Echinacea: nature's cold fighter

What is it?

Echinacea is a perennial plant that grows one to two feet in height and looks something like a Black-eyed Susan. Grown both commercially and in the wild, its flower, stem, and root are marketed in pill, liquid or powdered form. And it is gaining in popularity: in the United States alone, it is estimated to generate upwards of $300 million in sales per year.

History

Originally, echinacea was used by many Midwest Native Americans for a variety of medicinal purposes (including the treatment of infections and poisonous snakebites). As early as the 1880's, echinacea came into favor among American medical practitioners. Despite the fact that in 1910 the American Medical Association dismissed echinacea as worthless, it remained popular in the United States until penicillin and other anti-infection drugs were discovered.

In the 1930s, a German doctor, Gerhard Madaus, began researching the medicinal properties of echinacea. He discovered that it contained certain complex sugar molecules, known as polysaccharides, which stimulated the immune system. Dr. Madaus also developed a juice form of echinacea (derived from the plant's flower) that became (and remains) popular.

What does it do?

The claims regarding echinacea's medicinal uses are numerous. These include the treatment of coughs, colds, influenza, inflammation, toothaches and open wounds. At this point, most of these claims remain anecdotal. However, there is scientific evidence that echinacea is effective in helping people get rid of colds and flus more quickly and lessening the severity of the symptoms while the cold or flu lasts.

How it works

When you get a cold or flu, your immune system shifts into high gear. The immune system works by recognizing and then destroying foreign organisms in the body. This destruction is carried out by cells produced in the body's bone marrow, and then carried via the body's circulatory and lymphatic systems. Echinacea is beneficial in that it gives a quick boost to the immune system by:

• Stimulating phagocytosis, the process by which white blood cells and lymphocytes consume (and thus destroy) foreign organisms in the body
• Increasing the rate at which the immune system ejects foreign organisms from the body
• Increasing the number of cells working as part of the immune system
• Increasing the production of interferon, a major component of the body's immune system

Use and dosage

While echinacea has been scientifically shown to be effective in treating colds and influenza, there is not yet definitive proof that echinacea alone will prevent colds or the flu. In addition, there is evidence that long-term, uninterrupted use of echinacea can counteract its effectiveness by actually suppressing the immune system. Accordingly, it is recommended that echinacea should only be taken at the first sign of a cold or flu, in large doses (1,000-2,000 mg per day), and for short periods of time (three to five days).

If taken over a longer period of time as a possible preventive, it is generally recommended that it be taken in smaller doses (350-500 mg). Moreover, Erin Coffield, registered dietitian at Boston's Beth Israel Deaconess Medical Center, points out, "Echinacea should never be taken continuously for more than six to eight weeks at a time, and then, preferably only during cold season, since it can suppress the immune system over a long period of time." Generally either the pill or liquid form is recommended. Coffield suggests that you not take powdered echinacea, which you mix with water before taking, because it may not be as active as the pills or liquid.

Side effects

Other than the possible negative effect if taken too often, echinacea has been proven to be quite safe. Very limited side effects have been noted, and then generally only in a small number of people allergic to plants of the daisy or sunflower family, including artichokes. People allergic to those plant families should use echinacea with caution.

When echinacea should be avoided

Although echinacea is considered to be fairly safe for most people, there are some cases where echinacea should be avoided altogether. Recent studies have shown that echinacea can exacerbate a number of conditions, and therefore should not be taken under any circumstances by people who have:

• Tuberculosis
• Multiple sclerosis
• Colitis
• Diabetes mellitus
• Collagen disorders
• HIV and AIDS
• Any other autoimmune disease

Finally, it has also been suggested that women should avoid taking echinacea while pregnant.

Regulation of echinacea

Since echinacea is a natural growing compound, it is covered by the Dietary Supplement Health and Education Act (DSHEA) and is not regulated by the U.S. Food and Drug Administration (FDA). DSHEA mandates that the label of a dietary supplement must contain enough information about the composition of the product so that consumers can make informed choices. (The information must be presented in FDA-specified format). The manufacturer must make sure the label information is truthful and not misleading. The manufacturer is also responsible for making sure that all the dietary ingredients in the supplements are safe. Manufacturers and distributors do not need to register with the FDA or get FDA approval before producing or selling dietary supplements, nor is its use or effectiveness substantiated by the FDA.