If there is one plant image that has come to epitomise herbal medicine and good health in the last two decades, it would be the purple cone flower of echinacea. Splashed on supplements, chemist walls, natural healing centres, echinacea was the best selling herb of the 1990s. It’s prominence is well-deserved offering a range of potent medicines and a strong alternative to pharmaceutical antibiotics for Staphylococcus, Streptococcus and tuberculosis.
In our ever-escalating chemical arms race with germs, we look set to come off as the losers. Each year seems to see the mass-outbreak of drug-resistant bacteria and viruses that modern medicine just can’t seem to nail. Plants, especially herbs, offer our greatest hope. So why is it that plant therapies can work where the pharnmaceutical companies are failing? Complexity in nature, is a fine thing.
Pharmaceutical companies rely on incomplete science and market-driven solutions, to produce patentable isolates that are quick, efficient and cost-effective to get to market. For instance, penicillin has one chemical constituent-penicillin. Bacteria that reproduces so quickly can easily find a way around that one mechanism. Plants on the other hand have far more complexity. They have had hundreds of thousands of years to evolve their complex chemical compounds that work together to produce strong and effective medicines. This complexity makes it difficult for bacteria to bypass the plant medicine’s actions.
Echinacea’s complexity makes it a potent healer
Echinacea has complexity. The plant contains many chemicals that play a role in its therapeutic effects, including polysaccharides, glycoproteins, alkamides, volatile oils, and flavonoids.
Echinacea was highly valued as a medicinal herb by Native Americans and early settlers there, treating weeping wounds, boils, abscesses and snakebite. There are nine species of Echinacea of which two are used medicinally Echinacea angustifolia and E. purpurea. E. angustifolia, the narrow-leaf form, is the most cited in herbal medicine work as it is considered more potent. It is usually wild-harvested in the US and therefore the most expensive. E.purpurea has a broad leaf and is the most common as it is easier and faster to grow. It is still highly regarded amongst herbalists and those relevant chemical compounds seem to be consistent across the varieties.
Today, echinacea has a well researched and confirmed reputation for enhancing immune function. There are multiple lab and animal studies suggesting echinacea also relieves pain, reduces inflammation, and has hormonal, antiviral and antioxidant effects. For this reason, echinacea is recommended to treat a large range of infections, inflammations, hay fever, cold sores and slow-healing wounds. The effects on colds and flu are unclear with plenty of for and against studies. But it seems the quality of the plant extract taken seems to be the greatest area for dispute.
How to take echinacea
The University of Maryland Medical Center indicates that adults:
For general immune system stimulation, during colds, flu, upper respiratory tract infections, or bladder infections, choose from the following forms and take 3 times a day until you feel better, but not for more than 7 – 10 days:
- 1 – 2 grams dried root or herb, as tea
- 2 – 3 mL of standardized tincture extract
- 6 – 9 mL of expressed juice (succus)
- 300 mg of standardized, powdered extract containing 4% phenolics
- Tincture (1:5): 1 – 3 mL (20 – 90 drops)
- Stabilized fresh extract: 0.75 mL (15 – 23 drops)
- Apply creams or ointments for slow-healing wounds as needed.
It also states that people who are immune-compromised should not take echinacea due to possible drug-interactions.
How to grow Echinacea purpurea
Echinacea sales represent 10% of the dietary supplement market in the United States. For those of us who can’t afford these supplements, try growing your own patch of purple health in your cultivated beds.
Echinacea pupurea is best treated as a biennial and sown from seed. (Please note that seeds can take around 3 weeks to germinate). Best to sow pre-soaked seed into trays in early autumn, transplanting into the garden in spring. You’ll see flowering before the end of the next autumn. Echinacea loves full sun and can handle drought and wind, requiring only around 25mm of water per week through summer. Slugs and snails are its worst enemies.
For New Zealand readers: I have Echinacea purpurea seeds for sale, contact me here.
Echinacea purpurea tincture made from flowerheads
The best time to harvest echinacea flowerheads is when they are coming into flower and are at about one-twelth flowering (one in twelve flowers are open). Gather a large amount of the aerial parts including flowerheads and buds. This is when the active constituents in the aerial parts are in their prime. (If you do this early enough in the season you’ll probably be able to get a second go over).
To make the tincture you take the fresh clippings and add them to as high a proof alcohol as you can find, to the ratio of one part plant to two parts alcohol. Mix in a blender before placing in a glass jar and leaving on a sunny windowsill. Shake every day for two weeks before straining out the plant material and store the liquid in a cool, dark place.
Links to research supporting echinacea’s efficacy
Bauer R: Standardization of Echinacea pupurea expressed juice with reference to cichoric acid and alkamides. J Herbs Spices Medicinal Plants 1999;6:51-61.
HPLC methods are described for the determination of cichoric acid and alkamides (dodecatetraenoic acid isobutylamides) with an aim towards standardization of Echinacea purpurea preparations prepared from expressed juice. Analysis of commercial samples reveals the present quality status of a selection of these preparations. Regarding alkamides, the content ranges from 0.1 to 1.8 mg/ml. The content of cichoric acid varies more dramatically (0.0–0.4%) likely due to inconsistent inhibition of the enzymatic degradation of cichoric acid
Borchers AT, Keen CL, Stern JS, Gershwin ME. Inflammation and Native American medicine: the role of botanicals. [Review]. Am J Clin Nutr. 2000 Aug;72(2):339-347.
There is a growing interest in medicinal botanicals as part of complementary medicine in the United States. In particular, both physicians and consumers are becoming aware of the use of herbals by Native American societies; many botanicals sold today as dietary supplements in the United States were used by Native Americans for similar purposes. Yet, these supplements represent only a small number of the >2500 different plant species from vascular taxa, and >2800 species from all taxa, known to have been prized for their medicinal properties by the indigenous inhabitants of the North American continent. We review some of the studies of the immunomodulatory activities of botanicals used by native peoples of North America, the bioactive constituents responsible for those activities, and the mechanisms by which these constituents might modulate the immune system. We focus particularly on 3 species of purple coneflower (Echinacea) because of the widespread use of purple coneflower in the United States to boost immunity and prevent upper respiratory infections. Seven of the 10 most common botanicals sold in the United States were used extensively by Native Americans. However, there are very few data to support such use and even less information about drug toxicity or interactions.
Burger RA,Torres AR,Warren RP, et al.: Echinacea-induced cytokine production by human macrophages. Int J Immunopharmacol 1997;19:371-9.
Echinacea purpurea, a plant originally used by native Americans to treat respiratory infections, was evaluated for its ability to stimulate the production of cytokines by normal human peripheral blood macrophages in vitro. Commercial preparations of echinacea fresh pressed juice and dried juice were tested at concentrations ranging from 10 micrograms/ml to 0.012 microgram/ml and compared to endotoxin stimulated and unstimulated controls. Cytokine production was measured by ELISA after 18 h of incubation for IL-1 and 36 and 72 h for TNF-alpha, IL-6, and IL-10. Macrophages cultured in concentrations of echinacea as low as 0.012 microgram/ml produced significantly higher levels of IL-1, TNF-alpha, IL-6 and IL-10 (P < 0.05) than unstimulated cells. The high levels of IL-1, TNF-alpha, and IL-10 induced by very low levels of echinacea are consistent with an immune activated antiviral effect. Echinacea induced lower levels of IL-6 in comparison to the other cytokines measured. These results demonstrate the immune stimulatory ability of the unpurified fresh pressed juice of Echinacea purpurea and offer some insight into the nature of the resulting immune response as compared to endotoxin.
Frank LG. The efficacy of Echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double blind, placebo-controlled study. J Comp Alt Med. 2000;6(4):327-334.
The aim of this study was to determine the efficacy of an echinacea compound herbal tea preparation (Echinacea Plus) given at early onset of cold or flu symptoms in a random assignment double-blind placebo-controlled study. A total of 95 subjects with early symptoms of cold or flu (runny nose, scratchy throat, fever) were randomly assigned to receive Echinacea Plus tea five to six cups per day titrating to 1 over 5 days or placebo in a double-blind situation. Each participant completed a questionnaire 14 days after beginning the program. The efficacy, number of days the symptoms lasted, and number of days for change were measured with a self scoring questionnaire. The study period was 90 days (January 1, 1999 to March 30, 1999). There was a significant difference between the experimental group (Echinacea Plus) and control group (placebo) for all 3 questions measured: p < 0.001. There were no negative effects reported by any of the subjects in either group. Treatment with Echinacea Plus tea at early onset of cold or flu symptoms was effective for relieving these symptoms in a shorter period of time than a placebo.
Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea. Arch Intern Med. 2000; 160:3141-3143.
Echinacea products are among the most popular phytomedicines on the North American market. Since at least half of all pregnancies are unplanned, many women inadvertently use echinacea in their first trimester. Presently, there is a paucity of information regarding the gestational safety of this herb. The primary objective of this study was to evaluate the safety of echinacea in pregnancy when used for upper respiratory tract ailments. This first prospective study suggests that gestational use of echinacea during organogenesis is not associated with an increased risk for major malformations.
Ghemi A, Soleimanjahi H, Gill P, Arefian E, Soudi S, Hassan Z. Echinacea purpurea polysaccharide reduces the latency rate in herpes simplex virus type-1 infections. Intervirology. 2009;52(1):29-34.
Objective: During the latency period of herpes simplex virus type-1 (HSV-1), the virus can occasionally reactivate, travel back to the eye and cause recurrent ocular disease. As this condition arises from the ability of HSV-1 to produce a dormant infection, effective medication to prevent the virus enter a latent state should prevent it. In this study, we applied Echinacea polysaccharide (EP) fraction as prophylactic mediator for latency prevention. Methods: In order to investigate the protective properties of EP, we evaluated its immunostimulatory functions on different immune aspects that play important roles in latency prevention (particularly IFN-γ as one of the main indicators of cellular immunity and latency). Finally, we assessed establishment of latency by detection of thymidine kinase gene in trigeminal ganglia of BALB/c mice. Results: We demonstrated that EP promotes immune response, leading to a reduced latency rate, and it has a promising effect on latency prevention. Conclusion: EP was able to exert an antiviral action on the development of recurrent HSV-1 disease when supplied prior to infection.
Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther. 2004;29(1):75-83.
Background: Recently, echinacea has regained popularity as one of the treatments chosen most commonly by consumers with the expectation that it will reduce the severity and duration of the common cold. However, the results from a limited number of clinical trials for this application have thus far been inconclusive. This incongruity may be the result of investigators utilizing poorly standardized echinacea products, likely devoid of sufficient quantities of active constituents necessary to exert a definitive clinical effect. Therefore, a formulation containing alkamides, cichoric acid, and polysaccharides at concentrations of 0.25, 2.5, and 25 mg/mL, respectively, was prepared from freshly harvested Echinacea purpurea plants (commercially available as Echinilin, Natural Factors Nutritional Products, Inc., Vancouver, BC, Canada). The objective of this study was to test the efficacy of this highly standardized formulation in reducing the severity and duration of symptoms of a naturally acquired common cold. Conclusions: Early intervention with a standardized formulation of echinacea resulted in reduced symptom severity in subjects with naturally acquired upper respiratory tract infection. Further studies with larger patient populations appear to be warranted.
Islam J, Carter R. Use of Echinacea in upper respiratory tract infection. South Med J. 2005;98(3):311-8.
The significant burden of upper respiratory tract infection in adults and children, coupled with a lack of specific treatment options, invites the use of alternative therapies. Echinacea is an herb widely used for the prevention or treatment of upper respiratory tract infection. This review article examines the mechanism of action, dose, and types of Echinacea used for these purposes. The principal mode of action of Echinacea is through immunostimulation. Most Echinacea studies were done in Germany, but their results are difficult to interpret because of variability of experimental parameters. Types of Echinacea commonly used are Echinacea purpurea, E pallida, and E angustifolia. Both the plant’s upper parts and roots are used. For oral administration, tablets, extracts, fresh pressed juice, teas, and tinctures have been used. Though studies show a beneficial effect, clear conclusions and recommendations of Echinacea use cannot be made due to a lack of standard product, variability in dose, and variability in outcome measures. Therefore, well-designed studies with consistent standardized measures are required.
Kim HO, Durance TD, Scaman CH, Kitts DD: Retention of caffeic acid derivatives in dried Echinacea purpurea. J Agric Food Chem 2000;48:4182-6.
Different drying methods were applied to fresh Canadian-grown Echinacea purpurea flowers to determine optimal drying procedures for preserving caffeic acid derivatives. Fresh flowers of E. purpurea were dried by freeze-drying (FD), vacuum microwave drying with full vacuum (VMD), and air-drying (AD) at 25, 40, and 70 °C. Using HPLC, chicoric acid and caftaric acid levels were quantitated in dried flowers. These acids were significantly affected by the drying method conditions used. Although significant (p < 0.05) loss of chicoric acid was observed when flowers were stored at high moisture, VMD flowers with a low moisture content retained the highest levels of chicoric acid and caftaric acid similar to FD flowers. Flowers that were AD at 25 °C retained about 50%, while those dried by AD at 70 °C resulted in the lowest retention of these acids. Although flowers dried by AD at 40 °C retained relatively high amounts of chicoric acid and caftaric acid, the time (55 h) required to reach optimal drying was considerably longer than that (47 min) for VMD.
Perry NB, van Klink JW, Burgess EJ, Parmenter GA: Alkamide levels in Echinacea purpurea: effects of processing, drying and storage. Planta Med 2000;66:54-6.
The effects of processing, drying, and storage time and temperature on alkamide levels in Echinacea purpurea roots are described. Chopping altered the levels of some alkamides slightly, whereas drying had no effect. Levels of all alkamides fell by over 80% during storage at 24 degrees C for 64 weeks. Alkamide levels also dropped significantly during storage at -18 degrees C.
Rininger JA, Kickner S, Chigurupati P, et al.: Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells. Leukoc Biol 2000;68:503-10.
We have investigated the immunostimulatory, anti-inflammatory, and antioxidant activities of various Echinacea raw materials and commercially available products on murine macrophages and human peripheral blood mononuclear cells (PBMCs). To emulate oral dosing, a simulated digestion protocol was employed as a means of sample preparation.Echinacea-induced macrophage activation was used as a measure of immunostimulatory activity determined via quantitative assays for macrophage-derived factors including tumor necrosis factor α, interleukin (IL)-1α, IL-1ß, IL-6, IL-10, and nitric oxide. Echinaceaherb and root powders were found to stimulate murine macrophage cytokine secretion as well as to significantly enhance the viability and/or proliferation of human PBMCs in vitro. In contrast, Echinacea extracts chemically standardized to phenolic acid or echinocaside content and fresh pressed juice preparations were found to be inactive as immunostimulatory agents but did display, to varying degrees, anti-inflammatory and antioxidant properties.
Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007;7(7):473-80.
Echinacea is one of the most commonly used herbal products, but controversy exists about its benefit in the prevention and treatment of the common cold. Thus, we did a meta-analysis evaluating the effect of echinacea on the incidence and duration of the common cold. 14 unique studies were included in the meta-analysis. Incidence of the common cold was reported as an odds ratio (OR) with 95% CI, and duration of the common cold was reported as the weighted mean difference (WMD) with 95% CI. Weighted averages and mean differences were calculated by a random-effects model (DerSimonian-Laird methodology). Heterogeneity was assessed by the Q statistic and review of L’Abbé plots, and publication bias was assessed through the Egger weighted regression statistic and visual inspection of funnel plots. Echinacea decreased the odds of developing the common cold by 58% (OR 0.42; 95% CI 0.25-0.71; Q statistic p<0.001) and the duration of a cold by 1.4 days (WMD -1.44, -2.24 to -0.64; p=0.01). Similarly, significant reductions were maintained in subgroup analyses limited to Echinaguard/Echinacin use, concomitant supplement use, method of cold exposure, Jadad scores less than 3, or use of a fixed-effects model. Published evidence supports echinacea’s benefit in decreasing the incidence and duration of the common cold.
Sharma M, Schoop R, Suter A, Hudson JB. The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation. Phytother Res. 2011;25(4):517-21.
Acne is a chronic inflammatory disorder of skin follicles caused by the gram-positive bacterium Propionibacterium acnes. The possibility was investigated that a standardized preparation of Echinacea purpurea (Echinaforce®), with known antiviral, antiinflammatory and antibacterial properties, might provide a useful alternative treatment in the control of the disease. The herbal extract readily killed a standard laboratory strain of the bacterium and several clinical isolates. In cell culture models of human bronchial epithelial cells and skin fibroblasts, P. acne induced the secretion of substantial amounts of several pro-inflammatory cytokines, including IL-6 and IL-8 (CXCL8), as determined by means of cytokine-antibody arrays. However, the E. purpurea completely reversed this effect and brought the cytokine levels back to normal. Thus Echinaforce® could provide a safe two-fold benefit to acne individuals by inhibiting proliferation of the organism and reversing the bacterial-induced inflammation.
Taheri JB, Azimi S, Rafieian N, Akhaven Zanjani H. Herbs in dentistry. Int Dent J. 2011;61(6):287-96.
Herbs have been used for centuries to prevent and control disease. Herbal extracts are effective because they interact with specific chemical receptors within the body and are in a pharmacodynamic sense, drugs themselves. By using herbal medicines, patients have averted the many side effects that generally come with traditional medicines, but this does not mean that side effects do not occur. Only knowledgeable practitioners can prescribe the right herb and its proper dosage. Herbal medicines had been considered in every culture, however, pharmaceutical companies overturned this type of thinking. Now, pharmaceuticals are called traditional and herbs are libeled as the ‘alternative’. The biggest challenge and problem is lack of information about the effect of herbs in oral tissues, mechanism of effect, and side effects. Several popular conventional drugs on the market are derived from herbs. These include aspirin (from white willow bark), digitalis (from foxglove), and sudafed (modelled after a component in the plant ephedra). Herbal products can vary in their potency. Therefore, care must be taken in selecting herbs, even so, herbal medicines have dramatically fewer side effects and are safer to use than conventional medications. The herbs described in this article are Bloodroot, Caraway, Chamomile, Echinacea, Myrrh, Peppermint, Rosemary, Sage, Thyme, Aloe Vera, Propolis, and a summary of other herbs that are useful in dentistry. Herbs may be good alternatives to current treatments for oral health problems but it is clear that we need more research.
Weber W, Taylor JA, Stoep AV, Weiss NS, Standish LJ, Calabrese C. Echinacea purpurea for prevention of upper respiratory tract infections in children. J Altern Complement Med. 2005;11(6):1021-6.
Objective: The aim of this study was to determine whether Echinacea purpurea given to children for the treatment of acute upper respiratory tract infection (URI) was effective in reducing the risk of subsequent URI. Conclusions: Echinacea purpurea may be effective in reducing the occurrence of subsequent URIs in children. However this finding needs to be replicated in a URI prevention trial.
Woelkart K, Marth E, Suter A, et al. Bioavailability and pharmacokinetics of Echinacea purpurea preparations and their interaction with the immune system. Int J Clin Pharmacol Ther. 2006;44(9):401-8.
Echinacea is a widely used herbal remedy for the prevention and treatment of the common cold. Recently, many new insights concerning the molecular mode of action of the main lipophilic constituents, the alkamides, have renewed interest in this plant. In order to compare the bioavailability of alkamides from liquid and tablet preparations of E. purpurea (Echinaforce) in humans and to study the effects on ex vivo stimulated blood cells, a randomized, single-dose, crossover study with 10 (8 test, 2 placebo) volunteers has been performed. They received either 4 ml of the standardized E. purpurea (Echinaforce) tincture or 12 E. purpurea (Echinaforce) tablets or placebo. Both doses contained the same amount (0.07 mg) of the major alkamides, dodeca-2E,4E,8Z, 10E/Z-tetraenoic acid isobutylamides. Liquid chromatography electrospray ionization ion-trap mass spectrometry was used to determine the content of alkamides in serum. It was found that the arithmetic mean C(max) of dodeca-2E,4E, 8Z,10E/Z-tetraenoic acid isobutylamides absorbed after oral application of the Echinaforce tincture appeared after 30 min (0.40 ng/ml serum). In comparison, the t(max) of tablets was 45 min with a C(max) of 0.12 ng/ml. An ex vivo stimulation of blood by LPS was carried out to measure the influence of E. purpurea on the innate and adaptive immune system. Both E. purpurea preparations led to the same effects on the immune system according to the concentration of pro-inflammatory cytokines TNF-alpha and IL-8. 23 hours after oral application a significant down-regulation of TNF-alpha and IL-8 in LPS pre-stimulated whole blood was found. However, no significant changes in the concentration of IL-6 were observed. Although a quarter of the dodeca-2E,4E,8Z, 10E/Z-tetraenoic acid isobutylamides was absorbed from the tablets, the study shows that the formulations trigger the same effects on the measured immune parameters.
Yamada K, Hung P, Park TK, Park PJ, Lim BO. A comparison of the immunostimulatory effects of the medicinal herbs Echinacea, Ashwagandha and Brahmi. J Ethnopharmacol. 2011;137(1):231-5.
Aims: Herbs, as food or medicine, can strengthen the body and increase its resistance to illnesses by acting on various components of the immune system. For example, Echinacea is noted for its ability to enhance immune function, primarily through activation of the innate immune responses. Here, we investigated the potential for two herbs commonly found in India, Ashwagandha (Withania somnifera) and Brahmi (Bacopa monnieri), to enhance immune function and compared their effects to that of Echinacea. Conclusion: Herbal remedies based on Echinacea, Brahmi, or Ashwagandha can enhance immune function by increasing immunoglobulin production. Furthermore, these herbal medicines might regulate antibody production by augmenting both Th1 and Th2 cytokine production.