Cayenne Introduction   Cayenne is a member of the Solanaceae or Nightshade family. [1]  Capsicum frutescens is the scientific name for the plant that produces the chili peppers we now refer to as cayenne.  These plants originated in the tropical Americas and were later introduced to Africa and India.  Botanically, cayenne plants appear as a shrubby perennial, reaching 3 feet in height. [2]  The branches are purple in color, while the leaves are long stalked, ovate or oblong, nearly entire, and occasionally in pairs.    The fruit is the part of the plant used in both food and in medicinal applications.  Cayenne peppers have been popularized, mainly, by their culinary use, adding heat to spicy dishes.  These 'fruits' are typically red, up to 10 cm in length and oblong-conical in shape.  Peppers usually contain 10 - 20 seeds that are flattened and some 3 - 4 millimeters long.           Cayenne peppers contain a number of active constituents.  The primary medicinal components are capsaicin (0.1 - 1.5%) compounds, which exist as a mixture of capsaicin, dihydrocapsaicin, nordihydrocapsaicin, and homodihydrocapsaicin. [3] Being a brightly colored fruit, cayenne also contains a number of carotenoids, including capsanthin, capsorubin, and carotene.  Ascorbic acid (0.1 - 0.5%) and tocopherols are vitamins also found in cayenne peppers. The seeds of the fruit and the root contain steroidal saponins (capsicidins).   Capsaicin is the compound which has received much interest among researchers, with clinical efficacy in relieving pain and itching.  Its pharmacologic action is described as temporarily stimulating the release of certain neurotransmitters (mostly substance P, the main chemomediator of pain impulses outside the central nervous system) from C-fiber afferent neurons, leading to their depletion. [4]  This results in the absence of pain transmission.  It takes, an estimated, three and ten days to take effect following the administration of capsaicin 4 times per day for 7 days.  Once analgesia occurs, application must continue for three times daily to maintain the effect.  Substance P is also related to the pathophysiology of the skin condition, psoriasis.  It activates inflammatory compounds in the body that mediate the clinical manifestation of psoriasis.  By depleting substance P, psoriasis can be clinically impacted.   Knowledge of the pharmacology of capsaicin has resulted in the investigation of cayenne for the treatment of various disorders with associated, and significant pain syndromes, including: post-mastectomy syndrome urticaria psoriasis diabetic neuropathy arthritis osteoarthritis pruritis post-surgical neuromas Actions that are ascribed to cayenne include; circulatory stimulant, tonic, carminative (relieves gas in the digestive tract), spasmolytic (relieves digestive spasm), diaphoretic (causes perspiration), antiseptic, rubefacient (produces flushing of skin), appetite stimulant (in small doses) and counter-irritant.     Cayenne Uses   As mentioned, cayenne has been extensively studied for the treatment of diseases involving pain as part of the condition.  Patients with diabetes mellitus can develop a complication involving the nerves called diabetic neuropathy, which causes significant nerve pain.  In one particular double blind study, patients with diabetic neuropathy applied a 0.075% capsaicin containing ointment or a placebo application four times daily. [5]  Fifty two percent of patients who applied the capsaicin ointment experienced a 50% reduction in pain.  This was a significant improvement compared to individuals in the placebo group.   Another study regarding the treatment of pain with capsaicin was carried out in patients with oral neuropathic pain.  Patients applied a 0.025% capsaicin cream to the site of discomfort four times daily over four weeks. [6]  Thirty-two percent of these patients experienced complete relief, and 32% had at least 50% improvement in pain. Capsaicin cream used for the treatment of chronic postherpetic neuralgia has also been examined.  In a double-blind study, these patients applied a 0.075% capsaicin cream to the painful areas 3-4 times daily, over a six week trial period. [7]  Significant improvements were observed in patients using the capsaicin cream versus placebo, and 77% of the patients in the treatment group noticed considerable pain relief.   Headaches can cause great pain and suffering to those afflicted.  A severe type of headache, referred to as 'cluster' headaches, affect men more frequently than women.  These headaches result in bouts of excruciating head pain over the course of a few days.  Capsaicin cream applied to the inner nasal mucosa on the affected side for several days has been shown to result in complete disappearance of attacks in 11 out of 16 patients tested. [8]  Another study in patients with cluster headaches of both chronic and episodic types, experienced improvements in the course of their conditions following application of capsaicin cream to the nasal mucosa on the same affected side for seven days. [9]  Patients with the episodic form of cluster headaches noticed greater efficacy of the treatment.   Studies have shown that psoriasis may be treated using capsaicin cream, as mentioned above. [10, 11]  A double-blind study of patients with psoriasis involved a six week course of 4 daily applications of a 0.025% capsaicin cream.  Patients receiving the capsaicin therapy noticed an significant improvement in itching, plus objective measurements of scaling, thickness and erythema of psoriasis lesions. [11]   Interestingly, studies have been conducted to investigate the effects of capsaicin on human feeding behavior and energy intake.  In one study, the effects of dietary cayenne added to high-fat and high-carbohydrate meals on subsequent energy and macronutrient intakes were examined in female subjects.  The results showed that cayenne decreases appetite and subsequent protein and fat intake. [12]  The effects of dietary cayenne on energy metabolism at rest and during exercise were also examined. [13]  A group of long distance male runners, 18-23 yr of age, were given a standardized meal on the evening prior to the experiment and then a breakfast with 10 grams of cayenne.  Various measurements were taken during rest and exercise.  The results suggested that cayenne ingestion stimulates carbohydrate oxidation at rest and during exercise.   Other conditions for which cayenne may be useful include overactive bladder, arthritis, sore muscles, food poisoning, heat stress, and lung cancer. [14-17]     Cayenne Dosages   Generally, all internal forms of capsicum are best tolerated when taken with food.  If taking whole capsules, a dose of 30 - 120 milligrams (mg), three times daily is usually sufficient. [18]  Infusions of ½ to 1 tsp. of powder per cup of water should steep for 10 minutes.  Persons can then mix one tablespoon of this infusion with hot water and drink as needed. [19]  Tincture doses vary according to strength.    Example: 1:3 tincture/ 0.2 ml may be administered three times daily with a maximum weekly dose of 3 ml; 1:20 tincture/1 ml administered three times daily with a maximum weekly dosage tincture of 20 ml. [18]           Ointments and cream should be of the capsaicin form.  Topical applications should be administered four times daily to the affected area.  Most preparations are between 0.025% and 0.075% capsaicin.  Pain will be initially increased and then subside as substance P is depleted.  After 3-4 days, applications can be decreased to twice daily in the majority of cases.   There are a number of commercially available products sold in pharmacies, over-the-counter.     Cayenne Toxicities and Deficiencies   The administration of internal cayenne should not be recommended if a patient has acute gastrointestinal inflammation or ulceration.  Some research has indicated that cayenne (taken internally) in high does can prolong duodenal ulcers.  However, one study showed no difference in the healing rate of patients who had taken three grams of cayenne daily. [20]  Caution should also be exercised with the use of Capsicum in acute asthma or inhalation due to bronchoconstriction with initial systemic exposure. [21]  Application over damaged or hypersensitive skin is also contraindicated.   Potential drug interactions include; enhancement of theophylline absorption, increased sleeping times and plasma concentration of hexobarbital with acute use (which decreases with chronic use), reduced gastric mucosal damage when taken an hour before aspirin, potentiation of coughing due to ACE inhibitors with topical application, and potentiation of platelet aggregation inhibitors. [21]   Adverse effects of topical application may include burning, stinging, erythema, heat, pain, and, with prolonged use, may cause permanent loss of sensory nerve function in the application area.  Symptoms of internal toxicity (which can occur if large quantities are taken away from food) include heartburn, anal burning, and gastric erosions.  Very large doses may produce vomiting, purging, pains in the stomach and bowels, heat and inflammation of the stomach, and giddiness. [22]     Cayenne Products   The following table lists various products that contain a safe and reliable source of Cayenne:   Manufacturer Ingredient Amount US RDA Learn More Natures Way Cayenne and Ginger 40,000 HU -- Click Here

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