Anxiety

Work related illness is physical or mental illness caused by or aggravated by work. WRI affects all aspects of our community and economy.

Practitioner

Acupuncture is a form of TCM which uses thin disposable needles to tonify Yin & Yang and smooth the flow of qi and blood for health to ensue. Disease in Chinese Medicine is said to be due to deficiency of Yin or Yang or stagnation of Qi or Blood, Acupuncture increases the pain relieving & feel good hormones, serotonin & endorphins & decreases inflammation in the body.

Traditional Chinese medicine explains that health is the result of a harmonious balance of the complementary extremes of "yin" and "yang" of the life force known as "qi," pronounced "chi." Illness is said to be the consequence of an imbalance of the forces. For further details contact Carina[email protected]This email address is being protected from spambots. You need JavaScript enabled to view it.

Qi is said to flow through meridians, or pathways, in the human body. These meridiens and energy flows are accessible through 350 acupuncture points in the body.

Inserting needles into these points with appropriate combinations is said to bring the energy flow back into proper balance.

Though today we know this list to be more extensive, in 1979 the World Health Organization (WHO) published the following list of common conditions proven to respond to TCM Acupuncture:

Mental-Emotional:
Anxiety
Depression
Stress
Insomnia

Upper Respiratory Tract:
Acute sinusitis
Acute rhinitis
Common Cold
Acute Tonsillitis

Respiratory System:
Acute bronchitis
Bronchial asthma (most effective in children and in patients without complicating diseases)

Disorders of the eye:
Acute conjunctivitis
Central retinitis
Myopia (in children)
Cataract (without complications)

Disorders of the mouth:
Toothache, post extraction pain
Gingivitis
Acute and chronic pharyngitis

Gastro-intestinal disorders:
Spasms of the esophagus and cardia
Hiccough
Gastroptosis
Acute and chronic gastritis
Gastric hyperacidity
Chronic duodenal ulcer (pain relief)
Acute duodenal ulcer (without complications)
Acute and chronic colitis
Acute bacillary dysentery

Constipation
Diarrhea
Paralytic ileus

Neurological and Musculo-skeletal Disorders:
Headache and migraine
Trigeminal neuralgia (TMJ)
Facial palsy (early stage, i.e. within six months)
Pareses following a stroke
Peripheral neuropathies
Sequelae of poliomyelitis (early sage i.e. within six months)
Meniere’s disease
Neurogenic bladder dysfunction
Nocturnal enuresis (bedwetting)
Intercostal neuralgia
Cervicobrachial syndrome

“Frozen shoulder”, “Tennis elbow”
Sciatica
Low-back pain
Osteoarthritis

Today’s science shows Acupuncture can also be used effectively in:

Adverse reactions to radiotherapy and chemotherapy
Allergies
Blood pressure problems
Infertility
Sexual dysfunction (low libido, erectile dysfunction)
Breech position in pregnancy
Induction of labor

Rheumatoid arthritis

Points in the TRIANGULAR FOSSA

Your Practitioner

Ear acupuncture involves the stimulation of definite points on the ear to normalise the bodily function. These points are believed to correspond with specific organs, emotions or sensory feelings. Ear acupuncture increases serotonin and endorphins and is very relaxing.

Evidence exists for the use of ear acupuncture in drug and alcohol detoxification, smoking cessation, weight loss, stress anxiety, depression and musculoskeletal disorders.

For further details contact Carina This email address is being protected from spambots. You need JavaScript enabled to view it.

Read more Traditional Chinese Medicine

Practitioner Strength Organic or Wildcrafted Herbal Extracts

Nerve rings are depressions in the iris stroma and also are referred to as neurovascular cramp rings, cramp rings, contraction rings or nerve rings.

A Naturopathic Consultation is holistic and assesses the physical, psychological, emotional and spiritual aspects of a person. For example from a Western Medical Perspective you may be medically diagnosed with hypothyroidism however, from a Naturopathic Medical Perspective your diagnosis might be;

Practitioner

• Decreased Basal Metabolic Rate (BMR) due to "Functional Hypothyroid"
• Poor breakdown of fats and increased visceral adiposity due to a "Sluggish Liver".
• Excess cravings for carbohydrates due to “Insulin Resistance” and "Functional Hypoglycemia"
• Long term stress leading to "Adrenal Exhaustion", cortisol spikes and resultant weight gain
• Long term stress leading to “Nervous System Exhaustion” and emotional eating
• Nutritional deficiencies of Iodine, EFAs, selenium
• Excess Bioaccumulation of endocrine disrupting chemicals (EDCs) such as fluoride, aluminium and  BPA leading to a disruption of thyroid hormone production. 

Thus

Naturopathic Treatment Principles 

• Tonify the thyroid to boost BMR
• Improve insulin sensitivity
• Balance blood sugar
• Tonify the adrenal gland
• Nourish the nervous system
• Replace nutritional deficiencies
• Treatment in the terms of dietary, lifestyle, supplement and herbal medicine recommendations are then derived from these treatment principles.

Addtional Protocols

Traditional Chinese Medicine

As an Acupuncturist, I will also diagnose your Pattern of Disharmony according to Traditional Chinese Medicine. In obesity, it may be for example Cold Damp accumulation due to Spleen Qi and Yang Deficiency. I will prescribe Acupuncture, Chinese Herbal Medicine and Chinese Dietary Therapy to treat your Pattern of Disharmony. Rather than prescribing Chinese Herbal Patent Formulas, I specialise in preparing Traditional Chinese Herbal Formulations in organic 1:1 high practitioner strength extract form 

Once I have confirmed a Naturopathic Diagnosis, I will then explain the Naturopathic Causes of your condition from a Naturopathic Perspective so that you will be motivated to remove these causes to the best of your ability and have a better chance for cure, depending also, on the strength of your Vital Force. As the "Stress-Less Naturopath" I tailor a Health Management Solution to suit your lifestyle.

I am trained in pharmacology, herbal and supplement contraindications and drug/nutrient, drug/herb interactions. I can prescribe safely if you are pregnant and breastfeeding or on medication. As a Herbalist and Nutritionist I specialise in matching the pharmacological actions of drugs with natural alternatives using compounds found in food and herbs. I will always give dietary advice and assess your diet for nutritional deficiencies.

Classical Homeopathy

As a classical homeopath I may also prescribe what are described as your constitutional remedy, an acute lesional remedy or drainage remedy.

What to expect during a Naturopathic consultation?

At either a consult in person or an online consultation I will

Discuss your presenting symptoms

• Discuss any medications that you take to ensure that there are no drug/nutrient or drug/herb contraindications with proposed or current treatment
• Discuss your past health history
• Discuss your family history
• Ask you questions about relevant body systems to gain a better understanding of your condition
• Perform nail analysis and tongue and pulse diagnosis to asses for mineral deficiencies (For online consult you will need to email photo of tongue)
• Perform Iridology (for online consult you will need to attach photo of left and right iris)
• Take your blood pressure
• May recommend blood or other tests
• Explain the Naturopathic Causes of your health issues from a Naturopathic Medical Perspective
• Provide a diagnosis from a Chinese Medical Perspective
• Prescribe treatment in the terms of diet, (including Chinese dietary therapy), lifestyle, herbal medicine, homeopathy and supplements in the form of an email prescription.
• Provide ongoing support through www.carahealth.com Online Naturopathic Health Resource and Consultant Services.
• Face-to-face consultation includes acupuncture according to your Pattern of Disharmony.

For further details contact Carina This email address is being protected from spambots. You need JavaScript enabled to view it.

For a Natural Performance Boost,  three seperate consultations are reccomended, teaching about performance enhancing supplements, Carbohydrate loading, training tactics & match day diet, Fuelling tactics, Weight gain & Hyper-hydration.

The plan adapts WHO guidelines and sports nutrition protocols recommended by the Australian Institute of Sport and the adoption of legal ergogenic performance enhancing herbs & supplements.

Practitioner

Goals;

To achieve energy balance & healthy BMI
Reduce saturated fats & trans-fatty acids
Increase consumption of omega 3 healthy fats
Increase consumption of fruits, vegetables, legumes, whole grains & nuts
Limit the intake of simple sugars
Limit salt / sodium consumption from all sources
Ensure sufficient essential amino acids to assist immune system & repair
Include essential vitamins & minerals
Avoiding directly poisonous (e.g. heavy metals) & carcinogenic (e.g. benzene) substances.
Learn about performance enhancing supplement recommendations according to the Australian Institute of Sport including;

• Carbohydrate loading
• The training & match day diet
• Training tactics
• Fuelling tactics
• Meal timing
• Weight gain
• Hyper-hydration
• Evidence based herbal ergogenic/ performance-enhancing aids are prescribed to enhance physical strength and performance capacity.

What to expect

1st Consultation

Involves discussing presenting symptoms including and medications/supplements that you take to ensure that there are no drug/nutrient or drug/herb contraindications with proposed or current treatment. Next we will discuss your past medical and family history. Then I will ask questions about relevant body systems to gain a better understanding of your general health. I will assess your Basal Metabolic Index (BMI) to ascertain where you stand in relation to being a healthy weight. I will assess your current diet to ensure it contains sufficient essential amino acids, vitamins and minerals to assist body function such as immune system and repair and to look for specific nutritional deficiencies and to assess your diet and lifestyle to ensure you are avoiding poisonous and carcinogenic substances.

Your diet plan will;

• Make tailored dietary recommendations to address any specific deficiencies or issues
• Provide advice on healthy fats
• Provide advice on low GI fruits and vegetables, legumes, whole grains and nuts to sustain energy levels
• Provide advice on healthy low GI sugar alternatives
• Provide advice on healthy salt alternatives
• Provide advice on healthy snacks

Your prescription will provide a performance enhancing diet plan and lifestyle, herbal medicine and supplements advice in the form of an email prescription.

2nd Consultation

Involves discussing a tailored training diet plan to provide sufficient levels of all nutrients and sustained, slow release low GI carbohydrates to help provide energy for long and intense training sessions. The plan is a general guide, and portion sizes will need to be adapted to suit your daily routine.

We will also discuss;

Carbohydrate loading and performance enhancement the original and modern carb loading and how taper your exercise before the match/sporting event

• The Training Diet
• Match Day Diet
• Training tactics
• Fuelling Tactics
• Meal Timing
• Weight gain
• Fluids Hyper-hydration

3rd Consultation

Aims to ensure you are on track and address any pitfalls you may be experiencing and how to overcome them. You will be provided with more recipes that tick all boxes for essential healthy proteins, carbohydrates and fat and essential vitamins and minerals to promote recovery from injury and enhance performance.

Herbal Medicine as a performance booster to enhance athletic performance

Performance-enhancing substances enhance physical strength to improve performance. A performance boosteris also called an ergogenic aid. (1) Herbal medicine adaptogens acts as ergogenic aids to enhance performance. Frome a herbal medicine perspective adaptogens, testosteromimetic and caffeine rich herbs are ergogenic aids.

Carahealth uses high strength practitioner only, organic or wild crafted extracts. Tonics are 1:1 strength, 3 x stronger than available in health food stores or herbs used by other practitioners.

Herbal Medicine Protocol 

Adaptogen Herbs

Adaptogens increase resilience to stress whether it is physical, chemical, biological or emotional in origin. Adaptogens restore and normalise physiological functions in the event of stress allowing us to handle the stressful situations in a more resourceful manner. Adaptogens specifically help our bodies adapt to changes in our circadian rhythm caused by hectic lifestyles (2) or deficiency in sunlight. Current uses of adaptogens relate mainly to treating stress-induced fatigue, improving cognitive function and treating emotional and behavioural disorders. Adaptogens also protect against chronic inflammation, atherosclerosis, neurodegenerative cognitive impairment, metabolic disorders, and other age-related disease. (3)

Ginseng Asian ginseng Chinese,/Korean ginseng Panax ginseng 

Panax ginseng, also known as Chinese or Korean ginseng, is the one which is most widely used ergogenic aids. (4) Ginseng is a tonic herb that improves vitality, health and longevity. Ginseng is an adaptogen and enhance endurance and strength. Ginseng root increases muscular strength and aerobic work capacity. It has been reported that the use of ginseng does not lead to any positive test results for banned substances after urine testing of elite athletes, although ginsenosides and their metabolites are detectable in the sera and urine of athletes following the ingestion of ginseng.

Ginseng roots;

• Stimulate and protects the central nervous system. (5)
• Enhances cognitive function and improves mood. (6)
• Increased production of corticotropin and cortisol and has anabolic actions. (7)
• Has potent adaptogenic activity that is mediated by regulation of pituitary adrenocorticotropic hormone secretion to combat stress. (8)
• Possess antioxidant properties and inhibits lipid peroxidation. (9)
• Has stimulant effect and thus improves alertness and decreases fatigue and stress
• Increases exercise time to exhaustion. (10)
• Protects against cardiovascular disease. (11)
• Supports male reproductive function. (12)

Siberian ginseng Eletherococcus senticosus 

Studied extensively by Russian researchers, Siberian ginseng is distantly related to the Panax species. Siberian ginseng contains unique steroidal saponins termed eleutherosides that appear to be structurally similar to, but are distinct from, Panax ginsenosides. Siberian ginseng improves muscular strength, resistance to fatigue and recovery from exercise.

Siberian ginseng;

• Supports healthy ageing and improves quality of life. (13)
• Protects against cardiovascular disease. (14)
• Is immune stimulatory, has various anti-cancer properties and possesses anti-tumour effects. (15)
• Protect against cancer formation by inducing apoptosis (programmed cell death) (16)
• Reduces fatigue. (17)

Withania Ashwagandha/ Indian Ginseng Withania somnifera 

Withania is an adaptogen and enhances endurance and strength. A study aimed to determine the effect of Ashwagandha on the cardiorespiratory endurance capacity, that is, aerobic capacity in elite Indian cyclists found there was significant improvement in the experimental group in all parameters in terms of maximal aerobic capacity (VO2 max), metabolic equivalent, respiratory exchange ratio (RER), and total time for the athlete to reach his exhaustion stage. (18)

Withania ginseng;

• Reduces stress and anxiety. (19)
• Displays anti cancer effects. (20, 21)
• Is chemoprotective (protects against chemical damage). (22)
• Is neuroprotective to protect against neurodegenerative disease such as stroke and Alzheimer’s. (23)

Rhodiola Rhodiola rosea 

Rhodiola is an adaptogen, enhances endurance and strength. A study to determine the effects o Rhodiola rosea on endurance exercise performance, perceived exertion, mood, and cognitive function found acute Rhodiola rosea ingestion decreases heart rate response to submaximal exercise and appears to improve endurance exercise performance by decreasing the perception of effort. (24)

Rhodioloa;

• Improves endurance exercise performance. (25)
• Alleviates stress, anxiety and depression by increasing feel-good hormones. (26-29)
• Enhances cognitive function (30) and metal and physical performance. (31)
• Reduces physical and mental fatigue. (32)
• Is anti-inflammatory and neuroprotective. (33)

Testoteromimetic herbs

Testosteromimetic herbs increase testosterone thus are anabolic, can improve recovery time from resistance exercise and enhance strength. The following herbs increase testosterone levels. Women also make and utilise testosterone so these herbs are safe for use my women as an ergogenic aid during training and performance.

Sarsaparilla Smilax ornata 

In Traditional Chinese Medicine is traditionally used to treat sexual hypofunction. Sarsaparilla has a beneficial effect on exercise performance. (34)

Sarsaparilla

• Has a testostermomimetic effects thereby increases testosterone so is anabolic.(35)
• Is a herbal aphrodisiac. (36)

Tribulus Tribulus terrestra 

Sarsaparilla has testostermomimetic so is anabolic. It contains a variety of chemical constituents which are medicinally important, such as flavonoids, flavonol glycosides, steroidal saponins, and alkaloids. T. terrestris did not alter the urinary T/E ratio and would not place an athlete at risk of testing positive based on the World Anti-Doping Agency's urinary T/E ratio limit.

Tribulus

• Increases strength and fat free mass. (37)
• Is a male reproductive tonic and improves fertility. (38-40)
• Is an aphrodisiac and performance enhancer. (41)

Caffeine rich herbs

Caffeine supplementation improves performance at varying intensities and modalities of exercise. Caffeine is a well-documented stimulant of the central nervous system as well as the cardiovascular and respiratory systems. Caffeine ingestion increases blood catecholamine concentration. Caffeine's ergogenic effect on sports performance is also attributed to its effect on substrate availability, namely, free fatty acids. Increases in free fatty acid concentration in turn lead to a glycogen-sparing effect because the body's energy system will start using free fatty acid as a primary source of fuel. A significant increase (44%) in endurance running performance is achieved after athletes ingested 9 mg/kg body mass of caffeine 1 hour prior to exercise.

Kola nut Cola nitida 

Kola nut is a naturally rich source of caffeine. But unlike caffeine, kola nut is rich in vitamins and minerals so has a lot of health benefits. Kola nut is high in antioxidant polyphenols, it is anti-bacterial, rich in theobromine content, which is a vasodilator hence a circulatory stimulant.

Kola nut

• Improves locomotor function. (42)
• Is antioxidant rich and inhibits lipid peroxidation. (43)
• Is chemoprotective and has been shown to inhibit androgen dependent cancers in males. (44)

Carahealth PerformanceTonic

Formulated to help improve exercise performance capacity or enhance physical strength. The tincture contains a blend of adaptogenic herbs and herbs that increase testosterone hence is anabolic. The tincture also contains a caffeine rich herb.

Ingredients: Chinese ginseng, Siberian ginseng, Indian Ginseng , Rhodiola, Sarsaparilla, Tribulus & Kola nut.

Actions ;

Lowers cortisol levels during times of stress
Boosts immunity
Increases energy levels
Improves resistance to stress
Improves concentration
Enhances recovery from resistance exercise
Enhances strength
Increase muscle mass
Stimulates the central nervous system
Stimulates the cardiovascular and respiratory systems

Ketosis Diet as an ergogenic training aid

A long-term ketosis, high fat, low carbohydrate diet may be favourable for aerobic endurance athletes, during the preparatory season, when a high volume and low to moderate intensity of training loads predominate in the training process. Fat loading slows down the rate of carbohydrate utilization and enhance endurance performance in long distance events lasting from 2 to 5 h. This is especially true during long-term ketogenic diets, where the body adapts to increased fat oxidation through enzymatic and endocrine changes

A ketogenic diet has been used by professional cyclists. A ketogenic diet is a diet high in lipids and low in carbohydrates for ~4 days to induce nutritional ketosis. However a ketogenic diet may impair exercise performance via reducing the capacity to utilise carbohydrate, which forms a key fuel source for skeletal muscle during intense endurance-type exercise so is only recommender during training periods only. (45)

For further details contact Carina This email address is being protected from spambots. You need JavaScript enabled to view it. 

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2. Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel, Switzerland). 2010;3(1):188-224.

3. Panossian A. Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals. Annals of the New York Academy of Sciences. 2017;1401(1):49-64.

4. Lee NH, Jung HC, Lee S. Red Ginseng as an Ergogenic Aid: A Systematic Review of Clinical Trials. Journal of exercise nutrition & biochemistry. 2016;20(4):13-9.

5. Rokot NT, Kairupan TS, Cheng K-C, Runtuwene J, Kapantow NH, Amitani M, et al. A Role of Ginseng and Its Constituents in the Treatment of Central Nervous System Disorders. Evidence-based complementary and alternative medicine : eCAM. 2016;2016:2614742-.

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8. Liao L-Y, He Y-F, Li L, Meng H, Dong Y-M, Yi F, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chinese medicine. 2018;13:57-.

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10. Sellami M, Slimeni O, Pokrywka A, Kuvačić G, D Hayes L, Milic M, et al. Herbal medicine for sports: a review. Journal of the International Society of Sports Nutrition. 2018;15:14-.

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13. Cicero AF, Derosa G, Brillante R, Bernardi R, Nascetti S, Gaddi A. Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Archives of gerontology and geriatrics Supplement. 2004(9):69-73.

14. Kwan C-Y, Zhang W-B, Sim S-M, Deyama T, Nishibe S. Vascular effects of Siberian ginseng (Eleutherococcus senticosus): endothelium-dependent NO- and EDHF-mediated relaxation depending on vessel size. Naunyn-Schmiedeberg's Archives of Pharmacology. 2004;369(5):473-80.

15. Cichello SA, Yao Q, Dowell A, Leury B, He XQ. Proliferative and Inhibitory Activity of Siberian ginseng (Eleutherococcus senticosus) Extract on Cancer Cell Lines; A-549, XWLC-05, HCT-116, CNE and Beas-2b. Asian Pac J Cancer Prev. 2015;16(11):4781-6.

16. Kim CG, Castro-Aceituno V, Abbai R, Lee HA, Simu SY, Han Y, et al. Caspase-3/MAPK pathways as main regulators of the apoptotic effect of the phyto-mediated synthesized silver nanoparticle from dried stem of Eleutherococcus senticosus in human cancer cells. Biomedicine & Pharmacotherapy. 2018;99:128-33.

17. Hartz AJ, Bentler S, Noyes R, Hoehns J, Logemann C, Sinift S, et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychological medicine. 2004;34(1):51-61.

18. Shenoy S, Chaskar U, Sandhu JS, Paadhi MM. Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists. Journal of Ayurveda and integrative medicine. 2012;3(4):209-14.

19. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian journal of psychological medicine. 2012;34(3):255-62.

20. KHAZAL KF, SAMUEL T, HILL DL, GRUBBS CJ. Effect of an Extract of Withania somnifera Root on Estrogen Receptor-positive Mammary Carcinomas. 2013;33(4):1519-23.

21. Prakash J, Gupta SK, Dinda AK. Withania somnifera root extract prevents DMBA-induced squamous cell carcinoma of skin in Swiss albino mice. Nutrition and cancer. 2002;42(1):91-7.

22. Prakash J, Gupta SK, Kochupillai V, Singh N, Gupta YK, Joshi S. Chemopreventive activity of Withania somnifera in experimentally induced fibrosarcoma tumours in Swiss albino mice. Phytotherapy research : PTR. 2001;15(3):240-4.

23. Raghavan A, Shah ZA. Withania somnifera: a pre-clinical study on neuroregenerative therapy for stroke. Neural regeneration research. 2015;10(2):183-5.

24. Noreen EE, Buckley JG, Lewis SL, Brandauer J, Stuempfle KJ. The effects of an acute dose of Rhodiola rosea on endurance exercise performance. Journal of strength and conditioning research. 2013;27(3):839-47.

25. De Bock K, Eijnde BO, Ramaekers M, Hespel P. Acute Rhodiola rosea intake can improve endurance exercise performance. International journal of sport nutrition and exercise metabolism. 2004;14(3):298-307.

26. Anghelescu I-G, Edwards D, Seifritz E, Kasper S. Stress management and the role of Rhodiola rosea: a review. International Journal of Psychiatry in Clinical Practice. 2018:1-11.

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28. Mao JJ, Li QS, Soeller I, Xie SX, Amsterdam JD. Rhodiola rosea therapy for major depressive disorder: a study protocol for a randomized, double-blind, placebo- controlled trial. Journal of clinical trials. 2014;4:170-.

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31. Jówko E, Sadowski J, Długołęcka B, Gierczuk D, Opaszowski B, Cieśliński I. Effects of Rhodiola rosea supplementation on mental performance, physical capacity, and oxidative stress biomarkers in healthy men. Journal of sport and health science. 2018;7(4):473-80.

32. Ishaque S, Shamseer L, Bukutu C, Vohra S. Rhodiola rosea for physical and mental fatigue: a systematic review. BMC complementary and alternative medicine. 2012;12:70-.

33. Lee Y, Jung J-C, Jang S, Kim J, Ali Z, Khan IA, et al. Anti-Inflammatory and Neuroprotective Effects of Constituents Isolated from Rhodiola rosea. Evidence-based complementary and alternative medicine : eCAM. 2013;2013:514049-.

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35. Challinor VL, Parsons PG, Chap S, White EF, Blanchfield JT, Lehmann RP, et al. Steroidal saponins from the roots of Smilax sp.: Structure and bioactivity. Steroids. 2012;77(5):504-11.

36. Lim PHC. Asian herbals and aphrodisiacs used for managing ED. Translational andrology and urology. 2017;6(2):167-75.

37. Rogerson S, Riches CJ, Jennings C, Weatherby RP, Meir RA, Marshall-Gradisnik SM. The effect of five weeks of Tribulus terrestris supplementation on muscle strength and body composition during preseason training in elite rugby league players. Journal of strength and conditioning research. 2007;21(2):348-53.

38. Kamenov Z, Fileva S, Kalinov K, Jannini EA. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction—A prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017;99:20-6.

39. Gauthaman K, Ganesan AP. The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction – an evaluation using primates, rabbit and rat. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2008;15(1):44-54.

40. Roaiah MF, El Khayat YI, GamalEl Din SF, Abd El Salam MA. Pilot Study on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM). Journal of sex & marital therapy. 2016;42(4):297-301.

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42. Ajarem JS. Effects of fresh kola-nut extract (Cola nitida) on the locomotor activities of male mice. Acta physiologica et pharmacologica Bulgarica. 1990;16(4):10-5.

43. Oboh G, Nwokocha KE, Akinyemi AJ, Ademiluyi AO. Inhibitory effect of polyphenolic-rich extract from Cola nitida (Kolanut) seed on key enzyme linked to type 2 diabetes and Fe(2+) induced lipid peroxidation in rat pancreas in vitro. Asian Pacific journal of tropical biomedicine. 2014;4(Suppl 1):S405-S12.

44. Solipuram R, Koppula S, Hurst A, Harris K, Naragoni S, Fontenot K, et al. Molecular and biochemical effects of a kola nut extract on androgen receptor-mediated pathways. Journal of toxicology. 2009;2009:530279-.

45. Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G. The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients. 2014;6(7):2493-508.