|| Echinacea angustifolia/Echinacea pallida/Echinacea
|| Purple coneflower
One of the most popular herbs in America today is the Native American
medicinal plant known as echinacea. The herb is named for the prickly scales in
its large conical seed head, which resemble the spines of an angry hedgehog
(echinos is Greek for hedgehog).
Results of archeological digs indicate that Native Americans may have used
echinacea for over 400 years to treat infections and wounds and as a general
"cure-all." Echinacea has also been used throughout history to treat scarlet
fever, syphilis, malaria, blood poisoning, and diphtheria. Although this herb
was popular during the 18th and 19th centuries, its use began to decline in the
United States after the introduction of antibiotics. Echinacea preparations
became increasingly popular in Germany throughout the 20th century -- in fact,
almost all of the scientific research on this herb has been conducted in this
Today, echinacea is primarily used to reduce the symptoms and duration of the
common cold and flu and to alleviate the symptoms associated with them, such as
sore throat (pharyngitis), cough, and fever. Many herbalists also recommend
echinacea to help boost the activity of the immune system and to help the body
Several laboratory and animal studies suggest
that echinacea contains active substances that enhance the activity of the
immune system, relieve pain, reduce inflammation, and have hormonal, antiviral,
and antioxidant effects. For this reason, professional herbalists may also
recommend echinacea to treat urinary tract infections, vaginal yeast (candida)
infections, ear infections (also known as otitits media), athlete's foot,
sinusitis, hay fever (also called allergic rhinitis), as well as slow-healing
Two groups of researchers recently conducted a
review of the scientific literature to determine whether echinacea is safe and
effective in preventing or treating the common cold. Both groups of researchers
identified 13 high-quality European studies including a variety of different
echinacea preparations. Nine looked at the effectiveness of echinacea to treat
the common cold and four examined whether echinacea helps prevent this familiar
Most studies found that echinacea (when taken at the first sign of a cold for
8 to 10 days) reduced cold symptoms or shortened their duration. For example, in
a study of 95 people with early symptoms of cold and flu (such as runny nose,
scratchy throat, and fever), those who drank 5 to 6 cups of echinacea tea every
day for 5 days felt better sooner than those who drank tea without echinacea.
Other studies have found that echinacea reduces cold symptoms by roughly 34
One popular way that echinacea is used is to try prevent a cold or flu by
taking the herb throughout cold and flu season or just after exposure to an
infection via a friend or loved one. Despite the popularity of this approach,
several studies suggest that it does not work. Three out of four well-designed
studies found that echinacea was only "marginally" better than placebo in
preventing the common cold. The last study revealed that echinacea was, in fact,
no better than placebo at all in 117 healthy volunteers treated with one or the
other for two weeks after being exposed to rhinovirus (a virus that often causes
colds). An equal number of men and women in the placebo and echinacea groups
developed a cold. The consensus seems to be that echinacea may help treat but
not prevent the common cold.
Echinacea has tall stems, bears single flowers that are pink or purple, and
has a central cone that is usually purplish-brown in color. The large cone is
actually a seed head with sharp spines that resemble a stiff comb. Of nine
echinacea species, only three are used for medicinal purposes (Echinacea
angustifolia, Echinacea pallida, and Echinacea purpurea).
|What's It Made Of?|
Many chemicals contained in echinacea play a role in its therapeutic effects.
These include polysaccharides, glycoproteins, alkamides, volatile oils, and
The chemicals contained in the root differ considerably from the upper part
of the plant. For example, the roots have high concentrations of volatile oils
(odorous compounds) while the above-ground parts of the plant tend to contain
more polysaccharides (substances known to trigger the activity of the immune
system). The beneficial effects of echinacea appear to be due to the combination
of these active substances.
In Germany (where herbs are regulated by the government), the above-ground
parts of E. purpurea are approved to treat colds, upper respiratory tract
infections, urinary tract infections, and slow-healing wounds. The root of the
E. pallida plant is also approved for the treatment of flu-like
infections. Many echinacea products available in the United States contain one,
two, or even all three plant species.
There are three species of echinacea that are commonly used for medicinal
purposes: Echinacea angustifolia, Echinacea pallida, and Echinacea
purpurea. Many echinacea preparations available today contain one, two, or
even all three of these species. Different products use different parts of the
echinacea plant. For this reason, echinacea preparations vary considerably. This
is why, some experts believe, the effectiveness of echinacea tends to differ
from one product to the next.
Echinacea (including one, two, or all three species) is available in
extracts, tinctures, tablets, capsules, and ointments. Echinacea is also
available in combination with other immune-boosting herbs, vitamins, and
A recent study performed by ConsumerLab.com (an independent company that
tests the purity of health, wellness, and nutrition products) found that of 25
brands of echinacea purchased for testing, only 14 (56%) truly contained what
was stated on their labels. Six of the products were discarded because they were
inadequately labeled according to FDA guidelines -- they did not identify the
amount, species, or plant parts used. Among the 19 remaining products, two of 12
containing E. purpurea failed, with one product containing only 54% of
the minimum level of active ingredients. Neither of the E. angustifolia
products passed inspection. Be sure to buy products made by established
companies with good reputations, and who distribute their products through
trustworthy and knowledgeable establishments. Whenever possible, select products
with guaranteed potency or standardized extracts.
|How to Take It|
Adjust the recommended adult dose to account for the child's weight. Most
herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult.
Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of
echinacea for this child would be 1/3 of the adult dose.
Use alcohol-free preparations for children.
For general immune system stimulation, during colds, flu, upper respiratory
tract infections, or bladder infections, choose from the following forms and
take three times a day:
- 1 to 2 grams dried root or herb, as tea
- 2 to 3 mL of standardized tincture extract
- 200 mg of powdered extract containing 4% phenolics
- Tincture (1:5): 1 to 3 mL (20 to 90 drops)
- Stabilized fresh extract: 0.75 mL (15 to 23 drops)
For slow-healing wounds, creams or ointments should be applied as
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care, under the supervision of a
practitioner knowledgeable in the field of botanical medicine.
The American Herbal Products Association gives echinacea a class 1 safety
rating, which indicates that it is safe when used appropriately (as instructed
by the product label) and with the guidance of a healthcare professional. In
Germany, use of echinacea is restricted to no longer than eight weeks at a time.
This is because after eight consecutive weeks, echinacea losses its
effectiveness and may even diminish immune function. Regular users of this herb,
need "break" periods - namely, periods of time that
they are not taking echinacea in order for it to maintain its ability to enhance
immune function and fight infection.
Individuals with tuberculosis, leukemia, diabetes, connective tissue
disorders, multiple sclerosis, HIV or AIDS, any autoimmune diseases, or,
possibly, liver disorders should not take echinacea. There is some concern that
echinacea may reduce the effectiveness of medications that suppress the immune
system. For this reason, people receiving organ transplants (who must take
immunosuppressant medications [see
Possible Interactions]) should avoid
In rare cases, echinacea may cause allergic reactions ranging from a mild
rash to anaphylaxis (a life threatening reaction accompanied by throat
tightening, shortness of breath, and, possibly, fainting). People with asthma
and allergies may be at an increased risk for developing these adverse
There has been one report of an individual developing erythema nodosum (a
painful skin condition) after taking echinacea to treat the flu.
When taken by mouth, echinacea may cause a temporary numbing and tingling
sensation on the tongue.
Despite concerns that echinacea may be unsafe for pregnant or breastfeeding
women, new evidence suggests that the use of echinacea during pregnancy does not
increase the risk of birth defects or other pregnancy-related health problems.
If you are currently being treated with any of the following medications, you
should not use echinacea without first talking to your healthcare provider:
Echinacea may be useful in combination with
econazole, an antifungal agent used to treat yeast infections (such as athlete's
foot). When echinacea is used together with econazole, recurrence rates of these
infections may be reduced.
Immunosuppressants refers to a group of
medications that are used for two main purposes -- treat cancer and suppress the
immune system following organ transplant so that the new organ is not rejected.
Because echinacea can enhance immune function, it is not advisable to use the
herb with medications in this class, especially for organ transplant.
In terms of cancer treatment, however, a couple of test tube studies imply
that echinacea may prove useful when used in conjunction with cyclophosphamide,
one medication in this class. The idea is that using echinacea with this or
other chemotherapy agents that act as immunosuppressants, may allow the
cancer-fighting medicines to kill the tumors while the immune system continues
to be protected. If this theory proves to be correct, then, echinacea could
possibly prevent many of the untoward side effects of chemotherapy.
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|Review Date: April 2002|
|Reviewed By: Participants in the review process include: Constance Grauds, RPh (April
1999), President, Association of Natural Medicine Pharmacists, San Rafael, CA;
Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Harvard University and Senior Medical Editor Integrative Medicine,
Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson
Drugs, Natick, MA; Enrico Liva, ND, RPh, Vital Nutrients, Middletown, CT; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH; David Winston, Herbalist (April 1999),
Herbalist and Alchemist, Inc., Washington, NJ; Tom Wolfe, P.AHG (April 1999),
Smile Herb Shop, College Park, MD. All interaction sections have also been
reviewed by a team of experts including Joseph Lamb, MD (July 2000), The
Integrative Medicine Works, Alexandria, VA;Brian T Sanderoff, PD, BS in Pharmacy
(March 2000), Clinical Assistant Professor, University of Maryland School of
Pharmacy; President, Your Prescription for Health, Owings Mills, MD; R. Lynn
Shumake, PD (March 2000), Director, Alternative Medicine Apothecary, Blue
Mountain Apothecary & Healing Arts, University of Maryland Medical Center,
Glenwood, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman,
Hawaii State Consortium for Integrative Medicine, Honolulu,
Copyright © 2004 A.D.A.M., Inc
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