There are two types of Herbal Remedies available. One would be what we have come to call Western Herbs, the other would be Chinese Herbs. With Western Herbs, we generally understand the mechanism of action of the Herb. That is, we know what cellular function or metabolic process those Herbs effect, much like we understand the mechanism of action of prescription drugs. Unlike most prescription drugs, however, many Herbs effect cellular functions in more than one place or in more than one tissue, so they can be used for more than one symptom or condition. Chinese Herbs, on the other hand, are not directed at a particular cellular function or metabolic function. Rather, they are used in combinations, and are directed at symptoms or conditions that are felt to arise from an improper flow of energy, or Qi (pronounced chee), through the body.

If you decide to use Chinese Herbs, the combination of herbs given to you will be decided by our practitioner of Traditional Chinese Medicine based on her evaluation of you. If you decide to use Western Herbs, there are several herbal remedies that can be used in your case:

FOR BRONCHOCONSTRICTION:

The only herbal preparation approved by the German Commission E for treatment of respiratory difficulty due to narrowing of the airways is Ephedra. As well, Ephedra is indicated only in mild bronchoconstriction, and has no place in the treatment of more severe asthma attacks. The dose is 12.5 to 25 mg every six hours. Ephedra should only be used for short periods of time, as its effectiveness will lessen with time, and there is a potential for addiction.

Ephedra is derived from Ma Huang, and is a stimulant, causing the release of epinephrine which can lead to the following side effects: Agitation, restlessness, insomnia, irritability, headaches, nausea, a rapid pulse, a rise in blood pressure, and difficulty with urination, especially in men with enlargement of the prostate.

Ephedra should not be used by patients with hypertension, heart disease, glaucoma, anxiety, or in patients with difficulty urinating. Ephedra can cause interactions with, and should not be taken along with, the following drugs: Digitalis, digoxin, MAO inhibitors, guanethidine, or the anesthetic halothane.

Due to side-effects, and the fact that there are more effective bronchodilators available, it is our opinion that ephedra should be used only be those patients who have not responded to prescription bronchodilators, or who have had difficulty with their side-effects.

FOR COUGH AND MUCOUS PRODUCTION;

There are a number of herbal preparations which can be used for cough, congestion, and as expectorants. The preparation we recommend in asthma is Licorice root. Licorice Root (Glycyrrhiza Glabra) has properties of an expectorant to help clear excess mucous, and it also has anti-inflammatory properties and decreases the production of leukotrienes, which helps to reverse the reactive airway changes in acute attack.

The dosage of Licorice Root would be:

-Powdered Root- 1-2 mg three times a day.

-Fluid Extract- (1:1) 2cc three times a day.

-Solid Extract- (4:1) 250-500 mg three times a day.

There are no side effects with short-term use of Licorice Root at these doses. With prolonged use, or at higher doses, licorice can cause fluid and electrolyte disturbances, with loss of potassium and retention of sodium and water. Licorice root should not be taken along with thiazide diuretics.

Green Tea (Camellia sinensis) has been helpful as an adjunctive treatment due its content of methylxanthines, which act as bronchodilators, and antioxidants.

Other herbal preparations have been used in the treatment of asthma, such as Ginkgo biloba extract and Tylophora asthmatica.

The mechanism of action of Ginkgo is through inhibition of Platelet Activating factor, or PAF, which is accomplished by a component of Ginkgo called the ginkgolides. PAF is a key component in the inflammatory process in asthma, contributing to bronchoconstriction and excess mucous production. The dosage of Ginkgo that is recommended is 120g per day of the pure ginkgolides, which is presently very expensive to achieve.

The mechanism of action of Tylophora is unknown but is felt to be due to antihistamine and anti-spasmodic properties. While several studies have shown Tylophora to be effective,  the response appeared to be blunted with time, making Tylophora ineffective for chronic use.

HERBAL PREPARATIONS WHICH ARE CONTRAINDICATED IN ASTHMA:

There are two herbal preparations that should never be used in asthma, which are Pine Needle Oil, and Fir Needle Oil. These are both used as expectorants, but they should not be used in asthma as they can intensify the degree of bronchospasm.

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