Park Orchards Health & Wellbeing Centre

20/08/2026

A recent randomised, double blind, placebo-controlled, parallel-group trial provides one of the stronger recent clinical evaluations of orally administered gotu kola (Centella asiatica) for skin ageing, although several limitations should be considered when interpreting its clinical significance. The study enrolled 112 Korean women aged 30 to 60 years with visible facial wrinkles and relatively dry skin. After exclusions, the per-protocol analysis included 53 participants receiving gotu kola and 52 receiving placebo. The intervention lasted 12 weeks and compliance exceeded 94%.

Participants received 200 mg daily of a spray-dried hydroethanolic extract of gotu kola leaves, taken as a single oral tablet 30 minutes after a meal. The extract was prepared using 70% ethanol and standardised to contain 7% asiaticoside (70 mg/g). Although the authors acknowledged the presence of other important triterpenes, including madecassoside, asiatic acid and madecassic acid, their concentrations were not reported. The publication did not provide the extraction yield or drug-to-extract ratio, so the equivalent amount of starting dried leaf material cannot be determined. However, typical hydroethanolic extraction results suggest that 200 mg of extract could correspond to approximately 0.8 to 1.3 g of starting leaf.

After 12 weeks, participants receiving the gotu kola experienced statistically significant improvements in several objective wrinkle parameters compared with placebo. Average wrinkle depth decreased by 11.1%, largest wrinkle depth by 14.4%, maximum wrinkle depth by 13.3%, total wrinkle volume by 13.7%, and surface roughness by 10.4%. Skin barrier function also improved, as demonstrated by a significant reduction in cheek transepidermal water loss, indicating enhanced barrier integrity. Cheek skin hydration increased significantly relative to placebo, although improvements at other body sites were smaller and inconsistent.

Statistically significant improvements were also observed in skin elasticity and skin brightness, but these changes were very small, approximately 0.7%, making their clinical relevance uncertain. The intervention was well tolerated, with no serious adverse events reported, and liver function, renal markers and haematological parameters remained within normal limits throughout the study.

The study has several notable strengths. It employed a rigorous randomised, double blind, placebo-controlled design, which was adequately powered for its primary endpoint, achieved high compliance with low dropout rates, and relied on objective instrumental assessments, rather than the subjective cosmetic evaluations that are mostly used in such trials.

However, important limitations temper confidence in the findings. The study was funded and conducted by the manufacturer of the commercial extract, introducing the possibility of sponsorship bias. The primary analysis was conducted on a per-protocol rather than an intention-to-treat basis, which may overestimate treatment effects. Apart from the wrinkle measurements, most statistically significant improvements were numerically small.

While no one should confuse an oral herbal extract with injectable cosmetic procedures, these findings do tempt one to describe gotu kola as "Botox in a bottle"—a tongue-in-cheek nickname from a colleague that is now reflected in its measurable ability to soften wrinkles naturally. The dose used in the trial was relatively low, implying that even better results might be obtained from prescribing normal doses of this herb.

For more information see: https://pubmed.ncbi.nlm.nih.gov/42196964/

13/08/2026

10/08/2026

Can confirm something we were already hearing about 6 years ago in our Update in Under 30 episode on IV Fe - Ferric carboxymaltose (FCM) is bad to the bone ☠️
Independent of your age, s*x, renal health or baseline BMD! And the risk is not restricted to those who experience hypophosphataemia! And yes it is the most common form in use in Australia & around the world!
We should be discouraging its use and all IV administration unless truly indicated. Do you know how often it is actually indicated? Less. Far less than it is being recommended.
Yet another potent illustration of how form determine function and dose delivers the medicine/poison - all our Nutrient Prescriber teachings! The research by Wagner et al is extremely sophisticated - composed of 2 different human studies along with animal and in vitro evidence,
Well worth the read 🔗https://ashpublications.org/blood/article/148/1/15/567279/Ferric-carboxymaltose-increases-fracture-risk-in
HealthEd - if you can access did a great editorial on this

02/08/2026

The 2024 WHO review on mobile phones and cancer risk didn't lie about the data. It just stopped charting it early.

The review's own graphs cut off at around 1,400 hours of phone use. But one of the studies in that same review showed close to triple the brain tumour risk above 2,376 hours.

That data point exists. It's in the review's reference list. It's just not in the picture anyone's shown you.

If you left the heaviest smokers out of a lung cancer study, what would you conclude?

I go through exactly where the line was drawn, who drew it, and why — full breakdown on YouTube this week. Link in bio.

Once you know, you cannot unknow.

25/07/2026

Thank you dear Nicole Bijlsma. You are such a super star, and we all appreciate your hard work and expertise ✨

22/07/2026

More research is needed, but this is very promising 🌱❄️🌱

A randomised placebo-controlled trial examined whether peppermint oil could improve blood pressure and related cardiometabolic outcomes in adults with pre- and stage 1 hypertension. Forty participants were randomised to receive either peppermint oil (50 μL (about one drop) twice daily diluted in water; total 100 μL/day) or a peppermint-flavoured placebo for 20 days. The primary endpoint was systolic blood pressure (SBP), with secondary outcomes including diastolic BP, resting heart rate, anthropometry, lipids, glucose, psychological wellbeing and sleep indices.

The main finding was a statistically and clinically meaningful reduction in blood pressure in the peppermint group. Adjusted systolic BP fell by 8.48 mmHg versus placebo (p=0.005; effect size d=−0.94), while diastolic BP fell by −4.57 mmHg (p=0.043) and resting heart rate by −8.92 bpm (p=0.041). Mean SBP in the peppermint arm dropped from 130.1 to 122.0 mmHg over only 20 days, whereas the placebo group remained essentially unchanged. These are surprisingly large effect sizes for such a brief low dose herbal intervention, particularly given that many lifestyle interventions struggle to produce an 8 mmHg SBP reduction in three weeks.

Mechanistically, the authors speculate that menthol-mediated activation of TRPM8 receptors. TRPM8 receptors (Transient Receptor Potential Melastatin 8 channels) are temperature- and chemical-sensitive ion channels. Activated by cool temperatures and compounds such as menthol, they allow calcium and sodium ions to enter cells, generating sensory and physiological signalling responses. TRPM8 receptors are expressed in vascular tissue, autonomic sensory nerves, the gastrointestinal tract and parts of the nervous system, where they appear to play broader regulatory roles. In blood vessels, TRPM8 activation may promote vasodilation through endothelial calcium signalling, nitric oxide production and relaxation of vascular smooth muscle, while also potentially influencing autonomic balance by enhancing parasympathetic activity and reducing sympathetic tone. From a broader systems perspective, TRPM8 receptors can be viewed as environmental and phytochemical sensing channels that help integrate thermal perception, vascular tone, autonomic regulation and protective reflexes. Peppermint’s physiological effects likely extend beyond simple flavour or sensory stimulation into these wider neurovascular signalling networks.

Assessed biochemical parameters, including total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glucose and the triglyceride-glucose index, were not significantly altered by peppermint treatment compared with placebo.

The study had several strengths. It was preregistered, placebo-controlled and reasonably well blinded, with only 47% correctly guessing allocation, suggesting the placebo strategy was effective. Compliance was high (93%), attrition was very low, and dietary intake appeared stable between groups. The investigators also appropriately used baseline-adjusted regression models and intention-to-treat analysis with imputation for missing data.

However, several limitations temper the study’s findings. First, this was a very small pilot-style study (n=40, effectively n=38 completers), meaning the impressive effect sizes may partly reflect random variation, or exaggerated small-study effects. The confidence intervals were relatively wide. Second, the intervention duration was short at only 20 days. Blood pressure is inherently variable, and short-term reductions do not necessarily translate into durable antihypertensive effects. The authors themselves also acknowledged that longer studies with ambulatory blood pressure monitoring are needed. On that last point, the study used standard clinic-style BP measurements rather than 24-hour ambulatory monitoring, which is now considered more robust in hypertension research because it reduces white-coat effects and day-to-day variability.

Overall, this is an intriguing and surprisingly positive proof-of-concept study suggesting peppermint oil may have genuine vascular and/or autonomic effects capable of significantly lowering blood pressure in mild hypertension. The effect size is large enough to warrant further investigation and is certainly biologically plausible. One wonders what the impact on BP might be from higher doses, for example of peppermint oil capsules (enteric-coated to reduce the risk of gastro-oesophageal reflux). These are readily available as treatments for irritable bowel syndrome and typically contain 0.2 to 0.4 mL per capsule.

These findings also raise the intriguing possibility that peppermint oil may exert broader physiological effects beyond simple vasodilation, potentially helping to moderate aspects of “sympathetic dominance” through TRPM8-mediated influences on vascular tone and autonomic balance.

For more information see:
https://pubmed.ncbi.nlm.nih.gov/42024666/
https://www.lancashire.ac.uk/news/peppermint-oil-blood-pressure

22/07/2026

THC-CBD Combination Reduces Agitation in Advanced Dementia
🌱🌱🌱

18/07/2026

Possibly one of the best medicines 🍻

13/07/2026

🧡💛🧡💛🧡💛🧡

A new 12-week randomised, double blind, placebo-controlled trial has provided the strongest clinical evidence to date supporting saffron as a treatment for low mood and depressive symptoms (subclinical depression). Enrolling 202 adults aged 18 to 70 years, it is the largest clinical trial ever conducted on saffron for mood disorders and probably the most methodologically rigorous saffron study published to date.

The study used a proprietary saffron extract at a dose of 28 mg/day. Subclinical, subthreshold, or minor depression is defined as the presence of depressive symptoms but without fulfilling all the diagnostic criteria for major depressive disorder (MDD). Although participants in the trial did not have formally diagnosed MDD, their baseline DASS-21 (Depression, Anxiety and Stress Scale-21) scores averaged around 22, placing many in the severe symptom range despite being classified as ‘subclinical.’ At the same time, the cohort was relatively medically uncomplicated, with exclusions for major psychiatric diagnoses, significant medical illness, heavy alcohol use, smoking, ongoing psychotherapy and several medication classes, thereby creating a low-mood population largely free of potential confounders.

The primary outcome showed a statistically significant antidepressant effect favouring saffron. DASS-21 scores fell by 11.34 points in the saffron group compared with 8.42 points in the placebo group, producing a modest but clinically meaningful between-group effect size (Cohen’s d = 0.39, P = 0.010). Particularly noteworthy was the responder analysis: 72.3% of saffron-treated participants achieved a clinically meaningful reduction of at least 7 points on the DASS-21 depression scale compared with 54.3% in the placebo group (P = 0.010). However, the study also highlighted the enormous placebo responses that can be seen in low-mood trials. Much of the improvement occurred in both groups during the first 4 weeks, suggesting strong expectancy and nonspecific trial-participation effects.

Importantly though, the placebo response largely plateaued thereafter, whereas the saffron group continued gradual improvement across the full 12 weeks. This temporal divergence arguably strengthens the credibility of the findings because it suggests saffron may exert a progressively accumulating physiological effect rather than simply producing a short-lived expectancy response. Even longer treatment durations may have resulted in a larger separation between saffron and placebo.

Saffron did not significantly outperform placebo on most secondary measures including anxiety, stress and general wellbeing, although favourable trends were observed. The sleep findings were particularly interesting. Overall sleep outcomes were not statistically significant across the entire cohort, but exploratory subgroup analyses revealed meaningful improvements in participants with more substantial baseline sleep disturbance. In these participants, effect sizes for sleep improvement approached or slightly exceeded those seen for depression itself (d = 0.44). This suggests saffron’s sleep effects may be conditional and phenotype-dependent rather than universally sedative. The study also strengthened its methodological credibility by applying several observances: adjusting analyses for treatment expectancy effects, using intention-to-treat and per-protocol analyses, and incorporating daily mood ratings across the study duration.

The safety profile was excellent, with over 95% of participants rating tolerability as good or excellent and only a handful of mild treatment-related adverse events reported, including headache, abdominal pain and itchy skin. Overall, this landmark study substantially strengthens the evidence base supporting saffron as a genuine antidepressant phytomedicine, while simultaneously illustrating the profound challenge of the placebo response in mood research. But to my thinking, the very magnitude of the placebo response may actually enhance the credibility of the trial itself, because it reflects the real world.

In summary, this is arguably the most methodologically credible saffron mood trial yet conducted because of its size, duration, expectancy adjustment and rigorous analyses. The findings support saffron as a modest but clinically meaningful intervention for depressive symptoms, particularly in relatively healthy individuals, while also suggesting that its effects may accumulate progressively over time and potentially extend to sleep benefits in symptom-specific subgroups.

For more information see: https://pubmed.ncbi.nlm.nih.gov/40414301/