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Respiratory · also Immune / Rheum / Allergy

Allergic rhinitis

4 plants

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Antihistamines and INCS remain first-line. PA-free butterbur has human seasonal-rhinitis trials — unprocessed butterbur is a hepatotoxic PA plant. Nettle and elder are traditional/supportive, not replacements for fluticasone.

Primary plants

  1. Butterbur (Petasites hybridus)
    1
    ButterburHuman data

    Petasites hybridus

    PA-free extracts have human seasonal-rhinitis trials. Identity is the safety issue — raw herb is hepatotoxic.

    Typical. Certified PA-free Petasites extract as labeled (often 8–16 mg petasins tid — product-specific).

    Safety. Only certified PA-free. Avoid in liver disease and pregnancy. Asteraceae allergy.

  2. Stinging nettle (Urtica dioica)
    2
    Stinging nettleStrong traditional

    Urtica dioica

    Traditional freeze-dried leaf for hay fever. Human data mixed and small.

    Typical. Freeze-dried leaf 300–600 mg tid as in older hay-fever studies, or leaf tea.

    Safety. Fresh plant stings — that's not the oral product. Occasional GI upset.

  3. Black elder (Sambucus nigra)
    3
    Black elderStrong traditional

    Sambucus nigra

    Flower is the traditional catarrh tea. Berry extracts are more a viral-cold product than rhinitis.

    Typical. Flower tea 2–3 g. Cooked berry only if using fruit.

    Safety. Raw berry: nausea. Immune-modulating berry claims are oversold for rhinitis.

Supportive plants1
  • German chamomile (Matricaria chamomilla)
    German chamomileStrong traditional
    Matricaria chamomilla

    Steam or tea as a soothing adjunct. Not disease-modifying.

    Typical. Flower tea; inhalation steam optional. Eye compress only if no ragweed cross-reactivity.

    Safety. Asteraceae cross-reactivity can worsen the allergy you are treating.

Clinical notes

  • If they have poorly controlled asthma, treat that guideline-first.
  • Never recommend non-PA-tested butterbur.
  • Unilateral symptoms, bloody discharge, or anosmia lasting months is not hay fever.

When this is not enough

  • Anaphylaxis, stridor, facial swelling — epinephrine/ED
  • Unilateral nasal obstruction, bloody discharge, diplopia
  • Asthma exacerbation with the same trigger

Rooted is a private clinical reference for licensed practitioners. It is educational, not a treatment protocol, and not a substitute for the chart, the exam, or pharmacy review. Plant medicines interact with drugs and can harm liver, kidney, heart, pregnancy, and children.

All respiratory diagnoses