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By Dr. James T. Belanger & Dr. Karen Braga

General Immune Support

    As you may have noticed there are many kinds of Echinacea on the market. It can get confusing trying to decide which one to pick. This is what the research says.

1. Echinacea helps the immune system clear the cold or flu virus faster from the body by helping the white blood cells engulf the virus and speeding up the production of antibodies.

2. You should buy a product that contains the whole plant, ie. both the root and aerial parts (stem, leaves & flowers) of Echinacea because active components are found in both parts.

3. Do not rely solely on Echinacea tinctures (alcoholic extracts). Alcohol extracts only some of the active ingredients. Other active ingredients are found in Echinacea juice which is water soluble. We prefer capsules of echinacea which are standardized for both the alcohol soluble components (echinosides) and the water soluble components (polysaccharides). This way you are assured you are getting enough of the active components.

4. Contrary to what you may have heard, there is no conclusive evidence that it is detrimental to use Echinacea for long periods. This rumor started because of a misinterpretation of a study done in Germany. Another study, in fact, showed that Echinacea is even more effective at enhancing the immune system if given long term.

5. You should choose an Echinacea supplement that contains all three species: purpurea, pallida and angustifolia. Each one of these species contains different active components

6. Echinacea works best if begun as soon as you feel sick because viral replication peaks in 48 hours. If given early, it can decrease the duration of the infection by 4 days and can lessen the severity of symptoms. It can also be taken as a preventative and works best in people with poor immune function ie. People who get sick greater than 2 times per year.

(Bone K. Echinacea: When Should it be Used? Alt Med Rev 1997; 2, 87-93)

(Rehman J, et al. , Increased production of Antigen-specific Immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis Canadensis. Immunology Letters 1999; 68, 391-395)

Schulten B, et al. Efficacy of Echinacea purpurea in Patients with a Common Cold. Arz Forsch 2001; 51, 563-568)

  • ZINC:

1. Zinc gluconate in the form of a nasal gel has been clinically proven to shorten the duration of the common cold by 74% by blocking the attachment of cold viruses to nasal cells.

2. The nasal gel must be started within 24hrs of onset of symptoms and must be given four times daily (every 4 hours). The only preparation clinically proven to work is by the company Gel Tech. Other nasal gels made from zinc sulfate are not effective.

3. Zinc nasal gels are more effective than zinc lozenges because the common cold begins in the nose not the mouth. In addition, zinc nasal gels do not cause nausea or have an awful after taste.

Hirt M, et al. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo controlled trial. ENT Journal 2000; 778-782


1. Vitamin C can reduce the severity of cold symptoms by an average of 23%. It works best for throat and chest colds, not nasal colds.

2. Vitamin C needs to be taken frequently because it's removed from the body quickly.

3. Vitamin C should be in the form of ascorbic acid and should be combined with citrus bioflavonoids. Bioflavonoids increase the absorption of the vitamin C by 35% as long as the amount of bioflavonoids equal the amount of vitamin C. Bioflavonoids also help the body hold onto the vitamin C longer. (Vinson JA, et al. Comparative bioavailability to humans of ascorbic acid alone or in a citrus extract. Am J Clin Nutr 1988; 48, 601-4)

4. Vitamin C has also been shown to prevent colds & flu by as much as 80% in people who are deficient such as the elderly and people under heavy physical stress. For other people, the data is unclear, but it's postulated that adults would have to take 4500mg 4x/day to decrease the duration of cold episodes by half and children would have to take 875mg 4x/day.

(Hemila H. Vitamin C supplementation and common cold symptoms: factors affecting the magnitude of the benefit. Med Hypotheses 1999; 52, 171-178)

Hemila H. Does Vitamin C Alleviate the Symptoms of the Common Cold? A Review of Current Evidence 1994; 26, 1-6.

Hemila H. Int J Tuberc Lung Dis 1999; 3, 756-61

    Garlic supplements standardized for allicin can reduce the incidence of the common cold by 63% and reduce the duration of symptoms by about 4 days.

    (Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther 2001; 18, 189-93)

What We Recommend

EHB by NF Formulas:
We like this product because it meets all the above criteria and we've seen a lot of clinical success. It also contains vitamin B6, Beta carotene, small amounts of vitamin A, ginger and deglycyrrhizinated licorice. Vitamin B6 is necessary in helping white blood cells respond to viruses and beta-carotene helps increase the cells which kill virally infected cells. Vitamin A may help reduce the duration of respiratory infections especially in children and the elderly. 4 capsules three times a day at the first onsets of a cold or flu can help shorten the duration 2 capsules three times a day during the whole winter may help prevent a cold or flu. We often recommend this instead of a flu shot.

Children's Chewable Echinacea Vitamin C by NF Formulas:
Same reasons as EHB. Can be taken in higher doses for the treatment of a cold or flu or lower doses for prevention.

Spectra Throat Spray by NF Formulas :
This is an Echinacea-based spray which is great for sore throats.

Special Cough Formula made specifically for your type of cough. We will often mix 2-6 herbs together in a formula based on your signs and symptoms (see below).

Cough Treatments

Stubborn coughs that are not resolving with pharmacy cough syrups may clear quickly with the help of the right combination of herbs. Selecting the proper combination of herbs will depend on whether you have more of a dry, irritating cough or a wet, productive cough.

Dry, irritating coughs above the voice box:

Dry, irritating coughs which are above the voice box are best treated with a class of herbs called demulcents. These include plants such as Althea officinalis (Marshmallow root), Ulmus fulva (Slippery Elm bark), Plantago lanceolata (Plantain leaf), Tussilago farfara (Coltsfoot leaf & flowers) and Verbascum thapsus (Mullein leaves & flowers). These plants contain a substance called mucilage which coats the upper respiratory tract relieving the inflammation and soothing the irritation. All of these herbs must be prepared as teas in order to be effective.

Dry, irritating coughs at or below the voice box:

Dry, irritating coughs which are at or below the voice box can also be treated with the demulcent herbs. In addition, these types of coughs can be treated with the plant Prunus serotina (Wild Cherry bark) or with a class of herbs called sedative expectorants. Wild cherry bark contains a substance called prunasin which can relieve irritation in the air passages. The class of herbs called the sedative expectorants relieve dry, irritating coughs at or below the voice box by increasing the amount of respiratory fluid. These herbs are also very good at moistening thick, sticky mucus and helping expectoration. Plants in this class include Cephalis ipecacuanha (Ipecac), Sanguinaria canadensis (Bloodroot), Glycyrrhiza glabra (Licorice root) and Lobelia inflata. Ipecac in small, frequent doses is very effective in relieving the cough and clearing the mucus from croup, pertussis and childhood bronchitis. The doses needed are much less than the dose required to produce nausea and vomiting. Bloodroot is more indicated for dry coughs in adults which produce a sense of constriction in the throat or a tickling sensation. It is used primarily for acute bronchitis or laryngitis after the active inflammation has subsided. Licorice root can be added to any one of these herbs to make them taste better and it also has the ability to relieve the irritation and quiet the cough. The sedative expectorant herb, Lobelia is not only good at moistening thick phlegm associated with whooping cough and acute bronchitis, but it can relieve any sense of tightness in the chest associated with the cough. This herb and several other herbs are categorized as bronchial antispasmodics. They can help reduce bronchial tightness produced as a reflex to respiratory tract irritants. These herbs include Asclepias tuberosa (Pleurisy root), Sticta pulmonaria (Lungwort), Grindelia robusta (Gum plant), Drosera rotundifolia (Sundew),Trifolium pratense (Red Clover flowers) and Ephedra sinica. Each one of these plants has specific indications. Pleurisy root, Lungwort and Grindelia, for example, are good for tight, painful coughs with sore chest muscles. Lungwort is especially indicated if there is also wheezing and soreness in the back of the neck and shoulders. Sundew and Red Clover are most indicated for the hacking, explosive coughs associated with whooping cough and measles and for the dry, irritable coughs from bronchitis. Ephedra is best for coughs associated with bronchial asthma or emphysema because of it&Mac226;s ability to dilate the air passages and increase the inflow of oxygen. It is safe short term unless the patient has high blood pressure, glaucoma or heart problems.

Wet, productive coughs:

Wet, productive coughs associated with large quantities of purulent mucus and a persistent high fever may indicate pneumonia and require antibiotics. In all types of wet, productive coughs, however, herbs can help the body overcome the infection. Plants such as garlic and thyme contain substances called volatile oils which go to the lungs and can help facilitate expectoration. These plants also have an antiseptic action. Other herbs such as Inula helenium (Elecampagne), Eriodictyon californicum (Yerba santa) and Verbascum thapsus (Mullein) are also excellent for coughs associated with abundant expectoration. Elecampagne is especially useful if there is vomiting associated with the coughing and pain beneath the sternum.

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