Quinine from Cinchona Bark: A potent bitter herb, misunderstood

Quinine Medicinal Cinchona Tree Bark Leaves Flowers

There’s been much talk lately about Quinine, what is it, what does it treat, and how?

TL;DR;

  • Quinine is a natural plant compound traditionally used to treat malaria and other illnesses
  • Quinine is very potent and POTENTIALLY FATAL if used improperly
  • The—now infamous—Hydroxychloroquine drug was invented by synthesizing a chemical compound that would demonstrate properties similar to the naturally occurring Quinine compound found in Cinchona tree bark
  • Although there are no scientific studies that suggest Quinine as a treatment for COVID-19, people have made the inference that if Hydroxychloroquine may treat the disease, then Quinine may treat it as well. Makes sense, right?
  • Many pharmaceutical synthetics are just imitations of naturally occurring medicines found in various plant species anyway

If you are a naturalist, an herbalist, a purist, or self-reliant, you might prefer trying natural medicinal sources instead of purchasing pharmaceutical variations which contain chemical additives.

AN OVERDOSE OF QUININE (Natural or Synthetic) COULD BE FATAL.

You’ve been warned, this isn’t your everyday sassafras herbies!

~ Written by Another Avid Naturalist, Ishmael Angelo, May 5th, 2020

In general, I use what's natural, because it just feels... well, natural

That’s why I support the all-natural, traditional plant-medicine based brand, Medicinal Foods, which uses only all-natural and organic superfoods.

Through life-long experiences and study, I've learned that nature provides everything we need to be healthy and thrive, without any superfluous meddling.

But I can understand the reasoning behind synthetic modifications:

  • Concentration - stronger, more precise, cleaner doses
  • Shelf-life - greater ability to stockpile, market and render profits
  • Quality control - knowing exact dosage/concentrations is important
  • Patents © - there is nothing more important than one’s health, so if someone owns the exclusive rights to a treatment, then clients may come to depend on it; thus, continuous revenues baby!

There, my natural biases are out of the way.

So with all the talk about Quinine, I wanted to learn more about what it is, let’s get into my research:

Quinine’s Properties

Quinine is a plant alkaloid; a naturally occurring plant compound (phytochemical).

It is a bitter astringent produced in the bark of the Cinchona tree (Cinchona officinalis).

It is native to South America and of the Rubiaceae family.

Common names are: quinine, quina, red cinchona, cinchona bark, Jesuit’s bark, and loxa bark among a few.

Unassuming, but Easily Identifiable Appearance

Taxidermical artwork of Cinchona officinalis - Royal Botanical Gardens:

Cinchona Officinalis Curtis Botanical Royal Botanic Gardens

Do you know your plants?

As with any language or skill, learning to identify plants just takes tuning in, and then, like all things, practice.

Thereafter, like a musician who picks out notes that float through the air in a tune, we come to easily consume the data that easily identifies a plant, picking out clues from what used to be just cacophonies of green.

Cinchona Photo Flowers Tree Bark

Cinchona has rough bark and branchlets covered in minute hairs.

Stipules lanceolate or oblong, acute or obtuse, glabrous.

Leaves lanceolate to elliptic or ovate, usually about 4 inches long and 1.5 inches wide; acute, acuminate, or obtuse tip...

Inflorescences in terminal panicles, many-flowered; hypanthium with short coarse hairs; reddish calyx with triangular lobes; pink or red corolla… the corolla tube being about 2.5 inches long.

When the bark of the Cinchona tree is peeled back or chipped off, a bitter red liquid seeps out. This is the rawest source of pure, unadulterated Quinine; the bark has a concentration of about 5%

Tastes Horrible!

Freshly cut Cinchona officinalis bark:

Cinchona Officinalis Tree Red Bark

The redish liquid is so bitter that some vomit after ingesting it; this is powerful plant medicine.

(I’ve chewed a piece of Gentian root before, said to be as bitter as Cinchona bark. I’ll update here as soon as I get ahold of some Cinchona to taste).

Even after extraction or encapulation in a capusule, the bitterness and potency of this plant compound can still cause severe nausea and vomiting.

So how does is work as medicine?

Interestingly...

How quinine works as a medicine is not entirely clear...
[quinine, wiki]

Doctors have prescribed Quinine for malaria and scientist have studied its effects for over 100 years, but with all of today's latest technologies, they are still not entirely clear how it works.

But it appears to work by raising the pH, the alkalinity within cells and their interactions with pathogens.

Each of the antimalarials tested (chloroquine, quinine, and mefloquine) as well as NH4Cl inhibited parasite growth at concentrations virtually identical to those that increased parasite vesicle pH. [Source: nih.gov pubmed]

And here, another study links this pH elevating action of quinolines to the inhibition of viral replication:

In addition to the well-known functions of chloroquine such as elevations of endosomal pH, the drug appears to interfere with terminal glycosylation of the cellular receptor, angiotensin-converting enzyme 2. This may negatively influence the virus-receptor binding and abrogate the infection, with further ramifications by the elevation of vesicular pH, resulting in the inhibition of infection and spread of SARS CoV at clinically admissible concentrations. [Source: biomedcentral.com]

The mission of Science is to discover the how and why something works (and from there, reproduce its effects using a controlled, synthetic compound)...

I support good Science, however, I also admire the ancient plant wisdom from cultures around the world, which tends not to dissect the hows and whys. From experience, they just know a rememdy works; and that was sufficient enough...

(The plants themselves instructed them, say the ancient peoples; perhaps a useful skill we've lost: listening?)

General guidelines for use

Dried Red Quinine bark from the Cinchona officinalis tree:

Red Quinine Bark Cinchona Officinalis Tree:

There are numerous ways to take quinine in its natural form, without the use of pills.

And even though there is ”insufficient scientific evidence supporting its effectiveness,” Cinchona is still used around the world today, especially in tropical regions, for many ailments, including:

  • increasing appetite
  • promoting the release of digestive juices; and treating bloating, fullness, and other stomach problems
  • blood vessel disorders including hemorrhoids, varicose veins, and leg cramps
  • influenza, swine flu, the common cold, malaria, and fever
  • cancer, mouth and throat diseases, enlarged spleen, and muscle cramps

Cinchona is used in eye lotions to numb pain, kill germs, and as an astringent.

Cinchona extract is also applied to the skin for hemorrhoids, ulcers, stimulating hair growth, and managing varicose veins.

Source for indications and dosage information: [webmd.com]

Dosage of Cinchona bark, and herbs in general

I make my own dosage calculations later in this article using extrapolations from the 324 milligram dosage found in prescription Quinine capsules, but first, here are some guidelines given by webmd:

The appropriate dosage of cinchona depends on several factors such as the user’s age and health, amongst several other conditions.

At this time there is not enough scientific information to determine an appropriate range of doses for cinchona. (in other words, "not a big priority," so many plants to research, and probably not a profitable endevor)

Cinchona bark seems to be safe for most people when used appropriately. However, in large amounts, cinchona is UNSAFE and can be DEADLY. (yes, just like anything taken in large amounts)

As always, do not use cinchona if you are pregnant or breast-feeding. Evidence suggests cinchona is UNSAFE to use during pregnancy/breast-feeding. (Absolutely!)

Symptoms of overdose: ringing of the ears, headache, nausea, diarrhea, and vision disturbances. (yeah, you probably took too much there dude)

Cinchona can also cause bleeding and allergic reactions, including hives and fever. (took too much!)

As with all medicines, those that occur naturally in plants, and those synthesized in labs: one must know their own predispositions... know thy body, know thyself.

However, we each must consult our doctors, and personally, observe our reactions to foods and medicines: no one spends more time with you than you!

Natural Medicine Alternative Herbs

We must be in tune to how much is safe to take, a few people may not be able to tolerate any at all, even at recommended dosages.

Be aware of changes that occur in your body, when you smell an herb, then immediately how a bit of it feels on your toungue, does your pulse change shortly after?

Never over do it, always take it slow, start with the smallest possible dose and slowly work your way up to the recommended dose.

Remember, a person can overdose on any prescribed pills if they do not follow their doctor’s instructions or if they mix with additional substances.

Herbal medicine should be respected and treated with the same level of care, perhaps even a higher level of caution because the concentration of phytochemicals in plants may vary from one sample to another.

Some people have allergies or are sensitive to certain foods or compounds. Having an abnormal heart rhythm, like a prolonged QT interval, or having low blood sugar, are two examples of preconditions where Cinchona bark should be avoided.

The easiest way to begin testing one's own sensitivity to Quinine is to drink tonic water (discussed later), which has a very low FDA approved amount for general public consumption.

The difference between a medicine and a poison is dosage. Anything can be overdosed, even drinking too much water can kill a man.

Decoction from Cinchona bark

Again, Cinchona bark is approximately 5% Quinine. The bark can be taken in the form of a tincture, decoction, or infusion.

Traditionally, the bark is prepared as a decoction taken at a dosage of half a cup, 1 to 3 times daily.

Excellent resource: Detailed information on preparation and dosage of Quinine

Where can you get the bark?

If you are one of the brave and perhaps adventurous, it’s fairly easy and inexpensive to get your hands on Cinchona bark.

A pound of it only costs $6.30 at SF Herb (no affiliation, it's just what Google returned):

Cut Cinchona Bark from Sfherb

Personally, I'll be out on walkabout soon to see if I can, um, bark up the right tree.

Tonic Water as a source of Quinine

Tonic water contains a very small amount of Quinine, and yet the bitter taste remains palatably perceptible. The small amount in tonic water is safe for just about everyone to drink on an occasional basis.

The FDA allows only 83 parts per million of Quinine in tonic water; that’s a very small dose, only a lab can measure that.

But we can make a correlation to wrap our heads around it: that’s 1 drop diluted into 830 gallons of water!

Tonic water contains quinine, shown with lemon

And even when diluted as such, we detect its intense bitterness. Powerful stuff.

Traditionally, people turned to drinking tonic water to treat nighttime leg cramps. But...

The FDA banned its use for leg cramps because of potentially harmful side-effects.

Further guidelines on dosage for Quinine in tonic water and cocktails can be found here: Quinine, Tonic Water, Cinchona Bark Safety in Cocktails

Gin and Tonic

In the 18th century, British officers in India and other tropical areas took quinine to help fight off malaria

The quinine powder made from cinchona bark tasted awful so they mixed it with soda and sugar, creating tonic water and thus inventing the Gin and Tonic!

Traditional use / History of Quinine

Quinine and related alkaloids have been the mainstay of antimalarial therapy since the 17th century, originally in the form of Cinchona bark.

Synthetic quinolines were first developed in the 1920s and 1930s.

Quinine is still used for the therapy of severe malaria. [Science Direct]

First known use

According to ScienceMag.org:

"The natives of South America do not appear to have been acquainted with the medicinal properties of cinchona bark, the bitter taste of which inspired them with fear."

(I'd personally like to call B.S. on this statement, I've never known a native to be "afraid" of any plant lol, careful with certain plants sure, but not afraid.)

"Although explorers discovered Cinchona in Peru in 1513, the bark was first used for the cure of fevers around 1630." [Chloroquine, Past and Present, ScienceMag.org]

It is amazing to me how nature always provides natural remedies to diseases and ailments in whatever region they are needed throughout the world.

Where there is naturally malaria, there are plants that naturally treat malaria.

I find that the nature of the universe is to maintain balance, we as observers can tune in to perceive these intricate patterns and flow within this great and divine dance.

Quinine use in drugs, extrapolation of a safe dosage

Dosage of Quinine capsules

According to MedilinePlus.gov:

Quinine comes as capsules in the form of Quinine sulfate.

Capsules are usually available in 324mg doses

For adults, 2 capsules can be taken, recommended with food, three times a day (every 8 hours) for 3 to 7 days.

Doing my own extrapolations here:

If Cinchona bark is about 5% quinine, then 1 gram of the bark (1000mg x .05 = 50) would yield about 50mg of Quinine.

So an approximate 300mg dose of Quinine could be obtained from a decoction of 6 grams of bark.

To me, that's already a lot of Quinine to take as a prophylactic (as a preventative measure) to passively inhibit the effectiveness of viruses and bacteria, while also reaping some of Quinine’s additional benefits such as improved digestion...

Personally, I would only drink a decoction of about 4-5 grams of the bark per day, that would give an approximate of 250mg of Quinine per day. I would also take a break every other week. I'd add stevia or honey to taste.

Further instructions from MedilinePlus.gov site:

Take quinine at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take quinine exactly as directed.

Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not open, chew, or crush them. Quinine has a bitter taste. [Source: medlineplus.gov]

And remember: The FDA banned its use for cramps because of potentially harmful side-effects.

Quinine Alkaloid Natural Plant Compound

MedlinePlus also states that:

The former importance of cinchona bark and its alkaloids in the treatment of malaria has been lessened by the introduction of synthetic drugs such as Chloroquine and Hydroxychloroquine.

Not for me, most pharmaceutical products with Chloroquine or Hydroxichloroquine also include the following chemical additives: Dibasic Calcium Phosphate, Hydroxypropyl Methylcellulose, Magnesium Stearate, Polyethylene glycol 400, Polysorbate 80, Starch, Titanium Dioxide.

Do we really need to ingest all of that?

I prefer pure foods and herbal medicines that grow direct from the earth, that do not require multiple systems of machinery to produce and tons of packaging to preserve, barrels of petroleum to deliver to the pharmacy.

Sometimes, a small, local economy, with local consumption is the most efficient and effective way to support a thriving society; there is nothing more direct than your own garden.

Hydroxychloroquine proven effective against malaria

(and now being tested against coronavirus)

Hydroxychloroquine: from malaria to autoimmunity.

Quinine was first recognized as a potent antimalarial agent hundreds of years ago.
Since then, the beneficial effects of quinine and its more advanced synthetic forms, chloroquine and hydroxychloroquine, have been increasingly recognized in a myriad of other diseases in addition to malaria.

The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China

Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection.
In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.

Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

As with other quinoline antimalarial drugs, the antimalarial mechanism of action of quinine has not been fully resolved. The most accepted model is based on hydroxychloroquine and involves the inhibition of hemozoin biocrystallization, which facilitates the aggregation of cytotoxic heme. Free cytotoxic heme accumulates in the parasites, causing death.

Hydroxychloroquine showing effectiveness in treatment of COVID-19

6,000 doctors worldwide including Dr. Zalenko say it's the #1 treatment

However, we should be careful about making what seems to be the next logical step:

That Quinine will work the same as Hydroxychloroquine

These further studies have not been conducted, so we do not have any scientific evidence to prove or disprove the effectiveness Quinine.

We can only make anecdotal extrapolations, but logic would infer that it could be beneficial.

However, Reuters states the following claim is absolutely False, that "tonic water and zinc will kill the coronavirus", however the truth is not always so clean cut. Reuters might be more correct by stating that it is an unproven claim
False claim: Tonic water and zinc will kill the coronavirus

"There is no scientific evidence that tonic water and zinc can prevent or treat COVID-19. As of mid-April 2020, there is no specific treatment or vaccine for the illness."

Facebook has labled the video of the Dr. who makes this claim as "Partly False Information." Correct.

But here is a misleading heading from the conversation.com: No Cinchona Bark is not a Cure

Wrong, it has not been proven one way or the other. It is incorrect to say that it is not a cure, and it is also incorrect to say that it is. Two contradictory, false headlines do not get at the truth of the matter.

Another interesting headline: Don’t Rely on Supplements to Treat or Prevent COVID-19

True, you should not solely rely on supplements, but it does not mean that they might not be helpful.

The article goes on to state that:

“There is no magic bullet to prevent COVID-19 with diet or supplements,” added Sharon Palmer, a registered dietitian nutritionist from California. “You can do the most to support your immune health with a diet filled with nutrients that are functional in immune defense, such as vitamins C, D, E, and zinc.”

To date, there is no laboratory or clinical evidence that quinine or any other cinchona bark compounds exhibit activity against COVID-19. Also, not everything that is natural is safe. Cinchona and quinine are toxic and can cause serious side-effects known as “cinchonism” which can include hearing and vision loss, breathing issues, and heart and kidney issues. It can also lead to a coma.

That's all fine, I agree, there is no clinical evidence. But we have no proven cure yet.

If, God forbid I become ill, what possible remedy would be easy for me to find and self-administer at home? Without having to risk going out, without needing a prescription?

Until there is clinical evidence that shows Quinine to be harmful if taken as a possible remedy for viruses and infections, I'll rely on my instincts and on natural remedies.

I think people who state that Quinine is a cure have good intentions, but it is indeed risky to make that claim without the evidence.

Gin And Tonic Meme

Officials and government organizations can not let the public believe that by just drinking tonic water they're immune, because then everyone's out livining it up like it's 1999, sloshing down zinc tablets with gin and tonics, then dropping dead the next day.

We do need institutions to coordinate large-scale efforts, but sometimes they move too slow to meet everyone's specific needs at their time of need...

Sometimes it's the simple, uncoordinated efforts happening everyday in every little neighborhood and village that really keep the world together.

Personally, I would choose for myself a small, 250mg prophylactic dose of Quinine decoction as a preventative measure, just in case.

As long as I don't have any sensitivities or harmful side effects in my own body, and I continue to practice social distancing and wearing a mask, then what can it hurt?

Conclusions on Quinine

Scientists are not fully sure how and why Hydroxichloroquine and Quinine treat malaria, but it has shown to be effective and seems to be related to raised pH levels in cells.

Scientists are also still unsure if Hydroxychloroquine is an effective treatment against COVID-19, however it is being tested and looks to be a promising treatment.

Articles and media outlets are quick to state that Quinine is not effective in treating COVID-19. But no studies have been concluded

(And there probably won’t be any funding nor priority for these studies, because natural Quinine would not be very profitable, effective or not.)

I agree, it is false to claim that Quinine is an effective treatment when it hasn’t been scientifically tested.

However, it is also false to claim that it will not be effective, until studies have been conducted.

Anyone who is interested in trying for themselves must be aware though that they are on their own! and accept the consequences of their choices.

Aren’t we always really on our own anyway?

A doctor may be able to help us, and thank God for their expertise... but their knowledge and resources are limited… all knowledge and resources are limited to us.

There are no magic bullets nor magic potions and scientists still find themselves on a never ending quest to create cures for whatever is ailing you.

Ultimately, it's our own bodies that heal themselves and our own beating hearts that keep us going.

Humans have somehow gotten to this point just fine, for over 200,000 years on the planet without needing any pharmaceuticals or scientific studies to get by.

So in conclusion, take everything said, on both sides of the argument, with a grain of salt or a swig of tonic… and always, always… follow your heart.

Takeaways:

  • Most synthetic pharmaceuticals are concentrated, adulterated imitations of natural, herbal plant medicines.

  • Hydroxychloroquine was made to mimic properties of naturally occurring Quinine, a compound found in the bark of the Cinchona tree.

  • There is anecdotal information that suggests Quinine may have treatment properties similar to that of Hydroxychloroquine

  • If you are a naturalist, an herbalist, a purist, a self-reliant, or an adventurer who is confident in the use of Medicinal Herbs, why not go straight to the natural source instead of purchasing a synthetic variation that contains chemical additives?

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