Q&A: Cayenne, Kidneys, and Estrogen

It’s not unusual to see different responses to cayenne
—Robert Rountree, M.D.

In every issue of Herbs for Health, professionals from a variety of health-care fields answer your questions about using medicinal herbs. Medical doctor Robert Rountree and herbalist Rosemary Gladstar respond for this issue.

Hot Spots

Q. My husband and I both take cayenne capsules (40,000 units). We also bought a cayenne ointment for pain in my husband’s shoulder. When he used it, he felt a burning sensation on his shoulder and on the hand he had used to apply the ointment.

When I tried it myself, I didn’t feel anything, not even on my hand. Why and how could this be?
S. S.
Loveland, Colorado

A. Cayenne pepper (Capsicum annuum) contains a substance called capsaicin, which is responsible for the sensation of heat that occurs when it is eaten or rubbed on the skin. It appears to work by releasing substance “P” (for pain), a chemical messenger that activates pain fibers.

Capsaicin has been shown to be helpful in the treatment of arthritis and neuritis by ­initially elevating substance P in sensory nerves and then depleting it, which results in an overall decrease in pain. Unfortunately, the burning reaction is part of the process—it is simply an indicator that the capsaicin is working. Most people find this effect unpleasant but tolerable; however, a few patients need to add a topical anesthetic such as lidocaine.

A standard therapeutic dose is 40,000 units, but it is not unusual to see the widely different responses that you and your husband have had. This could be explained by your individual biochemistries or by different degrees of absorption through the skin. In your case, a higher potency ointment or larger amount may be effective. For your husband, I would recommend trying a small amount several times daily and using a disposable glove when he applies the ointment.

—Robert Rountree

A. Get your husband off that hot stuff! According to Mindy Green at the Herb Research Foundation, the recommended daily dose of cayenne is between 30 and 500 units. More than 3 g a day (3,000 units) can produce gastric ulcers, digestive disorders, rashes, and other skin eruptions. Your husband is taking far too much cayenne at 40,000 units daily and should completely discontinue its use for several weeks, introducing it over time in more reasonable amounts.

Cayenne is a wonderful healing herb and is used for ­chronic pain, heart conditions, circula­tory problems, cluster head­aches, poor digestion, and constipation. I recommend it often, and use it myself in a variety of situations. However, early on in my herbal career, I overdosed on it, taking far too much of this fiery herb and overstimulating my body to the point of spasms. I developed a healthy respect for the power of these small red peppers. High concentrations of capsaicin, the primary heat-producing chemical in cayenne, produces a counterirritant effect, meaning it works by activating pain fibers and increasing circulation. Like any strong herb, it should be used with prudence.

—Rosemary Gladstar