Health Tips / Cough

As any doctor will tell you, there are coughs–and then there are coughs! All coughs, though, are a response by your body to rid itself of something that wants to get out. This could be infected mucus in your lungs or the piece of popcorn that “went down the wrong tube.” Basically this means you don’t always want to interfere with the process. You feel the first type of cough, called bronchitic, deep in your chest. For these coughs, you need an expectorant to help the lungs bring up phlegm, to be “productive,” as doctors say.
Often a cough is an utterly useless endeavor, an involuntary response to an annoying tickle (cough, cough) like the drip-drip-drip of sinus drainage. This is called a tracheal cough. For these “unproductive” coughs, you need a demulcent to soothe your throat and a suppressant to turn the cough reflex off.

Let’s see if our recommendations from WholeHealth Chicago can help.

What is Cough?

A cough is a natural reflex reaction in which air is forcefully expelled through the mouth, clearing mucus secretions and foreign matter from the lungs, airways, and throat. The reflex is set in motion when an irritant enters the respiratory system and stimulates tiny cough receptors in the respiratory passages to secrete extra mucus. Alerted to the presence of excess mucus by cough receptor nerve endings, the brain triggers a cough that loosens and expels both the irritant and the mucus. Even though you may not even realize it, you probably cough once or twice an hour to clear your throat of debris. In fact, coughing is a vital bodily function. Illness or exposure to environmental irritants, however, can cause the persistent, uncontrollable coughing that sends millions of people to see their doctors every year.
Coughs that are a symptom of an underlying infection, inflammation, or irritation of the respiratory system fall into two broad categories: nonproductive (dry) coughs and productive (wet) coughs. The latter expel mucus and usually help speed recovery. (The cough of a cold, for example, may be dry at the beginning, but become productive once the recovery process is under way.)

Most coughs subside on their own, without treatment, although over-the-counter medications and natural herbal remedies can help relieve common coughs and shorten their duration. Persistent coughing, however, especially if it’s accompanied by fever, chest pain, breathing difficulties or dark, green or bloody mucus, can be a sign of a serious underlying condition and requires prompt medical attention.

Key Symptoms

Coughing is a symptom of other ailments–usually respiratory infections or irritations of the lungs and airways–rather than an ailment in itself.

Coughs can be dry, or nonproductive, failing to bring up sputum or other secretions, or they can be productive, or wet, succeeding in expelling mucus along with germs and irritants.

What Causes Cough?
Cold and flu viruses are among the most common causes of persistent coughing that lasts for several days. Other respiratory tract conditions that produce coughs include asthma, hay fever, bronchitis, and the childhood diseases croup (characterized by a barking cough) and whooping cough (characterized by a loud gasping cough).

Cigarette smoking is one of the main causes of chronic coughing. Smoking stimulates mucus production in the bronchial tubes, which must be continuously flushed out by coughing. Other environmental cough triggers include chemicals, perfumes, and dust.

The acid reflux of heartburn can irritate not only the esophagus but also the throat, causing bouts of coughing. Certain drugs, such as the ACE inhibitors prescribed for high blood pressure, produce coughing as a side effect.

Persistent coughing, often accompanied by chest pain, difficulty breathing, fever, and the production of dark or bloody mucus, can result from such serious medical conditions as pneumonia, congestive heart failure, and a tumor in the lungs, throat, or larynx.

Treatment and Prevention

Cough remedies and self-care measures, such as drinking plenty of fluids and using a humidifier to moisten the air, can make coughs easier to bear and perhaps speed recovery. Over-the-counter and herbal cough remedies come in two basic types: Expectorants thin and loosen mucus, making it easier to bring up; suppressants act on the cough center in the brain to quiet dry, hacking coughs.

If you feel congested but your cough is dry, an expectorant may help loosen and expel mucus. However, the main ingredient in over-the-counter expectorants, guaifenesin, is of unproven efficacy. Herbal expectorants, such as licorice and horehound, may be preferable.

By quieting a persistent dry cough, suppressants can help you get a good night’s sleep. Over-the-counter suppressants, especially those containing codeine or diphenhydramine, can cause side effects, such as stomach upset or drowsiness. Choose an herbal suppressant or an over-the-counter suppressant containing dextromethorphan, which produces much milder side effects. Because productive coughs clear the respiratory tract of germs and irritants and aid recovery, do not treat such coughs with a suppressant, unless the coughing is truly depriving you of sleep.

Preventing coughs is a matter of preventing the conditions that cause them, such as colds or flu, or avoiding the environmental irritants that provoke them, such as tobacco smoke, dust, chemicals, and air pollution.

How Supplements Can Help

The herb slippery elm is a natural cough suppressant. A tea made of slippery elm soothes the throat and quiets coughs.

Adding the herbs marshmallow and licorice can increase the efficacy of slippery elm tea. When steeped in hot water, marshmallow releases mucilage, a gel-like substance that coats and suppresses cough receptors in the throat and larynx. Licorice is a natural expectorant that loosens mucus and calms bronchial spasms. (Don’t take licorice for more than three weeks. Further use can raise blood pressure.)

Horehound tea is also an effective expectorant; unlike licorice, it has no effect on blood pressure.

Different combinations of slippery elm, marshmallow, licorice, and horehound are sold in tea bag form. The herbs are also available as liquid extracts, which can be taken diluted in small glasses of warm water.

To open clogged sinuses, clear air passages, and calm bronchial spasms, add a few drops of eucalyptus or peppermint oil to hot water and inhale the vapor.

Use cough drops or candies containing eucalyptus, peppermint, anise, or fennel to help soothe the throat and suppress coughing.

Self-Care Remedies

Drink plenty of water (or tea, warm broth, or tepid juices) to help thin mucous secretions and make them easier to expel.

Another way to help thin mucus and make your cough more productive is to moisten the air you breathe with a vaporizer or a humidifier.

Rubbing a camphor ointment, menthol salve, or pure peppermint oil on the chest may help quiet coughing.

Stop smoking and avoid smoke-filled rooms and chemical fumes, which can trigger coughing.

When to Call a Doctor

If coughing is accompanied by chest pain, difficult or painful breathing, wheezing, severe headache, weight loss, or a fever of 101°F or higher
If coughing brings up brown, yellow, green, or bloody mucus
If coughing persists day and night, is exhausting, or lasts for more than a week

Supplement Recommendations

From David Edelberg, M.D. at WholeHealth Chicago: Different treatments are needed for different coughs. You don’t want to suppress the deep, wet bronchial cough that brings up mucus from your lungs and bronchial tubes. But you do want to banish the dry tickle that keeps you (and your partner) awake all night.
Over-the-counter cough syrups are one way to deal with coughs, and they’re fine to take. Those that contain the expectorant guaifenesin will help bring up the mucus.

For that nagging feather-tickle cough, you need cough suppressants. Look for the “DM” on commercial syrups. The initials stand for dextromethorphan, one of the oldest and best suppressants. For dry coughs, doctors frequently prescribe codeine in a cough syrup or tablet; codeine acts like “DM” but it’s stronger.

All of the supplements in our list can be taken with any of these cough syrups. Generally, pushing fluids into your system and inhaling steam will thin the mucus and make it easier to bring up.

How to Take the Supplements

Herbal teas made from beneficial roots and bark can also help shake coughs. Licorice and horehound teas are natural expectorants that loosen the phlegm and clear it out. Even though they don’t work too well as suppressants, teas made from slippery elm and marsh mallow can be very soothing to your throat. They can be taken as often as desired, and adding a shot of bourbon and/or a teaspoon of honey to the tea improves their taste considerably.

You can prepare the teas with the herbs themselves or with liquid extracts of the herbs. You can also mix any of these herbs or liquid extracts together, in the dosages suggested, in the chart below, to make your own herbal cough preparation.

Sometimes, a cough is due to sinus congestion, with a maddening tickle right at the base of your throat. In case you’ve ever wondered about the unromantically named “post nasal drip,” that tickle is it. Although a cough suppressant will help turn off this annoying symptom, you might also try inhaling peppermint oil, or even better eucalyptus oil, to open up your clogged nasal passages. Add a few drops of either to some water, heat to boiling, and inhale the pungent steam. Blow your nose frequently, but gently, to clear the excessive mucus.


We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.

Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.

For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.

Be well,
David Edelberg, MD