Botanicals for Upper

Respiratory Conditions

Key Points
• If cold or flu symptoms are not improving or worsening, seek medical attention immediately.
• Botanicals for cold and flu symptoms need to be started within 48 hours of symptom onset to be
effective.

Botanicals for cold symptoms

Andrographis (Andrographis paniculata)
Andrographis is a popular botanical in Ayurvedic and Traditional
Chinese Medicine for its use as a digestive aid and its ability to
boost immunity. Due to these immune-modulating and anti-viral
properties, scientific researchers have become interested in this
plant’s potential to help decrease the severity and frequency of the
common cold. The leaves contain active compounds known as
andrographolides, which help stimulate the immune system. If
taken within the 48 hours of symptoms onset , this can help fight
off an upper respiratory infection and make the symptoms less
severe. While more research is needed, there is a small body of
scientific evidence to support its use for this purpose.1

Andrographis is generally well-tolerated. Important safety concerns

include avoiding usage in people taking blood thinners and using
with caution in people who have ulcer disease. Excessive doses may
cause liver damage.

Umckaloabo (Pelargonium sidoides)

If you are struggling to pronounce the name of this plant, you are
not alone! It’s pronounced “um-cah-oo-law-boo,” but many simply
refer to it as umcka or by its scientific name, Pelargonium.
Originally from South Africa, this plant was historically used in the
treatment of tuberculosis and other infections. It has anti-microbial
and anti-viral botanical actions, making it of great interest for
symptom management of upper respiratory infections. Researchers
have studied its effects in both adults and children, showing it
possibly to be effective in alleviating the symptoms of the common
cold, but noting that much more research is needed. 2

Umcka has a good safety profile, with only rare reports of

hypersensitivity reactions.

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Botanicals for Upper
Respiratory Conditions
Echinacea (E. purpurea, E. angustifolia, E. pallidae)
Echinacea is arguably one of the more well-known botanicals on the market,
due to its purported effect in treating the common cold. It includes three
distinct species: E. purpurea, E. angustifolia, and E. pallidae. All three have
immune-modulating and anti-inflammatory properties. The fresh-pressed juice
of the aerial parts of E. purpurea is the most researched for its effects in the
symptomatic treatment of the common cold, but other species and parts of the
plant have been studied as well. Current research is inconclusive as to the
effects of echinacea on the common cold. For every positive trial showing an
effect,3 a negative one shows no effect.4,5 This may be due to the difficulty of
comparing results when different species, dosages, extraction techniques, and
plant parts are used. More research is needed regarding the usefulness of this
botanical in the treatment of upper respiratory infection symptoms.

Overall, echinacea is very well-tolerated but should be avoided in people with

asthma and eczema.

Eucalyptus (Eucalyptus globulus)

This plant is native to Australia and its leaves are a favorite food for koalas.
Humans can also enjoy the benefits of this plant. The leaves are rich in essential
oils, including eucalyptol, which acts as an expectorant and a decongestant.
Multiple research studies6-8 have looked at the effects of using eucalyptus in
the treatment of sinusitis and bronchitis with positive results. The most
commonly studied product, Myrtol, is a proprietary product of a standardized
extract of eucalyptol and is only available in Europe. Lozenges and tinctures are
additional forms of eucalyptus that are more widely available. One popular way
to use eucalyptus essential oil is in a vaporizer or steam tent to act as a
decongestant.

Eucalyptus essential oil can be toxic if ingested orally, especially in children.

Overdose reports are typically related to vaporizers at ground level that are
accessible to young children who ingest the oil. Even ingesting as little as 2–5
mL of oil can cause altered levels of consciousness in children. Care should be
taken to keep eucalyptus oil out of reach of children and to not exceed
recommended dosages.
Thyme (Thymus vulgaris)
Although best known as a popular spice, thyme can also help provide relief
from upper respiratory infection symptoms. Thyme contains an essential
oil called thymol, which has a relaxing effect on the smooth muscle in the
respiratory tract that helps ease a bad cough. A great way to administer
thyme for a cough is to make a thyme-honey cough syrup.

© 2018 Regents of the University of Minnesota. All rights reserved.

Botanicals for Upper
Respiratory Conditions
Honey
While honey is not technically a botanical, it is still an important natural
remedy that can be beneficial in the symptomatic treatment of coughs.
Honey is rich in antioxidants, has anti-microbial effects, and provides a
soothing coating in the throat that can help reduce coughing. The World
Health Organization endorses honey as a remedy for coughs.

Honey is considered very safe but is not to be given to children under one
year of age due to concerns for botulism.

Botanicals for sore throat

Slippery elm (Ulmus fulva)
The inner bark of this plant contains mucilage and can be used in the
treatment of sore throats. The U.S. Food and Drug Administration has
approved slippery elm as a demulcent. Popular ways to consume slippery
elm include lozenges and using the powdered bark as a tea.

As with other demulcents, it’s best to not take slippery elm within one
hour of another medication as it may impair the absorption of the
medication. To date, no scientific research is available to support the use
of slippery elm for sore throats, but it has an excellent safety profile and is
a botanical worth knowing about for this condition.

Marshmallow (Althea officinalis)

Right now, you may be thinking, “Marshmallow for a sore throat?!” Yes,
but botanical marshmallow is a lot different than marshmallow candy. The
marshmallow plant has soft, velvety leaves. The roots contain a compound
called mucilage, which forms a gel-like substance that can serve as a
protective coating in the throat. The demulcent activity of marshmallow
makes it useful in the treatment of sore throats.

Because heat can destroy mucilage, it’s best to prepare marshmallow at

room temperature if consuming as a tea. It’s best to not take any
medications within one hour of consuming marshmallow, as it may
interfere with the absorption of the medication. Unfortunately, no clinical
research trials support the use of marshmallow in the treatment of sore
throats to date, although it remains a very popular remedy among
herbalists.

© 2018 Regents of the University of Minnesota. All rights reserved.

Botanicals for Upper
Respiratory Conditions

Sage (Salvia officinalis)

Popular as a culinary spice, sage is also useful in the treatment of sore
throats. Sage has anti-inflammatory, antioxidant, and anti-microbial
activity, with a particular affinity for the mouth, throat, and tonsils.
Gargling with sage is a traditional folk remedy that may alleviate some of
the discomfort that accompanies a sore throat. One small research study 9
looked at a combination sage and echinacea throat spray and found it to
be as effective as a chlorhexidine/lidocaine throat spray. An easy way to
consume sage is to mix it with honey. The combination helps ease a sore
throat and cough. It also tastes delicious!

Botanicals for influenza symptoms

Elderberry (Sawbucks nigra)
Thanks to its sweet fruit, elderberry is popular in jams, wine, and liqueurs.
The berries have more than just a delicious taste, however! The berries of
this plant are rich in compounds that possess anti-inflammatory and anti-
viral properties. In fact, elderberry may even be used to help minimize the
symptom severity of the influenza virus if started within 48 hours of
symptom onset.10 It’s thought that elderberry helps stimulate the immune
system to fight the influenza virus. There is a small body of research
supporting its use for alleviating flu symptoms, but more is needed.

It’s important to note that if flu symptoms are persisting or severe, it’s best
to seek medical attention.

Ginseng (Panax ginseng, Panax quinquefolius)

We’ve established that Panax ginseng may have the ability to help the
body fight fatigue, boost immunity, and combat the effects of stress. This is
all thanks to the adaptogenic and anti-inflammatory properties of this
botanical. Panax quinquefolius is the species that is grown in North
America and it has similar properties to P. ginseng. In some cultures,
ginseng is consumed over a period of time in colder months as a
preventative for the common cold. The effectiveness of P. ginseng and P.
quinquefolius in preventing cold symptoms has been researched with
positive results,11 although more research is needed.

Recall that many ginseng products may be adulterated, so it’s best to

purchase from a reputable brand. People who take blood thinners should
not take ginseng.

© 2018 Regents of the University of Minnesota. All rights reserved.

Botanicals for Upper
Respiratory Conditions

Botanicals for allergic rhinitis symptoms

Butterbur (Petasites hybridus)
You have already learned about butterbur and its potential to help with
migraines. Butterbur can be useful in managing symptoms from allergic
rhinitis as well. It has anti-inflammatory and antihistamine properties,
which contribute to relieving symptoms of congestion and inflammation
from allergic rhinitis. Unlike some pharmaceutical treatments for allergic
rhinitis that may cause drowsiness, butterbur is free from this side effect.
One research study12 found butterbur to be as effective as fexofenadine
(commonly known by its brand name Allegra) for relieving symptoms of
allergic rhinitis.

As previously discussed, it’s important to search for products that are free
of pyrrolizidine alkaloids (PAs) when purchasing products of butterbur
since PAs can potentially be harmful to the liver.

Nettle (Urtica dioica)

If you’ve ever encountered a plant that caused a sudden stinging sensation
on your skin after accidentally brushing up against it, chances are that
plant was none other than nettle, often referred to as “stinging nettle.”
The plant gets its name from the tiny hairs on the leaves and stem that
contain histamine, which causes an itching and stinging response when it
comes into contact with skin. Ironically, this plant has antihistamine
properties when taken internally. This comes in useful when treating
symptoms related to allergic rhinitis. In fact, one small research study has
shown it to be comparable to over-the-counter antihistamines. More
research is needed to confirm results.

This botanical is overall well-tolerated but can interact with the blood
thinner Coumadin and possibly medications for blood pressure or diabetes.

References
1. Coon, J.T. & Ernst, E. (2004.) Andrographis paniculata in the treatment of upper respiratory tract
infections: a systematic review of safety and efficacy. Planta Medica 70(4):293-298.
2. Timmer, J., et al. (2013). Pelargonium sidoides extract for treating acute respiratory tract infections.
Cochrane Database Syst Rev 10:CD006323.

3. Goel, V., Lovlin, R., Barton, R., et al. (2004) Efficacy of a standardized echinacea preparation (EchinilinTM)
for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm
Ther 29:75-84.

© 2018 Regents of the University of Minnesota. All rights reserved.

Botanicals for Upper
Respiratory Conditions

4. Karsch-Volk, et. al. (2014). Echinacea for preventing and treating the common cold. Cochrane Database
Syst Rev 2:CD000530.
5. Karsch-Volk, Barrett, B., & Linde, K. Echinacea for preventing and treating the common cold. (2015).
JAMA 313(6):618-619.
6. Federspil, P., et al. (1997). Effects of standardized Myrtol in therapy of acute sinusitis – Results of a
double-blind, randomized multicenter study compared with placebo. Laryngorhinootologie 76:23-7.
7. Matthys, H., de Mey, C., Carls, C., Rys, A., Geib, A., & Wittig, T. (2000). Efficacy and tolerability of myrtol
standardized in acute bronchitis. A multi-centre, randomised, double-blind, placebo-controlled parallel
group clinical trial vs. cefuroxime and ambroxol. Arzneimittelforschung ;50:700-11.

8. Gillissen, A., Wittig, T., Ehmen, M., Krezdorn, H.G., &de Mey, C. (2013). A multi-centre, randomised,
double-blind, placebo-controlled clinical trial on the efficacy and tolerability of GeloMyrtol® forte in
acute bronchitis. Drug Res (Stuttg) 63:19-27.

9. Schapowal, A., Berger, D., Klein, P., & Suter A. (2009) Echinacea/sage or chlorhexidine/lidocaine for
treating acute sore throats: a randomized double-blind trial. Eur J Med Res 14(9):406-412.
doi:10.1186/2047-783X-14-9-406.
10. Zakay-Rones Z., et al. (2004). Randomized study of the efficacy and safety of oral elderberry extract in the
treatment of influenza A and B virus infections. J Int Med Res 32(2):132-140.
11. McElhaney, J.E., et al. (2004) A placebo-controlled trial of a proprietary extract of North American
ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc
52(1):13-19.

12. Schapowal, A. (2005, August 22). Treating intermittent allergic rhinitis: a prospective, randomized,
placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytother Res.
13. Mittman P. (1990). Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of
allergic rhinitis. Planta Med 56:44-47.

© 2018 Regents of the University of Minnesota. All rights reserved.