HERBS USED IN ASTHMA TREATMENT- AN OVERVIEW

ABOUT AUTHORS:
Dipal Patel^*1, Dr. Kamal Singh Rathore¹, Dr. O.P.Mahatma¹, Twinkal Patel^2
1B.N. Institute of Pharmaceutical Sciences, Udaipur (Rajasthan), 313001
²Shree Sarvajanik College of Pharmacy, Mahesana (Gujarat).
*dipalpatel786@gmail.com

ABSTRACT:
Asthma is a respiratory disease that affects both adults and children and asthma is today one of the most common chronic childhood ailments. There is no scientifically proven cure for asthma but it can be controlled and regulated. Natural treatments for asthma are meant to complement, or as an addition, to your existing medication but never as a replacement. Before using an herbal asthma remedy keep in mind that medicinal herbs can be as powerful as pharmaceutical drugs and should be treated as such so it is important to seek the support of your health care provider as some natural herbs for asthma treatment may conflict with pharmaceuticals commonly prescribed for asthma.

Medicinal Herbs Used For Asthma Treatment, Licorice (Glycyrrhiza glabra)-The Licorice root has been used traditionally to restore breathing and calm the breathing passageways. Adhatoda (Adhatoda vasica)- The leaf has been used for centuries to treat asthma where it works as a bronchodilator and mild expectorant. Adhatoda also works by decreasing the viscosity of mucous to assist with expectoration. Key constituents of adhatoda leaf are the quinazoline alkaloids (0.5–2%). The major alkaloid is vasicine present at levels of 45–95% and is the original source of the drug bromhexine, which is often still used to assist expectoration. Ginkgo Biloba (Ginkgo biloba)-One of the oldest herbs in use today, ginkgo has a broad range of indications. For asthma sufferers, ginkgo works to inhibit PAF (platelet activating factor), a powerful inducer of platelet aggregator and anaphylactic reactions. Natural Herbs that stimulate anti-PAF activity are known to assist in the treatment of asthma, allergic reactions, thrombosis and shock. One study showed that a 600mg standardised dose of ginkgo reduced airway hypersensitivity in patients with asthma. Turmeric (Curcuma longa-)In an uncontrolled trial in India, 60% of asthma patients given 6-12grams of turmeric powder that had been fryed in ghee showed a relief in their symptoms. Curcumin is a powerful anti-inflammatory in both acute and chronic conditions, and it is believed to work in a variety of biological pathways to reduce inflammation. Chinese Skullcap (Scutellaria baicalensis)-The root of this plant has been used in traditional Chinese medicine (TCM) for a variety of conditions including asthma. Chinese skullcap contains flavone derivatives including baicalin, wogonin and baicalein which inhibit histamine release from mast cells in vitro. Baicalin showed antiasthmatic activity (antihistaminic and anticholinergic activity) in isolated tracheal muscle from asthmatic guinea pigs. Reducing hypesensitivity and inflammation in airways is vital to managing asthma. Other natural herbs that have been used for asthma treatment, Ephedra (Ephedra sinica),Garlic- (Allium sativum),Red Clover- (Trifolium pratense),Coleus- (Coleus barbatus),Echinacea- (Echinacea angustifolia),Skullcap- (Scutellaria lateriflora).Great Mullein- (Verbascum thapsus), Picrorhiza Kurroa- (Picrorhiza kurroa), Lobelia- (Lobelia inflata) etc. used in recently.

REFERENCE ID: PHARMATUTOR-ART-1756

Introduction:
Asthma is a chronic disease that affects the airways of the lungs. During normal breathing, the bands of muscle that surround the airways are relaxed and air moves freely. During an asthma episode or “attack,” there are three main changes that stop air from moving easily through the airways:

Fig.: Alveoli

• The bands of muscle that surround the airways tighten and make the airways narrow. This tightening is called bronchospasm.
• The lining of the airways becomes swollen or inflamed.
• The cells that line the airways produce more mucus, which is thicker than normal.

These three factors - bronchospasm, inflammation, and mucus production - cause symptoms such as difficulty breathing, wheezing, and coughing.

Symptoms of asthma
Asthma symptoms are not the same for everyone. They can even change from episode to episode in the same person. Also, you may have only one symptom of asthma, such as cough, but another person may have all the symptoms of asthma. It is important to know all the symptoms of asthma and to be aware that your asthma can present in any of these ways at any time.

The most common symptoms include:

• Coughing, especially at night
• Shortness of breath
• Wheezing
• Chest tightness, pain, or pressure

Fig.:  Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.

Fig.: Bronchoconstriction to Airway Inflammation

Causes of asthma
The airways in a person with asthma are very sensitive and react to many things, or “triggers.” Contact with these triggers causes asthma symptoms. One of the most important parts of asthma control is to identify your triggers and then avoid them when possible. The only trigger you do not want to avoid is exercise. Pre-treatment with medicines before exercise can allow you to stay active yet avoid asthma symptoms.

Common asthma triggers include:

• Allergens (dust mites, pollens, pets, mold spores, cockroaches, and sometimes foods)
• Exercise
• Infections (colds, viruses, flu, sinus infections)
• Irritants (strong odors from cleaning products, perfume, wood smoke, air pollution)
• Some medications
• Strong emotions such as crying or laughing hard
• Tobacco smoke
• Weather (changes in temperature and/or humidity, cold air)

Diagnosis of asthma
To diagnose asthma, your doctor will first review your medical history, family history, and symptoms. Your doctor will want to know any past history of breathing problems you may have had, as well as a family history of asthma, allergies, eczema (a bumpy, itchy skin rash caused by allergies), or other lung disease. It is important that you describe your symptoms in detail (cough, wheeze, shortness of breath, chest tightness), including when and how often they occur.

The doctor will perform a physical examination and listen to your heart and lungs. He or she may also order breathing tests, allergy tests, blood tests, and chest and sinus X-rays. The tests will find out if you do have asthma and if there are any other conditions that are contributing factors.

Treatment of asthma
Asthma can be controlled, but not cured. It is not normal to have frequent symptoms, trouble sleeping, or trouble completing tasks. Appropriate asthma care will prevent symptoms and visits to the emergency room and hospital. Asthma medicines are one of the mainstays of asthma treatment. The drugs used to treat asthma are explained below.

- Anti-inflammatory: These are the most important drugs for most people with asthma. Anti-inflammatory drugs reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers. These medications need to be taken daily and may need to be taken for several weeks before they begin to control asthma. Anti-inflammatory medicines lead to fewer symptoms, better airflow, less sensitive airways, less airway damage, and fewer asthma attacks. If taken every day, they CONTROL or prevent asthma symptoms.

- Bronchodilators: These drugs relax the muscle bands that tighten around the airways. This action opens the airways, letting more air in and out of the lungs and improving breathing. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily. In short-acting forms, bronchodilators RELIEVE or stop asthma symptoms by quickly opening the airways and are very helpful during an asthma episode. In long-acting forms, bronchodilators provide CONTROL of asthma symptoms and prevent asthma episodes.

- Asthma drugs can be taken in a variety of ways. Inhaling the medications—by using a metered dose inhaler, dry powder inhaler, or nebulizer—is one way of taking asthma medicines. Oral medicines (pills or liquids you swallow) may also be prescribed.

Asthma severity
Asthma is classified as either “intermittent” (comes and goes) or “persistent” (lasting). Persistent asthma is further described as being mild, moderate, or severe. The severity of asthma is based on how often you have symptoms both during the day and night, as well as by the results of lung function tests and by how well you can perform activities. The “severity” of asthma refers to how “intense” or “strong” your asthma.

Goals of asthma therapy
These are the goals of asthma treatment:

• Live an active, normal life
• Prevent chronic and troublesome symptoms
• Attend work or school every day
• Perform daily activities without difficulty
• Stop urgent visits to the doctor, emergency room, or hospital
• Use and adjust medications to control asthma with few or no side effects

If you are unable to reach all of these goals, your asthma is not under control. You should contact your asthma care provider for advice.

By learning about asthma and how it can be controlled, you take an important step toward managing this disease. Work closely with your asthma care team to learn all you can about your asthma, how to avoid triggers, what your medications do, and how to take them correctly. With proper care, you can live free of asthma symptoms and maintain a normal, healthy lifestyle.

Herbal Supplements Used For Asthma
Here are many natural herbs and herbal supplements that can be used for asthma treatment. Natural asthma treatment incorporates vitamins, minerals and herbs to relieve symptoms and prevent further attacks.

Asthma is a respiratory disease that affects both adults and children and asthma is today one of the most common chronic childhood ailments. There is no scientifically proven cure for asthma but it can be controlled and regulated.

Natural treatments for asthma are meant to complement, or as an addition, to your existing medication but never as a replacement. Before using an herbal asthma remedy keep in mind that medicinal herbs can be as powerful as pharmaceutical drugs and should be treated as such so it is important to seek the support of your health care provider as some natural herbs for asthma treatment may conflict with pharmaceuticals commonly prescribed for asthma.

Medicinal Herbs Used For Asthma Treatment

• Licorice (Glycyrrhiza glabra)
  The Licorice root has been used traditionally to restore breathing and calm the breathing passageways.
• Adhatoda (Adhatoda vasica)
  This herb is a small evergreen shrub that is found at lower altitudes in India and South East Asia. The leaf has been used for centuries to treat asthma where it works as a bronchodilator and mild expectorant. Adhatoda also works by decreasing the viscosity of mucous to assist with expectoration. Key constituents of adhatoda leaf are the quinazoline alkaloids (0.5–2%). The major alkaloid is vasicine present at levels of 45–95% and is the original source of the drug bromhexine, which is often still used to assist expectoration.
• Ginkgo Biloba (Ginkgo biloba)
  One of the oldest herbs in use today, ginkgo has a broad range of indications. For asthma sufferers, ginkgo works to inhibit PAF (platelet activating factor), a powerful inducer of platelet aggregator and anaphylactic reactions. Natural Herbs that stimulate anti-PAF activity are known to assist in the treatment of asthma, allergic reactions, thrombosis and shock. One study showed that a 600mg standardised dose of ginkgo reduced airway hypersensitivity in patients with asthma.
• Coltsfoot (Tussilago farfara)
  It has been used medicinally as a cough suppressant. The plant has been used in historical times to treat lung ailments such as asthma as well as various coughs by way of smoking.
• Turmeric (Curcuma longa)
  Turmeric is a member of the ginger family and has been used as a colouring agent, spice and medicine for thousands of years. The active constituents are the diarylhepanoids, including curcumin, which are found in the vividly yellow rhizome. In an uncontrolled trial in India, 60% of asthma patients given 6-12grams of turmeric powder that had been fryed in ghee showed a relief in their symptoms. Curcumin is a powerful anti-inflammatory in both acute and chronic conditions, and it is believed to work in a variety of biological pathways to reduce inflammation. In some models studied, curcumin showed a similar efficacy to cortisone and phenylbutazone.
• Chinese Skullcap (Scutellaria baicalensis)
  The root of this plant has been used in traditional Chinese medicine (TCM) for a variety of conditions including asthma. Chinese skullcap contains flavone derivatives including baicalin, wogonin and baicalein which inhibit histamine release from mast cells in vitro. Baicalin showed antiasthmatic activity (antihistaminic and anticholinergic activity) in isolated tracheal muscle from asthmatic guinea pigs. Reducing hypesensitivity and inflammation in airways is vital to managing asthma.
• Grindelia (Grindeliaspp.)
  This is an expectorant herb with bronchospasmolytic activity. It is traditionally recommended for the treatment of spasmodic respiratory conditions such as asthma and bronchitis. The British Herbal Pharmacopoeia 1983 lists the specific indication as bronchial asthma with tachycardia. Californian Native Americans used grindelia not only for skin infections but also for bronchial conditions where grindelia eventually gained the attention of the Catholic missionaries. The dried leaf and flowering tops of grindelia were official in the United States Pharmacopoeia 1882– 1926, and have been in the National Formulary, 1926–1960.

The Use of Herbal Supplements for Natural Asthma Relief
Like all herbal medications, natural herbs for asthma treatment need to be focused on the individual and any natural asthma treatment needs to address environmental and nutritional needs as well as reducing hypersensitivity of the airways.

A good herbal asthma remedy will help to reduce the incidence and severity of asthma and will form part of an overall treatment plan. Asthma should be taken seriously and treatment must be taken under the supervision of a qualified health care practitioner.

Botanical Name: Allium sativum.

Therapeutic Benefits and Uses of Garlic

• Garlic’s history as a medicinal herb tracks back to the Greeks and Romans.
• Garlic has been used historically as an herbal antiseptic. It was used to help prevent conditions such as gangrene in wounds. The raw juice was expressed, diluted with water, and put on swabs of sterilized Sphagnum moss, which was applied to wounds to prevented septic results.

- Garlic has been used for a long time to prevent and treat all kinds of health problems including colds, flu, menstrual pain, Crohn’s disease, sinusitis, gastrointestinal problems, fungal infections such as athlete’s foot, warts and atherosclerosis to name a few.

• It has been used as herbal remedy for bronchitis, whooping cough, coughs, hoarseness and difficulty of breathing and other disorders of the lungs, including asthma.
• There are suggestions that garlic may be helpful as an herbal cancer remedy by reducing the size of cancerous tumors and that it can help prevent certain cancers that attack the intestines, such as colon cancer.
• Garlic is used to naturally improve the immune system and is also supposed to be an excellent herbal antioxidant hence its popularity as an anti aging herb.
• The most research which has been done on its potential has been in the area of reducing heart disease. Garlic is a great herb for lowering cholesterol, and numerous large studies have shown that taking supplements that mimic fresh garlic can significantly lower LDL cholesterol levels without hurting beneficial HDL cholesterol levels. Garlic appears to act by blocking the liver from making too much LDL cholesterol.
• There is also some suggestion that garlic may prove to be mildly effective as a medicinal herb for lowering blood pressure by dilating or expanding blood vessels. Researchers are finding that it can help to prevent blood clots and therefore reduce the risk of heart attack and stroke.

Dosage and Administration
As supplement garlic is most commonly taken daily in capsule form containing between 1000 and 3000 mg, 0.03 to 0.12 mL of garlic oil can be taken three times a day.
Garlic Juice, 10 to 30 drops or as specified by manufacturer

Side Effects of Garlic
There are some herbalists who do not promote the use of garlic in capsule or tablet form. They believed that the full effect of garlic is best achieved by working with the whole clove.

Garlic supplements are said to have no side effects other than the strong odor.

The combination of using garlic and warfarin may result in a greater risk of bleeding. Large doses of garlic should not be ingested when using warfarin, indomethacin, dipyridamole, aspirin, or other medications that thin the blood.

Botanical Name of Red Clover: Trifolium pratense L.

Therapeutic Uses, Benefits and Claims of Red Clover

·         Red clover has a long history of traditional use in China, Europe and Russia for a variety of medical conditions including bronchial asthma, liver and digestive ailments.

• It was thought to purify the blood by promoting urine, mucus and bile production and improve circulation.
• Traditionally red clover ointments have been applied to the skin to treat conditions such as psoriasisand eczema.
• There is a history of use of red clover as a short-term herbal cough medicine for children.
• Red clover is a rich source of the isoflavones; formonnectin, biochanin A, daidzin and genistein which are natural hormones
• Red clover supplements are promoted worldwide for the treatment of menopausal symptoms and the maintenance of health and welfare after the menopause.
• Clinical trials show that red clover extracts may provides some benefit for hot flushes associated with the menopause.
• It is also suggested that red clover may be of use for women experiencing breast pain and menstrual cramps.
• There is promising evidence for a positive role for red clover in the development of osteoporosis.
• Red clover extracts have been shown to have a positive effect on high blood pressure.
• Clinical studies have shown red clover to have no detrimental effect on the womb or breast tissue.
• In addition it’s natural hormonal components; Red clover contains many essential vitamins and minerals like calcium, chromium, niacin, phosphorous, potassium, thiamine, magnesium, and vitamin C.
• Red clover can be found in herbal combinations thought to be useful for women’s health.

Side Effects of Red Clover
Side effects with red clover are generally mild and rare. They include breast tenderness, menstruation changes and weight gain. Red clover extracts have theoretically been associated with interactions with blood thinning agents e.g. warfarin and hormonal therapies but this has not been confirmed with actual case reports. Although there is no evidence for concern, it is advised that red clover extracts should be avoided in women with a history of breast cancer. Pregnant and breast feeding women should not take red clover.

* Botanical Name: Plectranthus barbatus, Coleus barbatu

Therapeutic Uses, Benefits and Claims of Coleus Forskohlii

• Coleus is a not a particularly remarkable plant to look at, yet is has a 3000 year history in Ayurvedic medicine and is mentioned in ancient Sanskrit texts as a tonic for healthy heart and lungs.
• Today, coleus is not just an herb for cardiovascular ailments but is increasingly being used to assist weight loss by breaking down adipose tissue and preventing production of fatty tissue. In addition, coleus mildly stimulates the metabolism by increasing thyroid hormones and increases the secretion of insulin. These therapeutic indications for coleus are due to its principal active compound, a diterpenoid called forskolin. This is the only plant derived compound known to directly stimulate the enzyme, adenlylate cyclase, and in turn, stimulates cellular cyclic AMP which boosts our metabolism.
• Coleus forskohlii preparations used as eye drops are known to reduce eye pressure in glaucoma.
• Like all good tonics, coleus directly stimulates digestion and is thought to assist in the absorption of nutrients in the small intestine.
• Increased cellular cyclic AMP reduces histamine, making coleus beneficial in the treatment of allergies. Coleus is also a bronchodilator with an anti-histamine action, making it useful in treating asthma.
• Conditions such as hypothyroidism, eczema, psoriasis are also improved by using coleus; largely due to its ability to increase cyclic AMP.
• Popular herb for angina and for the health of the hearth. Coleus increases stroke volume, which is the amount of blood pumped in each heart beat, and reduces the risk of blood clots, coleus lowers high blood pressure by acting to relax the arterial walls.
• Indian and Chinese studies in the last two years have isolated a number of diterpenoids in the stem and leaves of coleus forskohlii with a focus on treatment of gastric cancer and preventing metastatic (secondary) cancers. These have been carried out on animal models with considerable success.

Therapeutic Dosages
Recommended dosage of Coleus forskohlii is 50mg two to three times daily.

Side Effects of Coleus Forskohlii
Care should be used when using coleus with any medication to control asthma or cardiac disease. It is essential to consult your health care professional when altering medications and to thoroughly investigate how medications may interact with each other. If you take blood pressure and heart medications such as beta-blockers, clonidine, hydralazine you should only take coleus under the guidance of a physician. Similarly, blood thinners, including warfarin and heparin warrant coleus to be taken with caution under your physician’s care. ^{1, 2}

* Botanical Name: Echinacea angustifolia, Echinacea purpurea.

Echinacea Therapeutic Benefits and Claims.

• Echinacea is probably the most commonly used herb in the Western World. This herb is used to prevent and treat colds, infections and as an herbal remedy for flu. The three active constituents are alkamides, chicoric acid and polysaccharides; however, the action of these ingredients is still being understood. What useful evidence there is indicates that echinacea mainly stimulates phagocytosis, i.e it acts mainly to stimulate the immune response.
• Echinacea has been used to treat prophylaxis, gingivitis, sinusitis and as a treatment of infectious illness such as influenza, colds and related symptoms like coughs, high fever and sore throat. It is also used for bacterial infections, above all those of a chronic or recurrent nature.
• Echinacea is thought to be of help for allergies, mild septicaemia, pinkeye and skin disorders such as psoriasis.
• It has been used as an herbal remedy to strengthen the immune system and to treat conditions of damaged or suppressed immunity such as post-viral syndromes.

- Echinacea has been used traditionally for the natural treatment of bronchitis and whooping cough.

- As an additional point, a recent study on the value of echinacea in the treatment of colds noted that this herb had no value in treating the common cold. Unfortunately the dosage used in this study was 900mg per day and this is considerably below the therapeutic dose used by herbalists. Also, it should be noted that the cold virus was introduced artificially to young healthy subjects; in real life situations, echinacea is an immune booster for those with compromised immunity from a range of issues including stress, overwork, exhaustion who are exposed to a wide range of constantly evolving viruses

Side Effects of Echinacea
Taken orally, it is rare for Echinacea to cause side effects. In some people however, allergic reactions, such as skin irritations, exacerbated asthma, and anaphylaxis has occurred. People who have allergies to the daisy family, which include plants such as feverfew, chrysanthemums and calendula, may find they are sensitive to Echinacea.

It is advisable to let your health practitioner know of any allergies before they prescribe your herbal medication. In addition, it is worth noting that the quality of Echinacea products varies greatly and you should only buy this herb from a reputable company that guarantees the quality of the ingredients. Echinacea is also contra-indicated in those using immunosuppressant medications as it may reduce the effectiveness of the medication.

Dosage and Administration
Dosages of E. angustifolia root for chronic disorders and infection prophylaxis correspond to 10 to 40 mL per week of a 1:2 fluid extract. For acute disorders and for serious chronic states of immunodeficiency a daily total of 10 to 30 mL can be given at intervals throughout the day. Dosages of fresh Echinacea purpurea tincture used in German studies correspond to 20 to 60 mL per week. Dried herb in tablet form can be taken in doses of 1000mg three times daily

* Botanical Name: Scutellaria lateriflora

Therapeutic and Traditional Uses, Benefits and Claims of Skullcap

• Skullcap contains substances like flavonoids, iridol, sesquiterpene, tannins, bitter substances, essential oil, resin, iron, silicon, calcium, magnesium, lignin and wogonin.
• Some Native American tribes used it as an emmenagogue to bring young girls into womanhood.
• It was also traditionally used to bring on visions (in large doses) during spiritual ceremonies.
• It was once used as a treatment for rabies and schizophrenia (hence the names maddog skullcap, maddog weed and mad weed.)
• This plant is also a nervine with sedative qualities and is helpful in the treatment of many nervous conditions such as epilepsy, hysteria, anxiety and delirium tremens. It has also been found useful in treating symptoms of withdrawal from barbiturates and tranquilizers.
• Medicinal infusions of this herb have been used to promote menstruation.
• An infusion of skullcap may also be helpful in treating throat infections and, due to its antispasmodic and sedative effects. It's also used for treating headaches from stress, neuralgia, and from incessant coughing.
• This herb can also be used to induce sleep naturally without the negative effects of many prescription and over-the-counter sleep aids.
• Skullcap is gaining some recognition as an alternative treatment for attention deficit disorder (ADHD/ADD).
• This plant is sometimes used to treat the symptoms associated with anorexia nervosa, fibromyalgia and even mild Tourette’s syndrome.
• Skullcap is also used as an herbal treatment for asthma and as a hiccup and hangover remedy.

Dosage and Administration
Skullcap is available in powder or liquid extract form and as a dried herb. It is commonly sold in capsule form as well. The recommended dosage for adults is 1 to 2 grams of the dried herb, 2 to 3 cups of tea, 2 to 4 mL of the liquid extract three times daily, or 2 to 5 mL of the tincture three times daily. Children may use skullcap but in small doses. The best method of delivery is a mild tea. The child’s physician should be consulted before use. To make a medicinal tea try adding one pint of boiling water to 1 oz. of the dried herb and steep for 10 minutes. This can be served in half cup servings every few hours. For children add 1 cup boiling water to 1 tsp. of dried leaves and steep only 2 minutes to yield a milder tea.

Side Effects and Interaction of Skullcap
Overdose symptoms include giddiness, stupor, confusion, irregular heartbeat and twitching. Pregnant women shouldn’t use this herb since it may cause a miscarriage.

Some supplements have been tainted with plants of the Teucrium species, which have been shown to cause liver damage. It's important to seek skullcap from reputable sources.

There are no documented cases of negative interactions with other herbs or medications although it does have a sedative effect and should not be combined with prescription sedatives. ^3-9

* Botanical Name of Lavender: Lavandula angustifolia, Lavandula officinalis.

Therapeutic Uses, Benefits and Claims of Lavender

• Lavender is perhaps best known for its calming and soothing effects. There is evidence that it may slow the activity of the nervous system and therefore promote relaxation, improve sleep quality and bring about emotional balance. For this reason, it is often used in combination with other herbal remedies as it treats physical symptoms with a nervous element, such as tension induced headaches, heart palpitations, or stress related digestive issues.
• Lavender’s calming effect on the nervous system has also made it a valuable herbal remedy for the treatment of insomnia. Traditionally, lavender flowers were stuffed into pillows to help restless people sleep and today lavender is a common ingredient in baby bath soaps to promote restful sleep.
• This medicinal herb is used topically to treat fungal infections, wounds, eczema, varicose ulcers, sunburned skin and acne.
• Lavender is thought to be a useful herbal remedy for many symptoms associated with menstruation and other female related ailments. Its anti-spasmodic effect may relieve menstrual cramps and it could be useful in relieving headaches and exhaustion as well as improving mood. It is also thought to stimulate blood flow to the pelvic area and uterus and therefore stimulate menstruation.
• Lavender is currently being investigated for its antiviral and antibacterial properties. It contains volatile oils known to have significant antiseptic value. Evidence suggests that lavender is an effective natural treatment for pathogenic bacteria such as the strains responsible for diphtheria and typhoid, as well as streptococcus and pneumococcus. Its antiseptic qualities, which are enhanced when used in conjunction with tea tree oil, also make lavender useful in treating wounds and insect bites.
• When lavender oil is used topically as a chest rub, it is a traditional treatment for relief of symptoms associated with common colds, chronic coughs, asthma, persistent bronchitis, pneumonia, flu, persistent tonsillitis, and laryngitis.
• Many digestive disorders have been treated naturally with lavender. It may soothe muscle spasms and ease colic, relieve abdominal distension, persistent flatulence, spells of nausea, diarrhea and indigestion. Lavender is also believed to boost flagging appetites.
• Lavender oil has been used on the scalp to help treat head lice but also to promote hair growth among patients with the autoimmune disease alopecia areata.
• Lavender has also been used as an herbal treatment for halitosis and mouth ulcers when used as a mouthwash.

Dosage and Administration:
To prepare lavender tea use 1-2 tsp of whole dried herb, or 1 tbsp fresh herb, per cup of boiling water. Steep for 10-15 minutes and drink 1 to 3 cupfuls a day. A tincture can be prepared in a ratio of 1:4 and a dosage of 20-40 drops can be taken 3 times daily. Lavender oil can be used topically and is safely applied undiluted, though 1-4 drops can be added to a base oil (almond or olive) for ease of application. For an inhalation preparation, add 2-4 drops of oil to 2-3 cups of boiling water and inhale the vapours.

Side Effects of Lavender
There are no known interactions between lavender and conventional medications, however, because it stimulates relaxation, it may increase the effects of depressants such as morphine or oxycodone, as well as anti-anxiety agents or sedatives. It may also increase the sedative effect of antihistamines.

Lavender oil is toxic if taken in large doses orally. It can induce drowsiness and muscular convulsions. Direct contact should also be avoided around eyes or mucous membranes such as lips and nostrils. Some people may have allergies to lavender; dermatitis, nausea, vomiting, headache and chills are reported side effects in these cases. Pregnant or breastfeeding women should avoid use of lavender. Oral use in children is not recommended as there is some evidence that it may cause breast development in boys.

* Botanical Name: Panax quinquefolius.

Therapeutic Uses, Benefits and Claims of American Ginseng

• The active ingredients found in American ginseng are saponins, various acids, beta-sitosterol, tannin, magnesium, vanadium, zinc and trace amounts of germanium, which may be partially responsible for the herb's health benefits. The rootstocks also contain some essential oil.
• The Native Americans have a long historical tradition using the herb both as herbal medicine and in spiritual and ceremonial practices.
• American ginseng has been used as an herbal remedy for stress and mental, emotional and physical exhaustion. It's also looked on as a helpful herb for general weakness, poor appetite, indigestion, constipation, nausea, vomiting, poor memory, nervous agitation, irritability, anemia, impotence, vaginal dryness, blood sugar disorders, colds, night sweats, AIDS, expectoration of blood, coughs, bronchitis, respiratory problems, tuberculosis, rheumatism, headaches and cystitis.
• Modern research indicates that the American ginseng can help adrenal fatigue and as a regulator for the endocrine system. The herb is an adaptogen and can be useful for mild to moderate impairments in the adrenal glands.
• It's sometimes used to boost a weakened immune system.
• The herb has been used to treat allergies and allergic asthma. It's used as a treatment for insomnia associated with chronic fatigue syndrome, and to alleviate many of the symptoms of jet lag.
• Some think the herb can boost endurance and enhance the physical performance of athletes by increasing the amount of available oxygen in the muscles and some studies indicate that American ginseng might improve concentration.
• When American ginseng is taken over a period of one to three months, it's thought to regulate the production of stress hormones in a favorable way by reducing stress response. Although the exact mechanism responsible for the herb stress-reducing effect is not known, it's likely that the herb protects an area of the brain called the hippocampus against stress hormones. This mechanism may also explain why it may be useful to prevent memory loss and loss of cognitive abilities in people who suffer from bipolar disorder, depression and a disorder of the adrenal glands known as Cushing's disease.
• American ginseng may be of particular value as a treatment for some symptoms associated with menopause such as hot flashes and for women with breast cancer by increasing the effect of medication used in chemotherapy.
• American ginseng may effectively protect against spikes in blood glucose levels after ingestion of carbohydrate-rich meals in both healthy subjects and in patients with type 2 diabetes (non-insulin-dependent diabetes) when the herb is taken with or immediately after meals. Scientists, therefore, believe it might be a good alternative to conventional treatment of type 2 diabetes. They believe the herb has the same potential as insulin or other medications to help to control or prevent diabetes. Both men and women with type 2 diabetes might benefit from American ginseng in relatively high doses.
• American ginseng contains substances that regulate both the strength of the heartbeat and blood pressure. If the body has a deficit of potassium, the saponins in the herb curb the rate at which the heart muscle fibers contract. If there's a surplus of potassium, the saponins increase the strength of contraction of heart muscle fibers. To have optimal levels of potassium will also alleviate high blood pressure. Laboratory experiments have shown that American ginseng can lower blood pressure by stimulating the conversion of the amino acid arginine to nitric oxide, which makes the blood vessel walls relax. This action prevents the release of a protein known as endothelin, which can cause blood vessels to constrict during a heart attack.
• Traditionally, this medicinal plant is used to restore sexual desire in men. Although scientific studies involving human test subjects in this context can be difficult to implement, experiments with laboratory animals indicated that it increases interest in sex by influencing the action of the neurotransmitter dopamine in the brain.
• Different tribes of Native Americans have used American ginseng to treat infertility in women although no clinical studies have confirmed the herb has any value for this purpose. However, it is known that American ginseng has some active ingredients, just like Asian ginseng, that stimulate the pituitary gland, which, in turn, stimulates the lining of the uterus.
• Some in vitro experiments have shown that this herb can inhibit the growth of cancer.

Dosage and Administration
Short-term use of American ginseng is thought to have little effect, and it's usually recommended to use the herb for an extended period of time.

The herb can be taken as an infusion, a decoction, in dried powdered form or as a tincture.
Herbalists sometimes recommend the following doses.
Extracts can be made by pouring 3 cups boiling water over 1 to 2 g dried root and letting it simmer for 20 minutes before the herb is strained from the tea. This dose may be taken three timesdaily.
A decoction is made of 3 to 6 g of the dried root and then simmered in half a liter of water for half an hour. This decoction can be divided in three portions consumed throughout the day.
By tincture (1:5 in 30 percent alcohol) 3-5 mL (60-100 drops), three times daily.
A low dose of 200 mg, which can be increased gradually up to 600 mg daily, is often recommended when commercial capsules of American ginseng are used.

The great popularity and value of American ginseng has resulted in the plant´s extinction in much of its native habitat. If the plant is found in the wild allow it to grow in peace, and don't buy roots that are labeled “wild American ginseng”.

Side Effects and Interactions of American Ginseng
American ginseng is considered a very safe herb to use even over a long period of time. Some sources indicate the herb is safe to use during pregnancy, while others believe pregnant or lactating women should avoid it. People with diabetes may need to keep an extra eye on their insulin levels if using American ginseng, since the herb has a glucose lowering effect. Human studies have demonstrated that high doses of American ginseng can have disruptive effects on blood thinning agents like warfarin in otherwise healthy patients. Therefore, avoid consuming large amounts of this herb when using such medications. Some people can experience sleeplessness when they take American ginseng, especially if used with food or beverages containing caffeine. This side effect will reduce by cutting down on caffeine intake and refraining from taking American ginseng in the evening. ^10-16

* Botanical Name: Lobelia inflata.

Benefits, Therapeutic Uses and Claims of Lobelia Inflata

• Lobelia inflatawas used in the 19th century as a medicinal herb to induce vomiting as a mean to remove harmful toxins from the body, which explains one of its name "puke weed."
• Lobeline is a piperidine alkaloid found in the plant and gives rise to the therapeutic claims surrounding it. The herb is thought to stimulate the respiratory center of the brain resulting in deeper and stronger breathing. At a non toxic dose, lobelia is thought to be of value as an herbal remedy for treating bronchitisand whooping cough.
• Lobelia inflata is a bronchodilator and antispasmodic which explains its popularity as a medicinal herb for asthma, spasmodic croup and pneumonia.
• The herb has been used to ease anxiety and panic attacks. It has also been used externally to reduce swellings and as a pain relef.
• The plant has been used traditionally as an herbal remedy for insect bites and stings.
• Lobelia is often considered an herb that is useful for tobacco withdrawal and as an herbal remedy to quit smoking. While there is no information that consolidates this view, historically, lobelia has been used as an alternative to tobacco. Lobeline is also believed to have a similar chemical action to nicotine and this too could give reasoning behind its use in tobacco withdrawal. However, it is vital to note that this herb can have risks that outweigh its benefits and has been known to cause vomiting, dizziness, hypothermia, convulsions and even death.

Dosage and Administration
Recommended dosage of Lobelia are as follows:
Fluid extract – 1:1 ratio in 50% alcohol is 0.2-0.6ml three times daily
Dried Herb – 0.2-0.6gr three times daily.

Side Effects and Possible Interactions of Lobelia Inflata
Extreme care should be used when using any medication to control asthma and Lobelia inflata is no exception. It is essential to consult your health care professional when altering medications and to thoroughly investigate how medications may interact with each other.

Lobelia inflata should be safe to use in very small doses but it has been known to be toxic even at relatively low doses and in some countries this herb is scheduled, meaning its sale is restricted. Some practitioners argue that if lobelia could be produced in standardised form, where Lobeline is at a guaranteed dose, then this herb would be safer to prescribe.

Toxic doses of lobelia will give rise to symptoms such as nausea, vomiting, convulsions and can be fatal. Lobelia should be used only under the guidance of a qualified herbalist experienced in the use of this herb. _{17, 18}

Fig.: Sources of some Ayurvedic drugs.

Other Natural Herbs That Have Been Used for Asthma Treatment.

References
1) Foster Steven: Johnson R. Desk Reference to Nature's Medicine. National Geographic Society.WashingtonD.C.2006.
2) Mishra LC. Scientific Basis for Ayurvedic Therapies. CRC Press. New York. 2003. Duke, James A.: The Green Pharmacy Herbal Handbook: Your Comprehensive Reference to the Best Herbs for Healing. Rodale Books 2000. Pole S: Ayurvedic Medicine. Elsevier. Philadelphia. 2006.
3) Williamson, Elisabeth M.: Potter's Herbal Cyclopaedia. Essex, England. Saffron Walden 2003.
4) Bown, Deni: The Royal Horticultural Society New Encyclopedia of Herbs & Their Uses. London,DorlingKindersley2002.
5) Mindell, Earl: Earl Mindell's Herb Bible. New York. Simon & Schuster / Fireside 1992.
6) Duke, James A.: The Green Pharmacy Herbal Handbook. Rodale / Reach 2000.
7) Lucas, Richard M.: Miracle Medicine Herbs. Englewood Cliffs, New Jersey, Prentice Hall 1991.
8) Hershoff, Asa & Andrea Rotelli: Herbal Remedies: A Quick and Easy Guide to Common Disorders and Their Herbal Treatments. New York. Avery 2001.
9) Hoffmann, David: The New Holistic Herbal. Boston. Element Books Ltd. 1990.
10) Yarnell, Eric, Kathy Abascal & Robert Rountree: Clinical Botanical Medicine. 3md Ed, Revised and Expanded. New Rochelle, New York. Mary Ann Liebert, Inc. 2009.
11) Balch, Phyllis A.: Prescription for Herbal Healing. New York, Avery 2002.
12) Winston, David and Steven Maimes: Adaptogens. Herbs for Strength, Stamina, and Stress Relief. Rochester, Vermont. Healing Arts Press 2007. Blumenthal, Mark (senior editor): The ABC Clinical Guide to Herbs. Austin, Texas. American Botanical Council 2003. Tilgner, Sharol: Herbal Medicine. From the Heart of the Earth. Cresswell, Oregon. Wise Acres Press 1999. Tierra, Lesley: Healing with the Herbs of Life. Berkeley, California. Crossing Press 2003.
13) Skenderi, Gazmend: Herbal Vade Mecum. 800 Herbs, Spices, Essential Oils, Lipids Etc. Constituents, Properties, Uses, and Caution. Rutherford, New Jersey. Herbacy Press 2003.
14) Foster, Steven & Yue Chongxi: Herbal Emissaries. Bringing Chinese Herbs to the West. Rochester,Vermont.HealingArtsPress1992.
15) Foster, Steven: Herbs for Your Health. A Handy Guide for Knowing and Using 50 Common Herbs.Loveland,Colorado.InterweavePress1996.
16) Ody, Penelope: The Complete Medicinal Herbal. London. Key Porter Books 1993.
17) Rotblatt M, Ziment I.: Evidence-Based Herbal Medicine. Philadelphia, PA. Hanley & Belfus 2002. Karch SB: The Consumer's Guide to Herbal Medicine. Hauppauge, New York. Advanced ResearchPress1999.
18) Brinker F. Herb Contraindications and Drug Interactions. 3rd ed. Sandy, OR. Eclectic Medical Publications 2001. Auerbach, P. Auerbach: Wilderness Medicine, 5th ed. Philadelphia, PA. Mosby Elsevier. 2007.

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