In 400 BCE Hippocrates referred to the elder tree as his "medicine chest." Other noted classical healers, including Theophrastus, Dioscorides and Galen, regarded the elder as one of nature's greatest healing plants. Native Americans believed that elderberry would promote a long life, giving reason to the name elder. Maud Grieve dedicated the largest section of her classic 1930s book A Modern Herbal, the first comprehensive encyclopaedia of herbs to appear since the days of Culpeper (1600s), to elder. This book is considered to still be relevant today. In modern times elderberries are most frequently used for supporting immune system health, and symptoms of upper respiratory infections, however historically they were commonly used for pain and inflammation such as in rheumatism.

This centuries-old remedy moved into the mainstream consciousness during the height of the pandemic as the population rushed to fortify their immune health and fight infection. There was a huge surge in demand for elderberry, and it became the poster child for immunity, with solid clinical research showing benefits in fighting the viruses that cause colds and flu. With the shockwaves of COVID-19 subsiding the overall concerns about immune system health are still strong and immunity is seen as a key element of good health. Although elderberry is used by many as a year-round supplement for immune support its time to shine is for seasonal immune support during the winter cold and flu season which is now upon us. Elderberry’s deliciously tart and sweet flavour makes it easy to enjoy. This makes elderberry liquid extract a mainstay in many herbalists’ dispensaries as the go-to herb at the initial signs of a cold or the flu.

Elderberry studies validate the hype. Meta-analyses of clinical trials can help add a level of credibility and confirmation to elderberry studies. An article about elderberry research says meta-analyses “can cut through the noise of improperly structured studies or biases to arrive at conclusions with true clinical relevance and consistency.” One 2019 meta-analysis of four clinical trials, involving a total of 180 people, found that elderberry supplementation substantially reduced the severity and duration of upper respiratory symptoms in cold and flu patients. The researchers concluded that “these findings present an alternative to antibiotic misuse for upper respiratory symptoms due to viral infections, and a potentially safer alternative to prescription drugs for routine cases of the common cold and influenza.”

References

HEC Elderberry monograph

Blatman J. Elderberry sales are declining, but experts aren’t worried. Here’s why. Nutritional Outlook 2023 May 20;26:4

Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials.

Complement Ther Med. 2019 Feb;42:361-365. doi: 10.1016/j.ctim.2018.12.004. Epub 2018 Dec 18. PMID: 30670267.

Straus M. Elders & betters: Elderberry research is validating the hype. Nutritional Outlook 2022 March 5

Head colds are also known as the common cold because they are the most common cause of illness in both children and adults. When you come down with a cold it means you have a viral infection that affects your upper respiratory tract. There are more than 200 types of viruses that can cause colds, which are more common in the colder winter months. People tend to stay indoors more in winter which means they are in closer contact with each other at this time of year and are more likely to infect each other. The cold, dry air may also weaken resistance. The symptoms of a head cold (as opposed to a chest cold) are usually mild and may include fever, sneezing, blocked or runny nose, cough and sore throat. This can impact daily life and leave people feeling tired and run down. Some people, including those with a weakened immune system, can develop more serious illnesses as a complication of a head cold such as bronchitis, a sinus infection or pneumonia. While the best treatment for the common cold is prevention through nutrition, lifestyle and prophylactic herbal medicine there is no such thing as perfect protection. Instead there can be reduced risk, symptom reduction and quicker recovery.

Herbal Head Cold is a strong, balanced formula that has been specifically designed to reduce the duration and intensity of upper respiratory tract infections. The herbs in Herbal Head Cold complement each other to produce a powerful remedy that effectively targets the infection and reduces congestion. It contains traditionally used, and scientifically proven, herbs with anti-microbial, anti-viral, anti-bacterial, immune-stimulating, diaphoretic, anti-inflammatory and anti-catarrhal actions. Herbal Head Cold can be taken to either help prevent infection or alleviate the symptoms of a current infection.

A short description of each herbal component in Herbal Head Cold:
Elder Flowers (Sambucus nigra) are one of the most traditional and reliable herbs for use in the treatment of colds, influenza and fevers. They are indicated for any catarrhal inflammation of the upper respiratory tract. As a gentle relaxing diaphoretic they open the pores to cool the body, encourage sweating and help to expectorate phlegm, and so are indicated in fevers accompanied by stuffy sinus.
Echinacea (Echinacea purpurea) is the most researched and popular herb for assisting immune function in Western Herbal Medicine. It has traditionally been used in North America for the prevention and treatment of cold and flu symptoms. As an immune modulator, echinacea can be used both as a preventative and as treatment for a wide range of infections. Many studies have proven that echinacea successfully reduces the severity and duration of upper respiratory tract infections and that it can inactivate and/or inhibit many viruses at different levels.
Eyebright (Euphrasia officinalis) is an anticatarrhal herb for the upper respiratory tract particularly where there is profuse watery flow.
Ribwort (Plantago lanceolata) is ideal for coughs as it acts as a gentle expectorant while soothing inflamed membranes.
Yarrow (Achillea millefolium) may be used as the central ingredient in any fever management program including respiratory infections. It is a diaphoretic that can open up the peripheral circulation, helping to reduce unpleasant symptoms and keeping the body temperature from rising too high.
Lime Flowers (Tilia cordata) are commonly known as a diaphoretic to promote perspiration and are used in common cold and antitussive preparations. They have a relaxing, mild sedative action making them an ideal remedy for the treatment of acute feverish upper respiratory tract infections. Lime flowers are significant for upper respiratory tract catarrh and congestion, especially when headaches are associated with an increase in sinus pressure.
Calendula (Calendula officinalis) has been shown to be effective in reducing inflammation in the nose and throat. It is a mild diaphoretic and an efficient lymphatic, helping to remove the metabolic and immune toxic by-products from acute infections. 

Cinnamon (Cinnamomum verum): Classically a warming circulatory tonic, cinnamon is used for this purpose across many modalities including TCM, Western Herbalism and Ayurvedic Medicine. Cinnamon exhibits analgesic and astringent activity, making it applicable to reduce catarrh in the nasal passages while easing a sore throat. Cinnamon is pleasant tasting and encourages the assimilation of additional herbs in a medicinal complex.

References

Colds. Department of Health, State Government of Victoria, Australia c2021 State of Victoria. (updated 23 May 2022; accessed 8 Jun 2023). Available from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/colds

Elder. Jim McDonald Herbalist.  cJim McDonald. (accessed 8 Jun 2023). Available from https://herbcraft.org/elder.html

Hudson J, Vimalanathan S. Echinacea—A Source of Potent Antivirals for Respiratory Virus Infections. Pharmaceuticals (Basel). 2011;4(7):1019–1031. Published 2011 Jul 13. doi:10.3390/ph4071019

Bone K, Mills S. Principles and Practice of Phytotherapy. 2nd ed. Edinburgh: Churchill Livingstone Elsevier; 2013.

Hoffmann D. Medical Herbalism. Rochester: Healing Arts Press. 2003. p. 574

Mills S. The Essential Book of Herbal Medicine. Penguin:London. 1991. p.401-2

McIntyre A. The Complete Woman’s Herbal. Gai Books Limited:London. 1994. p. 191

Wyk van BE. Wink M. Medicinal Plants of the World Timber Press:USA. 2004. p74

Wichtl, M. Herbal Drugs and Phytopharmaceuticals. Medpharm Scientific Publishers:Germany. 2004. p102

Blumenthal, M. ABC Guide to Herbs. Theime International:USA. 2003. p138

A 2023 systematic review and meta-analysis of randomised controlled trials (RCTs) has found that supplementation with fenugreek seed, especially in doses of 15g or more per day over three months or less, might play a role in reducing systolic blood pressure. Cardiovascular diseases are a growing health issue worldwide with hypertension (high blood pressure) being one of the most common of these in all populations. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason it is essential that blood pressure is measured regularly. Hypertension is a major independent risk factor for coronary artery disease, stroke and kidney failure. The good news is that, in most cases, blood pressure can be managed to lower the risk of serious health problems (see The Naturopath’s Guide to Hypertension, under the Resources tab on our website, for more information).

Six RCTs, including a total of 373 participants, were included in the final meta-analysis. Fenugreek seed supplementation significantly reduced systolic blood pressure. The Iranian researchers said further investigations are warranted to ensure the clinical relevance of these findings. High systolic blood pressure can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity and eating an unhealthy diet. Certain health conditions, such as diabetes and obesity, can also increase the risk of developing high blood pressure.

The most well-researched area of therapeutic use for fenugreek includes effects on blood glucose, glucose tolerance and insulin levels. Fenugreek has been shown to decrease insulin resistance and increase insulin sensitivity, as well as reducing serum triglycerides in mild type 2 diabetic patients.

References

Amini MR, Payandeh N, Sheikhhossein F, Pourreza S, Ghalandari H, Askarpour M, Hekmatdoost A. The Effects of Fenugreek Seed Consumption on Blood Pressure: A Systematic Review and Meta-analysis of Randomized Controlled Trials. High Blood Press Cardiovasc Prev. 2023 Mar;30(2):123-133. doi: 10.1007/s40292-023-00565-6. Epub 2023 Feb 10. PMID: 36763260.

Fenugreek. The Herbarium, Herbal Academy. (accessed 1 Jun 2023). Available from https://herbarium.theherbalacademy.com/monographs/#/monograph/5128

We were proud to partner with the Naturopaths & Herbalists Association of Australia (NHAA) for the largest event in their calendar, the Naturopathic Symposium 2023, held in Melbourne. The event was brimming with clinical pearls of wisdom delivered by some of the most skilled and respected naturopaths from Australia and internationally. In a keynote presentation delivered on the first day, Dr Sue Evans and Dr Joanna Harnett discussed the impact of science on herbal medicine. Both presenters are distinguished in their chosen fields and have received many accolades for their dedication to herbal medicine. A life member of the NHAA, Dr Evans has been working with herbal medicine for nearly four decades. She is currently a senior lecturer in complementary medicine in the School of Medicine at the University of Tasmania. Dr Harnett is a senior lecturer within the Faculty of Medicine and Health at the University of Sydney’s Pharmacy School whose central focus is to contribute to fostering the appropriate and safe use of complementary medicines and building the evidence base. She is a member of the Australian Therapeutic Goods Administration Advisory Committee for Complementary Medicines. Dr Evans made an impassioned plea for the future of traditional herbal medicine while Dr Harnett complemented her view with a dive into science and evidence-based herbal medicine. 

Dr Evans said when the herbal medicine fraternity decided to “fight science with science” the emphasis on phytochemistry and evidence-based medicine meant the way herbalists prescribed and manufactured changed and “other things went by the wayside…The dominance of science means we’re ignoring the humanities.” She suggested modern herbalists could think about herbs in a broader context and understand the cultural connection of herbs through the lens of subjects such as history, literature and music. Dr Evans emphasised the importance of 12th Century abbess Hildegard of Bingen’s concept of viriditas, or vital energy, saying vitalism is a moral imperative that has been suppressed. “Herbs are special because they treat life with life. We have a different attitude to ethics when we think about this…such as the ethics of sustainability. It becomes more human centred and we ask: What’s our responsibility to non-human life forms?” she said. She also encouraged the audience to ask themselves “What does it mean to be an Australian herbalist and what is our contribution to society?” taking into consideration the relationship with colonisation and using herbs not of our land. This led to the field of bioethics and questions about the commodification of native plants. Dr Evans’ summation was that herbalists of today need to “think differently” and “ask ethical questions and look at herbs more broadly”. “Science led us out of the dark ages but we have different challenges now such as climate change and political problems. The thinking that got us here won’t fix them.” 

Dr Harnett began by asking what is actually meant by the word science. She gave a detailed description saying it goes beyond the reductionist philosophy. She highlighted the importance of “repetition, critical analysis and verification, and testing which includes critical exposure to scrutiny, peer review and assessment.” Her guiding principles were from the father of modern medicine himself, Hippocrates, who said “The greatest medicine of all is teaching people how not to need it” referring to the impact of preventative medicine. But when they do get sick then stimulating the self-healing process and respecting the “healing power of nature” (vis medicatrix naturae) is imperative in all facets of naturopathic assessment, diagnosis and treatment. Most importantly Dr Harnett said the principle of naturopathy primum nocere (“First do no harm” Hippocrates) means naturopaths should utilise practices, therapeutics and treatment which minimise the risk of harmful effects. Both speakers agreed that the takeaway message is that it is important for practitioners to ask their herbal medicine manufacturers questions. So, here at the Herbal Extract Company, we are ready and waiting to comply.

In modern times maritime pine is famed for its ability to fight inflammation, stimulate immune system action, ease swelling and exert antioxidant effects. The most extensively studied use of maritime pine is to treat cardiovascular health, especially improvement of endothelial (the thin layer of cells that lines blood vessels) function and chronic venous insufficiency, a condition defined by poor drainage of blood from veins resulting in swelling or skin problems. However, this claim to fame harks back to the frigid winter of 1536 at Stadacona (now Quebec City) when French explorer Jacques Cartier's critically ill crew were cured from scurvy, a severe deficiency of ascorbic acid (vitamin C), by drinking a decoction from the native American Indian tribe, the Iroquois. Four centuries later during a sabbatical at the University of Quebec Professor Jacques Masquelier, of the University of Bordeaux in France, heard about Cartier's account and this turned his attention to the antioxidant proanthocyanidins of conifer bark. He was investigating a group of substances called flavanols which he originally found in peanut skins. Masquelier found that these substances have beneficial effects in the body particularly in improving circulation and repairing tissue. Maritime pine is found around Masquelier’s home region Bordeaux so when he went for a walk one day, on his return home from Quebec, he took a piece of bark from a tree which reminded him of peanut skin. Masquelier and his colleagues came to regard the pine bark as a huge peanut skin and found that an abundant source of these substances was also in the bark of the pine trees that grew on these coasts of southern France.

Masquelier referred to proanthocyanidins as pycnogenols. This term was used to describe an entire group of procyanidin complexes found in a variety of plants including pine bark, grape seed, peanuts and citrus peel. The term pycnogenol is now considered obsolete in the scientific community to describe these compounds giving way to the terms procyanidins, oligomeric proanthocyanidin complexes (OPCs) and/or procyanidolic oligomers (PCOs). Pycnogenol is now a patented trade name for a water extract of the PCO of bark of the maritime pine commonly grown in the coastal southwest of France (Pinus pinaster ssp. atlantica). Concentrated standardised extracts like Pycnogenol are not the same as whole plant (broad or full spectrum) maritime pine bark medicine in the same way that curcumin is not the same as using whole plant turmeric and cannabidiol is not the same as using full spectrum cannabis. For example when Pycnogenol is manufactured the fresh outer bark is powdered and extracted with 70% ethanol and 30% water in patented equipment allowing an automated continuous process. After purification (there is no further information on how this is done on the manufacturer’s website) of the raw extract the aqueous solution of the extracted constituents is spray dried to a fine brownish powder during the standardisation process. According to the manufacturer 1000kg of maritime pine bark yields 1kg of Pycnogenol, making it 1000:1 (1kg equals 1g). In comparison The Herbal Extract Company make a 1:2 maritime pine extract, in 60% ethanol and 40% water, using continuous cold flow percolation in a simple process with no standardisation, heat or vacuum. The result is that 1ml (1g) of extract yields 500mg of maritime pine bark which is a very different, yet more sustainable, method of extraction. To get the equivalent 500mg of Pycnogenol you would need half a kilogram of maritime pine bark which is 500 times the amount The Herbal Extract Company use. 

The vast majority of the research on maritime pine is proprietary and geared at promoting the trademarked Pycnogenol and its associated products. It appears in the literature that the terms Pycnogenol and pine bark extract are used interchangeably. This makes it extremely challenging to write a highlight about a full spectrum maritime extract because there is a dearth of information. The Herbal Extract Company’s aim is not to be misleading and partake in “borrowed science” concerning the specific health benefits from researched Pycnogenol products, for the purpose of associating this science with full spectrum maritime pine bark. However, it is a fact that full spectrum maritime pine bark also contains these antioxidants along with other vitamins and phytonutrients. Previous studies have demonstrated that other maritime pine bark extracts also possess remarkable antioxidant activities similar to Pycnogenol. The research associated with these isolated active constituents is interesting because it suggests there is potential in using full spectrum extracts which mirror the natural, balanced phytochemical profile of chemical compounds of the original dry herbal material. The advantage of a full spectrum extract is that, when extracted in a balanced way, the synergistic activity of all the constituents allows the key compounds (OPCs) to work effectively for the patient.

References

HEC maritime pine monograph