Echinacea, also known by the common name cone flower, is a popular botanical medicine worldview, but there are more traditions surrounding its use than scientific evidence. There are multiple species of Echinacea and the roots and/or aerial parts of three of them, Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida, are primarily used in botanical medicines. Traditional use of Echinacea focused on infections and skin conditions. Current research on Echinacea has focused on treatment and prevention of upper respiratory illnesses, cold viruses, and influenza.

No single active constituent in Echinacea has been identified as having pharmacological effects; rather a combination of constituents including alkamides, caffeic acid derivatives, polysaccharides, and polyenes are assumed to be effective. Amounts of these active constituents differ from species to species as well as parts of the plant, time of harvest, and preparation of the botanical medicine, which makes evaluating the effectiveness of Echinacea products more difficult. In pre-clinical trials, expressed juice and dried extract from aerial parts of E. purpurea exhibited immune-modulating effects via increased synthesis of anti-inflammatory cytokines, including IL-1, IL-10, and tumor necrosis factor while dried extract from roots of E. purpurea exhibited an increase in natural killer cells. Pre-clinical trials have also shown Echinacea gel preparations to have anti-inflammatory and anti-fungal effects when used on skin abrasions and wounds of research animals; these results have not been replicated in human trials. In clinical trials, expressed plant preparations of E. purpurea appears to be most effective at shortening duration of cold or upper respiratory symptoms by 1-3 days, possibly due in part to immune stimulatory effects on tonsillar lymphoid tissues in the mouth. Clinical trials exploring the potential of Echinacea extracts or tinctures to prevent the occurrence of cold or flu viruses have been mixed, with some showing a 26-65% reduction in colds or days with cold symptoms and others showing no difference from placebo when taken three times a day for 8-12 weeks during peak cold and flu season. This variability may be due to lack of standardization between Echinacea products in terms of species, plant parts, and preparation.

Side-effects of Echinacea products are generally mild and include allergies, gastrointestinal discomfort, and skin rash. Contraindications for use include a tendency toward allergic conditions (atopy), autoimmune diseases, pemphigus vulgaris, acetaminophen, antibiotics, anti-viral medications, benzodiazepines, caffeine, estrogens, etoposide, immunosuppressant drugs, statin drugs, theophylline, tricyclic antidepressants, warfarin, Zofran, and more.

For treatment of colds or upper respiratory illnesses, standard dosing is 500-1200mg E. purpurea extract or tincture added to water or juice every 2 hours when awake during the first two days of symptoms, decreasing to 500-1200mg three times a day for the next four days. For prevention of cold or flu viruses, standard dosing is 700-900mg Echinacea extract or tincture three times a day during peak cold and flu season. Note: many supplements use powdered Echinacea, which have not been studied in clinical trials, rather than extracts or tinctures.

Disclaimer: The content herein is not intended to be a substitute for professional medical advice. It is not meant to diagnosis, cure, or treat any medical condition. Always consult a physician or other qualified healthcare provider with questions regarding a medical condition and before starting new diets and dietary supplements. Not all diets or supplements are appropriate for all people or all health conditions.


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