Natural products retailers know when it's autumn, not because of falling leaves, but because consumers begin roaming the HABA aisles looking for something to allay their runny noses and ease their body aches. Many retailers know what to give consumers for their colds and influenza, but what about that bothersome, and potentially dangerous, cough? Fortunately, many coughs can be treated successfully with herbs and homeopathy. With the wide variety of natural cough blends on the market, consumers can pick and choose what therapies and delivery systems are right for them.

Anatomy of a Cough
Coughs can be caused by a number of different things, says Raymond Lombardi, N.P., with Lombardi Health Center in Redding, Calif. "A cough can be the result of a general infection of the lungs or an upper respiratory infection," he says. When a runny nose, sore throat or sneezing accompanies the cough, there is usually an infectious process going on. He says coughs can also be related to more severe types of disease such as emphysema and chronic obstructive pulmonary disease.

Coughs take on a number of different forms but can usually be broken into two categories: the productive or wet cough and the nonproductive or dry cough. "With the productive cough, we are going to get some type of mucus or phlegm coming out of the lungs with the cough itself," Lombardi says. Yellow or green phlegm usually indicates infection.

Many coughs can be treated at home, but there are signs that indicate something more serious. If there's a high fever or blood with the cough, or if wheezing or shortness of breath accompanies a productive cough, it could be pneumonia; Lombardi recommends seeing a doctor immediately. He says that a nonproductive cough in children, without other symptoms such as runny nose, may seem benign, but could be whooping cough, which is a bacterial infection.

In general, with a common wet or dry cough, Lombardi recommends seeing a physician in seven to 10 days if symptoms persist.

Treating a Cough
Many herbs and homeopathic formulas are effective cough treatments .

Mindy Green, education director at the Herb Research Foundation in Boulder, Colo., says her favorite herbs for treating coughs are echinacea, ginger, marshmallow root and garlic. "Echinacea is probably the best out of the whole list. It's been studied for respiratory problems and has even been studied in children. There are not a lot of herbs studied on children," she says.

Green also recommends chest rubs and therapeutic baths with essential oils to treat coughs. Mix peppermint, eucalyptus and rosemary oils in a carrier oil, such as almond oil, and then blend with melted beeswax for an effective vapor rub. For a therapeutic bath, Green recommends adding eucalyptus or ravensara essential oils to the bathwater. "Both are good antivirals as well as respiratory tonics," she says.

Traditional Medicinals, based in Sebastapol, Calif., makes two herbal teas designed to treat coughs. Beth Davis, research and development assistant for the company, says HerbaTussin, with licorice root, slippery elm, wild cherry bark, elecampane and marshmallow root, is ideal for productive coughs. "The eucalyptus, wild cherry and elecampane will all help to move things out," she says.

The company's Breathing Thyme blend, with fennel, English plantain, licorice and thyme, is good for dry coughs, according to Davis. "This blend really helps to open things up in the upper respiratory tract and loosen some of that stuff up," Davis says. "So when you're hacking and nothing's coming up, this is going to help moisturize the respiratory tract and get things moving." The Breathing Thyme tea is a licensed cough drug in Germany, Davis says. And none of the herbs in either formula are contraindicated for children and both teas have a pleasant flavor.

In his practice, Lombardi uses herbs and homeopathy for a holistic approach to cough care. "It doesn't do any good to just address the cough locally without addressing the immune system if there is in fact an infectious process going on," he says. He uses a combination of immune modulators and boosters, such as echinacea or elderberry, with cough formulas. "I find that tends to work well.

"Initially, if someone has a wet cough, that person would want to be working on expectorating," Lombardi says. "Your body is usually trying to expel infectious material out of the lower lungs, and it's very important to get that out."

For a wet cough, Lombardi likes wild cherry bark, slippery elm and marshmallow root. He says that the slippery elm and marshmallow root act as anti-inflammatories and help reduce mucus membrane inflammation. He uses therapeutic doses when prescribing herbs to his patients. "I use a higher potency [of herbs] to get a pharmacological effect." His herb of preference for dry coughs is horehound. "Horehound is an excellent cough suppressant that can be useful when you have a nonproductive dry cough that just seems endless," he says.

Drugs and Labeling
Labeling cough remedies is no easy task, thanks to the U.S. Food and Drug Administration. "You've got to be very careful with [cough medicine], you can't just put a bunch of herbs together and call it a cough syrup," says Marwan Zreik, vice president of research and development for Irvine, Calif.,-based Naturade. "You have to call it something that doesn't use the word 'cough,' that's a drug word."

Naturade labels its cough products "herbal cough expectorants," and in order to do so, the products must contain guaifenesin, an FDA-approved drug. "Anyone who is labeling their product 'expectorant' has to put guaifenesin in it," Zreik says.

He says the company's cough products are unique because they are drug-herb blends. In addition to guaifenesin, the products contain wild cherry bark, ginkgo biloba, red clover and other herbs. The children's formula has lower herb dosages for a "gentler formula" and doesn't contain sugar or honey.

With the change of seasons right around the corner, retailers may want to make sure their HABA sections are well-stocked for the onslaught of sneezing, coughing customers. Because as sure as those leaves fall from the trees, the ailing will come.

Natural Foods Merchandiser volume XXII/number 8/p. 36, 40