Autonopedia

SORE THROAT

AH, THAT RAW, SCRATCHY FEELING. Where did it come from this time Many things can make your throat sore: hay fever, postnasal drip from a sinus infection, smoky air, a too-hot beverage, mouth-breathing while sleeping, shouting, and infections by viruses and bacteria. The most common type of sore throat comes with viral illnesses such as colds and flu. Viral sore throats typically last three to four days. They go away without any medical treatment, but antibiotics don't make them go away faster. Herbs, however, can soothe the symptoms of sore throats, boost immune function and fend off viruses.

COULD IT BE STREP?
Sore throats caused by the streptococcus bacterium, or 'strep' for short, account for about 15 per cent of sore throats for all ages. Strep most commonly strikes during the late winter and early spring.
Signs that you may have strep include fever greater than 38.5°C, white coating on the tonsils, and tender lymph nodes in the neck. Some people, particularly children, also have headache, stomach ache, and vomiting. The usual symptoms that accompany a cold - cough and runny nose - are commonly absent in strep.

If you think you have strep, go to your doctor to be tested. While it isn't life-threatening, strep is contagious. Left untreated, it can progress to complications including abscess formation in the throat and spread of infection to the blood, middle ear, sinuses, or mastoid bone (the bony bump just behind the ear). Even more rarely, untreated strep can lead to rheumatic fever and a kidney disease called acute glomerulonephritis.

Your doctor is likely to prescribe antibiotics for strep. If you have allergies, work with your doctor to find an antibiotic that has the fewest side effects for you. Take all of the medication.
There are things you can do to help antibiotics do their work (see `Can You Use Herbs with Antibiotics?' below). You can also minimise the antibiotic's effect on the `good' bacteria in your digestive tract by eating plenty of active-culture yogurt and kefir or taking a supplement of Lactobacillus acidophilus bacteria.

DRUG TREATMENT
Analgesics
Aspirin, ibuprofen, naproxen, paracetamol. Function: relieve pain and (except paracetamol) inflammation. Aspirin side effects: heartburn, indigestion, stomach irritation, mild nausea or vomiting. Ibuprofen and naproxen side effects: dizziness, nausea, stomach ache, headache; with continuous use, stomach lining irritation. Paracetamol side effects: long­term use or dosages higher than recommended commonly cause liver damage, with symptoms of jaundice, nausea, vomiting and an all-over ill feeling; long-term use can also damage kidneys.

Narcotic Analgesics
Codeine combinations (co-codaprin, co-codamol, Kapake, Solpadol, Tylex). Function: relieve severe sore throat pain. Side effects: dizziness, drowsiness, headache, nausea, vomiting, stomach ache, constipation.

Antibiotics
Penicillin, erythromycin (Erymax, Erythrocin, Ilosone, Tiloryth), clarithromycin (Klaricid), azithromycin (Zithromax). Function: kill bacteria in cases of strep throat. Penicillin side effects: hypersensitivity causing rashes, anaphylaxis. Side effects of other antibiotics: mild nausea, vomiting, diarrhoea, vaginal yeast infection, fever, joint pain and allergic reactions including rashes.

HERBAL REMEDIES

Echinacea (Echinaeea purpurea, E. angustifolia, E. pallida)
Anti-inflammatory echinacea helps thrust your immune system into all-systems-alert mode. It also can numb inflamed throat tissues. In studies, echinaea kills some of the viruses that commonly infect the upper respiratory tract. It's also weakly bacterial, but it shouldn't be relied upon to knock off strep bacteria. Liquid echinacea products produce a somewhat numbing tingle when swallowed. Depending on your symptoms, this property may be soothing or irritating.

You can take echinacea along with antibiotics for strep. A German study found that this combination led to faster healing time and fewer recurrent infections. Typical dosage: up to nine 300- to 400-milligram capsules per day; or 60 drops of tincture every two to three hours while you're awake the first two days of illness. Then decrease to 60 drops of tincture three times per day. Discontinue when symptoms are gone. Caution: if you're allergic to ragweed, you may be allergic to echinacea.

Shiitake (Lentinus edodes)
These culinary treasures have antiviral and immune-stimulating effects. You can cook with them or take encapsulated products. Typical dosage: up to five 400-milligram capsules a day.

Liquorice (Glycyrrhiza glabra)
Whole-root liquorice reduces inflammation, soothes the throat, stimulates the immune system and increases the body's production of the antiviral substance interferon. But the deglycyrrhizinated, or DGL, liquorice that's used to treat ulcers doesn't contain the components you want for cold- and flu-fighting. Typical dosage: up to 3 cups of tea per day (simmer 1/2 teaspoon of dried chopped root in 1/4 litre of water for 10 to 15 minutes); or up to six 400- to 500-milligram capsules per day; or 20 to 30 drops of tincture three times per day. Caution: do not take for longer than six weeks, or if you're pregnant or breastfeeding. People with high blood pressure, diabetes or diseases of the thyroid, kidney, liver or heart should not take liquorice unless advised to do so by their doctor.

Marshmallow (Althaea officinalis)
This root soothes inflamed mucous membranes. It also has a mild stimulating effect on the immune system. Typical dosage: up to six 400­to 500-milligram capsules a day; or 20 to 40 drops tincture up to five times per day; or 3 cups of tea per day (simmer 1 teaspoon of dried root in 1/4 litre of water for 10 minutes).

Mullein (Verbascum thapsus)
Soothing mullein fights flu viruses. Typical dosage: up to 6 cups of tea per day (steep 2 teaspoons of dried leaves and flowers in 1/4 litre of hot water for 10 to 15 minutes); or 25 to 40 drops of tincture every three hours.

Plantain (Plantago lanceolata, P. major)
Another tissue-soother, plantain is demulcent, anti-inflammatory and antibacterial. The German Commission E, that country's equivalent of the Medicines Cotrol Agency, endorses it as safe and effective for throat inflammation. Typical dosage: up to 4 cups of tea per day
(steep 2 teaspoons of dried leaves in 1/4 litre of hot water for 10 to 15 minutes); or 3 to 6 grams in capsules per day.

Eucalyptus (Eucalyptus globulus)
This fragrant herb has the Commission E's blessing as a remedy for easing sore throat. Its aromatic oils are antiseptic and cooling, and its tannins have an astringent action that shrinks inflamed, swollen tissues. Typical dosage: up to 3 cups of tea per day (steep 1 teaspoon of crushed leaves in 1/4 litre of hot water for 10 minutes). You can also suck on one of the commercially available types of eucalyptus lozenges. Caution: do not take eucalyptus internally if you have a serious liver disease or inflammatory condition of the gastrointestinal tract or bile ducts.

Slippery Elm (Ulmus rubra)
The inner bark of this tree has a long tradition of soothing all manner of sore throats. Typical dosage: 2 to 3 cups of tea per day (steep teaspoon of powdered bark in 4 litre of hot water for 10 minutes). You might also find lozenges made with slippery elm. Take them according to the manufacturer's directions.

Garlic (Allium sativum) and Onion (A. cepa)
These two pungent herbs possess antiviral and antibacterial activity. Garlic fights streptococcus. Typical dosage: up to three 500- to 600­milligram capsules per day; or 1 or 2 raw garlic cloves per day minced into food. As for onions, try including them in food daily.

Oregon Graperoot (Mahonia aquifolium)
This herb and its berberine-containing cousins, goldenseal (Hydrastis canadensis), gold thread (Coptis chinensis) and barberry (Berberis vulgaris), all fight bacteria. Berberine even has some activity against streptococcus. These plants are also mucous membrane tonics, meaning they help to ease the irritation of sore throat. Typical dosage: 60 drops (about two dropperfuls) of tincture three times per day; or up to six 500- to 600-milligram capsules per day. Caution: do not take if you are pregnant or breastfeeding.

Lemon Balm (Melissa officinails)
This mint-family member works against a variety of viruses and bacteria including streptococcus. It works well as a tea or as a gargle. Typical dosage: 3 to 4 cups of tea per day (steep 1 teaspoon of dried leaves in 1/4litre of hot water for 10 minutes); or gargle as needed.

Usnea (Usnea barbata)
Also known as old man's beard, this lichen fights streptococcus and has anti-inflammatory and immune-stimulating actions. Typical dosage: 60 drops of tincture three times per day.

CAN YOU USE HERBS WITH ANTIBIOTICS?
With all of the bad publicity antibiotics sometimes get, some people wonder if they should use them at all. Clearly, antibiotics have their place: fighting bacterial infections that herbs can't vanquish.
So are herbs worthless in fighting bacteria? Probably not. With respect to strep, however, most of the research on the antimicrobial abilities of herbs involves studies done on cultures in test tubes. None has compared herbs to either placebos (fake pills) or conventional antibiotics in humans.
Such research does suggest that applying these herbs directly to the infection site might do some good. For strep throat, this means you can gargle with a tincture dissolved in water or squirt a liquid extract on to the back of the throat.

Herbs can also help boost your immune system while the antibiotic kills the bacterial infection. One German study found that adding echinacea to the antibiotic treatment of strep throat helped patients get well faster and reduced the chance of relapse.
Until studies confirm that herbs are effective in fighting strep infections, don't substitute them for antibiotics. Instead, use them with whatever antibiotics your doctor prescribes.