The New Healing Herbs:

ECHINACEA
Major Immune Stimulant and Infection Fighter

Family: Compositae; other members include daisy, dandelion, marigold

Genus and species: Echinacea angustifolia, E. purpurea

Also known as: Purple coneflower

Parts used: Most often roots, but also leaves and flowers

Echinacea (pronounced eh-kin-AY-sha) has certainly had its ups and downs on its way to being one of the nation's bestselling herbal medicines. Since the 1870s, it has been reviled, then lionized, then forgotten, and finally resurrected. Today, it is THE herb for colds and flu, with many studies published in mainstream medical journals agreeing that it is a safe, effective immune stimulant that helps the body combat all manner of infections.

The Original "Snake Oil"

Echinacea is a tall, daisy-like flower native to the American Great Plains. It was the Plains Indians' primary medicine. They applied root poultices to wounds, insect bites and stings, and snakebites. They used echinacea mouthwash for painful teeth and gums and drank echinacea tea to treat colds, smallpox, measles, mumps, and arthritis.

Plains settlers adopted the plant, but it remained a folk remedy until 1870, when a patent-medicine purveyor, Dr. H. C. F. Meyer of Pawnee City, Nebraska, used it in his Meyer's Blood Purifier. He promoted the remedy as "an absolute cure" for rattlesnake bite, blood poisoning, and a host of other ills. Claims like Dr. Meyer's gave patent medicines the name "snake oil. "

But Dr. Meyer truly believed echinacea could cure rattlesnake bite, and he set out to prove it. In 1885, he sent a sample to John Uri Lloyd, professor at the Eclectic Medical Institute in Cincinnati, one of the first presidents of the American Pharmaceutical Association, and cofounder (with his brothers) of Lloyd Brothers Pharmacists, a prominent 19th-century drug company. Lloyd identified the plant as echinacea. But after one look at Dr. Meyer's label with its claim of "absolute cure" for rattlesnake bite, Lloyd dismissed Dr. Meyer as a crackpot.

Dr. Meyer wrote back insisting echinacea was, indeed, a cure for rattlesnake bite. He was so confident, he offered to bring a live rattlesnake to Cincinnati and let it bite him in Lloyd's presence to demonstrate his Blood Purifier's effectiveness. Lloyd declined the offer.

Undaunted, Dr. Meyer shipped some echinacea to Lloyd's Eclectic colleague, John King, who had mentioned the plant's Indian uses in the first edition of his Eclectic text, King's American Dispensatory. King tested the herb, and after successfully using it to treat bee stings, chronic nasal congestion, leg ulcers, and a variety of infections, he extolled the plant and included it in subsequent editions of his Dispensatory.

In Every Medicine Cabinet

Eventually, John Uri Lloyd accepted echinacea, declaring it useful in treating wounds, venomous bites and stings, blood poisoning (septicemia), diphtheria, meningitis, measles, chicken pox, malaria, scarlet fever, influenza, syphilis, and gangrene.

Lloyd's enthusiasm was not simply academic. His family business, Lloyd Brothers Pharmacists, developed several echinacea products, which enjoyed tremendous popularity nationally as infection treatments from the 1890s well into the 1920s. During the early 20th century it was a rare home medicine cabinet that didn't contain tincture of echinacea. (The Lloyd brothers also owned the New York Giants baseball team and founded the Lloyd Library in Cincinnati, which today houses one of the world's largest collections of botanical literature, and publishes the Journal of Natural Products, formerly Lloydia.)

Eclectics versus the "Regulars"

Unfortunately, echinacea became a casualty of the war between orthodox physicians (known prior to World War I as "regulars"), who favored the emerging laboratory-synthsized drugs, and the Eclectic physicians, who were more herbally inclined. Each side was hostile to the medicines touted by the other. In 1909, the following appeared in the Journal of the American Medical Association: "Echinacea ... has failed to sustain the reputation given it by its enthusiasts ... [who] make use of early unverified reports to endow their nostrums with remarkable therapeutic properties.”

By World War II, as modern antibiotics became available, echinacea's popularity waned. It was listed in the National Formulary, the pharmacists' reference, from 1916 until 1950, but from the 1940s on, it was largely forgotten--that is, until the herbal revival of the 1970s.

Contemporary herbalists are as enthusiastic about echinacea as the Eclectics were. They tout it as a botanical antibiotic and immune system stimulant for boils, colds and flu, bladder infections, tonsillitis, and other infectious diseases. Many recommend taking the herb daily as a tonic, infection preventive, and immune-system enhancer.

HEALING with Echinacea

Old Dr. Meyer would be tickled to learn how potent his favorite herb actually is. Echinacea has never been shown to cure rattlesnake bite, but from the 1950s through the 1980s, many studies--almost all of them German--showed that echinacea has remarkable immune-stimulating and infection-fighting properties. By the 1990s, American researchers were studying the herb and coming to the same conclusion.

IMMUNE STIMULANT. Echinacea helps treat infection by revving up the immune system. When disease-causing microorganisms attack, cells secrete chemicals that attract infection-fighting white blood, cells (macrophages) to the area. The macrophages (literally, "big eaters") engulf and digest the invaders. Echinacea boosts the macrophages' ability to destroy germs. The herb also energizes other important types of white blood cells, natural killer cells and T-lymphocytes, and increases secretion of interleukin 1, another component of the immune system.

Athletes who engage in ultra-strenuous exercise, for example, triathalons, often suffer immune suppression. German researchers gave 42 triathletes one of three daily treatments: a palcebo, a mineral supplement, or echinacea. A month later, shortly after a trathalon, the echinacea group showed the least immune suppression.

ANTIBIOTIC. In addition to its ability to stimulate the immune system, echinacea helps combat a broad range of disease-causing viruses, bacteria, fungi, and protozoa, which tends to support its traditional uses in wound healing and treatment of many infectious diseases. The herb fights infection in several ways. It contains a natural antibiotic, echinacoside, with broad-spectrum antimicrobial activity.

Echinacea also strengthens tissues against assault by invading microorganisms. Tissues contain a chemical (hyaluronic acid or HA) that in part acts as a shield against germ attack. Many germs produce an enzyme (hyaluronidase) that dissolves this chemical shield, allowing them to penetrate tissues and cause infection. But echinacea contains a substance (echinacein) that counteracts the germs' tissue-dissolving enzyme, keeping them out of the body's tissues.

In addition, echinacea mimics the body's own virus-fighting compound, interferon. Before a virus-infected cell dies, it releases a tiny amount of interferon, which boosts the ability of surrounding cells to resist infection. Echinacea appears to do the same thing. Researchers bathed cells in echinacea extract, then exposed them to two potent viruses, influenza and herpes. Compared with untreated cells, only a small proportion became infected.

German researchers report success using echinacea to treat tonsillitis, bronchitis, tuberculosis, meningitis, wounds, abscesses, whooping cough (pertussis), ear infections, and especially colds and flu.

COLDS AND FLU. By the late 1990s, more than a dozen studies had investigated echinacea as a cold treatment. Most showed significant benefit--shorter, milder colds. But enough showed no benefit to keep critics carping that echinacea offered more hype than substance.

Then, in a 1999 report published in the Journal of Family Practice, two mainstream M.D.s at the University of Wisconsin at Madison, along with a naturopathic physician at Bastyr University, the naturopathic medical school near Seattle, analyzed every published study of echinacea for both prevention and treatment for colds.

For treatment of upper respiratory infections, the researchers analyzed eight echinacea studies involving more than 1,000 participants. The trials were double-blind, meaning that some subjects received a placebo while the rest took echinacea. Those who used the herb took it in various preparations--tablets, capsules, juice, or tincture--and the preparations used all the immune-boosting parts of the plant: the root, leaves, and flowers.

All eight studies showed benefit. Six were statistically significant. Two were not, but they showed a clear trend in the direction of benefit. The reviewers' verdict: Echinacea is a solid winner as a treatment for colds and flu. In the eight studies, compared with untreated cold sufferers, the herb produced an average 50 percent reduction in symptom severity, and a similar reduction in the number of days the subjects felt ill. Commission E, the expert panel that judges the safety and effectiveness of herbal medicines for the German counterpart of the Food and Drug Administration, also endorses echiancea as a treatment for colds and flu.

Among the eight studies, this one was typical: In a large Swedish furniture factory, researchers identified 60 workers to be experiencing the initial stages of a cold. Half of these workers were given a placebo and half were given tincture of echinacea (20 drops in water every two hours for the first day, then three times a day for up to 10 days). In the placebo group, the average worker's recovery time was eight days. In the echinacea group, it was half that--just four days.

On the prevention side, the researchers analyzed four studies with a total of 1,152 participants. Again, the trials were double-blind, and used various preparations of all parts of the plant. None of these studies showed statistically significant preventive value. The reviewers discourage echinacea for prevention of colds and flu.

It should be noted that traditional herbalists have never recommended echinacea preventively, but only as a treatment for infectious illnesses.

The Wisconsin-Bastyr researchers concluded that echinacea treatment should begin as soon as you feel the first twinges of a cold or flu coming on. Take it several times a day, then taper off as you begin to feel better.

WOUND HEALING. Science has confirmed echinacea's traditional use in wound treatment. The same chemical (echinacein) that prevents germs from penetrating tissues also spurs broken skin to knit faster by spurring cells that form new tissue (fibroblasts) to work more efficiently.
Echinacea preparations can be applied to cuts, burns, psoriasis, eczema, genital herpes, and cold sores. Commission E supports the use of echinacea for wound treatment.

YEAST INFECTION. In a German study, 203 women with recurrent vaginal yeast infections were treated with either a standard pharmaceutical anti-yeast cream or the cream plus echinacea taken orally. After six months, 60 percent of the women treated with just the antifungal cream had experienced recurrences, but among those also treated with echinacea, the figure was only 16 percent, a highly significant difference.

CANCER CHEMOTHERAPY AND RADIATION. Cancer patients undergoing chemotherapy typically often suffer reduced white blood cell counts, increasing their risk of infection. German researchers gave 15 people with advanced esophageal and colorectal cancers chemotherapy plus echinacea and an extract of the thymus gland, a component of the immune system. Instead of falling, as would be expected, their white blood cell counts increased. Radiation treatments can also depress white blood cell counts, suggesting that echinacea may help. If you're taking cancer chemotherapy, or radiation, ask your medical and radiation oncologists about incorporating echinacea into your treatment plan.

INTRIGUING POSSIBILITY. Echinacea shows promising anti-cancer activity against leukemia and a few animal tumors. It's too early to call the herb a cancer treatment, but one day it might be.

Rx for Echinacea

Use either a tincture or decoction to take advantage of echinacea's infection-fighting potential or as a possible treatment for arthritis.

To make a decoction, bring 2 teaspoons of root material per cup of water to a boil, then simmer 15 minutes. Drink up to 3 cups a day. You'll find the taste initially sweet, then bitter.

In a tincture, take 1 teaspoon up to 3 times a day.

When using a commercial preparation, follow package directions.

Echinacea should not be given to children under age 2. For older children and people over 65, start with a lowstrength preparation and increase strength if necessary.

The Safety Factor

Echinacea often causes a tingling sensation on the tongue. This is normal and not harmful.

The FDA lists echinacea as an herb of "undefined safety." The evidence suggests it's safe, though allergic reactions are possible.

The only people who should not use echinacea are those with auto-immune conditions, for example, lupus. It's possible that stimulating the immune system might aggravate auto-immune diseases. People who are HIV positive should also exercise caution because the AIDS virus attacks the cells of the immune system, and stimulating them might also stimulate the virus.

For healthy adults who are not pregnant, not nursing, and who do not have auto-immune conditions or HIV infection, echinacea is considered safe in amounts typically recommended.

Echinacea should be used only in consultation with your doctor. If echinacea causes minor discomforts, such as stomach upset or diarrhea, use less or stop using it. Let your doctor know if you experience any unpleasant effects or if the symptoms for which the herb is being used do not improve significantly in two weeks.

Pretty Flowers

Echinacea is a 2- to 5-foot perennial whose flowers resemble black-eyed Susan, with purple rays radiating from a cone-shaped center-hence its common name, purple coneflower. Echinacea has black roots, a single stem covered with bristly hairs, and narrow leaves.

Echinacea grows from seeds or root cuttings taken in spring or fall. Don't cover seeds. When the temperature is in the 70s, simply tamp them into moist, sandy soil.

Echinacea grows in poor, rocky, slightly acidic soil under full sun, but it also thrives in richer soils.

It takes three or four years for roots to grow large enough to harvest. Pull them in autumn after the plant has gone to seed. Roots greater than 1/2 inch in diameter should be split before drying.