Coltsfoot Coltsfoot was traditionally used as an antitussive cough medication, which explains its botanical name Tussilago (from tussis, coughing; ago, to chase) and its common name, coughwort. It is similar to Petasites vulgaris, butterbur, which can be a dangerous toxic contaminant in coltsfoot products. Both the flowers and the leaves of coltsfoot are gathered for herbal use. Uses and Benefits: Coltsfoot has been used as a candy and herbal remedy in different formulations for thousands of years. Oral preparations were advocated for use in cough and various respiratory diseases, and the smoke from burning coltsfoot leaves or from herbal cigarettes was also used for treating asthma and bronchitis. Other former indications included diarrhea and slow metabolism, and coltsfoot has been employed as a blood purifier and as a diuretic. It is relatively unique in having been selected by both traditional Western and Chinese herbalists for the same specific purpose-the treatment of cough. Pharmacology: One of the main contents of coltsfoot leaves is a mucilage. This polysaccharide macromolecule forms a colloidal solution or a gel with water; this is said to coat the mucosa of the pharynx and have a demulcent effecP Historically, there was a tendency to assume that the sticky quality of mucilages, which resemble mucus, signified their inherent value as throat soothers or expectorant agents, and thus there arose the suggestion that the herbal sources of such products were helpful in coughs. Another component, tussilagone, has been reported to stimulate the respiratory center and to increase blood pressure in animal models. Components of greater concern are the pyrrolizidine alkaloids-senkirkine, senecionine, and seneciphylline-which are present in small amounts. Of these, senkirkine and senecioning contain unsaturated necine bases; in animals, these have been reported to cause hepatoxic, carcinogenic, and possibly pneumotoxic effects.? European coltsfoot has smaller quantities of toxic compounds than some Chinese plants. Coltsfoot also contains tannins, flavonoids, acids, bitters, and other constituents. Most of these have not been pharmacologically evaluated, but an expectorant effect has been hypothesized to occur through stimulating gastric receptors to cause a vagal reflex in the lung that results in bronchial gland secretion. Coltsfoot flower buds contain a compound (L-652,469) which has platelet-activating factor inhibitory properties, but no clinical evaluation of this component has been made. Clinical Trials: In spite of its long reputation as a "pectoral" for treating respiratory disease, there is no clinical trial evidence demonstrating that the herb itself or its components have any useful effect in treating cough or asthma. It may be of empiric benefit for soothing sore throats, but there is no evidence that it is more effective than other syrupy drinks or candies. Since it is very difficult to prove that any drug is an effective expectorant, it is not surprising that coltsfoot has never been demonstrated to possess this property. There is no clinical evidence to support claims that it has any clinically useful properties. Adverse Effects: There are no known side effects with brief or occasional use. Side Effects and Interactions: There are no recognized interactions with coltsfoot, although use with potential hepatotoxic agents should be avoided. Cautions: Occasional reports have implicated the prolonged use of coltsfoot with the development of severe hepatic veno-occlusive disease; this is due to the hepatotoxic pyrrolizidine alkaloids. Coltsfoot should be avoided by patients with liver disease and by those ingesting potentially hepatoxic drugs and/or alcohol. Occasional concerns arise about the allergenicity and carcinogenicity of coltsfoot, but these claims have not been substantiated in humans. It should not be taken by pregnant or breast-feeding women. Any use of coltsfoot should be restricted to a few days so as to decrease the risk of toxicity. Preparations & Doses: Coltsfoot is commonly incorporated into candies and teas, which are particularly popular in France.It is also available in many European countries as solutions, syrups, and tablets. A typical dose is 0.6-2 ml of a flower extract or to 8 ml of a syrup. Dosages of dried herb vary from 600 to ,2000 mg t.i.d. Summary Evaluation: Coltsfoot has no clinically documented value as a respiratory r'rnedy. As the herbal leaf and other components of coltsfoot have toxic effects and lack proven value, their use is discouraged. is unlikely that small amounts given for a few days could cause significant harm. Nevertheless, safer herbs that may be more effective should be preferred for treatment of sore throats and coughs and for improving expectoration. Due to its potential toxity, coltsfoot is not recommended by leading herbal authorities.
Comfrey Herb Description: Comfrey, Symphytum officinale, is an herb that grows in temperate climates. It was long known in Europe under names such as boneset, blackwort, slippery root, and gum plant. It is in the same family as borage. Various species of comfrey are grown in different countries. Uses and Benefits: Comfrey is named from its ancient application in "bonemending": the Latin, confirma which means made firm; the Greek, Symphytum, which means to unite. Traditionally, its roots and leaves have been used to treat broken bones and wounds. The mucilaginous root content was formerly promoted as an expectorant and antitussive, and to treat gastrointestinal disorders. Comfrey is promoted in Ayurvedic and other herbal systems, with claims for benefit in disorders such as peptic ulcer. Comfrey also has been commonly used as a topical anti inflammatory healing agent. Although still a component in some cosmetics, comfrey is no longer readily available as an herbal remedy in the U.S. due to its toxic potential. Pharmacology: Although the leaves are also used, the main therapeutic components are thought to be found in the roots. These include mucilage (fructans), tannins, allantoin, rosmarinic acid, sarracine, platyphylline, triterpenes, and sterols. However, the most important constituents of the roots are the hepatotoxic pyrrolizidine alkaloids, such as intermedine and its acetylated derivativessymphytine and the very toxic echimidine. These compounds include an unsaturated necine base, which causes the pyrrolizidine alkaloids to be hepatotoxic. The non-toxic allantoin, mucilage, astringent tannins, and anti-inflammatory rosmarinic acid, however, could have a soothing effect on inflammatory skin disorders. Clinical Trials: No significant clinical trials have been reported in humans. There is insufficient evidence of comfrey's value to justify clinical studies. Adverse Effects: The main toxic outcome of ingesting comfrey is liver disease, and several cases have been recorded of veno-occlusive disease of the liver, resulting in ascites and hepatic fibrosis. Other toxicity may be seen, including a curare-like defect, adverse effects in pregnant women, and possibly carcinoqenesis. Presumably, individual patient factors affect susceptibility, but the dangers of the herb are unpredictable. Because of this, systemic use of comfrey has been banned in many countries, and the FDA discourages its use. Russian comfrey is said to be more toxic than the common comfrey of North America. Side Effects and Interactions: There are no recognized drug interactions. Cautions: Comfrey should not be used orally or internally. Although it can be used topically, it should probably not be placed on broken skin. All forms of comfrey should be avoided in pregnant and nursing women. Preparations & Doses: Preparations of root and leaf parts are now less readily available. Tablets and other herbal extracts have been employed, but very dilute teas or decoctions are safer; however, internal use is not recommended. The herb is used in topical preparations including lotions, creams, salves, and poultices, and it is sometimes used as a gargle. Herbal authorities recommend that it can be employed externally for contusions, bruises, and sprains for up to 6 weeks during a year, but such use is rarely justified. SummaryEvaluation: No evidence exists to support the clinical use of comfrey, and it has been found to have significant hepatotoxic effects. The topical use of comfrey products for skin diseases may be safe, provided the skin is not broken and the preparation is not used chronically. Oral administration of dilute teas may be safe, but in view of the potential serious toxicity and the lack of proven value, oral intake of comfrey should be avoided.
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