Respiratory allergies are hyperinflammatory reactions that cause an array of symptoms, including watery itchy eyes, a stuffy or runny nose, itchy nasal passages, lung congestion, and, in severe cases, asthma. Sensitivity to household dust or animal dander can cause symptoms year round, but the most common cause of respiratory allergies is plant pollens. In the early spring, tree pollens are a major culprit. In late spring, it’s grasses. In late summer, the sneezes of hay-fever sufferers announce the release of pollen from the inconspicuous greenish flowers of ragweed (Ambrosia spp.). Goldenrods, which bloom in abundance at the same time, especially in the eastern United States, have been unjustly blamed for late-summer pollen allergies, but their pollen, unlike that of ragweed, is sticky and carried from flower to flower by insects.
The best natural treatment for allergies is probably prevention by avoiding the allergen. But when you can’t do that, you may wish to turn to ephedra, stinging nettle, goldenseal, or ginkgo to relieve some of your symptoms.
Perhaps the best-known and most widely used herbal products for relief of symptoms of respiratory allergy are derived from the Chinese herbs known as ma-huang (Ephedra sinica, E. intermedia, and E. equisetina), whose stems contain 1 to 2.5 percent alkaloids, primarily ephedrine and pseudoephedrine.
The pharmacological effects attributed to therapeutic doses of ma-huang and its alkaloids include stimulation of the central nervous system, constriction of peripheral blood vessels leading to elevated blood pressure, and dilation of the bronchi (the tubes leading from the windpipe to the lungs). It is this last action that gives rise to the use of the herb and its alkaloids in products that relieve symptoms of respiratory allergies. The U.S. Food and Drug Administration (FDA) has approved ephedrine and its salts (ephedrine hydrochloride, ephedrine sulfate, and racephedrine hydrochloride) as decongestants in nasal sprays and as bronchodilators for the treatment of mild asthmatic spasms. The over-the-counter drugs Primatene and Marax both contain ephedrine salts.
Pseudoephedrine and its salts (pseudoephedrine hydrochloride and pseudoephedrine sulfate) are approved for use in oral decongestants used for the treatment of colds, hay fever, other upper respiratory allergies, and sinusitus. Because it stimulates the central nervous system to a lesser extent, pseudoephedrine is preferred to ephedrine for products taken orally. The over-the-counter drug Sudafed contains pseudoephedrine.
While these alkaloids and their salts are registered as over-the-counter drug ingredients, ma-huang itself is defined as a “dietary supplement” under the provisions of the Dietary Supplement Health and Education Act of 1994. The medicinal effects of pure ephedrine and pseudoephedrine should not be confused with the effects of ma-huang, just as you wouldn’t confuse the effects of pure caffeine with the effects of a cup of coffee. However, according to Varro Tyler in Herbs of Choice, a tea made from a heaping teaspoon of high-quality ma-huang (containing at least 1.25 percent alkaloids) placed in a cup of boiling water and simmered for about 10 minutes should contain about 15 to 30 mg of ephedrine, or approximately the FDA-approved dosage in decongestant products.
The use of ephedra alkaloids in over-the-counter drugs has a long and safe history, as does the use of ma-huang (the latter was first mentioned in the herbal of the Chinese Divine Plowman Emperor Shen-Nong’s Ben Cao Jing, which survives as a list of 365 herbs from the first century a.d.). Nonetheless, they are not free from controversy. In recent years, abuse of weight-loss and stimulant products containing the alkaloids has been reported in a number of states. In addition, the Drug Enforcement Agency suspects that both ma-huang and its alkaloids have been used as starting materials for the manufacture of illicit drugs such as methamphetamine (“speed”) and methcathinone (“cat”). Fourteen states now have laws or regulations on how ephedra products may be used and to whom they may be sold. The FDA and other regulatory agencies are considering regulatory action as well.
Use of ma-huang in reasonable amounts under normal conditions of use is safe, but chronic use or abuse of the herb or products that contain its alkaloids may cause insomnia, motor disturbances, high blood pressure, glaucoma, impaired cerebral circulation, and/or urinary disorders. Ma-huang and products that contain its alkaloids should be used in appropriate formulations, at specified dosage levels, and for limited periods of time.
Mention stinging nettle (Urtica dioica), and most people think of the pain and itching that come from brushing against the plant’s stiff, stinging hairs. However, recent research indicates a possible role as a hay-fever remedy.
In 1990, a randomized, double-blind study compared the effectiveness of 300 mg freeze-dried nettle leaf extract against the same amount of a colored lactose placebo in relieving hay-fever symptoms. Sixty-nine of the original ninety-eight participants completed the one-week trial. Each participant kept a daily diary of symptoms and provided an overall assessment of the treatment in a follow-up visit at the end of the week. In the daily diaries, the nettle group recorded slightly greater relief of symptoms than the placebo group. In the overall assessment, 58 percent of the nettle group rated the extract as moderately effective or better than previous hay-fever medications. (On the other hand, 37 percent of the placebo group rated the placebo as moderately effective or better than previous medications.) Further longer-term studies using larger numbers of participants and objective evaluations by scientists (versus the participants themselves) are in order. A tea made from fresh or dried stinging nettle may produce results similar to those of the freeze-dried leaf extract used in this study.
The best-known historical use of goldenseal root (Hydrastis).
The word “chamomile”, from the Greek chamai, “on the ground”, and m–elon, “apple”, refers to the plants’ growth habit and to the fruity scent of their small, daisylike flowers. It is said to have been one of the herbs of choice of Asclepiades, a Bithynian physician of the first century b.c. The sixteenth-century English herbalist Gerard recommended it to promote urination, combat weariness and pain, relieve colic, and dissolve kidney stones and gallstones. He maintained that the oil was good for bruising and swelling and that a decoction of the flowers mixed with wine was good against “coldness in the stomach” and “sour belching” and that it “brought down the monthly courses”. A half century later, Nicholas Culpeper, another English herbalist, claimed that “bathing with a decoction of Camomile takes away weariness, eases pains, to what part of the body soever [it] be applied.”
According to the contemporary Slovakian chamomile specialist, Ivan Salamon, chamomile is the most favored and most used medicinal plant in Slovakia. A Slovakian folk saying indicates that an individual should always bow when facing a chamomile plant. This respect results from hundreds of years experience with the folk medicine of the country.
Varro Tyler considers it “the European counterpart of ginseng”, and says that the Germans call it alles zutraut—“capable of anything.”
But Beatrix Potter is probably responsible for immortalizing chamomile as a soothing, quieting beverage—at least for readers of English children’s literature. “One table-spoonful to be taken at bedtime” was Mrs Rabbit’s modest prescription for her adventurous son, Peter, in The Tale of Peter Rabbit.
canadensis is as a tonic and astringent for inflamed mucous membranes. Gargling with a half-teaspoon of the powdered dried root mixed into a cup of warm water may alleviate inflammation and itching in the mouth and throat caused by respiratory allergies. There are, however, no pharmacological or clinical studies to support this use.
Preparations of Ginkgo biloba or isolated components such as the ginkgolides may decrease inflammation due to respiratory allergies. Ginkgolide B, the most active of the ginkgolides, is a selective antagonist of the platelet-activating factor, which is involved in various inflammatory, cardiovascular, and respiratory disorders. Several experimental and clinical studies have reported inhibition by ginkgo leaf extracts of inflammatory responses induced by the platelet-activating factor. Further research is needed to fully determine ginkgo’s role in the treatment of inflammatory responses associated with respiratory allergies.
• Bradley, P. R. (ed.). British Herbal Compendium. 1. Bournemouth, Dorset, England: British Herbal Medicine Association, 1992.
• Leung, A. Y., and S. Foster. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs, and Cosmetics. 2nd ed. New York: Wiley, 1996.
• Mittman, P. Planta Medica 1990, 56:44–46.
• Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.