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Assessing the Effectiveness of Mullein on Respiratory Conditions Such as Asthma
Rachelle L Karman
American College of Healthcare Sciences
HERB 502 – Mullein Research
Asthma is a serious health concern, costing billions of dollars in healthcare prevention,
maintenance, and emergency hospital visits. Excess mucus and constricted airways cause
asthma attacks and if treatment is not provided quick enough during a severe attack,
oxygen will not be regenerated in the bloodstream; causing brain hypoxia that can lead to
brain damage, cardiac arrest, and even death. Western medicine treats upper respiratory
conditions with often unsafe and contraindicating pharmaceuticals, like Prednisone for
example, which has side effects similar to an asthma attack. Alternative treatments and
lifestyle adjustments, such as reducing inflammatory foods and drink while integrating
certain herbs have been known to reduce respiratory conditions. Various traditional
medicine books and websites indicate the use of Mullein (Verbascum thapsus)
throughout history for treating respiratory ailments, either in a tea or smoked. However,
clinical studies are lacking, and the intent of this research paper is to assess whether or
not Verbascum Thapsus can be effective when treating lung disorders such as asthma.
Keywords: respiratory disease, respiratory system, asthma, diet, nutrition, exercise,
meditation, Mullein, Verbascum thapsus.
Mullein’s Medicinal Effects on Asthma
Asthma affects more than 25 million people in the United States alone, contributing
to healthcare costs greater than $20 billion dollars and still rising ("Information about
asthma, a common respiratory disease and severe health problem," 2011). Some
common asthma triggers include food, environmental allergens, stress, weight, and
exercise. Upper respiratory conditions such as asthma prevent normal airflow in the
lungs; causing a lack of oxygen in the red blood cells that transport oxygen to the rest of
the body. After an extended period of inadequate oxygen supply, tissues start to break
down, and neurons begin to die, which can lead to brain damage and death. When an
asthma attack occurs, the muscles in the bronchioles become constricted; the cells
become inflamed, and extra mucus is produced (Figure 1).
Pharmaceutical drugs used to treat asthma (either for immediate attacks or
maintenance of the disease) often include side effects that have the potential to increase
risks for other diseases and infections.
A safer treatment choice may be Mullein (Verbascum thapsus), which is a versatile
medicinal plant considered to be both a demulcent and expectorant (Weiss, Fintelmann,
& Fintelmann, 2000) that loosens and removes excess mucus in the respiratory system
while also reducing inflammation. The anti-inflammatory and antispasmodic therapeutic
actions in Verbascum thapsus can also help relax the muscles during an attack while
opening the bronchial tubes. Among the many uses of Mullein, the dry leaves were used
by Native Americans to relieve congestion in the lungs and relax muscles spasms
(Hutchens, 1991).
Genes, food, and other variables can contribute to asthma attacks. Therefore,
positive lifestyle changes in diet, exercise, stress reduction, with the integration of
Verbascum thapsus is essential for the restoration of homeostasis in the body. The intent
of this research paper is to assess whether or not Verbascum Thapsus can be effective
when treating lung disorders such as asthma.
According to the Center for Disease Control, asthma is a severe chronic lung
disorder that inflames and narrows the airways in the respiratory system, affecting more
than 26 million Americans, and causing more than 3,000 deaths yearly (CDC, 2016);
generating billions of dollars in healthcare costs. Asthma is the leading chronic disease
in children; however, adults can contract this disorder as well - whether or not prior
indications of the condition existed.
There are two types of asthma, Atopic and Nonatopic asthma. Environmental
allergens (smog, smoke, mold, chemicals, pet dander, dry air, etc.) trigger Atopic asthma,
the most common type. When allergens enter the body, the immune system releases
antibodies called immunoglobulin E production (IgE), an important host defense against
parasites. Atopic asthma involves inflammation facilitated by the immune system's
elevated production of IgE (Janeway, Travers, Walport, & Shlomchik, 2001), whereas
Nonatopic asthma is intrinsic and inflammatory; created by the production of local IgEs
(viruses, etc.).
It is important to understand the anatomy and physiology of the respiratory system to
prevent or reduce asthma attacks and other respiratory conditions.
The Respiratory System
Airway structure. When we breathe in air, oxygen travels in through the nasal or
oral cavity and down through the trachea where it splits into two branches called the
primary bronchus that leads into each lung. The bronchus continues dividing into much
smaller and smaller bronchi until they reach the alveoli sacs (Figure 2).
Breathing process. The respiratory system has four processes. The first process is
the pulmonary ventilation process, which is responsible for moving air in and out of the
lungs. During normal breathing, the lungs inhale oxygen, reoxidizing the blood supply as
it enters the alveoli air sacs and expels Carbon Dioxide (CO2) during exhalation.
External respiration is the second process of the respiratory system that moves oxygen
from the lungs into the bloodstream and CO2 from the blood into the lungs. The third
process involves the transport of respiratory gasses, such as oxygen, by the red blood
cells through the alveolar capillaries and into the heart, where the heart pumps the
oxygenated blood out to different tissues and organs in the body. Cellular respiration
transfers oxygen from the blood to the cells, converting it into the form of Adenosine
triphosphate (ATP) and stored for energy. After the energy has been spent, CO2 is
transported from the tissues back into the blood (Marieb & Hoehn, 2014). The heart
pumps the CO2 up into the lungs in exchange for oxygen during exhalation; the fourth
respiratory process called internal respiration.
Recycle. Through a process called photosynthesis, plants take the exhaled CO2; and
with sunlight and water, create oxygen as one of the byproducts (carbohydrates is
another) where the cycle begins again.
Asthma Triggers and Symptoms
Stress, exercise, and allergens (pollen, chemicals, food, etc.) trigger asthma attacks,
producing increased levels of IgEs and mucous. The bronchioles then become irritated
and inflamed, restricting airflow through the respiratory system, causing wheezing,
shortness of breath, tightness in the chest, or coughing (Adamek-Guzik, Czerniawska-
Mysik, & Guzik, 1996).
A study conducted by the National Institute Health Allergy Center in Pakistan, found
higher levels of IgE in the patients with asthma and other allergy disorders, compared
with healthy patients (Agha, Sadaruddin, Ali, Centre, & Islamabad, 2015); indicating a
need for (alternative) preventative measures.
Pharmaceutical Treatment
Two typical types of treatment for asthma are long-term maintenance (for the
prevention of asthma attacks) and emergency relief (immediate treatment during an
occurrence). The first course of action when treating chronic asthma is to relax the
muscles and reduce inflammation by prescription anti-inflammatory inhalers (such as
Albuterol) and other pharmaceuticals (like Prednisone). The side effects of these
medicines can sometimes trigger the flare-up of other existing conditions or contradict
that which it is supposed to help.
Prednisone, for example, is a synthetic corticosteroid pharmaceutical (Ciriaco et al.,
2013) that works as an immunosuppressor used to treat various forms of inflammation
throughout the body, including the respiratory system. However, as the therapeutic
action indicates, the drug also quashes the immune system, weakening the body’s defense
system, which may further allow other forms of viruses and bacteria to enter the body.
Shortness of breath is another serious side effect that Prednisone can cause, imitating
symptoms of an asthma attack of which it is supposed to provide relief.
The bronchodilator, Albuterol, is often prescribed as a maintenance inhaler (taken
two to four times daily) to help the muscles in the airways relax. However, chest pains or
racing heartbeats, wheezing and shortness of breath are noted contraindications (Drugs,
Pharmaceuticals only address the disease (the effect), with the possibility of
instigating serious side effects rather than providing full relief. Using alternative
approaches and looking at the lifestyle (cause) of the host, may provide a safer approach
to treating inflammation and congestion in the respiratory system that can trigger asthma
and other pulmonary maladies.
Prevention and Treatment
Ayurvedic Medicine. According to Ayurvedic medicine (one of the oldest medical
systems in existence), there are six stages of disease (Accumulation, aggravation,
dissemination, localization, manifestation, and disruption) that upset the balance of the
human body’s ecosystem (Basisht, 2011). Asthma progresses through each stage,
beginning with inflammation caused by the accumulation of mucus and eventually
leading to a disruption of current activities during an attack. Incorporating healthy
lifestyles will reduce the chances of respiratory issues. When imbalances do occur, it is
essential first to understand the whole person rather than just treating the disease;
beginning with the doshas - three life forces present in everyone (Vata, Pitta, and Kapha),
each having their characteristics and symptoms of associated disease.
For example, individuals who have Kapha as their dominant dosha, also have a high
probability of developing respiratory illnesses such as asthma. Excess Kapha can lead to
excess mucus, causing inflammation and then sickness. When out of balance, any of the
doshas are susceptible to an increase in Kapha influence, so having a different dominant
dosha does not exclude the possibilities of contracting respiratory illnesses.
Diet. Food is either medicine or toxic to the body’s biome. Diets high in sugar and
carbohydrates cause inflammation in the body and have been known to trigger asthma
attacks, signifying that eliminating inflammatory foods from the diet would be beneficial.
The Mediterranean diet (and nutritional intake high in fruits and vegetables) has shown
positive effects in controlling atopic asthma (Berthon & Wood, 2015), while western
style diets have shown an increased risk of respiratory ailments. Consuming more
antioxidants and Omega-3 fats, which are considered anti-inflammatory and have shown
improved lung function, will lessen the chances for respiratory infirmities.
Overweight and obesity can contribute to the development of respiratory diseases,
therefore, including healthy nutritional choices and incorporating other lifestyle changes
(such as exercise, meditation, and herbs) will result in weight loss that can succeed in the
reduction of respiratory conditions.
Exercise. Studies have shown that exercise helps the body release toxins and
stagnation - another sign of Kapha imbalance. Although exercise can induce asthma,
certain types of exercise and routines are known to lessen the chance of onset asthma.
A random control trial (RCT) conducted at the University of São Paulo, Brazil
consisted of nutritional, exercise, and breathing treatments. The outcome proved that
lifestyle changes, including exercise, contributed to weight loss; therefore, inflammation
was decreased throughout the body while the lung capacity demonstrated significant
positive changes (Freitas et al., 2015).
Meditation. Mind over matter is more than just a saying. Thoughts are energy that
creates positive and adverse outcomes, especially in stressful situations. Stress and
anxiety cause muscle contractions, which tense the chest cavity and spawn breathing
issues. Learning to change belief patterns, implement mindful breathing, and meditate
(or sit quietly) will alleviate tightness in the chest that instigates respiratory distress.
A six-month Ayurvedic study (Joshi et al., 2016) was conducted to investigate lung
functions in asthmatics after receiving the Ayurvedic intervention. The study consisted
of 115 patients (including 69 healthy patients for comparison) that were divided into two
groups, depending on different disease stratification levels. Healthy lifestyle changes
were implemented to remove excess Kapha; including nutritional, breathing and physical
exercises; detoxifying and purification procedures, along with herbal integration. Of the
76 asthma patients that completed the trial, there was a significant increase in lung
performance and reduction of IgEs.
Although the above study does not mention the particular herb(s) used during
treatment, various herbs have been noted throughout history to help aid congestion and
relief of asthmatic symptoms.
Mullein Medicine History. The Native Americans utilized mullein, both in tea or
smoked the leaves to relieve respiratory disorders (and mental issues). During the
Eclectic movement in the 1800s, Verbascum thapsus was indicated for inflammation of
the respiratory tract (Masocco, 2016) and is used today for respiratory conditions in
cattle. An article appeared in the British Medical Journal during the 1800s discussing the
effects of Mullein on “phthisic sufferers” – those with lung pathologies (Quinlan, 1883) –
showing signs of coughing and distressed breathing.
An ‘in-house’ study conducted at St. Vincent’s Hospital, in Dublin, Ireland,
consisted of seven phthisic cases (most of which appeared to be caused by tuberculosis),
ranging from the age of 22 to 45 years old, males and females; each treated according to
the severity of the condition. Rather than summarize the study, an in-depth description of
each case with the corresponding results was given (including the name and personal
information of the patient).
Treatment consisted of placing Verbascum thapsus leaves in a pint of milk and then
boiled for 10 minutes, strained and immediately given warm to drink, twice daily. Cough
improved considerably with each, however, of the seven, one died due to the severity of
Therapeutic actions and constituents. The only therapeutic action mentioned in
the article was that the mucilaginous effects were comforting. Verbascum thapsus is
bitter, astringent, sweet, pungent, and cooling. Main therapeutic effects of this plant
include expectorant, anti-inflammatory, and antibacterial. Mucilage is an important
constituent of Verbascum thapsus, known to reduce coughing and tightness in the
respiratory system; and is generally regarded as safe. However, anyone with excessive
catarrh (an excessive discharge or buildup of mucus and inflammation of the mucous
membrane) and congestion should avoid using; in which case, including a decongestant
would be beneficial.
This study attempted to evaluate proven effects of Verbascum thapsus on respiratory
functions. However, the lack of current information corresponding to early traditional
therapeutic actions of Mullein was limited to the findings of a study conducted in the
early 1800s that resulted in convincing conclusions. The above study evaluated the
effects of Mullein on seven patients admitted into the hospital, exhibiting respiratory
distress symptoms, including coughing with difficulty breathing. The vague personal
information included the age, gender, and type of work associated with the individual if
appropriate. However, no other lifestyle measures were indicated.
Various lifestyle behaviors can contribute to respiratory ailments, such as diet, exercise,
environmental variables, and weight. Diets high in simple carbohydrates and other
sugars cause inflammation and weight gain, so reducing the consumption of these will
decrease the risk of systemic lung pathologies. Although one cannot control the
environment, changing lifestyle habits to include better nutrition and exercise will reduce
the weight stress on the body, thereby, decreasing the chances of asthma and other
respiratory conditions.
As indicated, many pharmaceuticals used to treat asthma and other upper respiratory
have contraindications and drug interactions. A common asthma drug, montelukast, lists
“shortness of breath or troubled breathing,a contraindication considering this drug is
prescribed to help prevent asthma attacks. Also, most pulmonary pharmaceuticals are
processed in the liver or kidneys ("Tarascon Pocket Pharmacopoeia: 2015," 2015), so
additional support for these organs should be given to prevent hepatic conditions.
There are several limitations indicated from this literature review. 1)
Demographically, there are several documented stories on the traditional uses of Mullein
relieving asthma from around the world. However, the only clinical study conducted
appeared in Dublin, Ireland in the early 1800s, and only consisted of seven cases.
Current studies show the effectiveness of Mullein on other ailments than that of
respiratory conditions, necessitating the need of more RCTs to confirm Mullein therapies
used in traditional and alternative medicine for lung infirmities. 2) Technical limitations
of the given study show that the basis was conducted on a whim and only slightly
controlled. Regardless of the convincing outcomes, the science-based evidence was
lacking, which indicates further needs of current RCTs to warrant the effectiveness of
Mullein. 3) The study proved successful actions of Mullein for phthisic conditions.
Current studies on Mullein, however, provide information on anti-viral therapies
(infections), which would prove beneficial in further respiratory ailment studies since
infections usually ensue with these conditions.
Conclusion and Recommendations
History has shown that Verbascum thapsus provides cough relief related to various
respiratory illnesses, including asthma and tuberculosis. The information rendered in the
Dublin study proved Mullein useful when treating pulmonary distress. However, current
studies on the effects of Mullein were for anti-viral properties (infections), and RCTs for
therapeutic actions on the respiratory system were lacking, or unsupportive – most peer-
reviewed articles were hypotheses yet to come to fruition.
Based on traditional, historical accounts, continued science-based research is
imperative to prove the effectiveness of Mullein when treating pulmonary diseases.
Integrating Mullein with nutritional changes, exercise, and stress relief techniques will
help healthcare practitioners become more aware and active in preventative care rather
than rely on pharmaceuticals that often lead to more harmful side effects; often
mimicking that which the drug is supposed to heal.
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Full-text available
Background: Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown. Methods/design: This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m(2)) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups. Discussion: This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms. Trial registration: NCT02188940.
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Diet and nutrition may be important modifiable risk factors for the development, progression and management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). This review examines the relationship between dietary patterns, nutrient intake and weight status in obstructive lung diseases, at different life stages, from in-utero influences through childhood and into adulthood. In vitro and animal studies suggest important roles for various nutrients, some of which are supported by epidemiological studies. However, few well-designed human intervention trials are available to definitively assess the efficacy of different approaches to nutritional management of respiratory diseases. Evidence for the impact of higher intakes of fruit and vegetables is amongst the strongest, yet other dietary nutrients and dietary patterns require evidence from human clinical studies before conclusions can be made about their effectiveness.
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Corticosteroids have been used since the 50s as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Corticosteroids have three principal mechanisms of action: 1) inhibit the synthesis of inflammatory proteins blocking NF-kB, 2) induce the expression of anti-inflammatory proteins by IkB and MAPK phosphatase I, and 3) inhibit 5-lipoxygenase and cyclooxygenase-2. The efficacy of glucocorticoids in alleviating inflammatory disorders results from the pleiotropic effects of the glucocorticoid receptors on multiple signaling pathways. However, they have adverse effects: Growth retardation in children, immunosuppression, hypertension, hyperglycemia, inhibition of wound repair, osteoporosis, metabolic disturbances, glaucoma, and cataracts. Less is known about psychiatric or side effects on central nervous system, as catatonia, decreased concentration, agitation, insomnia, and abnormal behaviors, which are also often underestimated in clinical practice. The aim of this review is to highlight the correlation between the administration of corticosteroids and CNS adverse effects, giving a useful guide for prescribers including a more careful assessment of risk factors and encourage the use of safer doses of this class of drugs.
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A SYMBIOTIC RELATIONSHIP BETWEEN ALLOPATHY (MODERN MEDICINE) AND AYURVEDA IS FUNDAMENTAL IN CREATING A HEALTH CARE SYSTEM THAT IS : (a) more effective than either system used alone, (b) less expensive, (c) less toxic and (d) more likely to create a healthier society. The fundamental basis of Allopathy is "offense thinking," corresponding to Newton's physics, which makes it an excellent disease management system; on the other hand, Ayurveda is based upon "defense thinking" and corresponds to Quantum physics, and is an excellent system for prevention of disease and for protection and rejuvenation of health. A judicious use of the two systems in group practice will provide better care to the masses.
Ethnopharmacological relevance: Over the past few decades, there have been significant scientific advances leading to improved understanding of asthma as a disease and treatment providing immediate relief. However, prevention of recurrent attacks, exacerbations and disease cure remains a challenge. Ayurveda refers to bronchial asthma as Tamaka Swasa and it is well explained in Charaka Samhita. Management of asthma in Ayurveda includes removal of vitiated Kapha through Shodhana, Shamana procedures, herbal and herbomineral formulations in addition to advising a healthy lifestyle and diet. Several clinical trials on Ayurvedic formulations for treatment of asthma are reported, however, whole system management of asthma has rarely been studied in the manner in which it is actually being practiced. Ayurveda therapeutics provides Dosha specific approaches, which needs biological investigation. Aim of the study: The objective of our study was to investigate lung functions and cytokine changes in Asthmatic individuals in response to Ayurvedic intervention. Methods: The study design was approved by the Institutional Ethics Committee of Tilak Ayurveda Mahavidyalaya (TAMV) & Sheth Tarachand Ramnath Charitable Ayurveda Hospital and followed guidelines of the Declaration of Helsinki and Tokyo for humans. It was conducted as a whole system individualized pragmatic clinical trial and written consent of patients was collected before enrollment. One hundred and fifteen patients with mild-to-moderate asthma were divided into 2 sub-groups depending on their disease subsets and administered phenotype specific ayurvedic interventions. Seventy six asthma patients completed the treatment. Serum IgE levels, blood eosinophil counts, spirometry and blood cytokine levels were measured before the start of treatment and six months at the end of treatment. Age and sex matched healthy participants (n=69) were recruited in the study for comparison of cytokines levels. Results: Significant improvements in FEV1(% predicted) (p<0.0001) and FVC (% predicted) (p=0.0001) was observed in asthmatic patients who underwent Ayurvedic treatment. Circulating levels of IgE (p<0.03) and eosinophil numbers (p=0.001) reduced significantly in the asthmatics after Ayurvedic treatment. This was associated with significant reduction in levels of circulating cytokines. Levels of Th2, Th1 and inflammatory cytokines in the peripheral blood were higher than healthy control participants at baseline (p values <0.0001) and reduced significantly after ayurvedic intervention. Conclusion: This proof of concept study highlights the potential benefits and possible mechanism of Ayurvedic interventions in patients with mild-to-moderate asthma. The interventions significantly reduced IgE and eosinophil count, also improved lung function and reduced levels of circulating Th2 cytokines.
Total serum IgE levels were estimated in 219 patients with various allergic disorders (119 with bronchial asthma, 68 with allergic rhinitis and 32 with urticaria) and 240 healthy age matched subjects. Serum IgE levels were significantly (P < 0.001) higher in healthy males (mean 181 IU/ml) than females (mean 99 IU/ml). Higher levels were found in the age group 15 to 24 years and lowest in over 55 years. Males had higher IgE levels than females at any given age. Mean IgE levels were significantly (p < 0.001) higher in all three groups of patients than in healthy subjects. Among all age groups, the difference in mean IgE levels between allergic subjects and controls was significant. Positive skin test reactivity (to pollen and dust allergens) was found in 60% patients with asthma, 51% with allergic rhinitis, 46% with urticaria and in 4.5% healthy subjects. Patients with positive skin test had higher mean IgE levels as compared to those with negative skin test, but the difference was insignificant.
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