Bala
(Sida cordifolia
L.)- Is it safe herbal drug?
Dr. Amrit
Pal Singh, BAMS; PGDMB; MD (Alternative Medicine), Herbal Consultant, Ind–Swift Ltd,
Address for correspondence:
Dr Amrit
Pal Singh,
House No: 2101 Phase-7,
Mohali-160062.
Email
amritpal2101@yahoo.com
Abstract
Bala is important medicinal plant of Ayurvedic system of medicine. Previous works have reported
presence of ephedrine in Bala although it has not
been reported in other varieties of Bala. Extracts of Sida cordifolia standardized
to ephedrine are available in the Indian as well as international market. In
western world ephedrine once upon a time was widely used for weight loss but
recently it has been banned due to reported hepatotoxicity
(injurious to the liver). Bala and its varieties including atibala (Sida rhombifolia
L.) are exclusively used in Ayurvedic composite
formulations. Owing to presence of ephedrine and norpesudoephedrine
(PPA) in extracts of Bala the plant should be subjected
to extensive pharmacological investigations (cardiovascular and CNS effects).
Key words: Bala /Ayurveda /Sida cordifolia/ Ephedrine
Introduction:
Madanpal Nighantu includes thirteen chapters on
drugs of plant and animal origin. In Abhyādivarga, four
drugs have been described under balā chatuśya. They have curative effect on gout.
From botanical point of view, these plants are representatives of family
Malvaceae. Phytochemically
they contain asparagine and potassium nitrate (Nadkarni 1976). They have demulcent, emollient and diuretic
properties (Nadkarni 976).
Monograph of Sida cordifolia L.
Syn: Sida herbacea, Sida althaeitolia,
Sida rotundifolia.
English name: Country mallow.
Ayurvedic names: Vatyālaka,
śītapāki, vātyodarāhva,
bhadraudanī, samangā,
samāmsa and svarayastikā.
Regional names: Bariar, Batyalaka, Beejband,
Bijband, Brela, Chikana, Chiribenda, Chitimutti, Hettuti-gida, Janglimethi, Kharenti, Khareti, Kisangi, Kungyi, Mayir-manikham, Muttuva, Paniyar-tutti, Simak, Tupkaria, Tutturabenda and Velluram.
Family: Malvaceae.
Habitat: Found
throughout the tropical and sub-tropical plains of
Habit: An erect, perennial under shrub, upto 1m. Tall. Stem
ascending, terete or sulcate,
softly villious and densely stellate-pubescent
all over. Leaves ovate or ovate-oblong, obtuse or subacute at apex. Flowers yellow, peduncles, axillary, jointed much above the panicles, upper flowers
nearly sessile and fasciculate towards the tip of the branches forming subspicate inflorescence. Fruits subdiscoid,
6-8 mm across, mericarps 10, 3 sided. Seeds trigonous, glabours,
tufted-pubescent near the hilum.
Chemical constituents: Asparagin,
alkaloids: ephedrine, hypaphorine, vasicinone, vasicine and vasicinol (Ghosal, Chauhan, and Mehta 1975), phytosterols,
mucin, gelatin, potassium nitrate and rutin. Ephedrine content of whole plant is 0.085 %. The seeds contain 0.32% of alkaloid. A study reported
0.112% of ephedrine in whole plant of Sida cordifolia (Khatoon, Srivastava, Rawat and Mehrotra 2005). The seeds contain
more alkaloids that that is found in the stems, roots or leaves. Non-polar
constituents have been reported from plant growing in
Action: Tonic, astringent, emollient and aphrodisiac.
Therapeutics: Sida
cordifolia is used in the treatment of
leucorrhoea, gonorrhea, general debility and rheumatism. Expressed juice of the
whole plant is useful in premature ejaculation. The juice obtained from the
roots is applied to unhealthy sores. Decoction of the root bark is given in
sciatica and rheumatism.
Parts used: Roots and seeds.
Dose: Powder (1-3 G).
Bioactivity: Analgesic, anti-inflammatory and hypoglycemic:
extracts of the aerial and root parts (Kanth and Diwan 1999; Franzotti et al., 2000) and hepatoprotective:
aqueous extract (Silva et al., 2006).
Monograph of Sida rhombifolia L.
Syn: Sida retusa.
Common name: Arrow leaf Sida,
Cuban jute, Indian hemp.
Ayurvedic names: Jyesthbala, katambhara, kesaruha, kesarika, mrigadani, harsapuspa, kesvardhini, purasani, devsaha, sarini, sahadevi, pitapuspi, devahara, gandhavallari, mrga and mrgarasa.
Family: Malvaceae.
Habitat:
Habit: Perennial, woody, fibrous stemmed shrub,
deeply rooted, grows up to 2m high with small green leaves, broad at base &
tapering to a point, alternate 3-7cm long & fine hairs on both sides. Small
orange, yellow flowers in clusters at end of branches or in forks of upper
leaves. Pods have fine bristles breaking up into segments.
Chemical composition: Mucilage and alkaloids: pseudoephedrine, beta-Phenethylamine,
vaccine and others (web reference 2).
Action: Tonic.
Therapeutics: In
Parts used: Leaf.
Bioactivity: Anti-inflammatory: the methanolic extract of the aerial parts and hepatoprotective: the powdered roots aerial parts and their
aqueous extract (Kumar & Mishra 1997).
Note: The ethyl acetate extract of the plant growing in
Comparison of Sida cordifolia and Ephedra sp
Ephedrine, a 2-aminophenylpropane alkaloid was first
isolated from Ephedra sinica Stapf. (Ma-Huang). Ephedra
gerardiana. Wall.
ex Stapf is widely used in Ayurvedic
system of medicine. Ephedrine is a
potent bronchodilator. Another alkaloid reported form Ephedra
sp is pseudoephederine which seems to be present in
lower concentrations in Sida cordifolia (web
reference 1).
Structure of ephedrine
Ephedrine content of Sida cordifolia is less as compared to Ephedra sinica. This
suggests feeble analeptic and central nervous system stimulating effects of Sida cordifolia. However Sida cordifolia
contains other bronchodilator alkaloids like vasicinone,
vasicine and vasicinol which
are absent in Ephedra sinica. In terms
of presence of alkaloids like vasicinone, vasicine and vasicinol, Sida cordifolia resembles with Adhatoda vasica Nees. N.O.: Acanthaceae.
Ayurvedic formulations
containing Sida cordifolia
should not be prescribed with cardiac glycosides, monoamine oxidase
inhibitors (Dawson, Eamshaw and Graham 1995) and
ergot alkaloids. Although no drug interactions have been reported with Sida cordifolia preparations
but owing to great variation of active constituent, great care should be taken
while prescribing Sida cordifolia
with cardiac glycosides (can cause disturbance of heart rhythm), monoamine oxidase inhibitors (as it can potentate the symapthomimetic activity) and ergot alkaloids (can cause
hypertension).
Although little data is
available on active constituent of Sida cordifolia but according to one study a minute dose of Sida cordifolia
given intravenously, causes a sharp and well marked rise of blood pressure in
anaesthetized or decerebrated animals which is maintained
for some time (Chopra 1982). This
pharmacological activity of Sida cordifolia resembles with ephedrine. According to Mark
Blumenthal effects of ephedrine should not be confused with Ephedra sinica. This is a typical example of difference in
pharmacological activities of whole herb and isolated constituents. Similar
concept applies when we compare Sida cordifolia with ephedrine.
Sida cordifolia and weight loss
Ephedra sinica is
widely used in the treatment of weight loss (Boozer, Naseer,
Hemsfield, et al 2001).
However the challenge is to get standard formulation on account of seasonal variation
of alkaloids like ephedrine, pseudo ephedrine, nor ephedrine, norpseudoephedrine, methyl ephedrine and methyl-pseudo
ephedrine. Ephedra species are well known for thermogenic activity on account of alkaloids ephedrine and nor
ephedrine.
Ephedrine and nor ephedrine
suppresses the appetite resulting in weight loss. Other alkaloids like norpseudoephedrine are less potent as compared to ephedrine
and norephedrine (also known as phenylpropanolamine)
and can cause serous ill effects. Therapy
with nor ephedrine has been linked with stroke in young age group. Food drug
administration has restricted the use of nor-ephedrine in States. Here it is
not worthwhile to mention that nor is ephedrine used in common cold
preparations also.
Today numbers of companies are
promoting Sida cordifolia
for anti-obesity effect. Experts are of the opinion that anti-obesity effect is
not limited to ephedrine content; other constituents may play a synergistic
role. Further chemical analysis reveals that seasonal variation of alkaloids in
Sida cordifolia
less as compared to Ephedra sp. Sida cordifolia, thus may be useful substitute to Ephedra
sp.
However safety of Sida cordifolia
extract will be always objectionable on basis of:
1.
Appetite suppression
and cardiovascular effects as these are associated with ephedrine (Haller and Benowitz 2000).
2.
Hypoglycemic effect in
animal models (Kanth and Diwan
1999).
These two effects may be
utilized therapeutically but on the whole are serious side effects. Keeping in
mind the fate of Ephedra sinica,
Sida cordifolia
extracts should be screened for pharmacological studies. Hepatotoxicity with
herbals is another burning topic. Recently acute hepatotoxicity
was reported with Ephedra sinica
(Nadir et al., 1996). Here Sida cordifolia has something to cheer about. Fumaric acid isolated from Sida cordifolia was reported to be hepatoprotective
(Kurma and Mishra, 1997). Recent work has reported hepatoprotective
effect of aqueous extract of Sida cordifolia after partial hepatectomy
(Silva et al., 2006).
Conclusion:
Sida cordifolia is widely used for its medicinal applications. Presence
of ephedrine and ban on Ephedra sinica has
highlighted the utility of the plant. However it is too early to say about
benefit of the plant in treating obesity as negligible data has accumulated in
term of its efficacy. Further the plant has hypoglycemic and appetite
suppressant activity (if we compare mode of action of Sida cordifolia and Ephedra sinica). Animal experiments however
report hepatoprotective effect of Sida
cordifolia (in contrast with Ephedra sinica, which is reported to be hepatotoxic).
References:
Anonymous. (1998). Indian Herbal
Pharmacopoeia Volume 1. Worli, Mumbai:
Indian Drug Manufacturers Association.
Boozer, C.N.; Naseer, J.A.; Hemsfield, S.B. et al., (2001). An herbal supplement
containing Ma Huang-Gurana for weight loss: a
randomized, double-blind trial. Int J Obes. 25(3): 316-324.
Bushell,J. (1998).
Australian Herbal Medicine Classnotes,
Chopra, R.N. (1982). Indigenous Drugs of
Franzotti, E.M. et al., (2000). Anti-inflammatory,
analgesic activity and acute toxicity of Sida
cordifolia L. (Malva-branca).
J Ethnopharmacol.
72: 273-8.
Ghosal, S.; Chauhan, R.R.P.S. and
Mehta, R. (1975). Alkaloids
of Sida cordifolia.
Phytother Res. 14: 830-2.
Haller,
Kanth V.R.; Diwan, P.V. (1999). Analgesic, anti-inflammatory and hypoglycaemic activities of Sida
cordifolia. Phytother Res. 13: 75-7.
Khan, M.W.; Rashid, M.A.; Huq,
E.; Ahmad, M.U. (1989). The non-polar constituents of Sida cordifolia Linn. J.
Bangl. Acad. Sci. 13: 55-60.
Kumra, R.S.; Mishra, S.H. (1997). Isolation and assessment of hepatoprotective
activity of fumaric acid obtained for the first time
from Sida cordifolia
Linn. Indian Drugs.
34(12): 702-706.
Kumar, R.S.; Mishra, S.H. (1997). Anti-inflammatory
and hepatoprotective activities of Sida rhombifolia
Linn. Indian J Pharmacol.
29(2): 110-116.
Nadir, A et al.,
(1996). Acute hepatitis associated with
the use of a Chinese herbal product, ma-huang. Am J Gastoenterol.
91(7):1436-8
Nadkarni, K.
(1976). Indian Materia
Medica vol 1,
Khatoon,
S.; Srivastava,M.; Rawat, A.K.S.; Mehrotra,S.
(2005). HPTLC method for chemical standardization of Sida species and estimation of the alkaloid ephedrine.
J. Planar Chromatogr.
18(5): 364-7.
Silva, R.S. et al., (2006). Effect of the
aqueous extract of Sida cordifolia
on liver regeneration after partial hepatectomy. Acta Cir. 21(1): 77-79.
Islam, E.; Haque, E.; Mossadik, M.A. (2003). Cytotoxicity and antibacterial activity of Sida rhombifolia (Malvaceae) grown in
Web references
1.http://www.ethnogarden.com/cart/index.pl/catid_86/proid_187/_/_/Bala2and4Extracts/SidaCordifolia.