PLANT OF THE DAY brings you easy to digest information exploring science backed plants for health and medicine. Written by scientists, it aims to increase understanding of how effective plant medicine is as well as encourage simple dietary interventions to increase health and prevent disease. Plant of the day promotes the scientific research on select plant medicines and thereby helps bridge the gap between the worlds of plant medicine and general medicine.

DID YOU KNOW? While you can take, for example, a cup of chamomile tea to aid relaxation and sleep anytime, to treat a condition with a plant medicine it is important to take the correct dose and plant medicine for your individual needs – and in that case always first consult a NIMH medical herbalist and inform your healthcare provider before giving to a child, if you are pregnant, have any medical condition or are taking any medication.

Respiratory and antimicrobial plant medicines – Common (English) Ivy

Supporting immunity

Among many approaches to supporting the immune system, inflammatory responses and treating respiratory disease, are a range of effective plant medicines.

We can also help boost our innate immunity by simple lifestyle changes such as regularly eating a rainbow diet, getting outdoors daily to boost vitamin D (which helps boost immunity), exercising which also helps lymphatic circulation (a crucial part of our immune response), ensuring relaxation time to help prevent chronic stress (which can lower immunity) and ensuring we rest and sleep well.

Respiratory Plant Medicine

Different plant medicines are used to support immunity and treat respiratory disorder in different parts of the world, such as elder berry in Europe, echinacea in North America, and astragalus in Asia. We have explored thyme in a previous post and will explore others in upcoming blogs.

Here we look at common ivy leaf (not the flower or berry). Ivy leaf is a plant medicine widely used in Europe, and one with significant clinical science behind its efficacy in treating respiratory disorders. It is also antibacterial and antiviral.

Ivy leaf extract – ‘a valuable option for the treatment of respiratory diseases’ Lang et al, 2015

  • The Plant

    Common or English Ivy 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, common (or English) ivy is a rampant evergreen vine that clings to walls and tree trunks and covers 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.

  • Human Studies

    A research paper that turned the spotlight on ivy for respiratory health was an analysis of controlled trials of ivy leaf for the treatment of acute (sudden) and chronic (long-term) 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 ((inflammation of the airways in the lungs) 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.

    Controlled clinical trials find ivy leaf to be as effective as the drug ambroxol for improving cough symptoms in adults with chronic bronchitis. Studies in children (over 2 years old) showed ivy leaf to be comparable to the medicine acetylcysteine in improving symptoms with acute (sudden) bronchitis.

  • Laboratory Studies

    Ivy works to alleviate respiratory disease by a number of ways. The extract and its main bioactive chemicals lower muscle spasms in the bronchus (airways), improve bronchodilation and aid secretolysis (breaking up mucus secretions), therefore being expectorant and lowering cough. Ivy also lowers inflammation and oxidation.

    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 anti-bacterial, anti-fungal and anti-parasitic.

  • Key Ingredients

    Ivy contains terpenoid saponins like hederacosides (B-I), with hederasaponin C the main bioactive, reducing the surface tension of bronchial mucus. Also contains an essential oil containing germacrene, β-caryophyllene, sabinene, α+β-pinene and limonene (volatile compounds present in other anti-viral plants); tannins, flavonoids like quercetin and kaempferol and vitamins and minerals.

    Time of leaf harvest, climate, vegetative development stage, and extraction method can all vary the chemical nature of the extracted leaf – this is why it is important to ensure plant material is harvested at the correct time and that products are purchased only from an established reputable standardised source or from your local NIMH registered medical herbalist.

  • Historical Use & Folklore

    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. She 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.

    Plant Medicine Ivy’s use as a cough medicine 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.

    Ivy is used in plant medicine today 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 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.

  • Dose and formulation

    CAUTION In order to treat any condition with a plant medicine it is important to take the correct dose and plant medicine for your individual needs – always first consult a NIMH registered medical herbalist in order to treat a child, if you are pregnant, have any medical condition or are taking any medication.

    To treat a cough, ivy leaves 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 for up to 20 days. The tea tastes quite pleasant but it is most often taken as a tincture (the plant material extracted in alcohol), 1-3ml daily. It is also commercially available in capsule, syrup or cough drop form – take according to the label. To treat a chronic condition the specific prescription depends on the degree of breathing impairment, age and other factors so first consult a NIMH medical herbalist. Not for long term use without consultation. Do not exceed recommended dose.

  • Safety

    Do not exceed the recommended dose. No contraindications are reported for medical conditions or medication (though CYP enzyme inhibition has been shown in a lab study so contraindications may be possible). Leaves may cause skin reactions such as hives in some, due to the chemical falcariol (these people will also likely react to carrots and other members of Apiaceae). Ivy leaf medicines must not be 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.

    Further information on any risk 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:

Scientific sources

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

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