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Monograph Library

Stop-It-Cold® Cough Syrup Adults

The physiology of a cough -  Bronchitis

Essentially, a cough is a reflex defensive action on the part of the body. A symptomatic reaction, it allows a person to clear mucus and other irritants from the throat and lungs. Most commonly, coughs are associated with respiratory tract infections such as cold and flu, although there are other causes too, like smoking, asthma, gastroesophageal reflux disease (GERD), and certain cardiac conditions, to name just a few. A cough can be wet and productive of phlegm or mucus or dry without the production of sputum. Coughs are possibly the most ubiquitous of medical conditions, prompting millions of visits to doctor’s offices.

The questionable effectiveness and pitfalls of over-the-counter cough syrups

When it comes to coughs, these are some of the main pharmaceutical, over-the-counter approaches:

  • Suppressants, also known as antitussives (e.g. dextromethorphan (DM), common in cough medicines like Dimetapp, Benylin DM, Robitussin, Nyquil etc.)
  • Expectorants (e.g. guaifenesin) that increase bronchial mucus secretion
  • Mucolytics, which increase the viscosity of bronchial secretions
  • Antihistamines
  • Decongestants

In 2016, Health Canada reminded parents not to give cold and cough medications to children six years old or younger, because the products “have not been shown to be effective” and, further, have the potential for “serious harm.” In an accompanying table, moreover, they itemize the active pharmaceutical ingredients that should not be given to children under the age of 6.[1] It’s not unreasonable to assume that these OTC drug products pose a similar problem in older children or adults.

Corroboratively, a review study conducted by the Cochrane Library concludes that there is no evidence to indicate that OTC cough medicines are indeed effective, whether it be in adults or children. This same review found, in fact, that 21 studies reported adverse effects, mostly in participants taking preparations containing antihistamines and dextromethorphan.[2]

Wild cherry bark and elderberry: two classically tasty antitussives

For Wild Cherry Bark, the Eclectics—doctors of the 19thand early 20thcenturies who largely relied on herbs—took their lead from the indigenous peoples, who used this herb for colds and coughs.[3] Eclectic doctor John William Fyfe describes the properties of wild cherry bark as effective for relieving “irritation of the mucous membranes of the respiratory tract,” its effect being due not just to the alleviation of the cough but also the fact that it “lessens the fever and increases the strength and appetite.”[4] While it has traditionally been used for cold, fever, and sore throat, it’s interesting to note that Wild Cherry Bark’s anti-inflammatory properties show significant suppressive action on human colorectal cancer cells.[5]

Elderberries on wooden floor

Elderberry has a long history in the annals of ethnobotany as a healing agent both in Europe and with North American indigenous peoples.[6],[7] Its reputation does not come unearned. A recent review amply illustrates its antiviral and antibacterial properties, pointing out that it has potent inhibitory activity on several strains of influenza.[8]

A clinical trial conducted in Norway in 2000, for example, investigated the effectiveness of elderberry extract in 60 patients with the flu. The results of the trial found that influenza symptoms disappeared 4 days earlier (in 2 days v. 6 in the placebo group) and the need for symptomatic medications like Tylenol or Advil was significantly less in those receiving elderberry as opposed to placebo. The authors concluded that “Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza.”[9]

An in-vitro study meanwhile compared the efficacy of elderberry compared to the antiviral drug, Oseltamivir, for inhibition of the virulent H1N1 virus, concluding that the anti-H1N1 activities “compare favorably” to the anti-influenza properties of Oseltamivir.[10]

At the same time, elderberry has mucous membrane soothing, bronchial secretion stimulating and immune-enhancing qualities.[11],[12],[13]

Echinacea: the classic antimicrobial

Echinacea is a well-known antiviral, antibacterial, and immune enhancing agent. Its safety and effectiveness as an antiviral measure for preventing colds have been well corroborated by a recent research study.[14] A 1997 clinical trial, moreover, demonstrates that echinacea as a component of a 4-ingredient formula is significantly more effective at relieving cough than is a placebo.[15]

With support from lobelia and marshmallow

Lobelia calms spasmodic coughs. Characterized by its lobeline component, this herb was discovered by Samuel Thomson, the progenitor of the Thomsonian movement in the US in the early 19thcentury. As Finley Ellingwood, MD pointed out as early as 1915, “Lobelia … has long had a splendid reputation as a cough medicine. It is indicated when there is a sense of tightness or constriction in the chest, with difficult breathing.”[16] Meanwhile, with its mucilaginous, cough-suppressing polysaccharides,[17] marshmallow is a classic demulcent herb. In his famous 17thcentury Herbal,for example, Nicholas Culpeper comments that marshmallow “doth marvellously help excoriation, the phthisic, pleurisy, and other diseases of the chest and lungs.”[18] 

Honey: hitting the therapeutic sweet spot

The use of honey for both nutrition and medicinal purposes goes back to classical antiquity. A significant body of research has in fact solidly established its role as an antioxidant, anti-inflammatory, antibacterial, and wound-healing agent, not to mention cough suppressant.[19] A 2007 clinical trial, for example, found that dextromethorphan (DM), the suppressant ingredient popular in many cough medicines, as noted above, was no more effective than placebo and that honey was indeed superior and significantly effective for relieving coughs![20] Similarly, a recent study found that honey provided better cough relief than diphenhydramine (an antihistamine marketed as Benadryl).[21]

Braced further by essential oils of lemon peel and cinnamon bark

Essential oil of lemon peel is composed mostly of limonene.[22] Besides having a significant anti-inflammatory effect,[23] it is a broad-spectrum antimicrobial.[24] Cinnamon bark essential oil is significantly antibacterial, its bioactive phytochemical being cinnamaldehyde.[25] At the same time, it is a promising topical anti-inflammatory agent.[26] Furthermore, cinnamon bark essential oil, as part of a three essential oil blend, has been found to be not only antibacterial, but antifungal and antiviral as well.[27]

Pharmacology

Elderberry is rich in Vitamin C and flavonoid compounds, including quercetin and anthocyanins, from which the therapeutic effects are believed to be derived.[28] Lobelia contains more than 20 piperine alkaloids, lobeline being the most prominent and biologically active.[29] A recent study finds that lobeline effectively inhibits acute lung edema and attenuates nonspecific pulmonary inflammation.[30] Lobelia also includes lobinaline, which has been found to be even more potent a free radical scavenger than quercetin, a natural product widely known for its free radical scavenging and antioxidant properties.[31] For its part, honey has a number of biologically active compounds, including vitamins A, E, K, B1, B2, B6, and C, as well as niacin, panthothenic acid, phenolics, flavonoids, fatty acids, and amino acids.[32] Rhamnogalacturonan, a polysaccharide isolated from the mucilage of marshmallow, has been shown to possess very high cough suppressant effect.[33]

Active Ingredients (per tsp, 5ml):

1.06 ml of *wild cherry(Prunus serotina,bark) decoction 1:2 (QCE 531 mg)

0.95 ml of *elderberry(Sambucus nigra, subsp.canadensis, berry)juice concentrate 4.22:1 (QCE 4009 mg)

0.75 ml of *lobelia(Lobelia inflata, root) tincture 1:7 (QCE 107 mg)

0.5 ml of *echinacea(Echinacea purpurea, herb top and root) tincture 1:1 (QCE 500 mg)

0.5 ml of *marshmallow(Althaea officinalis, root) tincture 1:1.85 (QCE 270 mg fresh) OR 1:4 (QCE 125 mg dry)

*Certified Organic

Non-Medicinal Ingredients: Distilled water, *Honey, *Alcohol, *Vegetable glycerine, *Lemon peel essential oil (Citrus limon), *Cinnamon bark essential oil (Cinnamomum verum)

*Certified Organic

Dose

Adults:Take 5ml (1 tsp), 3 times daily; take a few hours before or after taking other medications or natural health products.

Duration of Use

Consult a health care practitioner for use beyond 1 week.

Health Canada Approved Use Claims

Used in Herbal Medicine to help relieve symptoms of colds and flu (such as coughs and catarrh of the upper respiratory tract)

Cautions and Warnings

Consult a health care practitioner before use: if you have a progressive systemic disease such as tuberculosis, collagenosis, multiple sclerosis, AIDS, HIV infection, an auto-immune disorder or a cardiac or respiratory disorder; if you are using tobacco products or are taking lithium or immunosuppressants. Consult a health care practitioner if symptoms worsen or persist.

Contraindications

Do not use: if you are pregnant or breastfeeding; if you have high blood pressure or a digestive disorder; if you are suffering from infectious or inflammatory gastrointestinal conditions.

Known Adverse Reactions

Hypersensitivity (e.g. allergy) can occur, in which case, discontinue use. Discontinue use in case of gastrointestinal upsets, such as abdominal cramps, nausea, vomiting, diarrhea or if dizziness, increased respiratory rate or tremors occur. Diuretic effect may occur. Rare cases of severe allergic reactions have been known to occur; use caution if you are allergic to plants of the Daisy family. 

Quality Summary

Our products are all third party tested to ensure the absence of pesticides, microbes, and heavy metals and to confirm purity and stability.

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Who is it for

  • Anybody with a cough, especially from respiratory tract infections like cold and flu
  • Also those suffering from coughs due to smoking, asthma, GERD etc.
  • All who have a cough, whether it be wet or dry 

 

How it helps

  • Sidesteps the problems of over the counter pharmaceutical cough syrups naturally
  • Relieves coughs with a highly effective combination of herbs, honey, and essential oils
  • A taste to match its healing properties

 

References

[1] - “Health Canada reminds parents not to give cough and cold medication to children under 6 years old,” accessed August 28, 2017 at: http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2016/57622a-eng.php

[2] - SM Smith et al, “Over-the-counter (OTC) medications for acute cough in children and adults in community settings,” Cochrane Database of Systematic Reviews2014, Issue 11.

[3] - Daniel E Moerman, Native American Ethnobotany, Portland, OR: Timber Press, 1998.

[4] - JW Fyfe, Specific Diagnosis and Specific Medication, Cincinnati: John K Scudder, 1914, p. 683.

[5] - K Yamaguchi et al, “Anti-proliferative effect of horehound leaf and wild cherry bark extracts on human colorectal cancer cells,” Oncology Reports2006 January; 15(1): 275-81.

[6] - Mrs. M Grieve, A Modern Herbal, Volume 1, A-H, “Elder,” New York: Dover Publications, 1971 (republication of 1931 edition), pp. 265-276.

[7] - Daniel E Moerman, pp. 511-12; 513.

[8] - Randall S Porter and Robert F Bode, “A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products,” Phytotherapy Research2017 

[9] - Z Zakay-Rones et al, “Randomized Study of the Efficacy and Safety of Oral Elderberry Extract in the Treatment of Influenza A and B Virus Infections,” The Journal of International Medical Research2004; 32: 132-140.

[10] - Bill Roschek Jr et al, “Elderberry flavonoids bind to and prevent H1N1 infection in vitro,” Phytochemistry2009; 70: 1255-1261.

[11] - Donald Yance, “Elderberry,” [need citation]

[12] - “European Elder Berry,” The ABC Clinical Guide to Elder Berry, American Botanical Council

[13] - Mario Roxas and Julie Jurenka, “Colds and Influenza: A Review of Diagnosis and Conventional, Botanical, and Nutritional Considerations,” Alternative Medicine Review2007; 12(1): 25-48.

[14] - SM Ross, “Echinacea purpurea: A proprietary Extract of Echinacea purpurea is Shown to be Safe and Effective in the Prevention of the Common Cold,” Holistic Nursing Practice2016 Jan-Feb; 30(1): 54-7.

[15] - E Thom and T Wollan, “A Controlled Clinical Study of Kanjang Mixture in the Treatment of Uncomplicated Upper Respiratory Tract Infections,” Phytotherapy Research1997; 11: 207-210.

[16] - Finley Ellingwood, ed, “Protracted Cough,” Ellingwood’s Therapeutist1915; 9(2): 34.

[17] - M Sutovska et al, “The antitussive activity of polysaccharides from Althaea officinalis I., var. Robusta, Arctium lappa L., var. Herkules, and Prunus persica L., Batsch,” Bratislavske Lekarske Listy2007; 108(2): 93-9.

[18] - Nicholas Culpeper, Culpeper’s Complete Herbal,London: Richard Evans; 1816. (reprint of the original 1653 edition)

[19] - S A Meo et al, “Role of honey in modern medicine,” Saudi Journal of Biological Sciences2017; 24: 975-978.

[20] - IM Paul et al, “Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents,” Archives of Pediatrics and Adolescent Medicine2007 Dec; 161(12): 1140-6.

[21] - P Ayazi et al, “Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents,” PLoS One2017 Jan; 12(1): e0170277

[22] - Ikhlas A Khan and Ehab A Abourashed, Leung’s Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, Third Edition, Hoboken, NJ: John Wiley, 2010; pp. 410-412.

[23] - JL Amorim et al, “Anti-Inflammatory Properties and Chemical Characterization of the Essential Oils of Four Citrus Species,” PLoS One 2016 April; 11(4)

[24] - MM Nikolic et al, “Antimicrobial synergism and cytotoxic properties of Citrus limon L., Piper nigrum L. and Melaleuca alternifolia (Maiden and Betche) Cheel essential oils,” Journal of Pharmacy and Pharmacology2017 August

[25] - S F Nabavi et al, “Antibacterial Effects of Cinnamon: From Farm to Food, Cosmetic and Pharmaceutical Industries,” Nutrients2015; 7: 7729-7748.

[26] - Xuensheng Han and Tory L Parker, “Antiinflammatory Activity of Cinnamon (Cinnamomum zeylanicum) Bark Essential Oil in a Human Skin Disease Model,” Phytotherapy Research2017 April; 31: 1034-1038.

[27] - A Brochot et al, “Antibacterial, antifungal, and antiviral effects of three essential oil blends,” Microbiology Open2017 January; 6:e459.

[28] - V Schmitzer et al, “Elderberry (Sambucus nigra L.) wine: a product rich in health promoting compounds,” Journal of Agricultural and Food Chemistry2010 September; 58(18): 10143-6.

[29] - François-Xavier Felpin and Jacques Lebreton, « History, chemistry and biology of alkaloids from Lobelia inflata,” Tetrahedron2004; 60: 10127-10153.

[30] - KC Li et al, “Lobeline improves acute lung injury via nuclear factor-kB-signaling pathway and oxidative stress,” Respiratory Physiology and Neurobiology 2016 May; 225: 19-30.

[31] - Dustin P Brown et al, “Novel multifunctional pharmacology of lobinaline, the major alkaloid from Lobelia cardinalis,” Fitoterapia2016 June; 111: 109-123.

[32] - S A Meo et al, op. cit., p. 976.

[33] - M Sutovska et al, “Antitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan and its changes in guinea pigs with ovalbumine-induced airways inflammation,” Bratislavske Lekarske Listy 2011; 112(12): 670-675.

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