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By Will Block

W ill the real snake oil stand up? Everyone knows that snake oil is a fraud, that it is identical to fake medicine. We are sure of this because the American film industry, in one Western movie after another, has portrayed the traveling medicine man as a huckster who, calling himself a “doctor,” sold a full range of phony “elixers,” including snake oil, from his wagon. These “fake cures” were sold from a platform attached to his wagon from which the peddler preached the benefits of his medicines, claiming they would solve all sorts of ills, from joint pain, to congestion, to skin rashes. Yet many of the alleged fake cures were real cures, especially when you consider the content of real snake oil.

Probably a fraud
The Audience and the Shill

As portrayed in the movies, an audience would gather around the traveling medicine man to listen to his spell-binding pitch about the wonders of snake oil for a wide spectrum of relief. During the presentation, a shill in the audience would brazenly testify to the great relief he had experienced as a result of using Dr. Medicine’s relief elixer. The shill was secretly in the employ of the huckster and following this “testimonial,” people would pony up their hard-earned money so they too could be relieved of whatever ailed them.

The real thing
The movies convincingly depicted the medicine man to be a quack, a con artist—a “snake oil salesman”—without any credentials or medical training, and all of his nostrums were never anything but bogus liniments, salves, and liquids. And as the story continued, by the time his trusting customers discovered that the medicine did nothing and was worthless, the “medicine” man had long left town. So is it any wonder that most of us still believe that snake oil is a fraud, and illegal to sell? But if that’s your belief, you are wrong. The right type of snake oil is very good, and its earned reputation fostered a growing demand back in the good old days (there were certainly bad old days).

Snake Oil for Joint Pain during the Gold Rush

You can still can buy real snake oil, in places such as China, and the Chinatowns in major cities of the world. A strong case can be made that the oil of certain snakes is highly therapeutic, and that among other benefits, it has a long tradition of use for pain remedy. Derived from Chinese water snakes, the original snake oil has been used for hundreds of years in China for arthritis, bursitis and other joint pains.

Snake oil is believed to have first appeared in North America during the Gold Rush in the mid-nineteenth century, when the discovery of gold in California attracted miners from diverse backgrounds—united by the goal of striking it rich. Among them were the Chinese who, drawn together by a common language, settled in camps scattered along the tributaries of the Yuba and Bear Rivers. By 1880, they represented 22% of California’s mining population, making them the largest single nationality engaged in mining. And of course they brought along Chinese medicine, of which snake oil—which was really fat extracted from Chinese water snakes—was highly comprised of omega oils as studies have shown (e.g., see below). As we now know, omega-3 fatty acids are prescribed today to reduce inflammation (which can lead to arthritis), reduce blood pressure, and more. This was particularly important for the aches and pains produced by the hard labor of mining and railroad building (an industry in which the Chinese were also significantly employed).

Chinese Water Snake Oil Higher in EPA than Salmon

According to Richard A. Kunin, M.D.,1 in a letter published in the Western Journal of Medicine in 1989, snakes have been a part of Western medicine for at least 4,000 years going back to ancient Sumeria. They were used by Andromachus, Nero’s physician, and by Galen. Snake medicine was still quite popular in colonial America, and “only in the past century [the 19th] have snake and snake oil become synonymous with quackery.”

Yet, another kind of oil has come into medical vogue in the last few decades and that is omega-3 fish oil, which now occupies the front rank of medical therapeutics (there is even an FDA-approved version). Omega-3s have been found to offer a spectrum of far-reaching benefits, including cardiovascular improvement, memory enhancement, and arthritis and inflammation relief. These are amazingly similar to what 19th century Chinese emigrants thought snake oil could do.

Dr. Kunin was unable to find any credible analyses of snake oil, so he sent samples to a renowned laboratory for analysis. The lab reports showed that Chinese snake oil was extremely high in eicosapentenoic acid (EPA), one of the two principle omega-3s (the other being docosahexenoic acid, DHA), and that the level of EPA was higher than that normally found in salmon (20% vs. 18%). And, of course, EPA (alone or in concert with other omega-3s) is known to be an effective treatment for a wide variety of diseases and conditions. Many of its benefits involve its ability to lower inflammation.

How Did Snake Oil Get Such a Bad Name?

It is highly possible as the trade for traveling medicinals increased that Chinese water snake oil became scarce and became diluted so much that it had fewer pain-relieving properties. Another possibility is that the market expanded into other snakes with lower EPA levels (the diet of Chinese water snakes consisted of lots of fish and thus the high levels of EPA). These included rattlesnakes and other native North American, all of which have lower levels of omega-3 oils and thus had far fewer benefits (Dr. Kunin’s analysis found that black rattlesnake contained only 21% the EPA of Chinese water snake).

Today, we are far better off with the wide availability of primary-source scientific studies and the speed with which the findings can be communicated (although the FDA limits the way that information can be used). In addition, supplements have become significantly more science-based, allowing health seekers to make substantially better choices. If you are determined to know what is true, you can now find more credible and reliable information online (and through publications such as Life Enhancement). Consequently, it has never been easier to avoid quackery and false promises. Finally, you can readily find out the scientific truth about omega-3s and, if you are persistent, even the truth about snake oil.

TTFCA: A New Snake Oil for Varicose-Less Legs and More

This brings us to another “snake oil,” Gotu kola (its botanical name is Centella asiatica). Widely used in the form of TTFCA (total triterpenic fraction of C. asiatica), which combines three primary active ingredients of C. asiatica, asiatic and madecassic acids along with asiaticoside in a specific ratio not found in the plant, TTFCA produces an extraordinarily wide range of preventive and therapeutic effects. This array of benefits is so vast that you are tempted to think that its proponents are posturing it as a cure-all. And when you get the full thrust of what is known about it, you are likely become quite skeptical, until you familiarize yourself with the scientific literature

Reduced or negligible varicose veins
can help to keep your legs beautiful.

Life Enhancement published an article about TTFCA in 2002 ( “Gotu Kola Combats Venous Hypertension” in the June, 2002 issue). This article was based on a remarkable collection of studies published in the journal Angiology (angiology is the study of blood vessels and lymph vessels) in a 2001 supplemental issue touting a staggering number of benefits. Here is what was found: TTFCA rebuilds vein walls; TTFCA slows capillary leakage; TTFA offers relief for patients with chronic venous insufficiency (CVI) including relief from edema, pain, restless limbs, etc.; TTFCA combats vasodilation; higher amounts of TTFCA yield better results; TTFCA produces improvement in all measures; and TTFCA makes arterial plaque more stable and thus less dangerous (see “Gotu Kola Can Help Prevent Heart Attack and Stroke” in the August, 2002 issue). What we were able to conclude is that seldom do research results point so clearly and unambiguously to the safety and efficacy of a nutritional supplement as in the case of TTFCA. And the net result of all of this is that CVI and varicose veins are far, far less of a problem. And, as if you haven’t been able to visualize this, reduced or negligible varicose veins can help to keep your legs beautiful (this is especially important if you are a female, but men can be vain too).

Flavonoids for Chronic Venous Insufficiency

Also of value for CVI and varicose veins, the naturally occurring flavonoids diosmin, hesperidin, and troxerutin have been demonstrated to be safe, effective supplements. Varicose veins and the complications of venous disease are thought to affect over a quarter of the adult population and the management of these conditions are a major cause of health service expense. Flavonoids are plant pigments that give colors to flowers, fruits, and vegetables. Diosmin and hesperidin in combination are used throughout much of the world as a treatment for CVI and related disorders. The standard formulation is called micronized purified flavonoid fraction (MPFF), which consists of 90% diosmin and 10% hesperidin.

A recent Russian study enrolled 245 patients with varicose vein disease who underwent unilateral combined phlebectomy (a minimally-invasive surgical procedure that removes surface varicose veins).1 The main group (n=200) received micronized diosmin, 1000 mg/day) for 2 weeks before and 30 days after the procedure; the control group (n=45) did not receive diosmin in the pre- and postoperative period.

Pain severity and subjective feelings of limb heaviness and fatigability were evaluated at one week, two weeks, and 30 days after the procedure. Subjective symptoms and the area of subcutaneous hemorrhage were significantly lower in the test group, compared to controls. This trend was observed for limb heaviness and fatigability (characteristics of CVI). This group also reported exercise and improved orthostatic tolerance among patients in the early postoperative period. Micronized diosmin in pre- and postoperative period after plebectomy helped to lessen pain syndrome, decrease postoperative hematomas, and accelerate their resorption, while increasing exercise tolerance in early postoperative period.

In another study, researchers evaluated the effects of a diosmin-containing agent that regulates the circulatory tone of the venous system, and investigated the role of enlarged veins in the pathophysiology of pelvic congestion syndrome.2 Twenty women between the ages of 28–35 with chronic pelvic pain were enrolled who had been diagnosed with the syndrome at laparoscopy.* They all had prominent broad ligaments and ovarian veins without other pathologies, such as endometriosis, to explain the cause of pelvic pain. Ten women were randomized in a fashion to receive 450 mg of diosmin and 50 mg of hesperidin twice/daily for six months (900 mg of diosmin and 100 mg of hesperidin per day), and ten women were used as controls.

* Laparoscopy is a common procedure to remove mild to moderate endometriosis, an outgrowth of the uterus.

After three months, the frequency and severity of pelvic symptoms started to decrease with the flavonoids, but not in the placebo arm. The mean scores were significantly less at the end of six months allowing the researchers to conclude that the flavonoid formulation may restore pelvic circulation and relieve pelvic symptoms.

In a recent meta-analysis conducted by the Imperial College in London, troxerutin and MPFF were found, separately, to demonstrate clinical benefits in patients with venous disease, including varicose veins and varicose ulcers.3


  1. Pokrovsky AV, Saveljev VS, Kirienko AI, Bogachev VY, Zolotukhin IA, Sapelkin SV, Shvalb PG, Zhukov BN, Vozlubleny SI, Sabelnikov VV, Voskanian YE, Katelnitsky II, Burleva EP, Tolstikhin VY. Surgical correction of varicose vein disease under micronized diosmin protection (results of the Russian multicenter controlled trial DEFANS). Angiol Sosud Khir 2007;13(2):47-55.
  2. Simsek M, Burak F, Taskin O. Effects of micronized purified flavonoid fraction (Daflon) on pelvic pain in women with laparoscopically diagnosed pelvic congestion syndrome: a randomized crossover trial. Clin Exp Obstet Gynecol 2007;34(2):96-8.
  3. Gohel MS, Davies AH. Pharmacological treatment in patients with C4, C5 and C6 venous disease. Phlebology 2010 Oct;25 Suppl 1:35-41.

TTFCA for Collagen and Wound Healing

While over the last decade there appeared to have been no added information on TTFCA, all of a sudden there is much more—apparently a new wave is breaking because someone at the National Library of Medicine has discovered that TECA (titrated extract of Centella asiatica) is synonymous with TTFCA.

A recent paper2 published in Panminerva Medica has served to bring the progress on TTFCA (as TECA) up to date and now we know that there are many other benefits, from studies conducted during the last decade, some of which have been obscured from the public.* Nevertheless, according to the study, which is subtitled “A Status Paper,” TTFCA can modulate collagen production and deposition in wound healing. Also, it can be used to treat several microcirculatory problems, inflammatory skin conditions (leprosy, lupus, varicose ulcers, eczema, atopic dermatitis, psoriasis), and also intestinal problems, fever, amenorrhea, and genitourinary conditions. As well, cognitive functions, anxiety and mental impairment may be positively affected by TTFCA administration. Then there are new applications in neurology include nerve growth factor enhancement and applications in neurological degenerative conditions. What an update!

* A number of papers referenced in the aforementioned paper are either not available at the Angiology website, having presumably been pulled from circulation, or are available only by permission. They are not even listed in PubMed’s index.

TTFCA’s Principal Six Mechanisms

The paper goes on to spell out a clearer understanding of how TTFCA’s actions are associated with six important mechanisms, all interconnected and modulating each other:

  1. Edema—and capillary filtration—control
  2. Strong antioxidant power, effective on several forms of oxidative stress associated with inflammation or infections, and synergic with other antioxidant products
  3. Anti-inflammatory action
  4. Modulation of the collagen production, avoiding slower scarring, speeding up hyperthrophic scarring, and reducing cheloids (a type of scarring associated with early or late collagen)
  5. Modulating action of local growth factors
  6. Modulation of angiogenesis

On top of that, this “status” paper—resulting from an expert meeting held in Cobham, Surrey—indicates that much of the therapeutic potential of TTFCA is still to be explored in further studies.

All scar formation processes
appear to be modulated by TTFCA
and its metabolites.

Summarizing what is now known about C. asiatica, it is a mild adaptogen, mildly antibacterial, anti-viral, anti-inflammatory, anti-ulcerogenic, and it may improve cognitive functions and improves microcirculation. It may have – on the basis of different dosages—a mild diuretic activity and improves all cicatrisation (scar formation healing) processes.

A Kitchen Sink Supplement, the Stuff of Legends

Tradition suggests that C. asiatica, which has a history of food use as a salad leaf, helps maintain vigor and youthfulness. In Thailand, cups with gotu kola leaves are used as tea to improve attention. Juice from leaves is considered antihypertensive and used as a tonic. Leaves (and derived products) are also used to treat ulcers and burns and to prevent cheloids. Also from traditional use, C. asiatica improves wound healing, and it has been used for centuries in the treatment of wounds in leprosy. Treatment with C. asiatica helps controls inflammatory reactions and myofibroblast production. Isolated steroids from the plant have been used to treat leprosy. C. asiatica also has important anti-oxidant properties. Several products derived from C. asiatica (such as TTFCA) have been used for treating CVI. In the popular tradition, C. asiatica is quoted in the longevity myth concerning the life of the Tai Chi Chuan master Li Ching-Yun. The legend reports that he lived to be 256 using traditional herbs, including C. asiatica.

TTFCA is comprised of asiatic acid (30%), madecassic acid (30%) and asiaticoside (40%). Vascular effects on microcirculation and several other benefits are produced by TTFCA, including a reduction of free radicals, and dermis reconstruction, and even non-clinical, anti-aging actions.

Chronic Venous Insufficiency and Varicose Veins

The effects of TTFCA on an altered venous system have been studied in several clinical trials.3 Mucopolisaccarides (long chains of sugar molecules) in the vein walls are affected by treatment with TTFCA, which strengthens basic metabolism in the connective tissues of the vascular wall.

The levels of basal serum uronic acid and of other enzymes involved in mucopolysaccharide metabolism were evaluated in patients with varicose veins, indicating an increased mucopolysaccharide turnover. After treatment with TTFCA (60 mg/day for three months) the above enzyme levels fell progressively indicating an improvement in the venous system.4

As previously stated, all scar formation processes appear to be modulated by TTFCA and its metabolites. This observation is also true for arterial plaques that constitute most usually an irregular, hyperplastic scarring process. A study presented at the American Heart Association in 20022 indicated that plaque stabilization induced by oral TTFCA treatment is independent from cholesterol and lipid control (and from the normalization of other important risk factors such as hypertension, increased weight, and even diabetes).

TTFCA in Neurology

Finally there are new targets for TTFCA in neurology. A recent study indicates that C. asiatica lessens D-galactose-induced cognitive impairment in association with oxidative and mitochondrial dysfunction.5 Although this study was conducted in mice, there are also recent anedoctal reports of studies in China on nerve re-growth and on the production of nerve growth in humans.

More clinical evaluations of TTFCA and of its possible association with other natural products are under way. Quoting the paper, “As research in this field does not have very large grants due to patenting being relatively limited,[*] there is always the possibility that important results obtained with one product—generating important claims and revenues—should be shifted to theoretically comparable but actually different, possibly cheaper products.” For certain, this new “status” paper “opens a new window on an ancient but still partially unexplored product that may become an important value in prevention and treatment of several pre-clinical and risk conditions and in clinically significant disease both as single products and in association with other ‘natural’ products.”

* Could this be the smoking gun, explaining in part why recent research has been obscured and protected? Because patents have not been forthcoming may be why we are now seeing the undisclosed research.


  1. R A Kunin Snake oil. West J Med 1989 August; 151(2): 208.
  2. Belcaro G, Maquart FX, Scoccianti M, Dugall M, Hosoi M, Cesarone MR, Luzzi R, Cornelli U, Ledda A, Feragalli B. TECA (Titrated Extract of Centella Asiatica): new microcirculatory, biomolecular, and vascular application in preventive and clinical medicine. A status paper. Panminerva Med 2011 Sep;53(3 Suppl 1):105-18.
  3. Pointel JP, Boccalon H, Cloarec M, Ledevehat C, Joubert M. Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs. Angiology 1987;38:46-50.
  4. Arpaia MR, Ferrone R, Amitrano M, Nappo C, Leonardo G, del Guercio R. Effects of Centella asiatica extract on mucopolysaccharide metabolism in subjects with varicose veins. Int J Clin Pharmacol Res 1990;10:229-33.
  5. Kumar A, Prakash A, Dogra S. Centella asiatica Attenuates D-Galactose-Induced Cognitive Impairment, Oxidative and Mitochondrial Dysfunction in Mice. Int J Alzheimers Dis 2011;2011:347-569.

Will Block is the publisher and editorial director of Life Enhancement magazine.

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