Seasonal Respiratory Support

With cold and flu season upon us, now is the perfect time to consider herbal remedies for supporting respiratory health. During the fall and winter it is important to focus on strengthening the lungs with warming foods and drinks such as soups and hot teas, as well as specific tonic herbs. In my practice, I rely on botanical formulations of herbs that have a long history of traditional use for respiratory well-being to help us better adapt as we move into the colder months.

The Importance of Lung Health

In TCM (Traditional Chinese medicine), the lungs are referred to as the lung organ network, and within ETMS (The Eclectic Triphasic Medical System), also referred to as Mederi Medicine, we refer to this network as the Lung and Oxygen Network.  This network consists of the physical structures and the functional qualities of the lungs. The lung network oversees the distribution of fluid in the body, and is likened to a mountain, whose rivers and streams carry water to the surrounding areas. They are also responsible for the generation and maintenance of the defense Qi of the body, which is like a barrier that protects us from invading pathogens.

The job of the respiratory system is to facilitate the interface of our bodies with the air we breathe. The bronchial passages make up the primary networks for the exchange of air in the lungs. From the otopharynx in the throat, down the trachea, and into the bronchi and the terminal bronchioles, the passages get smaller and smaller until arriving at the alveoli, which provide a large surface area for respiration and allow maximal contact between the air and the blood. An intricate network of capillaries surrounds the alveoli and allows for the ready exchange of carbon dioxide and oxygen, as well as the many other elements comprising the air.

The alveolar network provides about 75 square meters of surface area, making the lungs a huge interface for the body with the environment. This is why the lungs are considered a primary part of the body’s detoxification network. The proper functioning of the lungs depends upon the health of the air passages. In TCM, the lungs are considered to be a delicate organ—the tissues are highly susceptible to injury by stress, trauma, hypersensitivity reactions, or toxic insult. Because of its direct link to the exterior environment, the maintenance of favorable environmental conditions in the lung system can be challenging for the body to maintain. Inhaled pathogens, irritants, or allergens can easily damage the lungs, thereby initiating internal environmental change.

Common Afflictions of the Respiratory System

Colds and flus, coughs, seasonal allergies, sinus infections, and asthma are all common maladies that afflict the respiratory system. Coughs are one of the most common symptoms associated with lung and throat issues. A cough may be the result of an infection, a defensive response to inhaled irritants like smoke, an allergic reaction, or an autoimmune condition.

Upper respiratory tract infections often begin with a sore throat; the sinuses become filled with turbid fluid, and the lungs may become overly wet or dry. Some coughs are productive, while others are unproductive. Mucous and any inhaled particles are normally voided from the lungs via the mucociliary escalator, but this self-cleansing mechanism can become impeded or overloaded if there is an excessive amount of mucus or if the mucus is very thick and sticky.  The characteristics of the cough give us clues as to the nature of the underlying condition.

Dampness/Phlegm

In TCM, phlegm is thought to be generated by the spleen, and is contained in the lungs. Many of the botanical therapies for resolving phlegm in the lungs are also directed at resolving dampness in the spleen, thereby inhibiting the formation of phlegm. The existence of phlegm/dampness in the lung makes the internal environment more favorable for opportunistic infections, and often heat or cold accompanies the phlegm, creating a condition of Phlegm Heat, or Cold Phlegm in the Lung. The more heat and bacterial infection is present, the more yellow, dark, and viscous the mucus becomes. In cold phlegm conditions, the phlegm is clear or white, copious, and thick or thin, but less viscous than in hot conditions.

Dryness

The delicate nature of the lung tissue makes it susceptible to dryness. Autumn is characterized by dryness, and often a condition of lung dryness can result from a combination of lung weakness and a very dry external environment. As in the case of wet lung conditions, dryness can lead to inflammation and tissue damage, and is characterized by dry cough with scanty sputum, or sticky sputum that is difficult to expectorate. As in the case of phlegm dampness preponderance, there is also a hot or cold nature to lung dryness conditions, which can be associated with upper respiratory tract infection, pneumonia, bronchitis and pharyngitis.

Supporting the Lung and Oxygen Network

When there is a deficiency of the overall Life Force, specifically the Vital Force and/or Vital Essence, and/or an imbalance of inward and outward energy, this must be addressed together with specific herbs for strengthening the Lungs. Primary and many secondary adaptogens, as with all the Organ Networks, are foundational to supporting the Lung and Oxygen Network. Although all of the plant extracts support the lungs and improve oxygen uptake through the lungs and within the cells of the body, some adaptogens with a bit more specificity for the Lung and Oxygen Network include American ginseng (Panax quinquefolius) and schisandra (Schisandra chinensis).

Many herbs that strengthen and/or nourish (moisten) the Kidney Network also strengthen and/or nourish (moisten) the Lung and Oxygen Network.  Licorice both strengthens and moistens the Kidney and Lung Networks and combines well with schisandra, which strengthens and tonifies, but is a bit drying. Cordyceps, an herb I classify as a secondary adaptogen, is another wonderful plant for both the Kidney and Lung Networks with immune-enhancing, anabolic, organ-protective, and cancer-suppressing attributes.

Adaptogens such as schisandra have an ability to fortify mitochondrial antioxidant status, thereby offering the body a generalized protection against noxious challenges both of internal and external origin. Given the indispensable role of the mitochondrion in generating cellular energy, the linking of schisandra and other adaptogens to the safeguarding of mitochondrial function and oxygen utilization provides a biochemical explanation for the TCM term, “Qi-invigorating” action.

How Herbs Benefit the Respiratory System

Herbs that support respiratory health typically do so by offering one or more of the following benefits:

• Soothe irritated throat and lung tissues.
• Fight viruses and bacteria that cause colds and flu.
• Calm coughs.
• Quell the release of histamines to calm allergies.
• Help break up and expel lung congestion.
• Relax and open the bronchial network.
• Nourish the respiratory system.
• Strengthen the Lung network.

Herbs for Respiratory Health

The following are some of my favorite botanicals for seasonal respiratory support:

• Elecampane (Inula helenium)

A member of the same plant family as sunflowers, elecampane is native to southern and eastern Europe but has naturalized around the world. Elecampane root has been used historically for the treatment of colds, flu, and respiratory ailments; as well as fungal, bacterial, and parasitic infections. It not only relieves coughs but also is rejuvenating and strengthening to the entire respiratory system. This is my number one favorite herb for the lungs, for both acute and chronic conditions, and even mixed together with adaptogens as a fall/pre-winter formulation.  Combined with adaptogens, elecampane is helpful for the person who tends to develop bronchitis or pneumonia during the winter months.

The Eclectic Physicians referred to elecampane as a specific for coughs caused by irritated bronchi and bronchioles, and for inflammation of the mucous membranes with copious production of thick phlegm. Elecampane is categorized as a stimulating expectorant because the saponin content increases the activity of the mucociliary escalator. This therapy is especially useful in cases of bronchitis and pneumonia. Two active compounds in elecampane root are responsible for the beneficial effects: inulin, which soothes bronchial passages, and alantolactone, an expectorant with antitussive action.

• Sundew (Drosera burmannii)

The unusual, insectivorous plant sundew has been traditionally used in Europe and Asia for respiratory ailments, particularly those where coughing is a primary symptom. Throughout the centuries, herbalists have valued sundew for relieving dry coughs, asthma, bronchitis, and whooping cough.

The dew-like sap of the plant (which it uses to attract and trap insects) has potent antispasmodic properties. Sundew contains other medicinally active compounds, including flavonoids, which help to reduce inflammation, and quinones, which possess broad-spectrum anti-microbial effects and inhibit drug resistance to pathogens.

• Thyme (Thymus vulgaris L.)

An aromatic member of the mint family, thyme originated in the Mediterranean and is commonly grown today throughout North America. Often used as a culinary herb, the essential oils that make it valuable in the kitchen also have potent medicinal properties. The antispasmodic, anti-microbial, and expectorant actions of thyme have made it a traditional recommendation for coughs. Combined with sundew, thyme is part of a classic European formula for spastic coughs, including whooping cough.

The primary constituents in thyme are the volatile oils, which include the phenols thymol and carvacol. These are complemented by the actions of antioxidant flavonoids. The low toxicity of thyme makes it a favorite for treating coughs in small children.

• Eyebright (Euphrasia officinalis)

A tiny, delicate annual plant, eyebright is native to Eastern Europe, where it grows wild in meadows and pastures. The plant flowers in late summer and autumn, and the whole plant is used in herbal medicine.

Eyebright has anti-inflammatory and astringent properties, and was a favorite of the Eclectic Physicians for acute congestion of the nasal and ocular membranes. Symptoms addressed by eyebright include profuse watery secretions or abundant flow of acrid mucus, accompanied by heat, pain, burning, and sneezing. For this reason, eyebright is a good remedy for hay fever, as well as sinus infections, coughs, and sore throat. The active compounds in eyebright include tannins, volatile oil, flavonoids, (including quercetin), phytosterols, resin, and vitamin C.

• Lobelia (Lobelia inflata)

Lobelia is perhaps the most famous herb used in traditional American herbal medicine.  It has a long history of use as an herbal remedy for respiratory conditions such as asthma, bronchitis, pneumonia, and cough. The herb is a specific for irritable, spasmodic coughs, oppressed breathing, and in respiratory disorders from exalted nerve force and nerve irritation, such as in whooping cough.

Lobelia is a reliable expectorant and is useful in all cases of dry, hard, barking cough, or where the expectoration is difficult to raise, as in both spasmodic and membranous croup. Lobelia also relieves the pain of spasmodic coughing, such as in acute bronchitis.

The primary active constituent in lobelia is lobeline, an alkaloid compound. Lobeline is an expectorant and bronchodilator; it helps to break down congestion, thin mucus, expand airways, and encourage deeper breathing. Lobelia also has strong anti-spasmodic properties, which makes it useful for spasmodic coughs caused by bronchitis, croup, and laryngitis.

• Mullein (Verbascum thapsus)

A tall wild plant with broad velvety leaves, mullein is native to Europe and Asia and has naturalized throughout North America.

Mullein leaf and flowers have long been used in traditional herbal medicine for relieving cough and cold symptoms, and have been employed in the treatment of asthma.

Mullein leaf is rich in mucilage, which has soothing and relaxing expectorant properties. This property is helpful in cases exhibiting thick or sticky mucous which is hard to remove, and characterized by an unproductive, irritable cough. Mullein relaxes the lungs, and encourages the production of a thin, loose mucous which is more easily voided.

• Nettle (Urtica dioica)

Nettle leaf, my favorite herb, is the most nutrient dense plant in the world. Nettle is found widely throughout North America and Europe, where it grows abundantly as a weed. The leaves and stems are covered with stinging hairs, thus the name stinging nettle.

Traditionally valued as an herbal panacea, nettle has been used as a food and herbal remedy for thousands of years. Containing a wide spectrum of highly absorbable vitamins and minerals, nettle leaf supports a healthy immune system and balances inflammatory response.

The fresh plant extract possesses an antihistamine-like effect, while tonifying and firming inflamed tissues. In the late 1980s, scientists studying the differences between dried and freeze-dried herbs accidentally discovered that freeze-dried nettles cured one of the researcher’s hay fever. Subsequently, a randomized double-blind study showed that 58 percent of hay-fever sufferers given freeze-dried nettles rated it moderately to highly effective.

As a lung tonic nettles has been used for asthma, mucus conditions of the lungs, and chronic coughs. Nettle tincture is also used for flu, colds, bronchitis and pneumonia.

• Fenugreek (Trigonella foenum-graecum)

Indigenous to southern Europe and southwest Asia, fenugreek is an annual herb with aromatic seeds. It was an important herb to the Greeks, and has been used for centuries in Chinese and Ayurvedic medicine. In traditional herbal medicine, fenugreek is often combined with thyme for respiratory system support.

Fenugreek seeds contain a wide array of compounds that are beneficial for the respiratory system, including volatile oils, alkaloids, saponins, flavonoids, and mucilage. The primary actions related to the respiratory system are expectorant, demulcent, anti-inflammatory, and antispasmodic.

• Marshmallow (Althaea officinalis)

Marshmallow is a perennial herb native to damp areas of northern Europe and western Asia. Used as a healing herb for at least 3,000 years, marshmallow root was valued by the ancient Greeks—the genus name Althaea comes from the Greek altho, to cure. The use of marshmallow as an herbal medicine spread to both Arabia and India, where it has played an important role in the Unani and Ayurvedic healing traditions.

Marshmallow is rich in mucilage (arabinogalactans and galacturonorhamnan), antioxidant flavonoids, coumarins, quercetin, tannins, and volatile oil. The primary use of marshmallow is to calm inflammation and irritation of the respiratory and gastric tissues, and combined with other herbs, to help alleviate coughs.

Dietary Recommendations for the Lung and Oxygen Network

Certain foods can help heal the Lung and Oxygen Network. For instance, pears cooked with honey and ginger are very beneficial (see recipe below), as well as white mushrooms and lotus root (available at Asian stores). Generally, all fresh greens are good for the lungs, because green food is rich in chlorophyll, which improves cellular oxygen uptake. Nettle greens are my favorite green food in the world, and are the best of all foods for strengthening lungs. Dr. Vogel, the famous Swiss doctor, had all patients with weak lungs consume nettle greens in the spring when they are young and best for cooking and eating, including the use of nettles in tea, or fluid extract form.  Garlic and onions, root vegetables, and green vegetables in soups also are wonderful for the lungs.

Foods rich in carotenoids also improve the Lung and Oxygen Network. Persimmons are one such food that not only contain an abundance of carotenoids, but also moisten the lungs. Research shows that the carotenoids lutein and zeaxanthin enhance lung function. In fact, high carotenoid intake appears to reduce the signs of lung aging by about one to two years, according to a population-based study.¹ Another study showed that from the six major serum carotenoids studied, alpha-carotene, beta-carotene, and lycopene were positively associated with lung function in the elderly.²

Carotenoids are found in green leafy vegetables, and beta-carotene is the predominant carotenoid. In the orange colored fruits and vegetables—such as carrots, apricots, mangoes, yams, and winter squash—beta-carotene concentrations are high. Yellow vegetables have higher concentrations of yellow carotenoids (xanthophylls), hence a lowered pro-vitamin A activity than beta-carotene. However, some of these compounds, such as lutein, have significant health benefits, potentially due to their antioxidant effects. The red and purple vegetables and fruits—such as tomatoes, red cabbage, berries, and plums—contain a large portion of non-vitamin A–active carotenoids. Legumes, grains, and seeds also are significant sources of carotenoids. In addition, carotenoids are found in various animal foods, such as egg yolks, salmon, and shellfish, in addition to spices such as paprika and saffron.

Seasonal foods to include in your diet:

Autumn: apples, pears, mushrooms, onions, parsnips, pears, plums, potatoes, pumpkins, nuts and seeds, sun chokes, cranberries, pomegranates, pumpkin, winter squash

Winter: artichokes, broccoli, cabbages, onions, collards, kale, pumpkins, rhubarb, root vegetables such as beets, carrots, turnips

A delicious recipe that our family enjoys in the fall and winter is cooked pears with warming spices, honey, and lemon. Pears have the quality of clearing heat, moistening the respiratory tract, and removing phlegm from the lungs. This helps to prevent respiratory problems while encouraging healing from colds, coughs, bronchitis, and other respiratory ailments. Honey is an excellent moistener for the lungs and throat as well as a natural anti-microbial, and has been used as a base for cough syrups for centuries. Cinnamon and ginger are warming, and lemon has natural expectorant properties.

This recipe is tasty, nutritive for the lungs, and soothing for sore throats, coughs, and any respiratory discomfort.

Cooked Pears With Honey, Cinnamon, Ginger, and Lemon

Ingredients:

• 2 large pears, any variety, peeled, cored, and cut into quarters
• 1 cinnamon stick
• 2 thin slices of fresh ginger
• raw honey, to taste
• fresh lemon, to taste

Directions:

• Bring pears, cinnamon, and ginger to a boil in 4 cups of water (or enough to cover the pears). Reduce heat and simmer, covered, for about 30 minutes.
• Add honey and lemon to taste.
• Serve the warm pears and the cooking liquid in individual bowls.

References:

• Schünemann HJ, McCann S, Grant BJ, Trevisan M, Muti P, Freudenheim JL. Lung function in relation to intake of carotenoids and other antioxidant vitamins in a population-based study. Am J Epidemiol. 2002 Mar 1;155(5):463-71.
• Grievink L, de Waart FG, Schouten EG, Kok FJ. Serum carotenoids, alpha-tocopherol, and lung function among Dutch elderly. Am J Respir Crit Care Med. 2000 Mar;161(3 Pt 1):790-5.