Echinacea E. purpurea, E. Angustifolia, E. Pallida
by Jean-Yves Dionne BSc. Pharm.
Does echinacea play a role in the treatment of upper respiratory tract infections (URTI)?
Echinacea has been the most widely used medicinal herb in Western Countries for several years. Millions of people use echinacea preparations to treat all sorts of respiratory disorders and infections. Still, the medical world has yet to be convinced. Some authors argue that the data is controversial and that the results are not conclusive enough to support the use of echinacea in URTI and infections.
Despite the lack of rigor of some research protocols on echinacea, there is nonetheless more and more clinical evidence (and users).
Researchers have noticed that Echinacea pallida dry extract (900 mg per day) reduces the duration of respiratory infections from 13 days (placebo) to 9.8 days for bacterial infections, and 9.1 days for viral infections.(1)
The Grimm and Muller study demonstrates that an Echinacea purpurea extract reduces the mean duration of a cold from 6.5 to 4.5 days. However, the extract did not show a prophylactic effect.(2)
Another study demonstrates that fresh Echinacea purpurea juice (20 drops in 4 oz. of water every 2 hours during the 1st day and 3 times a day afterwards) reduces by half the duration of colds compared to placebo (4 days vs. 8 days).(3)
Patients who took a preparation made of 3 echinaceas (E. purpurea, E. angustifolia, E. pallida) reported a significant decrease in symptoms associated with respiratory infections.(4)
Most contra-indications and cautions often associated with echinacea are challenged by K. Bone (principal of the Australian College of Phytotherapy). Based on the recent analysis of echinacea’s active ingredients and its bioavailability, he claims that limitations to the use of echinacea found in the German Commission E product monographs are unjustified. According to him, autoimmune diseases such as arthritis and lupus could benefit from the normalizing effect of echinacea. Also, K. Bone and M. Blumenthal (executive director of the American Botanical Council) mention that the use of echinacea is not contra-indicated in case of HIV infection. However, it is important to let patients understand that echinacea does not treat HIV.(5)
Finally, although some people consider that results are not sufficient, most authors generally agree that echinacea is useful in the treatment of URTI and reduces the duration and symptoms of cold and flu.
References
1-Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of Echinacea pallidae radix in upper respiratory tract infections. Complement Ther Med 1997;5:40-2. 2-Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of clods and respiratory infections. Am J Med 1999;106(2):138-43. 3-Hoheisel O, Sandberg M, Bertram S et al. Echinacea treatment shortens the course of the common cold: a double-blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261-9. 4-Brinkeborn RM, Shah DV, Degenring FH. Echinaforce and other echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial. Phytomedicine 1999;6(1):1-5. 5-Bone, K. Echinacea: When Should it be Used? The European Journal of Herbal Medicine, Vol 3(3) Winter, 97-98, pp. 13-17.
