Echinacea


Echinacea

Nine species of rhizomatous perennials make up this genus, which is native to E USA. Coneflowers give a colorful display in the border from mid-summer to early autumn and are excellent for cutting. The generic name Echinaceae comes from the Greek echinos, "hedgehog", and refers to the prickly scales of the flowers' central cone. Echinaceae purpurea is one of several species, including E. angustifolia and E. pallida, used by native N Americans, mainly to treat wounds. In Particular, the Plains tribes regarded E. angustifolia as a cure-all. The three species have similar constituents and can be used interchangeably. Both E. angustifolia and E. pallida were listed in the U. S. National Formulary (1916-1950), and the former became important in homeopathy in Europe in the early 20th century. Cultivation of E. purpurea began in Europe when the seed of E. angustifolia was in short supply. The seed was imported in 1939 by the German herbal company Madaus, who pioneered research into this species. It proved and easire crop, hence its place as a market leader today. Echinaceae is considered the most effective detoxicant in Western medicine for the circulatory, lymphatic, and respiratory systems. The chemistry of Echinacea is complex, and there appears to be no single constituent responsible for the detoxifying, immune stimulating effects. Key constituents are: alkylamides, which are anti-bacterial, anti-fungul, immune-stimulating, and detoxifying and cause a tingling sensation on the tongue; echinosides, with anti-bacterial properties; polysaccharides, which are anti-inflammatory and stimulate the production of interferon (a protein that inhibits virus replication); inulin (as in Inula helenium, See, Japanese elecampane); flavonoids, which strengthen blood vessels and destroy free radicals; polyacetylenes, which are anti-bacterial and anti-fungal; caffeoyl derivatives that are strongly anti-oxidant, preventing skin photodamage; resins; and volatile oil. Echinacea products are standardized for echinosides and polysaccharides, though other constituents may be equally important in the overal effect.

Scientifically proven to have antibiotic effects, echinacea (also known as the purple coneflower) was used by Native Americans to treat snakebites and skin wounds. Today research has shown that echinacea stimulates the production of the infection-fighting white blood cells, has antiviral activity, and is helpful in easing allergies, making it an excellent immune system enhancer.

Also known as Coneflower and Missouri Snakeroot, the echinacea plant got its name frmo the Greek word echinos, or sea urchin, which looks like the plant's prickly center cone. Healing properties have been linked to echinacea since the Native Americans employed it for dressing wounds. Later, its medicinal virtues were reported in more thatn 400 scientific journal articles from the 1930s to the 1980s, when U.S. herbalists "rediscovered" the herb. It quickly became renowned for being able to stop a cold or flu in its tracks. Immune-stimulating agents in both the Echinacea purpurea and Echinacea augustifolia do help the body to produce interferons, which destroy bacteria and viruses before they can proliferate. Besides its internal, infection-fighting uses, it's used externally to treat wounds. Keep in mind, it's most effective when taken at the onset of symptoms.

Echinacea is comprised of the polysaccharides echinacoside and echinacin, which stimulate several reactions in the lymph and immune systems. First, there is an increased production of interferons, which help to protect cells from viral infections while preventing the viruses from reproducing. Next, the lymphocyte cells form antibodies against germs, often remaining effective against the foreign invaders for years. Finally, the macrophage cells destroy both viruses and bacteria by ingesting them.

Research as shown that the stimulation of the macrophages lasts only 10 days and that the maximum stimulation of the immune system takes place between days three and six of the treatment. Therefore it is important to take this herb as soon as you feel symptoms coming on.

Echinacea tea may be an effective addition to cancer treatments involving radiation and chemotherapy. The herb helps patients recover more quickly and stay healthier during their treatment. If you plan to use echinacea for this purpose consult your physician first.

Echinacea (purple coneflower) species are perennial herbs native to midwestern North America, from Saskatchewan to Texas. The genus derives its name from the Greek echinos (from the word for sea urchin). This refers to the prickly scales of the dried seed head portion of the flower.
Of the nine Echinacea species, E. angustifolia, E. purpurea, and E. pallida are the most commonly used. E. angustifolia, with a typical height of up to 2 feet, is shorter than E. purpurea (1.5 to 5 feet) and E. pallida (1 to 3 feet). Another key to species identification is that E. angustifolia and E. purpurea have yellow pollen whereas E. pallida is noticeably paler and has white polen. The portions of the plant used for medicinal purposes include the aerial portion, the whole plant including the root, and the root itself. The taproot of E. angustifolia can reach a length of 3 to 4 feet.
E. angustifolia has thick, hairy leaves 3 to 8 centimeters long, found at the base of a purple seed head shaped like a cone. The only exception in this family of "purple" coneflowers is E. paradoxa, which has a yellow flower

Tall, rhizomatous perennial with hairy, ovate-lanceolate leaves, to 15cm (6in) long. Purple-pink, honey-scented, daisy-like flowers, to 15cm (5in) across, with conical, orange-brown centers, are produced in summer and early autumn.


Common Name:
Echinacea
Other Names:
Black Sampson, Coneflower, Hedgehog, Missouri Snakeroot, Purple Coneflower
Botanical Name:
Echinacea purpurea
Genus:
Echinacea
Family:
Asteraceae
Native Location:
E USA
Cultivation:
Rich, deep, well-drained, neutral to alkaline soil (ideally sandy soil) in sun. Tolerates drought.
Propagation:
By seed sown when ripe at 20°C (68°F); by root cuttings in late autumn to early winter; by division in autumn or spring. Fresh seed germinates in 5-20 days. Seed sown in spring may need stratifying for 28 days. Sow in deep pots, rather than seed trays, to allow root development.
Harvest:
Roots and rhizomes are lifted in autumn and dried for use in decoctions, infusions, liquid extracts, powders, tablets, and tinctures.
Variations:
Leuchstern syn. Bright Star
Has deep magenta flower heads
Height: 80cm (32in)

Magnus
has large flower heads, to 18cm (7in) across, with deep purple ray petals.

Robert Bloom
Has vivid, magenta pink ray petals that open wide.

White Lustre
Has creamy white flower heads.
Height: 80cm (32in)

White Swan
Is a dwarf, with white-rayed flowers to 11cm (4¼in) across.
Height: 60cm (24in)
Height:
1.5m (5ft)
Width:
45cm (18in)
Hardiness:
Z3-10
Parts Used:
Leaf, roots, rhizomes, above ground parts, whole plant
Chemical Composition:
Analysis of Echinacea species has yielded an assortment of chemical constituents with pharmacological activities. The broad chemical composition of this medicinal plant suggests possible synergistic effects among it constituents. For example, in some experimental models, echinacea's water-soluble polysaccharides stimulate the cellular immune system more so than the fat-soluble components, which enhance macrophage phagocytosis.
The important constituents, from a pharmacological perspective, of echinacea can be divided into seven categories: (1) polysaccharides, (2) flavonoids, (3) caffeic acid derivatives, (4) essential oils, (5) polyacetylenes, (6) alkylamides, and (7) miscellaneous chemicals. These are discussed below.
Polysachharides
A number of immunostimulatory and mild anti-inflammatory polysaccharides have been isolated from Echinacea species. Most notable are inulin, found in high concentration (5.9 percent) in E. angustifolia root, and the high molecular weight (25,000-50,000) polysaccharides found in the aerial part of E. purpurea. These components possess significant immune-enhancing properties. The most potent immune-enhancing polysaccharides are the water-soluble, acidic, branched-chain heteroglycans, which are composed of many types of sugar rather than one type of sugar. (Inulin, on the other hand, consists of fructose units).
Flavonoids
The leaves and stems of E. angustifolia and E. purpurea contain numerous flavonoids, with rutoside being the most abundant. The total flavonoid content (calculated as quercetin) for E. angustifolia and E. purpurea is 0.48 and )0.38 percent respectively.
Caffeic Acid Deriviatives
Caffeic acid serves as the backbone for a number of important medicinal plant compouds in other plants as well as echinacea. The first compound beleived to be unique to echinacea was echinacoside, a compound eventually shown to be composed of caffeic acid, a caffeic acid derivative (similar to catechol), glucose, and rhamnose, all attached to a central glucose molecule. Echinacoside accumulates in the roots, but is also found in smaller concentrations in the flowers. According to recent investigations, the roots of E. angustifolia contain 0.3-1.3 percent while the roots of E. pallida contain a similar concentration of 0.4-1.7 percent. It is assumed that E. purpurea has similar echinacoside levels as well.
Other caffeic acid derivatives important in the pharmacology of echinacea include: cichoric acid, chlorogenic acide, and cynarin. Cichoric acid was originally isolated from E. purpurea and is found in much higher concentrations in this species compared to E. angustifolia and E. pallida. However, E angustifolia and E. pallida have greater amounts of other types of caffeic acid derivatives. These differences are not thought to have much clinical significance rather, they may prove to be valuable in quick chemical differentiation of species.
Essential Oils
The essential oil content varies amongh the three common species. E. angustifolia root and leaves ahve a content of less than 0.1 percent; E. purpurea root has 0.2 percent, and flowers and leaves 0.6 percent; and E. pallida root has up to 2. percent, while its leaves have less than 1 percent. Interestingly, in one study the essential oil content of E. pallida root was found to rise to 3.5-4 percent in April and May, only to fall to 1-1.5 percent for the rest of the year. The major essential oil components are sesquiterpene derivatives, borneol, alphapinine, and related aromatic compounds.
Polyacetylenes
A number of polyacetylenes have been identified in the roots of all three commercial species. The difference in the type of polyacetylene and susceptibility to breakdown may help differentiate between species.
Alkylamides
Alklyamides typically cause a tingling sensation on the tongue. This feature is representative of their mild anesthetic effect. These compounds are found in highest concentrations in the roots. The roots of E. angustifolia contain higher concentrations (0.009 percent) than E. purpurea (0.004 percent) and E. pallida (0.001 percent).
Miscellaneous Chemicals
Other constituents undoubtedly contribute to the pharmacology of echinacea. The occurence of a "colorless alkaloid" was first reported by the great John Uri Lloyd in 1897 and substantiated recently by the isolation of the alkaloids tussilagine and Isotussilagine. Other compounds isolated from Echinacea species include resins, glycoproteins, sterols, minerals, and fatty acids.
History and Folk Use:
Native Americans used echinacea extensively. In fact, American Indians used enchinacea more than any other plant in the treatment of illness and injury. The root was used externally for the healing of wounds, burns, abscesses, and insect bites; internally for infections, toothache, and joint pains; and as an antidote for snake (rattlesnake) bites.
A commercial product containing echinacea was introduced to Americans around 1870 by H.C.F. Meyer, a German lay healer who recommended it as a wonder cure called "Meyer's blood purifier". Meyer recommended it for almost every conceivable malady and there were numerous case reports of successful treatments for snake bites, typhus, diphtheria, and other infections.
E. angustifolia became a favorite with Eclectic physicians, as it was thought to be greater in activity than other Echinacea species. Eclectics used it externally as a local antiseptic, stimulant, deodorant, and anesthetic; and internally for "bad blood", that is, to correct "fluid depravation with tendency to sepsis and malignancy".
Although many physicians began to investigate and use echinacea as a serious medicine, in 1909 the Council on Pharmacy and Chemistry of the American Medical Association refused to recognize echinacea as an active drug, stating, "in view of the lack of any scientific scrutiny of the claims made for it, Echinacea is deemed unworthy of further consideration until more reliable evidence is presented in its favor." Despite this opposition, echinacea was included in the National Formulary of the United States and remained there until 1950.
With the demise of the Eclectic movement, the popularity of echinacea in the United States waned except among naturopathic physicians. Around 1980 echinacea was "rediscovered", owing to increased consumer interest in immune system disorders sucha as candidiasis, chronic fatigue syndrome, acquired immunodeficiency syndrome (AIDS), and cancer. Although interest in echinacea had decreased in America between the 1930s and 1980s, European physicians continued research. Much of this research was initiated by a 1932 study by Gerhard Madaus. Madaus demonstrated the immune-enhancing effects of a preparation made from the fresh juice of the aerial portion of E. purpurea. This was followd by the development of a commercial product and a great deal of scientific study. Thus, E. purpurea began to be as respected as E. angustifolia among herbal practitioners in Europe.
Pharmacology:
The chemistry, pharmacology, and clinical application of echinacea have been the subject of over 350 studies. The overwhelming majority of the clinical studies have utilized an extract of the juice of the aerial (above-ground) portion of E. purpurea along with 22 percent ethanol (for preservation).
The following subsections summarize some of the vast phamacological information on echinacea, with particular attention given to the species used, part of the plant used, solvent used for extraction, and other relevant features. When no species delineation is made, the activity described is similar to all species.
Tissue Regeneration and Anti-inflammatory Properties
The fresh-pressed juice of E. purpurea, as well as the polysaccharide components of all Echinacea species, promote tissue regeneration and reduce inflammation in experimental studies. This is apparently largely due to inhibition of the enzyme hyaluronidase. Hyaluronidase is referred to as "spreading factor". It is secreted by microorganisms and is found in snake venom; its purpose is to break down hyaluronic acid, a major component of the ground substance (intracellular cement) that holds body cells together. Echinacea maintains the structure and integrity of the connective tissue and ground substance.
In addition to increased hyaluronic acid stabilization, echinacea also stimulates cells (fibroblasts) that manufacture ground substance.
Echinacea exerts a mild, direct, cortisone-like effect and enhances the secretion of adrenal cortex hormones. Echinacea's polysaccharide portion appears to be responsible for the direct anti-inflammatory effects, although the alkylaminde fraction has also demonstrated some activity.
Immunostimulatory Properties
Echinacea contains a diverse range of active components affecting different aspects of immune function. To fully appreciate echinacea's effect, you must understand some aspects of the immune system.
The immune system is perhaps one of the most complex and fascinating systems of the human body. The immune system's prime function is to protect the body against infection and the development of cancer. The immune system is composed of the lymphatic vessels and organs (thymus, spleen, tonsils, and lymph nodes), white blood cells (lymphocytes, neutrophils, basophils, eosinophils, monocytes, etc.), specialized cells residing in various tissue (macrophages, mast cells, etc.), and specialized chemical factors such as complement, interferon, and interleukin.
Effect of Echinacea on the Alternate Complement Pathway
Echinacea exerts many "nonspecific" effects on the immune system. For example, inulin, the major component in the root of echinacea, activates a part of the immune system known as the alternate complement pathway. As a result, the movement of white blood cells into areas of infection is enhanced; immune complexes solubilize; and bacteria, viruses, and other microorganisms are destroyed. Echinacea also increases the levels of properdin, a serum protein that stimulates the alternate complement pathway.
Effect ofn White Blood Cells
Echinacea elevates serum white blood cells counts when they are low. In addition, studies have shown that echinacea polysaccharides bind to receptors on the surface of white blood cells and literally turn these cells on. The white blood cells most sensitive to echinacea are T lymphocytes, macrophages, and natural killer cells.
Effect on T Lymphocytes
T lymphocytes, or T cells, are a type of white blood cell responsible for "cell-mediated immunity". Cell-mediated immunity referes to immune mechanisms not controlled or mediated by antibodies. Cell-mediated immunity is extremely important in providing resistance to infection by moldlike bacteria, yeast (including, Candida albicans), fungi, parasites, and viruses (including herpes-simplex, Epstein-Barr virus, and viruses that cause hepatitis). If you are suffering from an infection by these organisms, it's a good indication that your cell-immunity is not functioning up to par. Cell-mediated immunity is also critical in protecting against the development of cancer, autoimmune disorders such as rheumatoid arthritis, and allergies. Not surprisingly, echinacea has been used to treat all of these conditions.
Echinacea promotes nonspecific T cell activation. When echinacea polysaccharides bind to the surface of T cells, the T cells increase their production of interferon and other immune potentiators. The result is enhanced T cell replication, macrophage activity, antibody binding and increased numbers of circulating neutrophils. Neutrophils are another type of white blood cell. Neutrophils actively phagocytize—that is, engulf and destroy—bacteria, tumor cells, and dead particulate matter. Neutrophils are especially important in preventing bacterial infection. The nonspecific T cell activation by echinacea also increases the activity of another type of white blood cell—natural killer cells. They are called "natural killer cells" because they destroy cells that have become cancerous or infected with viruses. They are the body's first line of defense against cancer development.
The level or activity of natural killer cells in chronic fatigue syndrome is usually low.
Effect on Macrophages
Macrophages are blood monocytes that have taken up residence in specific tissues such as the liver, spleen, and lymph nodes. From here these large cells filter the lymphatic fluid (of lymph), engulfing (of phagocytizing) foreign particles including bacteria and cellular debris. Macrophages and monocytes are, in essence, the garbage collectors of the body. Macrophages protect the body against invasion by microorganisms, as well as prevent damage to the lymphatic system.
Echinacea polysachharides have also been shown to enhance macrophage phagocytosis and stimulate macrophages to produce a number of immune-potentiating compounds (e.g., tumor necrosis factor [TNF], interferon, and interleukin 1). Furthermore, macrophages have been shown to destroy tumor cells in tissue culter and inhibit Candida albicans infection in rats infected intravenously with a lethal dose (30,000 cells) or Candida albicans. The interactions with macrophages are most likely responsible for much of the immune system enhancement of echinacea polysaccharides.
In addition to the polysaccharides, fat-soluble alkylamides and caffeic acid derivatives such as cichoric acid are thought to contribute to the immunostimulatory aspects of echinacea, especially alcoholic extracts. Although most research has been devote to the water-soluble components (i.e., the polysaccharides), the fat-soluble fraction enhances macrophage phagocytosis most potently.
The carbon clearance test is often used to measure systemic macrophage activation. The method involves measuring, at timed intervals, the rate of disappearance of carbon granules from the blood following administration of a test substance. Root extracts of echinacea administered orally exert greater effects on phagocytic activity than does the aerial portion, with Echinacea purpurea > E. angustifolia > E. pallida.
Antiviral Properties
The fresh-pressed juice of the aerial portion of E. purpurea, along with alcoholic and aqueous extracts of the roots, possess antiviral activity. Some viruses inhibited in cell culture include influenza, herpes virus, and vesicular stomatitis virus.
Although certain echinacea components (e.g., echinacoside, other caffeic acid derivatives, and polysaccharides) may block virus receptors on the cell surface, the antiviral effects may also be due to inhibition of hyaluronidase, as virus-inhibiting action of echinacea is significantly diminished when hyaluronidase is added to the cell cultures. Remember, many organisms secrete the enzyme hylauronidase (the spreading factor), which increases connective tissue permeabiliyt and allows the organism to become invasive.
From a clinical perspective, echinacea's inhibition of hyaluronidase coupled with its general immunostimulatory properties are probably more important than its direct antiviral activity. Echinacea's nonspecific antiviral action works by enhancing cytotoxic killing of virus-infected cells and the release of interferon. Interferons bind to cell surfaces, where it stimulates synthesis of intracellular proteins that block the transcription of viral RNA.
Antibacterial Properties
The direct antibacterial activity of echinacea is quite mild. This is somewhat surprising, as echinacea has a long history of effective use in both internal and external bacterial infections. It is possible that it possesses some anti-infective properties that prevent bacterial adherence, although this has yet to be determined. Clearly, its clinical efficacy is due to its strong immune-potentiating actions.
Echinacea does possess some mild antibacterial action due largely to echinacoside, the complex caffeic acid derivative, found in highest concentrations in the root of E. angustifolia. Echinacoside and caffeic acid inhibit the growth of Staphylococcus aureus, Corynebacterium diphtheria, and Proteus vulgaris. Approximately 6.3 milligrams of echinacoside is equivalent to 10 Oxford units of penicillin.
Anticancer Activity
Echinacea obviously possesses indirect anticancer activity via its general immuneoenhancing effects. Particularly important is its stimulation of macrophages to greater cytotoxic activity against tumor cells. (Z)-1,8-pentadecadiene, a lipid-soluble component found in the root of E. angustifolia and E. pallida, possesses, in vivo significant direct anticancer activity.
Properties:
A bitter, slightly aromatic, alterative herb that stimulates the immune system, promotes healing, and has anti-viral and anti-bacterial effects.
Clinical Application:
Echinacea has long been used, with proven efficacy, to treat infections. Although injectable preparations are common, oral preparations are generally thought to yield similar or even better results.
An exception to echinacea's general effectivness in the treatment of infections may be the acquired immunodeficiency syndrome (AIDS). It is unclear at this time if echinacea should be recommended for AIDS treatment. Although this condition is associated with widespread depression of the immune system (presumably owing to the actions of human immunodeficiency virus, HIV), stimulation of T cell replication as well as increasing levels of tumor necrosis factor (TNF) may also stimulate replication of the virus. While there are some anecdotal reports of echinacea's efficacy in HIV infected individuals, more research is necessary to determine echinacea's effects in HIV.
Infections
Numerous clinical studies comfirm echinacea's immune-enhancing actions. Various echinacea extracts or products have shown results in general infections, urogenital infections, and other infectious conditions.
The effect against Candida albicans noted in animal studies has been firmed in several clinical studies. A study by Coeugniet and Kuhnast, demonstrated that the fress-pressed juice of E. purpurea greatly accentuates the efficacy of a topical antimycotic agent (econazole nitrate), decreasing recurrence from 60.5 to 5-16.7 percent. They used standardized skin tests to show that this enhancement was due to echinacea's boosting of cell-mediated immunity. Note the oral and injectable forms produced similar results.
The Common Cold
One of the most popular uses of echinacea is in the treatment of the common cold. Two recent studies offer considerable support for this clinical application. In one study, 180 patients with influenza were given either an extract of E. purpurea root at a daily dose of 450-900 milligrams, or a placebo. The 450-milligram dose was found to be no more effective than a placebo; however the group taking 900 milligrams showed significant reduction of cold symptoms.
In the other study, 108 patients with colds received either an extract of the fresh-pressed juice of E. purpurea (4 milliliters twice daily) or placebo for 8 weeks. The number of patients remaining healthy: echinacea, 35.2 percent; placebo, 25.9 percent. Length of time between infections: echinacea, 40 days; placebo 25 days. When infections did occur in patients receiving echinacea, they were less severe and resolved more quickly. Patients showeing evidence of a weakened immune system (CD4/CD8 ratio, <1.5) benefited most from echinacea.
Snake Bite
Echinacea has quite a reputation among naturopathic physicians and Native American healers for the treatment of snakebite. Echinacea's inhibition of hyaluronidase, a component of snake venom, might account for much of its reputed efficacy; most snake venoms permeate the body by way of hyaluronidase, which breaks down connective tissue in the ground substance between cells.
Wound Healing
Several uncontrolled clinical studies substantiate echinacea's wound healing activities. The largest (4,598 patients) demonstrated that a salve of the juice of the aerial portion of E. purpurea had an 85 percent overall success rate in the treatment of inflammatory skin conditions such as abscesses, foliculitis, wounds of all kinds, eczema, burns, herpes, and varicose ulcers of the leg.
Arthritis
Echinacea's anti-inflammatory activity helps alleviate rheumatoid arthritis: in an uncontrolled study performed by Seidel and Knobloch, 15 drops of the fresh-pressed juice of E. purpurea three times daily resulted in a 21.8 percent decrease in inflammation. Although this improvement was less than that of cortisone (42 percent) and prednisone (49.2 percent), no side effects were noted with the echinacea—whereas cortisone and prednisone have well-known side effects.
Cancer
One of the detrimental effects of radiation and chemotherapy in cancer treatment is that they depress white blood cell levels. Echinacea may offset this depression. Several studies have noted the stimulatory effects of echinacea on white blood cell counts in patients receiving radiation for cancery therapy. A study using the fresh-pressed juice of E. purpurea demonstrated that 85 percent of fifty-five patients showed a stabilization of white blood cell counts compared to the control group, which showed a steady decline in levels (starting value of 6,000 down to 2,500 after 45 days). This strongly supports the use of echinacea by patients undergoing orthodox cancer treatment.
Medicinal Uses:
Internally for skin diseases, fungal infections, septicemia, boils, abscesses, slow-healing wounds, chronic infections, chronic fatigue syndrome (CFS), venereal diseases, and early stages of coughs and colds; excess causes throat irritation. Externally for herpes, acne, psoriasis, and infected injuries, also as a gargle for sore throat, and to prevent premature aging and UV damage to skin. Often combined with Arctium lappa (See, burdock) for boils with Baptisia tinctoria (See, wild indigo) or Commiphora myrrha (See, myrrh) for throat infections, and with Hypericum perforatum (See, St. John's wort) for herpes.
To treat colds, infections, wounds, and leg ulcers; to stimulate the immune system. Germany's Commission E has approved the use of Echinacea purpurea to treat the common cold, cough, bronchitis, fevers, wounds, burns, infections of the urinary tract, and inflammation of the mouth and throat, and to reduce the risk of infection in susceptible people. It has also approved the use of Echinacea pallida to treat colds and fevers.
Typical Dose:
A typical daily dose of echinacea (either purpurea or pallida) is 500 to 1,000 mg in capsule form taken three times a day.
The following recommendations are for the use of echinacea as a general immune stimulant during infection. Doses should be given three times daily:
  • Dried root (or as tea): 1-2 grams
  • Freeze-dried plant: 325-650 milligrams
  • Juice of Aerial portion of E. purpurea stabilized in 22 percent ethanol (preferably standardized to contain a minimum of 2.4 percent beta-1,2-fructofuranosides): 2-3 ml (1/2 to 3/4 teaspoon).
  • Tincture (1:5): 3-4 milliliters (3/4 to 1 teaspoon)
  • Fluid Extract (1:1): 1-2 milliliters (1/4 to 1/2 teaspoon)
  • Solid (Dry powdered) extract (6.5:1 or 3.5 percent echinacoside): 300 milligrams

Whether echinacea should be used on a long-term or continual basis really depends on your need. If you are a healthy individual with no apparent depression of the immune system, continual administration is certainly not indicated. However, as recent studies have shown in patients with immune repaired function, long-term administration can provide long-term benefit. The usual recommendation for long-term use is 8 weeks on followed by 1 week off.
Commercial Preparations:
It should be clear by now that it's not easy to decide which echinacea preparation is best to use. Not only is it difficult to determine which species is most effective—the portion of the plant used and how it is prepared are also serious questions for debate. Dosage recommendations for all currently available forms are given below, along with a few observations regarding the "preparations controversy".
Another problem that needs to be addressed is quality control. Since 1904, many commercial sources of echinacea have contained adulterants and no echinacea. For example, it has been estimated that, owing to supplier errors in collection, more than 50 percent (and possibly as much as 90 percent at times) of the echinacea sold in the United States from 1908 through 1991 has actually been Parthenium integrifolium (Missouri Snakeroot). Some suggest this alteration is due to confusion of the common names. Others point out that while Parthenium integrifolium looks quite different "... once the root is cut and sifted it has an uncanny resemblence to E. angustifolia or E. pallida roots, though it possess its own characteristic flavor and fragrance". From a practical as well as clinical viewpoint, consumers, retailers, pharmacists, and physicians should require that suppliers adequately document their product: we should be assured that we are in fact buying echinacea, and be told what species it is.
The Best Species
No "best" Echinacea species can be recommended at this time, as different experimental models have at times yielded inconsistent results. Rather, the clinician must recognize the unique value of each species. Although E. angustifolia has long been considered the best species and to possess the greatest activity, some studies dispute this. For example, in one study E. purpurea demonstrated greater enhancement of phagocytosis. In fact, in a recent study an aqueous extract of E. angustifolia did not demonstrate any impact of phagocytic function in rats, whether it was administered orally, intraperitoneally, or intravenously. As E. purpurea is the easiest to grow commercially, it may become the most utilized in the United States as it is in Europe.
The Part of the Plant to Use
Most laboratory studies report that the root possesses the greatest immuno-enhancing properties. However, most of the data in these studies is based on the use of fresh-pressed juice from the aerial portion of E. purpurea. Therefore, this question cannot be fully answered until more clinical research is done with root preparations.
The Best Solvents
Even a small amount of ethanol results in precipitation or breakdown of the immunoactive polysaccharides, indicating aqueous extracts may be best. However, and aqueous extract leaves behind valuable fat-soluble immuno-enhancing alkylamides and caffeic acid derivatives. To optomize an extract's immune-enhancing effects, many manufacturers use low ethanol (10-20 percent) hydro/alcoholic mixtures. These extracts typically possess both water and fat-soluble compounds.
The Best Preparations
Echinacea products are available in many different forms: crude plant in either ground or powdered form, freeze-dried, alcohol-based tinctures and liquid extracts, aqueous tinctures and liquid extracts, and dry powdered alcoholic or aqueous extracts. Although there is no consensus, many experts consider the fresh-pressed juice of E. purpurea to be the best preparation because it provides the greatest range of active compounds and has by far the greatest level of clinical support.
Some standardized preparations of the fresh-pressed juice of Echinacea purpurea are guaranteed to contain a minimum 2.4 percent beta-1, 2-fructofuranides. Standardizing the product for these compounds guarantees that the plant was harvested in the blossom stage, the product was carefully prepared and suffered no enzymatic or microbiological degradation, and the product is stabilized.
Uses and Blends:
Preparation of the Tea:
Pour 1 cup of boiling water over 1 tsp. of thoroughly chopped roots, steep for 10 min. and then strain. Slowly drink 2-3 cups daily as hot as possible between meals. The bitter tasting tea can be sweetened with honey, if desired. Echinacea tea bags are available in stores, but the freshly dug roots have a much more potent effect than the dried plant.
For Colds, Flu, and Sore Throats:
For fighting off colds and flu as well as for treating their symptoms, such as a sore throat: Make echinacea tea and drink 2-3 cups daily for 5 days. For the prevention of colds and flu before the flu season starts, follow the same directions for a 3 week regimen: Drink 2-3 cups daily for 5 days, refrain for 2 days and then repeat.
For wounds, Hives and Boils:
For slow healing or infected wounds, hives, shingles, boils and insect bites or for such skin ailments as psoriasis or eczema, make a strong echinacea tea: Pour 1 cup of boiling water over 1 tbsp. of dried herb, steep for 10 min., strain and cool. Soak a cloth in the tea, apply it to the wound and change it ever 2-3 hr. To increase the medicinal effect of the herb, drink 1-2 cups of tea daily for 10 days, as well.
For Urinary Tract Infections:
For urinary tract infections: Make the tea and drink 2-3 cups daily until your symptoms abate. For the prevention of urinary tract infections, drink echinacea tea daily over a period of 3 weeks. To avoid overusing the herb (thereby decreasing its effects), drink 2-3 cups daily for 5 days, refrain for 2 daya and then repeat.
For Acne and Blemished Skin:
1 1/2 oz. Echinacea Root and Leaves
3/4 oz. Thyme Herb
3/4 oz. Calendula Flowers
3/4 oz. Veronica Herb
Prepare this tea to treat acne and skin blemishes. These medicinal plants have antibacterial properties, stimulate the immune system and purify the blood.
For Influenza Infections With Fever:
1 1/2 oz. Echinacea Root
3/4 oz. Peppermint Leaves
3/4 oz. Centaury Leaves
3/4 oz. Meadowsweet Leaves
Make this tea to reduce fever and relieve the aches and pains associated with influenza infections. Sweeten with honey, if desired.
For Chronic Urinary Tract Infections:
1 1/2 oz. Echinacea Root and Leaves
3/4 oz. Uva-Ursi Leaves
3/4 oz. Goldenrod Leaves and Herbs
3/4 oz. Horsetail Herb
1/2 oz. Marsh Mallow Root
Make this tea, and drink 2 cups daily for 3 weeks after symptoms have abated to destroy germs and strengthen immunity.
Possible Side Effects:
Echinacea's side effects include allergic reactions, nausea, vomiting, fever, heartburn, and constipation.
Drug Interactions:
Taking Echinacea with these drugs may cause or increase liver damage:
Abacavir, (Ziagen)
Acarbose, (Prandase, Precose)
Acetominophen, (Genepap, Tylenol)
Allopurinol, (Aloprim, Zyloprim)
Atorvastatin, (Lipitor)
Celecoxib, (Celebrex)
Cidofovir, (Vistide)
Ciprofloxacin, (Cipro, Ciloxan)
Colchicine, (Ratio-Colchicine)
Cyclosporine, (Neoral, Sandimmune)
Diazepam, (Apo-Diazepam, Valium)
Docetaxel, (Taxotere)
Dofetilide, (Tikosyn)
Doxycycline, (Apo-Doxy, Vibramycin)
Erythromycin, (Erythrocin, Staticin)
Famotidine, (Apo-Famotidine, Pepcid)
Fluconazole, (Apo-Fluconazole, Diflucan)
Fluphenazine, (Modecate, Prolixin)
Fluvastatin, (Lescol)
Foscarnet, (Foscavir)
Fosphenytoin, (Cerebyx)
Ganciclovir, (Cytovene, Vitrasert)
Gemfibrozil, (Apo-Gemfibrozil, Lopid)
Gentamicin, (Alcomicin, Gentacidin)
Glipizide, (Glucotrol)
Glyburide, (DiaBeta, Micronase)
Ibuprofen, (Advil, Motrin)
Indinavir, (Crixivan)
Ketoconazole, (Apo-Ketoconazole, Nizoral)
Ketoprofen, (Orudis, Rhodis)
Ketorolac, (Acular, Toradol)
Lamivudine, (Epivir, Heptovir)
Levodopa-Carbidopa, (Nu-Levocarb, Sinemet)
Lovastatin, (Altocor, Mevacor)
Meloxicam, (MOBIC, Mobicox)
Methotrexate, (Rheumatrex, Trexall)
Methyldopa, (Apo-Methyldopa, Nu-Medopa)
Methylprednisolone, (Depo-Medrol, Medrol)
Moxifloxacin, (Avelox, Vigamox)
Naproxen, (Aleve, Naprosyn)
Nelfinavir, (Viracept)
Nitrofurantoin, (Furadantin, Macrobid)
Ofloxacin, (Floxin, Ocuflox)
Ondansetron, (Zofran)
Paclitaxel, (Onxol, Taxol)
Pantoprazole, (Pantoloc, Protonix)
Phenytoin, (Dilantin, Phenytek)
Piroxicam, (Feldene, Nu-Pirox)
Pravastatin, (Novo-Pravastatin, Pravachol)
Prochlorperazine, (Compazine, Compro)
Rifampin, (Rifadin, Rimactane)
Rifapentine, (Priftin)
Ritonavir, (Norvir)
Saquinavir, (Fortovase, Invirase)
Simvastatin, (Apo-Simvastatin, Zocor)
Stavudine, (Zerit)
Tamoxifen, (Nolvadex, Tamofen)
Temazepam, (Novo-Temazepam, Restoril)
Tetracycline, (Novo-Tetra, Sumycin)
Triazolam, (Apo-Triazo, Halcion)
Zidovudine, (Novo-AZT, Retrovir)
Taking Echinacea with these drugs may worsen HIV or AIDS:
Abacavir, (Ziagen)
Acyclovir, (Alti-Acyclovir, Zovirax)
Allopurinol, (Aloprim, Zyloprim)
Amprenavir, (Agenerase)
Cidofovir, (Vistide)
Famciclovir, (Famvir)
Ganciclovir, (Cytovene, Vitrasert)
Indinavir, (Crixivan)
Nelfinavir, (Viracept)
Rifabutin, (Mycobutin)
Ritonavir, (Norvir)
Saquinavir, (Fortovase, Invirase)
Valganciclovir, (Valcyte)
Zidovudine, (Novo-AZT, Retrovir)
Taking Echinacea with these drugs may interfere with the action of the drug:
Antithymocyte Globulin, Equine, (Atgam)
Antithymocyte Globulin, Rabbit, (Thymoglobulin)
Azathioprine, (Imuran)
Basiliximab, (Simulect)
Betamethasone, (Betatrex, Maxivate)
Cyclosporine, (Neoral, Sandimmune)
Daclizumab, (Zenapax)
Dexamethasone, (Decadron, Dexasone)
Efalizumab, (Raptiva)
Hydrocortisone, (Cetacort, Locoid)
Methotrexate, (Rheumatrex, Trexall)
Methylprednisolone, (Depo-Medrol, Medrol)
Muromonab-CD3, (Orthoclone OKT 3)
Mycophenolate, (CellCept)
Pimecrolimus, (Elidel)
Prednisolone, (Inflamase Forte, Pred Forte)
Prednisone, (Apo-Prednisone, Deltasone)
Sirolimus, (Rapamune)
Tacrolimus, (Prograf, Protopic)
Thalidomide, (Thalomid)
Triamcinolone, (Aristocort, Trinasal)
Taking Echinacea with these drugs may worsen tuberculosis:
Doxycycline, (Apo-Doxy, Vibramycin)
Isoniazid, (Isotamine, Nydrazid)
Tetracycline, (Novo-Tetra, Sumycin)
Taking Echinacea with these drugs may be harmful:
Etodolac, (Lodine, Utradol)—may cause or increase gastrointestinal irritation.
Lab Test Alterations:
  • May increase alanine aminotransferase (ALT), aspartate aminotransferase (AST), lymphocyte counts, serum immunoglobulin E (IgE), and blood erythocyte sedimentation rate (ESR).
  • May interfere with sperm enzyme activity, when echinacea is taken in high doses.
Disease Effects:
May trigger allergic reactions in those who typically do not show allergic responses to skin testing.
Toxicity:
Echinacea is not toxic when used at the recommended doses; no studies report acute or chronic toxicity reactions due to echinacea. The fresh-pressed juice of E. purpurea, given intravenously, has caused fever (a 0.5 to 1 degree C elevation in body temperature) on occasion. This reaction its presumably a result of secretion of interferon and interleukin 1 by activated macrophages.
The LD50 (50 percent lethal dose) of intravenously administered fresh-pressed juice of E. purpurea has been determined to be 50 milliliters per kilogram body weight in mice and rats. The polysaccharides in E. purpurea (aerial portions) have an LD50 of 1,000-2,500 milligrams per kilogram when given peritoneally to mice. Chronic administration of the fresh-pressed juice of E purpurea to rats at doses many times the human therapeutic dose gave no evidence of any toxic effects. Mutagenic tests with the fresh-pressed juice of E purpurea demonstrated no mutagenic activity.
Bibliography:
Encyclopedia of Herbs by Deni Brown Copyright © 1995, 2001 Dorling Kindersley Limited Pp 199-200
The Essential Herb-Drug-Vitamin Interaction Guide by Geo. T. Grossberg,MD and Barry Fox,PhD Copyright©2007 Barry Fox,PhD. Pp.192-194
The Complete Guide to Natural Healing Copyright©:1999 International Masters Publishers,AB Group 2 Card 53 Therapeutic Teas.
The Healing Power of Herbs by Michael T. Murray ND Copyright©:1995 Michael T. Murray. pp.92-105