Most of us are preoccupied with COVID-19 right now, and for good reason. We’ve had to drastically change the way go about our day to day lives in order to protect each other, slow the spread of the virus and avoid overwhelming our healthcare system. Here in my state of Maryland we’re currently under a ‘shelter at home order’. We’re getting new information all the time, and there is so much uncertainty… Naturally there has been a lot of discussion about herbal medicine in relation to COVID-19 and many of my colleagues have weighed in, there’s a lot to talk about. So, what are herbalists saying and doing? We are approaching this in the way that we approach viral respiratory infections in general, informed by what has been learned from working with SARS in the past, and in relation to the current virus, from TCM treatment in China and case reports here in the US. It’s important to remember that, as herbalists, our work is not trying to prevent or treat a disease. That’s not what herbalists do or what herbal medicine is. We work with people and support body systems and functions. What does that mean? It means that we help the body to its many jobs, first by making sure that it has everything it needs in terms of nutrients, hydration, sleep, movement, fresh air and sunshine. To this end we would examine diet, lifestyle, and environment – in this case with a particular focus on immune and respiratory health. See this ATH post by my friend Donna of Green Haven Living for more on that. In relation to nutrition and lifestyle there are two things that particularly stand out for me right now: Vitamin D status plays many important roles immune function, modulating inflammation, interfering with viral replication and lifecycle, and more. This recent review published in the journal Nutrients examines these roles. Exercise, aerobic exercise specifically, stimulates the production of and important antioxidant, extracellular superoxide dismutase, that recent research suggests plays an important role in reducing the risk and decreasing the severity of acute respiratory distress syndrome (ARDS). Read a summary of the research here. Once nutrition and lifestyle are sorted out, we would turn our focus to herbs that support immune function and respiratory health, and to manage fevers. Obviously, we’re hoping to stay healthy and avoid getting sick, but if you do get sick herbs can help your body do what it needs to do to work through that. An important word of caution. While the majority of people experience mild to moderate illness with this virus, another feature of this illness is that it can take a quick turn and a person’s condition can deteriorate rapidly; sometimes even after they seem to be recovering. So be sure to read the section below titled “When to seek medical help”. With that said, here are some of the properties of herbs that can give us better chance of staying healthy and to support our bodies in moving through a viral respiratory infection if needed: Thin mucus, loosen phlegm, and move congestion up and out of the lungs Ease spasmodic coughs and make them more productive Help manage fevers should the need arise Enhance immune function Stimulate anti-inflammatory activity Stimulate antioxidant activity There are actually a lot of herbs that that can support us in accomplishing these goals and in considering the way in which I could best be of service in adding my voice to this very robust conversation, and in light of recent issues in the availability of many herbs and delays in shipping, I decided to focus on a few herbs that should be widely available and familiar to you. In fact, these herbs are so familiar that you may be tempted to take them for granted, but you shouldn’t. Your greatest allies for respiratory and immune support are probably already in your kitchen; and if they’re not you can probably get them easily, even now. Herbs that you may already have on hand or can probably obtain easily, even now. Garlic Ginger Cinnamon Fennel Thyme Sage Peppermint Chamomile Mushrooms A common feature of the COVID-19 illness seems to deep lung congestion. Garlic, ginger, cinnamon, and fennel all have in their repertoire of herbal actions an activity called warming expectoration. This means that they bring warmth to the lungs, help to thin mucus, loosen phlegm and move congestion out of the lungs. These herbs have been worked with in this way historically, and contemporary studies show that garlic can enhance immune function and reduce the severity and duration of cold and flu symptoms. Cinnamon and fennel also have demulcent properties which means that they are moistening and soothing; this might seem counterintuitive in the case of deep lung congestion, but this action is one of the ways that mucus gets thinned and loosened so it can be expelled. Ginger is a potent, systemic anti-inflammatory and it also has antispasmodic activity so it can help ease spastic coughs while encouraging more productive ones; and it is a terrific helper in managing fevers, as is peppermint. More on that below. Thyme and sage both have antispasmodic properties as well and are powerful anti-inflammatories and gentle astringents for mucus membranes so they can help ease irritated, spastic coughs and soothe sore throats. In addition to having immune modulating properties, mushrooms also stimulate immune response to the presence of pathogens. Maitake and shitake are well known medicinal mushrooms that are widely available, and it is highly likely that all mushrooms exhibit these properties so get what is available. How to work with the herbs To support and enhance health Integrate these herbs into your daily routine. Incorporate them into every meal and have tea in between. Here are some ideas: If you like to have oatmeal for breakfast add some cinnamon and fennel. If you prefer a savory breakfast include sautéed onions and garlic and add some thyme, sage and rosemary, these work really well with sweet potatoes. Have a chai blend tea that includes ginger, cinnamon, and fennel. You can blend this yourself (look for a recipe below) just use fresh ginger instead of dried. Avoid the premade chai beverages that come in boxes, they usually contain a lot of sugar. Prepare a broth with garlic, mushrooms, and herbs like thyme, sage, oregano and rosemary. Make soup with it or have a couple cups of it as is each day. You can make the broth from chicken or beef bones if you like or you can buy boxed organic broth and use that if you don’t happen to have bones. Mild to Moderate Illness Coughs and Congestion Coughs serve an important function when they are productive and bring mucus and phlegm up and out of the lungs. Sometimes though, mucus gets thick and sticky and feels stuck. This situation calls for the warming expectorants and demulcents mentioned above. Sip on a tea prepared from combinations of these herbs throughout the day. Alternatively, if you don’t have the energy to simmer the herbs, have a couple spoonsful of garlic-honey syrup that you’ve prepared ahead of time several times a day. You can also stir the syrup into warm water with some lemon and have it as beverage. Spasmodic coughs, where involuntary muscle contractions seem to be driving much of the coughing reflex, call for antispasmodics and demulcents like ginger, chamomile, cinnamon, and fennel. Fevers Fevers are an important part of your body’s immune response and, in the vast majority of cases, are not cause for fear. There are two main categories of fevers and generally, both are experienced during the course of an illness. One type of fever, often experienced in the early stages of illness, is characterized by chills, tension, and an inability to get warm. These are indications for a warming diaphoretic like ginger. Another type of fever is characterized by feeling to hot and is often accompanied by tension and irritability. These are indications for a cooling diaphoretic like peppermint. Chamomile can be combined with either of these to help ease tension. For a more nuanced discussion of herbal fever management check out this Herb Mentor Radio podcast featuring herbalist Jim McDonald. Sore Throat Sore throats usually accompany viral respiratory infections, and this calls for herbs with demulcent, anti-inflammatory, and gentle astringent properties. You can gargle with these or sip them through the day. Cinnamon, fennel, cardamom with honey for gentle moistening and soothing. Thyme with lemon and honey for sore throat caused by irritation from mucus and phlegm. Sage with lemon and honey for a hot, dry sore throat. Lemon and honey in water by themselves will help in a pinch. Immune Support Keep drinking your mushroom, garlic and herb broth, only now have more of it – more like 4 -6 cups per day. Recipes A note on preparing herbal beverages: Hard plant parts like roots, barks and seeds need to be simmered; this preparation is referred to as a decoction. Soft plant parts are prepared by boiling eater and then pouring it over the herbs; this is referred to as an infusion. If you want to combine soft and hard plant parts in one preparation simmer your hard plant parts, remove from heat, add your soft plant parts and cover. Scale these recipes up or down, according to your needs. Garlic, Ginger, Cinnamon decoction ½ tablespoon grated fresh ginger 1 cinnamon stick 2 cloves garlic Simmer 20 minutes in 2 cups water add a slice of lemon and a little honey. If you are feeling overly warm omit the ginger and replace with coriander seeds. Peppermint Chamomile Infusion 1 tablespoon loose chamomile or two chamomile teabags 1 tablespoon loose peppermint or two peppermint teabags Infuse, covered, in 2 cups boiled water. Strain. Thyme/Sage infusion 1 teaspoon dried herb Infuse in 1 cup boiled water. Strain and add lemon and honey. Ginger Chamomile Tea ½ tablespoon fresh grated ginger 1 tablespoon loose chamomile or 2 chamomile teabags Simmer ginger for 20 minutes in 2 cups water. Add chamomile, cover and steep for 10 minutes. Strain Garlic Honey Fill a glass jar ¾ full with sliced garlic and cover with honey. This draws the water from the garlic and will naturally make a syrup. This can be taken a few hours after preparing but will be stronger after a few days. Chai Spice Tea ½ tablespoon fresh grated ginger 1 tablespoon cinnamon chips or 1 cinnamon stick 1 tablespoon dried orange peel ½ tablespoon fennel seed ½ teaspoon peppercorns ½ teaspoon cloves Simmer gently in 4-6 cups of water for 30 minutes. Add honey if desired Immune Support Broth Crush several cloves of garlic (I often use an entire bulb) Mince 2 tablespoons of ginger Chop 2 to 4 handfuls of mushrooms into bite size pieces Sauté 2 minutes in a 2 tablespoons of olive oil in a large pot Add 8 cups of broth or broth-water mixture Add herbs like thyme, sage, oregano, and rosemary to taste. Use fresh herbs if you have them, dried if you don’t. Cover and Simmer gently for 2 hours When to seek medical attention While most people infected with the novel corona virus develop mild illness or remain asymptomatic, it is important to remember that there are some of unusual characteristics this illness, including: It can take a rapid turn for the worse It is possible to feel like you’re breathing comfortably yet still not have enough oxygen in your blood If your symptoms worsen don’t hesitate to seek medical attention. In addition to herbal support, you can check out this website for CDC advice for caring for yourself at home, and check out this podcast on herbal home nursing from Commonwealth Center for Holistic Herbalism. Monitor your symptoms and seek medical attention immediately if you develop any these symptoms that the CDC considers emergency warning signs. Trouble breathing (I would add shortness of breath, just for clarity) Persistent pain or pressure in the chest New confusion or inability to arouse Bluish lips or face Renata is a clinical herbalist with a private practice in Greenbelt, MD. She helps women build a solid foundation of wellness while working together to address their unique health concerns so they can live life with vibrance and vitality. She has a BS in Chemistry from University of Maryland, a MS in Therapeutic Herbalism, and a Post Masters Certificate in Clinical Herbalism from Maryland University of Integrative Health. Find her at renalynn.com and on Facebook @renatalynnclinicalherbalist and sign up her newsletter here.
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