Immune

Question 1

Immunomodulators

Answer 1

Immunodulator: deep immune stimulation
Facilitate greater immune system flexibility in body’s natural response to disease
Normalizes, modulates and balances the activity of the immune system, up- or down-regulating as needed
Adaptogenic too - Increases resistance, vitality. Adaptation to stress. Adrenal, Endocrine and CNS actions.
Tonifying too – Improves function of organ or system

Astragalus membranaceous (Astragalus)
Codonopsis pilosula (dang shen)
Ganoderma lucidum (Reishi)
Schisandra
Eleutherococcus (Siberian ginseng)

Dr Godfrey argues Echinacea may fit in this category as well as in the immunostimulatory category*

Question 2

Adaptogen

Answer 2

Adaptogen: increase tolerance to stressors: physical, mental and emotional. Many effect the hypothalamus and pituitary; they have far reaching effects - including immune system.
Enhances body’s use of glucose
*Increase glycolysis
*Enhance entry and utilization of glucose w/in cells

Eleutherococcus senticosus (siberian ginseng)
Lentinus edodes (shitake)
Ligustrum lucidum (chastity bush) 
Schisandra chinensis (schisandra)
Ganoderma lucidum (Reishi)

Question 3

Immunostimulants

Answer 3

Immunostimulants: more superficial immune activation; better for short term use and acute conditions.
Nonspecific stimulation or boosting of the immunological defense system without affecting immune system memory cells
Usually antimicrobial as well

Allium sativum (garlic)
Baptisia tinctoria (wild indigo)
Usnea spp (Old Man's Beard)
Echinacea spp

Question 4

Antihelminthic

Answer 4

Juglan nigra (Black Walnut)

Question 5

Anticancer

Answer 5

Larrea tridentata (Charparral)
Ganoderma lucidum (Reishi)
Lentinus edodes (shitake)
Eleutherococcus senticocus (siberian ginseng) = via its adaptogenic properties so maybe its a cheater in this category!

Question 6

Antifungal

Answer 6

Tabebuia spp (Pau D'arco)
Malaleuca spp (Tea tree)

Question 7

Genito-urinary Herbs

Answer 7

Arctostaphylos uva-ursi (bearberry)
Thuja occidentalis (thuja)
Barosma betulina (buchu)
Serenoa repens (saw palmetto)
Zea mays (corn silk)

Question 8

Allium sativum

Answer 8

(Garlic)
ANTIMICROBIAL + ANTIFUNGAL

Conditions: chronic bronchitis, recurrent colds, asthma, ringworm.

Question 9

Arctostaphylos uva ursi

Answer 9

(Bearberry)
ANTIMICROBIAL + DIURETIC + ASTRINGENT

Conditions: UB/KD stones, UTI, chronic KD dx, vaginal infx/ulceration; all GU infx.
Hoffman: PROSTATITIS
Acidic urine - will turn arbutin to hydroquinone and inactivate it.

Dr Gilbert says: GUT affinity

Question 10

Astragalus membranaceus

Answer 10

(Astragalus)
IMMUNOMODULATOR + ADAPTOGENIC

Conditions: Infections, leukopenia (low WBC) assx with steroid use, chemotherapy etc.

Potentiates IL-2 - so do not use with immunosuppressive drugs.
Polysaccharides shown in induce/potentiate phagocytosis + the herb can also restore the bodies depleted red blood cell count.

SAPONINS - active immune molecules in this herb

Question 11

Barosoma betulina

Answer 11

(Buchu)
RENAL ANTISEPTIC + weak DIURETIC

Conditions: cystitis, urethritis, gonorrhea, gout, urgency with no relief. All GU infx.

NOT in acute GI inflammation + Pregnancy

Dr Gilbert says: GUT affinity

Question 12

Codonopsis pilosa

Answer 12

(Dang shen)
IMMUNOMODULATOR + ADAPTOGEN

Conditions: chronic cough, SOB, diarrhea, fatigue, prolaps utuerus/stomach/rectum.

SAPONINS - active immune molecule in this herb

Question 13

Eleutherococcus senticocus

Answer 13

(Siberian ginseng)
ADAPTOGEN

Conditions: angina, HTN, hypotension, chronic bronchitis, CANCER, mild depression, insomnia, RECOVERY FROM SURGERY.

NOT to be used with heart meds, increase Abx, hypoglycemic.

SAPONINS - active immune molecules in this herb

Question 14

Ganoderma lucidum

Answer 14

(Reishi)
ADAPTOGEN + ANTI CANCER + DEEP IMMUNE (immunomodulatory)
antiallergenic/ antibacterial/
hepatoprotective/ antithrombotic

Conditions: allergies, bronchia issues, sinusitis, HTN, atherosclerosis, MI, AIDS, CANCER, hepatitis, high cholesterol.

NOT to be used in organ transplant + autoimmunity.
May cause DARK STOOL

Beta Glucans (a polysaccharide) which give the herb its immune actions!

Question 15

Juglans nigra

Answer 15

(Black Walnut)
ANTIHELMINTHIC + LAXATIVE + ANTIMICROBIAL

Conditions: worms, cold/flu, oral cankers, tonsilitis, ringworm (poultice)

OVERUSE = K+ secretion.

Question 16

Larrea tridentata

Answer 16

(chaparral)
ANTICANCER

Conditions: cancer, bacterial infx, HIV, viruses, parasites, yeast.

NOT: to be used in pregnancy/lactation. Prolonged use = KD/LV toxic d/t LIGNANS.
Banned in some countries due to concerns re.liver,kidneyand lymph toxicity w/ chronic use

Question 17

Lentinus edodes

Answer 17

(Shitake)
ANTICANCER + ADAPTOGEN + IMMUNOMODULATOR + ANTIBACTERIAL/VIRAL

Conditions: increased survival time in cancer, advanced cancer, influenza + colds, poor stamina/circulation.

Question 18

Ligustrum lucidum

Answer 18

(Chastity bush)
ADAPTOGEN + LV/KI TONIC + IMMUNOSTIMULANT (ANTI bact/viral)

Conditions: prevent bone marrow loss in chemo, neutropenia, HTN, parkinsons, high cholesterol, hepatitis, common cold.

Question 19

Malaleuca spp

Answer 19

(Tea tree)
ANTIMICROBIAL + ANTIFUNGAL

Conditions: athletes foot, ringworm, warts, infective rashes, acne, vaginal yeast infx.

TOXIC internally - volatile oil

Question 20

Schisandra chinensis

Godfrey

Answer 20

(Schisandra)
ADAPTOGEN + TONIFY Hrt/KD/LU YIN + MIND TONIC + SEXUAL TONIC + ANTITUSSIVE

Conditions: depression, forgetfulness, cirrhosis, cough, SOB.

NOT to be used in pregnancy; may cause heartburn.

Dr. Gilbert Notes
Energetics: warm, stillness
Const:lignans
Actions: adaptogen
TCM: collects and retains fluids (LU,KI,HT)
Secondary: sexual tonic, hepatoprotective, astringent, antitussive, expectorant
Cautions: don’t use with full heat or new
cough
Seed should be crushed to increase dispersing actions (prevent retention of unwanted pathogenic Qi)

Combo with heat-clearing herbs in hepatitis

Question 21

Serenoa repens

Godfrey

Answer 21

(saw palmetto)
MALE REPRO TONIC + DIURETIC + ENDOCRINE AGENT

Conditions: benign prostate enlargement, epididymitis, nasal bronchial catarrh, pertussis, laryngitis. All GU infx.

Dr Gilbert says: anti bacterial/fungal/viral + inhibits DHT

Question 22

Tabebuia avellanedae

Answer 22

(Pau D’arco)
ANIFUNGAL(parasitic) + ANTIMICROBIAL + IMMUNOSTIMULATORY

Conditions: chronic fungal infx, chronic viral infx, inflammatory dx of GI. Gilbert says: cancer

Contains NAPTHOQUINONES therefore NO use with warfarin (blood thinners); NOT to be used in pregnancy.

Question 23

Thuja occidentalis

Answer 23

(Thuja)
DIURETIC + GUT ANTISEPTIC + ANTIMICROBIAL
astringent + expectorant

Conditions: psoriasis, warts, thrush, ringworm, catarrh with heart weakness.

THUJA = toxic in large doses; NOT to be used in pregnancy.

Question 24

Usnea spp

Answer 24

(Old man’s beard)
ANTIMICROBIAL(bacteria, fungi, virus, parasite) + BITTER

Conditions: viral infx, vaginal douche, fungal infx.

Question 25

Zea mays

Answer 25

(corn silk)
URINARY SEDATIVE + DIURETIC + DEMULCENT

Conditions: UTI irritation. urethritis, cystitis, prostatitis, lithiasis, gonorrhea.

Question 26

Approaching ACUTE infection

Answer 26

Use herbs with more potent immunostimulatory actions
Echinacea, Ligustrum, Glycyrrhiza

Paired with specific antimicrobials:
Hydrastis (& other berberine containing herbs), Ligusticum porterii, Alium, Usnea

Generally, tonifying herbs are contraindicated in acute infections -> Add too much energy to an excess condition, feed the infection
E.g. Astragalus, Codonopsis, Panax spp.

Question 27

Approach to CHRONIC infection

Answer 27

Long-term infection may indicate an unresolved acute process, weak immunity, infection prone or weakness in organs/tissues, genetic susceptibility, nutritional issues
E.g. Chronic bronchitis, recurrent UTI’s, chronic prostatitis, herpes, diabetes

Treatment strategies:
Correct underlying cause (e.g. Vaginal dysbiosis predisposing chronic yeast infections)

Eliminate underlying infection-> antimicrobials, immunostimulants

Activate and build long-term immune function, resistance
E.g. Ganoderma, Withania, Astragalus

Rehabilitate affected organs and systems with specific herbal medicines

Question 28

Post Infection Recovery/Chronic Debility

Answer 28

Long term physical, emotional, physiological stress
Lowered vitality, increased toxicity, metabolic dysfunction
Susceptible to severe depletion after infection or corticosteroid use
Chronic Fatigue Syndrome, fibromyalgia
Require long term immune system support, adrenal tonics, adaptogens
Treatment centres on use of the deep immune activators
Astragalus, Schisandra, Ganoderma, Glycyrrhiza, Borago, Eleutherococcus, Panax spp.

Question 29

Major Indications for Immune Herbs

Answer 29

Prevention of infection / prophylaxis for cold/flu
Immune system adaptogens
Astragalus, Echinacea, Codonopsis, Eleutherococcus, Ganoderma

Auto-Immune Conditions
Increase innate immunity, decrease acquired immunity (Immunomodulation)
Uncover and treat activation factors (infection, GI permeability and dysbiosis)

Allergies
Decrease hypersensitivity, treat underlying aggravation

Cancer
Prevention: increase immune surveillance
Treatment: Increase NK cells, cytokines like TNF
Treat side effects from conventional treatments

Question 30

Major Constituents to Keep in Miind

Answer 30

Caffeic acid
Common phenylpropanoid: phenolic compound characterized by an aromatic ring to which a 3-carbon side chain is attached
Analgesic, anti-inflammatory, antibacterial, antifungal, antiviral and antioxidant properties
E.g. echinacoside (Echinacea)

Polysaccharides
High molecular-weight polymers made up of monosaccharide units
Effects on immune system:
activate T-lymphocytes, increase certain serum proteins, activate complement system, stimulate interferon production, increase phagocytosis
E.g. β-glucans (Ganoderma)

Saponins
3 common properties: bitter taste, hemolytic activity, and form stable foams when shaken in water
General pharmacological actions include:
adaptogenic, alterative/tonic, anthelminthic, antifungal, anti-inflammatory, antimicrobial, anti-ulcerogenic, capillary strengthening, cholesterol lowering, diuretic, expectorant, hemolytic, hepatoprotective, hormone modulating, immunomodulating, molluscicidal, piscicidal, spermicidal and contraceptive
Enhance humoral and cellular immune responses
Some induce ACTH and corticosterone release
E.g. astragaloside (Astragalus), Codonopsis, ginsenosides (Panax spp.), eleutherosides (Eleutherococcus), glycyrrhizin (Glycyrrhiza)

Pyrrolyzidine alkaloids
E.g. Borago

Question 31

Common Interactions to be Aware of!

Answer 31

May interfere with immunosuppressive drugs (Astragalus, Eleutherococcus, Ganoderma, Withania)

Additive hypoglycemic effects w/ insulin (Eleutherococcus, Panax ginseng, P. quinquefolius)

Improves outcome w/ interferon (Astragalus)

Enhances outcome w/ chemotherapy (Panax ginseng, P. quinquefolius)

Decreases gastric ulceration due to aspirin (Glycyrrhiza)

Inhibits liver toxicity of acetaminophen (Glycyrrhiza, Schisandra)

May lead to hypertension and hypokalemia (Glycyrrhiza)

DGL (deglycyrrhizinated licorice), frequently used to treat ulcers, does not; however, it also loses its adrenocorticotrophic activity

May lead to hypertension, esp. when used w/ caffeine (Panax ginseng)
Avoid concommitant use of stimulants

Question 32

Toxicity of Immune Herbs

Answer 32

Borago:
Leaves and flowers contain hepatotoxic pyrrolizidine alkaloids – caution w/ long term use
Seed oil does not contain toxic constituents

Glycyrrhiza:
Glycyrrhizin may lead to pseudoaldosteronism – hypokalemia, hypernatremia, edema, hypertension, weight gain, vertigo, headaches
Assess BP prior to administration and monitor regularly

Panax ginseng:
High doses may lead to Ginseng Abuse Syndrome (GAS): hypertension, euphoria, nervousness, insomnia, skin eruptions, & morning diarrhea (traditional antidote is mung bean soup)

Question 33

How Do Antimicrobials Work?

Answer 33

Directinteractionw/pathogen E.g. Melaleuca’s volatile oil content kills pathogens by interfering w/ their metabolism

Indirect action by stimulating immune response E.g. Echinacea spp. stimulates NK & T-cell mediated immunity

Secondary actions that affectmicrobial abilities
Arctostaphylos has anti-adherent properties, blocking E. coli from attaching to urinary tract mucosa

Question 34

How Should we Choose Antimicrobial Herbs?

Answer 34

Choose antimicrobials which have:
Affinity for body system(s) involved

Affinity for type of pathogen
Strength commensurate with vitality of patient

Different constituents than other botanicals in the formula

Specificity for pathogen involved +relevant tonics + system support

Once acute infection is over:
Tonify body system(s) involved
Usebitters, immunomodulators, adaptogens, hepaticalteratives and diuretics as indicated to restore overall health an