It's That Time of the Year -- Viral infections: Colds and Flu

It's been all over the news, and I know many people who have, unfortunately, already had the flu or have been recently exposed.  My husband had the the flu last weekend, and exhibited the classic symptoms of a rapid onset, chills, severe joint and muscle pain, headache, fever, and a dry cough. It began last Friday, and by today, Wednesday, he's feeling much better.  My treatment plan was simple: stay in bed, monitor fever, antivirals, respiratory tonics, lots of water. 

I used Andrographis, Yerba Santa, and Kick-Ass Immune Activator by Wishgarden Herbs. The tincture contains Yerba Santa, Baptisia, Goldenseal root, Elderflower, Yarrow, Osha, and Echinacea root.  In general, I do not use Goldenseal root for colds.  Many people think of Goldenseal as an antibiotic, which is partially true. Berberine, one of the constituents of Goldenseal, is topically antibacterial, which means it is effective when applied to wounds, or to infections of the mouth, stomach or urinary tract (where it is excreted by the body). Antibiotic berberine is also found in Barberry, Oregon Grape, Coptis, and Yellowroot.

A variety of Phytotherapeutic methods are useful in treating upper respiratory tract viral infections. In general, I employ Traditional Chinese Medicine (TCM) approaches with Western clinical herbalism during treatment. During the very early stages of cold and flu, symptoms of an upper respiratory tract infection respond to warming and stimulating botanicals, and can be combined with botanicals that inhibit viral replication:

•   Andrographis paniculata (called the King of Bitters in Ayurvedic medicine) In TCM, Andrographis is considered bitter and cooling. It has immunostimulating properties, is antipyretic, stomachic, has laxative properties, and is used as a bitter tonic.  This is the first remedy I choose at the onset of a cold or the flu. Much research on Andrographis has shown the herb to be effective in reducing fevers and relieving sore throat. It should not be used for more than 2 weeks at a time.

•   Spilanthes acmella (also called Toothache plant): native to Africa and western Asia, this plant is exceptionally high in immunostimulating isobutylamides, which are also found in Purple Coneflower (Echinacea spp.) and Prickly Ash (Zanthoxylum spp.). It has a spicy and warming energy that stimulates glandular and mucosal secretions.

•   Lomatium dissectum (also called Biscuit root): Long used by the First Nations people of North America, Lomatium gained the respect of early European settlers for the treatment of influenza. It has antiviral and antimicrobial properties and is very safe, although long-term use may produce a rash in some people. It is, however, endangered, so it is best to purchase cultivated forms if possible.

“Composition Powder,” a time-honored Thompsonian remedy, was highly utilized at from the mid 1800s through the start of the 20^th century. The following recipe is taken from Benjamen Coby’s 1864 book “A Guide To Health,” and should be in every medicine cabinet in preparation for colds, flus, and digestive upset.

Take the powders (finely ground herbs) of:

•   Bayberry bark (Myrica cerifera) 2 parts

•   Ginger root (Zingiber officinalis) 1 part

•   Cayenne fruit (Capsicum spp.) 1/8 part

•   Cinnamon bark (Cinnamomum cassia) 1/8 part

•   Prickly ash bark (Zanthoxylum americanum) 1/8 part

Mix well and sift through a sieve. The dose is one teaspoon in a half a cup of hot water. 

There are endless variations of this formula, and instead of powders, tinctures of the same herbs can be combined in the same proportion, but the dosage can be reduced by half. Other herbs may be added for additional benefit including Biscuit root (Lomatium dissectum), Turmeric (Curcuma longa) and White Pine bark (Pinus albicaulis).

FEVERS

Mamas, I know that nothing freaks you out more than worrying about a fever in your little one.  But I cannot say this enough, or more firmly, fever is critical to the healing process!!

Fever is regarded a friend in herbal medicine, and phytotherapies are used to support the fever and to enhance the body’s innate response so as to facilitate a more rapid and thorough recovery.

Modern medicine, even in the face of sound physiological reasons to support the fever process, continues to promote therapies to shut down the fever function.  The widespread use of acetaminophen and ibuprofen are ubiquitous in our culture. Many pediatricians and baby books will recommend alternating between the two to keep the fever down.  As can be seen in the Ayurvedic or the TCM model, such an approach, while alleviating the symptoms of fever in the short term, actually drive the pathogen deeper into the body where it can manifest as a disease at some later point, or can lead to an incomplete or longer recovery time. This modern medical approach prevents the body from responding fully to the pathogen through its natural processes.

It takes trust to allow a fever to progress without intervention, and a fever management plan should be in place. Know when to intervene!  If a fever spikes too suddenly or climbs too high, febrile seizures can occur. Care should be taken to prevent febrile seizures. A high fever that lasts for more than 24 hours should be monitored closely and a doctor’s advice should be sought when your comfort level is breached. Instead of relying on ibuprofen and acetaminophen, there are several phytoremedies that are useful for fever management.

Fever management

Fever management in herbal medicine rests upon understanding the stages of fever:

1.Initial or Prodromal Stage: coldness and chills begin and indicate that the body temperature is lower than that which is set in the hypothalamus, and is likely going up.  If the fever is having trouble starting, circulatory stimulants such as Ginger root (Zingiber officinalis), Cayenne (Capsicum spp.), Cinnamon (Cinnamomum cassia) and Angelica (Angelica archangelica) are useful to raise body temperature. External therapies can also be included, such as hot fomentations and warm water enema.

2. Increase Phase: hot, flushed skin and sweating, indicate that the body temperature is higher than that which is set in the hypothalamus. In most circumstances nothing needs to be used at this point, except perhaps sponging with cool water. Ensure ill person drinks plenty of water.  Tea or hot lemon water can be taken if desired.

3. Climax Phase: Continued feeling of heat and sweating. Temperature does not continue to climb. Person often feels hot and irritable.

4. Descent Phase: Fever starts to recede. Person often begins to feel noticeably better.  

If the person feels cold and is shivering, monitor the fever often, and be prepared to use antipyretic therapies to manage progression of the fever. Initially, it is better to try to use stimulants, such as Lobelia (Lobelia inflata) or Cayenne (Capsicum spp.).

If the person is hot and irritable, the use of cooling diaphoretics such as Lime blossom (Tilia), Catnip (Nepeta cattaria), Yarrow (Achillea millefolium) and Elder flower (Sambucus nigra) are all useful, especially for children.

If the fever remains persistent and high, herbs with an antipyretic activity such as  Aspen (Populus tremuloides), Willow bark (Salix ssp.), Goldenseal (Hydrastis canadensis), and Peruvian bark (Cinchona spp.) can be used. 

After a fever has resolved, stomachics such as Elecampane (Inula helenium), and Cardamom (Elettaria cardamomum), and bitter restoratives such as Dandelion root (Taraxacum officinalis), and Gentian (Gentiana luteum) are all useful, to restore digestive function and stimulate appetite.

In addition to the timely and appropriate use of diaphoretics, antipyretics and digestive stimulants, herbs with antiviral properties can also be used. There are several plants that have antiviral activities, but those that have the greatest activity upon upper respiratory tract infections include Biscuit root (Lomatium dissectum),  Osha (Ligusticum spp.), and Yerba Santa (Eriodictyon californicum). Additionally, both these herbs have a profound diaphoretic activity and will promote a fever to break.

During a fever, one of the most unpleasant side-effects is muscle and joint pain. Although uncomfortable, such symptoms indicate that interferons are doing their job, enhancing antiviral and phagocytic activity. Phytotherapies that can be used to help alleviate some of the side effects of the viral infection include diaphoretic, antipyretic and antispasmodic herbs such as Boneset (Eupatorium perfoliatum) and Black Cohosh (Cimicifuga racemosa).

Once a person starts feeling better and the flu symptoms start tapering off, immunomodulants, herbs that regulate the immune system, enhance immune activity, and regulate the inflammatory response, can be used to help in the final stages of recovery. Many immunomodulant herbs are contraindicated in fever and should not be used until the ill person starts to recover and appetite has returned. These herbs include Astragalus (Astragalus membranaceus), Marshmallow root (Althaea officinalis) and Ashwagandha (Withania somnifera).