by Raphael d’Angelo MD

Background
The human immune system must deal with a host of microbial and infectious agents throughout a person’s life. Such challenges come from viruses, bacteria, fungi, parasites and those organisms that do not easily fit such well-defined categories.

The drawback to a conventional approach is that antibiotics do not address most viral infections including the common cold. Furthermore, the worldwide incidence of infectious diseases has not been reduced and the emergence of antibiotic resistant bacterial strains has increased the difficulty in the treatment of infections due to these organisms.

Additional problems with antibiotics include decimation of friendly mucous membrane bacteria, overgrowth of yeast and fungi, potential allergic reactions and serious side effects, potential interference with metabolism of other medications; and in repeated usage antibiotics have been associated with the emergence of leaky gut and autoimmune disorders. Finally, there is the cost of treatment, which includes the visit to the doctor, the antibiotic prescription and the cost of treating side effects or allergic reactions.

The naturally minded practitioner knows that a strong immune system is the best defense against infection. This is accomplished through proper nutrition, regular exercise, plenty of pure water, proper detoxification and elimination, adequate refreshing sleep and emotional-spiritual-relationship balance.

“The ratio of oils is proprietary and slightly changed from batch to batch to make bacterial resistance less likely for those patients taking them long term.”

Even with this preventive approach, an infection’s first sign may become noticed. At this point there are many tools at one’s disposal such as rest, increasing the intake of liquids, the ingestion of herbal extracts such as elderberry, certain vitamins and of course the use of specific essential oils utilizing one or more interfaces (topical, inhalation, internal).

It cannot be overemphasized that essential oil therapy is most effective when initiated at the first sign of an infection. The potential drawbacks with essential oil therapy are having them immediately available when the need arises; the time and effort to prepare a blend when feeling ill, using too little oil too late and the potential for allergic or toxic reactions although quite small when compared to conventional antibiotics.

The Oral Interface
In my practice of integrative medicine I utilize essential oils on a daily basis for many difference conditions. When faced with a patient that is fighting an infection I have in the past made up capsules containing specific essential oils in suitable carrier oil for ingestion. The preparation of such capsules is time consuming and the dosing is imprecise. Essential oils can irritate the stomach, reflux into the lower esophagus and then there is the question of the liver having to deal with a bolus of absorbed essential oil chemicals.

Product development
In February, 2008 a local compounding pharmacy hosted a luncheon at the clinic where I practice. They had recently developed and patented a way of taking male and female hormones in oil, and placing them in a tablet for hormone replacement therapy. Their research showed that the hormones were selectively absorbed by the lymphatics of the intestines, thereby bypassing initial degradation in the liver.

This concept intrigued me and a series of discussions led to an experiment in which they were able to successfully place my essential oil blend into a tablet form. Further experimentation resulted in a lightly enteric-coated, scored tablet holding 78.5 mg of essential oil.

Formulation
The essential oil blend contains the following essential oils: Cymbopogon martini (Palmarosa), Kunzea ambigua (Kunzea), Origanum compactum (Oregano), Citrus x limon (Lemon), Melaleuca alternifolia (Tea Tree), Cinnamomum camphora (Ravintsara cv 1,8 cineole) and Ocimum basilicum (Basil cv linalool). GC/MS analysis is utilized for quality assurance. The ratio of oils is proprietary and slightly changed from batch to batch to make bacterial resistance less likely for those patients taking them long term.

Dosing
Considering that the first pass was to go through the lymphatics and not to the liver, an adult dose of 2 tablets (157 mg total) four times a day for two days as a loading dose and then two tablets three times a day for seven more days totaling 58 tablets was chosen as a starting dose. From that point the doses for other ages was constructed for both strong immune support (acute infections) and maintenance support (see Tables 1.a. and 1.b.).

Table 1.a.
Recommended Dose for Strong Immune Support

AgeInitial doseContinuation dose

Table 1.b.
Recommended Dose for Maintenance Immune Support

AgeDose

The Clinical Trial
An 18 month open-label clinical trial was conducted from February, 2008 through July, 2009. Regular patients of my practice at Clinix Health Center who had an outpatient treatable infectious disease diagnosis who declined conventional treatment were offered a course of AromaTab™ as an alternative experimental treatment along with detailed written information on safety and use. Conditions for which AromaTab™ immune support was used are listed in Table 2. Follow up was generally by phone but in person when possible.

Results
During the 18 month trial 612 patients ranging in age from 5 years to 84 years received one or more courses of AromaTab™. Gastric upset was the most common side effect causing premature stoppage of the full course in 16 patients (2.6% incidence). One patient accidentally took 33 tablets at one time while high on another drug and experienced hives lasting several days. A prescription antibiotic was added to the course of AromaTab™ in 14 patients (2.2%) after it was determined that AromaTab™ alone was not fully handling the infection. Complete resolution of symptoms of acute outpatient common infections was noted in 455 (74.3%). For those patients on chronic maintenance for Epstein-Barr virus induced fatigue, 106 (17.3%) noted improvement. A total of 20 patients (3.2%) were lost to follow up. In summary, for those patients for whom AromaTab™ was the sole antibiotic treatment, 561 (91.6%) showed improvement or their symptoms resolved completely.

Discussion
Advanced sinus infection was the most frequent reason for having to add an antibiotic prescription. In two cases of urinary tract (bladder) infection there was incomplete clearing of the infection and required a few days of an antibiotic. For patients in which an antibiotic had to be added it was noted that the combination of AromaTab™ and the antibiotic resulted in more rapid clearing of infection resulting in fewer days needed on the antibiotic prescription. Patients with Candida uniformly reported excellent improvement. Four patients with Lyme disease showed improvement in symptoms. The respiratory viral infections like rhinitis, early sinusitis, bronchitis and influenza responded very well to AromaTab™. For those on anticoagulant medications (Coumadin, Warfarin) the tabs did not interfere with good control of blood clotting. Laboratory testing of the blood in selected patients showed no liver or kidney abnormalities.

Table 2. Conditions
AromaTab™ Immune Support May be Helpful For

• Bronchitis
• Strep Throat
• Acute Otitis Media
• Acute and Chronic Sinusitis
• Influenza
• Viral Upper Respiratory Infections
• Acute and Chronic Sinusitis
• Cystic Fibrosis prophylaxis
• Urinary Tract Infection
• Candida and yeast infections
• Skin Infections including MRSA
• Bacterial and viral intestinal infections
• Acute and chronic Epstein-Barr virus infection
• Lyme spirochete infection
• Allergies
• Intestinal parasites

The reviewed literature and the clinical experience suggest that the essential oil lipophilic complex is released in the small intestine and is absorbed into the enterocyte (1, 2). The majority of the essential oils forms a chylomicron-essential oil complex and are absorbed into the lacteals of the small intestine joining up with the abdominal lymphatic channel and ultimately emptying into the vena cava near the entrance to the heart. There the essential oils distribute to the general circulation, reach the extracellular fluid and ultimately undergo metabolism for excretion. A small amount of the total essential oils released into the intestine does reach the liver, but in amounts hundreds of times less than from an oil-filled capsule (3). The enteric coating allowed the essential oils to bypass the stomach in all but a few patients. The scored tablet allowed treatment of children as young as five years of age.

Conclusion
Considering the cost of many prescription antibiotics, AromaTab™ was found to be cost effective, convenient and well tolerated. It greatly reduced the need for antibiotic prescriptions while providing a primary treatment for viral infections. Since concluding the clinical trial, other practitioners and aromatherapists are using AromaTab™ and finding similar results. AromaTab™ has the potential to provide a safe first treatment for many common outpatient infections, reserving antibiotic prescriptions for more serious or prolonged infections. There is a need for further studies looking at a range of doses and duration of treatment for specific conditions.

© Raphael d’Angelo 2015

AROMATAB™ INFORMATION
AromaTab™ comes in a bottle of 60 tablets. To place your order, or for more information, email Nancy d’Angelo at essentiallynancy@cs.com, subject line: AromaTab or call 303-668-4884.

Professionals interested in providing AromaTab™ to their clients or patients may request and receive a training packet to ensure a full understanding of the dosage, safety and use of AromaTab™.

Acknowledgment
Appreciation to the staff of Green Mountain Pharmacy, Lakewood, Colorado, Julia Rose Botanicals, Aurora, Colorado, and the staff and patients of Clinix Health Center, Centennial, Colorado, for their part in the development of AromaTab™ and participation in the clinical trial.

References
1. Gershkovich P, Hoffman A 2005 Uptake of lipophilic drugs by plasma
derived isolated chylomicrons: linear correlation with intestinal lymphatic bioavailability. European Journal of Pharmaceutical Science 26(5):394-404 http://www.ncbi.nlm.nih.gov/pubmed/16140514

2. Cheema M, Palin KJ, Davis SS 1987 Lipid vehicles for intestinal lymphatic drug absorption. Journal of Pharmacy & Pharmacology 39(l):55-56 http://www.ncbi.nlm.nih.gov/pubmed/2880987

3. Trevaskis N Charman W Porter C 2007 Lipid based delivery systems and lymphatic drug transport: A mechanistic update. Advanced Drug Delivery Reviews 6-(6):702-716 http://www.ncbi.nlm.nih.gov/pubmed/18155316

Adapted from an article published in Aromatherapy Today Vol 47, April 2010