So, this article aims to examine the reality of this recent tendency for the use of the bark of the herb for the reduction of weight. Our examination must base on scientifically proven data.

What is the Amur Cork Bark?

Amur Cork Bark is a protective outer covering of the Amur Cork tree. Phellodendron is the common name of this tree. Its scientific name is Phellodendron amurense. It belongs to the family of Rutaceae. It is native to China, Japan & Korea.

Constituents of Amur Cork or Phellodendron

Amur cork or Phellodendron contains many beneficial ingredients. So far, researchers identified 140 compounds of Amur Cork or Phellodendron (1, 2). Among those, the main ingredients are as follows:

Alkaloid: Berberine

Limonoid

Phenolic Acid

Quinic Acid

Lignan

Flavonoid: Amurensin, quercetin, phellmurin, phellatin, phellavin & phellodendroside

Coumarin

Glucoside

Phenol

Is Amur Cork Bark Effective for weight loss?

There is a recent tendency to use Amur cork bark as a weight loss aid. Naturally,  the question arises – how much is it effective to lose weight?

In this regard, let us look at the various clinical trials conducted at different times. But the studies did not involve the extracts of Amur cork alone. Rather, those were related to a mixture of Amur cork and other herbal extracts.

Magnolia and Phellodendron

Medical Scientists conducted a pilot clinical trial on a dietary supplement containing Magnolia Officinalis and Phellodendron amurense. The respondents received 250 mg capsules three times daily for 6 weeks. After completion of the trial, the scientists found that the supplement ingredients were well tolerated. Also at the same time, they opined that obese people might benefit from this dietary supplement.

Phellodendron and Citrus extracts

Researchers conducted a human trial to ascertain the effectiveness of Phellodendron and Citrus extracts on cardiovascular defensive characteristics in overweight and normal-weight adults with osteoarthritis in the knee.

In addition to the above, its other essential purpose is also to monitor the weight loss situation of the respondents.

The dietary supplement is known by its symbolic name NP 06-1. It is produced in a combination of two herbal extracts: one is from Phellodendron amurense tree bark and another is from Citrus sinensis (orange) peel. The supplement belongs to Next Pharmaceuticals of Canada, which is available in the market under the name of Flavoxine™ / Citrofen™.

In the trial, the respondents were separated into four groups. Such as:

Group                   Treatment

Overweight           Placebo

Overweight           Dietary Supplement

Normal weight      Placebo

Normal weight      Dietary Supplement

After 8 weeks of the trial, the researchers observed that alongside the beneficial effect of the supplement on the cardiovascular risk factors such as lipid levels, blood pressure & fasting glucose, there was a significant decrease in weight both in overweight and normal-weight treatment groups compared to their respective placebo groups.

Amur Cork as a Source of Weight Loss Compound Berberine

Berberine is a powerful agent for producing weight loss supplements. It has a strong scientific basis for weight loss. So far, two reliable studies experimented with the efficacy of beberine on weight loss. Interestingly, the studies showed that beberine not only reduced weight but also significantly lowered blood lipid levels and blood glucose count (3, 4).

The significance of Amur cork lies in the fact that it is one of the great sources of this berberine. Research shows that Amur cork extracts contain 33% berberine. As a result, Amur cork has attracted the attention of well-reputed herbal brands in recent days.

Dosage

For therapeutic doses, I have found no single use of Amur cork bark extracts. Rather, the clinical trials were conducted in a mixture of Amur cork bark and other herbal ingredients. So, I shall mention here the dosage of combined extracts of Amur cork bark with other herbs. The doses are in the following:

Phellodendron and Citrus Extracts: At a dose of 370mg twice a day, there is no adverse effect (5).

Magnolia and Phellodendron Extracts: At a dose of 250 mg thrice a day was found to be at a tolerable limit (6).

Side Effects

Usage of the Amur Cork in the mixture of magnolia or citrus extracts at the above-mentioned doses causes no side effects.

But what about the single-use of Amur Cork or Phellodendron?

In this respect, ScienceDirect provides that long usage of Phellodendron may cause deficiency of yin and fluids in the body.

But some leading health websites mentioned some more side effects without citing the source of information. They include headache, tiredness, heartburn, shaking hands, sexual dysfunction, or thyroid dysfunction. However, they also revealed that they are unsure if Phellodendron is directly linked to these side effects. (7, 8).

Special Precautions to a Pregnant and Breastfeeding Mother

If you are a pregnant or breastfeeding mother,  avoid Amur Cork or Phellodendron. Because it may cause harm to your fetus or newly born child.

Now, question is-  how?

Yes, this is berberine. Certainly, you have already known that Amur Cork contains a lot of berberine.

It is this berberine that may harm the fetus crossing the placenta. Likewise, it may pass to the infants through breast milk and may harm them by causing or worsening hyperbilirubinemia (jaundice). And thus, it may lead to kernicterus (brain damage), a life-threatening disease ( (9, 10, 11, 12).

But for this effect of berberine on fetuses and newborns, do not take the wrong message as to berberine. Because it is full of medicinal qualities. Everything beneficial in this universe may be harmful in a special situation. So, berberine is also not free from this reality.

Please note that like Amur cork, Goldenseal (Hydrastis Canadensis) and Barberry (Berberis vulgaris) are great sources of berberine. This is why you will find the names of these herbal plants in the references above.

Takeaway

From this discourse, it is clear that amur cork is effective to lose weight in combination with other herbal extracts like magnolia or citrus extracts. But the most important is that amur cork provides berberine which is the most effective to lose weight. Despite the innumerable benefits of Amur cork bark and other herbal ingredients, over-dose of the same may cause troubles in your health. So, be careful about the dosage of the supplements.

Are you Searching to learn the terms IIEF15 and IIEF5? No problem, I will make it clear in easy language. Also at the same time, some exclusive herbal remedies which are highly effective to improve ED will be focused here based on scientific data.

What Are IIEF15 and IIEF5?

IIEF15 and 5 are related to sexual performance. Now question is- what is IIEF15 and what is IIEF5?

The full form of IIEF is International Index for Erectile Function. IIEF is a questionnaire comprising 15 questions designed to measure the various dimensions of sexual performance and to determine the disease severity of ED. To imply these 15 questions, IIEF is otherwise called IIEF15. (1, 2).

On the other hand, IIEF5 is an abridged 5-item version of the 15-item International Index Erectile Function (IIEF15). This abridged version has been developed to identify the presence and severity of erectile dysfunction (ED). IIEF 5 is otherwise called SHIM (Sexual Health Inventory for Men) (3).

In both research and clinical trials, IIEF is a very reliable and multidimensional scale to measure sexual performance in men (4).

The 15-question International Index Erectile Function questionnaire is divided into 5 domains. The domains are as follows (5):

1. Erectile Function

2. Orgasmic Function

3. Sexual Desire

4. Intercourse Satisfaction

5. Overall Satisfaction

Understanding Some Terms Relevant to Sexual Performance

1. Sexual activity: an act of physical intimacy between two people for sexual pleasure.

2. Ejaculation: discharge of semen from the body

3. Sexual stimulation: any stimulus that leads to sexual arousal

4. Sexual intercourse: sexual contact between individuals involving penetration.

5. Orgasm: the climax of sexual excitement that happens following sexual stimulation or intercourse.

It is noteworthy that there is a difference between ejaculation and orgasm. Ejaculation is the discharge of semen from the body. Orgasm is a sensation of extreme pleasure, relaxation, and intimacy that happens at the peak of sexual excitement. However, orgasm and ejaculation occur concurrently in most cases but they are indeed different physiological occurrences that may happen separately (6).

Difference Between IIEF15 and IIEF5

IIEF 15 is a questionnaire comprising 15 questions for measuring various dimensions of sexual performance, whereas IIEF 5 is a shortened 5-item version that has been introduced by choosing 5 specific questions from IIEF 15 to measure the existence and severity of erectile dysfunction.

Scores for International Index for Erectile Function

IIEF15 Score

Each of the first 9 questions is awarded 0-5 points and the last 6 questions are awarded 1-5 points. IIEF15 Score indicates the sum total of the points earned for answers to the 15-item International Index for Erectile Function Questionnaire.

IIEF5 and SHIM Scores

Now, let’s have a look at what IIEF 5 and SHIM scores indicate.

IIEF5 or SHIM implies the sum-total of the ordinal responses to the 5-item International Index for Erectile Function Questionnaire and Sexual Health Inventory for Men Questionnaire respectively.

Indeed, keep in mind that IIEF 5 and SHIM are the same but the only difference between these two lies in answer options and scoring. All the questions of the IIEF 5 questionnaire contain 5 answer options having a score range of 1 to 5. On the contrary, the 1st question of the SHIM Questionnaire contains 5 answer options having a score range of 1-5 and the remaining 4 questions of the SHIM Questionnaire contain 6 answer options having a score range of 0-5.

The potential score range for the IIEF 5 is 5 to 25 and for the SHIM is 1-25. The existence and severity of ED have been shown as per IIEF 5 and SHIM Scores in the following (7, 8):

IEEF5 Scores           SHIM Scores             ED Status

5-7                                 1-7                         Severe

8-11                              8-11                         Moderate

12-16                           12-16                        Mild to Moderate

17-21                            17-21                       Mild

22-25                           22-25                      No ED

The causes of ED

Erectile dysfunction (ED)  is an inability to achieve or maintain an erection sufficient for satisfactory sexual performance (9).  Now the question is- why does it happen?

Vascular, neurologic, psychological, and hormonal factors are responsible for ED. The most common causes are

diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment.

Performance anxiety and relationship issues are common psychological causes.

Precisely it can be said that ED is caused by vascular damage as well as testosterone deficiency (10).

Natural Remedies for the Improvement of ED

There are many herbs and foods for the improvement of ED. The most important of those are:

1. Black Seed
2. Honey
3. Fenugreek
4. Tongkat Ali
5. Ashwagandha
6. Maca Powder
7. Watermelon
8. Panax Ginseng
9. Saffron
10. Tribulus Terrestris
11. Catuaba Bark
12. Muira Puama
13. Talmakhna
14. Shotomul
15. Shimul Root
16. Akarkora
17. Moringa
18. Horny Goat Weed
19. Yohimbine
20. Musoli
21. Shilajut
22. Ginger
23. Garlic
24. Walnuts
25. Almonds
26. Pumpkin Seed
27. Talbina
28. Sareed

Besides these, there are many more natural remedies to destroy ED. For using this, you have to choose the ones which are fit for your own health condition. Before consuming this, know the rules of usage and dosage at the very outset.

Best Herbal Supplements for Mild to Moderate ED

Viasil

Viasil is famous for its dual-action formula. It functions naturally by way of supporting the body’s routine work of producing nitric oxide and ATP.

It is good for the persons suffering from mild to moderate ED because of age, stress, and anxiety. But the patients with severe ED may try this supplement composed of all thorough natural ingredients. Because it has no adverse effect.

Alpha Strength

Alpha Strength is the best natural supplement in the world. It contains scientifically proven natural ingredients. Viagra-like ingredients like l-citrulline from watermelon, Tongkat Ali from Malaysia, and fenugreek gave the supplement uniqueness. The supplement used the extracts of the ingredients in a safe and therapeutic dosage. Besides, it has also added some most common essential ingredients so that the pill can function synergistically to give patients with erectile dysfunction optimal results.

Male Extra

Male extra is good for harder erection and powerful orgasm. It has used more unique ingredients necessary for sexual problems. It has used much more ingredients than other supplements in this arena.

Treatment for Severe ED

For treating severe ED, FDA approved four drugs introduced by modern medical science:

1. Viagra
2. Cialis,
3. Levitra, and
4. Stendra

These supplements are highly effective to remove severe ED. But these supplements have an acute adverse effect. So, you should consume this pill in accordance with the prescription and supervision of a skilled physician.

Viagra

Viagra is a brand-name drug. It has used Sildenafil Citrate as an active ingredient. So, its generic name is Sildenafil. Its generic versions are also available.

Viagra generally requires 30 t0 60 minutes to work. Its functionality lasts 4 hours in the body.

Cialis

Cialis is a brand-name drug. Tadalafil is its active ingredient. Consequently, its generic name is Tadalfil. Its versions are also available. It works up to 36 hours in the body. In a long-term study, the researchers found tadalafil (Cialis) safe and well-tolerated for 18 to 24 months (11, 12, 13).

Levitra

Levitra is a brand-name drug. Vardenafil hydrochloride is its active ingredient. Naturally, its generic name is Vardenafil. Its generic versions are also available. Its duration in the body is 4-5 hours.

Stendra

Stendra is a brand-name drug. Avanafil is its active ingredient. So, its generic name is Avanafil. But its generic versions are not available. It lasts 6 hours in the body.

Brand Name Drug Vs. Generic Drug

When a company introduces a new drug, it gets a patent and sells the drug under a brand name. It is called a brand-name drug.

After the expiration of the patent, other companies may produce and sell the drug using the same active ingredient of the brand-name drug. This is called a generic drug.

So, you can say a brand-name drug means the name given by the inventor company, and a generic drug means a drug produced using the active ingredient of the brand-name drug.

It is pertinent to mention here that generic drugs are marketed in two ways: sometimes using generic names and sometimes using different brand names (14).

But keep in mind that whatever brand names are used, the status of the drugs remains as generic drugs.

Pfizer, for example, invented a specific ED drug ingredient named sildenafil, obtained a patent, and sold it under a brand name Viagra. Thus, Viagra is the brand-name drug, and sildenafil, the active ingredient of Viagra, is the generic name of the drug.

When the patent of Pfizer expires, many more companies start producing and selling drugs using the same active ingredient of Viagra, i.e. sildenafil. These drugs are generic drugs.

It is to be noted that the inventor company of a brand-name drug itself can produce the generic drug of the same. As for example, in the UK Pfizer itself marketed  over-the-counter (OTC)  ED pill named Viagra Connect which is the generic drug of Viagra.

To have a clearer idea of brand-name drugs and generic drugs, look at the following image:

Takeaway

IIEF is the most famous standard to measure the various dimensions of sexual performance especially erectile dysfunction. Using this standard, you can measure yourselves. You can get rid of the problem of erectile dysfunction by simply following a healthy lifestyle and consuming some natural foods and herbs. But in using a prescription drug, you must consult your physician. Though these drugs are highly effective to solve the severe ED problem, improper usage of the same without the supervision of a skilled physician may destroy your conjugal life causing permanently impotent.