Adaptogens and Gastric Ulcers. Christine King, BVSc, MACVSc, MVetClinStud

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1 Adaptogens and Gastric Ulcers Christine King, BVSc, MACVSc, MVetClinStud Equine gastric ulcer syndrome (EGUS) remains a serious problem in racehorses and other performance horses. Sometimes in overt ways, but often in more insidious ways, it robs both horse and owner by compromising the horse s appetite, feed efficiency, condition, comfort, and willingness to work. Were we to be able to accurately calculate it, the amount of money lost to this disease would probably be breathtaking. GastroGard (omeprazole) paste has been a great leap forward in our ability to treat and prevent EGUS, particularly in horses that must remain in training, but over time the benefit of this drug can be outweighed by its cost. Changes in diet, feeding schedules, housing, exercise, and other management factors are important and they help many of these horses, as can the addition of antacids to the diet. But the fact remains that strenuous exercise is an important contributing factor for EGUS, and it simply cannot be avoided in horses in race training. Why are racehorses prone to ulcers? Why galloping increases the risk for EGUS is still not fully understood, probably because it encompasses a number of different factors. One theory involves the piston-like effect of the abdominal contents during the gallop: the rhythmic forward-and-back movement of the intestines with every stride repeatedly compresses the stomach against the liver and diaphragm, in the process sloshing the acidic contents of the stomach all over its upper wall, where most gastric ulcers occur. (This effect probably occurs at the canter, as well.) In horses, this upper portion of the stomach the squamous mucosa is lined with several layers of flattened cells called squames, similar to the outer layer of the skin (the epidermis). The lower portion of the equine stomach the glandular mucosa is similar to the stomach in humans and is the site of acid, enzyme, and mucus secretion. It is the upper, or squamous, portion of the stomach that is most prone to ulceration in horses, with the notable exception of ulcers caused by nonsteroidal anti-inflammatory drugs such as phenylbutazone, which typically occur in the glandular portion.

2 Strenuous exercise also causes transient elevations in stress hormones, changes in fluid and electrolyte balance, and a reduction in blood flow to the gut, all of which may slow the rate of cell turnover and repair in the squamous mucosa. In other words, the squamous cells which protect the upper portion of the stomach lining are replaced more slowly than normal, so the effects of minor or intermittent acid erosion can accumulate over time, eventually resulting in ulceration. To make matters worse, the damage is repaired more slowly if the horse remains in training. How can adaptogens help? Adaptogenic herbs can help with both the treatment and prevention of EGUS because they help moderate the stress response, increase the body s overall resistance to the various physical and psychological stresses of athletic training and competition, and improve the rate of cell turnover and repair in bodies under stress. Some of these herbs, such as Aralia species, have been shown to be as effective as the anti-ulcer drug cimetidine (Tagamet ) in treating and preventing gastric ulcers. Many different herbs have adaptogenic properties. The most commonly used and extensively studied include these: Asian and American ginsengs (various Panax species) Siberian ginseng (Eleutherococcus senticosus, aka eluthero; not a true ginseng, by the way) rhodiola (Rhodiola rosea, aka rose root and arctic rose) aralia (various Aralia species) schizandra (Schisandra chinensis) maral root (Rhaponticum carthamoides) Several of the medicinal mushrooms also have adaptogenic properties. Tables 1 and 2 summarize the most common effects of the adaptogens that are particularly relevant in athletes. But the properties and potential of the adaptogens can be summed up even more simply: better cell function, repair, and resistance. That translates into better function, repair, and resistance i.e. resilience of tissues, organs, and the system as a whole. The practical benefits for racehorses include these:

3 restoration and maintenance of healthy, lean muscle mass during the racing season increased resistance to illness and injury faster recovery from illness or injury (including gastric ulcers) increased resistance to wear-and-tear injuries and overtraining optimization of exercise capacity (speed and stamina) without the use of artificial stimulants restoration and maintenance of a good appetite and a general feeling of well-being Another potential benefit provided by Rhaponticum in particular is a positive effect on bone metabolism, which may help prevent or speed recovery from bucked shins, fractures, and other bone damage. How simple plant extracts can do all that is a subject for another time. Suffice it to say for now that adaptogens are among the most widely researched medicinal substances, with good safety profiles and a long track record in human athletes. When used as part of a good management and training program, the adaptogens can help get and keep the hard-working horse performing well and going strong over a season and for a lifetime. Where to find them Most of the adaptogenic herbs listed above can be found singly or in various combinations wherever herbal products are sold for humans. However, for both safety and convenience, it s usually best to stick with products that have been formulated specifically for horses, with good quality control and appropriate dosing instructions. One of my favorites is APF Pro (auburnlabs.com), which was formulated by an equine veterinarian, Dr. Mike Van Noy, for use in equine athletes. I do still buy individual adaptogenic herbs and use them either singly or in custom combinations for individual patients, but I use the APF products in most cases. Not only are they convenient for use in busy barns and at events, but I appreciate the fact that the company is committed to quality control, the safety and effectiveness of their products, and to veterinary research. Also, these products can safely be used in athletes competing under jurisdictions with strict medication rules. Final thoughts

4 In closing, GastroGard or other veterinarian-recommended medication is usually the best way to go when ulcers are present. And while GastroGard may also be used at a reduced dosage for on-going ulcer prevention, adaptogens are well worth considering for this role. Not only can they aid in ulcer prevention, they help further by supporting the entire system under the stress of training and competition, increasing the horse s resilience and thus his overall capacity to stay healthy and compete to the best of his ability. That makes the adaptogens both good medicine and good sense.

5 Table 1. Physical effects of adaptogens that are particularly relevant for athletes. Physical effects better endurance, delayed onset of fatigue better work capacity when tired or stressed improves the effectiveness of training, whether training for strength/speed or stamina faster recovery from strenuous exercise improves resistance to physical stressors (e.g. heat, cold, low oxygen, harmful chemicals, radiation) faster rate of tissue repair following injury improves immune function when stressed, which improves resistance to, and recovery from, illness antioxidant; helps protect against oxidative damage, which can be considerable with strenuous exercise improves cardiovascular function and oxygen transport mechanisms (counters anemia, improves oxygenation, maintains healthy blood flow) improves blood glucose regulation and facilitates the movement of glucose into muscle cells facilitates healthy carbohydrate, fat, and protein metabolism for optimal energy production and maintenance of lean muscle mass with training Table 2. Psychological effects of adaptogens that are particularly relevant for athletes. Psychological effects better resistance to mental/emotional fatigue better focus and accuracy when tired or stressed better learning and memory, particularly when tired or stressed calming in those prone to anxiety, nervousness, irritability, or aggression antidepressant in those prone to depression improves enjoyment of work improves quality of life and general sense of well-being