Ephedra is safe for asthma when used in traditional ways.
In every issue of Herbs for Health, professionals from a variety of health-care fields answer your questions about using medicinal herbs. Medical herbalist Terry Willard and medical doctor D. Paul Barney respond for this issue.
Q: I’m a physician, and I work primarily with asthmatic children. I’m very interested to know your recommendations for herbs that act as broncodilators, mucolytics, or natural antibiotics.
A: My favorite botanicals to use in treating asthmatic patients are reishi (Ganoderma lucidum), ephedra, goldenseal (Hydrastis canadensis), and coptis (Coptis chinensis).
Reishi mushroom is, by far, the most important remedy for asthma. I have found that stress is a common trigger for asthma attacks, especially in children, and Chinese herbalists would say that reishi helps ease stress by resolving disturbed sheng qi (mental spirit) and by loosening a knot in one’s chest. Reishi is also one of the best botanicals for allergic reactions, a major cause of asthmatic attacks, because it increases resistance to allergens so that a person can handle more exposure. I use 200 mg of a 15:1 extract, twice daily.
Ephedra, known in Chinese as ma huang, is the best bronchodilator—many pharmaceuticals have been patterned after chemical models of this herb. Ephedra is a bit controversial because it has been abused as a weight-loss herb, but one of its alkaloids, ephedrine, works wonders for asthma. Ephedrine has a neurotransmission effect similar to epinephrine, but can pass through the digestive tract and still be active. However, it can make a person somewhat hyper, as though they’ve had too much coffee. Combining ephedra with reishi can minimize this effect, so I often use them in combination. The dosage range for ephedra is 150 to 400 mg, two to three times daily.
Both goldenseal and coptis are good mucolytics (substances that thin mucus) and natural antibiotics. Goldenseal, which has a reputation as “king of the mucous membrane,” contains two major alkaloids, hydrastine and berberine, both of which are strong antibiotics. Because goldenseal is an at-risk species (see page 47 for more information), I use only cultivated, organically grown goldenseal. Coptis and barberry (Berberis vulgaris) also contain berberine and are good alternatives if you can’t find cultivated goldenseal. The dosage range for any of these three herbs is 200 to 600 mg, two to three times a day.
Lobelia, given in two daily doses of 100 to 300 mg, is also a very effective bronchodilator, but this herb should be used only under professional supervision.
A: As you know, treating asthma can be very difficult. Using herbs is one way to add options to your treatment plan.
Ginkgo biloba can be used by itself or added easily as a second- or third-line treatment; take a 60-mg tablet one to three times a day. Ginkgo is thought to decrease the number and severity of asthma attacks by inhibiting platelet-activating factor (PAF), which increases the release of histamine and in turn leads to bronchial spasms.
I also frequently use ephedra to treat asthma. The bad publicity that it has received by its injudicious use in some weight-loss products has endangered the reputation of this extremely valuable asthma herb. Ephedra is very safe when used in a traditional manner and in traditional blends; I recommend 375 mg of the whole herb or one to two capsules three to four times a day.
Horehound (Marrubium vulgare), pleurisy root (Asclepias tuberosa), and mullein (Verbascum spp.) are all useful expectorants—I usually use a commericial blend of the three. Saw palmetto (Serenoa repens) and boswellia (Boswellia serrata) are also useful in treating asthma because of their ability to decrease leukotriene production. Use whole saw palmetto or products that have been standardized to 85 to 95 percent fatty acids, in doses of 160 mg once or twice a day; boswellia should be standardized to 65 percent boswellic acids and taken in doses of 325 mg, two to three times a day.
I also have used lobelia with great success, but because of some potential side effects, I only recommend it for patients who I feel are responsible and are willing to follow up frequently with me.
—D. Paul Barney
Q: I have lupus. Are there any herbs that can help me?
A: Lupus is a fairly dramatic autoimmune disease for which there is no simple solution. It’s best for you to deal with this disease in the confines of a practitioner’s office, because counseling is as important as natural supplements.
The goals of natural therapy for lupus are to empower the immune system and relieve associated stress. I have seen many patients release stress by journal writing, doodling, dancing, singing, or practicing Tai Chi. Herbs can help too.
Reishi (Ganoderma lucidum) both supports and calms the immune system. It relaxes the mind without any feeling of sedation and has been used for nervous problems such as insomnia and paranoia, symptoms often associated with lupus. Dosage: three capsules, twice daily.Reishi can soothe lupus symptoms such as insomnia and paranoia
Kava-kava (Piper methysticum) also relaxes the system; it affects the brain stem and soothes the lining of the stomach and bladder. Kava also inhibits muscle spasms. Dosage: two to three capsules, two to three times daily.
Siberian ginseng (Eleutherococcus senticosus) has a strong effect on stress and the adrenals and stabilizes emotions. The extract also can improve physical performance and stress tolerance. Polysaccharides in the herb also stimulate the immune system. Dosage: two capsules or forty drops of tincture, twice daily.
St.-John’s-wort (Hypericum perforatum) is the second most prescribed drug in Germany for depression. The tranquilizing quality was once attributed to hypericin, but it now appears that a group of chemicals are responsible for its action. Dosage: 300 mg, three times daily.
Skullcap (Scutellaria lateriflora) was heavily used by the turn-of-the-century Eclectic physicians for health issues that seemed very similar to lupus. The calming effect of skullcap has been attributed to a compound named scutellarein. Dosage: two capsules or twenty drops of tincture, twice daily.
Other helpful nutritional supplements include vitamins C and B6, zinc, and beta-carotene. Ask your health-care provider about appropriate doses.
To support treatment, dip into the large pool of literature on autoimmune issues, lupus included. In particular, I recommend that you explore psychoneuroimmunology, a relatively new field that suggests that many health issues have psychological, neurological, and immunological components.
A: Lupus, the short name for systemic lupus erythematosus, is a chronic, autoimmune disease. It also belongs in the group of conditions known as connective tissue diseases. It can be a mild, almost nonprogressive condition or a severe, rapidly progressive disease. Lupus by definition always has an effect on the immune system, causing the immune system to attack a part of the body (most commonly the skin, joints, blood, or kidneys) as though it were something foreign. We are not sure what triggers lupus, but stress, in various forms, can cause a flare-up in someone who has it. Therefore, reducing stress can be very helpful, including learning meditation or biofeedback techniques.
Herbal therapy is aimed at modulating the immune system so that it acts more normally. There are several herbs that appear to do this. One of the better-known herbs for people with autoimmune diseases is astragalus (Astragalus membranaceus). I use it in a guaranteed potency form or as part of an herbal combination where the exact dose is harder to determine. Other Chinese herbs also have immune-modulating effects. These include Asian mugwort, (Artemisia argyi), coix, (Coix lachryma-jobi), lithospermum, (Lithospermum erythrorhizon), and dong quai (Angelica sinensis). Two traditional Chinese formulas, Lithospermum 15 and Salvia Shou Wu, contain these herbs plus others and are used in combination for lupus and related conditions. People with lupus should be careful not to use herbs that are strictly immune stimulating, such as echinacea.
I would highly recommend the book Living a Healthy Life with Chronic Conditions (Bull Publishing, 1994). This book can help a person regain a sense of control independent of any illness.
—D. Paul Barney
Terry Willard is a clinical herbalist, president of the Canadian Association of Herbal Practitioners, and founder of the Wild Rose College of Natural Healing in Calgary, Alberta, Canada. He is the author of eight books and a CD-ROM, Interactive Herbal.
D. Paul Barney is a family-practice and emergency-room physician in Layton, Utah. He is also an adjunct professor at Weber State University and author of Doctor’s Guide to Natural Medicine (Woodland, 1998).
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The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.
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