Tuesday, November 8, 2011

Herbal Remedies for fevers ~ part 4

Lions and Tigers and Fevers, oh my!

Fevers are often the most dreaded aspect of having the flu. They can bring aches and pains with them as well as uncomfortable thermal changes in the body. From cold shivers to waking up drenched in sweat, to aches and pains and restlessness, fevers are not most people’s cup o’ tea. 

Many people even fear fevers and this fever seems to be exponentiated when it is a fever in children. Officially called, “fever phobia” there is a current drive to educate people and parents to dispel many of the myths surrounding fevers. 

Herbalist jim mcdonald has a great list of resources about “Fever Phobia” here. If you are concerned about fevers or if you often reach for tylenol or NSAIDs during times of fever I highly suggest you take a look at jim’s resource page to better understand fevers.

Beneficial immune system response
Fevers are one of our most important immune system defenses. Physiologically, a fever is created by the hypothalamus gland raising the body temperature in response to detecting bacterial proteins in the body, or the detection of cytokines, which are chemicals released in the body at the site of an infection. The raising of the body temperature is a defense mechanism of the immune system that attempts to kill various viruses and bacteria because they do not tolerate high temperatures.

Not only does the temperature of the body affect pathogenic growth, but fevers also increase blood  and lymphatic circulation, thereby helping to deliver a better immune response. Herbalist Paul Bergner says that antibody production is increased 20 fold during a fever.

The fact that fevers are beneficial does not change the fact that they can be uncomfortable. In the herbalist’s paradigm the focus of addressing someone with a fever is not to suppress the fever, but rather to support the person’s immune system as well as bring comfort to the feverish person. 

How we do this depends on the state of the person and the stage of the fever. I am going to present a fever in four different stages, which is how I originally learned from Paul Bergner. Please keep in mind that fevers rarely progress along a linear track. 

Don’t Forget!
I’ve said it many times in this series on cold and flu, but it is worth mentioning again. Rest and sleep are often the best medicine we can take while we are sick. None of these herbal suggestions are meant to replace rest. 

Beginning Stages of a Fever - External Wind-Cold
The first indications of a fever are often feelings of being cold.  As discussed above, the hypothalamus detects the need to raise the body’s set point temperature. In this first stage the patient often feels cold as the body attempts to heat up. Shivering, which raises the metabolism up to 30%, may occur to increase body temperature and there is usually an aversion to cold and to wind.

In this stage we often instinctually reach for more clothes, take a warm bath, or crawl under the covers. By taking these actions we are helping the inherent wisdom of the body by taking care to warm up!

Another highly effective approach during this stage of the fever is sweating therapy. If you don't have easy access to a sauna, this can be done by putting your feet in a tub of water while sitting in a chair. The water should be as hot as possible without causing discomfort. Then, wrap a sheet and then a thick blanket around yourself, covering your body, the steaming water and chair. Leave your head poking out. The steam will heat up your tent giving you a DIY sauna. Keep up the sauna, changing out the water as necessary, for as long as it feels good to you. 

We can further help support our immune system by administering warming and stimulating diaphoretics. Warming or stimulating diaphoretics, sometimes referred to as diffusive herbs, increase the core temperature that then radiates to the surface.

Materia Medica of Warming and Stimulating Diaphoretics
In general we want to give the following herbs as hot teas. Tinctures can also be used by placing the tincture in hot water. 

I’ve mentioned ginger in every part of this series. It’s true that if I only had one herb during a respiratory infection, I would want it to be ginger. 

This spicy herb is an effective stimulating diaphoretic. You can use fresh or dried ginger root (actually rhizome) for this, I prefer dried since it is spicier in nature. For the best results make the strongest decoction you can of the root. I generally use 2 tablespoons of dried root to about10 ounces of water. If this is too strong for you, dilute it with some water and then use less root next time.

Yarrow (Achillea millefolium) 
Yarrow is famous for it’s ability to aid a person during a fever. Like most herbs it refuses to be categorized and I use it both during the cold stages of a fever and the warm stages. You can also take a dropperful of the tincture in a quarter cup of warm/hot water. Read more about yarrow here. 

Butterfly on yarrow flowers

The following recipe is a wonderful tea blend for fevers that is beneficial for most people during the various stages. I think it is important that we learn to differentiate what herbs to use for specific stages and people. However, for those friends and family less herbally nerdy than myself I often give them this tea blend to have on hand since it just plain helps fevers. I’ve heard that this recipe comes from the European Gypsies. 

Gypsy Tea for Fevers
1 part elder flower
1 part yarrow leaf and flower
½ part peppermint
½ part rose hips

Garlic (Allium spp.) 
Take one bite of a fresh clove of garlic and you’ll have no doubt about this potent herb’s facility to heat the body. You can read more about the different ways of taking this herb in previous parts of this series.

Bee balm (Monarda spp.) and Thyme (Thymus spp.) 
These two herbs have very similar actions, although I often find bee balm to be spicier. These are two delicious herbs that can be enjoyed as hot teas. You can read more about bee balm here. 

Bee balm

Traditional Chinese Medicine
In Traditional Chinese Medicine herbs associated with the Liver are often used during times of fever. I’ve only just begun to use western “liver” herbs for fevers but wanted to mention this since it is my current interest. 

Popular Chinese formulas for fevers include Gan Mao Ling which is a formula commonly used for External Wind-Heat (see below). And Minor Blue Dragon Combination (Xiao Qing Long Tang) is more commonly used for External Wind-Cold. 

Minor Bupleurum Combination (Xiao Chai Hu Tang) is an interesting formula built around Bupleurum and Skullcap (Huang Qin)  that is used for lingering colds and flu and for those manifestations that are half internal and half external, half hot and half cold and half excess half deficient. 

You can buy these formulas as patent formulas, but more traditional medicine would formulate these core formulas to match the person more closely. 

Warm stages of a fever - External Wind-Heat
The second stage is when the body temperature has reached the set point. The thermometer will read a higher temperature. 

During this stage of the fever the pulse may be rapid and strong, there may be a yellow coating on the tongue and the skin may feel warm and dry. Drowsiness may also result. The patient is no longer shivering. Although keep in mind that once we have a fever the temperature is rarely set in stone. It’s quite normal to see temperatures rising and lowering slightly.

During this stage we want to focus on the following: rest, a well-ventilated room, being hydrated with an emphasis on lukewarm drinks rather than hot beverages and bringing comfort to the person with a fever. Hydrotherapy can also be employed by taking tepid (not cold) baths.

Herbally speaking we generally use relaxing diaphoretics during this time. Relaxing diaphoretics open the pores, letting the heat escape. To borrow a analogy from jim mcdonald, it’s like opening a window in a hot a stuffy room. 

Pain and restlessness are the biggest complaints during this stage of the fever. Using herbs to soothe and comfort the feverish person are also quite welcome.

Boneset (Eupatorium perfoliatum) 
During a fever it’s common to experience general aches and pains throughout the body. These aches are from muscle tissue being broken down as a result of amino acids being taken from the muscles. Once these amino acids are freed up they are utilized in anti-body production, white blood cell production, and tissue repair. Boneset, which we will discuss below is specific for helping this phase of a fever.

Boneset has been an important herb historically during intense flu outbreaks. The common name most likely refers to its use during an illness when the “bones feel like breaking.” It was used extensively during the flu outbreak of 1918 as well as for dengue (an acute febrile infection in the tropics) outbreaks. It is specific for when you feel the aches and pains of a fever.

Boneset also has immunostimulant properties and has been clinically shown to increase phagocytosis (Bergner). This may make it another important regimen at the beginning stages of a cold or flu.

If you feel the aches creeping in, have a 1⁄2 cup serving of warm boneset tea. Drink this bitter herb too hot and it can cause vomiting. 

I am going to warn you that this is generally not people’s favorite herb to taste. It’s incredibly bitter. Adding elderflowers, rose hips and mint may slightly improve its taste. Many people find that it bring such welcome relief to their aches and pains that they become accustomed to the taste and even welcome it during feverish stages. 

Elderflower (Sambucus nigra, S. canadensis) 
Elderflower is a relaxing diaphoretic that is effective, yet extremely gentle. Young children, expecting mothers, and elders can use this herb as needed. I often tell parents that this is the one herb to have on hand for their child’s illness. 

One common formula is to mix elderflowers with mints. I usually take my elderflower in a tea blend as listed in the above section on yarrow. You can also place a cup of elderflowers in a quart mason jar, fill with just boiled water, strain after a half hour and then drink lukewarm.

Elderflowers near Escalante, Utah

Chamomile (Matricaria recutita)
Chamomile often doesn’t get the respect it deserves! This is a wonderful herb to use in fevers and is especially useful for calming a distressed child (along with hugs and comfort from caregivers) and for those aches and pains. But don’t get fooled into thinking chamomile is a “child’s herb.” It can soothe us adults as well and bring a lot of relief from pain during a fever. 

Catnip (Nepeta cataria) 
Another safe yet effective plant, catnip has a mild taste makes it a good choice for little ones.

Lemon Balm (Melissa officinalis) 
Another relaxing diaphoretic, lemon balm can also soothe the nerves to allay stress and reduce the duration and painfulness of fever blisters (herpes virus). More info here.

The Third Stage
During the third stage of fever the hypothalamus lowers the set point temperature to normal. The body’s cooling response is to sweat profusely. This “breaking of the fever” involves profuse sweating and is often accompanied by the throwing off of the covers.

It’s normal during this third stage for there to be a fluctuation of temperatures, so a person may feel chilled and then too hot, then chilled and then too hot and so on. In the end the temperature can often linger about a degree too high and will then, eventually, fall to normal.

Willow (Salix spp.)
Willow bark is specific for intermittent fevers or those fevers with fluctuating  temperatures. I generally use it as a tincture in lukewarm water but you could certainly use it as a decoction as well. More info here. 

Stay hydrated!
In this stage the highest risk from harm is due to dehydration. Throughout all the stages of a fever a person should be kept well-hydrated, but this becomes especially important during this stage due to the large loss of liquid through the sweating process.

Aviva Romm suggest the following blend to help balance the electrolytes and keep some dehydrated. 

Quart of water
1/2 teaspoon of salt
1/2 teaspoon of baking soda
2-3 tablespoons of honey or sugar
juice of half a lemon

Mix all the ingredients together (you may need to heat the mixture slightly to get everything to blend well). Then drink often as sips. 

Fourth Stage of the Fever
The fourth stage involves repairing and healing. Generally it is recommend that a person recovering from a feverish illness rest two days for every three days of fever. It’s also important to eat easily digestible protein (such as bone broth soups), to shower, to change sheets and generally making sure you are nourished, rested, clean, and comfortable. Returning to a regular regime too quickly can further compromise your immune system, leaving you more susceptible to sickness in the future.

Fever Considerations

When is a temperature too high? 
It’s important to not become too obsessed with the numbers on the thermometer. The best indication that a fever has become serious enough for more advanced care is the state of the person or child. Delirium, loss of consciousness or extreme fatigue are all serious signs. 

Anytime severe dehydration comes in to play also indicates time for medical treatment. 

In a normal person a fever has to get extremely high before it will cause injury. Human cells start dying at 1100.

Truly the highest risk from fevers is from dehydration and electrolyte imbalance.
However, there are special considerations when dealing with infants and the elderly or anyone who has a compromised immune system such as AIDS, cancer, or prolonged illness.

Bergner relates a review published in the conservative medical journal The New
English Journal of Medicine that looked at the treatment of fevers. It concluded
that there are three classes of people for whom lowering the fever is beneficial.
  • people with heart disease (because the heart has to work really hard during a fever)
  • very weak patients (increased metabolic demand may be too much)
  • some cases of pulmonary disease
Basically if you have special health circumstances or if you are caretaking someone with a fever who is displaying alarming signs (as stated above) then please seek medical help. 

To eat or not to eat?
Ever wonder why it’s commonly said to starve a fever and feed a cold? When a person’s temperature rises one degree past their normal set point their natural appetite disappears. This is due to amino acids in the body being used for the immune response rather than for digestion. Ingesting bone broth soups and nutritious teas and infusions will serve you much better than eating while you have a fever. Once a temperature returns to normal, regular foods can be introduced back into the diet. 

Most importantly do not force yourself to eat during illness. Stay hydrated and only eat when hungry. 

Febrile seizures
A febrile seizure is a convulsion triggered by a rise in body temperature. It is a myth that high fevers cause febrile seizures. If children are prone to febrile seizures then that seizure will happen as easily at 1010 as it will at a higher temperature.

Paul Bergner:
Febrile seizures in children are not correlated with the severity of the fever. The cause is generally unknown, and they affect 3-5% of children in the U.S. and about 15% in some countries. Giving antipyretic drugs does not reduce the incidence of future seizures in children. Most disappear by age five. Most do not indicate a serious cerebral disease.

If a baby is experiencing a febrile seizure it is recommended to place the baby on their side to allow for saliva to flow from the mouth to keep the baby from choking. If a seizure lasts longer than 5 minutes call 911.

Herbalist Kiva Rose told me about using elderflower for those children who are prone to febrile seizures. It’s believed to help reset the fever mechanism.

In treating fevers use your best judgment and remember our job is to support the body’s natural functions, not quell symptoms. Fevers can be serious – if in doubt seek more advanced care.

Further resources