The Musculoskeletal Aspects of Lobelia Inflata and Beyond

By Eric Yarnell, ND, RH

Every naturopathic physician knows lobelia inflata and its important effects on the lungs. However, many have forgotten or did not learn of its uses in the musculoskeletal and nervous systems.

I was personally taught that lobelia had musculoskeletal effects by my mentor, Silena Heron, ND. She recommended that an oil extract of fresh leaf, flower, and seed be applied to the chest wall for people with spasmodic coughs. She felt that not only would this decrease the spasms, but also relieve soreness in the intercostal muscles. Dr. Heron also taught that it would relieve rheumatic pains. For those patients unwilling to deal with the moderate amount of messiness that comes with any oil extract, she would use an ointment.

I recommended lobelia oil to a 60-year-old Portuguese patient with a primary concern of Graves’ disease, but who developed intercurrent bronchitis. Her chest was very sore from coughing. She applied the lobelia oil, and to this day, I still do not know if it helped her muscular soreness. This is because she was astounded at the profound improvement in the chronic achiness and stiffness in her fingers (previously diagnosed as osteoarthritis related to a lifetime of sewing) and would speak of nothing else.

Since then, I have had one other patient with osteoarthritis who used lobelia oil topically to great effect as well, again in the hands. Because my own practice focuses on urology and men’s health, I have otherwise not had much occasion to help people with osteoarthritis. However, these experiences reinforced for me that lobelia is not just a lung herb.

Clearly lobelia can act as a mild relaxant when taken internally (at least using a fresh plant tincture or acetract). This reflects a central nervous system effect consistent with the agonism of nicotinic receptors by lobeline and related alkaloids.1 The alkaloids indirectly relax smooth and skeletal muscle. It is not clear how topical lobelia acts on muscle.

The effects of lobelia on osteoarthritis or rheumatism suggest that lobelia may have inflammation and/or immune modulating activity. This might also help explain some of its effects on muscle. Unfortunately, no research could be located in these areas. It remains open to speculation.

Neurological Effects

Lobelia has potential uses for patients with various neurological problems. Most of these are based on theoretical extrapolations from the fact that nicotine is helpful. For example, nicotine and synthetic analogs of it are being researched for treatment of patients with Alzheimer’s disease and Parkinsonism. Though no studies have been done with lobelia or lobeline related to either of these conditions, the similarity of actions of the two constituents suggests potential.2

Many other neurological conditions fit a similar pattern in which nicotine or smoking is helpful, suggesting that lobelia or lobeline would be safer alternatives. Such conditions include schizophrenia, Tourette’s syndrome, attention deficit disorder and anxiety. Though it hasn’t been clinically proven that any of these conditions is improved by nicotine or lobelia, the potential is intriguing.

Treating Addiction

Somewhat better substantiated is the use of lobelia as support for people attempting to break addictions. Lobelia is, of course, best known for helping people break nicotine addiction. Clinical trials on purified lobeline have yielded mixed results.3 Part of the problem with the approach of using pure lobeline is that it is much more likely to cause nausea than lobelia. This may greatly reduce a patient’s willingness to use the medicine regularly, and thus decrease effectiveness. Furthermore, there is more to lobelia than lobeline, and all sorts of side benefits may be lost by using the isolated alkaloid. Instead, future studies should look at whole herb extracts to see if they can be more consistently effective. Lobelia should be combined with a multifactorial program for optimal results in breaking addiction.4

Recently, an argument has been made that lobelia may also have a role in reducing amphetamine addiction.5 These authors suggest that lobeline acts primarily by inhibiting dopamine uptake and by stimulating release of dopamine from storage granules in presynaptic terminals via an interaction with the vesicular monoamine transporter 2. This action was shown to interfere with the addictiveness of amphetamine and methamphetamine in vitro. Given the rising plague of methamphetamine addiction, this hypothesis could be enormously important.

References

1. Reavill C, Walther B, Stolerman IP, Testa B. Behavioural and pharmacokinetic studies on nicotine, cytisine and lobeline. Neuropharmacology 1990;29(7):619-24.
2. McCurdy CR, Miller RL, Beach JW. Lobeline: A natural product with high affinity for neuronal nicotinic receptors and a vast potential for use in neurological disorders. In: Cutler SJ, cutler HG (eds) Biologically Active Natural Products: Pharmaceuticals (Boca Raton, FL: CRC Press):2000;151-62.
3. Davison GC, Rosen RC. Lobeline and reduction of cigarette smoking. Psychol Rep 1972;31(2):443-56.
4. Abascal K, Yarnell E. Botanical remedies for nicotine addiction. Alternative and Complementary Therapies 2001;7(6):337-340.
5. Dwoskin LP, Crooks PA. A novel mechanism of action and potential use for lobeline as a treatment for psychostimulant abuse. Biochem Pharmacol 2002;63(2):89-98.

Eric Yarnell, ND, RH is a graduate of Bastyr University. He completed a two-year residency with Silena Heron, ND, and served as chair of botanical medicine at SCNM. He is past senior editor of the Journal of Naturopathic Medicine. Dr. Yarnell is a founding member and current president of the Botanical Medicine Academy and author of numerous textbooks and articles, including Naturopathic Urology andMen’s Health, Naturopathic Gastroenterology and Clinical Botanical Medicine. His area of clinical focus is urology and men’s health. He is assistant professor in botanical medicine at Bastyr University.