Horseradish: Prevention of infection and essential fatty acid deficiency at advanced age

Günter Valet

Summary: Knowing the shortterm health promoting properties of horseradish, the subsequent casuistic pilot study was initiated to explore longterm effects of horseradish consumption on the organism. Daily quantities of 4g grated horseradish root (Amoracia rusticana, around 50mg/kg bodyweight) admixed to apple sauce ("Apfelkren", Austrian specialty) provide a base level of systemic antibiosis (teeth, bronchial tree, skin) but also regrowth of hair within bald head areas, gingiva proliferation on previously nude toothbone as well as disappearence of skin xerosis and plantar keratosis at simultaneously diminished foot perspiration, furthermore improved tear flow and digestion. At 12g/day wisdom and molar tooth infections were successfully kept down for several weeks without noticeable side effects prior to tooth extraction. Oral antibiotics as an alternatuve would not have been tolerated for such a long time without significant gastrointestinal symptoms. Horseradish spiciness and pungency was very significantly reduced by 10-12h preincubation of freshly grated horseradish root at 4C prior to apple sauce addition. It can afterwards be consumed teaspoon wise without mouth, oesophagus or stomach irritation, in contrast to Apfelkren preparations with freshly grated horseradish root.

Introduction: Longer self subsistence at higher age could significantly lower public health care costs by maintening the physical and mental capacities of older people. Conservation of blood capillary density in tissues by antioxidant polyphenols in dealcoholized apple or grape wines, in combination with essential amino acids (EAA) maintains muscular strength by preventing progressive sarcopenia as well as skin thinning (1). “Apfelkren”, an Austrian specialty of freshly grated horseradish root, mixed with apple sauce (2) provides antibiotic (3, 4) as well as antiinflammatory and anticancer potential (5, 6) but consumption is typically limited by high spiciness and pungency. Preincubation (10-12h) of the grated material at 4C prior to mixing it with apple sauce largely eliminates spiciness and pungency, It was investigated to what extent longterm consumption of low pungency horseradish/apple sauce provides health benefits at higher age.

Material and Methods: Apfelkren is typically eaten with boiled beef meat (Tafelspitz) (7) and was prepared in the context of this study from 600g peeled apple slices, cooked for 15min just above boiling point together with 8 tablespoons of water, 6 teaspoons of lemon juice and 2 tablespoons of sugar, cooled subsequently to 20C in a cold water bath and subsequently homogenized using a whisk. Grated horseradish (120g, Steiermark) after previous storage for 10-12h at 4C was admixed to the apple sauce. The slightly greyish appearence of the grated horsradish material after storage disappears under the slightly acidic conditions in the applesauce, caused by the previous lemon juice addition. The mixture was subsequently filled into screw cap glasses and stored at 4C. Isothiocyanates (ITCs) like allylisothiocyanate (AITC) are generated from glucosinolates (Sinigrin) (8) by myrosinase enzymes, being liberated from intracellular vesicles upon cell disruption. Horseradish preincubation permits regular consumption of 4 – 12g/day of horseradish/applesauce without irritation. The standard daily dose consists of two heaped teaspoons, totalling around 28g horseradish/apple sauce. The first one is taken at 8 a.m and the second at 8 p.m., each with around 2g of grated horseradish as shown in fig.1 left. This corresponds to 48.2mg/kg body weight (fig.1 middle), while 1.5 heaped teaspoons at 8a.m. 12.am., 8p.m. 12p.m. totalling 12g/d (144,6mg/kg) horseradish (fig.1 right) are required as high dose for example in case of severe tooth infections (wisdom or molar teeth). The preparation self sterilizes during storage at 4C by continuous liberation of small ITC quantities from a continuously desintegrating small quantity of horseradish cells.

Results: Apfelkren consumption unexpectedly lowered pressure pain of a several years preexisting apical cyst under the lower left second molar tooth as remainder of a successful antibiotic treatment (3 days Amoxicillin clavulanic acid 500/125mg, 3x1/d) of an acute infection, emerging several days after a caries cavity in the front of the tooth was closed by a dentist. A certain number of bacteria temained in the cyst, inaccessible to antibiotics. In parallel, a just developing furuncle at the lower lip had disappeared after 3 days without necessity for the application of a topic antibiotic ointment. These accidental observations prompted further Apfelkren use, resulting in total disappearance of the tooth cyst pain after six weeks.

Admixture of freshly grated horseradish to applesauce resulted in significant pungency, irritating mouth, oesophagus and stomach epithelia, thus limiting consumable quantities to maximally 6g horseradish/d. Central nervous symptoms like equilibrium disturbance (open eye stork test <10sec instead of >60sec) and a felt internal emptiness, were observed at higher doses. Horseradish/apple sauce preparations remained stable at 4C for several months without bacterial or fungal growth or noticeable changes of color or taste. Low level spiciness developed during storage, probably due to ITC liberation from dying cells, without noticeably affecting consumability or efficacy.

The sudden deterioration of caries affected left lower and upper wisdom teeth as well as of the already mentioned lower left second molar tooth 9 months later, despite continuous Apfelkren consumption of 4g/d led to unbearable pain development, accompanied by painful lower left mandibular lymph node swelling. The acute infection was treated with amoxicillin/clavulanic acid for 48h as above. Pain and lymph node swelling diminished but reappeared within 8 hours after therapy arrest. Owing to circumstances, teeth extractions were only possible 9 weeks later, excluding continuous antibiotic therapy. In this situation, the horseradish dose was tripled to 12g/d that is 3g at 8a.m. 12a.m., 8p.m. and 12p.m. to contain the infection. Total disappearence of pain as well as of the painfully swollen surrounding tissue and left mandibular lymph node was observed within hours, indicating a strong antibiotic effect without noticeable intestinal or other side effects. Three approximately equidistant intermediate therapy stops made reappear inflammatory symptoms within 8-10h, indicating that the inflammatory process due to the open tooth lesions had not disappeared during high dose horseradish therapy of 12g/day but was efficiently kept down until tooth extraction.

The standard horseradish dose of 4g/day diminished furthermore the susceptibility for respiratory infections between October and May/June of the following year, as they had occurred during several previous decades, typically descending from tonsils to larynx, trachea and bronchial tree, accompanied by chronic bronchitis and tenacious short cough episodes around every half hour to eliminate accumulated bronchial mucus. Bronchitis susceptibility totally disapperad with the standard horesradish dose of 4g/d. It is no more necessary to protect the neck region at temperatures between 0-15C by a woolen scarf during autumn, winter and springtime.

Additionally, significant hair growth at a previously bald area at the back of the head (fig.2) was observed after around 8 weeks of treatment,

 

as well as partial coverage of a gingiva defect, reaching initially about 4mm upward on the toothbone of the first right upper front tooth to approximately 2mm after around 8 weeks of therapy, indicating gingiva reproliferation. Further eight months were required to almost completely close the defect (fig.3).

 

At the same time the need for eye drops against eye fatigue and burning sensations disappeared. Simultaneously, a significant diminution of plantar keratosis with return of the elastic skin state of earlier times indicated the systemic effects of continued horseradish consumption. Furthermore, microorganism induced odor formation from bacterial skin keratin degradation diminished significantly with skin regeneration, accompanied by a similar decrease of volatile intestinal sulphur containing molecules like H2S.

Discussion: The antibiotic, antiinflammatory and anticancer properties of horseradish root are well known but horseradish therapy has so far not found wide application, probably because antibiotically active isothiocyanates (ITCs) (9) irritate tissues (10). but also the central nervous system upon consumption of more than 6g/d of freshly grated horseradish admixted to applesauce, possibly due to lipid soluble ITCs traversing the blood brain barrier.

Preincubation of freshly prepared horseradish root for 12h at 4C to decay most of the ITCs liberated during grating was crucial for regular longterm horseradish consumption in quantities above 6g/d. Intact horseradish cells in these preparations die gradually during the digestion process, liberating myrosinases that generate enough new ITCs from cellular glucosinolates for body protection. ITCs bind covalently to free NH2 and SH groups of protein amino acids (11) but also split S-S bonds (12) prior to binding. This reaction inactivates a multitude of bacteria (3, 4), explaining the broadband activity of ITCs without likelihood for resistance development like for example penicillinase against penicillin. The antiinflammatory and anticancer potential (5) of horseradish constituents increases general organism defence capacities (mesoderm). Horseradish properties may be of interest for antibiotic and antiinflammatory therapy of sepsis patients by feeding horseradish/applesauce prepared with preincubated grated horseradish through a stomach tube, as well as to replace antibiotics to some extent in cystitis or pneumonia therapy.

Hair regrowth, loss of plantar keratosis (ectoderm) as well as gingiva proliferation (entoderm) and loss of necessity for eye drops against burning eyes due to altered meibum lipid composition as secreted by the meibomian glands (13) concern horseradish effects that have so far not found attention despite their importance in organism maintenance and defence. The observed effects are compatible with a gradually developing essential fatty acid deficiency (linoleic (omega-6), alpha-linolenic (omega-3)) (14, 15) with age despite constant food habits (flexitarian, family cooked) over decades. Horseradish itself does not contain the required essential fatty acids, rather induces intestinal mucosa or microbiome changes such as to facilitate essential fatty acid uptake from digested food to restore the skin stratum corneum structure. Water loss (xerosis) is reduced and microbial skin colonisation is diminished by the antibiotic activity (16) of essential fatty acids.

The occurrence of malignancies increases in many instances with age. Research efforts try importantly to investigate molecular cancerisation mechanisms. It seems of equal importance to strengthen the defence systems of the body by providing EAA to maintain sufficient protein synthesis (17) as a prerequisite for effective repair capacities against aberrant cells of skin, bone marrow and intestinal tract. Horseradish strengthens in addition systemic antibiosis, together with antiinflammatory and anticancer activities of the immune system. In any case, the increasing development (2018 1x, 2021 1x, 2022 3x) of facial skin keratoakanthomas (18) as well as of recurring local facial skin inflammations has stopped in the own case since the begin of daily horseradish consumption. The age related lowering of immune cell function is usually seen as consequence of molecular changes within specific immune cell lines (19, 20). Part of this immune aging process may be caused by impaired cellular repair activity, resulting from insufficient intestinal uptake of EAA essential amino and essential fatty acids. It is overcome by essential amino acid supplements and regular horseradish consumption.

ITCs react with free amino and sulfhydyl grops of amino acids, thus potentially reducing EAA uptake in the stomach in case of simultaneously eating horseradish. EAAs were therefore taken around 15min prior to meals, followed by horseradish at their end, thus providing around 30min for undisturbed EAA uptake by the stomach.

Brassica plants like horseradish have been suspected to affect iodine uptake and to be goitrogenic. No convincing evidence for this view has been found in a recent review (21) for humans. Being situated in South Germany as an iodine poor region, 2x200ug/w of potassium iodide serve as personal prophylaxis since decades. No thyroid swelling was observed during the up to now 11 months of personal horseradish consumption.

Altogether the substantially lowered directly sensible allylisothiocyanate content of freshly grated horseradish following 8-12h storage at 4C permits longterm horseradish application as an important supplement to molecule oriented home medicine for the elderly (1). Broadening of the application beyond family scale will show the usefulness of this approach. Limitations may be encountered in case of unpalatibility or allergic reaction against horseradish.

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