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Echinacea

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Echinacea Dosage
Many clinical studies suggest that Echinacea is most effective when used at the first sign of infection, when symptoms first become apparent. Taking repeated small doses throughout the day may be better than taking larger, less frequent doses. The German Commission E Monographs recommends that continuous use of Echinacea be limited to no longer than eight weeks.

Pressed juice: 6 to 9 ml Echinacea a day in divided doses
Tincture: 15 to 20 drops of Echinacea two to five times a day
Capsules: 500 to 1000 mg of Echinacea three times a day.

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Scientific Support for Echinacea
More than 350 scientific studies document the clinical applications, pharmacology, and chemistry of Echinacea. The most consistently proven effect of the herb is in stimulating phagocytosis, an important function of the immune system. This means that Echinacea enhances the activity of the immune system by encouraging white blood cells and other immune cells to attack and destroy invading organisms. Echinacea's stimulation of immune function has been demonstrated both in laboratory studies and in human subjects.^1,2,3

Most of the research on Echinacea has been carried out in Germany. Clinical studies have shown that when taken at the first sign of infection, Echinacea shortens the duration of cold and flu symptoms and lessens the likelihood that a minor infection will develop into a full-blown cold. Other clinical studies support Echinacea's traditional reputation for effectiveness in the treatment of wounds and other skin problems. In a large, uncontrolled clinical study in 4,598 patients, an Echinacea ointment was 85 percent effective in treating wounds, inflammatory skin conditions, eczema, leg ulcers, burns, and herpes simplex infections.⁴ Another study suggests that Echinacea may be useful in the treatment of recurrent vaginal yeast infections.⁵ A number of compounds in Echinacea have shown an ability to protect collagen against the effects of free radicals, suggesting that Echinacea may have value in defending skin against sun damage.⁶ Echinacea given by injection has shown some promise in the supportive treatment of colorectal and liver cancers.

Not all Echinacea research has yielded positive results. In some studies, Echinacea failed to demonstrate a protective effect against upper respiratory tract infections in study participants. For example, in one American study designed to test the effectiveness of Echinacea in preventing respiratory tract infection, Echinacea purpurea and Echinacea angustifolia root extracts were not significantly more protective than placebo. The 302 study participants took placebo, Echinacea purpurea or Echinacea angustifolia continuously for a period of 12 weeks. The dosage used was 50 drops Echinacea taken twice daily. The investigators noted when participants contracted respiratory tract infections, how many infections occurred, and how many participants had side effects. The researchers observed no significant differences between any of the groups. Nonetheless, subjects in the Echinacea groups felt that they derived more benefit from their treatment than those in the placebo group.⁷

One difference between this study and other, more positive studies was the manner in which Echinacea was used. In the negative study, healthy subjects took Echinacea continuously, as a preventive remedy. In other studies, in which Echinacea demonstrated positive results in shortening the duration of colds and flu, subjects were instructed to take Echinacea at the first sign of infection. This use is more consistent with the way in which Echinacea has been used traditionally in the treatment of infections.

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References

1. Jurcic K, Melchart D, Holzmann M, et al. Two proband studies for the stimulation of granulocyte phagocytosis through Echinacea extract-containing preparations [in German]. Zeitschrift fur Phytotherapie 1989; 10: 67-70.
2. Braunig B, Dort M, Limburg E, et al. Echinacea purpureae radix for strengthening the immune response in flu-like infections [in German]. Zeitschrift fur Phytotherapie 1992; 13: 7-13.
3. Bauer R. Echinacea: biological effects and active principles. In: Lawson LD, Bauer R, eds. Phytomedicines of Europe. Washington, DC: American Chemical Society, 1998; 141-157.
4. Viehmann VP. Experiences with a skin salve containing Echinacea [in German] Exfahrungsheilk 1978; 27:353-358.
5. Coeugniet E, Kuhnast R. Relapsing candidiasis: adjuvant immune therapy with different Echinacin dosage forms [in German]. Therapiewoche 1986; 36: 3352-3358.
6. Facino RM, Carini M, Aldini G, et al. Echinacoside and caffeoyl conjugates protect collagen from free radical-induced degradation: a potential use of Echinacea extracts in the prevention of skin photodamage. Planta Medica 1995; 61(6): 510-514.
7. Melchart D, Waltjher E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections. Archives of Family Medicine 1998; 7:L 541-545.
8. Hoheisel O, Sandberg M, Bertram S, et al. Echinagard treatment shortens the course of the common cold: a double-blind, placebo-controlled trial. European Journal of Clinical Research 1997; 9: 261-268.
9. Bleuenthal M, Busse W, Goldberg A, et al., eds. The Complete German Commission E Monographs. Austin, TX: The American Botanical Council; Boston: Integrative Medical Communications, 1998.
10. 10. Bone K. Echinacea: when should it be used? European Journal of Herbal Medicine 1998; 3(3): 13-17.
11. McGuffin M, Hobbs C, Upton R, et al., eds. American Herbal Products Association Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997.

By Krista Morien in Herb Research News. Herb Research Foundation, Volume 3, No 1; 4-6. Article is reproduced with exclusive permission from the Herb Research Foundation.

Photo courtesy of NIEHS News: Environmental Health Perspectives Volume 107, Number 12, December 1999

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