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Echinacea: Herbal Medications, What Works

Echinacea (Echinacea species) was the best-selling herbal medicine in U.S. health food stores from 1995 to 1997.

Widely used by the Plains Indians, especially for infectious diseases and wound healing, echinacea was adopted by Eclectic physicians in the late 1800s. Once very popular, it was largely replaced by antibiotics, but is again gaining popularity.

Echinacea is primarily used to prevent and treat the common cold, flu, and upper respiratory tract infections; to enhance immune system function; and to treat systemic Candida infections. There is good clinical research support for its use in colds, flus, and upper respiratory infections, but research on other applications is more equivocal. Echinacea is inappropriate for HIV and AIDS, since echinacea may promote the replication of T-cells, which is where the HIV virus resides.

  • A 1994 review by Melchart and associates of twenty-six controlled clinical studies examined the activity of echinacea on immunity. The authors concluded that echinacea could strengthen immunity. The most striking effects of echinacea were a reduction in susceptibility to infection and a decrease in the incidence of colds.

  • Braunig in 1992 found that the dosage of echinacea was critical. One hundred and eighty subjects were divided into three groups, one receiving a placebo, one receiving 450 mg of echinacea, and one 900 mg. Improvements in the 450 mg group were only comparable to the placebo group, whereas those in the 900 mg group showed a statistically significant improvement in flu symptoms.


When using echinacea to prevent cold and flu or to relieve their symptoms, Dr. Varro Tyler recommends taking it in small doses every few hours, with a maximum length of treatment of six to eight successive weeks.


  • In a study of recurrent Candida vaginal yeast infections, half the women were treated with the commonly prescribed antiyeast medication econazole nitrate alone, while the other half received both econazole nitrate and echinacea. Those receiving just the drug had a 60.5 percent recurrence rate, while those also taking echinacea had a recurrence rate of only 16.7 percent.

  • At the University of California at Irvine Medical Center, See and colleagues examined cells infected with mononucleosis and found that echinacea enhanced immune function in cells in both normal subjects and those with depressed immunity.


While more well-designed clinical trials of echinacea extracts are certainly desirable, there seems to be sufficient clinical and pharmacological evidence to suggest that it is safe and effective. However, echinacea preparations on the U.S. market have proven inconsistent in quality. Relying on reputable brands and standardized extracts should help to ensure quality and proper dosage.




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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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