Articles written by me on Self-care and Palliative Medicine
On Self-Care & Palliative Medicine

Echinacea. . . “Gesundheit!”

“As a cure for the cold, take your toddy to bed, put one bowler hat at the foot, and drink until you see two.” Sir Robert Lockhart (1886–1970) British author and diplomat

Though a hot toddy has frequently been suggested as a home remedy for colds, alcohol can actually cause the nose to become more congested–though it will help to suppress a cough. However, Echinacea is an herbal remedy that is used widely and in fact has scientific support for its use. As our cold and flu season rapidly approaches, the time is right for a discussion of this very popular herb.

Echinacea (pronounced Eck-keh-NAY-sha), or coneflower, is a perennial member of the daisy family and is native to the central United States. It grows on a stout stem to a height of approximately three feet and is crowned by a beautiful purplish flower head. Nine species of Echinacea grow in the United States, though three: E. angustifolia, E. pallida, and E. purpurea are the species chiefly used for medicinal purposes.

Dr. H.C.F. Meyer, a Nebraska physician practicing in Pawnee City, is credited with introducing echinacea as a medicine in 1871. However, the Native American Indians had been using the plant for centuries to treat a variety of ailments, and Meyer had learned of echinacea’s benefits from them. Dr. Meyer used the herb in his “blood purifier” which was, indeed, a magical tonic with the potential to cure a host of illnesses–from colds to hemorrhoids. A Cincinnati pharmaceutical manufacturer introduced several echinacea products to the market in 1885, and by 1920, echinacea was the firm’s most popular plant drug. It’s popularity declined dramatically with the discovery of antibiotics, but echinacea continues to be used widely as an over-the-counter supplement in the United States and other countries as well.

An immune-stimulant effect is probably the best substantiated benefit of echinacea. Most of the scientific and clinical studies of the herb have been carried out in Germany (as is the case with a number of the medicinal herbs used today). For those of you who require big, scientific terms and explanations before you’ll believe anything, here goes. . . Three mechanisms: 1)stimulation of phagocytosis, 2)increased respiratory activity, and 3)increased mobility of leucocytes seem to be the mechanisms responsible for this stimulant effect. The important pharmacologic constituents of echinacea fall into 7 categories: polysaccharides, flavonoids, caffeic acid derivatives, essential oils, polyacetylenes, and alkylamides, with good ole ‘miscellaneous chemicals’ bringing up the rear. Now, I hope you’rehappy putting everybody else through that ponderous explanation!

On a more pragmatic note, the chief practical uses of echinacea seem to be in the prevention and treatment of the common cold (including the associated sore throat), decreasing symptoms and duration of some other upper respiratory infections, and as an external preparation in treating some wounds. Because it is an immune-stimulant, it is best to take echinacea for a specific period of time. . .generally no more than eight weeks at a time without a break. There seems to be a decrease in its efficacy if it is taken continuously. Of course, start it as soon as you can at the onset of cold symptoms– taking it three or four times/day for 7–14 days. It is available in tablet, powder, and liquid extracts. Apparently, for adults in whom alcohol consumption is not contraindicated, the alcohol-based extracts may be preferred, because of their high solubility and good shelf life. Fresh-pressed juice is the premiere preparation. . .but few of us have the luxury to obtain this form. Probably all three medicinal species of echinacea mentioned above have specific immune-boosting properties, so if you can find a preparation that contains all three, buy it. Beware of poor quality products! Check the manufacturing date and the ingredients in the preparation. Snake root (P. Integrifolium) and other fillers may be used in some preparations. Such ingredients are not harmful, but they add no beneficial qualities. Though no specific toxicities have been demonstrated in oral use of echinacea, avoidance during pregnancy and lactation seems prudent. Also, remember, if you have allergies to flowers in the daisy family–BEWARE

So, do I recommend Echinacea concentrate to my patients experiencing acute cold and upper respiratory viral illnesses? You bet your sweet purple coneflower I do! Taken at the first symptoms of a cold, it may shorten the duration by two to four days. Look for quality manufacturers and find a specific preparation that seems to work for you individually. These are the ‘cold facts’; I hope you’ll find them easy to swallow.

Stephen L. Hines, M.D.
September 2000

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