Herbal therapy - Chaste tree berry (Vitex agnus-castus)

Chaste tree berry is a species of Vitex agnus-castus, genus Vitex, belonging to the family Lamiaceae, native to the Mediterranean region. It has been used in herbal medicine for thousands of year as anaphrodisiac herb and is considered as Queen herb in treating menstrual problems and discomforts by taking it in a prolonged period of time. There was report that reports chaste tree berry stems and leaves used by women as bedding "to cool the heat of lust" during the time of the Thesmophoria,

Chemical constituents
1.  β-citronellol
2. Labdane-type diterpenoids,
3. Halimane-type diterpenoid,
4. Oleanane-type triterpenoids,
5. Ursane-type triterpenoids,
6. Sesquiterpenoid,
7.  Flavonoid
8. Viteagnusins C, D, E, F, G, and H
9. Abietane-type diterpenoids

Health Benefits
1. Chaste tree berry and premenstrual syndrome (PMS)
Premenstrual syndrome effects over 70% to 90% of women in the US and less for women in Southeast Asia because of their difference in living style and social structure. It is defined as faulty function of the ovaries related to the women's menstrual cycle, it effects a women's physical and emotional state, and sometimes interferes with daily activities as a result of hormone fluctuation. The syndrome occurs one to two weeks before menstruation and then declines when the period starts.
A double-blind, randomized, placebo-controlled parallel trial was conducted over 16 weeks on menopause-related symptoms with combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus (chaste tree/berry), showed a superior effect of the combination when compare to placebo in total PMS-like scores (p = 0.02), PMS-D (p = 0.006), and PMS-C clusters (p = 0.027).  significant reductions in the anxiety (p = 0.003) and hydration (p = 0.002) clusters and  suggested that the combination may be a  potentially significant clinical application for this phytotherapeutic combination in PMS-like symptoms among perimenopausal women(1). The  preliminary data of Technion-Israel Institute of Technology also support the efficacy of Chaste tree fruit (Vitex agnus) in the treatment of PMS(2). In a 1634 patients suffering from premenstrual syndrome (PMS), to test fpr the effects of Vitex on psychic and somatic complaints, on the four characteristic PMS symptom complexes depression, anxiety, craving, and hyperhydration (DACH), and on single groups of symptoms, indicated that Vitex treatment period of three menstrual cycles 93% of patients reported a decrease in the number of symptoms or even cessation of PMS complaints(3).
References
(1) Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis by van Die MD¹, Bone KM, Burger HG, Reece JE, Teede HJ.(PubMed)
(2) [Herbal medicine in womens' life cycle].[Article in Hebrew] by Ben-Arye E¹, Oren A, Ben-Arie A.(PubMed)
(3) Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus by Loch EG¹, Selle H, Boblitz N.(PubMed)


2. Chaste tree berry (Vitex agnus-castus) and leukaemia
Leukemia is defined as condition of abnormal increase of white blood cells produced by the bone marrow and/or the lymphatic system. Depending to the malignant granulocytes or lymphocytes, leukemia is classified into myelogenous or lymphoblastic leukemia.
Bone marrow is soft tissue inside the hollow center of major bone. including spine, pelvis, under arm, leg. etc.
Chaste tree berry may process an anti leukaemia effect. According to the Tokyo University of Pharmacy and Life Sciences, Chaste tree berry extract inhibited HL60 liver cancer cell line through  Vitex induced a dose- and time-dependent decrease in cell viability associated with induction of apoptosis and G2/M cell cycle arrest in a a dose- and time-dependent manner(1). Also on leukemia cell lines, HL-60 and U-937, extract from the ripe fruit of Vitex agnus-castus (Vitex), inhibited both cell lines through its  cytotoxicity activity in dose depend manner(2).


References
(1) Involvement of histone H3 phosphorylation via the activation of p38 MAPK pathway and intracellular redox status in cytotoxicity of HL-60 cells induced by Vitex agnus-castus fruit extract by chi H¹, Yuan B¹, Yuhara E¹, Imai M¹, Furutani R¹, Fukushima S¹, Hazama S¹, Hirobe C², Ohyama K¹, Takagi N³, Toyoda H¹.(PubMed)
(2) Cytotoxicity of Vitex agnus-castus fruit extract and its major component, casticin, correlates with differentiation status in leukemia cell lines by chi H¹, Yuan B, Nishimura Y, Imai M, Furutani R, Kamoi S, Seno M, Fukushima S, Hazama S, Hirobe C, Ohyama K, Hu XM, Takagi N, Hirano T, Toyoda H.(PubMed)

3. Chaste tree berry (Vitex agnus-castus) and anticancer effects
Cancer is a class of diseases in which a group of cells growing and multiplying disordered and uncontrollable way in our body, have become progressively worse and damaged other healthy tissues, sometimes spreads to other organs in the body via lymph or blood and results may be in death.

In human uterine cervical canal fibroblast (HCF), human embryo fibroblast (HE-21), ovarian cancer (MCF-7), cervical carcinoma (SKG-3a), breast carcinoma (SKOV-3), gastric signet ring carcinoma (KATO-III), colon carcinoma (COLO 201), and small cell lung carcinoma (Lu-134-A-H) cells, crude extract prepared with ethanol from dried ripened Vitex agnus-castus fruits, inhibited SKOV-3, KATO-III, COLO 201, and Lu-134-A-H cell lines through  its cytotoxic activity and apoptosis(1).
In a human gastric signet ring carcinoma cell line, KATO-III, according to Tokyo University of Pharmacy and Life Science, ethanol extract of the dried ripe fruit of Vitex agnus-castus (Vitex) also displayed cytotoxic activity through intracellular oxidative stress and mitochondrial membrane damage(2).  In prostate epithelial cell lines (BPH-1, LNCaP, PC-3), the Extracts of Vitex agnus-castus fruits (VACF), inhibited proliferation and induced apoptosis in a concentration-dependent manner(3).

References
(1) Cytotoxicity and apoptotic inducibility of Vitex agnus-castus fruit extract in cultured human normal and cancer cells and effect on growth by Ohyama K¹, Akaike T, Hirobe C, Yamakawa T.(PubMed)
(2) Human gastric signet ring carcinoma (KATO-III) cell apoptosis induced by Vitex agnus-castus fruit extract through intracellular oxidative stress by Ohyama K¹, Akaike T, Imai M, Toyoda H, Hirobe C, Bessho T.(PubMed)
(3) A Vitex agnus-castus extract inhibits cell growth and induces apoptosis in prostate epithelial cell lines by Weisskopf M¹, Schaffner W, Jundt G, Sulser T, Wyler S, Tullberg-Reinert H.(PubMed)

4. Chaste tree berry (Vitex agnus-castus) and Menopausal symptoms
Menopause is the defined as a condition in which a woman is in the transition stage of permanent cessation of the ovaries functions in egg production because of less production of estrogen and progesterone, signalling the end of the reproductive phrase a woman's life. In menopause, menstruation has become irregular and slowly stop overtime, but in some women, menstrual flow comes to a sudden halt.

 In a self-administered questionnaire, containing 15 questions, sent to all gynecologists in private practice in Germany to evaluate the complementary and alternative medicine (CAM) in the treatment of climacteric disorders, 98% of the returnees are experience with therapies of black cohosh (Cimicifuga racemosa), chaste tree (Vitex agnus castus) and St. John's wort(1). According to the ¹Royal Melbourne Institute of Technology (RMIT) University, Bundoora, although evidence from rigorous randomized controlled trials is lacking for the individual herb emerging pharmacological evidence supports a role for V. agnus-castus in the alleviation of menopausal symptoms(2). Dr. Chopin Lucks B. in the trial of two essential oils (derived separately from leaf and fruit) of Vitex agnus castus indicated that both essential oil shows a strong symptomatic relief of common menopausal symptoms(3).
Unfortunately, according to the University Hospital Hamburg-Eppendorf, Agnus castus showed no significant difference in the treatment of climacteric complaints(4) with  a combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus (Chaste tree/berry) also showed the same(5).


References
(1) The value of complementary and alternative medicine in the treatment of climacteric symptoms: results of a survey among German gynecologists by von Studnitz FS¹, Eulenburg C, Mueck AO, Buhling KJ.(PubMed)
(2) Vitex agnus-castus (Chaste-Tree/Berry) in the treatment of menopause-related complaints by van Die MD¹, Burger HG, Teede HJ, Bone KM.(PubMed)
(3) Vitex agnus castus essential oil and menopausal balance: a research update [Complementary Therapies in Nursing and Midwifery 8 (2003) 148-154] by Chopin Lucks B.(PubMed)
(4) Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review by Laakmann E¹, Grajecki D, Doege K, zu Eulenburg C, Buhling KJ.(PubMed)
(5) Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial by van Die MD¹, Burger HG, Bone KM, Cohen MM, Teede HJ.(PubMed)

5. Chaste tree berry (Vitex agnus-castus) and Hyperprolactinaemia
Hyperproclinaemia is a condition with levels of prolactin in the blood that may disrupt the normal menstrual period in women.
Vitex agnus-castus L. (chaste tree; chasteberry) has long been sued in herbal medicine for treatment, predominantly in wide range of female reproductive conditions. According to the ¹Royal Melbourne Institute of Technology-University, Bundoora, there are some reports of the herb in reducing TRH-stimulated prolactin secretion, normalising a shortened luteal phase, increasing mid-luteal progesterone and 17β-oestradiol levels of which comparable to bromocriptine for reducing serum prolactin levels and ameliorating cyclic mastalgia(1). The study in monitoring the prolactin release 15 and 30 min after i.v. injection of 200 micrograms TRH. 37 complete case reports (placebo: n = 20, verum: n = 17) after 3 month of therapy, indicated that the herb did not change with the exception of 17 beta-estradiol which rouse up in the luteal phase in patients receiving verum with no adverse effect(2).

References
(1) Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials by van Die MD¹, Burger HG, Teede HJ, Bone KM.(PubMed)
(2) [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study].[Article in German] by Milewicz A¹, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, Schmitz H.(PubMed)

6. Chaste tree berry (Vitex agnus-castus) and  Mastalgia
Mastalgia is a condition of breast tenderness and pain come and gone with monthly periods.
Vitex agnus castus (VACS) extract in treatment phase lasted 3 consequent menstrual cycles (2 x 30 drops/day = 1.8 ml of VASC) or placebo in a double-blind, placebo controlled in two parallel groups (each 50 patients), showed to inbibit cyclical breast pain in women(1).  In support to the view, the study of Gynecology: select topics, indicated that chaste tree may attenuate the symptoms of mastalgia(2) such as premenstrual mastodynia(Breast pain)(3).

References
(1) [Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo].[Article in Czech by Halaska M¹, Raus K, Bĕles P, Martan A, Paithner KG.(PubMed)
(2) Gynecology: select topics by Sidani M¹, Campbell J.(PubMed)
(3) Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications by Wuttke W¹, Jarry H, Christoffel V, Spengler B, Seidlová-Wuttke D.(PubMed)


7. Chaste tree berry (Vitex agnus-castus) and Propionibacterium acnes
Propionibacterium acnes is a type of acne dur to infection of    aerotolerant anaerobic, Gram-positive bacterium (rod) or as a result of chronic blepharitis and endophthalmitis.
Vitex agnus-castus has long been used for treatment of hormonally induced acne in herbal medicine(1) with mild or no adverse side effect(2). Vitex negundo, a five-leaved chaste tree extract, according to the study by the The Institute of Science, India,  showed a significant inhibition of lipase activity and number of P. acnes(1).

References
(1) The genus Vitex: A review by Rani A¹, Sharma A².(PubMed)
(2) Vitex agnus castus: a systematic review of adverse events by Daniele C¹, Thompson Coon J, Pittler MH, Ernst E.(PubMed)
(3) Inhibition of Propionibacterium acnes lipase by extracts of Indian medicinal plants by Patil V¹, Bandivadekar A, Debjani D.(PubMed)



8. Chaste tree berry (Vitex agnus-castus) and oligomenorrhea and Amenorrhea
Oligomenorrhea is an irregular menstruation and defined as a condition of infrequent period or a woman menstrual period does not occur at a interval of greater than 35 days.
Amenorrhea is defined as a health condition of absence of period.
In a study of 37 women with oligomenorrhea and 30 women with amenorrhea received 50 drops of Phyto Hypophyson , a an Agnus castus-containing homeopathic preparation,  or placebo 3 times a day over 3 months or 3 cycles, conducted by Universitäts-Frauenklinik, suggested that women with sterility and oligomenorrhea, a treatment with Phyto Hypophyson L can be recommended over a period of 3-6 months(1). Dr. Veal L. suggested that Vitex agnus-castus, or a blend of essential oils designed to treat amenorrhoea or scanty/irregular periods(2).
References
(1) [The efficacy of the complex medication Phyto-Hypophyson L in female, hormone-related sterility. A randomized, placebo-controlled clinical double-blind study].[Article in German] by Bergmann J¹, Luft B, Boehmann S, Runnebaum B, Gerhard I.(PubMed)
(2) Complementary therapy and infertility: an Icelandic perspective by Veal L.(PubMed)

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