If it works it works - the controversy over Echinacea: Home Medicine Cycle 21

I had a fight with a doctor friend about Echinacea.  My family has used  Echinacea for cold and flu prevention and early treatment for decades. I now grow it in my garden. (It was very hard to start but it's pretty and stalwart once started.) But my friend who's a doctor insisted that clinical trials have shown it to be ineffective medicinally.

Creative Commons image by Arie Farnam

Creative Commons image by Arie Farnam

I looked into the studies on Echinacea and it is true that the more widely publicized studies on the plant are disappointing. If they show any medicinal benefit it is minimal. I was confused because I've had good results with Echinacea tincture. So I looked closer. What I found was that all eight of the studies cited in my friend's medical database were run exactly the same way. They all used  freeze-dried echinacea juice to treat acute upper respiratory infections (essentially colds). The age and processing of the Echinacea was not specified beyond that description. It occurred to me that it was odd that the medical establishment had not considered using Echinacea the way herbalists do--as either tea or tincture.

I can't run a large study myself but I pay close attention to the effects of medicinals I use for my family. And over the years I have seen that Echinacea tincture usually reduces the symptoms of coughs and colds within twenty-four hours. The past few years have brought some terrible flus and coughs that had us and our neighbors hacking away for weeks or even months. I am not particularly susceptible to coughs, but even I succumbed several times. Each time I started taking large doses of Echinacea tincture and the cough improved for several days, at which point I forgot to take the tincture, because I thought the infection had passed. Then the cough invariably came back. It only stayed away if I took Echinacea for four to five days after the symptoms had cleared as well as during the illness. 

It was a hard lesson but over three winters, I have learned. Homemade Echinacea tincture will work for some stubborn upper respiratory infections (both viral and bacterial), but you have to take it and keep taking it for several days after symptoms have disappeared. I have yet to find another herb or medicine that works as reliably when it comes to acute respiratory infections. It also appears to help in prevention of colds or in mitigation of the symptoms if you take it when you are surrounded by people with colds or just feel the first signs that you may have caught something.

Through further research, I have found that there are actually more studies that show that what I observe with Echinacea is clinically proven. But for whatever reason, these positive studies are not as well publicized. A meta-analysis of many studies shows that most studies do in fact show a benefit from consuming Echinacea for prevention and treatment of upper respiratory illnesses. Another study showed that Echinacea is effective in mitigating chronic autoimmune disease in mice and other trials showed that Echinacea improves the modulation of the human immune system by affecting gene expression.

Some studies use air-dried Echinacea tea for treating upper respiratory illnesses, instead of tincture and their results are okay but not spectacular. One trial used Echinacea tincture and had better results, but it was in an vitro trial, rather than one using actual people, which makes it more difficult to gauge exact results in practice. 

My thoughts looking at all of these results are that Echinacea is sensitive to processing, storage, heat and light. The best way to preserve Echinacea is in the form of an alcoholic tincture. Recovering alcoholics and children should not use such tinctures and can either use a tea or an extract in edible glycerin.

Tincture made from fresh Echinacea flowers has a good effect in boosting the immune system and in fighting both viral and bacterial infections. Tincture made from Echinacea roots can be made to be even stronger, but it requires several batches of root to be soaked in the same alcohol. Most purchased Echinacea tincture is made from a single soaking of roots and it is too weak. Homemade tinctures made with fresh flowers or roots and kept strictly away from light and heat will work best.

Dried Echinacea flowers make a nice tea for children to prevent colds and coughs in the winter, but this is also best made with local or homegrown flowers because after about nine months the flowers will lose potency. The tea has to be sealed in an airtight container, preferably ceramic or glass and kept away from light. Teas bought in stores are often in light plastic that isn't really airtight and they sit out in the light for days or weeks before sale.

The capsules of freeze-dried Echinacea juice sold in just about every health food and herbal shop in the western hemisphere are largely ineffective. Some consumer studies have shown that many "health food" products that claim to be made from Echinacea don't actually contain any molecules of the plant. (This was a fact helpfully pointed out and documented by my friend the doctor.) 

The bottom line: Echinacea is a beneficial but sensitive herb for immune support and fighting respiratory illness, which needs to be processed locally, grown at home or obtained from trusted sources. 

I will continue to use Echinacea for my family. Safety trials have shown that it is safe, even during pregnancy and breastfeeding .

The controversy over the effectiveness of Echinacea in treating the common cold is much more indicative of the difficulty of studying colds than any problem with Echinacea. Colds are usually short-term and difficult to pinpoint in source, type and length. That has always made studying these illnesses difficult. It is even relatively difficult to observe individual cases. Many pharmaceutical cold medicines have similarly mixed results in clinical trials. So, the results aren't as dramatic here as with some of the other herbal remedies I use, but Echinacea is at least as effective as pharmaceutical medicines for colds and it's probably safer. Rest and warmth also remain crucial treatments for the common cold.

Feel free to add your comments below. Ask questions and discuss. Also please keep in mind that this doesn't constitute medical advice for a specific person and I'm not your doctor. Home medicine information is intended to be used with common sense and in consultation with doctors and professional herbalists who can see you personally.