Common (English) Ivy to support respiratory health

Hedera helix

Aid respiratory health with this anti-viral respiratory supporting medicinal plant.
There are safe plant medicines, that have been used by humans for centuries, that carry the same efficacy as drugs with fewer if any side-effects. Only a select few of these plant medicines have been studied in controlled clinical studies. For example in patients with bronchial asthma there are plant medicines that safely decrease airway resistance and improve forced expiratory volume. These plant medicines include dried Ivy Leaf Extract (read more below), a plant medicine commonly used clinically and available in pharmacies in Europe for a wide range of respiratory disorders and one we include ivy leaf in our Respiratory Tincture

The Plant

Hedera helix L.
Regarded by some gardeners and home owners as a menace and only truly valued at Christmas time, ivy has some surprising health benefits and some surprising relatives. It belongs to the Apiaceae (Umbelliferae) plant family that contains vegetables like carrot and celery, and herbs like parsley and fennel.
 
Native to most of Europe and western Asia, common (English or European) ivy is a rampant evergreen vine, clinging to walls and tree trunks and covering ground in wild spaces. The leaves are of two types – lobed juvenile leaves and unlobed adult leaves on flowering stems. Flowering late summer to late autumn, small clusters of greenish-yellow blooms, rich in nectar, are an important food source for bees. Fruits are orange-yellow to purple-black to berries ripening in late winter and while attractive to many birds are poisonous to humans. It is the leaves, gathered from non-flowering stems, that are used in plant medicine.
 
Another surprising fact about this neglected plant is that perfumes were made from the flowers – though we have yet to find a source of ivy essential oil to check this out!

Folklore

Ivy was associated with the Roman god of revelry.
According to Mrs Grieve (A Modern Herbal, 1931) “Ivy was in high esteem among the ancients. Its leaves formed the poet’s crown, as well as the wreath of Bacchus, to whom the plant was dedicated, probably because of the practice of binding the brow with ivy leaves to prevent intoxication, a quality formerly attributed to the plant. We are told by old writers that the effects of intoxication by wine are removed if a handful of Ivy leaves are bruised and gently boiled in wine and drunk.”
 
Grieve also says that Greek priests presented ivy wreaths to newly-married couples and ivy has long been regarded as the emblem of fidelity. And adds that “the custom of decorating houses and churches with ivy at Christmas was forbidden by one of the early councils of the church, on account of its pagan associations.” The plant was in fact sacred to the druids and considered the female counterpart to the masculine holly.

Ivy’s use as a cough medicine across Europe today was said to have been discovered by an early 20th century doctor in the south of France who noticed children from the region did not suffer from bronchitis and that they drank from cups made from the wood of the ivy plant.

Traditional Use

Ivy is used in plant medicine for the symptomatic treatment of chronic inflammatory bronchial conditions and as an effective anti-inflammatory for bronchial conditions such as asthma and bronchitis.
 
Ivy extracts are widely used in cough medicines in Europe, as an expectorant to treat cough and for bronchitis. The leaf extract is approved by the German Commission E and European Medicines Agency for use against chronic inflammatory bronchial conditions and productive coughs, due to its actions as an expectorant.

Science

HUMAN STUDIES
A research paper that turns the spotlight on ivy for respiratory health is an analysis of controlled trials of ivy leaves for the treatment of acute and chronic respiratory diseases (Lang et al, 2015). Preparations from ivy leaf (Hedera helix) dry extracts were shown efficacious and safe in the treatment of different respiratory diseases from acute bronchitis to bronchial asthma in clinical trials in children (over 2 years) and adults (only two trials being placebo controlled).
Overall, 18 publications covered clinical trials and observational studies of, in total, 65,383 patients suffering from acute, as well as chronic respiratory diseases were included in the study.
 One double-blind clinical trial found ivy leaf to be as effective as the drug ambroxol for treating the symptoms of chronic bronchitis.
 
LAB STUDIES
Ivy works to alleviate respiratory disease by a number of ways. The extract and its main chemicals lower muscle spasms in the bronchus (airways), improving bronchodilation, aiding secretolysis (breaking up mucus secretions), therefore being expectorant and lowering cough. The plant significantly reduced serum oxidative stress biomarkers and inflammatory cytokines in in-vivo acute lung inflammation.
There are numerous research reports on common ivy’s antiviral action – for example, it is effective against influenza A virus and against enterovirus. Ivy is also antibacterial, antifungal and antiparasitic.
 
CHEMICAL INGREDIENTS
Ivy contains terpenoid saponins like hederacosides (B-I), with hederasaponin C the main bioactive, reducing the surface tension of bronchial mucus. Ivy also contains an essential oil containing germacrene, β-caryophyllene, sabinene, α+β-pinene and limonene; tannins, flavonoids like quercetin and kaempferol and vitamins and minerals.

Dose and Formulation

CAUTION: Do not stop taking medication you have been prescribed. In order to treat a condition a plant medicine must be taken at the correct dose and prescription for your individual needs – consult a NIMH registered medical herbalist first, and always in order to treat a child, if you are pregnant or are taking any medication, have any medical condition or allergy.

To treat a cough, ivy leaves collected from non-flowering stems, can be taken as a tea (finely chopped or ground, dried) using 0.5g of dried leaf (one teaspoon is 0.8g) per cup 1-3x daily. The tea tastes quite pleasant but it is most often taken as a tincture (the plant extracted in 45% alcohol), 1-3ml daily, and is also commercially available in capsule or syrup form. To treat a chronic condition the specific prescription depends on the degree of breathing impairment, age and other factors. Not for long term use without consultation. Do not exceed recommended dose.
 
SAFETY
Do not exceed recommended dose. No contraindications are reported for medical conditions or medication (though CYP enzyme inhibition is shown in lab studies and contraindications may be possible). Leaves may cause contact dermatitis in some due to a chemical called falcarinol (these people will also likely react to carrots and other members of Apiaceae). Ivy leaf medicines are not given to children under two years of age because of the risk of worsening respiratory symptoms. Side effects such as nausea, vomiting or diarrhoea have been reported at higher doses. Information on the risks associated with ivy leaf medicines, including the appropriate precautions for their safe use, can be found in the monograph on the European Medicines Agency website: https://www.ema.europa.eu/en/medicines/herbal/hederae-helicis-folium.

Selected References

Hong EH, Song JH, Shim A, et al. Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir. PLoS One. 2015;10(6):e0131089. Published 2015 Jun 22. doi:10.1371/journal.pone.0131089
 
Lang C, Röttger-Lüer P, Staiger C. A Valuable Option for the Treatment of Respiratory Diseases: Review on the Clinical Evidence of the Ivy Leaves Dry Extract EA 575®. Planta Med. 2015;81(12-13):968‐974. doi:10.1055/s-0035-1545879
 
Maidannik V, Duka E, Kachalova O, Efanova A, Svoykina S, Sosnovskaja T. Efficacy of Prospan application in childrenʼs disease of respiratory tract. Pediatr Tocol Gyn 2003; 4: 1-7
 
Rai A. The Antiinflammatory and Antiarthritic Properties of Ethanol Extract of Hedera helix. Indian J Pharm Sci. 2013;75(1):99‐102. doi:10.4103/0250-474X.113537
 
Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7):1241. Published 2017 Jul 24. doi:10.3390/molecules22071241
 
Schmidt M, Thomsen M, Schmidt U. Suitability of ivy extract for the treatment of paediatric cough. Phytother Res. 2012;26(12):1942‐1947. doi:10.1002/ptr.4671
 
Song J, Yeo SG, Hong EH, et al. Antiviral Activity of Hederasaponin B from Hedera helix against Enterovirus 71 Subgenotypes C3 and C4a. Biomol Ther (Seoul). 2014;22(1):41‐46. doi:10.4062/biomolther.2013.108
 
Grieve, M. A Modern Herbal, 1931.

Schmidt M, Thomsen M, Schmidt U. Suitability of ivy extract for the treatment of paediatric cough. Phytother Res. 2012;26(12):1942‐1947. doi:10.1002/ptr.4671

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