Ellagitannins for brain health (pom peel and other superfoods)

Pros and Cons of standard mouthwashes and a variety of potential herbal/plant alternatives - goji berry, persimmon or sumac leaves and fruit/peel would help balance mouth or gut microbiomes.

Pomegranate peel may help reduce amyloid beta protein within the brain, protecting against Alzheimer’s dementia type risks. (Morzelle, et al., 2016)

Ellagitannins are one group of potent phytonutrients in pomegranate, and they are also found in green or black tea and persimmon, pomegranate or goji berry leaves. Goji berries (also known as wolf berries), edible sumac (in Zataar spice mix), persimmon, and quince, are all sources of ellagitannin polyphenols too. Very likely a strong tea/extract made with some of the other sources would also help reset the mouth microbiome in a beneficial way like the pomegranate research shows is possible. Dysbiosis in the mouth has been linked to brain conditions and risk of breast cancer as the infected lymphatic fluid flows down through the chest region and can also enter the brain somewhat easily through nasal regions.

• Research worth noting: ‘Impact of Mouthwash-Induced Oral Microbiome Disruption on Alzheimer's Disease Risk: A Perspective Review’ — The review team is calling for more research into use of mouthwash and cognitive risks.

“This perspective review examines the current evidence linking CHX mouthwash use to disruptions in the oral microbiome and explores the potential indirect implications for Alzheimer's disease (AD) risk. CHX mouthwash is effective in reducing dental plaque and gingival inflammation, but it also significantly alters the composition of the oral microbiome, decreasing the abundance of nitrate-reducing bacteria critical for nitric oxide (NO) production. This disruption can lead to increased blood pressure, a major risk factor for AD.” (Boulares, et al., 2025)

• Also worth noting: Goji berry leaf exerts a comparable effect against colitis and microbiota dysbiosis to its fruit in dextran-sulfate-sodium-treated mice. (Yu, et al., 2023) … Goji berry leaf extract would likely make an effective mouthwash that helped support beneficial species and protect against negative microbes.

My search for ‘sumac mouthwash research’ arrived at no sumac research, however Brave AI gave me some of the reasons to not use the sterilizing types of mouthwashes frequently recommended by dentists…. kill off all microbes and the negative species tend to be the types to return.

*Sumac has been found effective against fungal species for use as an agricultural antifungal agent that wouldn’t be harmful to beneficial microbes. A search with agriculture added as a keyword led to quite a bit of research which shows the leaves (Joseph, et al., 2023) or edible berries would work and it is ellagitannins involved in the bioactive mechanism:

“Subsequent column chromatography allowed the isolation and purification of the following three compounds, which were found to be the only active constituents against the bacteria: methyl gallate (1; minimum inhibitory concentration (MIC) of 13 g/mL), 4-methoxy-3,5 μ dihydroxybenzoic acid (2; MIC of 25 g/mL), and gallic acid ( μ μ g/mL) (Fig. 1)” (Rayne and Mazza, 2007)

*methyl gallate and gallic acid are ellagitannins or metabolites.

Sterilizing the mouth microbiome can lead to a variety of negative effects potentially including increased blood pressure from less nitric oxide, and killing beneficial microbes can lead to an increase in negative species leading to worse mouth dysbiosis.

Brookes, et al., mentions that it is not yet known which ‘antimicrobial mouthwash’ might be the ideal, which would ““balance” antimicrobial communities, especially those associated with health,” (Brookes, et al., 2023) by combatting negative species but not killing beneficial species. I would suggest that a mouthwash that favors helpful species and knocks out negative bacteria and fungus or other microbes would clearly then be the best fit for health. …and ellagitannins in pomegranate peel mouthwash or juice have been shown in human clinical trials to reduce cavity causing pathogens while sparing beneficial species.

“Whilst certain mouthwashes have proven antimicrobial actions and clinical effectiveness supported by robust evidence, this review reports more recent metagenomics evidence, suggesting that mouthwashes such as chlorhexidine may cause “dysbiosis,” whereby certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. There is little known about the effects of mouthwashes on fungi and viruses in the context of the oral microbiome (virome) in vivo, despite evidence that they “kill” certain viral pathogens ex vivo. Evidence for mouthwashes, much like antibiotics, is also emerging with regards to antimicrobial resistance, and this should further be considered in the context of their widespread use by clinicians and patients. Therefore, considering the potential of currently available OTC mouthwashes to alter the oral microbiome, this article finally proposes that the ideal mouthwash, whilst combatting oral disease, should “balance” antimicrobial communities, especially those associated with health. Which antimicrobial mouthwash best fits this ideal remains uncertain.” (Brookes, et al., 2023)

Brave AI:

• Research indicates that alcohol-based mouthwashes can significantly alter the composition of the oral microbiome, increasing the abundance of certain opportunistic bacteria such as Fusobacterium nucleatum and Streptococcus anginosus, which have been linked to gum disease and cancers.4

• Alcohol-free mouthwashes, on the other hand, may have a less disruptive effect on the oral microbiome.2 ←—— An herbal extract based mouthwashes would be alcohol free and spoilable. I freeze my pom peel extract in an ice cube tray so I can use it slowly.

• Studies have shown that mouthwashes can change the proportion of bacteria in the mouth, but there is not much evidence to show this is cause for concern, especially when used on a temporary basis.2

• Some research suggests that mouthwashes, particularly those containing chlorhexidine, may cause "dysbiosis," where certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. (5 = Brookes, et al., 2023)

• There is also evidence that prolonged use of antibacterial mouthwashes may impact the gut microbiome, affecting nutrient absorption and fat accumulation in mice. (6 = Carvalho, et al., 2024)

• Additionally, the use of chlorhexidine mouthwash has been associated with a decrease in nitrate-reducing bacteria, which are critical for nitric oxide production, potentially leading to increased blood pressure and other systemic effects. (11 = Boulares, et al., 2025; Brookes, et al., 2023)

Nitric Oxide and Heart Health: Bonus benefit from Pomegranate (and likely the other ellagitannin superfoods)

• Modulatory benefits for oxidative stress – pomegranate peel can help increase Nitric oxide by promoting eNOS (Delgado, et al, 2017), (de Nigris, et al, 2007a), (Wang, D., et al, 2018), or reduce excess by promoting iNOS. (Kandeil, et al, 2019)

• Reduced Nitric oxide level in a nephrotoxicity model, by promoting iNOS. (Kandeil, et al, 2019)

• Antioxidant/anti-inflammatory in exercise - Reduced free radicals produced by exhaustive exercise with use of a combination of Pomegranate peel hydroAlcoholic extract and vitamin E supplementation. Paraoxonase and myeloperoxidase activities and nitric oxide levels were reduced in the pomegranate extract and vitamin E treated group; animal model. (Veiskarami, et al, 2017)

• Improved endothelial function in a Prenatal complication,

  Improved endothelial function in the placenta for a diabetic pregnancy animal model, eNOS -/- knockout mice and wild-type were used. (El-Sayyad, El-Ghawet, El-Sayed, 2019)

• Nitric oxide, NOS activity was up-regulated in the heart with age; animal-based study. Calcium-dependent NOS activity was elevated from endovascular origin rather than from myocytes and could be a treatment approach for improving ventricular relaxation. (Zieman, et al, 2001)

Benefits of Pomegranate for Hypertension or Cardiovascular Health (and pre-eclampsia in pregnancy)

• ACE inhibition: Potential for treating hypertension and cardiovascular disease by affecting oxidative stress by reducing coronary activity of angiotensin-converting enzyme (ACE) and vascular wall remodeling. (Dos Santos, et al, 2016)

• Vasculoprotective effects. (Wang, D., et al, 2018)

• Diabetes, liver, & heart health - a review of research with pomegranate products. (Middha, Usha, Pande, 2013)

• Wound healing - increased revascularization - (Nirwana, et al, 2017)

• Hypertension: Review of literature on use of pomegranate products for hypertension found pomegranate juice and pomegranate seed extract beneficial. (Asgary, et al, 2017)

• Menopausal hypertension: Animal model of menopausal risk of hypertension and heart disease due to drop in estrogen levels, pomegranate hydroalcoholic extract (PHE), (250 mg/kg for 30 days by gavage) helped promote more relaxed vascular response. Coronary vascular reactivity and cardiovascular parameters were improved. (Delgado, et al, 2017)

• Prenatal complication of the placenta: Improved endothelial function in the placenta for a diabetic pregnancy animal model, eNOS -/- knockout mice and wild-type were used. (El-Sayyad, El-Ghawet, El-Sayed, 2019)

A recommendation was made for us to get ~ 600 mg of this type of polyphenol each day. About 3 cups of green tea might provide 200 mg. Half to one teaspoon of inner pith of pomegranate (fresh) might provide ~ 100-450 mg of polyphenols. I use that amount about once or maybe twice a day.

As a mouthwash the polyphenols are affecting the mouth microbiome but is then spit out, so it is protecting the mouth but not adding to a total daily intake of polyphenols. The same extract could be used by spoonfulls in other beverages but is too strong and acidic to drink. As a mouthwash, follow with a rinse with sea salt to restore more normal acidity to the mouth.

Roughly…. the other superfoods mentioned have similar polyphenol potential as these pomegranate dosing estimates. Pomegranate has proven very beneficial but the research I’ve found on sumac, persimmon, and goji berries is all very similar in showing effectiveness for the same concerns.

Disclaimer: This information is being shared for educational purposes within the guidelines of Fair Use and is not intended to provide individual health care guidance.

Reference List

Boulares, A., Jdidi, H., Bragazzi, N.L., Impact of Mouthwash-Induced Oral Microbiome Disruption on Alzheimer's Disease Risk: A Perspective Review, Int. Dental Journal, Vol 75(1), 2025, pp 45-50, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2024.07.005. https://www.sciencedirect.com/science/article/pii/S0020653924001977 (Boulares, et al., 2025)

Brookes, Z., Teoh, L., Cieplik, F., Kumar, P., Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?, Int. Dental Journal, Vol 73(2), 2023, pp S74-S81, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2023.08.010. https://www.sciencedirect.com/science/article/pii/S0020653923004550 (Brookes, et al., 2023)

Carvalho, L.R.R.A., Boeder, A.M., Shimari, M. et al. Antibacterial mouthwash alters gut microbiome, reducing nutrient absorption and fat accumulation in Western diet-fed mice. Sci Rep 14, 4025 (2024). https://doi.org/10.1038/s41598-024-54068-y https://www.nature.com/articles/s41598-024-54068-y (Carvalho, et al., 2024)

Joseph, G., Koltai, H., Ron, E.Z., Azzam, N., Hazan, H., Raskin, I., et al., Rhus coriaria L. (sumac) leaves harbour robust antimicrobial activity, Journal of Herbal Medicine, Vol 41, 2023, 100729, ISSN 2210-8033, https://doi.org/10.1016/j.hermed.2023.100729. ttps://www.sciencedirect.com/science/article/pii/S2210803323001070

Morzelle MC, Salgado JM, Telles M, Mourelle D, Bachiega P, Buck HS, Viel TA. Neuroprotective Effects of Pomegranate Peel Extract after Chronic Infusion with Amyloid-β Peptide in Mice. PLoS One. 2016 Nov 9;11(11):e0166123. doi: 10.1371/journal.pone.0166123. PMID: 27829013; PMCID: PMC5102433. https://pmc.ncbi.nlm.nih.gov/articles/PMC5102433/ (Morzelle, et al., 2016)

Yu C, Chen Y, Ahmadi S, Wu D, Wu J, Ding T, Liu D, Ye X, Chen S, Pan H. Goji berry leaf exerts a comparable effect against colitis and microbiota dysbiosis to its fruit in dextran-sulfate-sodium-treated mice. Food Funct. 2023 Apr 3;14(7):3026-3037. doi: 10.1039/d2fo02886g. PMID: 36861301. (Yu, et al., 2023)