Tips for Kicking a Cough

Back when I was a graduate student doing my internship in Chinese Medicine, I got my first patient whose chief complaint was a lingering cough, and I remember thinking, “This will be easy.” Boy, was I naïve. Even under the guidance of an elder practitioner, it took months of treatment for it to resolve. In the nearly two decades since then, coughs have often proven stubborn. Luckily, they usually run their course within a few weeks – with or without intervention – and I’ve found some herbs that can often speed up the recovery process.

First, a few words on coughs and how they work. The respiratory tract (airway) consists of two main regions. The upper part includes the nasal cavity, sinuses, pharynx (the area where the back of the nasal cavity becomes the throat) and is sometimes considered to include the larynx (“voice box”). This is the site of most common colds, or “upper respiratory infections” (URI’s). Coughs coming from this area are usually due to throat irritation and post-nasal drip, and are pretty responsive to treatment.

The lower respiratory tract consists of the trachea (“windpipe”), the tubes through which it branches into the lungs – the bronchi, the smaller bronchioles, and finally the little sacs called alveoli – and sometimes the larynx. All but the smallest of these passageways are lined with cough receptors, which are highly sensitive to light touch. The presence of phlegm (or dust, or certain chemicals) triggers the cough reflex. Coughing is a cooperative effort between the diaphragm, abdominal muscles, the muscles between the ribs (intercostals), and the structures of the airway – an attempt to forcibly expel whatever’s in there.

Sometimes it’s effective – what we refer to as a “productive cough” – but when the respiratory passages are inflamed and dry, or full of sticky, tenacious phlegm, a cough can go on and on. The hard part is that coughs themselves can be debilitating. We lie down to sleep, the phlegm spreads out, post-nasal drip trickles down, and the cough worsens. It degrades the restorative value of sleep, and the continuous spasmodic contraction of our muscles wears us out, sapping us of the energy to cough in a productive way.

The herbs I’ll discuss here are for these acute forms of cough. Coughs that occur for much longer and those that are due to weakness, asthma, or damage to the lungs fall into the chronic category and they’re beyond the scope of this article because they require more comprehensive treatment.

I have taken and prescribed nearly every Chinese and Western herb that’s commonly used for cough, and they rarely work as well as I hope. That cough reflex is difficult to overcome – and, really, you would only want to suppress it if you were doing something to address the underlying problem. I’ve found that when I’m more accurate about discerning the type of cough (dry / moist, strong / weak, clear phlegm / yellow phlegm), my treatments are usually more effective, but the herbs I’ll introduce today are usually beneficial for most types of cough.

  • Mullein: Mullein is a fuzzy, sage-colored plant that grows all over the place in the United States. I see it nearly every day. The leaves and yellow flowers are excellent for coughs. Adults can take an ounce of dried leaves or flowers and steep covered (don’t simmer) in a few cups of just-boiled water. Strain it to avoid drinking the little hairs, and drink it, divided into three portions, over the course of the day.
  • Pine, Spruce, and Fir Needles: All of these evergreen needles are useful for coughs and are rich in vitamin C. You can throw a handful of them into a bowl of hot water, put your face over it, cover your head and the bowl with a towel, and inhale the steam. Then you can drink the resulting tea. Or you can just brew a strong tea by simmering a large handful in a couple cups of water. Keep it covered and the heat low, so you don’t lose all the essential oils. I like to chew spruce, fir, and pine needles when I’m out on walks, and the ones that work best for coughs tend to be those with the best, strongest flavor.
  • Thyme leaves: Thyme has long been a popular herb in Europe for coughs, and it probably has some antimicrobial effects (one of the noteworthy compounds in the herb, called thymol, is the active ingredient in Listerine and various antiseptic cleaners). The flavor is rather strong, so the usual dose is just one to two teaspoons of the dried herb steeped in a cup of water. I don’t have great faith in thyme on its own, but it can be a useful adjunct herb combined with others.
  • Ginger: Ginger’s pungency is good for opening the respiratory tract. The dried herb is considered “hotter” than the fresh stuff, so I use the dried product more for coughs will lots of clear or white phlegm, and the fresh herb more for coughs with yellowish phlegm. You can use approximately a thumb-sized piece of ginger, sliced or grated, simmered for a few minutes in about a cup of water (do this multiple times a day).
  • Licorice root: Licorice is a mild herb for coughs, but it’s a nice adjunct with other herbs, especially when the throat and/or respiratory tract feels raw and sore. Licorice is sweet and mucilaginous, and has a calming effect on spasmodic coughs and a soothing effect on mucous membranes. You can use approximately 2 teaspoons per day. Keep in mind that prolonged use of licorice or high doses can cause a temporary elevation of blood pressure (usually not more than about ten points systolic).
  • Hyssop leaves: This common garden herb is a member of the mint family and has a longstanding reputation, especially in Europe, as a useful herb for coughs and sore throats. Several times a day, steep two to three teaspoons of the dried herb (or much more of the fresh herb) in a cup of water to make a pleasant tasting tea. Hyssop is mild, and therefore best combined with other herbs.
  • Horehound leaves: Horehound also has a longstanding reputation in Europe and northern Africa as a valuable herb for respiratory complaints, and it’s one of the main ingredients in Ricola cough drops. I’ve noticed that it’s not much used in the United States, perhaps because the FDA claims it has no value in the treatment of cough, but I had one profound experience with it about 20 years ago, when I made some horehound tea and it completely stopped a nagging cough in about a day. You can make a tea using about two to three teaspoons of the dried herb in a cup of boiled water.
  • Slippery Elm Bark and Marshmallow Root: These herbs are soothing to mucous membranes and especially appropriate for dry coughs. You can add one or both to your cough formula (approximately a teaspoon per cup of tea) to add a “demulcent” effect that will also soothe your throat.
  • Nigella Seed Oil: This herb, also known as “black seed” or “black cumin,” has been trendy recently, though perhaps for good reason. A number of studies show it has promise in the treatment of a variety of health issues, and there’s rather robust research on its value in respiratory problems (asthma, in particular). For cough, you can take a teaspoon of the oil at a time, in a cup of hot water. You can also try rubbing the oil on your chest, over your lungs.
  • Umckaloabo root: This African relative of the geranium is useful for upper respiratory infections. It’s available in raw, dried form as well as tinctures and homeopathics. The easiest form to take is as the commercial product Umcka. It’s one of very few substances that can legally claim to benefit the common cold. The specific verbiage allowed by the FDA is, “shortens severity and reduces duration of upper respiratory symptoms.” I always have some of the powdered form of Umcka in the house, which I mix into hot teas to add some additional potency.
  • Pineapple Juice: I don’t know of any research on pineapple juice for coughs, but it’s a popular folk remedy, often drunk warm and seasoned with cinnamon, cayenne, or black pepper. I don’t know why it would be beneficial in coughs and I haven’t tried it myself, but it may have something to do with the activity of the enzyme bromelain that it contains. In any case, it’s not likely to hurt – especially if it gets you to drink more fluids.
  • Water: Speaking of fluids, staying well hydrated is super important when you have a cough, as it helps keep the mucous in a more liquid state so that it can be more readily expelled. Also, immune function just tends to work better when you’re getting enough water. Other than possibly consuming some pineapple juice with it, it’s best to stick to pure water or tea, rather than juice or sweetened beverages.

 

Choose a few of these substances, use them simultaneously and consistently (like, all day long), and get as much rest as you can. If necessary, sleep in a semi-upright position to reduce nighttime coughing.

Whenever I write articles on herbs I wonder if I’m doing the field of herbal medicine a disservice by simplifying it and presenting it in such a way as to suggest we can choose herbs simply based on the symptoms we want to treat, without respect for the diagnosis. But I feel the need for accessible home remedies is more important. In the case of the herbs above, they are all quite safe and unlikely to do any harm. However, if your cough persists, if it is severe, if you cough up blood, or if anything else alarming happens, or if you intend to use these herbs on small children, please consult with a qualified healthcare practitioner.

 

Be well and breathe freely,

Dr. Peter Borten

27 thoughts on “Tips for Kicking a Cough

  1. Thanks. I’m have mild cough-variant asthma and look forward to trying some of these herbs and techniques. Burning a little sweetgrass helps calm my coughs from asthma. I have no idea why, but it works.

    1. Thanks / you’re welcome, Barbara. I hope these ideas are helpful. You might also look into the ASHMI formulas. The simplified version – sophora root, ganoderma mushroom, and licorice root – is often a helpful “module” in other formulas, and in your case it would probably need more herbs that are cough-specific.

    2. My Son (13 has a cough now) I’ve been using 3 Essential Oils together (Lemon, Lavender & Peppermint) swish 30 seconds and swallow slowly…it really helps BUT not enough –

      Excited to try these and some other oils to help when it comes it’s not fun…
      Your Articles & Information are Wonderful. Hugs to you. Namaste

      1. You’re welcome, Heidi. I hope these herbs help. And I’m going to assume that if your son is swallowing them, those are really high grade EO’s, right? Take care.

        1. Is it really advisable to administer oils orally? And how can you tell if an oil is a really high grade oil? I recently learned the term “pharmaceutical grade” oil which did not exist in any industry is “owned” by copyright so no other company can use it to describe the quality of their oils- in this case it doesn’t matter because it doesn’t really MEAN anything if it was made up to begin with. So how does someone know if they are getting a good quality oil?
          I’ve been searching tirelessly for an oil blend recommended by my ENT doctor that once was a $10 bottle at my pharmacy (they mixed it there- rare, I know) but now I have to go to an Apothecary to get it and it’s almost $100 for a bottle. It’s just camphor and menthol with a carrier oil of some sort. One to two drops in each nostril at bedtime and it helps keep the sinus passages from drying out. Any suggestions ? My husband and so have had sinus and deep ratteld coughs for over a month but docs tell us it’s viral and tell us OTC cough and sinus remedies are the way to go. No relief. I’m ready to find a poultice recipe my grandmother never wrote down for pneumonia she would use. All I know is it had mustard or mustard seed in it.

          1. Hi Susan,
            I don’t generally recommend internal consumption of essential oils. There are some cases where internal use is probably safe, as long as the EOs are good quality – for instance, there are many medications containing oils of peppermint or spearmint, and there is an anti-anxiety product containing lavender oil – but determining good quality is very difficult. Unscrupulous companies create labels like “certified therapeutic grade” to present themselves as better, or as the only ones with good oils. And many companies just procure large quantities of oils, put them in very small bottles, mark up the price, and have no idea of the actual manufacturing process or the quality of the original plant material. We can obtain documents, such as a Certificate of Analysis, but depending on who provided the document, it may not be genuine. Therefore, it’s usually advisable to use these incredibly strong substances topically or diffused.

  2. Nice article, Peter. Essential oil of eucalyptus can also be very effective in opening both sinus and lung passages, as well as essential oil f wintergreen.

    1. Thanks, Stuart. Yes, I decided not to get into essential oils in this article, but I often use and recommend the ones you mentioned, as well as peppermint, ravensara, pine, fir, spruce, ginger, calamus, lavender, and others (depending on the presentation).

  3. I have had a cough for almost 4 months. Seems it is from the sinus infection (along with polys apparently). Long story short-I am antibiotics for the sinus infection, and inhalers etc for breathing. When I can breath ENT wants to operate and take out polyps! Is surgery the only remedy for polyps. I feel like I have been in prison all these months. I am 66 and rarely get sick-just seasonal sinus issue. What can I take for the sinus that will help the congestion as well?

    1. Sorry to hear it, Karen. I believe there are herbs that might help with the polyps if applied to the nasal passages very consistently, but my guess it that it would take time, diligence, and the guidance of a skilled healthcare practitioner. In contrast, removing those polyps surgically is likely to be quick, easy, and minimally invasive. If you never had breathing or nasal problems before this episode, it may be the case that the polyps are of little consequence, however.
      As for what you can take, if you’re on antibiotics for the sinus infection, this should take care of it pretty readily (unless it’s actually a fungal infection). If anything, I would recommend taking a course of probiotics after you’re done with the antibiotics to replenish the beneficial microorganisms in your gut and elsewhere that are killed by the antibiotics.
      Be well,
      Peter

  4. what about fritally and loquat for cough?

    1. I like this product and forgot to mention it. As you know, it’s a premade Chinese herbal formula. It’s a thick syrup containing rather a large amount of honey and sugar – which is one of the few things I dislike about it. It’s quite common for adults to take doses significantly larger than what’s recommended on the label.
      The most popular brand comes in a red box, though there are now numerous companies making a similar product. Typically the formula contains: Fritillaria bulb – an excellent phlegm-clearing herb that’s one of the most effective herbs for stopping cough (however, given its high expense, I can’t help but wonder how much is actually in this product); Loquat leaf – a decent cough suppressant, Adenophora root – a lung-moistening herb (yin tonic) that help ease coughing; Poria – a white mushroom that dries excess fluids in the body and mildly strengthens digestion (which can be a factor in continued phlegm production); Pummelo peel – an herb for drying out phlegm and moving Qi; Platycodon root – a white root for drying out phlegm in the lungs, guiding the formula to the lungs; Pinellia rhizome – another herb for drying out phlegm; Schisandra – this berry helps “astringe” the lungs to stop coughing while also moistening them; Trichosanthes seed – another phlegm clearing herb that also has some moistening function; Ginger – discussed in the article; Licorice root – discussed in the article; Apricot seed – an herb that helps to stop coughing by (in the language of Traditional Chinese Medicine) directing the energy of the lungs downward; Menthol – the aromatic potency of this key component in mint helps open the respiratory passages and soothe discomfort; Honey – a decent cough suppressant; plus water, sugar, caramel color, etc.

      I usually have a bottle of this stuff in the house which I will occasionally swig from when I have a cough. Sometimes it seems useful; other times it seems completely ineffective. To me, it is SO sweet that I have to assume it contains a huge amount of sugar (through the sugar and honey), and sugar tends to thwart immune activity so this might be a factor that works against anyone who is actively fighting an infection.

  5. What about Chaga from birch trees?
    Can you give me more information on this?

    1. Chaga is one of several medicinal mushrooms that have gotten a lot of press in recent years. Chaga, along with reishi (ganoderma), agaricus blazeii, shiitake, maitake, lion’s mane, cordyceps, and others, has immune enhancing activity. I don’t think chaga has a history of use specifically for coughs or other respiratory complaints, but it has a reputation for helping Siberian tribespeople live long, healthy lives, which is similar to the reputations of these other legendary mushrooms. These mushrooms are sometimes referred to as “adaptogens” because they are thought to improve the consumer’s ability to adapt to a variety of stressors.

      In Chinese medicine, we usually recommend taking “tonics” like this – herbs that improve the “tone” of various bodily systems – when a person is not actively sick. But in cases where a sick person is also depleted and their weakness has become an impediment to their recovering from the illness, tonics are often given in combination with other herbs to help expel pathogenic factors from the body.

      Chaga isn’t the first mushroom that comes to mind to me for coughs (I would think first of reishi [ganoderma] and white wood ear [tremella]), but I don’t think you’d cause yourself any harm by trying it.

  6. Great article! Thank you very much! 🙂

    1. You’re welcome, Jessica

  7. Thank you Dr. Boston! I have had a ongoing cough for months now. Went to doctors and all they do is prescribe antibiotic and cough medicine for night with codeine. I even went for a chest xray. [Clear] I am not one for strong medicines and I know the end result of over-medicating. Your advise could not have come at a better time for me. I am going to use some of these herbs and see if that helps. I believe in the universe giving me answers and reading your article gave me hope from this hacking cough!

    1. Sorry , typo Dr. Borton…

    2. Thanks, Rosemarie. There probably isn’t an herb (other than opium poppy – the source of your codeine) that’s stronger than codeine for suppressing coughs, but the herbs mentioned here may yet offer some benefits by breaking down phlegm and soothing and healing irritated tissues.
      Be well.

  8. Dr. Borton, any comment on the use of using fresh or dried rosemary as a breathing treatment for coughs? I sometimes use it along with thyme and chamomile and find it works well. It seems to help dry up the running mucous, but I feel like you have to careful not to over use it.

    1. Hello Vicki,
      Rosemary isn’t among the first herbs that come to mind for cough, but I could see it being helpful due to the makeup of its essential oil. The main components are 1,8-cineole, also known as “eucalyptol” – the key constituent of eucalyptus oil; camphor – which can help open respiratory passages and move phlegm; and alpha-pinene – a key constituent in evergreen tree oils, which is a bronchodilator (opens lungs) as well as having anti-inflammatory and anti-microbial properties. I think I’m going to start including it in my cough treatments! Either fresh or dried needles would be fine, though I feel the fresh herb is much more potent.

  9. Thanks Dr. Borton this came at a perfect time and with 4 young boys and 1600 Petri dishes that they are exposed to at school we seem to pass a few viruses around each season. We also use essential oils so you helped point me to a few select choices for a blend to help for a run to break up mucus and help with the coughs. Was just missing the fir. Helping already. Thanks

    1. You’re welcome, Megan. I know the kids/school/germs factor well. Yes, fir is a great one. And if you ever have the opportunity to make tea from Douglas Fir needles, it’s a lovely experience.
      Also, within those 3 main conifer oils – pine, spruce, fir – there are countless variants – white pine, pinyon pine, silver fir, blue spruce, black spruce, etc. – all worth trying and each with its own wonderful nuances.

  10. Thank you Dr Borton for this article. It is well written and easy to understand. I have tried a few of these, but know my knowledge is expanded of these immaculate herbs, that Mother Nature is providing. Thank you again for offering thus important information! 🙂

    1. You’re welcome, Lynette!

  11. Thanks so much for this information Dr. Borten! While I have suffered with a persistent cough in the past, it is my best friend needing to find something that will help her right now. This information arrived at just the right moment….what synchronicity!

    I also just purchase the Dragontree book – am very excited about using it.

    Thanks again,
    Jill Jones

    1. You’re welcome, Jill. I hope you can help your friend. Thanks for getting our book!

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