Dear Doctor: I've heard that a product called paractin, a plant extract, promotes a healthy inflammatory response. Is this true? How does it work?

Dear Reader: Paractin is an extract from the herb Andrographis paniculata that has been used as a remedy for hundreds of years in China, India, Thailand and other Southeast Asian countries for multiple infectious and inflammatory diseases and to relieve various symptoms. A. paniculata's main active ingredient is andrographolide, which inhibits the activity of chemicals linked to inflammation, and which may decrease fever and diarrhea by boosting the immune system.

As for its effectiveness, a 2015 review assessed six randomized controlled trials that studied the use of A. paniculata for cough. Combined, the studies compared 333 patients who took the herb to 348 who took a placebo. The studies all showed benefit in decreasing the severity of the cough, but there was significant variation as to the degree of benefit.

A 2004 review of seven double-blind studies, with a total of 896 patients, looked at the use of A. paniculata for upper respiratory infections. Participants started the herbal preparation 36 to 72 hours after the onset of symptoms. Five of the studies used a dose of 60 milligrams, one study used a 48-milligram dose, and one study compared doses of 180 milligrams and 360 milligrams. A confounding factor is that three studies used A. paniculata in combination with another herb, Eleutherococcus senticosus.

Nonetheless, all the studies showed improvement of symptoms with A. paniculata, with users reporting decreased fever, runny nose, cough and sore throat. Side effects included nausea, vomiting, dizziness and drowsiness, which were reported at higher frequency in the 180- and 360-milligram dosages. The authors concluded that the herb was a promising treatment for the symptoms of an upper respiratory infection.

The anti-inflammatory effect of A. paniculata has also been studied against ulcerative colitis. In a 2013 study published in the American Journal of Gastroenterology, researchers randomized 224 patients with mild to moderate ulcerative colitis to 1,200 or 1,800 milligrams of A. paniculata or a placebo for eight weeks. A colonoscopy was performed prior to the trial and then after eight weeks, and symptoms such as stool frequency and blood in the stool were monitored at two, four, six and eight weeks.

After eight weeks, 45 percent of those who took 1,200 milligrams showed measurable response to the herb's efficacy, while 40 percent of those who took a placebo showed response as well. So the results weren't so great at this dose. But at 1,800 milligrams, 60 percent of patients showed some measurable response to the herb.

Further, on the follow-up colonoscopy, 33 percent of the placebo group showed mucosal healing, while 50 percent who took 1,800 milligrams of A. paniculata showed healing. While this is a good response, it is significantly inferior to the medication Mesalamine, which has mucosal healing rates of 68 to 80 percent.

Also, a rash occurred in 8 percent of patients who took this high dose of A. paniculata.

In short, much remains unknown about Andrographis paniculata. Those interested in the herb could consider it for an upper respiratory infection or for a cough, but I would hope they would do so with caution. We need more studies of the herb before I would recommend it further.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I see that psilocybin mushrooms -- what we used to call magic mushrooms -- are being studied now as a possible treatment for post-traumatic stress disorder and depression. I've struggled with severe depression my whole life. Would it be risky for me to give magic mushrooms a try?

Dear Reader: In a word -- yes. Although emerging research into the potential benefits of psilocybin for people with depression and anxiety disorders is encouraging and intriguing, we absolutely recommend against self-experimentation.

First and foremost, psilocybin, which is the compound in certain mushrooms that gives them their hallucinogenic quality, is illegal in the United States. It is a Schedule I substance under the Controlled Substances Act and carries the same legal penalties as heroin. But even more to the point, the studies you are reading about are complex and multilayered. They use specialized drugs in standardized doses. Participants take them under rigorously monitored conditions. Results are evaluated every step of the way.

Experimenting on yourself with unverified drugs in uncontrolled doses can be dangerous and lead to unforeseen consequences. Side by side with the research suggesting the beneficial applications of psilocybin mushrooms, recreational users are self-reporting significant challenges as well.

In an online survey completed last year, researchers at Johns Hopkins asked 1,993 individuals about their experiences with psilocybin mushrooms. Close to 40 percent said it was the most challenging experience of their lives. Eleven percent of respondents said they put themselves or someone else at risk while under the influence. Another 8 percent went on to seek treatment for psychological symptoms that didn't go away.

The researchers found that the difficulties users experienced were associated with taking too large a dose, and with being in an environment that felt unsafe. Both of these variables are hard to control in a real-world setting.

Treating depression -- and living with it -- is challenging. Finding the right combination of existing drugs to alleviate symptoms can take months of trial and error. In the interim, patients suffer. That's why the potential benefits of psilocybin mushrooms have fascinated researchers for some time.

In the 1950s and '60s, researchers in Europe began to explore the use of psychoactive drugs in mental health therapy. Their promising results encouraged similar research in the U.S. Between 2004 and 2008, scientists at UCLA did groundbreaking research into the effects of psilocybin on cancer patients who were gravely ill. The results showed that it significantly relieved their extreme anxiety.

In another study last year, researchers at Johns Hopkins administered psilocybin to cancer patients who were gravely ill. The sessions took place in pretty and comfortable settings, with two monitors present. Participants were encouraged to lie down, listen to music on headphones, and focus their attention inward on ideas, thoughts and emotions.

As with previous experiments, the outcomes were encouraging. Participants reported a substantial decrease in depression and anxiety, a result that endured for at least six months.

How psilocybin works, and why it is effective against depression, is not yet known. But with so much promise, the research continues.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: A new study said that prolonged antibiotic use is tied to colon polyps. But "prolonged" meant "two weeks or more." I had a couple of bacterial infections in a six-month timespan. How worried should I be?

Dear Reader: Antibiotics have undoubtedly revolutionized medicine, saving countless lives against multiple types of bacterial infections. However, with antibiotics readily available and a society that craves a quick fix, antibiotics have been overused. For example, they are often prescribed needlessly for upper respiratory symptoms that are not due to bacterial causes. Such overuse has led to the formation of antibiotic resistance; alterations of normal bacterial populations in the intestinal, oral and nasal cavities; and unnecessary side effects from the antibiotics themselves.

As for whether antibiotics can increase the risk of precancerous polyps in the colon, let's look at the evidence.

The study to which you're referring, published this year in the journal Gut, reviewed the antibiotic usage of 16,642 female nurses age 60 or older. In 2004, the women filled out a questionnaire reporting the amount of antibiotics they used between the ages of 20 and 39 and between the ages of 40 and 59. In 2008, the women filled out another questionnaire reporting their antibiotic usage between 2004 and 2008. All the women had at least one colonoscopy between 2004 and 2010.

Researchers found that women who took antibiotics between the ages of 20 and 39 had an increased risk of colon polyps compared to women who hadn't taken antibiotics. The increased risk was relatively small for women who had taken antibiotics for only one to 14 days within that 20-year period, but the risk increased significantly -- by about 1.4 times -- among women who took antibiotics for 14 days to two months. That heightened risk didn't increase further among women who took antibiotics for greater than two months.

For women who took antibiotics between ages 40 and 59, the rate of colon polyps increased more dramatically and was more dependent upon the length of antibiotic use. Those who took antibiotics for more than two months had a 1.69 times greater risk of developing colon polyps compared to women who hadn't taken antibiotics. Because colon polyps can eventually lead to colon cancer, the findings are worrisome.

Additionally worrisome are the findings of a 2008 Finnish study of people ages 30 to 79 assessing their antibiotic use from 1995 through 1997. The researchers found that people who had six or more prescriptions of antibiotics in that two-year timeframe had a 15 percent increased risk of colon cancer.

A possible theory about why antibiotics may lead to the formation of colon polyps, and later cancer, could be because they indiscriminately kill healthy gut bacteria. As this occurs, other, more unhealthy bacteria predominate in the colon, which can affect its immune response, leading to disruptions in its lining and the formation of polyps.

So, yes, there does appear to be some increased risk of colon polyps with antibiotic use. I wouldn't be overly concerned about two courses of antibiotics, though I would be concerned for a multitude of reasons about a repetitive use of antibiotics. Such use raises the need to look for new ways to prevent, and treat, infections.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)