by Jeffrey Dach MD
It was about twenty years ago, and I still remember vividly an anxious middle aged man on oxygen sitting up on his stretcher in the waiting area of the Hospital Xray department outside my office. He was there for his daily chest Xray to follow his viral pneumonia. After a few days, he stopped coming down, and the hospital staff informed me he had succumbed to his illness. This was a bitter lesson that, although we doctors have effective antibiotics for bacterial pneumonia, we have no such drugs for viral pneumonia, and in fact, we have very little to offer these unfortunate people except supportive care. And yes, some people will die from viral pneumonia. Above image Elberberries (sambucus) courtesy of Wikimedia commons.
Although modern medicine has made considerable progress in antiviral drug discovery such as Acyclovir for Herpes virus, most cultures and ethnic groups on the planet have successfully used anti-viral medicinal plants for thousands of years for prevention and treatment of a viral disease. The mechanism is fusion inhibition, which prevents attachment of the viral capsule to the host cell membrane, thus preventing entrance of virus into the cell where replication takes place.
An excellent book on this topic was written in 2013 by Stephen Harrod Buhner on Herbal AntiVirals. This book has an excellent discussion of the Influenza epidemic of 1918 and discusses various herbal treatments for various viral diseases as well in depth discussion of each herbal. I must say the book is impressive for a number of reasons. One is the extensive reference to the medical literature as well as the ethnic herbal literature, pulling usually separated sources together. My only quibble is that reference numbers are missing in the text, so one is forced to search through the bibliography to find the reference if interested in reading it. Left Image Courtesy of Stephen Harrod Buhner author of Antiviral Herbals.
According to Dr. Buhner’s book, the three top anti-viral herbals are Elderberry, Licorice Root and Chinese Skull cap.
Perhaps the most widely available of the antiviral botanicals is Black Elderberry Syrup, which can be found at most health food stores and markets. Nature’s Way offers a children’s version of Elderberry . This is just the thing for little kids who pick up a new bug every week at child day care.
Licorice Root is widely available at most health food stores as capsules or tinctures. One must be careful to avoid the DGL (deglycyrrhizinated licorice root) as this form has the active ingredient removed. Douglas Labs offers a licorice capsule which Dr Buhner recommends: Licorice Root-V, standardized to 12% glycyrrhizin per each 500 mg capsule. I have given this product to family members during viral illness with good results. Licorice Root is also available from various herbal apothecaries as tinctures. More on that later.
Dr Buhner reminds us to avoid the American Skullcap which is a different species and less effective than Chinese skullcap which contains the active ingredients Baicalin and Baicalein. American skullcap is called Scutellaria lateriflora whereas the correct one, the Chinese skullcap, is called Scutellaria baicalensis. The Chinese Skullcap comes as a dried root, and best used as a tincture prepared in alcohol. Dr Buhner lists a number of herbal apothecaries that he likes for the tinctures.
offers a number of tinctures. I ordered the separate tinctures for Baikal Skullcap (Chinese skullcap) and the Licorice dried root tincture. (see image at left). I made tea with hot water and both tinctures mixed with Black Elderberry Syrup to help get over a flu big I had. I think it helped, as I felt better after each dose of tea. Woodland Essence Web Site.
Located in Laramie Wyoming, Elk Mountain Herbs offers a product called Elderberry Plus (see image at left). This contains concentrated elderberry tea, raw cheyenne honey, tinctures of boneset, Baikal Skullcap, ginger and fresh lemon juice. I ordered the licorice root tincture separately, as together this contains most of the antiviral ingredients recommended in Dr Buhner’s book. Perhaps the honey and lemon juice makes this the best tasting and palatable of this group. Here is the label on the bottle:
Sage Woman Consulting and Apothecary
Sage Woman Apothecary offers the EBV formula which is perhaps the most true to Dr Buhner’s herbal anti-viral recipe, as you can see from the label. This EBV formula contains the top ingredients, the Scutellaria baicalensis (Chinese skulcap), and glycyrrhiza glabra (Licorice Root) . In addition a host of other anti-virals are added:Isais indigota, Rhodiola rocea, Ganodermum lucidum, Lomatium dissectum, Pueraria rhizome. Although the name EBV, refers to Epstein Barr Virus, the formulas are similar so this may also be used for most other viruses such as Influenza, RSV, respiratory syncytial virus etc.
Unlike the other two web sites which are solely ordering sites and do not return phone calls, Sage Woman Consulting actually called me back to discuss my order.
This list of herbal anti-virals is by no means final, as there are perhaps hundreds more, such as ginger, Olive Leaf, Garlic, Artemisinin, Berberine, Monolaurin, Humic Acid, Lactoferrin, colostrum etc. A study by Dr. M Salem showed thymoquinone from black seed oil “exhibited a striking antiviral effect against CMV infection (cytomegalovirus) “(1)
One should remember the importance of replenishing vitamin C and selenium levels in the critically ill patient with pneumonia as discussed in my previous article. A good Vitamin D level prevents viral infection as mentioned in my previous article.
Buy Book on Amazon: Herbal Antivirals by Stephen Harrod Buhner
Articles with Related Interest
Links and References
1) CMV https://www.ncbi.nlm.nih.gov/
Int J Immunopharmacol. 2000 Sep;22(9):729-40.
Protective effect of black seed oil from Nigella sativa against murine cytomegalovirus infection.
Salem ML1, Hossain MS.
In this study, antiviral effect of black seed oil (BSO) from Nigella sativa was investigated using murine cytomegalovirus (MCMV) as a model. The viral load and innate immunity mediated by NK cells and Mφ during early stage of the infection were analyzed. Intraperitoneal (i.p.) administration of BSO to BALB/c mice, a susceptible strain of MCMV infection, strikingly inhibited the virus titers in spleen and liver on day 3 of infection with 1×10(5) PFU MCMV. This effect coincided with an increase in serum level of IFN-gamma. Although BSO treatment decreased both number and cytolytic function of NK cells on day 3 of infection, it increased numbers of Mφ and CD4(+) T cells. On day 10 of infection, the virus titer was undetectable in spleen and liver of BSO-treated mice, while it was detectable in control mice. Although spleen of both control and BSO-treated mice showed similar CTL activities on day 10 after infection, serum level of IFN-gamma in BSO-treated mice was higher. Furthermore, BSO treatment upregulated suppressor function of Mφ in spleen. These results show that BSO exhibited a striking antiviral effect against MCMV infection which may be mediated by increasing of Mφ number and function, and IFN-gamma production.
Stephen Harrod Buhner is an Earth poet and the award-winning author of ten books on nature, indigenous cultures, the environment, and herbal medicine. He comes from a long line of healers including Leroy Burney, Surgeon General of the United States under Eisenhower and Kennedy, and Elizabeth Lusterheide, a midwife and herbalist who worked in rural Indiana in the early nineteenth century. The greatest influence on his work, however,has been his great-grandfather C.G. Harrod who primarily used botanical medicines, also in rural Indiana, when he began his work as a physician in 1911
3) Jassim, S. A. A., and Mazen A. Naji. “Novel antiviral agents: a medicinal plant perspective.” Journal of Applied Microbiology 95.3 (2003): 412-427. Novel antiviral agents medicinal plant perspective Journal Applied Microbiology Jassim and Mazen 2003
Virtually all cultures around the globe have relied
historically, and continue to rely on medicinal plants for
primary health care.
J Ethnopharmacol. 1995 Dec 1;49(2):101-10.
Antiviral screening of British Columbian medicinal plants.
McCutcheon AR1, Roberts TE, Gibbons E, Ellis SM, Babiuk LA, Hancock RE, Towers GH.
One hundred methanolic plant extracts were screened for antiviral activity against seven viruses. Twelve extracts were found to have antiviral activity at the non-cytotoxic concentrations tested. The extracts of Rosa nutkana and Amelanchier alnifolia, both members of the Rosaceae, were very active against an enteric coronavirus. A root extract of another member of the Rosaceae, Potentilla arguta, completely inhibited respiratory syncytial virus. A Sambucus racemosa branch tip extract was also very active against respiratory syncytial virus while the inner bark extract of Oplopanax horridus partially inhibited this virus. An extract of Ipomopsis aggregata demonstrated very good activity against parainfluenza virus type 3. A Lomatium dissectum root extract completely inhibited the cytopathic effects of rotavirus. In addition to these, extracts prepared from the following plants exhibited antiviral activity against herpesvirus type 1: Cardamine angulata, Conocephalum conicum, Lysichiton americanum, Polypodium glycyrrhiza and Verbascum thapsus.
Ganjhu, Rajesh Kumar, et al. “Herbal plants and plant preparations as remedial approach for viral diseases.” Virusdisease 26.4 (2015): 225-236.
Lin, Liang-Tzung, Wen-Chan Hsu, and Chun-Ching Lin. “Antiviral natural products and herbal medicines.” Journal of traditional and complementary medicine 4.1 (2014): 24-35.
Antiviral Herbs by Gabe Garms
Use Antiviral Herbs to Boost Immune System & Fight Infection
J Altern Complement Med. 1995 Winter;1(4):361-9.
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. Zakay-Rones Z1, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M.
Evid Based Complement Alternat Med. 2005 Sep; 2(3): 309–314.
Echinacea: a Miracle Herb against Aging and Cancer? Evidence In vivo in Mice. Sandra C. Miller
Echinacea has been viewed as an immunoenhancing herb since it became commercially available several years ago. Indeed, its medicinal significance is responsible for billions of dollars in worldwide sales annually. Unfortunately, most of the ‘evidence’ for the purported medicinal efficacy of Echinacea has been anecdotal and, moreover, to this day, there is no formal proof on how to achieve the best results—whether it should be consumed daily throughout life as a prophylactic; consumed by either young or old; or consumed after diseases, such as cancer, have taken hold. Our work over the past 5 years has led to conclusive answers to some of these questions, at least in mice. Our results have shown that daily consumption of Echinacea is indeed prophylactic, extends the life span of aging mice, significantly abates leukemia and extends the life span of leukemic mice. Given that humans are 97% genetically common with mice and that virtually all our basic physiology is identical, it is neither unjustified to extrapolate these observations to humans nor would it be an arduous task to perform many of these studies in humans, thus establishing viable scientific evidence replacing the anecdotal.
Bing Du Xue Bao. 2013 Nov;29(6):673-9.
[Anti-virus research of triterpenoids in licorice].
[Article in Chinese]
Pu JY1, He L2, Wu SY2, Zhang P2, Huang X2.
Licorice is a leguminous plant of glycyrrhiza. It is a traditional Chinese herbal medicine. Triterpenoid is one of the mainly active components of licorice. In recent years, the broad-spectrum antiviral activity of many triterpenoids in licorice was confirmed, and these findings have become a hot spot of antiviral immunity. The triterpenoids of licorice has the potential to become a novel broad-spectrum antiviral medicine and will be widely used in the clinical treatment. This review provided a summary of the recent anti-virus research progress on several triterpenoids in licorice, such as glycyrrhizic acid, glycyrrhizin, glycyrrhetinic acid and its derivatives. The antiviral roles of triterpenoids in licorice against herpes virus, HIV, hepatitis virus, SARS coronavirus and influenza virus were briefly summarized.
Cheel, José, et al. “Free radical-scavenging, antioxidant and immunostimulating effects of a licorice infusion (Glycyrrhiza glabra L.).” Food chemistry 122.3 (2010): 508-517.
Herbal Medicine: Influenza Pandemics and the Cytokine Storm by Michele and edited by Bam Bam February 26, 2014 By M.D. Creekmore
elderberry keeps the virus from attaching to the cell walls so it is unable to enter the cell and replicate.
14) Glycyrrhiza glabra.(licorice) root higher glycyrrhizin content,
15) douglass labs 500 mg caps 2 caps three times a day.
16) Skullcap baicalensis root
17) ginger root fresh juice (see article below)
J Ethnopharmacol. 2013 Jan 9;145(1):146-51. doi: 10.1016/j.jep.2012.10.043. Epub 2012 Nov 1.
Fresh ginger (Zingiber officinale) has anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines.
Chang JS1, Wang KC, Yeh CF, Shieh DE, Chiang LC.
Ginger, Zingiber officinale Roscoe, is a common spice and also a widely used medicinal plant in ancient China. Ginger is an ingredient of Ge-Gen-Tang (Kakkon-to; GGT). GGT has been proved to have antiviral activity against human respiratory syncytial virus (HRSV). However, it is unknown whether ginger is effective against HRSV.
AIM OF THE STUDY:To find a readily available agent to manage HRSV infection, the authors tested the hypothesis that ginger can effectively decrease HRSV-induced plaque formation in respiratory mucosal cell lines.
MATERIALS AND METHODS:Effect of hot water extracts of fresh and dried gingers on HRSV was tested by plaque reduction assay in both human upper (HEp-2) and low (A549) respiratory tract cell lines. Ability of ginger to stimulate anti-viral cytokines was evaluated by enzyme-linked immunosorbent assay (ELISA).
RESULTS:Fresh ginger dose-dependently inhibited HRSV-induced plaque formation in both HEp-2 and A549 cell lines (p<0.0001). In contrast, dried ginger didn’t show any dose-dependent inhibition. 300 µg/ml fresh ginger could decrease the plaque counts to 19.7% (A549) and 27.0% (HEp-2) of that of the control group. Fresh ginger was more effective when given before viral inoculation (p<0.0001), particularly on A549 cells. 300 µg/ml fresh ginger could decrease the plaque formation to 12.9% when given before viral inoculation. Fresh ginger dose-dependently inhibited viral attachment (p<0.0001) and internalization (p<0.0001). Fresh ginger of high concentration could stimulate mucosal cells to secrete IFN-ß that possibly contributed to counteracting viral infection.
CONCLUSIONS:Fresh, but not dried, ginger is effective against HRSV-induced plaque formation on airway epithelium by blocking viral attachment and internalization.
18) Skullcap baicalensis root
21) Respiratory Syncytial Virus Respiratory syncytial virus is also a single-strand, enveloped RNA virus with high variation in its genome. It is a very common infection, especially in young children, throughout the world. It causes bronchiolitis and other types of respiratory infections, especially in the lower respiratory tract. It generally presents as a common cold but can sometimes become serious, turning into pneumonia if left untreated. The herbs specific for respiratory syncytial virus infections are Chinese skullcap, Eleutherococcus senticosus, elder, isatis, licorice, and Sophora flavescens. Other herbs found active are Barleria prionitis, Blumea laciniata, Elephantopus scaber, Laggera pterodonta, Markhamia lutea, Mussaenda pubescens, Narcissus tazetta, Selaginella sinensis, Scutellaria indica, and Schefflera octophylla (in vitro). Treatment: The same as for mild influenza. If it becomes serious, the same as for moderate to severe influenza.
Yarnell, Eric. “Herbs for Emerging Viral Infectious Diseases.” Alternative and Complementary Therapies 22.4 (2016): 164-174.
Several coronavirus (severe acute respiratory syndrome [SARS], Middle East respiratory syndrome [MERS]), flavivirus (yellow fever, West Nile, dengue, Zika), and alphavirus (chikungunya, Ebola) infections have, in the past 10–20 years, emerged or reemerged as major problems across large regions of the globe. While, currently, many of these infections are confined to the tropics, global warming, the spread of some mosquito vectors northward, and emergence of temperate-tolerant pathogens such as West Nile virus mean that these problems are increasingly affecting the global north as well. After discussing mosquito-based preventions for the zoonotic infections mentioned in this article, a review of herbal responses to the SARS and MERS epidemics are highlighted. Houttuynia cordata (houttuynia, yú xīng cǎo) and Glycyrrhiza spp. (licorice) stand out as particularly interesting single herbs for addressing these coronavirus infections. Herbal approaches to flavivirus infections, most notably clinical trials of Carica papaya (papaya) leaves for treating dengue fever, are reviewed. A discussion of many of the extensive range of herbs studied to treat flaviviruses in preclinical studies is provided. Potential herbal treatments for alphavirus infections are then presented.
Discovery of berberine, abamectin and ivermectin as antivirals against chikungunya and other alphaviruses.
Varghese FS1, Kaukinen P1, Gläsker S2, Bespalov M3, Hanski L4, Wennerberg K3, Kümmerer BM2, Ahola T5.
Chikungunya virus (CHIKV) is an arthritogenic arbovirus of the Alphavirus genus, which has infected millions of people after its re-emergence in the last decade. In this study, a BHK cell line containing a stable CHIKV replicon with a luciferase reporter was used in a high-throughput platform to screen approximately 3000 compounds. Following initial validation, 25 compounds were chosen as primary hits for secondary validation with wild type and reporter CHIKV infection, which identified three promising compounds. Abamectin (EC50 = 1.5 μM) and ivermectin (EC50 = 0.6 μM) are fermentation products generated by a soil dwelling actinomycete, Streptomyces avermitilis, whereas berberine (EC50 = 1.8 μM) is a plant-derived isoquinoline alkaloid. They inhibited CHIKV replication in a dose-dependent manner and had broad antiviral activity against other alphaviruses–Semliki Forest virus and Sindbis virus. Abamectin and ivermectin were also active against yellow fever virus, a flavivirus. These compounds caused reduced synthesis of CHIKV genomic and antigenomic viral RNA as well as downregulation of viral protein expression. Time of addition experiments also suggested that they act on the replication phase of the viral infectious cycle.
Bioorg Med Chem Lett. 2007 Mar 15;17(6):1562-4. Epub 2007 Jan 4.
Antiviral activity of berberine and related compounds against human cytomegalovirus.
Hayashi K1, Minoda K, Nagaoka Y, Hayashi T, Uesato S.
Berberine chloride (1) and the structurally related compounds were assessed for the anti-human cytomegalovirus (HCMV) activity using the plaque assay. The anti-HCMV activity (IC(50) 0.68 microM) of 1 was equivalent to that (IC(50) 0.91 microM) of ganciclovir (GCV). The mechanism of action by which 1 inhibits the replication of HCMV is presumed to be different from that of GCV; 1 would interfere with intracellular events after virus penetration into the host cells and before viral DNA synthesis.
Arch Virol. 2010 Dec;155(12):1933-41. doi: 10.1007/s00705-010-0779-9. Epub 2010 Aug 5.
Anti-herpes simplex virus effects of berberine from Coptidis rhizoma, a major component of a Chinese herbal medicine, Ching-Wei-San.
Chin LW1, Cheng YW, Lin SS, Lai YY, Lin LY, Chou MY, Chou MC, Yang CC.
Berberine is an alkaloid extracted from Coptidis rhizome. Among the individual herbal components of a Chinese herb medicine, Ching-Wei-San, Coptidis Rhizoma has the most potent antimicrobial activity. By high-pressure liquid chromatography, the quantitative analysis of berberine from 6.25-mg/mL (w/v) Coptidis rhizome extract or 50.00-mg/mL (w/v) Ching-Wei-San was determined to be 0.26 mg/mL. To explore the potential use of Ching-Wei-San against herpes simplex virus (HSV) infection, the cytotoxicity, anti-HSV-1 and anti-HSV-2 activity in Vero cells were assayed. The selectivity index of berberine was about 1.2-1.5 times higher than that of Coptidis rhizome extract and Ching-Wei-San. Moreover, the antiviral activities correspond to the content of berberine in the aqueous solution. Berberine may interfere with the viral replication cycle after virus penetration and no later than the viral DNA synthesis step, and its activities were not affected by the preparation processes. Berberine, the natural plants that contain this component, including Coptidis rhizome, and Ching-Wei-San have all shown anti-HSV effects.
Chin J Integr Med. 2011 Jun;17(6):444-52. doi: 10.1007/s11655-011-0640-3. Epub 2011 Jun 10.
In vivo and in vitro antiviral effects of berberine on influenza virus.
Wu Y1, Li JQ, Kim YJ, Wu J, Wang Q, Hao Y.
To explore the potential effects of berberine on influenza virus infection both in vitro and in vivo.
METHODS:In vitro anti-influenza virus assays were performed by cytopathogenic effect and neuraminidase assays in Madin Darby canine kidney cells. In vivo anti-influenza virus assays were performed on the viral pneumonia model of mice. The numbers of mice that died within day 2 to day 14 postinfection were recorded to calculate the mortality. On days 2, 4, and 6, the viral titers in the lungs were determined by hemagglutination assay; hematoxylin/eosin staining was used to assess the pathogenic changes of lung tissues; the concentrations of tumor necrosis factor-alpha (TNF-α) and monocyte specific chemoattractant molecule (MCP-1) were measured by radio immunoassay or enzyme-linked immunosorbent assay; the concentrations of nitric oxide (NO) and inducible nitric oxide synthetase (iNOS) were detected by colorimetric method; reverse transcription polymerase chain reaction was used to detect the mRNA level of TNF-α and MCP-1.
RESULTS:Berberine showed inhibitory effects on cytopathogenic effects and neuraminidase activity of virus, with the therapeutic index 9.69. In vivo, berberine decreased mice mortality from 90% to 55%, reduced virus titers in the lungs on day 2 postinfection (P<0.05). The lung histology scores were 1.50 ± 0.67, 4.50 ± 1.00, and 5.50 ± 1.00 in the berberine group on days 2, 4, and 6, respectively, which were significantly reduced compared to 2.17 ± 0.22, 6.83 ± 0.44, and 8.50 ± 0.33 in the infected group (P<0.05). The productions of NO and iNOS were repressed by berberine compared with those in the infected group (P<0.01). The transcription and expression of TNF-α were inhibited by berberine on day 4 (P<0.01) and day 6 (P<0.05), and those of MCP-1 were inhibited on day 6 (P<0.01) compared with the infected group.
CONCLUSIONS:Berberine exhibited antiviral effects on the influenza virus both in vitro and in vivo. The possible therapeutic mechanism of berberine on influenza-induced viral pneumonia might be inhibiting the virus infection, as well as improving the pathogenic changes by repressing inflammatory substances release.
HISTORY OF LOMATIUM DISSECTUM Dr. Krebs Uses Lomatium for Influenza Epidemic . The Following is Verbatim From: Bulletin of the Nevada State Board of Health, No. 1 , Carson City, Nevada , January, 1920. MTN. Oaks, LLC. PO Box 155 • Doyle CA 96109.
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Scutellaria baicalensis (Chinese skullcap).The Sunlight Experiment
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Buhner, Stephen Harrod. Herbal Antivirals: Natural Remedies for Emerging & Resistant Viral Infections
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