the gastroprotective effects, restore healthy digestive secretions, regulate motility and protect endothelial lining. It is used clinically for gastritis, peptic ulcers, acute/chronic diarrhea, and abdominal pain associated with gastrointestinal spasms and inflammation.
In the formula HuangLianJieDu Tang, Coptis is combined with the heat-clearing medicinals Scute, Phellodendron, and Gardenia fruit to bolster and broaden its anti-inflammatory, anticancer, hypoglycemic, and anxiolytic effects.
In the modern era of East Asian medicine, it is important to remain focused on correct dosing and proper pairing with other plant medicinals to elicit the best effects. Research into the chemical structure of Coptis provides insight, but best practices on clinical use of Coptis continue to be its use as a whole plant material and in combination with supportive plant medicinals.
Here at Flow Heath Clinic, we rely heavily on Coptis for the trifecta of gastroprotective, metabolic restoration, and anxiolytic effects. For GI tract inflammation it is a must-have ingredient. For weight loss, insulin resistance, and hyperlipidemia it is a powerful tool. And for anxiety and insomnia relief it is a helpful addition.
Thus it is a frequent ingredient in prescriptions for many of our patients. Schedule a consultation to discuss how a custom plant-based prescription can help you.
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