Herbal Medicine 4, 2010

PHYTOTHERAPY FOR THE IMMUNE SYSTEM

CONTENTS:
Chronic fatigue Syndrome References:
Auto-Immune Disorders Mills and Bone. 2000. Principles and Practice of
Phytotherapy: Herbal Approaches to Systemic
Rheumatoid Arthritis Dysfunctions.
Case Study Pizzorno and Murray. Encyclopaedia of Natural Medicine:
2nd Ed, Little Brown Books, London

NOTE: herbs listed below under each condition in bold underline are herbs you have
covered so far in Herbal Medicine 4.

The role of the immune system is to differentiate the ‘I’ from the ‘not-I, thus operating as the
body’s defence system. The immune system protects and forms our boundaries. Hence
underlying many immune system disorders are issues around ‘sense of self’/ reactivity to the
external environment (physical, mental, emotional, situational).

CHRONIC FATIGUE SYNDROME

Causes: No established [physical] cause but the condition frequently occurs as a sequel to
viral infections such as Glandular fever (EBV). It may be an extreme post-viral reaction.

Naturopathic Understanding:
Look for when the illness started?
Is there prior history of viral activity (any glandular fever)?
Often history of upper respiratory illness
Catarrhal conditions, swollen glands
Often associated with depression (before or during)
Often nutritionally deficient
May need counselling and other therapies along with naturopathic treatment.

In practice ‘CFS’ is often a very broad and non-specific diagnosis. Individuals suffering from it
usually have unique life histories, and the causes of their condition are often varied and
complex – inherited constitution, environmental toxins, history of viral infection (including
glandular fever, Ross River Fever, influenza, toxoplasmosis, whooping cough, past E. coli
infection etc), ill effects of vaccines (eg. Gulf War Syndrome), work/ family/ relationship stress,
poor diet, and so on. Understanding the causative factors is important.
Do not expect quick improvement with these cases: slow 5-10% increments are significant.
These cases are often long-term.

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MENTAL/ EMOTIONAL PATTERN: (from Homeopathic literature/ clinical cases)
A common characteristic of M.E./ CFS sufferers is that they push themselves despite everything inside
them that says “no, stop”. They feel they have got to keep going, and they push themselves to the point
of collapse. They often set for themselves high standards that are almost beyond achievability.
While they push themselves beyond their tolerable limits, at the same time they feel this is still not
quite good enough, so they try harder still. Another symptom you’ll see with people with ME/ CFS is
that they can alternate from having zero energy to having a kind of nervous/ excess energy they don’t
know what to do with at times. As they strive to maintain their levels of effort, they gradually become
depleted and eventually collapse into a state of exhaustion that requires rest and non-activity.
They can be perfectionists, fastidious; prone to feelings of guilt that they haven’t done well enough or
let other people (or themselves) down, which drives them on to greater heights. Their need for control
can be tremendous. All the while they become physically worn out, ironically, to the point where their
level of achievement is no longer an option for them, and they have to spend long periods of time
resting from exhaustion. [Book: ‘Getting to know ME’]
As well as physical strategies, sufferers’ mental/ emotional landscapes need to be understood for them
to be able to progress through their condition.

Herbal Treatment Strategy:

Address any specific physical weakness or symptoms (eg headaches – allergy, toxicity,
muscular tension?) (Myalgia? – massage therapy etc)
Recovery may often be long and slow – need to have realistic expectations for progress.
All treatment is aimed at improving immunity and vitality.

Supportive Therapy: To improve and build overall health.

Using nutritives, tonics, adaptogens, immune modulators/ enhancers, bitters and
digestives
 Slippery Elm combined with acidophilus can be very good for addressing candida
which is often part of the condition.
Gently Detoxify: by stimulating organs of elimination (particularly liver and lymphatics);
lymphatic massage may be appropriate.
Immune Stimulation: Immune enhancers/tonics.

Herbs:
Anti-virals:
 Hypericum  Olive leaf
 Glycyrrhiza  Aloe
 Baptisia – keynote indication never well since glandular fever

Bitters: to enhance digestion and assimilation. Use bitters sparingly as they are cooling and
therefore reduce vitality. Examples:
 Matricaria  Berberis
 Verbena  Gentiana
 Taraxacum
  Cynara

You would also employ Aromatic Digestives to improve digestive enzyme production and
absorption of nutrients, such as:
 Fennel  Ginger
 Garlic  Turmeric
 Rosemary & Thyme  Cinnamon, Star Anise, Cardamom etc.

Immune enhancers:
 Echinacea  Panax Ginseng
 Hydrastis  Garlic
 Olive leaf  Andrographis
 Siberian ginseng  Astragalus

Alteratives:
 Galium aparine  Trifolium pratense
 Rumex  Iris versicolour
 Arctium  Calendula
 Urtica  Stillingia sylvatica (Queen’s Delight)

Adaptogens:
 Astragalus (the most appropriate)  Ginsengs (lower dose if appropriate)
 Withania  Liquorice
 Rhodiola  Schizandra
 Shatavari  Reishi/ Shiitake etc

Gentle Lymphatic Cleansers:

 Galium  Echinacea
 Iris  Phytolacca (small doses)
 Trigonella (Fenugreek)  Viola odorata

Tonic Nervines:
 Hypericum  Scutellaria
 Withania  Verbena
 Avena  Rosemary

Nutritives:
 Urtica  Raspberry Leaf
 Withania  Aloe

General Tonics:
 Andrographis  Urtica
 Astragalus  Spirulina and Chlorella
 Schisandra chinensis  Aloe
 Centella  Turnera (Damiana)
Other:
Diet: light and nutritious, juices.
Nutritional supplementation (very important)
Acidophilus and Ulmus, Shitake and Reishi
mushrooms (immune modulators, although be careful
with candida)
Counselling
How happy is the person in their work and
relationship(s)? Situational factors can play an
important role in auto-immune illnesses. Astragalus
Gentle exercise and stress reduction, yoga or meditation etc.
HAVE FUN!!!!!
Massage, Reiki and other gentle body work.

AUTO-IMMUNE DISORDERS
Excessive reactivity of the immune system – the body reacting against itself.
Autoimmune disorders are becoming increasingly prevalent in Western society for a
variety of poorly understood reasons, most probably related to modern lifestyle factors
interacting with genetic predisposition.
Auto-immune diseases can have different causes in different individuals.
Usually a strong genetic cause – many people have an inherited ‘auto-immune
constitution’ which predisposes them down this path. Environmental triggers play a part.
A multi-factorial problem – often complex
(primary lesion – usually a previous infection)
Immunological cross-reactivity = the immune system is provoked and then confused by
the similarity between bacterial, viral or other antigens and those of its own tissues and
attacks both.
Intestinal wall damage – often presence of leaky gut (gut permeability), gut inflammation
and damage.
Damage to gut mucosa may cause an increase in local antigenic stimulation and could
readily lead to secondary systemic immunological disorders.
Autoimmune disorders may also be caused (more often triggered) by food allergy,
environmental factors (chemicals), injury or foreign bodies (eg breast implants, rose thorn
in finger), stress and hormone changes. Pre-existing susceptibility usually exists.

Herbal Treatment Strategy:

Identify the primary lesion (the initiating cause or trigger (usually infection)/ what system,
original pathogen /bacterial, viral, fungal)
 Look for any atypical childhood illness
Any surgeries or accidents
Any severe illness in respiratory tract or GIT.

Find the trigger(s) for immune dysfunction and address them.

GIT function
Allergies/ intolerances – often wheat; dairy
Stress
Environmental factors (chemicals) etc.
Wheat: aggravates many auto-immune conditions:

General Treatment Goals:

(not applicable to all cases):
1. Decrease micro-organisms with:
Immune regulating herbs:
 Astragalus  Olive leaf
 Echinacea  Siberian ginseng
 Andrographis  Panax ginseng
 Glycyrrhiza

Anti-microbials/ Anti-infectives:
 Thuja – anti-viral and fungal
 Hypericum – anti-viral and restorative
 Garlic – lungs and GIT
 Berberis – GIT
 Echinacea – throat and GIT
 Lavendula – topically (skin disorders)
 Hydrastis – GIT antiseptic
 Propolis – GIT antiseptic
 Thyme – lung antiseptic
 Inula – lung antiseptic
 Juniper – UT antiseptic
 Buchu – UT antiseptic

2. Eliminate any possible GIT Infestation

Gentle Lymphatic Cleansers:
Vermifuges / anthelmintics:  Trigonella
 Berberis  Garlic
 Hydrastis  Thuja
 Wormwood (Artemisia absinthum)  Pumpkin seeds
 Black Walnut

3. Address possible intestinal dysbiosis (looking for GIT symptoms of bloating, irregular
bowel activity, constipation, flatulence etc)
GIT antiseptics – bacteria, viruses, yeast infection (see list above)
 Herbs: ________________________________________________

Demulcents – to address inflammation

Herbs: ________________________________________________

Bitters – to improve enzyme production.

Herbs: ________________________________________________
Acidophilus and bifidus re-inoculation.

4. Repair leaky gut

Eliminate food allergens
Avoid OH
Demulcents – Glycyrrhiza, Ulmus and Althea.
Anti-inflammatories –Matricaria and Filipendula
Vulneraries – Hydrastis, Calendula, Aloe, Propolis.
Immune modulators: ___________________________________
Bitters: _____________________________________________

5. Improve gastric secretions to ensure breakdown of proteins to reduce risk of

adverse immune response.
Bitters
Enzyme supplements
Pineapple, Kiwi, Papaya.

6. Remove toxins (both from body and environment)

Amalgams
Insecticides
Chemical exposure
Hair dyes
Use alteratives and hepatics to cleanse (Arctium lappa & Silybum)

7. Support the Organs and Systems Involved

Identify the trigger for the immune dysregulation and support and treat organs and
systems involved.
___________________________________________________

___________________________________________________
___________________________________________________

___________________________________________________
8. Decrease inflammation with anti-inflammatory
Gentle Lymphatic Cleansers:
 Aloe vera – reduces GIT wall inflammation  Picrorrhiza
 Calendula – reduces inflammation in the  Rehmannia
throat and stomach  Scutellaria baicalensis
 Dioscorea – reduces inflammation of  Turmeric
lower gut wall
 Zingiber
 Hamamelis – astringent to gut wall
 Feverfew (Tanacetum)
 Matricaria – cooling and reduces damage
to upper GIT  Filipendula
 Ulmus – demulcent to upper GIT wall.  Salix alba
 Glycyrrhiza  Stellaria media
 Bupleurum  Harpagophytum (Devil’s Claw)
 Verbascum

* Anti-inflammatory herbs are often contraindicated with the use of strong prescriptive
anti-inflammatory medications.

RHEUMATOID ARTHRITIS
RA (rheumatoid arthritis) = Autoimmune disorder where the immune system mounts an attack
against protein in the joints leading to inflammation, degeneration and eventual destruction of
the joints.
Can also affect skin, lymph nodes, lungs, liver, kidneys and heart.
RA is far more severe and generalised than osteoarthritis.

Rheumatoid Arthritis is caused by a hereditary blood factor - it is an inherited potential. It

comes down the family tree down the maternal branches – it affects women more than men.
It is present as a genetic predisposition from a long way back. It is worse in some countries,
particularly Scotland - the ‘Scottish constitution’.
Rheumatoid Arthritis involves inflammation around joints, resulting in aches, pains &
twinges. People often believe it to be part of their day-to-day ‘aches’ and may ignore it.
It is often triggered by an injury of some kind. One such traumatic trigger can be
menopause/ post-menopause time, when much trauma can be experienced by a woman.
It burns itself out if you do something about it. Otherwise it leads to overgrowth of tissue,
pain, immobilisation of joints; clawed hands/ toes, which may need surgery (if not treated
promptly). The person loses strength in the joints concerned.
Some onset of RA is in early life, which represents the extreme degree of inheritance. This is
becoming increasingly common, with children developing it more commonly at younger ages.
Rheumatoid Arthritis is much worse in hot climates and worse for humidity. It is better in
cold climates. Sufferers often feel too hot, even on a cool day. They feel hot at night.
 There is too much iron (Fe) in the blood, with not enough copper (Cu) to balance it. They
are at risk of excess-iron problems (not enough Cu to balance it), even to the point of
developing heart problems.
The underlying process is inflammation of tendons and joints - the synovial fluid burns out
Iron and heat - excess body heat. They do not sweat very much, they just burn up –
circulatory heat; florid face.
RA sufferers feel better if they can keep moving, which decreases the risk of seizing up.
Upon waking the arthritis is often worse for initial movement, then better for movement
once limbered up – a hot bath or shower will often help limber them up.
The person feels worse for heat which they shy away from, but their arthritis is better for
hot water.

Triggers:
Genetic
Trauma/ injury
Infective agents, viral, bacterial, foreign body.
Hormonal (women with RA tend to go into remission while pregnant).
Medical drugs/ vaccines.

Naturopathic Understanding:
Looking for possible leaky gut
Possible food or environmental allergy
Prostaglandin imbalance.

Herbal Treatment Strategy:

Treat GIT with bitters, demulcents and mucous membrane tonics (gut repair program if
necessary)

GIT anti-inflammatories and astringents.

Follow GIT guidelines from above section on general GIT treatment for autoimmune
disorders.

Systemic anti-inflammatory herbs and supplements.

Anodynes for pain reduction

Herbs:___________________________________________

Adaptogens to support adrenals (especially if medicated with corticosteroids)

Herbs:______________________________________________
Glucosamine, chondroitin, green lipped mussel extracts, Fish/ EPO.
Anti-inflammatory Herbs:
 Bupleurum  Boswellia (Frankincense)
 Curcuma longa (Turmeric)  Uncaria (Cat’s Claw)
 Harpagophytum procumbens (Devil’s  Zingiber
Claw)  Stellaria media (Chickweed)
 Salix alba (White Willow bark)  Cinnamonum
 Sassafras  Dioscorea (Wild Yam)
 Ruta graveolens  Phytolacca (Poke Root)
 Guaiacum – lubrication of joints  Rehmannia
 Bryonia alba (White Bryony)  Sarsaparilla

Anodynes: Adaptogens:
 Salix alba (White Willow Bark)  Rehmannia
 Filipendula (Meadowsweet)  Glycyrrhiza
 Ginsengs
Prostaglandin balancers:
 Feverfew
 Zingiber

Balance Fe & Cu levels – Red Clover

Support Measures:
Copper bracelets – are often useful for RA Castor Oil – externally.
sufferers (to balance excess iron). Linseed Oil (unrefined) - rubbed into joints
Chi-Kung finger rolls – brings Chi into the every morning & night.
hands/ fingers Electric Soda – washing soda.
also good for Raynaud’s
Carpal Tunnel Syndrome/ Dupuytren’s

Rue (Ruta graveolens) White Willow

CASE STUDY:
A 43 year old female client presents with chronic fatigue. Her symptoms include extreme
tiredness/ no energy, lethargy and mild depression.
She says her fatigue has grown steadily worse over the past year.
About two years ago she went to her doctor complaining of very sore joints following a severe
flu. Further exploration was done and she was diagnosed with RA. She has a fairly moderate
case but is on cortisone treatment to reduce the inflammation and damage to her joints. The
main joints that are currently affected are her toes and fingers.
She says that the last two years have been a nightmare. She had lots of time of work with the
flu that she had originally and since then has had to give up completely due to the pain in her
hands and the fatigue.
She used to work on an assembly line in a car factory.
She feels very depressed at the changes that have occurred in her health and she would like
some advice about where to start improving things. She would like to address all of her health
issues but particularly the fatigue and depression.
Her GIT function has always been average, but has declined over the past two years. She
suffers continually with dreadful indigestion and bloating. Her flatulence seems to be getting
worse and her stools are nearly always very soft or runny.
She also feels her immune system has gotten even worse as she seems to catch every cold
going.
She has a strong personal history of respiratory infection and has suffered with recurrent
bronchitis from the age of twelve. She used to get a bad bout most years but says that now it
is rare for her to have bronchitis but instead she suffers with very bad seasonal rhinitis.
Her current diet comprises toast and vegemite for breakfast with a cup of white tea. Lunch is
usually a ham and cheese sandwich or left over pasta and sauce. Dinner is either pasta and
sauce, sausages and mashed potato with peas, chicken nuggets with frozen vegetables or
frozen lasagne.
She consumes up to 20 white instant coffees per week (needs them for energy) and about 1-
3 cups of water daily.
She has been a smoker since age 17 and smokes about one packet daily.
She consumes no alcohol as it makes her sick.

What is your basic naturopathic understanding of this case?

What treatment goals would you like to achieve?
What treatment protocol would you suggest?
Formulate three different herbal mixes that would address this woman’s problems.