FitSugar

Echinacea Is Effective, Probably Maybe

FitSugar — Tue, 22 Apr 2008 13:00:00 -0700

Have you been taking echinacea to ward of a cold this Spring? If so you're probably doing the right thing. Maybe.

Newsweek is reporting that new research has found that taking echinacea reduces the chances of getting a cold by 31 percent. And if you've already come down with one, the herb will make you feel better a day and a half earlier - may not seem like a lot but, oh the things I could do in a day in a half. With that being said, there are a few issues with this theory. The first is that researchers are not quite sure which of the more than 200 strains of the cold viruses are affected by echinacea, so it may do absolutely nothing for your cold. Also, echinacea has been found to interact with other medications adversely, so be sure to talk to your doctor before taking it.

Source

Zinc and Echinacea vs. the Common Cold

FitSugar — Mon, 03 Dec 2007 15:30:00 -0800

Nobody wants to get stuck with a cold, so when you hear that you can take something simple and inexpensive to prevent a week's worth of misery, why not jump at it? Echinacea and zinc are much buzzed-about when it comes to preventing or shortening the duration of colds, but do they really work?

When it comes to zinc, hundreds of studies have been conducted, including one in 2000, which found that taking zinc lozenges during a cold produced "modest" benefits. A more recent study published by Stanford Medical School analyzed data from 14 previous studies and reported that the effectiveness of using zinc to treat a cold "has yet to be established." Hmm.

Well, what about echinacea? To find out read more

Over the summer, a large study published in the Lancet Infectious Diseases journal said that taking echinacea can reduce your risk of catching a cold by 58 percent. This contradicted an earlier study published in the New England Journal of Medicine, which said that echinacea didn't help at all. It's tough to determine echinacea's effectiveness, because so many parts of the plant are used to make tinctures, teas, and pills. More research definitely needs to be done to figure out what part of the plant is helpful.

Fit's Tips: The bottom line is that there really is no consistent opinion about whether zinc or echinacea really benefits you when it comes to colds. During this season of sickness, instead of wasting money on things that possibly help, stick to doing things that are proven to work. Be sure to eat a healthy diet, exercise regularly, get your daily supply of vitamin C (75 mg), and get plenty of rest each night. This will help to keep your immune system strong, so if your body does come in contact with germs, it can fight them off so you don't get sick.

Echinacea Proves Medical Worth, Safety Still in Question

FitSugar — Thu, 26 Jul 2007 02:00:00 -0700

Echinacea is a little herb that has been a big topic in the health world for some time now. Does it fight colds or doesn't it? Is it safe or isn't it?

Well according to new reports Echinacea actually does reduce a person's risk of catching a cold significantly (by 58 percent). While the herb also shortened the duration of the average cold, researchers from the University of Connecticut said they weren't sure by how much.

Take this all with a grain of salt since the studies authors said they had only evaluated Echinacea's effectiveness for cold prevention, not the herb's overall safety. Plus if you're on the pill be especially careful since they are still figuring out if the herb can interfere with its effectiveness.

Source

Echinacea: Herbal Cold Remedy Vindicated

FitSugar — Tue, 26 Jun 2007 01:50:00 -0700

Cold and flu season has been officially over for weeks, if not months. However, if you have ever suffered through a summer cold, the new findings on the herb echinacea will certainly be of interest to you.

A new reveiw of 14 clinical studies published in the British Journal "Lancet Infectious Diseases" indicates that echinacea cuts the chance of catching a cold by 58% and can reduce the duration of colds by about a day and a half.

These findings directly contradict last year's study by the National Institute of Health which found echinacea to be ineffective in protecting against the common cold and reducing cold symptoms. The American Botanical Council feels the dosage of the herb used in the NIH tests were too low and this new analysis of past studies obviously indicates that further studies are needed. Especially since the active ingredient of echinacea, derived from the Purple Cone Flower, is still unknown. Also unknown is that proper dosage of echinacea and the most effective form of the herb to take.

So the controversy continues and hopefully we will see more research on this immunostimulating drug soon. Hopefully we will have some answers before the next cold and flu season is upon us.

Source

The Skinny On: Echinacea

FitSugar — Mon, 18 Dec 2006 09:00:00 -0800

When I was in college, come cold and flu season, all the hippies I knew started taking their echinacea herbal remedies to boost their immune system. It was like clock work. When I tried it my reaction was just icky-nacea since the taste was so bad.

Well, my tune has changed, at least slightly. Several controlled studies have found that the herb can reduce symptoms of the common cold as well as shorten a cold's duration. That was good news for my runny nose. It is important that the echinacea is prepared as an alcohol extract or a pressed juice.

A bummer for my dear hippie friends, no evidence has been found that echinacea prevents colds or bolsters the immune system. So there is no need to take it on a regular basis to enhance your immunity. I will use anything I can to make my colds shorter. How about you?

Do You Use Herbal Remedies?

FitSugar — Wed, 04 Nov 2009 07:00:56 -0800

I ran into a friend this week who was on his way to an herbal medicine shop to bulk up on tinctures and teas because his wife is sick.

I've dabbled a little bit with herbal remedies - ginger for an upset stomach and echinacea for a cold - but not to the extent that he and his wife do. He said that for minor illnesses they only use herbal remedies, and that they're more effective than drugstore meds.

I'm still dubious about herbal remedies because the research is a bit spotty, but I think there may be some benefits to their use. What do you think of them? If you've had any experiences with using herbal remedies, share your thoughts in the comments section.

Common cold

FitSugar — Wed, 08 Oct 2008 17:35:26 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

A cold is an upper respiratory infection caused by a virus. They tend to occur most often in winter, although scientists aren't sure why. In the United States, adults usually have between two and four colds per year, and children have as many 10.

There is no foolproof way to prevent a cold – and no way to cure it – but you can treat the symptoms. Colds tend to last about a week, and can be accompanied by sore throat and cough. Unlike the flu, colds don't usually cause you to run a high fever (above 102 degrees Fahrenheit).

Signs and Symptoms

Sneezing and runny nose from nasal congestion
Sore throat
Cough
Hoarseness
Low-grade fever (less than 102 degrees)
Headache
Fatigue

Causes

Colds are caused by more than 100 different viruses, although most colds are caused by rhinoviruses. You can get a cold by touching a person with a cold (for example, by shaking hands) and then touching your nose or eyes, or by touching a surface that a person with a cold has touched (such as telephone or keyboard). Colds are also transmitted through the air, when someone with a cold coughs or sneezes. Although you're more likely to get a cold in winter, exposure to cold outdoor air and fatigue do not increase your risk of getting sick (but stress may do so).

Risk Factors

People more likely to get colds include:

Children, especially those who attend day care or whose parents smoke
Smokers and those exposed to second hand smoke
Those exposed to industrial smoke, toxic fumes, or other air pollutants
People with immune system disorders, such as HIV, AIDS, or cancer, or who take medications that suppress the immune system, such as corticosteroids
People under a fair amount of stress

Diagnosis

Most people treat colds without seeing a doctor. If you do see your doctor, the diagnosis will be made based on your symptoms and exam. He or she may take a throat culture to rule out strep throat. If you have an underlying lung condition, such as asthma or emphysema, you should let your doctor know right away when you get a cold.

Preventive Care

Although anyone and everyone can get a cold, there are a few things that you can do that may help improve your immune system and make you less susceptible to getting colds:

Wash your hands frequently
Exercise regularly
Eat a diet rich in fruits and vegetables and low in fat
Get sufficient rest
Minimize your stress and your reaction to stress. Yoga, tai chi, or other forms of relaxation may help.

Treatment Approach

With a cold, the goal of treatment is to improve your symptoms as quickly as possible. But even if you do nothing, they should go away within a week to 10 days. Antibiotics cannot help your cold. However, there are medications, herbs, supplements, and homeopathic remedies that may make you feel better while you have a cold.

Lifestyle

Drink a lot of water to help loosen mucus.
Rest to restore your energy and avoid complications such as bronchitis or pneumonia.
Eat a diet rich in fresh fruits and vegetables. These foods provide lots of antioxidants (substances that may help boost your immune system), especially vitamins A and C.

Medications

A number of over-the-counter medications are available to help treat cold symptoms. Children under the age of six should not be given any over-the-counter cold or cough medicine.

Decongestants - help open your nasal passages so you can breathe easier. If decongestant nasal sprays or drops are used for more than three days, however, they can cause rebound congestion. Decongestants are often combined in cold medicines with antihistamines, cough suppressants, and pain relievers. People with heart disease, high blood pressure, diabetes, or glaucoma should not take decongestants. Popular brands of decongestants include Sudafed, Afrin, and Neo-Synephrine.

Antihistamines - can temporarily relieve a runny nose by drying up nasal secretions. Non-drowsy antihistamines available over the counter include loratadine (Claritin); others, such as fexofenadine (Allegra) and cetirizine (Zyrtec), are available by prescription.

Cough medicines - cough suppressants (for a dry cough) or expectorants (for a wet, productive cough that brings up mucous) are available over the counter and by prescription.

Pain relievers - such as aspirin, acetaminophen (Tylenol), and ibuprofen (Advil, Motrin) can be used for fever, body aches, and headaches. Children under the age of 16 should not take aspirin due to the risk of a rare but serious illness called Reye's syndrome.

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Be sure to talk to your physician about any supplements you are taking or considering taking.

Chicken soup - It’s about as traditional a remedy for a cold as you can find (at least in modern history). In fact, chicken soup and warm liquids (broth, tea) can help soothe a sore throat and loosen mucus, which in turn helps ease congestion from a cold.
Probiotics (Lactobacillus) - So-called “good” bacteria or probiotics help prevent infections in the intestines, and there is preliminary evidence that they might help prevent colds, too. One study found that children in daycare centers who drank milk fortified with Lactobacillus had fewer and less severe colds. Several studies that examined probiotics combined with vitamins and minerals also found a reduction in the number of colds caught by adults, although it’s not possible to say whether the vitamins, minerals, or probiotics were most responsible for the benefit.
Vitamin C - Despite the popular belief that vitamin C can cure the common cold, the scientific evidence hasn't found that to be true. Only a small reduction in the duration of a cold (about 1 day) has been found when some people take vitamin C supplements regularly (not just at the beginning of a cold). The only other piece of evidence supporting vitamin C for preventing colds comes from studies examining people exercising in extreme environments (athletes such as skiers and marathon runners, and soldiers in the Arctic). In these studies, vitamin C did seem to reduce the risk of getting a cold. Talk to your doctor about any pros and cons with regards to using vitamin C during cold and flu season. Some people believe that you have to take very high doses of vitamin C to get any benefit, and they suggest taking enough to cause diarrhea and then reducing the dose. You should only use such high doses of vitamin C under your doctor’s supervision.
Zinc - Your body needs zinc for its immune system to function properly, so it has long been thought that zinc could help protect against catching a cold. But the evidence has been decidedly mixed, with some studies finding a benefit from zinc lozenges but others showing no effect. Recently, a review of studies that compared zinc to placebo found that most of them had flaws that made any positive results unreliable. Only four studies were deemed reliable, and three found no benefit from zinc lozenges. The remaining positive study suggested that zinc nasal sprays might help reduce nasal stuffiness. If you do decide to try zinc lozenges for a cold, remember that getting too much zinc (more than 50 mg per day over a long period of time) can be dangerous.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a healthcare practitioner. Before giving any herbs to a child to treat a cold, talk to your pediatrician.

Echinacea (Echinacea purpurea, 300 mg three times per day) – Although evidence on whether echinacea works to prevent or treat colds has gone back and forth, recent evidence is encouraging. An analysis of 14 scientific studies found that people who took echinacea reduced their risk of getting a cold by 58 percent and reduced the duration of a cold by an average of a day and a half. However, many of the studies used echinacea in combination with another herb or vitamin, so it’s impossible to say which one was responsible for the benefit. Echinacea should not be used by women who are pregnant or breastfeeding, or by anyone taking drugs that suppress the immune system (such as corticosteroids or methotrexate).

Preventing colds

In addition to echinacea, several other herbs that are used to strengthen the immune system may also be beneficial in preventing you from catching a cold. As is true with echinacea, these herbs should be avoided by anyone taking drugs to suppress their immune system.

Andrographis (Andrographic paniculata) - One study found that andrographis, an herb used in Ayurvedic medicine, combined with eleuthero or Siberian ginseng (Eleutherococcus senticosus) in a formula called Kan Jang, helped reduce cold symptoms.
Garlic (Allium sativum) - In one study, people who took garlic for 12 weeks between November and February had 63 percent fewer colds than people who took placebo. Those who did get a cold recovered about one day faster. Because garlic can increase the risk of bleeding, people who take anticoagulants (blood-thinners, such as aspirin or warfarin) should not take garlic. Women who are pregnant or breastfeeding should talk to their doctor before taking garlic supplements.
Ginseng (Panax quinquefolius, 400 mg per day) - At least two studies suggest that taking American ginseng may help prevent colds, as well as reduce the number of colds experienced and the severity of symptoms.

Treating colds

Elder or elderberry (Sambucus nigra) - By lessening congestion and possibly helping you sweat, elder may help reduce the symptoms of colds and flu. One study suggested that using a standardized elderberry extract, Sambucol™, could shorten the duration of flu by about three days. Sambucol™ also contains other herbs plus vitamin C, so it isn’t known whether elder by itself would have the same effect. Pregnant and breast-feeding women should not take elder.
Eucalyptus (Eucalyptus globulus) - Eucalyptus is used in many remedies to treat cold symptoms, particularly cough. It can be found in many lozenges, cough syrups, and vapor baths throughout the United States and Europe. Fresh leaves can be used in teas and gargles to soothe sore throats. Ointments containing eucalyptus leaves are also applied to the nose and chest to relieve congestion and loosen phlegm.
Goldenseal (Hydrastis canadensis) - Goldenseal is often combined with echinacea in herbal cold remedies, although scientific evidence that it works is lacking. Women who are pregnant or breast-feeding should talk to their doctor before taking goldenseal.
Licorice (Glycyrrhiza glabra) - Licorice root is a traditional treatment for sore throat, although scientific evidence is lacking. Licorice interacts with a number of medications, so ask your doctor before taking it. People with high blood pressure or heart disease, women who are pregnant or breast-feeding, and those who take anticoagulants (blood thinners) should not take licorice.
Marshmallow (Althea officinalis) - Although there isn’t any scientific evidence that it works, marshmallow has been used traditionally to treat sore throat and cough.
Peppermint (Mentha x piperita) - Like eucalyptus, peppermint is widely used to treat cold symptoms. Its main active agent, menthol, is a good decongestants. Menthol also thins mucus and works as an expectorant, meaning that it helps loosen and break up phlegm. It is soothing and calming for sore throats and dry coughs as well.
Slippery elm (Ulmus fulva) - Slippery elm may help ease sore a sore throat and has been used traditionally for this purpose, although scientific evidence is lacking.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of the common cold based on their knowledge and experience. It is important to note, however, that cold symptoms are viewed in homeopathic medicine as the body's natural way of eliminating a virus. For this reason, homeopathic doctors may recommend no treatment at all. If a remedy is selected, usually it is intended to boost the body's natural immune response. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Aconitum - for symptoms including fever, anxiety, and thirst, that start abruptly, often following exposure to a cold climate or draft; most effective during the first 24 hours of the illness
Allium cepa - for colds with clear watery discharge that burns and/or irritates the nostrils; red, burning eyes; and symptoms that worsen in warm rooms and in the evening
Arsenicum album - for colds with watery, burning discharge from the eyes and nose, throbbing headache, nasal congestion that is not relieved by sneezing, dry mouth, sensitivity to cold, and a thirst for small sips of fluid
Belladonna - for colds with sudden onset of high fever, flushed face, watery nasal discharge, sore throat, throbbing headache, earache, and cough that tends to worsen at night; this remedy is most appropriate for individuals who are often agitated and sometimes delirious; these symptoms may cause children to cry
Bryonia - for chest colds with spastic cough that produces only a small amount of mucus and sharp chest pain that worsens with inhalation and while coughing; a dull headache, little to no nasal discharge, and sneezing may also be present
Euphrasia - for colds with excessive, non-irritating watery discharge that tends to worsen in the morning and when the person is lying down
Ferrum phosphoricum - for the early stages of a cold with slight fever, flushed face (redness may be patchy), and fatigue; may also be used in children with nosebleeds or bloody nasal discharge
Gelsemium - for colds that have gradual onset with watery nasal discharge that causes irritation, a feeling of fullness or tickling in the nose and/or the back of the throat, muscle aches, fatigue, lack of energy, lightheadedness or spaciness, and a headache with pain in the back of the head
Hepar sulphuricum - for late stages of a cold when nasal discharge turns from watery to thick, yellow, and foul smelling; symptoms tend to worsen in the evening and with cold and wind
Mercurius - for fluctuating body temperature and thick, yellow nasal discharge with a foul odor; symptoms may also include bad breath and a swollen tongue
Pulsatilla - for coughs and nasal congestion with thick, yellow-green mucus that does not burn the skin; symptoms tend to worsen in warm, stuffy rooms and when the person is lying on his or her back; this remedy is most appropriate for children (even newborns) and adults who are weepy, have mood swings, and are easily influenced by others

Mind-Body Medicine

A study of a small number of university students suggests that practicing relaxation techniques on a regular basis may help reduce the duration of a cold or the flu. A similar study of children reached the same conclusion. Some good stress reduction techniques include meditation, deep relaxation, yoga, tai chi, and breathing exercises.

Other Considerations

Pregnancy

Tell your healthcare provider if you are pregnant or think you are pregnant. Some medications, herbs, and supplements may be harmful to your baby and should not be taken if you are pregnant or trying to become pregnant.

Special Populations

If you have asthma, emphysema, or any other respiratory disease, you should talk to your doctor as soon as you develop cold symptoms.

Warnings and Precautions

If your symptoms aren’t better in 7 to 10 days, you should call your doctor. Other reasons to see your doctor include high fever (above 102° Fahrenheit), thick, green nasal discharge, or development of a productive cough (cough with phlegm), especially if it is thick and green as well.

Prognosis and Complications

Colds usually get better within 7 to 10 days. Some potential complications include:

Worsening of a pre-existing respiratory condition, such as asthma or emphysema
Bronchitis
Pneumonia
Ear infection
Sinusitis

Supporting Research

Alvarez-Olmos MI. Probiotic agents and infectious diseases: a modern perspective on a traditional therapy. Clin Infect Dis. 2001;32(11):1567-1576.

Audera C, Patulny RV, Sander BH, Douglas RM. Mega-dose vitamin C in treatment of the common cold: a randomised controlled trial. Med J Aust. 2001;175(7):359-362.

Barrett BP, Brown RL, Locken K, Maberry R, Bobula JA, D'Alessio D. Treatment of the common cold with unrefined Echinacea: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2002;137:936-946.

Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med. 2001;111(2):103-108.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:57-61, 233-239, 240-243, 244-248 , 297-303.

Brinkeborn RM, Shah DV, Degenring FH. Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial. Phytomedicine. 1999;6(1):1-6.

Cohen S, Hamrick N, Rodriquez MS, Feldman PJ, Rabin BS, Manuck SB. Reactivity and vulnerability to stress-associated risk for upper respiratory illness. Psychosom Med. 2002;64(2):302-310.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 67-73.

de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, et al. Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. Vaccine. 2006 Nov 10;24(44-46):6670-4.

Douglas RM, Chalker EB, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2000;(2):CD000980.

Eby GA. Zinc ion availability-the determinant of efficacy in zinc lozenge treatment of common colds. J Antimicrob Chemother. 1997;40:483-493.

Farese RV, Biglieri EG, Shakelton CHL, et al. Licorice-induced hypermineralocorticolism. N Engl J Med. 1990;325(17):1223–1227.

Fortes C, Forastiere F, Agabiti N, et al. The effect of zinc and vitamin A supplementation on immune response in an older population. J Am Geriatr Soc. 1998;46:19–26.

Garland ML, Hagmeyer KO. The role of zinc lozenges in treatment of the common cold. Ann Pharmacother. 1998;32:63-69.

Glatthaar-Saalmuller B, Sacher F, Esperester A. Antiviral activity of an extract derived from roots of Eleutherococcus senticosus. Antiviral Res. 2001;50(3):223-228.

Gruenwald J, Brendler T, Jaenicke C, et al, eds. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company Inc; 2000:283-287, 477-479.

Hambridge M. Human zinc deficiency. J Nutr. 2000;130(5S suppl):1344S-1349S.

Hatakka K, Savilahti, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centers: double-blind, randomized trial. BMJ. 2001;322(7298):1327.

Hemilia H. Vitamin C intake and susceptibility to the common cold. Br J Nutr. 1997;77(1):59-72.

Hemilia H, Douglas RM. Vitamin C and acute respiratory infections. Int J Tuber Lung Dis. 1999;3(9):756-761.

Hewson-Bower B, Drummond PD. Psychological treatment for recurrent symptoms of colds and flu in children. J Psychosom Res. 2001;51(1):369-377.

Hirt M, Nobel Sion, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. ENT J. 2000;79(10):778-780, 782.

Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Prim Care. 2002;29(2):231-261.

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Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 202-203.

Josling P. Preventing the common cold with a garlic supplement: a double blind, placebo-controlled survey. Adv Ther. 2001;18(4):189-193.

Kligler B. Echinacea. Am Fam Physician. 2003;67(1):77-80.

Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study. J Altern Complement Med. 2000;6(4):327-334.

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McElroy BH, Miller SP. Effectiveness of zinc gluconate glycine lozenges against the common cold in school-aged subjects: a retrospective chart review. Am J Ther. 2002;9(6):472-475.

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Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007 Jul;7(7):473-80. Review. Erratum in: Lancet Infect Dis. 2007 Sep;7(9):580.

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Turner RB, Riker DK, Gangemi JD. Ineffectiveness of Echinacea for prevention of experimental rhinovirus colds. Antimicrob Agents Chemother. 2000;44:1708-1709.

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Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 226.

Van Straten M, Josling P. Preventing the common cold with a vitamin C supplement: a double-blind, placebo-controlled survey. Adv Ther. 2002;19(3):151-159.

Review Date:
12/19/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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Influenza

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment Approach
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Influenza, or "flu," is a caused by a virus infecting the respiratory system (nose, throat, bronchial tubes, lungs). Flu symptoms are usually more severe than those of the common cold and are more likely to affect other parts of your body. Flu also tends to come on suddenly, while colds can take a while to develop. Flu is very contagious, spreading easily from one person to the next. Most people with healthy immune systems will get over the flu in a week or two, but young children, senior adults, and people with chronic illnesses are more likely to develop complications such as pneumonia. About 36,000 people die of flu each year in the United States.

There are three types of flu viruses: A, B, and C. Type A viruses are the ones responsible for periodic pandemics (worldwide epidemics, such as the one in 1918 that killed as many as 50 million people worldwide). The avian or bird flu is a type A flu virus.

The best way to protect yourself from the flu is to get an annual vaccine (flu shot).

Signs and Symptoms

Fever that comes on suddenly (usually above 101 degrees Fahrenheit)
Chills and sweats
Headache
Muscle or body aches
Fatigue
Dry cough
Sore throat
Sneezing, runny nose, stuffy nose
Loss of appetite
Nausea, vomiting, or diarrhea, especially in children

Causes

Influenza is caused by viruses that are spread through the air by sneezes and coughs, or by touching a surface a person with the flu has touched and transmitting the virus to your mouth or nose. Some flu viruses cause a very mild illness, or none at all. Others cause serious, widespread illness.

Since there are many types of influenza virus, and because they change over time, a new flu vaccine is offered every fall. Getting vaccinated before the flu season starts reduces your chances of getting the flu, and helps you recover faster if you do get it. You should not take the vaccine if you have an allergy to eggs, because the viruses for the vaccines are grown in chick embryos. See Risk Factors for list of people who should get the vaccine every year.

Risk Factors

Infants and young children, as well as senior adults, are considered at highest risk of complications from flu. Other risks include:

Having a chronic illness, such as heart disease
Having a weakened immune system, from medications or HIV
Pregnant women
Peole who work in healthcare
People who work in childcare
Residents of nursing homes

If you are at risk for complications, you should get an annual flu shot (see Prevention).

Diagnosis

Your doctor will probably be able to diagnose flu from a physical exam and a description of your symptoms. He or she may take a chest X-ray if there is concern about complications such as pneumonia.

Preventive Care

The best way to prevent the flu is by getting a flu shot. Annual flu shots are recommended if you:

Are 50 or older
Have chronic heart, lung, or kidney disease
Live in an institution (such as a nursing home)
Have a weakened immune system
Have sickle cell anemia

You should not receive the vaccine if you are allergic to eggs.

You can also cut your risk of flu by washing your hands frequently during flu season.

Treatment Approach

Bed rest and drinking plenty of fluids are usually enough to treat flu. Mild over-the-counter pain relievers and fever reducers (such as acetaminophen or Tylenol, and ibuprofen or Advil), can help relieve fever and muscle aches.If you are at high risk for complications (see Risk Factors), then your doctor may prescribe antiviral medications (drugs that fight the virus). They must be started within two days to be effective. Certain herbs, supplements, and homeopathic remedies may help some of your symptoms.

Lifestyle

Drink lots of fluids
Rest to restore your energy and avoid complications like pneumonia.
Eat a diet rich in fresh fruits and vegetables. These foods provide lots of antioxidants (substances that may help boost your immune system), especially vitamins A and C.
Exercising regularly may cut your risk of flu and help your body respond better to a flu shot.
Minimize stress and your reaction to stress. Consider yoga, tai chi, or other forms of relaxation on an ongoing basis. Stress can put you at increased risk for viruses like influenza.

Medications

Pain and fever reducers - include ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) for fever reduction and relief of minor aches and pain. Children under 18 should not take aspirin due to the risk of a rare but serious illness called Reye's syndrome.
Decongestants - help open your nasal passages so you can breathe easier. If decongestant nasal sprays or drops are used for more than three days, however, they can cause rebound congestion. Decongestants are often combined in cold and flu medicines with antihistamines, cough suppressants, and pain relievers. People with heart disease, high blood pressure, diabetes, or glaucoma should not take decongestants. Popular brands of decongestants include Sudafed, Afrin, and Neo-Synephrine.
Cough medicines - cough suppressants (for a dry cough) or expectorants (for a wet, productive cough that brings up mucous) are available over the counter and by prescription.
Antiviral medications - Several antiviral medications have been approved by the Food and Drug Administration to treat flu, although a number of flu viruses have developed resistance to some of the medications. In addition, using these medications may help contribute to other strains of flu becoming resistant. These drugs must be started within 48 hours of becoming sick to be effective. Medications include
- Oseltamivir (Tamiflu): The FDA requires Tamiflu to carry a warning that people who have the flu, especially children, may be at increased risk of confusion and injuring themselves after taking Tamiflu.
- Zanamavir (Relenza)
- Amantadine (Symmetrel): Recently, most flu viruses in the U.S. have been resistant to Symmetrel
- Rimantadine (Flumadine): Recently, most flu viruses in the U.S. have been resistant to Flumadine

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Be sure to talk to your doctor about any supplements you are taking or considering taking.

Warm liquids - Chicken soup and warm liquids (broth, tea) can help soothe a sore throat and loosen mucus, which in turn helps ease congestion from the flu.
Probiotics (Lactobacillus) - So-called “good” bacteria or probiotics help prevent infections in the intestines, and there is preliminary evidence that they might help prevent colds, too, although they have not been studied for the flu. One study found that children in daycare centers who drank milk fortified with Lactobacillus had fewer and less severe colds. Several studies that examined probiotics combined with vitamins and minerals also found a reduction in the number of colds caught by adults, although it’s not possible to say whether the vitamins, minerals, or probiotics were most responsible for the benefit.
Zinc - Your body needs zinc for its immune system to function properly, so it has long been thought that zinc could help protect against catching a cold or flu. But the evidence has been decidedly mixed, with some studies finding a benefit from zinc lozenges but others showing no effect. Recently, a review of studies that compared zinc to placebo found that most of them had flaws that made any positive results unreliable. Only four studies were deemed reliable, and three found no benefit from zinc lozenges. The remaining positive study suggested that zinc nasal sprays might help reduce nasal stuffiness. If you do decide to try zinc lozenges for a cold, remember that getting too much zinc (more than 50 mg per day over a long period of time) can be dangerous.
Spirulina - In test tubes, spirulina seems to be able to stop some flu viruses from reproducing. It isn't known whether it will have the same effect in humans, however.

Herbs

Andrographis (Andrographic paniculata) - One study found that andrographis, an herb used in Ayurvedic medicine, combined with eleuthero or Siberian ginseng (Eleutherococcus senticosus) in a formula called Kan Jang, helped reduce symptoms and shorten the duration of the flu. More studies are needed to say for sure whether it is effective.
Echinacea (Echinacea purpurea, 300 mg three times per day) - Although evidence on whether echinacea works to prevent or treat colds and flu has gone back and forth, recent evidence is encouraging. An analysis of 14 scientific studies found that people who took echinacea reduced their risk of getting a cold by 58 percent and reduced the duration of a cold by an average of a day and a half. However, many of the studies used echinacea in combination with another herb or vitamin, so it’s impossible to say which one was responsible for the benefit. The analysis looked at colds, not flu, so the evidence may be more mixed as to whether Echinacea can help prevent flu. Echinacea should not be used by women who are pregnant or breastfeeding, or by anyone taking drugs that suppress the immune system (such as corticosteroids or methotrexate).
Garlic (Allium sativum) - Some studies suggest taking garlic may help reduce your risk of getting an upper respiratory infection, such as a cold or flu. More studies are needed to tell whether garlic has any true benefit for flu, however. Because garlic can increase the risk of bleeding, people who take anticoagulants (blood-thinners, such as aspirin or warfarin) should not take garlic. Women who are pregnant or breastfeeding should talk to their doctor before taking garlic supplements.
Elder or elderberry (Sambucus nigra) - By lessening congestion and possibly increasing perspiration, elder may help reduce the symptoms of colds and flu. One study suggested that using a standardized elderberry extract, Sambucol™, could shorten the duration of flu by about three days. Sambucol™ also contains other herbs plus vitamin C, so it isn’t known whether elder by itself would have the same effect. Pregnant and breast-feeding women should not take elder.
Eucalyptus (Eucalyptus globulus) - Eucalyptus is used in many remedies to treat cold and flu symptoms, particularly cough. It can be found in many lozenges, cough syrups, and vapor baths throughout the United States and Europe. Fresh leaves can be used in teas and gargles to soothe sore throats. Ointments containing eucalyptus leaves are also applied to the nose and chest to relieve congestion and loosen phlegm.
Goldenseal (Hydrastis canadensis) - Goldenseal is often combined with echinacea in herbal cold and flu remedies, although scientific evidence that it works is lacking. Women who are pregnant or breast-feeding should talk to their doctor before taking goldenseal.
Licorice (Glycyrrhiza glabra) - Licorice root is a traditional treatment for sore throat, although scientific evidence is lacking. Licorice interacts with a number of medications, so ask your doctor before taking it. People with high blood pressure or heart disease, women who are pregnant or breast-feeding, and those who take anticoagulants (blood thinners) should not take licorice.
Marshmallow (Althea officinalis) - Although there isn’t any scientific evidence that it works, marshmallow has been used traditionally to treat sore throat and cough.
Peppermint (Mentha x piperita) - Like eucalyptus, peppermint is widely used to treat cold and flu symptoms. Its main active agent, menthol, is a good decongestants. Menthol also thins mucus and works as an expectorant, meaning that it helps loosen and break up phlegm. It is soothing and calming for sore throats and dry coughs as well.
Slippery elm (Ulmus fulva) - Slippery elm may help ease sore a sore throat and has been used traditionally for this purpose, although scientific evidence is lacking.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of the flu based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

A combination remedy including Aconite, Gelsemium, Eucalyptus, Ipecacuanha, Phosphorus, Bryonia, and Eupatorium perfoliatum
A mixture of Anas barbarice hepatis and Cordis extractum
Gelsemium - for chills, weakness, lack of energy, fever, and headaches in the back and top of the head; this is one of the most common homeopathic remedies for the flu
Eupatorium perfoliatum - for deep aches, sneezing and coughing
Nux vomica - for violent vomiting, irritability, dry cough, chills, and a stuffy nose that develops into a watery, irritating discharge

Other Considerations

Warnings and Precautions

If you are in any of the high-risk groups described in the Risk Factors section, be sure to call your doctor at the earliest signs of flu symptoms. The sooner you are treated, the less likely you are to develop complications.

Prognosis and Complications

Most healthy people get over the flu in one to two weeks. For those at high risk, certain serious, even life-threatening, complications can occur including:

Pneumonia
Encephalitis (an infection of the brain)
Secondary bacterial infection elsewhere in the body

Supporting Research

Alvarez-Olmos MI. Probiotic agents and infectious diseases: a modern perspective on a traditional therapy. Clin Infect Dis. 2001;32(11):1567-1576.

Barak V, Birkenfeld S, Halperin T, Kalickman I. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. Isr Med Assoc J. 2002;4(11 Suppl):919-922.

Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. 2001;12(2):290-296.

Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med. 2001;111(2):103-108.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:57-61, 233-239, 240-243, 244-248, 297-303.

Cohen S, Hamrick N, Rodriquez MS, Feldman PJ, Rabin BS, Manuck SB. Reactivity and vulnerability to stress-associated risk for upper respiratory illness. Psychosom Med. 2002;64(2):302-310.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 57, 69.

Douglas RM, Chalker EB, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2000;(2):CD000980.

Eby GA. Zinc ion availability-the determinant of efficacy in zinc lozenge treatment of common colds. J Antimicrob Chemother. 1997;40:483-493.

Fiore C, Eisenhut M, Krausse R, Ragazzi E, Pellati D, Armanini D, Bielenberg J. Antiviral effects of Glycyrrhiza species. Phytother Res. 2007 Sep 20; [Epub ahead of print]

Fortes C, Forastiere F, Agabiti N, et al. The effect of zinc and vitamin A supplementation on immune response in an older population. J Am Geriatr Soc. 1998;46:19–26.

Glatthaar-Saalmuller B, Sacher F, Esperester A. Antiviral activity of an extract derived from roots of Eleutherococcus senticosus. Antiviral Res. 2001;50(3):223-8.

Gruenwald J, Brendler T, Jaenicke C, et al, eds. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company Inc; 2000:283-287, 477-479.

Guo R, Pittler MH, Ernst E. Complementary medicine for treating or preventing influenza or influenza-like illness. Am J Med. 2007 Nov;120(11):923-929.e3. Review.

Guralnik M, Rosenbloom RA, Petteruti MP, Lefante C. Limitations of current prophylaxis against influenza virus infection. Am J Ther. 2007 Sep-Oct;14(5):449-54. Review.

Hayashi K, Hayashi T, Kojima I. A natural sulfated polysaccharide, calcium spirulan, isolated from Spirulina platensis: in vitro and ex vivo evaluation of anti-herpes simplex virus and anti-human immunodeficiency virus activities. AIDS Res Hum Retroviruses. 1996;12:1463–1471.

Hewson-Bower B, Drummond PD. Psychological treatment for recurrent symptoms of colds and flu in children. J Psychosom Res. 2001;51(1):369-377.

Hirt M, Nobel Sion, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. ENT J. 2000;79(10):778-780, 782

Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Prim Care. 2002;29(2):231-261.

Jackson JL, Lesho E, Peterson C. Zinc and the common cold: a meta-analysis revisited. J Nutr. 2000;130(5S Suppl):1512S-1515S.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 213.

Kligler B. Echinacea. Am Fam Physician. 2003;67(1):77-80.

Kohut ML, Cooper MM, Nickolaus MS, Russell DR, Cunnick JE. Exercise and psychosocial factors modulate immunity to influenza vaccine in elderly individuals. J Gerontol A Biol Sci Med Sci. 2002;57(9):M557-M562.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:190-196.

Mahady GB. Echinacea: recommendations for its use in prophylaxis and treatment of upper respiratory tract infections. Nutr Clin Care. 2001;4(4):199-208.

McElroy BH, Miller SP. Effectiveness of zinc gluconate glycine lozenges against the common cold in school-aged subjects: a retrospective chart review. Am J Ther. 2002;9(6):472-475.

Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing and treating the common cold. [Review]. Cochrane Database Syst Rev. 2000;(2):CD000530.

Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, PA: Hanley & Belfus, Inc; 2002:166-169, 221-225, 252-258, 369-371.

Roettger B. Homeopathy as an effective treatment for colds and flus. Nutr Sci News Mag. August 1995.

Roxas M, Jurenka J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. Altern Med Rev. 2007 Mar;12(1):25-48. Review.

Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer; 1998:150.

Takkouche B, Regueira-Mendez C, Garcia-Closas R, Figueiras A, Gestal-Otero JJ. Intake of vitamin C and zinc and risk of common cold: a cohort study. Epidemiology. 2002;13(1):38-44.

Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis. 2001;33(11):1865-1870.

Turner RB, Riker DK, Gangemi JD. Ineffectiveness of Echinacea for prevention of experimental rhinovirus colds. Antimicrob Agents Chemother. 2000;44:1708-1709.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 107.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 229.

Van Straten M, Josling P. Preventing the common cold with a vitamin C supplement: a double-blind, placebo-controlled survey. Adv Ther. 2002;19(3):151-159.

Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med. 1995;1(4):361-369.

Review Date:
12/19/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Bronchitis

FitSugar — Wed, 08 Oct 2008 17:35:33 -0700

Overview

Signs and Symptoms
Causes
Diagnosis
Preventive Care
Treatment Approach
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Bronchitis occurs when the air passages in your lungs become inflamed. Bronchitis can be acute or chronic. Acute bronchitis is usually due to a viral infection – such as a cold – that starts in your nose or sinuses and spreads to the airways. Acute bronchitis usually lasts a few days, although you may have a cough for weeks afterward. Chronic bronchitis, on the other hand, occurs most often in people who smoke and, together with emphysema, is known as chronic obstructive pulmonary disease (COPD). Chronic bronchitis is characterized by a productive (wet) cough that is persistent. The mucus that’s produced by the inflamed airways eventually causes scar tissue to form in the lungs, making breathing difficult. For more information, see the article on Chronic Obstructive Pulmonary Disease.

Signs and Symptoms

Acute bronchitis:

Cough that produces yellow or green mucus
Burning sensation in the chest
Wheezing
Sore throat
Fever
Fatigue

Chronic bronchitis:

Chronic cough that produces mucus
Wheezing, shortness of breath
Blue-tinged lips
Ankle, feet, and leg swelling

Causes

Acute bronchitis is usually caused by the same viruses that cause colds. But exposure to cigarette smoke or pollution, a condition called gastroesophageal reflux disease (GERD), and bacterial infections can also cause bronchitis.

The main causes of chronic bronchitis are cigarette smoking and prolonged exposure to air pollution or dust.

Diagnosis

Your doctor will listen to your chest and back, look at your throat, and may draw blood and take a culture of the sputum from your lungs. If your doctor is concerned about possible pneumonia or COPD, a chest X-ray might be ordered or a lung function test (which measures the amount of air in your lungs) may be ordered.

Preventive Care

The best way to avoid chronic bronchitis is to not smoke and to stay away from air pollutants. For acute bronchitis, take steps to avoid colds and respiratory infections, such as washing your hands frequently, getting an annual flu shot, and (if you are over 65 or have a chronic illness) asking your doctor about the pneumococcal vaccine (Prevnar).

Treatment Approach

Acute bronchitis from a virus generally clears up on its own within 7 to 10 days. Using a humidifier, taking a cough medicine that contains an expectorant (something that helps you "bring up" mucus), and drinking plenty of fluids can help relieve symptoms. If a bacterial infection is the culprit, your doctor may prescribe antibiotics.

Lifestyle

Do not smoke, and avoid secondhand smoke.
Use a humidifier or inhale steam from a bowl.
Drink plenty of fluids.
Rest.
If you have low oxygen levels from chronic bronchitis, you may need home oxygen therapy.

Medications

For chronic bronchitis:

Bronchodilators - increase airflow by opening airways and help make it easier to breathe

Corticosteroids - reduce inflammation; either inhaled with an inhaler or taken by mouth, they are usually used to treat moderate to severe COPD

For acute bronchitis:

Antibiotics - for bacterial infection

Cough medicines - Two types of cough medicines, cough suppressants (for a dry cough) or expectorants (for a wet, productive cough that brings up mucus), are available over the counter and by prescription. Usually doctors recommend not suppressing a cough in cases of acute bronchitis, unless your cough is keeping you from sleeping at night.

Nutrition and Dietary Supplements

For chronic bronchitis:

N-acetylecysteine (NAC, 400 to 1,200 mg per day) - NAC is a modified form of a dietary amino acid that works as an antioxidant in the body. Several studies using it to treat COPD indicate that it may help relieve symptoms by acting as an antioxidant to reduce oxidative stress on the lungs (damage caused by free radicals, particles that harm cells and DNA). Although not all the studies agree, some suggest that taking NAC can reduce the number of attacks of severe bronchitis.

For acute bronchitis:

Because bronchitis often follows a cold, some of the same supplements used to prevent or treat a cold may be helpful.

Probiotics (Lactobacillus) - So-called “good” bacteria or probiotics help prevent infections in the intestines, and there is preliminary evidence that they might help prevent respirator infections, too. One study found that children in daycare centers who drank milk fortified with Lactobacillus had fewer and less severe colds. Several studies that examined probiotics combined with vitamins and minerals also found a reduction in the number of colds caught by adults, although it’s not possible to say whether the vitamins, minerals, or probiotics were most responsible for the benefit.
Chicken soup - It’s about as traditional a remedy for a cold as you can find (at least in modern history). In fact, chicken soup and warm liquids (broth, tea) can help soothe a sore throat and loosen mucus, which in turn helps ease congestion from a cold.

Herbs

For acute bronchitis/Preventing respiratory infections:

Echinacea (Echinacea purpurea, 300 mg three times per day) - Echinacea may help prevent colds, which can lead to bronchitis. An analysis of 14 scientific studies found that people who took echinacea reduced their risk of getting a cold by 58 percent and reduced the duration of a cold by an average of a day and a half. However, many of the studies used echinacea in combination with another herb or vitamin, so it’s impossible to say which one was responsible for the benefit. Echinacea should not be used by women who are pregnant or breastfeeding, or by anyone taking drugs that suppress the immune system (such as corticosteroids or methotrexate).
Andrographis (Andrographic paniculata) - Andrographis may also help lessen cold symptoms and possibly reduce your risk of getting bronchitis. One study found that andrographis, an herb used in Ayurvedic medicine, combined with eleuthero (Eleutherococcus senticosus) in a formula called Kan Jang, helped reduce cold symptoms.
Garlic (Allium sativum) - In one study, people who took garlic for 12 weeks between November and February had 63 percent fewer colds than people who took placebo. Those who did get a cold recovered about one day faster. Because garlic can increase the risk of bleeding, people who take anticoagulants (blood-thinners, such as aspirin or warfarin) should not take garlic. Women who are pregnant or breastfeeding should talk to their doctor before taking garlic supplements.
Ginseng (Panax quinquefolius, 400 mg per day) - At least two studies suggest that taking American ginseng may help prevent colds, as well as reduce the number of colds experienced and the severity of symptoms.

For acute and chronic bronchitis/Expectorants for cough:

Essential oil monoterpenes - A combination of essential oils, including eucalyptus (Eucalyptus globulus), a citrus oil, and an extract from pine, has been suggested for several respiratory illnesses, including both acute and chronic bronchitis. One study found that people with acute bronchitis treated with essential oil monoterpenes did better than people who took placebo. Another study found that people who took the herbal treatment did as well as those who took antibiotics. However, more studies are needed.
Lobelia (Lobelia inflata) - Also called Indian tobacco, lobelia has a long history of use as an herbal remedy for respiratory problems including bronchitis. It is an effective expectorant, meaning that it helps clear mucus from your lungs. However, lobelia can be toxic and should only be used under a doctor’s supervision.
Mullein (Verbascum densiflorum, 3 g per day) - Mullein is an expectorant, meaning it helps clear your lungs of mucus. Traditionally, it has been used to treat respiratory illnesses and coughs with lung congestion. However, it has not been studied for bronchitis.
Peppermint (Mentha x piperita) - Peppermint is widely used to treat cold symptoms. Its main active agent, menthol, is a good decongestant. Menthol also thins mucus and works as an expectorant, helping loosen and break up phlegm.

For acute bronchitis:

South African geranium (Pelargonium sidoides ) - Although scientific evidence is preliminary, a specific extract from South African geranium did show positive results in a few studies. In one study, people with acute bronchitis recovered faster when taking this extract than those who took placebo. In another study, people who took the extract did as well as those who took antibiotics, but without some side effects of the antibiotics. More studies are needed.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bronchitis in addition to standard medical care. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Aconitum - for early stages of bronchitis or other respiratory disorders; this remedy is most appropriate for people with a hoarse, dry cough who complain of dry mouth, thirst, restlessness, and being awakened by their own coughing; symptoms tend to worsen in cold air or when when lying on one's side

Antimonium tartaricum - for wet, rattling cough (although the cough is usually too weak to bring up mucus material from the lungs) that is accompanied by extreme fatigue and difficulty breathing; symptoms usually worsen when lying on one's back; this remedy is particularly good for children and the elderly and is generally used during the later stages of bronchitis

Bryonia - for dry, painful cough that tends to worsen with movement and deep inhalation; this remedy is most appropriate for individuals who are generally thirsty, chilly, and irritable

Hepar sulphuricum - for later stages of bronchitis, accompanied by wheezing, scant mucus production, and coughing that occurs when any part of the body gets cold

Ipecacuanha - for the earliest stages of bronchitis accompanied by a deep, wet cough, nausea and vomiting; this remedy is commonly prescribed for infants

Phosphorus - for several different types of cough but usually a dry, harsh cough accompanied by a persistent tickle in the chest and significant chest pain; this remedy is most appropriate for individuals who are often worn out and exhausted, tend to be anxious and fear death, and require a lot of reassurance

Massage and Physical Therapy

Aromatherapy

Running a humidifier with an essential oil such as cedarwoord, bergamot, eucalyptus, myrrh, sweet fennel, jasmine, lavender, tea tree, or marjoram at night may help thin mucus and ease cough. Talk to an experienced aromatherapist to learn which oil, alone or in combination, is best for you.

Prognosis and Complications

For acute bronchitis, symptoms usually resolve within 7 to 10 day; however, a dry, hacking cough can linger for a number of weeks.

The chance for recovery is poor for advanced chronic bronchitis. Early treatment, combined with stopping smoking, can stop lung damage from progressing and improve quality of life.

Supporting Research

Barrett B, Vohmann M, Calabrese C. Echinacea for upper respiratory infection. J Fam Pract. 1999;48:628-635.

Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med. 2001;111(2):103-108.

Blumenthal M, Goldberg A, Brinkman J, ed. Herbal Medicine. Expanded Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 2000:33-35, 297-303, 335-340.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 68.

Frank LG. The efficacy of Echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double blind, placebo-controlled study. J Comp Alt Med. 2000;6(4):327-334.

Guo R, Pittler MH, Ernst E. Complementary medicine for treating or preventing influenza or influenza-like illness. Am J Med. 2007 Nov;120(11):923-929.e3. Review.

Jackson IM, et al. Efficacy and tolerability of oral acetylcysteine (Fabrol) in chronic bronchitis: a double-blind placebo controlled study. J Int Med Res. 1984; 12(3): 198-206.

Hasani A, Pavia D, Toms N, Dilworth P, Agnew JE. Effect of aromatics on lung mucociliary clearance in patients with chronic airways obstruction. J Altern Complement Med. 2003 Apr;9(2):243-9.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 210.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:40-43.

Lizogub VG, Riley DS, Heger M. Efficacy of a pelargonium sidoides preparation in patients with the common cold: a randomized, double blind, placebo-controlled clinical trial. Explore (NY). 2007 Nov-Dec;3(6):573-84.

Mahady GB. Echinacea: recommendations for its use in prophylaxis and treatment of upper respiratory tract infections. Nutr Clin Care. 2001;4(4):199-208.

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Review Date:
12/27/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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Sinusitis

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment Approach
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Sinusitis occurs when your sinuses – air-filled cavities around your nose, eyes, and cheeks – get inflamed. The inflammation is often due to an infection, caused by a virus (such as a cold), bacteria, or fungus. Healthy sinuses are open, allowing mucus to drain and air to circulate in your nasal passages. But inflamed sinuses are blocked, so that mucus can’t drain out, and eventually the sinus cavities become blocked.

Sinusitis can be acute (with symptoms lasting less than 12 weeks) or chronic (with symptoms recurring or lasting longer than 12 weeks). Most cases of sinusitis are acute and are caused by a cold. Sinusitis is very common; each year, more 30 million people (adults and children alike) get sinusitis in the United States.

Signs and Symptoms

The symptoms of acute and chronic sinusitis are similar. Chronic sinusitis usually does not cause fever, and its symptoms last longer and include fatigue. Chronic sinusitis is most common in people who have allergies.

Pain or pressure in your forehead, temples, cheeks, nose, and behind your eyes
Nasal congestion
Nasal discharge (yellow or green)
Postnasal drip (a sensation of fluid dripping down the back of your throat, particularly at night or when lying down)
Toothache
Cough, often worse at night
Sore throat
Fever
Bad breath
Loss of smell
Fatigue
General sense of not feeling well (malaise)

Causes

Sinusitis usually follows an upper respiratory infection (such as a cold) or an allergic reaction (such as hay fever, or allergic rhinitis). These can cause inflammation and swelling that keeps the sinuses from draining properly. When sinuses become blocked, they provide a place for bacteria, viruses, and fungus to live and grow rapidly. Although a cold is most often the culprit, sinusitis can be caused by anything that prevents the sinuses from draining.

Other common causes for sinusitis include the following:

Allergies (hay fever, cigarette smoke, dry air, pollutants)
Changes in air pressure (for example, from swimming or climbing high altitudes)
Infections from dental problems
Obstructions in the nasal or sinus cavities (such as nasal polyps, deviated septum, or nasal bone spur)
Physical injury to the sinuses
Bacteria, viruses, and fungi

Risk Factors

Having asthma
Overuse of nasal decongestants
Frequent swimming and/or diving
Climbing or flying to high altitudes
Nasal polyps (swellings in the nasal passage) or nasal bone spurs; or other abnormalities such as a deviated septum or cleft palate
Dental infection
Exposure to air pollution and cigarette smoke
Pregnancy
Gastroesophageal reflux disease (GERD), in which stomach acid backs up into the esophagus
Being in the hospital, especially if the reason you are in the hospital is related to a head injury or you needed a tube inserted into your nose (for example, a nasogastric tube from your nose to your stomach)

Diagnosis

Although chronic sinusitis can be hard to diagnose because the symptoms are similar to that of a cold, your doctor can generally make a diagnosis of sinusitis from your medical history and by examining you. If your doctor suspects chronic sinusitis, he or she may order imaging tests, including an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If your doctor suspects allergies may be causing your sinusitis, he or she may suggest an allergy test. Sometimes, a referral to a specialist – known as an ear, nose and throat (ENT) doctor or an otolaryngologist – is necessary. This specialist may perform a nasal endoscopy using a fiber optic scope to look at your sinuses.

Preventive Care

The best way to prevent sinusitis is to prevent or quickly treat flu or colds by:

Getting an annual flu shot
Washing your hands often, particularly after shaking hands with others
Eating plenty of fruits and vegetables to keep your immune system strong
Reducing stress

Treatment Approach

Treatment of sinusitis aims to reduce inflammation and clear your sinuses. Your doctor may prescribe antibiotics or corticosteroids. Lifestyle changes, such as using a humidifier or irrigating your nasal passages with salt water, may also help. Several dietary supplements and herbs may help prevent colds and flu or shorten their duration, or work together with antibiotics to treat your infection and support your immune system.

Lifestyle

These measures can help reduce congestion in your sinuses:

Using a humidifier
Using a saline nasal spray
Inhaling steam 2 to 4 times per day (for example, sitting in the bathroom with the shower running)
Quickly treating allergic and asthma attacks

Medications

Antibiotics - Your doctor may prescribe antibiotics if he or she suspects you have a bacterial infection. are prescribed if a bacterial infection is present or suspected. To treat acute sinusitis, you may take from 10 to 14 days of antibiotics. Treating chronic sinusitis may take longer, usually 3 to 4 weeks.

Nasal corticosteroids - These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although it can take from a few days to a week after you start using them to see improvement.

Beclomethasone (Beconase)
Fluticasone (Flonase)
Mometasone (Nasonex)
Triacinolone (Nasacort)

Antihistamines - Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies. Over the counter antihistamines are short-acting and can relieve mild to moderate symptoms. All work by blocking the release of histamine in your body.

Over-the-counter antihistamines: Include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist). These older antihistamines can cause sleepiness. Loratadine (Claritin), a newer antihistamine, does not cause drowsiness.
Prescription antihistamines: These medications are longer-acting than over-the-counter antihistamines and are usually taken once a day. They include fexofenadine (Allegra) and cetrizine (Zyrtec).

Decongestants - Many over-the-counter and prescription decongestants are available in tablet or nasal spray form. They are often used with antihistamines. Oral and nasal decongestants include Sudafed, Actifed, Afrin, Neo-Synephrine. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or enlarged prostate should not take drugs containing pseudoephedrine. Nasal decongestants can cause "rebound congestion," where the nasal passages swell. Avoid using nasal decongestants for more than 3 days in a row, unless specifically instructed by your doctor, and do not use them if you have emphysema or chronic bronchitis.

Surgery and Other Procedures

For chronic sinusitis that doesn’t respond to medication, your doctor may recommend endoscopic sinus surgery, which may be done to remove polyps or bone spurs. Enlarging the sinus opening is also sometimes recommended. A newer procedure called balloon rhinoplasty involves inserting a balloon inside the sinus cavity and then inflating it.

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider.

Bromelain - Several studies suggest that bromelain, an enzyme derived from pineapples, may help reduce inflammation and swelling and relieve symptoms of sinusitis. However, not all studies found any benefit. Bromelain is often combined with quercetin a flavonoid (plant pigment responsible for the colors found in fruits and vegetables) that may act as an antihistamine. Bromelain may increase the risk of bleeding, so people who take anticoagulants (blood-thinners) should not take bromelain without talking to their doctor first. Taking bromelain with ACE inhibitors may cause a drop in blood pressure (hypotension).
Quercetin - Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables. In test tubes, it inhibits the production and release of histamine, which causes allergy symptoms such as a runny nose and watery eyes. It’s often combined with bromelain, a supplement made from pineapples. However, there is not yet much evidence that quercetin would work the same way in humans. More studies are needed. Some people report that water-soluble quercetin such as quercietin methyl chalcone may work best.
Probiotics (Lactobacillus) - Probiotics, or "friendly" bacteria, may be helpful if you are taking antibiotics for sinusitis. They may also reduce your chances of developing allergies.
N-acetylcysteine (NAC, 1,000 mg three times per day with meals) - NAC is a modified form of a dietary amino acid that works as an antioxidant in the body. It also helps thin mucus. Although no scientific studies have been done to see if it works for sinusitis, some doctors report that it does lessen sinus congestion..

Herbs

Eucalyptus (Eucalyptus globulus) - Laboratory studies show that eucalyptus oil has strong antibacterial properties. Studies in animals and test tubes also found that eucalyptus oil acts as an expectorant (helping get rid of mucus in the respiratory passages, which might help sinusitis). It’s often used to treat congestion from a cold or flu. One study found that people who took 200 mg of an extract of eucalyptus oil (cineole) three times per day had a greater reduction in symptoms of sinusitis than those who took placebo.
Essential oil monoterpenes - A combination of essential oils, including eucalyptus, a citrus oil, and an extract from pine, has been suggested for several respiratory illnesses, including sinusitis. One study found that people with viral sinusitis who took essential oil monoterpenes did better than people who took placebo. However, more studies are needed.
Sinupret (A proprietary formulation containing Sambucus nigra or European elder, Rumex acetosa or common sorrel, Primula veris or cowslip, Verbena officinalis or European vervain, Gentiana lutea or gentian) - In two studies, Sinupret was found to be more effective than placebo in relieving symptoms of sinusitis. The herbs it contains may work by thinning mucus and helping the sinuses to drain, and they may also help strengthen the immune system.

Acupuncture

Although studies are few and have found conflicting results, some people may find that acupuncture helps relieve symptoms of sinusitis. Acupuncturists usually describe sinusitis as "dampness" which creates inflammation and congestion in the mucus membranes. This dampness is cleared by strengthening the spleen meridian and by working with the stomach meridian. Practitioners often perform needling therapy and/or moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) for this condition.

Chiropractic

Although no studies have examined using chiropractic to treat sinusitis, some practitioners suggest that it may decrease pain and improve sinus drainage for some people.

Homeopathy

There have been few studies examining the effectiveness of specific homeopathic remedies in general. In one study of homeopathy for sinusitis, however, more than 80% of the 119 participants had significant improvement in their symptoms after taking the homeopathic remedy for 2 weeks without antibiotics or other medications. Professional homeopaths may recommend one or more of the following treatments for sinus congestion based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Hepar sulphuricum - for the later stages of sinus inflammation when the pain is concentrated between the eyes and is worsened by cold or motion; nasal discharge tends to be thick and the individual may experience sensitivity of the scalp
Kali bichromicum - this remedy is considered the first choice homeopathic treatment for sinusitis; it is most appropriate for individuals who have pain between the eyes or in the forehead above one eye; nasal discharge is generally stringy; scalp and facial bones are tender to touch and the person may feel dizzy or nauseated; pain is worse around noon and with cold and motion, but improves with warmth and pressure
Mercurius - for sinusitis with thick, green, foul-smelling nasal discharge which may be blood tinged; there may also be a gripping pain around the head extending to the teeth; persons for whom Mercurius is appropriate have symptoms that worsen with open air, sleeping, eating, drinking, and extreme hot or cold; they may also have difficulty regulating their temperature (the individual often fluctuates from feeling cold and chilled to hot and sweaty)
Pulsatilla - for individuals who have a thick, bland, yellow or greenish discharge that is often accompanied by nausea and indigestion; symptoms tend to improve with cool air, pressure, and cool compresses; symptoms worsen when the individual is lying down, especially in a warm room; this remedy is appropriate for individuals who are distinctly not thirsty and require tremendous comforting
Silicea - for individuals with chronic congestion accompanied by head pain that tends to be worse in the right eye; this pain is worsened by cold, movement, light, noise, and mental concentration (such as when studying) but relieved by heat and pressure
Spigelia - for sinusitis with sharp pains on the left side of the face, generally coming on after exposure to cold, wet weather; symptoms are aggravated by warmth, light, noise, and movement, but are relieved by cold compresses or cool water on the face and when the individual is lying down with the head propped up

Other Considerations

If you are not better in a few weeks, your doctor may refer you to an ENT specialist for tests to find the cause of your sinus infection.

Pregnancy

Sinusitis often acts up during pregnancy. There are many herbs and medications that pregnant and breastfeeding women should not use, so always ask your doctor before taking any medication, whether prescription, over-the-counter or alternative.

Warnings and Precautions

Some serious diseases can have similar symptoms to sinusitis. Be sure to see your doctor if you are not feeling better or have new symptoms. Tell your doctor if you may be pregnant.

Prognosis and Complications

Acute sinusitis is usually curable. If you have recurrent attacks, you should be evaluated for underlying causes (such as nasal polyps or another structural problem). Although very rare, complications may include:

Osteomyelitis, an infection that spreads to the bones in the face
Meningitis, an infection that spreads to the brain
Orbital cellulites, an infection that spreads to the area surrounding the eye
Abscess
Blood clot

Supporting Research

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Review Date:
12/20/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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