Immune system – Herbal Reality

African geranium

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Frankincense

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Myrrh

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Daisy

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Dill

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Chai hu

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Goldenrod

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Boneset

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Woad

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Anise hyssop

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Forsythia

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Couch grass

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Self-heal

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Fu ling

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Bladderwrack

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Cat’s claw

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Thuja

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Lovage

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Wild indigo

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Birch polypore

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Surgical recovery

Jessika Thiele — Sat, 26 Apr 2025 10:30:51 +0000

Whether emergency or elective, open or laparoscopic, surgical recovery can take a long time. We explore natural remedies to help you heal after surgery.

Understanding surgical interventions

Surgery has been defined as, “any intervention involving the incision, excision, manipulation, or suturing of tissue, usually requiring regional or general anaesthesia” (1). The term ‘surgery’ is said to have its origins in both the Greek and Latin language translating as either “hand work” or “hand action”(2).

Human remains have been discovered that suggest mankind has attempted surgical measures dating back to the Neolithic era; including trepanation during which a hole was drilled into the skull. In many of these cases it appears to have been undertaken as an intervention following physical head injury, however, may also have been intended to relieve symptoms of other physiological and potentially psychological conditions (3).

The oldest known medical text to mention surgery is considered to be an Egyptian papyrus which has been dated from close to 5000 years ago (4). More recent historical texts have been discovered that describe surgeries such as rhinoplasties and caesarean sections being performed throughout Ancient India over 2600 years ago (5,6).

Despite there being evidence to suggest that many of the individuals who underwent surgical procedures during these ancient times were seen to have survived, by the early 19^th century throughout Britain and Europe surgery had become fraught with risks through filthy conditions in hospital theatres invariably leading to the high rate of post-operative infections and likely death. Furthermore, although the use of anaesthesia would soon become an accepted practice, prior to this, strength and speed were considered the most desirable attributes for a surgeon (7).

Since these times we have seen extraordinary breakthroughs in the medical field including infection control, anaesthesia and advanced surgical techniques that would have been unimaginable even a hundred years ago. It is estimated that 60% of the population will have some sort of surgical procedure during their lifetimes, with 230 million people worldwide undergoing surgery each year (8,9).

What surgery entails

Surgery is seen to have a role across a wide spectrum of conditions that impact and may decrease the quality or longevity of a person’s life if left untreated, or cause unnecessary pain and suffering to that individual. Surgery encompasses seemingly minor procedures such as dental work or relief from an in-growing toenail to major operations, such as heart transplants or neurosurgery. Surgical care can be required at any age from treating newborns with life-threatening defects or abnormalities to a hip replacement in an elderly person.

Surgery is often a vital intervention in acute emergency care of patients with life threatening injuries or conditions. In these cases it is frequently performed immediately, or within 24 hours of admission to hospital (10,11).

However, the majority of surgical procedures are considered elective and subsequently can be planned for in advance. These surgeries are scheduled for conditions that are not immediately life threatening and may be considered to be curative, to improve quality of life or for cosmetic reasons (10,12). Some types of surgery may be carried out as either an elective or emergency procedure depending on the circumstances; for example, a caesarean section or removal of the gallbladder (13,14).

Having surgery may involve a length of stay in hospital afterwards. Following emergency surgery the length of stay is an average of five days; however, factors influencing this will include the seriousness of the condition resulting in emergency surgery being required or the type of surgery performed. The overall health of the patient prior to emergency surgery will also potentially affect recovery time and consequently the length of time spent receiving in-patient care. Other factors affecting surgical recovery time include pre-existing health conditions and age. Postoperative complications may also increase the length of time necessary to remain in hospital post-operatively. Socioeconomic or safeguarding issues are also seen to impact delayed discharge from hospital based care (15,16).

In contrast to surgery following an emergency admission, elective surgery provides an opportunity for forward planning of the peri- and post-operative period resulting in reduced anxiety for the patient and their family and improved surgical outcomes. Length of stay is dependent on a manner of factors, some of which are unmodifiable such as the age of the patient, underlying diagnosis, other concurrent health conditions and the type of procedure being performed.

Although a significant amount of patients undergoing surgery electively, particularly orthopaedic procedures or those that are an aspect of cancer treatment, will require hospital care as an inpatient, there has been a transition from automatic overnight hospital admission to day case surgery for more minor procedures. Furthermore, length of stay is seen to be influenced by considerations such as surgical start time, requirements for peri- and post-operative medication and early mobilisation — which has been seen to be crucial for optimal surgical recovery and the reduction of the length of hospital stay required (17,18).

Types of surgery

The majority of surgical procedures by their very nature are invasive to the body (19).

Historically, surgery has been done as an open procedure requiring a relatively wide incision and the use of stitches or staples to close the resulting wound. Open surgery is in many cases still a necessity providing increased exposure to the surgical field however is frequently associated with greater postoperative pain levels, and consequently greater requirement for analgesic medications, alongside a longer recovery time (12,20). Since it was first pioneered in the 1980s, keyhole surgery, including laparoscopic procedures, has been used for increasingly, having the advantage of being considered less invasive, causing less trauma and pain to the patient and often resulting in a shorter length of stay in hospital and enhanced overall recovery time (21,22).

Excision and resection

Excision and resection surgery involve the removal of part, or in the case of resection surgery, all of an organ, tissue or growth using a sharp instrument such as a scalpel, laser or other cutting tool. The names of this type of surgery tend to end with the suffix ‘-ectomy’, from the Greek word εκ-τομια which translates as ‘the act of cutting out’. In the cases involving an organ, this is often prefixed with the name of the organ, such as removal of the appendix being referred to as an appendectomy (19,23,24). Excision surgery includes procedures such as polypectomy (removal of polyps), whilst examples of resection surgery would include cholecystectomy (removal of the gallbladder) and sigmoidectomy (removal of the entire sigmoid colon) and are often performed as a result of chronic disease, acute inflammatory states or cancer (23). On occasion, some of these surgeries may be accompanied by a procedure to create a permanent or temporary opening known as a stoma, such as a colostomy following a sigmoidectomy (25).

Ablation

Ablation surgery involves the use of heat, cold or radiofrequency to destroy tissue or a body part (24). This may be used to correct a range of conditions such as cardiac ablation to treat an irregular heartbeat or endometrial ablation in the treatment of excessive menstrual bleeding as an alternative to hysterectomy (26,27,28). Cardiac ablation is considered to be a minimally invasive procedure during which keyhole incisions are made in the groin through which catheters can be passed into the veins and guided towards the area of the heart targeted for treatment (26). During endometrial ablation the majority of the lining of the womb is destroyed or removed. This is a relatively short procedure taking on average about 30 minutes and is often performed as day surgery. A hysteroscope, a tiny camera, is passed through the cervix into the womb and the uterine lining destroyed or removed using either radiofrequency, heat or an electric wire-loop (27).

Amputation

Amputation involves the removal by surgery of a limb, or part thereof, or extremities such as fingers or toes. In the 1800s, this would have been the main domain of the surgeons of that time as surgery to other parts of the body such as chest and abdomen had proven to be inevitably fatal (7). Reasons for amputation still include extreme injury to a limb seen to be beyond repair or reconstruction, frostbite when the tissue damage is irreversible, malignant tumours unresponsive to other treatment or severe infection resistant to antibiotics that is considered life-threatening. However, in developed nations today diabetes and peripheral arterial disease (PAD) are the leading causes of lower limb amputations. Patients who are diabetic are twenty times more likely to undergo amputation surgery in their lifetimes than non-diabetic patients with 90% of the lower limb amputations performed in the UK each year being attributed to peripheral arterial disease. (29,30).

Reconstructive

Although reconstructive, or cosmetic, surgery is often perceived as being a personal choice by individuals for aesthetic reasons, it is frequently performed for reasons such as the repair of tissues due to extensive burns or complex wounds to restore both function and appearance of the affected area (31,32). Reconstructive surgery may also be an option following the removal of cancerous tumours that result in significant loss of tissue or disfigurement. For example, breast reconstruction after mastectomy — an increasingly prevalent surgery owing to the number of patients opting for reconstruction after breast cancer surgery rising to 43.3% in 2014 compared to only 26.9% in 2005 (33)

Surgery to reconstruct tissues that are damaged or deformed due to circumstances including severe injury or congenital conditions may be necessary to increase an individual’s ability to eat, speak or breathe, improving psychological wellbeing as well as physiological function (34).

Transplantation

The first successful human organ transplant surgery was performed in 1954 and involved the transplanting of a kidney. By the end of the 1960s heart, liver and pancreas transplants had been successfully performed whilst lung transplants were not achieved until the 1980s (35). In 2023 there were over 170,000 organ transplants globally for end stage organ failure with kidney transplants being most commonly performed. Organs are donated from either living or deceased donors depending on the type of procedure being performed (36). As with any surgical procedure, potential complications may arise. However the risk of rejection of the transplanted organ along with an increased infection risk due to anti-rejection medications are specific to transplant surgery (37).

Surgery may be done for preventative reasons, also referred to as prophylactic surgery. This may be considered by patients with increased risk factors for developing a disease in the future, such as women with a family history of breast or reproductive organ cancers or having been identified as carrying the BRAC 1 or 2 gene (10). However, other types of surgery are performed as preventative care aimed to reduce the risk of developing health issues or complications in the future, such as bariatric surgery to assist weight loss, aimed to prevent future cardiovascular and metabolic disease; voluntary male circumcision, seen to reduce the transmission of HIV by 60% (38) or removal of a healthy appendix prior to military expeditions or those involving travel to polar regions or space to prevent the possibility of acute appendicitis whilst in the field (39).

Endoscopy

Minimally invasive investigative procedures may also be done within a surgical setting and are commonly used for the diagnosis and treatment of many conditions. Endoscopy involves passing a long thin tube which carries a small camera inside of the body to visualise the organs and tissues. The specific name of the procedure depends on which body system is being investigated.

Gastroscopy, also referred to as an upper endoscopy or oesophagogastroduodenoscopy, allows for the upper digestive tract to be visualised and is used for diagnosis of conditions such as unexplained acid reflux, gastritis, gastric ulcers, cancers of the upper digestive tract as well as narrowing of or swollen veins in the oesophagus. It may also be used in procedures to remove growths in the upper gastrointestinal tract such as polyps or to treat bleeding from ulcers (40).

Colonoscopy, which involves the imaging of the entire colon, or sigmoidoscopy, imaging solely the lower part of the colon, are included in established guidelines for the diagnosis of inflammatory bowel diseases such as ulcerative colitis and crohn’s, diverticulitis, polyps as well as cancer of the bowel and colon. Biopsies may be taken during these procedures for further histological investigation (41).

Hysteroscopy allows for minimally invasive visualisation of the intrauterine cavity entering into the uterus through the cervix. It is most commonly indicated in the investigation of abnormal uterine bleeding or thickening of the endometrium and fertility issues and may also be used for the surgical management of cervical or uterine pathologies (42).

How does surgery affect the body?

The effect that surgery has on the body will depend on a number of factors including method and duration of anaesthesia, type of procedure performed, whether the surgery is performed electively or after emergency admission, age, state of health of the patient at the time of the surgery (43). Comorbidities such as diabetes, cardiovascular and respiratory conditions, kidney or liver disease and obesity have a higher theoretical risk of increased complications after surgery including for infection of the surgical site (44).

Post-operative complications

Complications as a consequence of any kind of surgery may be relatively minor, resolving without undue harm or distress to the patient, or have more serious implications that result in a potential threat to life, extended length of stay in hospital, admission to intensive care facilities and additional surgical interventions. Furthermore complications following surgery may cause long-term disability, decreased quality of life and psychological stress to the patient (45). In addition, there is seen to be a reduction in long-term survival rates of patients who have experienced complications within 30 days of surgery (8).

The most common postoperative complications include (19):

Blood loss
Blood clots
Adverse drug reactions to postoperative medications
Infection
Pain
Scarring and adhesions
Dysbiosis of the gut microbiota due to antibiotics and the stress of surgery

All surgical procedures, even those considered to be minor procedures or minimally invasive, are inevitably traumatic to the body triggering multiple local and systemic changes intended to restore homeostasis, which is disturbed by surgery. Localised acute inflammation is a vital response by the innate immune system to initiate the process of repair to damaged tissues; however, pain, redness, heat and swelling of the area are invariably a necessary result of this, subsequently causing postoperative discomfort for which analgesic medication is often required (46,47).

Stress to the body during surgery is characterised by the increased demand for oxygen and changes to metabolism required to provide energy sources, maintain fluid levels and restore homeostasis. These demands trigger the activation of the sympathetic nervous system (often described as the fight or flight response) as well as an increase in pituitary gland activity, which results in a rise of hormones such as cortisol (8,48).

It has been estimated that up to around 40% of individuals will experience some level of post-operative cognitive dysfunction with the likelihood of this increasing in older patients over 65 years. It is defined as a significant reduction in cognitive function which may negatively affect memory, attention span, verbal ability and executive function and is seen to persist for several weeks after the surgery was performed (49,50). Causes include surgical trauma induced inflammation, infection, opioid pain medications, sleep disturbance, stress and the effect of general anaesthesia (17,19).

Herbal solutions for surgical recovery

The main concerns around the taking of herbal medicines or supplements during the perioperative period include their potential effects on blood clotting and interactions with anaesthetic or post-surgical medications. For this reason it is generally advised that patients should stop taking any herbs a week before surgery is due to be performed. When herbs can be recommenced following surgery will depend on the herbs themselves along with any post-surgical medications that have been prescribed. It is recommended that advice around this is sought from a qualified medical herbalist with experience in this field and that the medical team involved in post-surgical care have full awareness of any herbs or supplements being taken (19,51,52,53),

Milk thistle flower (Silybum marianum)

Before surgery

Milk thistle (Silybum marianum)

An exception to the rule regarding stopping all herbs a week before surgery is milk thistle. Milk thistle has been shown to reduce the impact on the body of having a general anaesthetic, particularly on the liver. Its hepatoprotective, hepatotonic and anti-inflammatory actions protect the liver whilst being very safe, with no evidence to suggest that it has any interactions with anaesthesia. It is recommended that it is started three weeks before the date of surgery and continued for between three weeks and three months afterwards depending on the length of the procedure and subsequent time spent under anaesthesia. It can be taken until the day before surgery and may be restarted as soon as possible afterwards (19,51,54,55).

Passionflower (Passiflora incarnata)

Passionflower has been found to be of benefit to patients feeling understandably apprehensive in anticipation of imminent surgery. It has been shown to be effective at reducing anxiety without resulting in interactions with general anaesthetics or level of sedation (56).

After surgery for enhanced recovery

Ginger (Zingiber officinale) and chamomile (Matricaria chamomilla)

Both ginger and chamomile have been found to reduce the symptoms of post-surgical nausea. These herbs can be taken as a tea; to be drunk either hot or cold, or a few drops of the tincture can be added to a little water and sipped (57).

Echinacea (Echinacea purpurea/ E. augustifolia)

The immunomodulating, anti-inflammatory, antimicrobial, lymphatic, antiseptic and wound healing properties of echinacea make it an ideal herb for post-surgical use to promote improved healing and enhanced surgical recovery. Even minor surgery unavoidably causes some level of tissue damage and consequently requires the activation of the innate immune system to initiate the inflammatory processes necessary for healing. Major surgery has been shown to suppress activity of natural killer cells, a type of white blood cell vital to the immune system for their role in destroying infected or damaged cells. The ability of echinacea to support the innate immune response and increase natural killer cell production and activity further indicate its use after surgery (51,53,54)

Gotu kola (Centella asiatica)

Gotu kola has a range of properties seen to be beneficial to promote enhanced post-surgical recovery. Its nootropic, cerebral circulatory stimulant and anxiolytic actions may be indicated to improve post-surgical cognitive dysfunction. In some studies it has been shown to promote nerve regeneration and reduce levels of cortisol and adrenaline (19,58).

The benefits of gotu kola are also evident for the promotion of healthy wound healing. Its actions as an antifibrotic and connective tissue regenerator make it particularly valuable in the prevention of adhesions and post-surgical scarring (54,57).

In addition to it being taken as an internal remedy, gotu kola may be used externally as a topical preparation to enhance the healing of post-surgical wounds and is specifically indicated for the prevention of keloid or hypertrophic scars (54).

Holistic solutions

Preparing for surgery, also referred to as prehabilitation, is increasingly being recognised as a key factor in supporting positive surgical outcomes including a reduction in post-surgical complications and length of hospital stay required (8). Optimal nutrition is recommended during the months leading up to a surgical procedure and any deficiencies, such as iron or B12 which may indicate anaemia, corrected during this time (8,19). Optimal bowel function should be established prior to surgery and may help in preventing or reducing the post-surgical constipation experienced by some patients as a combined effect of insufficient hydration, reduced mobilisation and opioid pain medications following a procedure (19,59,60). Ensuring a healthy gut microbiome is maintained is a priority both before and after surgery for optimal immune function, particularly if antibiotics are prescribed (19).

Exercise in preparation for surgery has been seen to be associated with lower rates of post-surgical complications and earlier restoration of normal function in post-surgical patients, subsequently reducing the time taken before they are able to return to their previous daily lifestyle and routines (8,61).

Consistently good restful sleep needs to be a priority in the time leading up to surgery and during surgical recovery. It has been shown that insufficient sleep has a negative impact on systems including immune responses and cognitive function. It has also been associated with increased sensation of pain (61,62). Alongside good sleep, stress management around the time of surgery is essential particularly given that anxiety regarding a forthcoming procedure or the unconducive to relaxation hospital environment may be added to existing day to day stresses and concerns. Herbs such as nervines and adaptogens may help as can practices such as yoga, meditation or mindfulness (19,58,61).

A balanced, nutrition-rich diet is the optimal option whilst recovering from surgery; however, this may be affected by the choice of hospital food whilst receiving in-patient care and issues such as reduced appetite, decreased mobility, and pain levels once discharged to home. Supplements that are often suggested to be of benefit during this time include B and C vitamins, zinc, selenium, omega 3 oils, probiotics, green tea and turmeric (19,63).

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Barber MD, Fearon KC. The physiological response to surgical trauma. Surgical Palliative Care.:39.
J. P. Desborough, The stress response to trauma and surgery, BJA: British Journal of Anaesthesia, Volume 85, Issue 1, 1 July 2000, Pages 109–117, https://doi.org/10.1093/bja/85.1.109
Zhao Q, Wan H, Pan H, Xu Y. Postoperative cognitive dysfunction-current research progress. Front Behav Neurosci. 2024 Jan 30;18:1328790. https://doi.org/10.3389/fnbeh.2024.1328790
Brodier EA, Cibelli M. Postoperative cognitive dysfunction in clinical practice. BJA Educ. 2021 Feb;21(2):75-82. https://doi.org/10.1016/j.bjae.2020.10.004
Bone, K. The 5 herbs your patients need to know about before going under the knife. https://sownutritionalsystems.com/wp-content/uploads/2019/05/Surgery-protocols.pdf
Yeh TC, Ho ST, Hsu CH, et al. Preoperative use and discontinuation of traditional Chinese herbal medicine and dietary supplements in Taiwan: a Cross-Sectional Questionnaire survey. Healthcare. 2023;11(11):1605. https://doi.org/10.3390/healthcare11111605
Rowe DJ, Baker AC. Perioperative risks and benefits of herbal supplements in aesthetic surgery. Aesthetic Surgery Journal. 2009;29(2):150-157. https://doi.org/10.1016/j.asj.2009.01.002
Thomsen M. The Phytotherapy Desk reference: 6th Edition. Aeon Books; 2022.
Mills S, Bone K. The essential guide to herbal safety. Elsevier Churchill Livingstone; 2005.
Bone K. Functional Herbal Therapy: A Modern Paradigm for Western Herbal Clinicians. Aeon Books; 2021.
Yarnell E, Abascal BS. Herbs as adjuncts to surgery. Alternative and complementary therapies. https://doi.org/10.1089/act.2014.20506
Winston D. Adaptogens. Healing Arts Press; 2019.
Trads M, Deutch SR, Pedersen PU. Supporting patients in reducing postoperative constipation: fundamental nursing care – a quasi‐experimental study. Scandinavian Journal of Caring Sciences. 2017;32(2):824-832. https://doi.org/10.1111/scs.12513
Kehlet H. Fast-track surgery—an update on physiological care principles to enhance recovery. Langenbeck S Archives of Surgery. 2011;396(5):585-590. https://doi.org/10.1007/s00423-011-0790-y
Hanscom D. Back in control: A Surgeon’s Roadmap Out of Chronic Pain, 2nd Edition.; 2016.
Walker M. Why we sleep: The New Science of Sleep and Dreams. Penguin UK; 2017.
McKinney N. Naturopathic Oncology. Liaison Press; 2012.

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Jujube fruit

Jessika Thiele — Fri, 25 Apr 2025 14:06:53 +0000

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Mulberry

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Codonopsis

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Tansy

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Ground ivy

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Arnica

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Centaury

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Prickly ash

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Poke root

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Goat’s rue

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Wormwood

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Immune health: An Ayurvedic perspective

Jessika Thiele — Mon, 18 Nov 2024 09:25:39 +0000

Immunity is our body’s defence against infection and disease. In Ayurveda, immune health, or vyadhikshamatva, can be preserved and replenished by herbs and practices.

Understanding immune health

The immune system protects the body from illnesses. It defends the body against the pathogens, harmful substances and the cellular changes that can lead to damage and disease. The immune system has two lines of defence, along with chemical and structural barriers. They are innate immunity, which is a rapid response against the pathogen, and adaptive immunity, which is antigen dependent, specific and relies upon previous exposure. Adaptive immunity offers more efficient and rapid immune response. The immune system also has the capability to differentiate between the self and non-self (foreign body) cells (1,2).

If there is a defect in the mechanism of these two systems, then it may lead to diseases and conditions like inflammation, immunodeficiency disorder, autoimmune diseases and hypersensitivity (3).

The immune disorders can present itself in four forms:

Primary immune deficiency: Being born with a weak immunity or immune system.
Acquired immune deficiency: The immune system weakens due to a disease or medication.
Allergic reaction: When the immune system becomes hyperresponsive.
Autoimmune condition: When the immune system targets the host cells (4).

More than six million people are under the influence of primary immune deficiency all over the world and around 70 to 90% are undiagnosed (5). The example of acquired immune deficiency is human immunodeficiency virus (HIV), and by the end of 2022, it was estimated that 39.0 million people were living with HIV globally (6). One in four people in the UK are believed to be affected by allergies (7). One in 10 individuals in the UK suffer with an autoimmune disorder. (8)

How does immune health work?

The pathophysiology of the immune disorders are as follows:

Hypersensitivity reaction

Hypersensitivity reactions occur when the normal immune system produces undesirable responses. These are of three types. Type 1 is the most common hypersensitivity reaction. Allergens are the specific type of antigen. When there is a re-exposure of these allergens, then it induces type 1 hypersensitivity. The plasma cell secretes IgE which is different from normal immune response. Later, when there is an exposure of allergens, the active mediators like prostaglandins, histamines and leukotrienes are secreted. These cause contraction of smooth vessels and vaso-modulatory changes. Food allergies are the common example.

Type 2 reaction takes two to 24 hours and is a rare condition. Here, the IgM and IgG antibodies attach to the cell-surface molecule of the host. This, leading to the clumping of the red blood cells, is anexample of autoimmune anaemia. In type 3 reaction, IgM and IgG form a complex by binding with soluble protein. This leads to inflammation, degranulation of mast cels, and neutrophil influx. Type 4 are antibody-independent, and cell mediated and these are the second most common. It takes 2 or more days to develop. There is an overstimulation of macrophages and T cells (types of white blood cell), which releases cytokines (chemical messengers) causing tissue damage, inflammation and cell death (9,10).

Autoimmunity

When the normal immune homeostasis is lost, an abnormal response is produced by the host’s body towards its own tissues. In case of autoimmunity, auto-antibodies, self-reactive T cells, and inflammation is observed. Some examples include type 1 diabetes, celiac disease, Addison’s disease (11).

Inflammation

In an immunopathological event, tissue damage and improper inflammatory response due inflammation is often noticed. Inflammation can be a part of normal immune response against infection or foreign bodies, but it can convert into chronic inflammatory disease if it is uncontrolled. In this condition, there is overproduction of cytokines and inflammatory cells recruitment.

Immunodeficiency

In this state, there is a compromised capability of the body’s immune system to fight any disease. It can either be primary in which there is any pathway or selected immune cells inhibition or it can be secondary where the immune system is impaired due to a disease or treatment (12,13).

Understanding the root

In Ayurveda, immunity is referred to as vyadhikshamatva. The power or capacity of the body to resist against disease production or to fight against a disease is called vyadhishamatva. Its role can be understood in two forms: 1) to fight against the disease which has already occurred within the body, 2) to prevent the manifestation of any disease within the body (14).

The human body is composed of the doshas, dhatus and mala. Along with these there is another element which is responsible for the integral structure, function and vitality of the body — ojas. The ojas provide strength to the body to develop vyadhishamatva. Some functions of ojas are, destroying the vitiated dosha, development of muscles, normal sensory and motor functioning, unobstructed movements, homeostasis, and clarity of complexion and voice. (15).

When there are abnormalities in the state of ojas, then immunity-related health conditions develop. These abnormalities are known as ojovikriti. There are certain factors, which reduce the ojas: (16)

Long fasting period
Excessive physical activity
Less moisture/ excessive dryness
Constant worry, anger, grief or sorrow
Eating less food
Excessive sun exposure or wind
Old age
Excessive alcohol consumption
Mental or physical trauma

The above factors lead to abnormalities in ojas, which happens in two stages (discussed in signs and symptoms).

Signs and symptoms

The signs and symptoms of altered immunity present themselves in two stages (17):

First stage of altered immunity

Loosening of the joints
Weakness in the body
Movement of all three doshas from their normal seat
Inability or difficulty in performing normal function

Second stage of altered immunity

Heaviness and stiffness in the body
Swelling due to vata imbalance
Exhaustion
Drowsiness or feeling sleepy
Discolouration or change in complexion

Some symptoms of low immunity

Death in severe conditions
Decrease in muscles
Fainting and unconsciousness
Brain fog or mental disturbance
Delirium

Herbal solutions

There are a wide range of herbs that possess immune-modulatory properties. Some are discussed below:

Guduchi (Tinospora cordifolia)

Guduchi (Tinospora cordifolia)

Numerous studies have noted that guduchi enhances the intercellular bactericidal potential, phagocytic capacity, activity of lysozyme, antiprotease activity, level of enhanced nitro-blue tetrazolium (NBT), myelo-peroxide activity, total immunoglobulin level, macrophage activation, prevention of Kupffer cell activity deterioration and lysosome secretion. (18–20) Furthermore, an in vitro study reported that on IL-6 cytokines it showed an upregulating effect in response to inflammation, injuries, B cell diffraction or activation of cytotoxic T cell. (21) Another study suggested that it enhances the phagocytic function without interacting with the humoral and cell-mediated immune system. It also acts like an immunomodulator by inhibiting C3 canvertase. (22)

Turmeric (Curcuma longa)

A total of 117 randomised controlled trials have suggested that the active constituent of turmeric, curcumin, inhibits the activation of NF-kB after inflammatory stimuli. (23) Another study suggests that after the supplementation with curcumin, the levels of IL-6, TNF-a, MCP-1 and TGF-B were significantly reduced. (24) It inhibits NF-kB activation, IL-2 synthesis and lymphocyte proliferation stimulated by mitogen. (25) It was reported in a study that higher and early immune response of humoral and cell mediated system were initiated by curcumin. It also increases the weight of lymphoid organs and the production of white blood cells. (26)

Yashtimadhu (Glycyrrhiza glabra)

Yashtimadhu (liquorice) is known for its anti-inflammatory, antioxidant, antipyretic, immunomodulatory, antiviral and antitussive activities. (27). The main component is glycyrrhizin, which targets the dendritic cells to produce the immune response. It enhance the production of IL-12 and upregulate the presentation of CD86, CD40 and MHC-2 on dendritic cells. It increases the production of IL-10 and IFN-Y and reduces the production of IL-4. (28) In mice with allergic rhinitis, it decreased the lipid peroxidation which was free-radical induced and increased the antioxidant activity. (29) along with zinc, the root of yashtimadhu has reported immunomodulatory activity. (30)

Amalaki (Emblica officinalis)

Amalaki possesses an antioxidant, antimicrobial, anti-inflammatory, immunomodulatory, anticancer, antidiabetic, hepatoprotective, diuretic, nephroprotective, hypolipidemic and antimalarial properties. (31) the fruit restores the gamma-IFN and IL-2 production and decreases reactive oxygen species (ROS) production, lipid peroxidation level, apoptosis and caspase-3 activity. It also increases antioxidant enzyme levels, cell viability, potential of mitochondrial membrane and cytochrome c oxidase levels. (32) Along with macrophage phagocyte, it stimulates the cell-mediated and humoral immunity. (33)

Ashwagandha (Withania somnifera)

Ashwagandha is widely known for its immunomodulatory, adaptogenic, antioxidant, anti-tumorigenic, antidiabetic, antihypertensive, antifungal, antimicrobial, anti-inflammatory anti-stress and organ-protective activities. (34) In BALB/c mice, it was noticed that ashwagandha supported cell-mediated and humoral immunity by upregulating Th-1- dominant polarisation. (35) Another study suggests that the nitric oxide synthase activity of macrophages are enhanced by ashwagandha aqueous extract. It also enhances the phagocytic activity of macrophage and lysosomal enzyme activity. (36) Along with fatty acids, it also inhibits the pro-inflammatory cytokines and NF-kB expression. (37)

There are certain herbs like, tulsi (Ocimum sanctum), ginseng (Panax ginseng), arjuna (Terminalia arjuna) and guduchi (Tinospora cordifolia), which stimulate the immune system and colla (Alternanthera tenella), which suppresses the immunity.

Holistic solutions

Food choices

It is important to eat the right food along with right eating habits. It is best to eat when the previously eaten meal is well digested.

There are certain foods that act like a immunomodulators for example, cow milk, clarified butter (ghee), dark grape raisins, easily digestible meal, meal which contains all six tastes, and meals that includes a variety of ingredients, containing an abundance of nutrients and micronutrients.

However, if the food choice and eating habits are unwholesome, then it can compromise immunity. This may include eating before the previous meal is undigested or eating wrong food combinations like milk and fruit. Excessive use of packaged and refrigerated food items, over or under consumption of food, mixing wholesome and unwholesome food and eating at improper time.

Suitability and habit

Ayurveda suggests eating and following a routine that one has become habitual to. Every region has a specific climate and environment; therefore, it is best to eat the seasonal as well as regional food and follow the routine based on climate and season changes.

Mind acuity

A healthy mind can be achieved by avoiding unwholesome activities and consumption, and following of wholesome activities. One must not be overly indulgence of the sense organs (indriya). Mental stability and management of mental stress enhances the immunity.

Daily routine

Waking up at a regular time, having adequate sleep, daily body massage, exercising within the capacity, nasya with ghee (putting two drops of ghee in each nasal cavity), bathing and not eating before taking bath and a regular spiritual practice enhances the immunity.

References

Chaplin, D. D. (2010). Overview of the immune response. Journal of allergy and clinical immunology, 125(2), S3-S23.
How does the immune system work?. informedhealth.org. (n.d.). https://www.informedhealth.org/how-does-the-immune-system-work.html
Marshall, J. S., Warrington, R., Watson, W., & Kim, H. L. (2018). An introduction to immunology and immunopathology. Allergy, Asthma & Clinical Immunology, 14(2), 1-10.
Disorders of the immune system. JHM. (2021, August 8). https://www.hopkinsmedicine.org/health/conditions-and-diseases/disorders-of-the-immune-system
Meyts, I., Bousfiha, A., Duff, C., Singh, S., Lau, Y. L., Condino-Neto, A., … & Drabwell, J. (2021). Primary immunodeficiencies: a decade of progress and a promising future. Frontiers in Immunology, 11, 625753.
World Health Organization. (n.d.). HIV and AIDS. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
Allergies. Illnesses & conditions | NHS inform. (n.d.). https://www.nhsinform.scot/illnesses-and-conditions/immune-system/allergies
Conrad, N., Misra, S., Verbakel, J. Y., Verbeke, G., Molenberghs, G., Taylor, P. N., … & Cambridge, G. (2023). Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. The Lancet, 401(10391), 1878-1890.
Gell, P. G. H., & Coombs, R. R. A. (1963). Clinical aspects of immunology. Clinical Aspects of Immunology.
Rajan, T. V. (2003). The Gell–Coombs classification of hypersensitivity reactions: a re-interpretation. TRENDS in Immunology, 24(7), 376-379.
Castro, C., & Gourley, M. (2010). Diagnostic testing and interpretation of tests for autoimmunity. Journal of Allergy and Clinical Immunology, 125(2), S238-S247.
Notarangelo, L. D. (2010). Primary immunodeficiencies. Journal of Allergy and Clinical Immunology, 125(2), S182-S194.
Chinen, J., & Shearer, W. T. (2010). Secondary immunodeficiencies, including HIV infection. Journal of Allergy and Clinical Immunology, 125(2), S195-S203.
Gupta, G. K., & Devi, G. A Conceptual Study of Function of Ojas wsr to Vyadhikshamatva and its Clinical Significance.
Shastri, R. D., Upadhyaya, Y., & Pandey, G. (2003). Charak Samhita, Part 1, Sutrasthana, Chapter 30, Verse 24.
Shahi, P., Saraswat, O. P., Shahi, S. R., & Panwar, N. (2022). OJAS-A REVIEW ARTICLE.
Durgesh Senthiya, Meera K Bhojani, Mahesh Vyas, & Pankaj Pathak. (2020). A study on Ojas and Ojakshaya in etiopathogenesis of MADHUMEHA (diabetes mellitus). International Journal of Ayurveda and Pharma Research, 66–70. https://doi.org/10.47070/ijapr.v8i6.1518
Thatte, U. M., Kulkarni, M. R., & Dahanukar, S. A. (1992). Immunotherapeutic modification of Escherichia coli peritonitis and bacteremia by Tinospora cordifolia. Journal of postgraduate medicine, 38(1), 13.
Aranha, I., Clement, F., & Venkatesh, Y. P. (2012). Immunostimulatory properties of the major protein from the stem of the Ayurvedic medicinal herb, guduchi (Tinospora cordifolia). Journal of ethnopharmacology, 139(2), 366-372.
More, P., & Pai, K. (2012). In vitro NADH-oxidase, NADPH-oxidase and myeloperoxidase activity of macrophages after Tinospora cordifolia (guduchi) treatment. Immunopharmacology and immunotoxicology, 34(3), 368-372.
Sharma, U., Bala, M., Kumar, N., Singh, B., Munshi, R. K., & Bhalerao, S. (2012). Immunomodulatory active compounds from Tinospora cordifolia. Journal of ethnopharmacology, 141(3), 918-926.
Sinha, K., Mishra, N. P., Singh, J., & Khanuja, S. P. S. (2004). Tinospora cordifolia (Guduchi), a reservoir plant for therapeutic applications: A Review.
Li, H., Sureda, A., Devkota, H. P., Pittalà, V., Barreca, D., Silva, A. S., … & Nabavi, S. M. (2020). Curcumin, the golden spice in treating cardiovascular diseases. Biotechnology advances, 38, 107343.
Panahi, Y., Hosseini, M. S., Khalili, N., Naimi, E., Simental-Mendía, L. E., Majeed, M., & Sahebkar, A. (2016). Effects of curcumin on serum cytokine concentrations in subjects with metabolic syndrome: A post-hoc analysis of a randomized controlled trial. Biomedicine & pharmacotherapy, 82, 578-582.
Ranjan, D., Chen, C., Johnston, T. D., Jeon, H., & Nagabhushan, M. (2004). Curcumin inhibits mitogen stimulated lymphocyte proliferation, NFκB activation, and IL-2 signaling. Journal of Surgical Research, 121(2), 171-177.
Afolayan, F. I., Erinwusi, B., & Oyeyemi, O. T. (2018). Immunomodulatory activity of curcumin-entrapped poly d, l-lactic-co-glycolic acid nanoparticles in mice. Integrative medicine research, 7(2), 168-175.
El-Saber Batiha, G., Magdy Beshbishy, A., El-Mleeh, A., M. Abdel-Daim, M., & Prasad Devkota, H. (2020). Traditional uses, bioactive chemical constituents, and pharmacological and toxicological activities of Glycyrrhiza glabra L.(Fabaceae). Biomolecules, 10(3), 352.
Bordbar, N., Karimi, M. H., & Amirghofran, Z. (2012). The effect of glycyrrhizin on maturation and T cell stimulating activity of dendritic cells. Cellular Immunology, 280(1), 44-49.
Li, X. L., Zhou, A. G., Zhang, L., & Chen, W. J. (2011). Antioxidant status and immune activity of glycyrrhizin in allergic rhinitis mice. International journal of molecular sciences, 12(2), 905-916.
Mazumder, P. M., Pattnayak, S., Parvani, H., Sasmal, D., & Rathinavelusamy, P. (2012). Evaluation of immunomodulatory activity of Glycyrhiza glabra L roots in combination with zing. Asian pacific journal of tropical biomedicine, 2(1), S15-S20.
Harikrishnan, H., Jantan, I., Alagan, A., & Haque, M. A. (2020). Modulation of cell signaling pathways by Phyllanthus amarus and its major constituents: potential role in the prevention and treatment of inflammation and cancer. Inflammopharmacology, 28, 1-18.
Singh, M. K., Yadav, S. S., Gupta, V., & Khattri, S. (2013). Immunomodulatory role of Emblica officinalis in arsenic induced oxidative damage and apoptosis in thymocytes of mice. BMC Complementary and Alternative Medicine, 13(1), 1-13.
Suja, R. S., Nair, A. M. C., Sujith, S., Preethy, J., & Deepa, A. K. (2009). Evaluation of immunomodulatory potential of Emblica officinalis fruit pulp extract in mice. Indian Journal of Animal Research, 43(2), 103-106.
Gurav, N. S., Gurav, S. S., & Sakharwade, S. N. (2020). Studies on Ashwagandha Ghrita with reference to murcchana process and storage conditions. Journal of Ayurveda and Integrative Medicine, 11(3), 243-249.
Bani, S., Gautam, M., Sheikh, F. A., Khan, B., Satti, N. K., Suri, K. A., … & Patwardhan, B. (2006). Selective Th1 up-regulating activity of Withania somnifera aqueous extract in an experimental system using flow cytometry. Journal of ethnopharmacology, 107(1), 107-115.
Rasool, M., & Varalakshmi, P. (2006). Immunomodulatory role of Withania somnifera root powder on experimental induced inflammation: An in vivo and in vitro study. Vascular pharmacology, 44(6), 406-410.

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Tea tree

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Violets

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Coltsfoot

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Eucalyptus

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Irish moss

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Usnea

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Rose geranium

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Atractylodes

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Olive leaf

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Honeysuckle

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Oak

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Yellow dock

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Chaga

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Propolis

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Mustard seed

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Japanese knotweed

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Tremella

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Lyme disease

Jessika Thiele — Sat, 13 Jan 2024 18:31:33 +0000

Lyme disease is a bacterial infection spread to humans by infected ticks. We find out what Lyme disease is and herbal treatment methods.

Understanding Lyme disease

Lyme disease is a bacterial infection spread to humans by infected ticks. The causative bacterium carried by ticks is called Borrelia burgdorferi. Early treatment for Lyme disease is crucial for a better prognosis. When the disease is diagnosed and treated promptly with appropriate antibiotics or herbs (always consult a professional herbalist) in the early stages, most individuals recover completely.

If treatment is delayed or the infection is not recognized early, the bacteria can spread to other parts of the body, leading to more severe symptoms and complications. Lyme is a multisystemic disease that can affect and strain all organs of the body. In some cases, Lyme disease can cause persistent symptoms even after antibiotic treatment. If left untreated, Lyme disease can progress to more severe symptoms, affecting the joints, heart, and nervous system. Early detection and treatment are crucial for a full recovery.

By 2050, 55.7 million people (12% of the population) in the USA and 134.9 million people (17% of the population) in Europe will have been infected with Lyme disease (1).

It’s worth noting that not all tick bites result in Lyme disease, and prompt and proper tick removal can reduce the risk of infection. Additionally, the use of preventive measures, such as wearing protective clothing and using insect repellents, can help minimize the risk of tick bites.

How does Lyme disease happen?

Ticks are tiny arachnids (the size of a sesame seed when young) found in long grass or woodland areas. They feed on the blood of mammals such as deer, mice, rats, cats, and dogs, as well as humans. It is estimated that a tick can carry 120 different species of bacteria.

Ticks can be very small and their bite is not painful, so you may not realise you have one attached to your skin. However, there is a higher risk of becoming infected if the tick remains attached to your skin for more than 24 hours. When an infected tick bites, the saliva produces anticoagulant compounds that deactivate the inflammatory response normally triggered by an insect bite. Pain signals and itching of the skin are dampened, allowing the tick to continue to feed. Once infected, the B. burgdorferi (a species of Spirochetes bacteria) cells move slowly into the blood and lymphatic system.

Understanding the root of Lyme disease

Though it is thought that Lyme disease has been around for hundreds of years, it was first recognised and named only in the 1970s in Lyme, Connecticut. It was linked to cases of arthritis in adults and children who also had other puzzling symptoms. This syndrome, or combination of signs and symptoms, are what came to be known as Lyme disease.

Lyme disease is a year-round problem, but it is more common during spring and summer, when the ticks are active and feed.

Most Lyme disease tests are designed to detect antibodies made by the immune system in response to an infection. These antibodies can take several weeks to develop, so people may test negative if infected only recently.

Testing for Lyme disease typically involves an initial screening called ELISA to measure IgG and IgM (two different kinds of antibody) levels. Even though lab tests for initial screening can be important here, they can be variable and are not always 100% reliable. If ELISA shows a positive or uncertain result, a more specific test called the Western blot is performed to confirm the result. However, a 2016 study found that ELISA misses 46% of cases, and even when followed by Western blot, an additional 37.5% on average go undetected. There are also multiple co-infections of Lyme disease; it rarely occurs alone and these tests are not often done. (1)

The controversy surrounding the use of antibiotics in the treatment of Lyme disease revolves around the duration and effectiveness of prescribed antibiotic regimens. While the National Institute for Health and Care Excellence (NICE) Guidelines in the United Kingdom states that early-stage Lyme disease is typically treated with a short course of antibiotics, some patients with persistent symptoms advocate for prolonged antibiotic therapy, arguing that it helps alleviate chronic manifestations of the disease known as post-treatment Lyme disease syndrome.

However, the medical community is divided on the efficacy of prolonged antibiotic treatment, as studies have yielded mixed results, and potential risks, such as antibiotic resistance and adverse effects, need to be considered. Striking a balance between addressing the genuine concerns of patients with persistent symptoms and adhering to evidence-based medical practices is essential in navigating this ongoing controversy in the management of Lyme disease.

Signs and symptoms

During stage 1 of the disease, signs and symptoms are localised. The person may experience flu-like symptoms and a bull’s eye rash at the site of the tick bite. The rash, though known to the public in relation to Lyme, is not very common and may occur in only 15–25% of those bitten.

In stage 2, bacteria have begun to spread, affecting the whole body. Flu-like symptoms including fever, chills, fatigue, muscle and joint aches, and swollen lymph nodes are noticeable. Neurological symptoms may occur such as headaches, dizziness, and difficulty concentrating. Joint pain due to inflammation is characteristic, particularly in the knees.

Stage 3, also known as late-stage Lyme or persistent/chronic Lyme, may appear months or years after initial infection. A whole range of symptoms have been linked with this condition, most notably chronic joint inflammation, facial palsy with neuropathy, nerve damage, brain, and heart complications. Brain problems may include confusion, inability to concentrate, as well as impaired memory, mood, personality, and balance. There may be tiredness and joint pains – called “post-Lyme syndrome” – with symptoms similar to fibromyalgia or chronic fatigue syndrome. Other complications can cause heart rhythm abnormalities and irregularities. Sadly most infections will become chronic if left untreated (2).

Lyme disease can manifest as a variety of symptoms, including:

Unexplained episodes of fever, sweats, chills, or flushing
Unexpected fluctuations in weight, whether it’s loss or gain
Persistent fatigue and tiredness
Unexplained hair loss
Swollen glands
Sore throat
Testicular or pelvic pain
Irregularities in menstrual cycles
Unexpected milk production or breast pain
Irritable bladder or issues with bladder function
Sexual dysfunction or a decline in libido
Upset stomach
Changes in bowel function, such as constipation or diarrhoea
Chest pain or soreness in the ribs
Shortness of breath and coughing
Heart-related symptoms like palpitations, pulse skips, or heart block
Previous history of a heart murmur or valve prolapse
Joint pain or swelling
Stiffness in joints, neck, or back
Muscle pain or cramps
Facial muscle twitching
Recurring headaches
Neck aches or stiffness
Sensations like tingling, numbness, burning, or stabbing
Facial paralysis (Bell’s palsy)
Issues with eyesight, including double or blurry vision
Ear-related symptoms like buzzing, ringing, or ear pain
Increased susceptibility to motion sickness or vertigo
Lightheadedness, wooziness, poor balance, and difficulty walking
Tremors
Confusion and difficulty in thinking
Problems with concentration or reading
Forgetfulness and poor short-term memory
Disorientation, leading to getting lost or going to the wrong places
Difficulty with speech or writing
Mood swings, irritability, or depression
Disturbed sleep patterns
Exaggerated symptoms or a heightened hangover effect from alcohol

Herbal solutions

Japanese knotweed stems (Reynoutria japonica)

If you do find a tick on your (or someone else’s) skin, remove it carefully by twisting it off with a tick remover. It is essential that the mouth parts are removed in addition to the body. A paste created by mixing slippery elm bark or marshmallow root powder, or clay powder, with some Andrographis tincture can be used to cover the bite to help draw out any toxins. Removal of an attached tick within the first 24 hours will usually prevent an infection.

Put the tick in a Ziploc bag or other container in the freezer, so it can, if necessary, be sent off and tested.

Treatment plans, including herbs and minerals, vary depending on individual needs, resources and experiences.

Reducing the burden placed on the body by the inflammatory response to the invading bacteria is a key feature of addressing Lyme disease. By modulating Inflammation and stress triggers, we can further reduce inflammatory symptoms. The following exemplify treatment goals that might be used by medical herbalists:

Improving resilience to pathogens: By improving immunity with antimicrobials, supporting the innate and adaptive immune responses, and using other self-regulating calming activities that can improve resilience.
Repairing and restoring lost function: Improving cognitive function and gut health are often priorities for people experiencing Lyme disease. Supportive treatment goals include stabilising blood sugar and supporting connective tissue integrity with herbal remedies and food.
Reconnecting with vitality and self: By meeting our needs for self-care, reflection, and social contact and connection.

A study published in 2020 in Frontiers in Medicine examined the potential of 12 herbs used in treating Lyme disease by testing them in vitro for activity against Borrelia burgdorferi. (3)

These are commonly used herbs in my clinic:

Chinese skullcap (Scutellaria baicalensis)
Japanese knotweed (Fallopia japonica)
Black walnut (Juglans nigra)
Ghanaian quinine (Cryptolepis sanguinolenta)
Sweet wormwood (Artemisia annua)
Cat’s claw (Uncaria tomentosa)

Holistic solutions

Healing Lyme disease is not a linear journey: it goes in layers and can require different strategies at different stages of the process. One can follow broad guidelines and protocols that have been developed over many years by various clinics and Lyme specialists, but health outcomes can be greatly improved by using herbal medicine, working with an empathetic practitioner and making nutritional changes.

Acupuncture

Traditional Chinese Medicine (TCM) practices such as acupuncture may help manage symptoms and promote overall well-being.

Meditation

Mindfulness meditation can be beneficial for managing stress and supporting the vagus nerve and mental well-being.

Moderate exercise

Engaging in regular, low-impact exercise or cold water therapy can help maintain physical and mental health.

Quality sleep

Ensure adequate and restful sleep, as it plays a crucial role in immune function and overall health.

Stress reduction techniques

Practices such as deep breathing, progressive muscle relaxation, or biofeedback may help manage stress.

Infrared saunas

Some individuals find relief from symptoms through infrared sauna therapy, which may help with detoxification

Manual Lymphatic Drainage (MLD)

This gentle massage technique may help support the lymphatic system.

Precautions to help prevent Lyme disease

Wear a long-sleeved shirt when walking in risk areas.
Tuck your trousers into long socks.
Use insect repellent.
Avoid long grass, and stay on the path.
Check yourself for ticks at the end of the day and remove any ticks thoroughly.
Check your children and pets for ticks.

As a preventative measure in high-risk areas during tick season (May– September), or all year round if you work outdoors, the noted herbalist Stephen Buhner recommends taking Astragalus, with meals. Astragalus is an immune regulator; it increases the effect of enzymes that activate white blood cells and support immune function.

For new tick bites, Buhner typically recommends taking Astragalus 3,000 mg daily for 30 days and 1,000 mg daily thereafter until symptoms improve. However, if symptoms persist or get worse, stop taking it.²Astragalus is not recommended for chronic Lyme disease.

Lyme disease is often referred to as the “great imitator” due to its ability to mimic a diverse range of illnesses. Beyond the direct impact of the Lyme bacteria and its co-infections, individuals with Lyme disease may experience symptoms that resemble various other health conditions. Recognizing this complexity is crucial for a comprehensive approach to diagnosis and treatment.

It’s essential to investigate and address potential contributing factors that can exacerbate the symptoms or hinder recovery. These factors may include issues such as mineral deficiencies, blood sugar imbalances, allergies, gut dysbiosis, hormone imbalances, and autoimmune disorders. By taking a holistic approach and considering the broader context of an individual’s health, healthcare professionals can better tailor treatment plans to address the multifaceted nature of Lyme disease and enhance the overall well-being of those affected.

References

X. Zhang et al., “Economic impact of Lyme disease”. Emerg. Infect. Dis., 12 (4) (2006): 653–660.
M. Davidsson, “The financial implications of a well-hidden and ignored chronic Lyme disease pandemic”. Healthcare (Basel), 6 (1) (2018): 16.
J. Feng et al., “Evaluation of natural and botanical medicines for activity against growing and non-growing forms of B. burgdorferi”. Front. Med. (Lausanne), 7 (2020): 6.
S. H. Buhner, Healing Lyme Disease Coinfections: Complementary and Holistic Treatments for Bartonella and Mycoplasma 2^nd addition (Rochester, VT: Healing Arts Press, 2013).
Natural Treatments for Lyme Coinfections: Anaplasma, Babesia, and Ehrlichia Paperback – 12 Mar. 2015( Healing Arts Press; 1st edition (12 Mar. 2015)
Richard i.Horowitz ,Why Can’t I Get Better?: Solving the Mystery of Lyme and Chronic Disease Hardcover – Illustrated, 12 Nov. 2013

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Oregon grape root

Eve Brazil — Wed, 27 Dec 2023 12:59:38 +0000

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Maitake

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Mistletoe

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Shiitake mushroom

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Oregano

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Marjoram

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Basil

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Turkey tail

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Lion’s mane

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Yarrow

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Barberry

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Cleavers

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Willow

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Schisandra

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Gentian

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Maca

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Bai shao

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Saffron

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Vaginal thrush

Jessika Thiele — Wed, 09 Mar 2022 08:45:32 +0000

Vaginal thrush is one of the most common fungal conditions affecting the vulva and/or the vagina of everyone with a female anatomy.

Understanding vaginal thrush

Vulvovaginal Candidiasis or thrush is one of the most common fungal conditions affecting the vulva and/or the vagina of female-anatomied people. It is believed to affect up to 70% of all women at least once in their lifetimes (1). Of that number between 5 and 9% of those women will go onto experience it recurrently or chronically, meaning they have experienced a flare up at least four times in a year. Interestingly, although sounding a small percentage, recurrent thrush globally impacts around 138 million women annually (2).

Thrush is caused by species of the Candida genus of fungi, most commonly Candida albicans. While these fungi live in most vaginas during adulthood without causing problems, when conditions are right the fungi can overgrow, causing thrush.

Thrush is one of the most common causes for vulvovaginal irritation and infection and can easily be mistaken for conditions such as bacterial vaginosis (BV), vulval dermatitis or aerobic vaginitis. Testing via swabbing is a key diagnostic that must be undertaken so the correct treatment can be used to regain control in this area.

How does thrush work?

Both the vagina and the vulva have their own microbiomes. These are communities of beneficial microbes that work symbiotically with the body to the benefit of both the host body and that of the microbial community. Most areas of the body have their own microbiome types, distinguishable from that of other sites in or on the body by community make up.

The role of the vaginal microbiome is to provide immune defence against pathogenic microbes that may otherwise cause infection. In health, the vaginal microbiome is made up of a mix of beneficial viruses, fungi and bacteria that live together in harmony and balance.

The relatively new field of vaginal microbiome mapping has shown us that the most prevalent and beneficial (when in the right ratios) microbes for the vaginal space are a group of 5 lactobacilli bacteria. It is these which work mainly to keep any pathogenic microbes in check by dominating the space and producing lactic acid which keeps the vagina acidic at around pH4.

Although Candida fungi live in most vaginas without causing an issue, there are multifactorial reasons that Candida can proliferate and cause a problem. In addition, because they are more or less the only pathogenic microbes in this space that prefer a more acidic environment, they can thrive in the a Lactobacilli dominated space (1).

When the conditions are right Candida yeast numbers can increase in number to colonise the vaginal mucous membrane surfaces and change from bud cells to hyphae and pseudohyphae states. In these states the Candida can burrow into the vaginal tissue to take hold or remain mobile to acquire nutrients. This then causes the common signs and symptoms associated with thrush.

Thrush can be caused by around 4 main species of Candida. The most commonly found form is Candida albicans. Many of the allopathic treatments are aimed at this type of Candida. However, if it is caused by another type, it may be harder to shift with allopathic treatment alone.

In the UK, swab microscopy and culture testing is the standard diagnostic for thrush but result reports varies from area of area and some may define which species of Candida is involved and some may not. Testing is also able to determine whether hyphae growth is involved and how heavy the growth is (1).

In addition, there are several forms of thrush: acute, recurrent and chronic. Acute can be considered a one time incident that is easily cleared by treatment. Recurrent is defined as a minimum of four episodes in a year, one of which has at least been proven on testing. A recurrent form can also prove stubborn to allopathic treatments. Chronic is considered a much more persistent form that can be related to the person’s menstrual cycle, but not always. Signs and symptoms can improve or worsen over time, but some or all of them will always be present at some time or other (1). Possible causes and treatments can differ depending on type.

Understanding the root

As previously mentioned there are multifactorial causes to thrush and these can change depending on the person and the type. Here are lists of typical causes by type.

Acute vaginal thrush

Use of antibiotics
Poorly controlled blood sugar levels
Tight, warm clothing
Fabric washing agents
Tissue damage due to trauma
Pregnancy

Recurrent and chronic vagina thrush

Subclinical immune deficiency
Several acute flares ups within a short amount of time
Subclinical hormone imbalance
Poorly controlled blood sugar levels
Atopic allergy
Tissue damage due to trauma
Intimate washing with soaps
Fabric washing agents
Toilet paper
Cycling or rowing
Use of hormonal medications
Pregnancy
Poor condition and hygiene of sex toys
Resistance to repeated use of anti-fungal medication

All of these factors can disrupt the delicate microbiome balance and mean that Candida can proliferate in the vaginal space. When this goes on for long enough or the causal conditions remain the same for significant length, recurrent and chronic pictures can build up. In these situations tissue damage is more likely to occur, through irritation and hyphae growth, meaning that it becomes much more stubborn, is challenging to clear and a great place for opportunistic infection to take hold.

More difficult to define are the psychological factors influencing the recurrent and chronic types, and these definitely have an impact on the person suffering with them.

Signs and symptoms of vaginal thrush

Vaginal conditions can be a challenge to diagnose correctly. The most common sign is a white cottage cheese-type discharge and the most common symptom is itch.

These may be accompanied by (1):

A white film on the vulva or in the vagina
Redness and inflammation of the area
Visible patches of fungal growth
Pain on intercourse
Pain on urination
And if a lot of scratching in response to the itching has taken place, the vaginal or vulval tissues can appear damaged and may bleed.

As previously addressed, testing is of vital importance as thrush can appear to have many of the same symptoms as other vaginal conditions but needs very different treatment.

The recurrent or chronic forms can exist in the background, flaring up at prone times. If this is the case, you may experience background signs and symptoms such as mild irritation and redness for the majority of the time, with other symptoms only accompanying them during a flare up.

Herbal solutions

Calendula field (Calendula officinalis)

As challenging as vaginal conditions can be to diagnose so they can be to treat and effectively clear up. Recurrence is common so longer term strategies may need to be considered and prepared for.

Once testing has been performed (ideally finding out the species causing the issues), it would be a good idea to work out the triggers involved in the individual case. This helps to understand what is going on. Once some of these have been determined the approach can be tailored to the type. In this section we will be covering herbal solutions most ideal for an acute type, some of which can also find a place in treating a recurrent and chronic picture.

If you have a recurrent or chronic type, you keep getting acute flare-ups or what you are trying hasn’t improved the situation after a month, its best to seek professional help from a qualified medical herbalist.

If you have ever experienced a thrush flare up you will know that cooling and soothing the itch is paramount. With this in mind we want to reduce discomfort as quickly as possible whilst looking at longer term strategies.

So let’s start with the anti-inflammatories that you use topically.

Anti-inflammatory herbs

Aloe vera

Aloe vera is easily bought as a gel from your local health food shop. This is made from the ‘gel’ matrix in the centre of Aloe vera leaves. It is anti-inflammatory and anti-fungal, soothing and calming. Applied topically it can be popped in the fridge before hand to make it an extra cooling application. Use externally, so on the vulva. Be sure to read the labelling when buying aloe vera gel though, as these products are particularly filled with chemicals which may be irritating.

Calendula

Marigold can be purchased from herbalists’ suppliers or good health food shops as dried petals and is very healing for the skin and also anti fungal. It can be used as a tea to be drunk or to be applied as a calming anti-inflammatory ‘wash’, and is the key ingredient for vaginal pessaries.

Chamomile

Chamomile can be purchased from herbalists’ suppliers or good health food shops as dried petals, it can be made into a ‘tea’ to be applied as a calming anti-inflammatory ‘wash’.

Marshmallow root (Althaea officinalis)

Mucous membrane support

Next, we look at herbs that are for oral consumption.

Plantago major

Taken as a tea, plantain is wonderfully supportive to the mucous membranes and can help if there is an allergic component to the thrush too and plantago acts as a natural antihistamine.

Marshmallow root

Decoct overnight in cold water. Marshmallow root is a wonderful cooling demulcent which affects and strengthens all mucous membrane throughout the body including that of the vagina, where the vaginal microbiome lives.

Nervous system support

Oat straw

Oat straw is a wonderfully grounding and nourishing nervine for the nervous system, this also has a tradition of being useful for vaginal nerve pain. Drunk as a tea, but it can also be added to sitz baths, below (1).

Siberian ginseng

Siberian ginseng is known as an adaptogen, which helps your body adapt to all types of stress, which includes vaginal infections, this herb supports your nervous system and is useful during times of stress. It supports your energy rather than depleting it (1). Stress weakens immunity leading to bacterial overgrowth so ginseng can help with the root cause of this.

Chamomile

Chamomile is such a simple plant we almost certainly all have in the cupboard as teabags. Wonderful to take as a tea, it can soften the edges around stress and also supports your digestive function (1).

Anti-fungals/ Anti-bacterials

Garlic

Garlic is a powerful anti-fungal herb. Use this crushed, chopped and lightly cooked in food this is a great way to get the benefits systemically without directly damaging the vaginal microbiome. Can be a useful adjunct to a direct approach (1).

P’au d’arco

Made from the bark of the tree, P’au d’arco is a herb traditionally used by the Inca people and has many useful actions. It is anti-fungal and specific to Candida, but also aids immune system health generally. Drunk as a tea it has a warming, almost smokey taste and can be drunk daily during a flare up to help bring things into check (1).

Immune system support

Medicinal Mushrooms – often recommended by herbalists, medicinal mushrooms enhance the immune response due to their polysaccharide content. This is helpful as a background therapy to aid vaginal infection and also where allergy may play a role in thrush (1). These can include chaga, reishi, cordyceps, shitake and maitake.

Echinacea

Echinacea is one of the herbs most publicly associated with boosting immunity, Echinacea can be helpful when looking at acute infection or for long standing conditions that have really taken hold. Best used as a tincture rather than a tea due to its chemistry (1).

Calendula

Traditionally known as a lymphatic, Calendula is immunomodulatory, assisting the lymph nodes in ‘cleaning’ the lymphatic fluid where many components of the immune system reside (1).

Holistic solutions

Aside from using herbs alone, there are other holistically supportive things you can do alongside when you have thrush.

Find your triggers

Finding your triggers is a very important one. Can you tell what makes it better or what makes it worse? What was happening just before you noticed the flare up? Keeping a diary or journal can be very useful when looking at this. You may notice some patterns emerging!

Probiotics

Although we don’t yet have any evidence to support direct transmission from the digestive system to the vagina, translocation from the anus to the vagina may occur. Taking probiotics containing Lactobacillus rhamnosus and Lactobacillus reuteri have been extensively trialled and shown to have some efficacy for women suffering with thrush (1).

Improve your GI

Reducing the glycemic load of your food will impact blood sugar balance. As Candida feeds on sugars, helping your body to process sugars properly can mitigate the risk of future flare ups (1).

Washing

Something we are not routinely taught when growing up, but the way we wash can have a big impact on our intimate microbiome. Using soap on the mucous membranes of the vulva and vagina is likely to strip them of their beneficial microbial colonies, making opportunistic infection more likely. Only use soap on the areas where hair grows and wash the labia with water only. The vagina is self-cleaning so no need to wash or douche there at all (1).

Caprylic acid

Caprylic acid is a fatty acid found in coconut oil and used as a supplement, taken orally, with anti-fungal properties. It is believed to break down the cell membranes of Candida cells, making it very handy in a flare up. Dosage is 150-300mg a day but is best avoided in pregnancy. (1)

Apple cider vinegar

Apple cider vinegar is a rich, acidic vinegar made from apple cider, containing enzymes and proteins is perfect for use in a Sitz bath to help restore the acidic environment and soothe the affected area. Use 1-2 cups per Sitz bath. (1)

References

Bishop, K. It’s Your Power Portal: Take Control of Your Vaginal Health with Herbal and Holistic Care. 1st ed. Aeon Books; 2022
Denning, David W et al. “Global Burden Of Recurrent Vulvovaginal Candidiasis: A Systematic Review”. The Lancet Infectious Diseases, vol 18, no. 11, 2018, pp. e339-e347. Elsevier BV, https://doi.org/10.1016/s1473-3099(18)30103-8. Accessed 18 Jan 2022.

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Elderflower

Jessika Thiele — Sat, 05 Mar 2022 17:16:31 +0000

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Eyebright

Jessika Thiele — Sat, 05 Mar 2022 16:05:45 +0000

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Sinusitis

Jessika Thiele — Sat, 05 Mar 2022 12:31:08 +0000

Sinusitis is an infection or inflammation of mucous membranes of the paranasal sinuses and nasal passages.

Understanding sinusitis

Sinusitis is one of the most common diagnoses within primary care (7) and accounts for more antibiotic prescribing than any other condition or single diagnosis in the United States (6). Sinusitis can have marked effects on quality of life and is responsible for reduced workplace and school attendance by 3-4% and performance by 30-40%. Sinusitis, therefore, has a high economic burden with the condition and its related conditions occupying approximately one-third of primary care consultations (4). This highlights the importance of how valuable herbal medicine are for symptomatic relief and the treatment of sinusitis, especially in the treatment of viral and allergic sinusitis. They can also be a vital aid for our global burdened health systems in growing pandemic of antibiotic resistance.

Sinusitis is classified according to duration. This can be:

Acute sinusitis: Sudden onset, lasting less than 4 weeks with complete resolution
Subacute sinusitis: A continuum of acute sinusitis but less than 12 weeks
Recurrent acute sinusitis: Four or more episodes of acute, lasting at least 7 days each, in any 1 year
Chronic sinusitis: Signs and symptoms persist 12 weeks or longer (8)

Most cases of sinusitis are due to viral pathogens with a resolution of symptoms for these acute cases being very favourable. Antibiotics or imaging may not be the necessary first port of call for clinical diagnosis or treatment for acute viral sinusitis (9).

How does sinusitis work?

Irritation and inflammation of the nasal passages and sinuses from infection or inhaled pollutants cause the cells lining (mucous membranes) of the respiratory tract to secrete extra mucus as a protective mechanism. This accumulates as catarrh and can predispose to sinusitis, which can be painful and cause headaches and postnasal drip, which in turn can cause recurrent throat and chest problems (1). This mucous membrane is a soft, moist, pink layer of cells that lines several passages and cavities in the body with openings that are exposed to the external environment and can be found in the digestive, respiratory, reproductive, and urinary tracts. As the sinus mucous is continuous with the nasopharynx (uppermost part of the throat), the microbiology of sinusitis overlaps with inflammation of the nose, throat, and inner ear.

The inflammation or swelling affects the tissue lining of the sinuses of which there are four paired cavities (spaces) located in the head. These paranasal sinuses are named after the bones that provide their structure.

With sinusitis, drainage of the sinuses is partially blocked, usually by congestion and mucosal swelling. This results in a stasis that allows a bacterial infection to take hold. Pain is caused by either negative pressure (due to absorption of the gases by the vasculature) or the positive pressure of mucosal congestion (3).

Understanding the root

Acute sinusitis is generally triggered by a viral upper respiratory tract infection, with 2% of cases being complicated by bacterial sinusitis (7) and approximately 90% of patients with colds having an element of viral sinusitis (8). It can be caused by allergens, irritants, viruses, fungi, and bacteria, with allergenic irritants such as animal dander, pollution, smoke, and dust (8).

Factors involved in the etiology of chronic sinusitis and catarrh include pollution, occupational dust exposure, tobacco smoke, adenoids, allergy (especially in children), rhinitis, cold and damp weather, dental problems, trauma, and flying. A deviated septum or other structural causes may be present (3). Chronic catarrh and sinusitis have also been linked to poor diet, food allergies, gut flora disturbances, and toxicity (1).

There is also a link to chronic sinusitis and the pathogenic fungus Candida albicans. A study in 1999 looked at a group of 210 chronic sinusitis suffers and collected mucous from the nasal cavities of each patient, and found that 96% of these patients had fungi present in their mucous. The researchers concluded that in patients with sensitivity to fungi, the presence of these fungal cells in the nasal cavity triggers an immune response that resulted in typical sinus infection symptoms (10).

Signs and symptoms

Rhinorrhea (anterior or posterior): Commonly known as a runny nose
Itching
Sneezing
Nasal obstruction: Difficulty breathing normally through the nose
Headache
Cough
Facial pain
Poor olfaction: A loss or change in smell
Disturbed sleep
Pharyngitis, also known as sore throat
Poor concentration and brain fog
Postnasal drip
Exacerbation of lower respiratory tract problems (4)

Herbal solutions

Herbs, which hold anti-infective and anti-microbial properties, are key in acute infection. Immune-stimulating herbs are an essential component in acute infection, but also important in recurrent and chronic conditions where a lowered immune system is often seen. Symptomatic relief for sinusitis usually includes anti-catarrhal, mucolytic and anti-inflammatory herbs.

Demulcent herbs (that relieve inflammation and irritation), such as marshmallow, plantain, and mullein, are useful to ensure that the herbal treatment isn’t too drying to the mucous membranes causing further irritation to the upper respiratory system.

Herbs such as calendula, nettle leaf, cleavers, echinacea, and solidago, help cleanse the lymphatic system of toxins and infection which otherwise can lead to excess toxins building up in the blood causing further congestion, inflammation, and a lowered immune system.

Andrographis (Andrographis paniculata)

Andrographis (Andrographis paniculata)

Andrographis is a bitter herb that has been used widely throughout Asia to enhance immunity and to treat a variety of chronic and acute infectious diseases. It has the additional benefit of supporting the liver and helping to protect it from damage from infections and toxins through its bitter action (1).

Echinacea

Many herbalists use a combination of E. purpurea and E. angustifolia within their practice, but there is evidence that the less common Echinacea pallida, is specifically referred to for reducing the symptoms and lessening the duration of upper respiratory tract infections for both bacterial and fungal infections (12).

Thyme (Thymus vulgaris)

Thyme contains volatile oils that are highly antiseptic as well as a powerful anti-microbial (11), an anti-bacterial, and anti-fungal herb that is commonly used with infection particularly when the infection is in the respiratory system especially where this is characterized by excess levels of mucus, phlegm or catarrh.

Baptisia tinctoria

Baptisia tinctoria is a potent antimicrobial and is often used in preventing and treating infections of the ears, nose, throat, and chest through its anti-viral and antibacterial properties. It’s considered that antimicrobial herbs such as Turmeric, Garlic, Echinacea, and Wild Indigo are best combined with decongestant and astringent herbs as hot teas (1, 15).

Horseradish (A. rusticana/C.armoracia)

Both horseradish species are indicated in cold, damp, and mucous-based conditions of the respiratory system such as excess mucous production characterized by coughing, sinusitis, chronic bronchitis, and chronic asthma. It will remove excess phlegm and stagnation by encouraging expectoration and acting as a decongestant (15).

Ground ivy

Ground ivy (G. hederacea) is a wonderful herb for both nasal and bronchial catarrh, specifically for sinusitis. It is a mucous membrane restorative, expectorant, and astringent for the upper respiratory system (2)

Gallium aperine

Gallium aperine is a lymphatic tonic. G. aperine enhances lymphatic circulation, helping the body to cleanse, purify the blood and promote immune function. It is often used in conditions where there is lymphatic congestion (1).

Holistic solutions

Nasal irrigation

Rinsing the nasal passages with a saltwater solution can help remove any excess mucous and irritants inside the nose, reducing inflammation and relieving sinusitis symptoms (14). Also known as a Jala Neti, it has a long tradition within Ayurvedic practices, where it is still a common practice performed using a teapot shape device called a neti pot.

Essential oils

Essential oils used externally such as thyme, peppermint, rosemary, lavender or chamomile are good as inhalants, baths, or massages around the nose and sinuses (1,11). Steam inhalation containing anti-inflammatory and antimicrobial herbs such as tea tree, pine, or chamomile may be useful (3,15).

Traditional Chinese acupressure

In a 2002 study, The American Journal of Chinese Medicine found that subjects receiving acupressure treatment for sinusitis had significant improvement of both nasal and non-nasal symptoms (13). There are some excellent resources online that outline the non-invasive and effective techniques of using finger pressure at specific points.

Lymphatic drainage and facial massage

Lymphatic drainage and facial massage techniques can help relieve sinus pain by breaking up the mucous that collects in the sinus cavities, clearing the passageways, alleviating congestion and pressure to the neck and the face can help to decongest the painful swelling in the sinus mucous membranes and nasal cavity. Both these techniques are not recommended in the acute stages of infection without guidance from a professional.

Supplements

Supplements such as vitamin C and D, and probiotics (to support gut health) can also be beneficial in the treatment and prevention of sinusitis. Vitamin C is a powerful antioxidant, which helps to reduce damage to the cells of the body and supports immune cell function. Low vitamin D levels have been linked with conditions where there are high levels of inflammation such as sinusitis. Vitamin D is essential for a strong immune system, but it is advised to have your vitamin D levels checked before starting supplementation.

Anti-inflammatory diet

Focus on a whole food anti-inflammatory diet. Gluten, dairy, and sugar increase mucosal production and excess phlegm leading to increased congestion and discomfort. Poor gut health and diet can exacerbate the condition and lead to overgrowth of Candida in both the digestive and sinus mucosal membranes. If you are concerned about gut health or candida overgrowth, please do see a herbalist who will be able to recommend an individual herbal approach and nutritional plan.

References

McIntyre A. The Complete Herbal Tutor. 2nd ed. London: Aeon; 2019.
Stableford A. Handbook Of Constitutional And Energetic Herbal Medicine. 1st ed. London: Aeon; 2020.
Bone K, Mills S. Principles And Practice Of Phytotherapy. 2nd ed. Edinburgh: Churchill Livingstone; 2013:246.
Scadding G. Rhinitis and Sinusitis. Clinical Respiratory Medicine. 2008:409-423. doi:10.1016/b978-032304825-5.10032-7
Allied EMT. Sinusitis Image.; 2022. https://aentsc.com/wp-content/uploads/2020/08/sinuses_1155957880-1024×649.jpg. Accessed February 4, 2022.
Smith S, Evans C, Tan B, Chandra R, Smith S, Kern R. National burden of antibiotic use for adult rhinosinusitis. Journal of Allergy and Clinical Immunology. 2013;132(5):1230-1232. doi:10.1016/j.jaci.2013.07.009
DeBoer D, Kwon E. Acute Sinusitis. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK547701/. Published 2022. Accessed February 4, 2022.
Battisti A, Modi P, Pangia J. Sinusitis. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK470383/. Published 2022. Accessed February 4, 2022.
De Sutter A, Lemiengre M, Merenstein D, Young J, van Driel M. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database of Systematic Reviews. 2006. doi:10.1002/14651858.cd006089
Ponikau J, Sherris D, Kern E et al. The Diagnosis and Incidence of Allergic Fungal Sinusitis. Mayo Clin Proc. 1999;74(9):877-884. doi:10.4065/74.9.877
Sebeşan M, Cărăban A. Analysis of the Essential Oils from Thyme (Thymus vulgaris L) and from Peppermint (Mentha piperita L). Citeseerx.ist.psu.edu. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.551.1150&rep=rep1&type=pdf. Published 2008. Accessed February 4, 2022.
Community Herbal Monograph on Echinacea pallida (Nutt.). Ema.europa.eu. https://www.ema.europa.eu/en/documents/herbal-monograph/superseded-community-herbal-monograph-echinacea-pallida-nutt-nutt-radix_en.pdf. Published 2009. Accessed February 4, 2022.
Xue C, Zhang T, Zhang C, Da Costa C, Story D, Thien F. Effect of acupuncture in the treatment of seasonal allergic rhinitis: results from a randomised controlled trial. Integr Med Res. 2015;4(1):4. doi:10.1016/j.imr.2015.04.293
Mari Egan J. Saline irrigation spells relief for sinusitis sufferers. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183918/. Published 2009. Accessed February 4, 2022.
Yarnell E. The Botanical Approach to Chronic Sinusitis. Alternative and Complementary Therapies. 1998;4(2):109-111. doi:10.1089/act.1998.4.109

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Allergies: A traditional Chinese medicine perspective

Jessika Thiele — Sat, 05 Mar 2022 11:57:23 +0000

In TCM, there is no overarching disease category for allergies as we understand them in the west. Rather, the clinical manifestations relating to allergies are essentially seen as an imbalance in the body’s energies (qi).

Understanding allergies

Allergies involve an excessive immune response to normally harmless substances such as pollen, dust mites, pet hair, mould and certain food and drugs. Hayfever (allergic rhinitis) is perhaps the best known of these conditions, with around 49% of people in the UK reporting symptoms in a 2020 study. Other allergies include skin allergies, asthma and food allergies. As a disease category, they are the most common chronic disease in Europe and, globally, appear to be on the rise (1).

Traditional Chinese Medicine (TCM) has a long history of treating allergic conditions and seeks to both provide symptomatic relief and correct underlying causative factors.

How do allergies work in TCM?

In 1911, Austrian scientist, Clemens von Pirquet, named this heightened immune response ‘allergy’; allos being Greek for ‘altered’ and ergeai meaning‘energy’ (2). As it happens, this is an apt description of the TCM perspective of allergies. In TCM, there is no overarching disease category for allergies as we understand them in the west. Rather, the clinical manifestations relating to allergies are essentially seen as an imbalance in the body’s energies (qi).

Perhaps the most prominent TCM allergy pattern is that of deficient defensive qi (wei qi). Circulating beneath the skin, our defensive qi forms our immunity to the external environment. It originates from a combination of Kidney qi (constitutional energy), Lung qi (energy from respiration) and Spleen qi (digestive energy). If any of these pivotal energies are weak, our wei qi is compromised and fails to provide the exterior defence needed to repel external pathogens (allergens) (3).

Allergens typically fall in to the category of external wind; the external pathogen which enters the body most readily (often combined with another factor eg. wind cold), is at its most prevalent in Spring and, like the wind itself, is moving and changeable in nature, often appearing with speed. Acute hives (urticaria) – an allergic skin reaction – illustrate this concept pointedly both in their nature – the sudden eruption of raised, itchy welts – and TCM name; ‘feng zhen’ (‘wind rash’) (4).

At the most superficial level, wei qi deficiency can result in such skin allergies. Here, weakened wei qi allows penetration of the skin by ‘toxins’ and the resultant battle between our qi and the pathogenic factor generates heat and dampness which accumulates in the skin in the form of lesions (4).

Going a little deeper, allergic rhinitis results when external pathogens penetrate the mucous membranes of the nose and throat and lodge, causing irritation and inflammation and disrupting the proper flow of lung qi in the nose causing sneezing (3).

Further still, weak wei qi allows wind to enter the lungs causing inflammation, the constriction of airways and disruption of the descending function of the lungs resulting in cough and wheeze, i.e. allergic asthma.

Food allergies arise from a weakness in our digestive energy, governed in TCM primarily by our Spleen and Stomach functions and fired by our Kidney qi.

In addition to deficiencies, allergies often occur against a backdrop of pre-existing excess in the body, making these conditions both more likely and severe. These ‘internal excesses’ are what TCM describes as pathogenic factors. Wind, heat, dampness, phlegm and dryness often feature in allergic conditions. These can be external or internal in origin, determine the symptom expression of the allergy, stem from a variety of sources to create an intolerant constitution and hypersensitivities which are then triggered by ordinarily harmless substances. Retained heat in the body, for example, may be likened to chronic low-grade inflammation stemming from the Th2-dominant immune milieu common to atopic individuals. (5)

Understanding the root

Constitution

There is often a family history of allergies in individual allergy sufferers. This fits with the TCM view that our inherited constitution (ie. Kidney qi) greatly impacts the likelihood of experiencing allergies.

Lung qi deficiency

This can be due to many factors including aninherited constitutional weakness of the Lungs, previous respiratory illness, a sedentary lifestyle, over-exercising, poor posture leading to shallow breathing, smoking, air pollution, stress and unresolved grief.

Spleen qi deficiency

Spleen qi is weakened in particular by stress, over-thinking, poor eating habits (ie. eating on the run/ at the desk) and by a damp diet; one that features excessive dairy, cold, raw, greasy, sweetened foods, alcohol, antibiotics and (for some) wheat. Children have underdeveloped digestive energy and are, therefore, especially sensitive to damp diets and prone to the development of dampness and allergies.

Signs and symptoms

Allergic rhinitis

Typical symptoms of allergic rhinitis – blocked nose, nasal discharge, sneezing – will be accompanied by the following patterns:

Wind: Acute rhinitis with cold (nasal discharge will be thin and clear) or heat (thick, yellow/green discharge, red itchy eyes, thirst). Responds well to treatment.

Kidney qi deficiency: Chronic rhinitis. As it is often a constitutional deficiency, is typically present from childhood. Symptoms worse following sex and when overworked as these deplete Kidney qi. Accompanying symptoms may include typical Kidney deficiency symptoms such as weak and sore knees and lower back, low libido and premature aging and/ or signs of Kidney yin deficiency (eg. nightsweats, dry mouth at night, red tongue) or yang deficiency (eg. cold lower back, profuse, clear urination, pale tongue). Treatment of this pattern will require time and dedication as Kidney qi is our core energy and not easily replenished.

Lung qi deficiency: Recurrent episodes of hayfever, frequent colds, shortness of breath, possible accompanying asthma.

Lung and Spleen qi deficiency with Phlegm: Recurrent hayfever with copious mucus, foggy head, fatigue, poor appetite, loose stools, swollen tongue with teeth marks (3).

Skin allergies

Allergic skin reactions such as eczema (atopic dermatitis), contact dermatitis and urticaria (hives) can cause itching, burning, redness, bumps and swelling. Generally speaking, in TCM the level of heat present relates to the level of inflammation and redness, dampness to swelling and oozing, wind to itching and dryness to dryness and scaling (4).

Food allergies

The characteristic symptoms of food allergy flare-ups – itchy mouth, hives, swollen face, mouth and throat, difficulty swallowing, wheezing or shortness of breath, dizziness, nausea or vomiting, abdominal pain or diarrhoea, hay fever-like symptoms and possible anaphylaxis (severe allergic reaction and medical emergency) – may be accompanied by the following pre-existing patterns:

Spleen qi deficiency: Frequent loose stools,poor appetite, fatigue. This pattern is particularly common in children.

Spleen yang deficiency: As per Spleen qi deficiency with cold signs, eg. cold intolerance, lower abdomen that is cold to the touch, abdominal pain alleviated by warmth, nausea or vomiting better for warm foods, undigested food in stools. (6)

Herbal solutions

TCM formulae used in the treatment of allergies are many and varied, depending on the condition, presenting symptoms and underlying imbalance. However, some commonly used herbs and formulas include:

Astragalus (Astragalus membranaceus)

Allergic rhinitis

huang qi (Astragalus membranaceus, Astragalus root): adaptogen, diuretic, anhydrotic (stops sweating), antiviral, antioxidant. Animportant immune-booster and Lung tonic, huang qi fortifies qi and defensive qi and enhances digestion, thereby addressing the primary underlying causes of allergic rhinitis. Along with xin yin hua and cang er zi, these are the three most common herbs found in TCM formulae for hayfever (7,8).

xin yi hua (Magnolia liliflora, Magnolia flower): diaphoretic, decongestant, expectorant, aromatic stimulant. A primary herb for unblocking the nasal passages in all varieties of patterns, xin yi hua also ‘releases the exterior’ making it appropriate for externally-contracted wind conditions (7,9). May also be used as a nasal rinse (3).

cang er zi (Xanthium sibiricum, Xanthium fruit): analgesic, anti-inflammatory, antibacterial, stimulant. Slightly toxic and drying, cang er zi shares the functions of xin yi hua but also dries dampness and, therefore, nasal discharge and alleviates sinus headache (7,9).

Yu Ping Feng San (Jade Windscreen Powder): huang qi (Astragalus membranaceus, Astragalus root), bai zhu (Atractylodes macrocephala, white Atractylodes), fang feng (Ledebouriella divaricata, Siler). Creating a ‘screen’ against the wind, as the title suggests, this is a popular formula to tonify defensive qi. Bai zhu strengthens digestion, thus, defensive qi and fang feng (‘guard against wind’), releases the exterior. It is ideally used as a preventative formula against allergic rhinitis to build up the Lungs and immunity. In the case of perennial rhinitis, it may be used in between episodes and for seasonal allergic rhinitis, it is best taken over a period of several months in the lead up to allergy season. When taken for symptomatic relief, it is often combined with Cang Er Zi San (Xanthium Powder)(cang er zi, xin yi hua, bai zhi (Apiaceae dahurica, Angelica root), bo he (Mentha haplocalyx, Mint)). (7,10)

Skin allergies

Common TCM treatment strategies for skin allergies involve clearing damp, heat and wind with herbs such as jin yin hua (Lonicera japonica, Honeysuckle), fang feng (Ledebouriella divaricata, Siler) and ku shen (Sophora flavescens, Sophora root). Chronic conditions may also require the nourishing of Blood and dryness with herbs such as dang gui (Angelica sinensis, Chinese angelica root).

External application of herbs is also an important component of TCM dermatology. San Huang Xi Ji (Three Yellow Wash) – a wash applied twice daily until symptoms subside – is a popular formula for contact dermatitis, containing the three huangs; da huang (Rheum palmatum, Rhubarb), huang bai (Phellodendron amurense, Phellodendron) and huang qin (Scutellaria baicalensis, Scutellaria root). (4)

Food allergies

Wu Mei Wan (Mume Pill), a TCM formula traditionally used to treat intestinal parasites, chronic diarrhea and dysenteric disorders, is the basis of FAHF-2 (Food Allergy Herbal Formula – 2), a novel TCM formula involved in a number of promising clinical trials, some of which approved by the US FDA. FAHF-2 utilises the internal-warming properties of Wu Mei Wan (minus two of the toxic herbs) and combines this with the immunomodulatory, anti-inflammatory and anti-allergy properties of addition, ling zhi (Ganoderma Lucidum, Reishi mushroom) (11). It “has been shown to be highly effective in providing long-term protection against peanut-induced anaphylaxis, with a high safety margin” (12).

Holistic solutions

Acupuncture: Acupuncture is an important adjunctive treatment to TCM for the treatment of allergies for its immunomodulatory, anti-inflammatory and analgesic properties (13,14).
Strengthen the Lungs: For tips on optimising lung health see Respiratory health: A Traditional Chinese Medicine perspective, Respiratory health: An Ayurvedic perspective and Keeping your lungs healthy
Strengthen the Spleen: Adopt healthy eating habits including relaxing while eating and eating slowly and adopting a diet low in damp-forming foods.
Incorporate relaxation techniques in to your everyday life
Skin allergies: During an outbreak avoid damp or ‘heating’ foods (eg. spicy foods, lamb, shellfish, duck, alcohol, chocolate, caffeine) (4).
Hayfever: Daily nasal flushing with warm salty water clears and strengthens the mucous membranes of the nose and sinuses. Powdered gan jiang (dried ginger) mixed with honey and applied to the nasal cavity may also be beneficial in cases from Lung qi deficiency (3).

References

Allergy UK https://www.allergyuk.org/about-allergy/statistics-and-figures/
Dwyer J. The Body At War: How Our Immune System Works. 2^nd ed. London: J M Dent; 1993.
Maclean W, Lyttleton J. Clinical Handbook of Internal Medicine: The Treatment of Disease with Traditional Chinese Medicine. Vol 1. Sydney: University of Western Sydney; 1998.
De-Hui S et al. Manual of Dermatology in Chinese Medicine. Seattle: Eastland Press; 1995.
Powell M. Medicinal Mushrooms: A Clinical Guide. Eastbourne: Mycology Press; 2010.
Maclean W, Lyttleton J. Clinical Handbook of Internal Medicine: The Treatment of Disease with Traditional Chinese Medicine. Vol 2. Sydney: University of Western Sydney; 2002.
Tierra L. Healing with the Herbs of Life. New York: Crossing Press; 2003.
Li D et al. ‘Mechanisms of traditional Chinese medicines in the treatment of allergic rhinitis using a network biology approach’. Journal of Traditional Chinese Medical Sciences. January 2021; 8(1). doi.org/10.1016/j.jtcms.2016.11.007.
Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. 2nd ed. Washington: Eastland Press; 1993.
Barolet R, Bensky D. Chinese Herbal Medicine: Formulas and Strategies. Washington: Eastland Press Inc.; 1990.
Tasaka K et al. ‘Anti-allergic constituents in the culture medium of Ganoderma lucidum’. Agents Actions. April 1988; 23(3-4):153-6. doi: 10.1007/BF02142526.
Wang J, Li X-M. ‘Chinese Herbal Therapy for the Treatment of Food Allergy’. Curr Allergy Asthma Rep. August 2012; 12(4): 332–338. doi: 10.1007/s11882-012-0265-4.
Pesheva E. ‘Quieting the Storm’. The Harvard Gazette. August 2020. https://news.harvard.edu/gazette/story/2020/08/study-reveals-acupuncture-affects-disease-course/
British Acupuncture Council. ‘Allergic Rhinitis’.

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Allergies: An Ayurvedic perspective

Jessika Thiele — Sat, 05 Mar 2022 11:24:04 +0000

From an Ayurvedic perspective, the underlying cause of allergies is the accumulation of toxins and low immunity.

Understanding allergies

An allergy is a reaction the body has to a particular food or substance (8). The difference between an intolerance or sensitivity and an allergy is that an allergy will trigger an immune system reaction that can affect numerous organs of the body (11).

Over the last 50 years the incidence of allergies has increased exponentially. Worldwide about 1/3 of people experience some sort of allergy with this increasing to half in the Western world. This is quite shocking considering that 100 years ago allergies were much rarer. In places where people still live subsistence lifestyles allergies are practically non-existent. This changes where a more Western style of living is embraced. The UK, Europe, Australia and the USA have the highest rates of allergies (2).

40% of children in the UK have been diagnosed with an allergy. Back in 2010 it was reported that 44% of British adults were diagnosed with at least one allergy. The number of people living with allergies in the UK rises by 5% every year (3).

How do allergies work?

Adults and children may experience allergies caused by a variety of things. Environmental or inhalant allergies caused by pollen, dust or animal dander, often referred to as hay fever. Food allergies are common with triggers such as nuts, shellfish, eggs. Chemical allergies to synthetic substances like food additives, pesticides, pharmaceuticals and household cleaners are also common (12).

The ‘Hygiene Hypothesis’ has been put forward as to why allergies are far more common in the Western world. The possibility of the “clean” surroundings, immunizations and antibiotics that are prevalent in these countries reduce children’s exposure to infections. It is thought that the IgE system, which is part of the immune response that causes allergy symptoms, evolved as a defence against intestinal parasites, which are still common in many less economically developed countries. If the immune system isn’t exposed to infections, it then focuses on dust or pollen or food, which in reality are not a threat at all (12).

Understanding the root

From an Ayurvedic perspective, the underlying cause of allergies is the accumulation of toxins and low immunity (1).

70% of our immune system is in our gut. Ayurveda places great importance on how good digestion is vital for optimum health. Incomplete digestion or digestive disorders contribute to the formation of ama, a toxic residue that can stagnate and ferment in the gut. When agni (digestive fire) is strong our food is digested and absorbed which provides nourishment for all of our cells. The digested food that is not required is removed via the elimination pathways (malas). Eating the wrong foods for our unique mix of doshas (vata, pitta and kapha), incompatible food combinations and unaddressed stress or emotions can weaken agni and lead to the formation of ama (5).

If the doshas are out of balance and combine with ama it becomes known as sama (sama vata, sama pitta and sama kapha) (5).

If ama is not cleared from the body and continues to build up, it can travel via the channels of circulation (strotas) and settle in weak areas of the body, which could be the respiratory system or other areas prone to allergies (1).

Overtime this settled ama will mix with sub-doshas, malas or dhatus (tissues) to become amavisha, a far more toxic and reactive form of ama (7).

Whilst ama is sticky, clogs channels and can create imbalances in the doshas, it doesn’t affect the chemical balance of the immune system. Amavisha’s reactive nature disrupts the immune system resulting in its loss of ability to deal with sudden change (4).

During the change of seasons, for example as winter turns to spring, the kapha that accumulates in our bodies over winter starts to liquefy weakening agni. Pollen is also being released by newly blossoming plants. These both can contribute to an immune response, formation of congestion and allergy symptoms due to already challenged immune system with amavisha (9).

Amavisha reacts with pollen or other potential allergens making it hard for cells to function properly at that site of the body. If this reactions affects the skin it could result in rashes or irritation, in the lungs it can cause respiratory issues (4).

It is important to understand that it is not the allergens causing the reaction but the presence of amavisha. It is possible to prevent these reactions by undertaking cleanses at the change of season (4).

Amavisha is also the root cause behind allergies that arise later in life with foods and environmental irritants. Here it is not necessary to wait for the change in season to cleanse, it can be started straight away (4).

According to Ayurveda, the reason more children are experiencing allergies today is that they are not being fed a nutritious diet full of the intelligence of nature, instead living on a diet of frozen, canned, packaged and ultra-processed foods. Their diets also lack spices and herbs that aid digestion and promote good gut health. Children’s immune systems also need to be challenged with time spent outside interacting with earth and water with exposure to fresh air and the sun (4).

Signs and symptoms

Allergic reactions usually happen quickly within a few minutes of exposure to an allergen (8). They can cause:

Sneezing
A runny or blocked nose
Red, itchy, watery eyes
Wheezing and coughing
A red, itchy rash
Worsening of asthma or eczema symptoms

Herbal solutions

Ama is cold and heavy. It can be cleared using heat such as sipping on warm water throughout the day and using warming spices. Amavisha is very hot so needs to be removed with care using cooling herbs and spices.

Amavisha detoxing tea

Boil 1 liter water and steep the following for 20 minutes

½ teaspoon whole coriander seeds
½ teaspoon slippery elm powder
½ teaspoon licorice powder

Coriander pulls out amavisha and directs it to urine to be removed away from the skin

Slippery elm and liquorice lubricate the channels so they don’t rupture or become inflamed as the hot toxin is removed (10).

Ayurveda formulas

These formulas contain herbs and spices that are warming, help to stimulate the digestive fire (agni) and will clear ama (toxins) therefore reducing the likelihood of allergies.

Trikatu: A classic Ayurvedic blend of ginger, long pepper and black pepper
Trikulu: A lovely blend of clove, cinnamon and cardamom
Hingwashtaka churna: A formulation consisting of long pepper, black pepper, ginger, celery seed, cumin seed, caraway seed, asafoetida and rock salt

Single herbs

Turmeric (Curcuma longa)

When used in moderation helps to balance agni and removes ama from the strotas. It is a good anti-inflammatory and protects from environmental toxins

Coriander (Coriandrum sativum)

Coriander (Coriandrum sativum)

Balances all doshas, cools hot, inflammatory conditions, stimulates agni and clears ama

Dried ginger (Shunthi)

Clears blockages due to ama or kapha, increases agni, relieves congestion, is anti-inflammatory and enhances immunity

Guduchi (Tinospora cordifolia)

Stimulates agni, promotes good gut flora while removing ama from the gut and strotas. Protects the liver, clears heat, toxins and enhances immunity

Long pepper (Piper longum)

Used for kapha conditions such as congestion and allergies, increases circulation to the lungs, increase agni and clears ama

Nettle (Urtica dioica)

Excellent detoxing remedy for a spring cleanse, removes excess kapha from winter and reduces pitta in preparation for spring or summer heat, clears ama and is an excellent anti-histamine

Dandelion (Taraxacum officinale)

Good for including in spring detoxes as reduces kapha by flushing out excess fluids and toxins. Increases agni but cools excess pitta in the liver and supports the liver in its detoxifying work

Albizia (Albizzia lebbeck)

Excellent ability to clear ama, excess pitta and kapha. Good for itching, inflammation and infection

Holistic solutions

Detoxifying cleanse

For seasonal allergies Ayurveda recommends cleansing just before the arrival of spring to remove the kapha and impurities accumulated over winter. Another cleanse is recommended as autumn arrives.

Eat a light, nourishing diet of cooked, lightly-spiced organic, fresh vegetables and fruits, whole grains, and dhal soups for protein. Ensure all food is warm, fresh, spiced with small amounts of ghee. Avoid heavy foods such as red meat, hard cheese, cold foods or ultra-processed foods containing chemicals and preservatives.

Sip warm water throughout the day to help remove ama.

Balance agni

Eat lighter meals that don’t overburden the digestive system
Don’t overeat and only eat when hungry
Eat your largest meal at lunch time when agni is strongest
Eat mindfully focusing on your food without any technology distractions
Eat freshly cooked foods

Reduce stress

Mindfulness, meditation and pranayama breathing exercises help to reduce stress and enhance the cleaning process of emotional ama.

Nasal irrigation

Fill a neti pot with warm water, add a pinch of salt and rinse the nasal cavity. This helps to remove irritants, reduce inflammation and congestion. It also helps to keep the mucus membranes healthy so that they can trap dust, pollen, viruses and bacteria.

Nasaya

This is the application of herbal oils to the nasal passage. The oil helps dry or inflamed nasal passages and reduces symptoms of allergies. Nasaya also helps to keep the mind and senses sharp.

Avoid allergens

Increase indoor air quality with spider plants and holy basil. Avoid exposure to pesticides by eating organic foods as much as possible, use chemical free household products and body care products, use a good quality water filter.

References

Sharma, V., 2018. Ayurveda and Allergy Cure All Type Of Allergies Naturally by Vipul Sharma. [online] Boloji.com. Available at: <https://www.boloji.com/blog/1989/ayurveda-and-allergy> [Accessed 17 February 2022].
Allergies and Health. Why are allergies increasing? n.d. [online] Available at: https://www.allergiesandhealth.com/general/allergies-increasing [Accessed 17 February 2022].
Natasha Allergy Research Foundation. 2019. Why are Allergies on the Rise? Allergy Statistics — Natasha Allergy Research Foundation. [online] Available at: <https://www.narf.org.uk/the-allergy-explosion> [Accessed 19 February 2022].
Mapi.com. n.d. Allergens: The Ayurvedic Solution| Maharishi AyurVeda. [online] Available at: <https://mapi.com> [Accessed 16 February 2022].
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield, pp.196-224.
Lad. and Frawley., 2001. The Yoga of Herbs. Lanham: Lotus Press.
Precision Ayurveda for Disease Care & Sustained Wellbeing. n.d. Allergies. [online] Available at: <https://ayurvaid.com/allergies> [Accessed 17 February 2022].
nhs.uk. n.d. Allergies. [online] Available at: <https://www.nhs.uk/conditions/allergies/> [Accessed 19 February 2022].
Vine Professional, 2014. Allergies: The Ayurvedic Picture. [online] Banyanbotanicals.com. Available at: <https://www.banyanbotanicals.com/info/blog-banyan-vine/details/allergies-the-ayurvedic-picture/> [Accessed 20 February 2022].
Teitelbaum, M., 2019. Healing the Thyroid with Ayurveda. 1st ed. Vermont: Healing Arts Press, pp.64-67.
Li, J., n.d. Food allergy vs. food intolerance: What’s the difference?. [online] Mayo Clinic. Available at: <https://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538> [Accessed 21 February 2022].
Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160(1):1-9. doi:10.1111/j.1365-2249.2010.04139.x

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Hayfever

Jessika Thiele — Sat, 19 Feb 2022 10:14:18 +0000

Hayfever (or seasonal allergic rhinitis) is an allergic reaction of the nasal passages and airways to wind borne pollens.

Understanding hayfever

Hayfever (seasonal allergic rhinitis) occurs mostly between late March and September, when high concentrations of pollen are released into the environment. If hayfever develops in spring, it is usually caused by tree pollens. If it develops in summer, grass and weed pollens are usually responsible (1).

Perennial allergic rhinitis occurs when symptoms are present all year round, and can be triggered by other common allergens such as dust mites, pets, mould, or even sensitive foods. The condition shares many features with asthma, as the mechanisms responsible for both the development and treatment are similar.

Symptoms, include watery nasal discharge, sneezing, and itchy eyes. Hayfever sufferers may feel worse during warm, humid and windy weather. Natural changes in temperature during the morning or evening may also make symptoms worse. Hayfever can affect both adults and children.

How does hayfever work?

An allergy is an unnecessary immune response to a harmless substance, in this case, grass, tree and weed pollen (3). Exposure to these allergens triggers a hyper-reactive response which causes the body to release histamine and allergic antibodies known as immunoglobulins, in an attempt to neutralise the perceived invader.

Some people have an inherited tendency towards allergies, a condition known as atopy. Atopic individuals are more prone to asthma, eczema and hay fever (the atopic triad) (12).

When exposed to pollen, mast cells (specialised white blood cells found in a variety of body tissues) release chemicals that control or produce inflammation. These inflammatory mediators are responsible for many of the allergic responses seen in hayfever.

Once the mast cells have been exposed to the allergen, they then become “sensitised” meaning that each time the perceived invader is encountered, an allergic reaction is triggered.

Understanding the root

There are a number of factors that may pre-dispose people to develop hayfever. Usually, one or more of these factors combine to initiate or exacerbate symptoms. Herbalists offer a personalised approach to each individual case. Tailored advice takes into account a person’s lifestyle, environment and genetic factors to create a suitable, effective treatment plan.

Allergic rhinitis is common and affects 10–15% of children and 26% of adults in the UK. (11) Unfortunately, this number is continuing to rise. (3) One of the reasons is thought to be linked to changes in our modern lifestyle that have altered our exposure to the diversity of microbes we come into contact with.

The Hygiene Hypothesis describes how children in families with older siblings are less likely to develop allergies due to an increased incidence of infections in early childhood, transmitted from older siblings (4). This theory has developed into what is now known as the ‘Old Friends Mechanism,’ which explains how exposure to a wide range of microbes in early life may help with the development of a properly regulated immune system, which is less likely to overreact to harmless allergens.

Less breastfeeding, smaller families, increased antibiotic use, and chemicals used in food production, all have an impact on the diversity of the gut microbiome, which makes up a large portion of our immune system (13).

Both leaky gut syndrome and an overgrowth of the common yeast Candida albicans have also been implicated in the development of allergic conditions such as hayfever (1).

Leaky gut syndrome is where the gut lining has been compromised, allowing large molecules of food that have not been properly absorbed to find their way into the body. This creates an increased level of allergic compounds in the circulatory system, which in turn increases the likelihood of an allergic response (1).

Signs and symptoms

Hayfever can have a significant impact on a person’s life.

Anxiety is common among hayfever sufferers. Up to 56 % fear others may think their symptoms are related to covid 19 (5). Others avoid going outside due to worry about exposing themselves to allergens. Due to the irritation caused to the nasal passages and throat, sufferers often endure poor quality sleep, compounding the feelings of tiredness and lethargy caused by their symptoms during the daytime.

Common symptoms include:

Sneezing and coughing
A runny or blocked nose
Itchy, red or watery eyes (allergic conjunctivitis)
Itchy throat, mouth, nose and ears
Loss of smell
Pain around the temples and forehead
Headache
Earache
Feeling tired
The sensation of mucus running down the back of the throat (post-nasal drip)

Herbal solutions

Herbs are not usually prescribed as a single remedy, but as part of a prescription tailored to the individual needs of each patient. The following list represents a small variety of remedies (from the vast number of options available) which may be considered useful as part of a formula. When formulating a prescription, herbalists always try to match the energy (qualities of the plant such as warming, drying etc) to the nature of both the symptoms, and the patient’s constitution.

Marshmallow (Althaea officinalis)

Anti-histamine / anti-inflammatory herbs

In studies, extracts of nettle (Urtica dioica) were shown to inhibit the inflammatory action of mast cells, preventing the release of the chemicals that cause the symptoms of hayfever (6).

Eyebright (Euphrasia officinalis) has long been used as a traditional remedy for supporting the mucous membranes. It is useful in cases of acute or chronic inflammation, particularly where the eyes are involved.

Marshmallo w (Althaea officinalis) helps soothe irritation and calm inflammation of the affected tissue.

The following herbs also help tone mucous membranes and de-sensitise them to allergens.

For gut dysbiosis

Licoric e (Glycyrrhiza glabra) has a long history of use as an anti-inflammatory and anti-allergy agent.

Garlic (Allium sativum) contains pre-biotic (a substance which promotes the growth of beneficial gut micro-organisms) and anti-bacterial compounds. It may therefore be useful for people whose hayfever symptoms are linked to candida overgrowth or leaky gut syndrome.

Liver supportive herbs to help remove the offending allergen from the system

Dandelion (Taraxacum officinale) stimulates the mucous membranes and absorbs toxins from the bowel, helping beneficial flora to thrive, and inhibiting the growth of unhealthy bacteria (10). Gut bacteria play a crucial role in immune response and play an impactful role in the allergic response. Dandelion also helps the very important liver detoxification required to minimise systemic allergic responses (8).

A note of caution: In some sensitive individuals, allergic rhinitis can be caused by pollen from common herbs which also flower in the summer (7). This includes herbs like chamomile, plantain and nettle, which should therefore be avoided by people with known sensitivities.

Hayfever herbs

If you are unable to visit a herbalist who can create a tailored individual prescription, there are some “over the counter” herbs that may help allay some of the common symptoms associated with hayfever:

Ginger (Zinger officinale) has a pungent, warming and moving action, which helps to “melt” phlegm, thereby reducing the symptoms of a blocked nose. As a peripheral circulatory stimulant, it may also be helpful in cases of headache and painful sinuses, particularly where the lining of the mucous membrane is inflamed. It can be added to food, or is pleasant taken as a hot tea with slices of lemon or citrus peel.

Marshmallow root syrup (Althea officinalis) helps to stop the bark of an unproductive cough. It calms inflamed and irritated mucous membranes, and is particularly helpful if coughing is keeping the person awake at night (15).

Lemon balm (Melissa officinalis) helps to reduce feelings of anxiety (16). Taken as a tea, it is particularly soothing to children with its pleasant aroma and palatable flavour profile. A small dab of essential oil on a handkerchief or favourite toy not only helps to calm and soothe, but can also open up the airways and relieve inflammation.

Holistic solutions

Reduce the allergic threshold by reducing your exposure to the allergen
Install an air purifier in your home and avoid using air fresheners and aerosols which contain nasal irritants
On high pollen days, shower and wash your hair after arriving home and change your clothing.
Apply an effective allergen barrier balm around the edge of each nostril to trap or block pollens and other allergens.
Follow a detoxification, anti-candida, or gut rebalancing programme before and during hayfever season
Take vitamin C. In studies, vitamin C has been shown to be a beneficial anti-oxidant and anti-inflammatory agent that is helpful in reducing the severity of hayfever symptoms (14).
Steam baths can be useful to clear the airways, especially with essential oils like eucalyptus
Applying a balm to the nostrils can help to trap any incoming pollen preventing the allergic response

References

Murray M, Pizzorno J. The Encyclopaedia of Natural Medicine. Revised 2^nd Ed. Little, Brown & Co; 2000.
C. Gopalakrishman et al. “Effect of tylophorine, a major alkaloid of tylophora indica on immune-pathological and inflammatory reactions. Indian Journal of Medical research 71 (1980): 940-8.
Allergies. British Society of Immunology. https://www.immunology.org/ Accessed Jan 2022.
Strachan 1989. British Medical Journal. 299 (6710) 1259- 60.
Allergy UK. https://www.allergyuk.org/types-of-allergies/hayfever/ Published Jan 2022. Accessed Jan 2022.
Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009 Jul;23(7):920-6. doi: 10.1002/ptr.2763. PMID: 19140159.
Forkel S, Beutner C, Heetfeld A, Fuchs T, Schön MP, Geier J, Buhl T. Allergic Rhinitis to Weed Pollen in Germany: Dominance by Plantain, Rising Prevalence, and Polysensitization Rates over 20 Years. Int Arch Allergy Immunol. 2020;181(2):128-135. doi: 10.1159/000504297. Epub 2019 Dec 5. PMID: 31805564.
12. Cai L, Wan D, Yi F, Luan L. Purification, Preliminary Characterization and Hepatoprotective Effects of Polysaccharides from Dandelion Root. Molecules. 2017;22(9):1409. doi:10.3390/molecules22091409
Chen K, Xie K, Liu Z, Nakasone Y, Sakao K, Hossain A, Hou DX. Preventive Effects and Mechanisms of Garlic on Dyslipidemia and Gut Microbiome Dysbiosis. Nutrients. 2019 May 29;11(6):1225. doi: 10.3390/nu11061225. PMID: 31146458; PMCID: PMC6627858.
Shipard. I. How can I use herbs in my daily life? 7^th Edition. David Stewart. 2016.
Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, Durham SR, Farooque S, Jones N, Leech S, Nasser SM, Powell R, Roberts G, Rotiroti G, Simpson A, Smith H, Clark AT. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 2017 Jul;47(7):856-889. doi: 10.1111/cea.12953. PMID: 30239057.
Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J. 2015;2:10.3402/ecrj.v2.24642. Published 2015 Mar 24. doi:10.3402/ecrj.v2.24642
Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med. 2016;8(1):39. Published 2016 Apr 13. doi:10.1186/s13073-016-0294-z
Bucca C, Rolla G, Oliva A, Farina JC. Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis. Ann Allergy. 1990 Oct;65(4):311-4. PMID: 2221490.

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