Polyphenols as Mood Elevating Agents

weight lossEvidence suggests that free radicals and oxidative stress may be a cause of mood disorders such as anxiety and depression. That both these disorders are associated with increases in environmental stress, and that stress can be a cause of free radical generation, creates a mechanisms by which free radicals and oxidative stress may influence mood. Diets high in antioxidants may be protective of mood disorders, and this may relate to the ability of dietary antioxidants to prevent the deleterious effects of free radicals and oxidative stress. One interesting finding of research is that a large number of drugs that are useful in the treatment of mood disorders including anxiety and depression, are also effective antioxidants in the brain. This has lead to speculation that the antioxidant capacity of mood enhancing drugs may explain their mechanism of action. If drugs used to treat mood disorders are effective because they are able to inhibit oxidative stress, this may explain the beneficial effects of antioxidants in foods.

polyphenols anxiety depression

A number of mood elevating drugs including imipramine, fluoxetine, sertraline, citalopram and amitriptyline have all shown antioxidant effects in various models of testing, including human trials. The antioxidant effects of polyphenols may therefore explain in part their clinical effectiveness at treating mood disorders. This antioxidant effect may derive from a neuroprotective effect. Berries, cocoa, red wine, tea, fruit and vegetables are excellent sources of polyphenols.

Polyphenols are one class of phytochemicals that have been shown to have antioxidant effects in humans and animals. A large number of polyphenols have been shown to have antidepressant and anxiolytic effects including chlorogenic acid, rosmarinic acid, caffeic acid, quercetin, rutin, epigallocatechin gallate, chrysin and apigenin. A number of these polyphenols have been shown to interact directly with the GABA receptors in the brain that may be involved in reducing anxiety. However, studies have shown that in addition to these GABA effects, polyphenols do appear to have mood elevating effects by other mechanisms, perhaps by their ability to reduce oxidative stress in the tissues of the brain. For example, chlorogenic acid has been shown to interact with the GABA receptor directly conferring an anxiolytic effect, but also confers a general neuroprotective effect in brain tissue, probably due to its ability to inhibit the oxidative stress that damage neurones. Other polyphenols have also shown this dual role.

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Behr, G. A., Moreira, J. C. and Frey, B. N. 2012. Preclinical and Clinical Evidence of Antioxidant Effects of Antidepressant Agents: Implications for the Pathophysiology of Major Depressive Disorder. Oxidative Medicine and Cellular Longevity. 2: doi:10.1155/2012/609421
Bouayed, J. 2010. Polyphenols: a potential new strategy for the prevention and treatment of anxiety and depression. Current Nutrition and Food Science. 6(1): 13-18
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The Stress, Inflammation, Free Radical Link to Low Mood

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Alpha Linolenic Acid Is Neuroprotective

weight lossAlpha linolenic acid (ALA, C18:3 (n-3)) is a long chain fatty acid synthesised by plants. It is polyunsaturated fatty acid and contains three double bonds. Alpha linolenic acid is present in small amounts in most plants, and green leafy vegetables can provide a reasonably intake. However, flax and hemp seeds as well as walnuts are particularly rich sources. Alpha linolenic acid is an omega-3 fatty acid (it’s first double bond is 3 carbons from the methyl end of the molecule) and also happens to be an essential nutrient in human nutrition. Humans cannot synthesis ALA, but require it for the synthesis of longer more unsaturated fatty acids such as eicosapentaenoic acid (EPA, C20:5 (n-3)) and docosahexaenoic acid (DHA, C22:6 (n-3)). These fatty acids play a role in brain development and may have neuroprotective effects because they can confer anti-inflammatory effects on cells and tissues. Evidence suggests that in its role as a precursor to these compounds, ALA might have beneficial effects on mood and brain health.

wlanuts depression

Walnuts are a good source of alpha linolenic acid. Walnuts also contain high amounts of antioxidant nutrients. Walnuts may therefore provide anti-inflammatory and antioxidant effects that could benefit brain health through a neuroprotective effect.

For example, it has been shown that ALA can protect the brain of animals from damage after a single treatment via injection. Further a lower and more physiologically relevant dose can also provide beneficial neuroprotective effects. In this regard ALA injected into the animals was able to increase the generation of new neurones and increase the expression of key proteins required for correct neuronal signalling. These effects were associated with increases in brain-derived neurotrophic factor (BDNF), a protein that has been shown to be required for neuronal growth, repair and regeneration. It is known that BDNF has antidepressant effects in animals and humans, and when administered ALA, mice shows significantly lower levels of depressive-like symptoms. Therefore ALA appears to have significant neuroprotective effects in animals, and this seems to translate into improvements in brain plasticity and mood. As well as animal models evidence also suggests that ALA is beneficial to mental health and mood of adult humans.

flax seeds depression

Other dietary sources of alpha linolenic acid include flax seeds (pictured) and hemp seeds. Green leafy vegetables also provide a source of dietary alpha linolenic acid.

It is known that the large increases in depression observed over the last century, coincide with reductions in the intakes of omega-3 fats. Biochemical assessments of blood also show that lower levels of omega-3 fatty acids correlate with increased risk of depression. Elevations in the ratio of arachidonic acid (AA, C20:4 (n-6)) to EPA appear to be predictive of depressive symptoms being present. This supports the contention that elevated levels of omega-6 fatty acids, in combination with depressed levels of omega-3 fatty acids are particularly important in producing an increase in the risk of depression. Supplemental EPA has been shown to be beneficial in treatment-resistant depression, unipolar disorder and women with borderline personality disorder. The genetic individuality for enzyme activities involved in metabolising long chain fats could explain the varying susceptibility to depression from different diets. That some antidepressant drugs also have anti-inflammatory effects might explain their benefits.   

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Blondeau, N., Nguemeni, C., Debruyne, D. N., Piens, M., Wu, X., Pan, H., Hu, X., Gandin, C., Lipsky, R. H., Plumier, J., Marini, A. M. and Heurteaux, C. 2009. Subchronic alpha-linolenic acid treatment enhances brain plasticity and exerts an antidepressant effect: a versatile potential therapy for stroke. Neuropsychopharmacology. 34(12): 2548-2559
Richardson, A. J. 2003. The importance of omega-3 fatty acids for behaviour, cognition and mood. Scandinavian Journal of Nutrition. 47(2): 92-98
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Asparagus racemosus: Possible Mood Elevating Herb?

weight lossAsparagus racemosus is a herb traditionally used in Ayurvedic medicine as an adaptogenic herb. In this regard, extracts of the herb may provide an anti-stress effect on the consumer and the effects of the herb are non-specific, but improve the general resistance of the individual to stressful events. In Ayurvedic medicine, tonics that have general anti-ageing, anti-stress, immune and cognitive stimulating effects are called rasayanas, and Asparagus racemosus is considered to fall into this category as an adaptogen. As with other adaptogenic herbs such as Panax ginseng, jiaogulan, ashwagandha, Siberian ginseng, mimosa, brahmi and gotu kola, Asparagus racemosus contains a group of phytochemicals called saponins that may provide the anti-stress effects of the herb. Studies have shown that extracts of Asparagus racemosus standardised for saponin can reduce the effects of experimental stress on rats. As stress is implicated in the development of mood disorders, Asparagus racemosus may have mood elevating properties.

asparagus racemosus shatavari anxiety depression

One caveat about Asparagus racemosus is that some animal data suggest that it might have teratogenic effects. Therefore, as with most herbs, care should be taken in those females who are at risk of getting pregnant. Image is Asparagus racemosus. Image from: By Neha.Vindhya (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons.

The mood elevating properties of Asparagus racemosus have been investigated in animal models. For example in one study, methanol extracts of Asparagus racemosus were prepared to contain 62.2 % saponins. These extracts were then administered to rats and for 7 days at various doses before the rats were exposed to experimental stress. The results of the study showed that the Asparagus racemosus extracts conferred significant antidepressant effects on the rats. In addition the researchers noted that the extracts were able to attenuate the fall in antioxidants seen following exposure to stress. Based on the way the rats responded to administration of 5-hydroxytryptophan but not to L-DOPA, the researchers concluded that the Asparagus racemosus extracts were probably having their effect through regulation of the serotonin, rather than dopamine system. Therefore Asparagus racemosus may have mood elevating effects through modulation of the serotonin systems of the brain, at least in rats.

asparagus racemosus shatavari anxiety depression

Asparagus racemosus is a herb that is common to Nepal, India and Sri Lanka. The herb can grow to 2 meters in height and grows predominantly in rocky and sandy soils at higher altitudes. The leaves of the herb are shaped like pine needles, and it produces white flowers. Other common names for Asparagus racemosus include satavar, shatamull and shatavari. The plant contains a number of steroidal saponins including shatavaroside A, shatavaroside B, filiasparoside C, shatavarins, immunoside, and schidigerasaponin D5 (also called asparanin A), and these have been isolated from the roots. The flavonoid isoflavone 8-methoxy-5,6,4′-trihydroxyisoflavone 7-O-β-D-glucopyranoside has also been isolated from the plant. Image is Asparagus racemosus flowers. Image from: By Silk666 (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons.

In another study, researchers investigated the possible metabolic effects of Asparagus racemosus using in vitro experiments. The results showed that extracts of Asparagus racemosus were able to significantly inhibit the enzyme acetylcholinesterase and monoamine oxidase, but this was less effective than known acetylcholinesterase and monoamine oxidase inhibiting drugs. Also, the researchers noted that there was a positive correlation between the saponin content of the herbs and the enzyme inhibiting effects, suggesting that the saponins may have been causing the effects. In another study, Asparagus racemosus was evidenced to have anxiolytic effects similar to those of diazepam in animal experiments, but without evidence of sedation. In this experiment, the Asparagus racemosus extracts increased serotonin and noradrenaline levels in the brains of the rats and increased expression of serotonin receptors. The effects of the herbal extracts were evidenced to be caused by interaction with the GABA receptor.  

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Singh, G. K., Garabadu, D., Muruganandam, A. V., Joshi, V. K. and Krishnamurthy, S. 2009. Antidepressant activity of Asparagus racemosus in rodent models. Pharmacology Biochemistry and Behavior. 91(3): 283-290
Meena, J., Ojha, R., Muruganandam, A. V. and Krishnamurthy, S. 2011. Asparagus racemosus competitively inhibits in vitro the acetylcholine and monoamine metabolizing enzymes. Neuroscience Letters. 503(1): 6-9
Garabadu, D. and Krishnamurthy, S. 2014. Asparagus racemosus attenuates anxiety-like behavior in experimental animal models. Cellular and Molecular Neurobiology. 34(4): 511-521
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Selenium and Mood

selenium mood anxiety depression

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Multivitamin and Mineral Formula For Mood?

multivitamin mood anxiety depression

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Pomegranate Juice To Lower Blood Sugar?

weight lossA high postprandial glycaemic response to foods is detrimental because it leads to the nutrient overload syndrome. Simplified, the nutrient overload syndrome is a situation whereby a high intakes of carbohydrate overwhelm the ability of cells to cope with the energy efficiently. This leads to activation of metabolic pathways to deal with the excess energy, and if these pathways are repeatedly activated disease may result. The nutrient overload syndrome may cause excessive free radical generation in cells and this may lead to insulin resistance and weight gain. If this process continues it is likely that type 2 diabetes will eventually develop. Healthy people therefore must limit the amount of carbohydrate that is presented to the cells with each meal, and this will allow them to more efficiently deal with the energy. Because of the problems with postprandial glycaemia a large amount of research has been performed to investigate foods and food components that can slow the rate of digestion and absorption of carbohydrate foods.

Polyphenols are one group of phytochemicals that may have beneficial effects on the rate of absorption of carbohydrate foods. Polyphenols have been shown to slow the rate of absorption of glucose following the ingestion of starch. For example, pomegranate polyphenols have been investigated for their ability to lower postprandial glycaemia. In one study subjects consumed bread with either pomegranate juice containing pomegranate polyphenols or a supplement of pomegranate polyphenols. The pomegranate juice was effective at lowering the postprandial response of the subject to the bread, indicating that the juice was effective at slowing the absorption of the glucose from the starch. In contrast, the supplement containing pomegranate polyphenols was not effective. In addition, the researchers noted that solutions containing malic acid and citric acid, to mimic the acidity of the pomegranate juice, were also ineffective at lowering postprandial glycaemia in the subjects, indicating that pH may not have been a factor.

pomegranate polyphenols

Polyphenols may inhibit starch digesting enzymes and glucose transport proteins on enterocytes. These two factors may reduce the digestion and absorption rate of starch and glucose, respectively, when co-administered with high polyphenol foods.

The same group of researchers then investigated the effects of the pomegranate polyphenol punicalagin on the starch digesting enzyme alpha-amylase. The results of this experiment showed that punicalagin was able to significantly inhibit the activity of alpha-amylase in a comparable way to the known alpha-amylase inhibiting drug acarbose. Therefore one of the mechanisms by which pomegranate may provide beneficial glycaemic effects is through the inhibition of starch digesting enzymes. In addition, the researchers also showed that certain glucose transporters may be inhibited by punicalagin, thereby further slowing the absorption of glucose. This is not surprising as it is known that some polyphenols may be absorbed from the small intestine by sugar transporters, and this may relate to the fact that many polyphenols are bonded to sugars in plants, forming polyphenol glycosides. The authors suggested that the lack of effect of the supplement may be due to inefficient mixing of the supplement in the stomach.

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Kerimi, A., Nyambe-Silavwe, H., Gauer, J. S., Tomás-Barberán, F. A. and Williamson, G. 2017. Pomegranate juice, but not an extract, confers a lower glycemic response on a high–glycemic index food: randomized, crossover, controlled trials in healthy subjects. The American Journal of Clinical Nutrition. 106(6): 1384-1393
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Weight Loss Causes Skeletal Muscle Loss: More Evidence

weight lossThe mainstream solution to weight gain is a forced calories restriction diet and aerobic exercise. These are often used in combination in order to elicit a ‘negative energy balance’ which is assumed will cause weight loss. Often weight loss does result from such a strategy, but what is often not explained is that this weight loss includes a large amount of skeletal muscle mass and internal organ weight. For example in one study researcher investigated the effects of a dietary lifestyle interventions on overweight subjects with type 2 diabetes. One of the interventions was successful at causing weight loss in the subjects which amounted to a significant 6.6 kg over the course of one year. However, by year two some of this weight had been gained back and so at the year 2 point, weight loss amounted to 5.2 kg. Around 1.4 kg of the lost weight was skeletal muscle, and this was from both appendicular and trunk muscle mass. The subjects regained their appendicular skeletal muscle mass in the second year, but their trunk mass did not return.

weight loss

Weight loss can often include skeletal muscle loss and internal organ weight reductions. Such changes may explain some of the negative metabolic changes that occur with forced energy restriction in combination with aerobic exercise. The safest and most effective way to lose body fat, is to consume high quality foods and perform a combination of light aerobic exercise such as walking, in combination with some sort of resistance or higher intensity exercise. This allows maintenance and perhaps even the synthesis of new muscle mass, and this causes significant improvements in body composition and body shape.

Compared to many studies the skeletal muscle loss in this group of subjects was not extreme, but it does illustrate that skeletal muscle mass will be lost when energy restriction occurs. This study also noted that there was a significant reduction in the weight of some of the internal organs, most notably the liver and the spleen. Some of this weight could have been associated fatty tissue, as the liver particularly will increase its weight due to fatty acid accumulation. There was also a significant decrease in the mass of the kidneys of the subjects. Weight loss using forced energy restriction and aerobic exercise to cause a negative energy balance does therefore have a downside, and care should always be taken in such matters. That trunk skeletal muscle mass did not return may be due to the lower body weights that required less support, or may have been for other reasons. If this was for other reasons, this is concerning, and highlights that some weight loss changes are semi-permanent in nature, and could have long term health implications.

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Gallagher, D., Kelley, D. E., Thornton, J., Boxt, L., Pi-Sunyer, X., Lipkin, E., Nyenwe, E., Janumala, I., Heska, S. and the MRI Ancillary Study Group of the Look AHEAD Research Group. 2016. Changes in skeletal muscle and organ size after a weight-loss intervention in overweight and obese type 2 diabetic patients. The American Journal of Clinical Nutrition. 105(1): 78-84
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The Post-Antibiotic Era: Probiotics and Predatory Bacteria

weight lossIt is undeniable that the advent of antibiotics saved a large number of lives of people who would otherwise have died of bacterial infection. Penicillin was the first widely available antibiotic, but since this time a large number of antibiotics have been produced and now they are routinely given to animals and humans often for minor infections of the upper respiratory tract infection or prophylactically added to the food supply to increase food production. It has become evident that antibiotic use has become excessive and this has lead to a serious problem with antibiotic resistant strains of bacteria that are now immune to the antibiotics that were once used to kill them. Saving antibiotic use for the most severely ill patients, and using other strategies to improve the health of those with less serious infections would be a far more efficient and sustainable strategy to improve the health of populations as a whole. In this regard there are a number of factors that can be considered to achieve these goals.

antiobiotics

Antibiotic resistance is a serious issue. Avoiding the use of unnecessary antibiotics, and improving general health as much as possible are the best strategies to limit infections.

Firstly, bacterial infections are much less likely is a healthy population. Humans and animals have immune systems that are designed to identify, find and kill bacteria, before they have a chance of causing infection. Improving general health is therefore the most obvious way to limit the requirement for antibiotics. Claude Bernard described the health of the interior of the tissues as the milieu interieur, and suggested that the health of the internal terrain of the organisms was paramount in maintaining the health of the cells and their components. Eating high quality foods, rich in fruits and vegetables, with adequate high quality protein, the correct balance of essential nutrients, and living a relatively stress free life can go along way to supporting an immune system that is able to defend against pathogens such as bacteria and viruses. This is a basic requirement of human health but is sadly overlooked by most individuals, and as a result their health suffers and they become chronically ill and suffer frequent infections.

Another important strategy in maintaining health and preventing bacterial infections is the use of probiotics and prebiotics. Probiotics are ‘friendly’ bacteria required by the gut for correct function. These can include species such as Lactobacillus acidophilus and Bifidum bacteria which are colonisers of the gut and are required for the fermentation of food stuffs into useful and metabolically active components. In this process, these Gram-positive bacteria outcompete pathogenic Gram-negative bacteria for food, and this limits their growth and potentially reduces the chance of bacteria infection. Fermented milk products such as yoghurt, or supplements containing beneficial bacteria can significantly improve the health of the individual for this reason. Prebiotics are foods that can be used by the Gram-positive bacteria, and this increases their population sizes further. Foods containing fibre have prebiotic effects, and supplements of specific fibre types such as inulin and fructooligosaccharides (FOS) are also prebiotics.

garlic antibiotics

Antibiotics can have serious health effects. Evidence shows that antibiotic use can cause mental health problems in some individuals, and use of doxycycline may increase depression and the risk of suicide. Natural antibiotic foods such as garlic provide a very useful and efficient alternative to pharmaceutical drugs.

Another more recent innovation is the use of predatory bacteria. While probiotics tend to kill pathogenic bacteria through the outcompeting of the bacteria for food, predatory bacteria actively kill the Gram-negative bacteria. Mice and rats are particularly susceptible to upper respiratory tract infections by Gram-negative bacteria. In rats and mice, Gram-negative predatory bacteria have been used to significant lower rates of infection caused by problematic pathogenic bacteria. In cell culture studies, the use of predatory bacteria such as Bdellovibrio bacteriovorus and Micavibrio aeruginosavorus have been investigated for their anti-pathogenic effects. In this regard, they have been shown to inhibit the growth of Acinetobacter, Aeromonas, Bordetella, Burkholderia, Citrobacter, Enterobacter, Escherichia, Klebsiella, Listonella, Morganella, Proteus, Pseudomonas, Salmonella, Serratia, Shigella, Vibrio and Yersinia in biofilms, suggesting the technology might have useful applications in humans health.  

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Walter, J. 2008. Ecological role of lactobacilli in the gastrointestinal tract: implications for fundamental and biomedical research. Applied and Environmental Microbiology. 74(16): 4985-4996
Shatzkes, K., Singleton, E., Tang, C., Zuena, M., Shukla, S., Gupta, S., Dharani, S., Onyile, O., Rinaggio, J., Connell, N. D. Kadouri, D. E. 2016. Predatory bacteria attenuate Klebsiella pneumoniae burden in rat lungs. MBio. 7(6): e01847-16
Dashiff, A., Junka, R. A., Libera, M. and Kadouri, D. E. 2011. Predation of human pathogens by the predatory bacteria Micavibrio aeruginosavorus and Bdellovibrio bacteriovorus. Journal of Applied Microbiology. 110(2): 431-444
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Guduchi (Tinospora cordifolia): Ayurvedic Mood Enhancer?

weight lossGuduchi (Tinospora cordifolia) is an ayurvedic herb belonging to the Menispermaceae family of plants. Other common names for guduchi include heart-shaped moonseed and giloy. The herb is a deciduous climbing vine with greenish yellow flowers that grows as high altitudes in parts of India and Sri Lanka. Guduchi has been used traditionally for its anti-stress, antidiabetic, antioxidant, anti-allergic, anti-microbial, hepatoprotective and immune enhancing effects. Evidence suggests that guduchi may also possess mood elevating effects in animals. For example, in one study, researchers investigated the effects of guduchi extracts on the mood of mice exposed to experimental stress. After 14 days of consuming guduchi extracts, the mice experienced significantly less depressive behaviour indicating the extracts may have had an antidepressant effect. Evidence suggests that the extracts inhibited the monoamine oxidase enzymes, thus raising levels of brain monoamine neurotransmitters.

In another study the mood elevating effects of guduchi were tested on rats. Rats were deprived of sleep in order to induce detrimental mood changes such as anxiety and detrimental motor coordination. Administration of guduchi extract was able to significantly attenuate these negative sleep deprivation related effects. A number of cellular effects were observed that included a decrease in inflammation and an inhibition of markers that are associated with neuronal death. Therefore guduchi extracts appears to provide beneficial neurochemical changes that may occur as a result of sleep deprivation, and this produces cognitive benefits. Guduchi like many herbs also possesses significant antioxidant effects. These effects may play a central role in the beneficial effects of the herb as improving antioxidant status can have significant neuroprotective effects. Antioxidants may also significantly decrease inflammation and this may also indirectly protect neuronal structure and function.

guduchi anxiety depression

Guduchi contains a number of phytochemicals that may explain its biological activity including alkaloids, steroids, diterpenoid lactones, aliphatics, phenolics, sesquiterpenoids, polysaccharides and glycosides. These phytochemicals give guduchi adaptogenic and rejuvenating properties. It is likely that some of the beneficial mood elevating effects from guduchi come from its anti-stress effects, as stress is an important factor in the development of anxiety and depression. However, increases in monoamine neurotransmitters and modulation to the GABA system may also be contributory factors. Image: By Tmd at Thai Wikipedia [Public domain], via Wikimedia Commons.

In another study, a poly herbal preparation called Rasayana Ghana, which contains Guduchi, along with Aamalaki (Emblica officinalis) and Gokshura (Tribulus terrestris) was administered to mice exposed to experimental stress. The results of the study showed that the tablet was able to confer anxiolytic and antidepressant effects on the mice. In addition, the co-administration of ghee and honey significantly increased the mood elevating effects of the Rasayana Ghana formula, but co-administration of diazepam did not further improve the mood elevating effects of the herbal preparation. In certain tests the Rasayana Ghana was as effective as the antidepressant drug imipramine at inhibiting the depressive symptoms in the mice. Evidence suggests that guduchi is non-toxic, which may make it a viable alternative to mainstream treatments for mood disorders. The anti-stress effects conferred by guduchi, along with increases in monoamine neurotransmitters, may account for its beneficial effects.  

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Saha, S. and Ghosh, S. 2012. Tinospora cordifolia: One plant, many roles. Ancient Science of Life. 31(4): 151-159
Dhingra, D. and Goyal, P. K. 2008. Evidences for the involvement of monoaminergic and GABAergic systems in antidepressant-like activity of Tinospora cordifolia in mice. Indian Journal of Pharmaceutical Sciences. 70(6): 761-767
Mishra, R., Manchanda, S., Gupta, M., Kaur, T., Saini, V., Sharma, A. and Kaur, G. 2016. Tinospora cordifolia ameliorates anxiety-like behavior and improves cognitive functions in acute sleep deprived rats. Scientific Reports. 6: 25564
Deole, Y. S., Chavan, S. S., Ashok, B. K., Ravishankar, B., Thakar, A. B. and Chandola, H. M. 2011. Evaluation of antidepressant and anxiolytic activity of Rasayana Ghana Tablet (A compound Ayurvedic formulation) in albino mice. Ayu. 32(3): 375-379
Mutalik, M. and Mutalik, M. 2011. Tinospora cordifolia: Role in depression, cognition and memory. Australian Journal of Medical Herbalism. 23(4): 168-173
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