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herbal decongestant

What Is It?
Health Benefits

Forms

Dosage Information

Guidelines for Use
General Interaction

Possible Side Effects

Cautions
References
Evidence Based Rating Scale
 

What Is It?

Herbal decongestants relieve the uncomfortable swelling and stuffiness of clogged nasal passages to improve airflow and ease breathing. Most of these herbs work by reducing nasal secretions and/or shrinking swollen nasal Mucous membranes. While they can certainly be purchased and used individually, a blend of these botanicals provides the unique healing qualities of many different herbs--often in just a single pill.

First a note of warning: In the past, the primary herbal mainstay for decongesting was ephedra (also called by its traditional Chinese name Ma huang). Its synthesized form, ephedrine, is actually the basis for many prescription and over-the-counter drugs. In December 2003, U.S. the FDA banned the use of ephedra in over-the-counter herbal products due to safety concerns regarding this Herb  that arose with excessive use as a stimulant and for weight loss. (1) Large doses of ephedra have been associated with  heart attack, stroke and death.

WholeHealthMD recommends avoiding any ephedra-containing dietary supplement that may have been obtained before the FDA ban on the sale of products with this herb.

Health Benefits

Several ephedra-free herbal decongestants have been shown to be effective in relieving congestion associated with conditions like allergies, the common cold, sinusitis, and other respiratory complaints. Herbal decongestants work in different ways and may include any of the following:

  • Bromelain, ginger, dong quai, turmeric, and/or feverfew for their anti-inflammatory properties

  • Garlic as a natural Antibiotic

  • Marshmallow (the herb, not the candy) to soothe irritated mucous membranes

  • Licorice to stimulate the adrenal glands and serve as a natural anti-inflammatory

  • Elderberry to act as an antiviral and anti-inflammatory

  • Echinacea as a general immune booster

  • Peppermint leaves and stems to supply the powerful decongestant known as menthol

  • Eucalyptus leaves and branch tips to provide the decongestant known as eucalyptol

  • Goldenseal to calm inflamed mucous membranes, boost levels of germ-fighting chemicals, and battle both viruses and bacteria directly by activating white blood cells

Specifically, herbal decongestants may help to:

Control allergy symptoms. Allergy symptoms typically include a runny nose and swollen, congested, itchy nasal passages. Butterbur is a well-studied treatment for seasonal allergies that decreases levels of histamine and leukotrienes (substances that cause muscle contraction in the respiratory tract).It works as a decongestant to reduce nasal inflammation and other allergy symptoms. Taking a specific butterbur leaf extract standardized to 8 milligrams of total petasin (Tesalin, Ze 339, Zeller AG) has been shown to decrease nasal inflammation and decrease nasal allergy symptoms like itching, sneezing and runny nose. (2-5) Some evidence also suggests that the extract may reduce allergy symptoms as well as the conventional medications cetirizine (Zyrtec) and fexofenadine (Allegra). (2)

Other herbal decongestants have not been as well studied for this use, but many have a history of use in alternative medicine. Bromelain, a natural anti-inflammatory derived from pineapple, has been shown to reduce inflammation and fluid retention in the nasal membranes. In a 2006 study, bromelain reduced nasal allergy symptoms like itching and sneezing in mice. (6) Bromelain is often used in combination with quercetin, a plant pigment (or flavonoid) prominent in apples and onions, that exhibits antihistamine action. When used together, bromelain and quercetin enhance each other's anti-inflammatory actions. (7) In a small 2004 study of 12 patients with allergies, a nasal spray containing a mixture of essential oils and flavonols, including quercetin, relieved nasal congestion, sneezing and runny nose. The effect was rapid and significant, noticeable within the first five minutes of administration and lasting for several hours. (8) Quercetin also works well with nettle, or stinging nettles, to decrease the sneezing and itching that often accompanies an allergy attack. Nettle also helps reduce the swelling of nasal passages. (9) Ginger and peppermint – both natural decongestants – may also provide relief from allergy symptoms by reducing inflammation in the nasal passages. Drinking teas made from these herbs may also ease breathing. (10, 12) In a preliminary study in mice, peppermint leaf extract seemed to alleviate nasal allergy symptoms, such as itching and sneezing. (12)

Treat sinusitis. Herbal decongestants can help to alleviate the runny nose, congestion, and postnasal drip associated with acute or chronic sinusitis. This condition is characterized by persistent inflammation of the mucous membranes in the sinus cavities. It may be triggered by a bacterial infection; due to prolonged allergy attacks, to exposure to dust, smoke, or airborne pollutants; or from overuse of nonprescription nasal sprays or antihistamines. The anti-infective and mucous membrane anti-inflammatory properties of goldenseal may be helpful in easing sinusitis symptoms and hastening the healing process. It is particularly effective when used in the form of a warm sinus irrigating solution that loosens and washes away the thickened, infected mucus that can cling to the walls of the inside of the nose. (13) Research has shown that Siberian ginseng helps to relieve inflammatory symptoms of sinusitis. (14) Preliminary studies have shown that patients with influenza (flu) who take a specific combination product containing Siberian ginseng plus andrographis (Kan Jang) feel better faster than those taking the conventional medication amantadine. In addition, they have a reduced risk of post-flu complications, such as sinusitis or bronchitis. (15) Astringent substances in Eucalyptus oil, called tannins, have been shown to shrink and soothe swollen and inflamed mucous membranes in the mouth, nose, and throat, helping to relieve symptoms of sinusitis. (16, 17)

Relieve congestion associated with colds, flu, and respiratory infections. The same decongestant properties of Eucalyptus that relieve symptoms of sinusitis also help in opening clogged airways during colds,  flu, and upper respiratory infections. (16, 17) When Eucalyptus is inhaled, the oil's key medicinal ingredient, eucalyptol, also works as an expectorant, loosening sticky mucus and making it easier to cough up and out of the chest. (18) If started at the onset of sneezing, aches, congestion, or fever common in colds and flu, Echinacea purpurea preparations may reduce the severity of these symptoms and help them to subside more quickly. (19-22)

Prevent earache. Patients who are prone to developing an earache in association with allergies, colds, or upper respiratory infections may benefit from including an herbal decongestant in the treatment plan. Earaches are frequently the result of fluids backing up in the Eustachian tube – the channel between the middle ear and the back of the throat – and settling into the middle ear. The inflammation associated with allergies and upper respiratory infections like colds can cause swelling around the opening of the Eustachian tube that blocks drainage. The mucolytic and anti-inflammatory properties of Eucalyptus and Echinacea help to relieve the congestion that can lead to an earache. (23-26) When inhaled, a steam solution containing Eucalyptus oil will prompt the Eustachian tubes to open, allowing fluids to drain more easily.

Forms

  • Capsule
  • Drops
  • Nasal spray
  • Pill
  • Tea 

Dosage Information

Follow label dosage instructions, and see individual entries in the WholeHealthMD Reference Library for dosage guidelines for specific ingredients. Look for an ephedra-free product.

Guidelines for Use

See individual entries in the WholeHealthMD Reference Library for guidelines on specific ingredients contained in any particular herbal decongestant.

General Interaction

Overall, the best approach for anyone concerned about possible interactions with a specific drug or dietary supplement is to refer to the separate herb entry in our WholeHealthMD Reference Library. Your pharmacist may also provide useful information.

Possible Side Effects

See individual entries in the WholeHealthMD Reference Library for possible side effects associated with specific ingredients contained in any particular herbal decongestant.

Cautions

Look for products that do not contain ephedra, a powerful substance found in some herbal decongestants. See the ephedra entry in the WholeHealthMD Reference Library for more detailed information on this herb and the cautions associated with it.

See individual entries in the WholeHealthMD Reference Library for cautions on specific ingredients contained in any particular herbal decongestant.

References

1. U.S. Food and Drug Administration. "FDA acts to seize ephedra-containing dietary supplements." http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2005/ucm108524.htm. Accessed March 19, 2012.
2. Schapowal A. Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324:144-6.
3. Lee DK, Carstairs IJ, Haggart K, et al. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Clin Exp Allergy. 2003;33:882-6.
4. Thomet OA, Schapowal A, Heinisch IV, et al. Anti-inflammatory activity of an extract of Petasites hybridus in allergic rhinitis. Int Immunopharmacol. 2002;2:997-1006.
5. Schapowal A, Study Group. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytother Res. 2005;19:530-37.
6. Suzuki M, Itoh M, Ohta N, et al. Blocking of protease allergens with inhibitors reduces allergic responses in allergic rhinitis and other allergic diseases. Acta tolaryngol. 2006 Jul;126(7):746-51.
7. Thornhill SM, Kelly AM. Natural treatment of perennial allergic rhinitis. Altern Med Rev. 2000 Oct;5(5):448-54.
8. Remberg P, Björk L, Hedner T, et al. Characteristics, clinical effect profile and tolerability of a nasal spray preparation of Artemisia abrotanum L. for allergic rhinitis. Phytomedicine. 2004 Jan;11(1):36-42.
9. Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med. 1990;56:44-7.
10. Langner E, Greifenberg S, Gruenwald J. Ginger: history and use. Adv Ther. 1998;15(1):25-44.
11. White B. Ginger: an overview. Am Fam Physician. 2007 Jun 1;75(11):1689-91.
12. Inoue T, Sugimoto Y, Masuda H, Kamei C. Effects of peppermint (Mentha piperita L.) extracts on experimental allergic rhinitis in rats. Biol Pharm Bull. 2001 Jan;24(1):92-5.
13. Bergner P. Goldenseal and the common cold; goldenseal substitutes. Medical Herbalism: A Journal for the Clinical Practitioner. 1996-1997;8(4).
14. Gabriellan ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine. 2002 Oct;9(7):589-97.
15. Kulichenko LL, Kireyeva LV, Malyshkina EN, Wikman G. A Randomized, Controlled Study of Kan Jang versus Amantadine in the Treatment of Influenza in Volgograd. J Herb Pharmacother. 2003;3:77-92.
16. Silva J, Abebe W, Sousa SM, Duarte VG, Machado MI, Matos FJ. Analgesic and anti-inflammatory effects of essential oils of Eucalyptus. J Ethnopharmacol. 2003 Dec;89(2-3):277-83.
17. Vigo E, Cepeda A, Gualillo O, Perez-Fernandez R. In-vitro anti-inflammatory effect of Eucalyptus globulus and Thymus vulgaris: nitric oxide inhibition in J774A.1 murine macrophages. J Pharm Pharmacol 2004;56:257-63.
18. Sinclair, A. Remedies for common family ailments: 10. Nasal decongestants. Prof Care Mother Child. 1996;6(1):9-11.
19. Linde K, Barrett B, Wolkart K, Bauer R, Melchart D. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.
20. Melchart D, Linde K, Worku F, et al. Immunomodulation with Echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245–54.
21. Hoheisel O, Sandberg M, Bertram S, et al. Echinacea shortens the course of the common cold: a double-blind, Placebo-controlled clinical trial. Eur J Clin Res 1997;9:261–8.
22. Grimm W, Müller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory tract infections. Am J Med 1999;106:138–43.
23. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health Care Professionals. London, England: The Pharmaceutical Press; 1996:72-73.
24. Herbs2000. Earache. http://www.herbs2000.com/disorders/earache.htm. Accessed March 20, 2010.
25. DigHerbs. Ear Ache Herbal Remedies. http://www.digherbs.com/ear-ache.html. Accessed March 20, 2012.
26. Sharma SM, Anderson M, Schoop SR, Hudson JB. Bactericidal and anti-inflammatory properties of a standardized Echinacea extract (Echinaforce): dual actions against respiratory bacteria. Phytomedicine. 2010 Jul;17(8-9):563-8. Epub 2009 Dec 29.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies and what our clinical advisors have found to be efficacious in their personal practice into a visual and easy to interpret format. This tool is meant to simplify the information on supplements and therapies that demonstrate promise in the treatment of certain conditions.

 

Condition

Rating

Explanation

 

Allergies

   

Butterbur is well-studied and shown to be efficacious in relieving nasal symptoms; preliminary studies for bromelain, quercetin, nettle, ginger and peppermint indicate potential efficacy. More research is needed. (2-12)

Colds  
Several studies indicate efficacy of Eucalyptus and Echinacea when started at the onset of symptoms. (16-22)
Earache  
Preliminary evidence indicates potential efficacy to prevent fluid build-up in the ear; long history of use and preliminary evidence indicates efficacy to relieve congestion that causes earache. (23-26)
 

Flu  
Several studies indicate efficacy of Eucalyptus and Echinacea when started at the onset of symptoms. (16-22)
Sinusitis  
Large trials have shown efficacy of goldenseal, Eucalyptus, and Echinacea; small trials have shown benefit of specific Siberian ginseng product. (13-17)


Date Published: 04/18/2005
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