Metabolic syndrome in the horse is on a steady rise over time. In truth, given the high number of cases, diagnosed or not, it could be considered an epidemic. Metabolic related problems in the horse are an ‘effect’ more than a ’cause’, and if you desire to truly resolve or better manage the problem, it is best to seek cause rather than stifle the effects. There are many options in the metabolic horse which can assist you in accomplishing this feat, but now, there are even newer and potentially more effective therapies. Let’s dive into them!
EMS or equine metabolic syndrome is a complex cascade of events in the horse creating a multitude of health and soundness problems. In taking a rough guess based on experience, as to how many horses are impacted, I would estimate upwards of 65-70%. This estimation includes not only the obvious cases of metabolic syndrome in the horse, being overweight and sore footed, but includes a large percentage of equine athletes who go undiagnosed despite clinical problems.
Metabolic syndrome is a complex cascade of events, as mentioned above. For some horses, the main issue is being overweight, while in others there are foot related problems including laminitis or just sole tenderness. In some, the metabolic related cellular events cause problems regarding tendon and ligament health, performance and recovery. The bottom line in all of them is that there is a disruption of normal cellular metabolism. Does this have to result in an overweight horse? Not in all cases, but one thing is for certain and that is that an overweight horse has an increased tendency towards metabolic concerns.
There are many therapy options for managing the average metabolic horse, which have been discussed in numerous articles. The bottom line goal in helping the average EMS horse is to improve cellular function and health. This can be accomplished through many methods, some more potent or effective than others. The precise approach required for each individual horse can vary dependent on the severity of their condition and other factors such as diet, medications being given, and exercise. There are many working ‘arms’ in the creation of metabolic syndrome in the horse, thus, there is never ‘ONE’ thing that will resolve the problem. More so, it is a matter of altering many factors along with the proper use of nutrition and herbal therapy that will provide the best results in the majority of cases.
The vast majority of metabolic horses are plagued with insulin dysfunction and glucose metabolism problems, which are then connected to and secondarily create other inflammatory events such as foot pain, laminitis, and circulatory problems. These are all tied together.
In this article, our goal is to introduce you to some new formulas which have provided immense benefit in some of our small clinical trials in equine patients. These options are now readily available, but do require some knowledge and know-how, in their use and choosing between them.
Gynostemma, Gymnema, and Banaba Leaf in the Metabolic Horse
There are many herbs which can impact insulin function and glucose regulation in the horse, but many accomplish this feat secondarily. This means that the herbs are used and known for other main clinical benefits, but as an effect, they do modulate insulin and glucose metabolism. This is not their primary function essentially, but a secondary effect. Curcumin is one of them, as an example.
Gynostemma (Jiaogulan), Gymnema, and Lagerstroemia (Banaba leaf) are three herbs that are well known and heavily researched for their ability to impact insulin function and glucose or sugar metabolism. One of them, Gynostemma (Jiaogulan) is also utilized by many horse owners already in various doses to help them to manage their metabolic patients. Despite its usage, Gynostemma does not always yield favorable results in every horse, which is true for almost every herb. This is where and why we get into herb energetics, proper dosing, and synergism with other herbs.
Gynostemma is an herb used in Traditional Chinese Medicine to assist diabetic patients with glucose metabolism and weight loss. Gymnema is an herb used in Ayurvedic medicine to assist their diabetic patients with glucose metabolism and weight loss. Banaba leaf is an herb utilized in the Philippines for the exact same purposes. Three different medical cultures, same end goals, but different herbs. All three herbs are also heavily researched in the medical fields with documented papers noting clinical benefits when it comes to sugar metabolism, insulin function, and in some cases, weight reduction. Their usage goes back decades if not centuries in alternative medical fields.
All herbs used for medicinal purposes have within them phytochemicals which exert the health benefits, whether that be antioxidant properties, glucose lowering abilities, cardiovascular benefits, or curbing inflammatory events. It is these phytochemicals that we are interested in as they are responsible for most of the clinical benefits. Gynostemma pentaphyllum possesses many phytochemicals but the main ones of research interest are called Gypenosides. Gymnema sylvestre also possesses many phytochemicals with Gymnemic acids being of research interest, that not only can impact glucose metabolism and blood sugar levels, but interestingly ‘numbs’ the tongue to the point where the sweet taste of sugar is blunted. Banaba is much the same but the main chemical of interest is called Corosolic acid. These individual phytochemicals are the area of interest in research and are what appear to be responsible for most of the ‘metabolic’ type of benefits to the herbs. Of course, there are other phytochemicals present, but it is important to concentrate as much as possible on the primary phytochemicals as it allows for dose reduction and likely an improved efficacy in benefiting the metabolic horse.
When it comes to herbs, there are many herbs that can accomplish a certain task or provide health benefits, but every herb is not ideal for every patient, including the horse. Every herb has within it an energy and effects. Some herbs are warming, some cooling, and some outright heating to the body. Others can be moisturizing, while some are drying. Some are sweet and benefit digestion, while others can create upset in an already ulcerated environment. All three of these herbs; Gynostemma, Gymnema, and Banaba Leaf are cooling in nature and mildly drying upon the body. This is a good thing for most metabolic horses given that the vast majority of them do not do well in the heat and humidity of the spring and summer, and most of them have retained moisture or dampness within their bodies.
Going further, it is interesting to note that most metabolic horses, like their human counterparts, have disrupted digestive microbiomes which equates to digestive problems, dampness in the body, weight retention, and inflammatory events. These three herbs; Gynostemma, Gymnema, and Banaba Leaf, due to their energetic properties are also highly beneficial to the digestive tract and microbiome, so there are additional benefits. Going one step further, all three herbs have been demonstrated to modify and balance the inflammatory events in the body. Thus, there is a win-win in most metabolic horses with clinical problems.
The ideal scenario when using herbs is to use them in combination to achieve synergism. This is how herbs are used in Ayurvedic and Traditional Chinese Medicine for optimal results. Combinations allow for reduced doses and the ability to take advantage of synergism, which is built on similar benefits between herbs. For many horse owners, herbs are used individually and often haphazardly with little direction or intent. This can create problems and further imbalances if you are not careful, hurting rather than helping.
In our ongoing research in the metabolic horse, we have found synergism between Gynostemma, Gymnema, and Banaba leaf, using their concentrated extracts for optimal benefits and a lower dose. In our clinical trials, horses on the herbal blend as a stand alone with no other herbs given, demonstrated a reduced pre and post-prandial glucose, reduced fasting glucose, and a higher post-prandial ketone level. This translates into the fact that the majority of horses on this blend demonstrated much improved glucose control with lower levels and a higher ketone level after eating, which would equate to improved insulin function. Additionally, the horses on the herbal blend appeared more content, less irritable, more comfortable in hot environments and had reduced foot pain. These clinical benefits are the result of the improved glucose metabolism, insulin function, and likely reduced inflammation and improved digestive microbiome.
The herbal formula that we were using in those clinical trials is the Cur-OST EQ I.S., which is a synergistic blend of the three herbs in their concentrated extracts. This blend worked well for upwards of 80% of the horses with improvement noted in as little as 14 days with no side effects. Some digestive upset was noted at increased doses, however, which is likely due to the cooling nature of the herbs.
Impacting Circulation and Foot Pain in the Metabolic Horse
Metabolic syndrome, laminitis and foot pain go hand in hand. Where there is one, there is often the other, although some are not diagnosed or recognized. Many metabolic horses have diagnosed laminitis, which is inflammation of the connective tissue surrounding the coffin bone, resulting in foot pain, abnormal hoof growth and perceived rotation of the coffin bone on radiograph. Other horses, however, struggle with plain foot pain which is often the result of an unhealthy and thin sole, necessitating shoes, many times with pads, and an inability to walk on hard or rough surfaces.
The key to resolving these foot situations is to recognize that they are not separate from the main internal problem of metabolic related issues in the horse. If you treat the foot separately, as it’s own entity, without addressing the internal problems in your horse, you will lose the battle nine out of ten times. This is why many horse owners are constantly dealing with laminitis from one season to the next, or others are constantly switching shoes or using boots to keep their horses comfortable.
In the metabolic horse, foot related pain is associated with circulatory issues created secondary to the insulin dysfunction and lack of proper glucose control. These create inflammatory events in the body which lead to endothelial dysfunction, a fancy term to describe cellular damage inside blood vessels, which can lead to improper blood flow.
The primary goal in managing a metabolic horse with foot related pain would be to better manage the insulin dysfunction, inflammation, and secondary circulatory events. Sounds simple, right? It can be for some, but certainly more complex for others. One again, there is and never will be any ‘ONE’ solution which resolve all clinical problems in your horse. Metabolic syndrome and associated events are a result of many factors and for optimal results, all factors are managed.
When it comes to foot pain in the metabolic horse, it is interesting to note that some have more foot discomfort in the warmer times of the year, while others suffer more in the colder seasons. This is not unusual in any way, but signifies that there are different patterns present. On a basic level, the horse that has more problems in the warmer times of the year has more internal ‘heat’ inside their body, which is exacerbated by the heat and humidity of the season. The horse which has more problems during the colder times of the year has more ‘cold’ present in their body, which is likewise made worse by the colder environmental temperatures. The ‘hotter’ metabolic horse seems to be improved during the cooler seasons while the ‘colder’ metabolic horse stabilizes during the warmer times.
What’s the importance of this observation? You need to determine which one is your horse and use herbs appropriately to benefit their condition.
When it comes to improving circulation and blood flow, there are two herbs which stand out in research and alternative medicine. Those two herbs are Terminalia arjuna and Hawthorn Leaf and Berry. Terminalia arjuna is an herb used in Ayurvedic medicine to benefit heart disease and circulatory concerns. Hawthorn leaf and berry are herbs used in Traditional Chinese Medicine to benefit circulatory concerns and digestion.
As noted with other herbs, both Terminalia arjuna and Hawthorn contain numerous phytochemicals which demonstrate clinical health benefits. Terminalia arjuna is known for chemicals called tannins, while Hawthorn leaf and berry are both known for the chemical called vitexin. There are numerous benefits to these phytochemicals including improved blood circulation, altered nitric oxide levels, and balanced inflammation. The metabolic horse can benefit from all of these.
There is one thing here which separates these two herbs and that is their energy. Terminalia arjuna is known to be a cooling herb to benefit circulation, while Hawthorn is a more warming herb which can benefit circulation and digestion. Thus, Terminalia arjuna would be more suited for the ‘hotter’ type metabolic horse that has a harder time in the warmer times of the year. Likewise, Hawthorn would be better suited for the ‘colder’ metabolic horse that has more difficulties in the cooler times of the year. One horse needs to be warmed up and the other cooled down.
Ideally, we combine these circulatory herbs with the main three herbs to impact insulin function and glucose metabolism, especially in the metabolic horse with foot related pain. In our clinical studies, both circulatory herbs in conjunction with Gymnema, Gynostemma, and Banaba Leaf extracts resulted in improved foot comfort in about 14 days with a reduced digital pulse. These results have been far superior to anything we have witnessed to date, considering they were a stand alone blend, and only the diet was modified otherwise.
The two herbal blends that we use were:
- Cur-OST EQ I.S.C.C – cooling blend for foot related discomfort in the horse.
- Cur-OST EQ I.S.C.W – warming blend for foot related discomfort in the horse.
There are many approaches to benefit the metabolic horse and improve their quality of life. These herbal formulas are just one of many, but offer much promise and benefit, even when used alone with dietary modifications and lifestyle adjustments.
For more information on managing the metabolic horse, check out our book:
Author: Tom Schell, D.V.M, CVCH, CHN