Desktop Guide to Herbal Medicine

To begin with, a cold is a rather non-trivial event. It's much more than a nuisance, like some might assert. For example, the author and his wife just returned from what would have been a lovely Christmas family reunion. Instead, we and some of our loved ones experienced the gamut of respiratory issues. It's as if we exchanged diseases rather than presents.  "Well what did you get?"  "Oh, I got the strep throat."  "Wow, all I had was the flu."  "That's nothing. I received walking pneumonia."   We had all of these during the reunion. (I had never even heard of walking pneumonia before.) So instead of a memorable time playing in the snow near Hood River, Oregon, most of us were holed up in the vacation house during the gathering. That's pretty non-trivial in my book. About the book on the right:  The Desktop Guide to Herbal Medicine. I have found myself going to this book repeatedly if I want to find out a the most information on any given herb. It describes the main medicinal/nutritional benefit, as well as other traditional and modern benefits, and gives a comprehensive list of the herb's flavonoids, essential oils, alkaloids, vitamins, and minerals. I have other books but most of them are categorized by diseases or conditions, with lists of possible herbs that might be used for the condition (but with limited information on each the herbs themselves), and still other books that concentrate on where the herb typically grows and other plant-related stats (but limited information on the medicinal or nutritional uses).  Clicking on these links takes you to the most current availability and best price on Amazon, and helps to support your Wrackline Blog.

So in this article. I propose to offer some slightly different information - some of it from the more recent articles in the herbal area - as well as some more subtle nuances of treatment. And I will end the article with some deeper observations/ramblings. If you have read some of my other essays on this blog, you are probably getting used to this by now. It's what the Wrackline Blog is all about.
 By the way, one of the advantages of being an older person is that you can look forward to fewer respiratory diseases. At the age of 73, I find that I get a cold about every 1 - 2 years now. After all, there's only 100-200 cold viruses, and by the time you have reached the age of 50-60 or more, you just about seen 'em all.

Prevention
 A few words on prevention. During the winter months, this is the time to keep your immune system in top shape. For starters, it's well to know where the immune system actually is. It's in the blood, right? You know; all those killer T cells and the like.
 Wrong.
 There are many articles nowadays pointing out that 70% of the immune system is in the gut, and is directly related to gut flora - the "good" bacteria. It is the gut bacteria that prompt certain cells in the intestinal mucosa to create the Killer T's, along with immunoglobin A (IgA), and macrophages. They also counteract "bad" pathogens in other ways. This is the reason that you should not take antibiotics lightly. As you probably know, antibiotics have no effect on viral infections such as the cold and the flu. If you have recently had an course of antibiotics, it is absolutely essential to restore this intestinal flora system, perhaps by taking extra probiotics.
 If all this isn't enough, consider that gut bacteria are responsible for 90% of serotonin! That's right. Serotonin, THE "feel-good" neurotransmitter.
 The mucus membranes in the upper respiratory tract are also an important part of the immune system. It has been pointed out that it is not necessarily cold temperatures in winter that promote colds and the flu. It's the drying effect of indoor heat and closed windows. This dries up the mucus in the protective mucous membranes, and the cilia are not as effective in sweeping viruses out of the respiratory tract. The mucous membranes can even develop cracks, which further exposes your physicality to infection. In some homes it might be necessary to use a vaporizer or humidifier during some of the colder days.
 While we are talking about "Sweeping viruses out of the respiratory tract", here's a useful tip: If you sneeze, something's irritating your nasal passages. Stop what you're doing and go blow your nose! You want to immediately remove that irritant, just in case it might be something you don't want. If nothing else, this will help you stop sneezing.

Some suggested foods/supplements/teas for prevention:  Yogurt to help maintain the intestinal flora, particularly if you have recently had a course of antibiotics  Powdered greens drink. The author takes a scoop of greens mix every morning, and highly recommends this practice, whether or not you are trying to reduce the ocurrence of colds. Many nutritional articles suggest the consumption of greens mixes as a normal daily practice,  Fish Oil supplement. This provides you with the Omega 3s, which provide raw material with which you can produce your own anti-inflammatories as needed. This vastly reduces muscle soreness and headaches, as will be covered in the upcoming "eliminating muscle pain" article in the Wrackline Blog.  Vitamin D, among its other benefits, is being touted of late as an immune system supporter. For example, a 2010 article in the American Journal of Clinical Nutrition notes that vitamin D can help to reduce your chances of getting the flu (Ref: http://www.ncbi.nlm.nih.gov/pubmed/20219962)  Allegro "Seasonal Well-Being" tea (Whole Foods). This tea contains several herbs that are thought to be "adaptogens", which help your physical form to handle stress.  Celestial Seasonings "Tension Tamer" tea. This is the author's fav. It contains eleuthero, which is an adaptogen, and which the author finds to help enhance a sense of well-being.

Specific Suggestions

At the onset of symptoms (sore throat, runny nose, sneezing)

This might be a good time to start the Elderberry lozenges. Why? Because Elderberry has anti-viral properties (see the next paragraph), and you want this effect as soon as the viruses show their presence by irritating the throat and also the nasal passages. This early pre-treatment is similiar to that recommended for Tamiflu, Rapivab, Relenza and similar anti-viral compounds that might be prescribed for the flu, and must be taken within 48 hours of the start of symptoms.

Elderberry.
 Elderberry has been showing up in many recent articles lately, and has been getting a lot of recommendations. Elderberry juice and syrup have been used for more than 2000 years for colds, flu, and coughs. It helps remove toxins by way of its diaphoretic (warming) and diuretic action, and is said to have a decongestant action. The herb is rich in flavonoids, which have antioxidant properties. In addition, "these flavonoids in the berry help bind and disarm hemagglutinins, tiny viral spikes which otherwise allow the virus to penetrate cellular membranes." (Ref: The Desktop Guide to Herbal Medicine) Thus Elderberry has anti-viral properties, and is especially useful if taken immediately upon experiencing the first symptoms of a cold or flu.
 Vitamin C is said in recent articles to enhance the antihistamine activity of other nutrients, so if you want some C with your Elderberry, the product "Sambucha" has Elderberry and Vitamin C. So does another product named "Sambucol". (See the graphic below showing several packages of Elderberry lozenges.)

Antihistamines (herbal and medical) and the initial runny nose/sneezing
 The cold will probably start with the initial highly runny nose/sneezing and the like. You may notice that the sneezing and/or episodes of "acute" runniness are both associated with a tickling sensation in the nose. You can temporarily stop this tickling with the nasal saline treatments described a few paragraphs below.
 By the way, all these events are caused by your Mast Cells reacting to the virus invaders. Mast Cells are leukocytes that settle in various places in your physical form, particularly in locations that are in contact with the external environment (skin, intestines, and airways). They produce histamines and other pro-inflammatory hormones when reacting to viruses or other toxins.
 There are three natural remedies to help manage the histamine response:

Quercetin. This flavonoid helps modulate the histamine response, as well as providing anti-inflammatory abilities. This is found in red onions, blueberries, strawberries, apples, grapes, and black or green tea. To get a pretty good dose of quercetin, you can "quick saute" some sliced onion and put it on top of your meal. "Jimmie's Quick Saute" is described in my link from the "Home" page to "Quick Nutritious Lunches", but basically all you do is place some sliced onion, some olive oil, and a bit of seasoned salt into a Pyrex dish and microwave it for 1 1/2 to 2 minutes.

Nettle. Nettle tea seems to do a good job in reducing the runniness/sneezing during the day, but I had to have OTC reinforcements when I went to bed (see below). Nettle is said to stabilize mast cells and reduce mucus membrane hyperactivity. (Ref: The Desktop Guide to Herbal Medicine)

Vitamin C. Vitamin C is said to assist in the activity of nutrients like Quercetin and Elderberry.

In any case, if you can manage to put up with all this drainage (and not take an OTC antihistamine), you might find that it will last only one day or less. When there is drainage and excessive nasal secretions, usually it's because potential invaders (viruses) are being expelled. On the other hand, if it gets too rough at bedtime, you could consider a well-placed antihistamine just before retiring. And sometimes the nasal runniness and the sneezing, like some other bodily processes, can get away from you. If the nasal saline treatments do not provide and hour or two of relief, it also might be time to shut it down with an antihistamine. The two main OTC antihistamines are chlorpheniramine maleate (Chlor-Trimeton) and diphenhydramine (Benedryl), which has the significant side effect of making you very drowsy.
 NOTE: These two antihistamines are "First Generation". They interact with the nervous system to cause drowsiness. The "Second Generation" antihistamines do not have this drowsiness effect, if you prefer - or need - to remain alert. These newer compounds are loratadine (Alavert and Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).
 I suspect that it would NOT be well to mix the two types.
 If you do decide to take an OTC antihistamine toward the evening (and maybe one more during the night), be careful the next morning! If you start the morning blowing your nose constantly and/or sneezing, take another antihistamine! By doing so, you'll have more chance of shutting down the excessive histamine response.

Other Tips

On Not Interfering
 In general, the author prefers and recommends that the less you do to interfere with bodily processes by using OTC antihistamines and decongestants, the better. Your physicality knows what it is doing, even though you might not feel like it knows what it's doing! So try to content yourself with the saline treatments and herbal remedies, with the exception perhaps of a few doses of the antihistamines discussed above. (And anything, including Medicine's Big Guns, is fair game on The Cough!!)

Warmer internal temperature as your ally:
 Likewise with the internal temperature. If you have a slightly elevated termperature, say 99 or 100, this can actually mean that your immune system is active in eliminating viruses. Recent research has shown that certain lymphocytes are more efficient at a slightly elevated temperature. Thus, unless you are in significant discomfort, try to avoid taking aspirin or acetaminophin, since these act to reduce fever. NOTE: we are talking about slightly elevated temps here! Higher temperatures possibly warrant a call to the doc.

Drink lots of warm water as well as various teas.
 All this acts like a natural expectorant, and helps keep the internal temperature up. Drinking lots of cold water tends to make you chilled. Warm water might sound disgusting, but you get used to it. Try not to let it, or the teas, be too hot. The throat is highly irritated and too much heat may irritate it further. Think your drink is "warm", not hot? Try pouring a few drops on your palm, not your fingers - they're too used to heat.

Make your immune system "Locked and Loaded":
 This is the time to arm your immune system with the best foods and drinks you can find. Some folks can't eat much when they're down with a cold, but if you can, make it count. Lots of spinach. Some "Green Drinks" or powdered Greens mixes. Fix some nourishing soups, generally with clear broth, and yes, chicken soup does seem to help - perhaps even providing a bit of drying/decongesting effect. In any case, this is NOT the time for cokes, other soft drinks, and junk food! Your immune system will then be shooting blanks!

Saline solutions and "snorting salt"
 You can't go wrong by gargling as often as possible with warm saline, and ocasionally "snorting" some to clear out the nose. Just put a bit of salt in your cupped hand, fill it with warm water, and breathe it gently up your nostrils. Then expel it from your nostrils. This may take some getting used to! Your first attempt may make you feel like you did when you were a kid and accidently breathed in some swimming pool water. But once you are used to it, you will find that this procedure is excellent for all stages of a cold, and even for other times when your nose is partially stopped up, as for instance when you have been outside in dusty conditions, or after driving some distance on a busy smoggy freeway. Neti pot salt is fine-grained, as is Hain's large container. Thus it dissolves more easily. But the big container of Morton's Sea Salt works fine too.
 This is a "biggie"! Snorting salt up the nose can act as an antihistamine because it removes the irritating substances from the nose. It can also act as a decongestant and open up the airways. In both cases, the effects can last up to an hour or more, even longer during the latter stages of a cold. I recently managed a 3 day cold using this method (along with the Elderberry).
 Indeed, by the second or the third evening of the cold, you will likely begin to switch from excessive runniness to congestion. Take note of your condition. If you feel congestion, with airways partially closed up, even though there might still be dripping, it might be well to tough it out and just use the nasal saline treatment. Taking an antihistamine when you begin to be congested might make the congestion worse.

Dry room?
 If your room is dry, a portable humidifier/vaporizer significantly helps. Don't have a vaporizer? Then hang a damp towel over a portable clothes rack and place next to your bed.

Some selected items to take during the cold/flu  Powdered greens drink! First on the list! This really amps up the immune system! Consider taking a scoop in the morning and the afternoon, and perhaps even one more before going to bed.  Elderberry, as described above, can be of significant benefit, especially if started at the onset of a cold or flu Fisherman's Friend throat lozenges seem to offer a temporary decongestant effect  Thayer's Slippery Elm lozenges act as a demulcent, or coating agent. They may or may not help a cough, but they are useful for the dry throat that ocurrs at the late stages of a cold.  Spinach and other greens are nutritional powerhouses. The immune response is at its best when nourished by such foods.  "Clems", sometimes called satsuma mandarins, help throughout the day.  Add all the garlic you can take to your foods. Garlic has significant antibacterial effect and thus may help prevent sinus infections. Let the garlic sit for about 10 minutes to allow the allicins to combine. This will make them more stable during heating.  The sea salt is for gargling and "snorting".	Selected good teas to drink  The Yogi Breathe Deep tea, the Traditional Medicinals Breathe Easy tea, and the Traditional Medicinals Herba-Tussin tea all seem to have a decongestant effect, to provide a temporary opening of the airways, as well as to reduce the drainage somewhat. They also include some diaphoretic (warming) herbs.  The Yogi Honey-Lemon tea seems to help reduce coughing and has an expectorant effect.  Peppermint tea seems to also have a partial decongestant effect.  The Traditional Medicinals Throat Coat tea provides a demulcent effect, and should help with the dry throat.  NOTE: Many of these teas contain licorice, and might raise your blood pressure a bit. If you already have high blood pressure, check for licorice as an ingredient.
Elderberry  Consider one of these Zinc/Elderberry lozenges, or a liquid extract. Elderberry is a potent antiviral. I describe Elderberry extensively, along with references to various studies that have been conducted on it, in my article "Don't Just Incubate - Fight Back!" A link to this is on my home page (just select the "Back" button at the top of this page.)  Also, these three Elderberry Lozenges are supplanted with the benefits of Zinc. While the studies of Zinc as a cold remedy have been mixed, many of the studies have shown some benefit from the Zinc, particularly if taken at the onset of a cold. Zinc is involved with immune system function, and helps stimulate white blood cell activity. It also has a role in activating T lymphocytes (the "killer Ts").  One of these lozenges might be taken in the morning and one in the evening.  When your cold improves and you begin to feel better, taper off the lozenges, rather than suddenly stopping them.

The Cough

And this brings us to the subject of The Cough. If you're like me, the ending phase of a cold/flu is a protracted cough. Some coughing is productive and allows for the removal of spent cells and excess mucous. But somewhere toward the end is the dry, utterly useless, unproductive cough. The one for which you don't dare go out to a store without a bottle of water. The one which keeps you from going to sleep for several hours each night. This is what all the warm water and teas is for. You want to convert the cough. By "convert" i mean that you are replacing the cough with just a productive clearing of the throat. Any time you can succeed in this, the cough stops.

During the cough phase, some well-timed use of the expectorant guaifenesin (Mucinex) can help loosen up the mucous. Get the 600 mg version rather than the extra strength 1200mg version. If you wake up with a cough, you can then take another 600mg tab. Too much (e.g.: 1200mg tabs), particularly near the end, may even exacerbate the cough, by producing too much liquid - hence too much dripping. Small-framed people could even cut a 600 tab in half. Yes, I know. The package warns against this.

Medicine's Big Guns are these:

Tussinex. This is (was?) the most powerful. It's actually hydrocodone. But watch out! It worked great for me years ago but of late it is supplied with an antihistamine. The antihistamine is supposed to help with the "post-nasal drip". But in the author's experience this additional drying only made things worse.

Cheratussin (sometimes supplied as "Virtussin"). This is a bit of guaifenesin (100mg) and some codeine (10mg) per 5 ml dose. This seems to work the best. The usual recommended dose might be 5ml every 6 hours, but some doctors will bump this to 5ml every 4 hours. You (or the cough) can be the judge. . .

Tessalon Perles (Benzontonate). These are useful for a mild cough, perhaps during the day, but not so much at for more pronounced coughs.

Combining the perles and the Cheratussin does NOT seem to work.

Dextromethorphan HBr (not shown). This is the Over-the-Counter cough suppressant. It's described in the notes for the graphic below.

NOTE: There seem to be two kinds of dry coughs:

The "tickle-induced" cough. This is the one which won't let you get to sleep. Each breath slightly irritates the "tickle area" in the throat. This is the one for which the cough suppressants are helpful. You can tell because you can't take deep breaths without setting it off.

The dry cough. This is the one which comes up suddenly during in the night or in the morning, when your throat is bone dry. A few sips of water can at times make this one productive. It may persist for several days and get worse in the afternoon/evening, and may be accompanied by quite a bit of post-nasal drip.

Don't STOP taking the cough medicine! TAPER it off! This applies to all meds, herbs, or anything else you are depending on for physical support. You might think, "Oh I did well later in the night and towards morning. So I won't take a cough suppressant until later today". The cough suppressant should probably be taken for a while even though you might think you don't need it. You cannot let the cough get away from you!

Prop yourself up with pillows when you first go to sleep. This reduces the drip and associated tickling of the throat. After a few hours of intermittent sleep, you will finally get tired enough that you can sleep despite the cough. (It might be noted that there's dripping ALL the time - probably a sign of a healthy, moist mucal membrane system. But we just don't notice it all other times, because the cough reflex is not active.)

The Fisherman's Friend - or other menthol tablets - act as a temporary clearing agent, enough perhaps to allow you get to sleep.

The Allegro Wellness Tea seems to have a drying effect, and seems to help stop the "drip"

Medical Science's Offerings:  Delsym: Dextromethorphan Polistirex. Each 5ml contains 30mg Dextromethorphan HBr "equivalant". BUT, see the comments further down about Dextromethorphan HBr!  Robitussin DM (liquid): Dextromethorphan Hydrobromide plus guaifenesin (an expectorant) in liquid form. Each 10ml provides 20mg Dextromethorphan and 400 mg guaifenesin  Robitussin DM (capsules): Dextromethorphan Hydrobromide plus guaifenesin capsule form. Each tablet provides 10mg Dextromethorphan and 200 mg guaifenesin. Dextromethorphan Hydrobromide (HBr) vs Destromethorphan Polistirex: Dextromethorphan HBr is the standard OTC cough suppressant, and can be quite effective. Note that the "12 hour" Delsym is Dextromethorphan polistirex. Polistirex is an "edible plastic". It is gradually broken down by digestive enzymes to provide the extended effect. Apparently, polistirex is commonly used to provide an extended release. Nicotine gum, for example, is nicotine polistirex. Thus, dextromethorphan HBr is the actual cough suppressant. THIS is the Destromethorphan that you want.  4 hour vs "Time Release" 12-hour: The two Robitussins with the Dextromethorphan HBr are 4-hour period doses. For any of these types of compounds, the 4-hour version is MUCH PREFERRED over the extended time release version. This applies to antihistamines as well as cough suppressants. If you find that one dose does not appear to be working, you can freshen it up with another dose after 4 hours (maybe 3 if you really need it.) But if you have taken the 12 hour time release, you're stuck! Mucinex. This contains the expectorant guaifenesin only.  Sucrets. These cough drops have menthol, along with Dyclonine, which is an oral anesthetic. They may or may not be useful in numbing the throat for a while. There is a new Sucrets available (May not be in stores yet) which adds a demulcent, in this case pectin. Not shown is Cepacol cough drops. They contain menthol and benzocaine, which is another anesthetic. One variation of Cepacol contains some Dextromethorphan HBr along with the menthol and benzocaine.  The bottle is an empty container which held Cheratussin. (Don't know about the ramifications of displaying narcotic-based compounds on the Wrackline Blog!) This is the prescription compound, and contains 10 mg Codeine and 100 mg guaifenesin per 5 ml dose. The author finds it to be of significant benefit.  The smaller bottle is Tessalon Perles, or benzontonate. These are usually supplied as 100 mg or 200 mg capsules. The author finds this to be helpful for a less serious cough, during the day perhaps. As noted above, combining the Perles and the Cheratussin does not seem to work. Note that they should NOT be allowed to dissolve in the mouth, since they can numb the throat in such a way as to make swallowing difficult.  NOTE: Medical Compound manufacturers have NO qualms about adding: artificial flavors artificial colors preservatives parabens

Tapering and the Relapse Soon you will enter the "Final Stages", discussed right below. You are starting to feel like you are again a member of the human species rather than a member of the rhinovirus species! You will be tempted to just stop taking the extra green drink, the special teas, the cough suppressant (if you started that), or whatever else you might have chosen as your helper during the cold.  Consider this: don't just stop suddenly, but taper off the extra compounds.  Why? Because your physicality has temporarily learned to depend on them! If you stop supplementation abruptly, there's a bit of a risk of a relapse. So for example, if you have been taking three of the Zinc/Elderberry lozenges a day, take 2 lozenges for a couple of days, then 1 lozenge for a couple more. This is particularly true if you have been using one of Medicine's Big Guns! It is interesting to note that our physical form wants to maintain a homeostasis - a balance - between pro-inflammatory and anti-inflammatory compounds. The same applies for histamine and anti-histamine. Thus, if you take an anti-histamine, our systems respond by making more histamines! Apparently the net result is that temporarily you have fewer net histamines, and the anti-histamine is indeed working. But when you stop the anti-histamine, the histamine level stays up for a small period of time. This accounts for the temporary "rebound" effect.  So rest assured that you have not "relapsed"! And no, you can't "catch the same cold" twice.

The Final Stages

Towards the end, you have the toxin-clearing time. The lungs are being purged. There may be a return to a "productive" cough as the the final toxins are expelled. Also, these toxin clearing times might be associated with temporarily more powerful dripping, more dry cough, and the like. There may be more discomfort, more soreness; you might awake with a headache. All this is caused by the toxins and cellular debris being moved about for disposal. This is another time for drinking lots of liquids, to help in the expulsion of the toxins. Here's an interesting parallel: A nutritional course in "Natural Healing" was describing the "Elimination Diet", which is the one whereby you start by eliminating all six common food sensitivity groups (dairy, eggs, etc). The lecturer noted that, after you have started this diet:

"Between days two and seven, you may start to feel like your symptoms are getting worse, but this is expected. As you clear your body of the toxins, sometimes they flare up". (Ref: The Science of Natural Healing) Course #1986, The Great Courses.

When you awake, the throat may be dry. Drink enough warm water to cause expectoration, to "convert" the cough. Also you might need to do this if you wake up during the night. Also gargle with salt water when you wake up during the night. Sometimes it's not easy when you in the midst of coughing, but try to gargle anyway. The cough suppressants may not be as useful for this cough.

And don't get discouraged if you feel fine (or relatively fine) during the day, only to find that it goes all to heck in the evening. This is normal; inflammation peaks toward the end of the day.

Finally, the cough might persist a bit toward the end, even though the lungs are clear and there's nothing left to expectorate. For this reason, taper off the guaifenesin (Mucinex). As a matter of fact, toward the end, it's a tough call on the Mucinex. Loose, watery drip: not a good time to use Mucinex, since it exacerbates the drip. Dry cough that is unproductive and doesn't become productive even with lots of water: not a good time. Thick material that you can't seem to clear/swallow: might be a good time for the Mucinex.