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Prescription 2016: Natural Sore Throat Remedies

January 25, 2016 Written by JP       [Font too small?]

Pharyngitis is the technical name for a sore throat. In most cases viral infections, such as the common cold or influenza, are responsible for the characteristic inflammation and swelling in the back of the throat or pharynx. Thankfully, there are some evidence-based alternatives that address sore throat prevention, recovery time and symptom severity.

Holistic sore throat remedies tend to fall into three categories. The first emphasizes supplements that promote resistance to infection and/or hasten recovery. When prevention isn’t successful, the next logical step is to use herbal decoctions to minimize symptoms. If additional relief is needed, the ancient practice of acupuncture can act as a last-ditch, soothing adjunct.

Tier One: Immunity and Onset - Many supplements claim to protect against colds and flu. However, most haven’t been scientifically tested in humans. Three exceptions can be found in Panax quinquefolius aka American ginseng, Andrographis paniculata and zinc acetate lozenges. Cold-fX, a patented American ginseng extract, enhances immune function (antibody response) and significantly reduces sore throat associated with acute respiratory illness. KalmCold, a standardized Andrographis paniculata extract, speeds along uncomplicated respiratory tract infections as compared to placebo. High dosages of zinc acetate lozenges (80-92 mg/day), taken within 24 hours of cold onset, alleviate several throat-related symptoms: cough, hoarseness, scratchiness and soreness. Please note that such large amounts of zinc are generally recommended for two-weeks of use or less.

Bonus Tip: The efficacy and reliability of Echinacea for cold and flu prevention is decidedly mixed. Even so, according to a recent review in Advances in Therapy, some echinacea products do, in fact, modulate immunity and possess antiviral activity. In turn, this “lowers the risk of recurrent respiratory infections and complications” in “susceptible individuals”. If you plan to try Echinacea, it’s essential to look for concentrated extracts with some degree of clinical validation. A few examples are A. Vogel’s Echinaforce and Echinamide by Natural Factors. Lastly, for pharyngitis symptoms in particular, a throat spray compromised of Echinacea and sage appears more effective than Echinacea alone.

Tier Two: Symptom Management - Tea is a great place to start. Hot beverages are documented relievers of various cold and flu symptoms. In this case, one of the best hot beverages you can have is Throat Coat – an herbal blend consisting of licorice, marshmallow root, slippery elm bark and more. One study found that 4 – 6 cups/day of Throat Coat tea quickly decreased sore throat pain in patients with acute pharyngitis. Also, adding honey to the mix is advisable as it suppresses coughing while alleviating throat irritation.

Bonus Tip: Licorice is one of the key ingredients in Throat Coat. At least three experiments report that gargles and lozenges made of licorice reduce symptoms in a related condition known as post-operative sore throat. Therefore, perhaps gargling with Throat Coat or adding some other form of licorice to your treatment plan may be helpful. Hypertensives should use licorice carefully as it contains glycyrrhizin, a chemical which can elevate blood pressure. Licorice use doing pregnancy is also discouraged as it may increase the risk of pre-eclampsia and stillbirth.

Tier Three: Adjunctive Care - For most, the first two tiers will likely to be enough. If not, acupuncture is yet another option. A study in the November-December 2015 issue of the Journal of American Board of Family Medicine describes how ear acupuncture safely lowers pain and medication use in patients with acute sore throat. Previous research indicates that other forms of acupuncture present similar effects. Best of all, acupuncture for acute conditions such as pharyngitis is usually brief and not very costly.

Bonus Tip: Massages are often relegated to times of good health and leisure. But, why not have a massage when your body needs it most? A few trials have determined that massage benefits compromised immunity in cancer patients and premature infants. What’s more, massage therapy positively affects immune-related gene expression in healthy adults as well. Practically speaking, this provides an incentive to get more massages when cold and flu season comes around.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Randomized Double Blind Placebo Controlled Clinical Evaluation (link)

Study 2 - Randomized, Controlled Trial of Panax Quinquefolius Extract (link)

Study 3 – Efficacy and Safety of CVT-E002, a Proprietary Extract of Panax(link)

Study 4 - Efficacy of COLD-fX in the Prevention of Respiratory Symptoms (link)

Study 5 - The Effectiveness of High Dose Zinc Acetate Lozenges on Various (link)

Study 6 - Echinacea Reduces the Risk of Recurrent Respiratory Tract (link)

Study 7 - Efficacy and Tolerability of a Spray with Salvia Officinalis in the (link)

Study 8 - Echinacea/Sage or Chlorhexidine/Lidocaine for Treating Acute (link)

Study 9 - Effects of a Hot Drink on Nasal Airflow and Symptoms of Common (link)

Study 10 - Safety and Efficacy of a Traditional herbal medicine (Throat Coat) (link)

Study 11 - Effect of Tualang Honey in Enhancing Post Tonsillectomy Healing (link)

Study 12 - Honey and Beehive Products in Otorhinolaryngology: A Narrative (link)

Study 13 - Effect of Preoperative Licorice Lozenges on Incidence of (link)

Study 14 - A Randomized, Double-Blind Comparison of Licorice Versus Sugar- (link)

Study 15 - An Evaluation of the Efficacy of Licorice Gargle for Attenuating (link)

Study 16 - The Pharmacological Activities of Licorice (link)

Study 17 - Severe, Very Early Onset Pre-Eclampsia Associated with Licorice (link)

Study 18 - Fetal & Neonatal Outcomes in Women Reporting Ingestion of Licorice (link)

Study 19 - Ear Acupuncture for Acute Sore Throat: A Randomized Controlled (link)

Study 20 - Acupuncture in Preventing Postoperative Anaesthesia-Related Sore (link)

Study 21 - An Instant Pain-Relief Effect of Balance Acupuncture for Relieving Sore (link)

Study 22 - Effectiveness of Aromatherapy with Light Thai Massage for Cellular (link)

Study 23 - Effect of Massage on Immune Function and Stress in Women w/ Breast … (link)

Study 24 - Randomized Placebo-Controlled Trial of Massage Therapy on Immune (link)

Study 25 - Effects of Traditional Japanese Massage Therapy on Gene Expression (link)

Brief Acupuncture Treatment Reduces Sore Throat Pain

Source: J Am Board Fam Med. 2015 Nov-Dec;28(6):697-705. (link)

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7 Comments & Updates to “Prescription 2016: Natural Sore Throat Remedies”

  1. JP Says:

    Updated 1/25/16:

    Note: Qinghoyan is a traditional Chinese medicine. A list of ingredients can be found here: http://www.pacificphar.com/en/product_2_5.htm

    http://www.ncbi.nlm.nih.gov/pubmed/26080572

    Zhongguo Zhong Yao Za Zhi. 2015 Jan;40(2):351-5.

    [Clinical study on Qinghouyan lozenge in treatment of acute pharyngitis].

    To evaluate the clinical efficacy and safety of Qinghouyan lozenge in the treatment of acute pharyngitis due to Lung-heat and Yin-deficiency, and compare with Qinghouyan oral Liquid. Totally 144 subjects were enrolled and randomly divided into two groups (72 in the test group and 72 in the control group). The participants in the test group were given Qinghouyan lozenge for 5 days, and those in the control group were given Qinghouyan oral Liquid for 5 days. The effectiveness evaluation indexes were pharyngalgia/odynophagia disappearance rate, overall efficacy of TCM syndromes, TCM syndrome scores, and single syndrome and sign disappearance rate. During the test, the safety was evaluated by vital sign, lab examination indexes and adverse events. The results for the full analysis set showed that the couth disappearance rate, the incidence rate of TCM syndromes, and the throat/uvula congestion disappearance rate of the test group were higher than that of the control group (P < 0.05), with significant differences in the changes in syndrome scores between the two groups (P < 0.05). Altogether 3 adverse events were observed in the test group while 6 adverse events in the control group, without significant differences in the adverse event rate between the two groups (P < 0.05), serious abnormal laboratory examinations and vital signs. In conclusion, Qinghouyan lozenge has better efficacy in treatment of acute pharyngitis due to Lung-heat and Yin-deficiency than Qinghouyan oral liquid, with good safety.

    Be well!

    JP

  2. JP Says:

    Updated 1/25/16:

    http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1933830

    Anesthesiology. 2012 Sep;117(3):512-8.

    Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study.

    BACKGROUND: Postoperative sore throat (POST) is an undesirable complaint after orotracheal intubation. Magnesium is a noncompetitive N-methyl-D-aspartate receptor antagonist thought to be involved in the modulation of pain. The present study aimed to investigate the effect of preoperative administration of oral magnesium lozenge on POST.

    METHODS: Seventy patients undergoing orthopedic surgery were randomly allocated into two groups, to either receive placebo (control) or magnesium lozenges (magnesium) to be dissolved by sucking 30 min preoperatively. Patients were assessed for incidence and severity (four-point scale, 0-3) of POST at 0, 2, 4, and 24 h postoperatively. The primary outcome was sore throat at 4 h after surgery. The secondary outcome was the severity of POST at four evaluation time-points postoperatively.

    RESULTS: The incidence of POST at 4 h was higher in control group than in magnesium group (95% CI: 26%, 14-42%; P=0.032). The highest incidence of POST occurred at the second hour after surgery, with the rate of 23% in the magnesium group and 57% in the control group (95% CI: 34%, 20-51%; P=0.007). The severity of POST was significantly lower in the magnesium group at 0 (P=0.007) and 2 h (P=0.002). The incidences of POST at 0 and 24 h and severity scores at 4 and 24 h were not significantly different between the groups.

    CONCLUSIONS: The administration of magnesium lozenge 30 min preoperatively is effective to reduce both incidence and severity of POST in the immediate postoperative period.

    Be well!

    JP

  3. JP Says:

    Updated 1/25/16:

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101180

    PLoS One. 2014 Jul 10;9(7):e101180.

    Vitamin D levels and monospot tests in military personnel with acute pharyngitis: a retrospective chart review.

    Some recent studies have proposed an important role for vitamin D in reducing the risk of infection by assisting in the suppression of viruses and by controlling the inflammatory response. A low vitamin D state may have a detrimental effect on the immune system’s ability to produce activated CD8+ T cells, and it may increase the inflammatory reaction to Epstein Barr virus. The aim of this chart review was to see if serum 25 OH vitamin D3 levels in service members with acute pharyngitis were lower in those who had positive rather than negative monospot tests. A retrospective chart review was conducted on the medical records of service members who presented to sick call at Camp Lejeune, NC with acute pharyngitis from October 8, 2010 until June 30, 2011. Serum 25 OH vitamin D3 levels were compared between those with positive and negative monospot test results. Of the 25 records that were reviewed, there were 9 (36%) service members with positive results, and they were found to have lower vitamin D levels (Median = 20.80 ng/ml, Interquartile range = 10.15) than those with negative test results (Median = 30.35 ng/ml, Interquartile range = 17.05), Mann-Whitney U = 41, p = .039. Only 1 of the 9 with positive test results had a normal serum 25 OH vitamin D3 level (30 ng/ml or greater) compared with 9 of the 16 with negative test results. Optimal vitamin D stores may play a significant role in reducing the risk of developing acute mononucleosis but larger, prospective studies will be needed to verify these findings.

    Be well!

    JP

  4. JD Says:

    Be just my luck I’ll now get a sore throat..after not having one in years. Thanks JP!

  5. JP Says:

    Ha! I sure hope not, JD! But, if you do …

    Be well! < — :-)

    JP

  6. JP Says:

    Updated 07/30/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939213/

    Biomed Res Int. 2016;2016:8503426.

    Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat.

    The in vitro antibacterial activities of 29 traditional medicinal plants used in respiratory ailments were assessed on multidrug resistant Gram-positive and Gram-negative bacteria isolated from the sore throat patients and two reference strains. The methanolic, n-hexane, and aqueous extracts were screened by the agar well diffusion assay. Bioactive fractions of effective extracts were identified on TLC coupled with bioautography, while their toxicity was determined using haemolytic assay against human erythrocytes. Qualitative and quantitative phytochemical analysis of effective extracts was also performed. Methanolic extract of 18 plants showed antimicrobial activity against test strains. Adhatoda vasica (ZI = 17-21 mm, MIC: 7.12-62.5 μg/mL), Althaea officinalis (ZI = 16-20 mm, MIC: 15.62-31.25 μg/mL), Cordia latifolia (ZI = 16-20 mm, MIC: 12.62-62.5 μg/mL), Origanum vulgare (ZI = 20-22 mm, MIC: 3-15.62 μg/mL), Thymus vulgaris (ZI = 21-25 mm, MIC: 7.81-31.25 μg/mL), and Ziziphus jujuba (ZI = 14-20 mm, MIC: 7.81-31.25 μg/mL) showed significant antibacterial activity. Alkaloid fractions of Adhatoda vasica, Cordia latifolia, and Origanum vulgare and flavonoid fraction of the Althaea officinalis, Origanum vulgare, Thymus Vulgaris, and Ziziphus jujuba exhibited antimicrobial activity. Effective plant extracts show 0.93-0.7% erythrocyte haemolysis. The results obtained from this study provide a scientific rationale for the traditional use of these herbs and laid the basis for future studies to explore novel antimicrobial compounds.

    Be well!

    JP

  7. JP Says:

    Updated 09/20/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27642569

    Anesth Pain Med. 2016 May 9;6(3):e32108.

    The Effect of Green Tea Gargle Solution on Sore Throat After Coronary Artery Bypass Grafting: A Randomized Clinical Trial.

    BACKGROUND: Tracheal intubation is an essential method of keeping the airway open in patients under general anesthesia. Sore throat is a prevalent complication after endotracheal intubation.

    OBJECTIVES: The aim of this study was to investigate the effect of green tea gargling on sore throat after coronary artery bypass grafting (CABG).

    PATIENTS AND METHODS: This was a single-blind, randomized clinical trial, in which 121 patients who had undergone CABG were divided into two groups: those who gargled distilled water and those who gargled a green tea solution. An hour after extubation, the patients of the intervention group were asked to gargle 30 cc of green tea, and the patients of the control group were asked to gargle 30 cc of distilled water, every 6 hours for up to 24 hours (four times per patient). A sore throat questionnaire was filled out 6, 12, and 24 hours after endotracheal extubation.

    RESULTS: The results showed that there were no significant differences between the two groups with regard to patient age, sex, body mass index, smoking background, and duration of anesthesia. There was no significant difference between the two groups in terms of sore throat before the intervention (P = 0.461) and 6 hours after the intervention (P = 0.901). However, a significant difference was observed between the two groups in terms of sore throat 12 hours (P = 0.047) and 24 hours (P < 0.001) after removing the endotracheal tube.

    CONCLUSIONS: Gargling a green tea solution, an anti-inflammatory, natural, and harmless substance, can reduce the pain of sore throat in patients after endotracheal extubation.

    Be well!

    JP

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