Sarsaparilla Consisting of the dried root of various species of the genus Smilax that

Sarsaparilla Consisting of the dried root of various species of the genus Smilax that

grow in Mexico and Central America, the technical nomenclature of these vining plants is extremely confusing. It is expeditious, therefore, to refer to them by the botanical origins assigned when the drug was last listed in the official compendia in 1965; prior to that time, sarsaparilla had been monographed in the USP and NF for 145 years. Mexican sarsaparilla is obtained from Smilax aristolochiaefolia Miller; Honduras sarsaparilla from S. regelii, Killip & Morton; Ecuadorian sarsaparilla from S. febrifuga Kunth; and Central American sarsaparilla from other undetermined Smilax spe- cies of the family Smilacaceae. 36

204 Tyler's herbs of choice: The therapeutic use of phytomedicinals Originally, the botanical enjoyed an undeserved reputation for the

treatment of syphilis. Later it began to be used as a flavoring agent for pharmaceuticals and for soft drinks (root beer). In recent years, it has been extensively advertised in bodybuilding publications as a natural source

of testosterone and a legal replacement for illegal androgenic steroids. 37 Some suppliers claim that sarsaparilla actually contains testosterone; oth- ers imply that it increases testosterone levels in the body following con- sumption. Neither assertion is true.

Sarsaparilla does contain several steroids, including sarsapogenin and smilagenin, as well as their glycosides (saponins), which can serve as precursors for the in vitro production of various steroidal drugs. However, these compounds themselves do not function as anabolic steroids and there is no evidence that they or any other sarsaparilla constituents are converted directly to anabolic steroids in the human body. Testosterone itself does not occur in sarsaparilla or in any higher plant.

As if this were not deception enough, it was reported in 1988 that for the ten previous years some commercial herb products labeled sar- saparilla contained instead Hemidesimus indicus R. Br., a plant sometimes referred to as false sarsaparilla or Indian sarsaparilla after the country of

origin. 38 Belonging to an entirely different plant family (Asclepiadaceae), this substitute contains neither the same saponins nor the other principal constituents found in authentic sarsaparilla. The latter must be obtained from Smilax species originating in tropical America.

At present the only legitimate use of sarsaparilla is as a flavoring agent. It has no utility as a performance or endurance enhancer. Because its utility is so often misrepresented and another drug is often substi- tuted for it, the facts concerning sarsaparilla are presented here as a mat- ter of record.

Sassafras Another herb that cannot be recommended but is still widely used by lay persons as a tonic or performance enhancer and must therefore be men- tioned is sassafras. As is the case with sarsaparilla, this native American herb, the root bark of Sassafras officinalis Nees & Eberm. (family Lauraceae), was originally recommended as a cure for syphilis. Although sassafras proved ineffective in this regard, it retained its ancient reputation, which became euphemistically expressed as a “blood purifier.” In modern par- lance, the herb is said to function as a tonic or performance enhancer; in fact, sassafras has been known for more than two centuries to be without significant therapeutic utility. 39

Sassafras root bark contains 5–9 percent of a highly aromatic oil of which about 80 percent is safrole, a phenolic ether. In 1960, safrole was shown to

be carcinogenic in rats and mice, and both sassafras volatile oil and safrole were prohibited by the FDA from use as food additives or flavors. 40 In 1976,

Chapter eleven: Performance and immune deficiencies 205 bark sold for making sassafras tea was also banned. Nevertheless, the bark

is still an article of commerce and is commonly, but unwisely, used as a pleasantly flavored spring tonic. For this reason, the herb is mentioned here, in spite of the fact that it is both unsafe and ineffective.

Ashwagandha Another herb with purported performance-enhancing effects is ashwa- gandha. The dried root of Withania somnifera Dunal (family Solanaceae) is

used extensively in Ayurvedic medicine as a tonic. Ayurveda has enjoyed considerable popularity in the United States during recent years, and sev- eral herbs used in its traditional healing practices are currently available in tablet form. Ashwagandha is one of these.

Wagner and colleagues have reviewed the evidence supporting the herb’s adaptogenic activity. 41 Although preliminary tests in small animals indicate that several contained steroidal derivatives known as sitoindo- sides may produce some positive effects, substantial clinical evidence obtained from human studies is lacking. Until this is forthcoming, ashwa- gandha cannot be considered a useful adaptogen or tonic.

Cordyceps

A botanical of unusual origin is cordyceps. It is a fungus, Cordyceps sin- ensis (Berk.) Sacc. (family Clavicipitaceae), that parasitizes certain adult caterpillars in the high-mountain regions of China. Historically, this cat- erpillar fungus has been used in Chinese medicine to aid kidney function, enhance endurance, speed recovery from exhaustion, and promote lon- gevity; however, the rarity of the fungus prevented its widespread use.

Recently, fermentation methods have been developed in China that allow the production of pharmacologically active fungal cells in culture. This fungal cell product has been extensively investigated in China, where it is used for the treatment of chronic bronchitis, kidney disorders, lethargy, and male sexual dysfunction. In the United States, it is marketed as an adaptogen to enhance stamina, reduce symptoms of fatigue, and energize body systems. The active constituents of the fungus have not

been identified. 42 In addition, the scientific and medical literature is lack- ing in clinical studies to support these uses of the drug; consequently, at the present time its effectiveness as an adaptogen remains unproven.