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Herbal Medicine                                            
REF:  http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/31402.html  

Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain Echinacea. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with a pharmacist or health care professional before starting.

• Unproven Uses
• Potential Dangers
• Interactions
• Dosing
• Summary
• Resources

Evidence    

Scientists have studied Echinacea for the following health problems:

Common cold treatment

Although multiple low-quality studies have previously suggested that taking Echinacea orally when cold symptoms first begin may reduce the length and severity of the symptoms, a clinical trial reported in July 2005 did not demonstrate any clinical benefit. The sum of the evidence cannot support Echinacea as a treatment for the common cold.

Common cold prevention

Studies have found that taking Echinacea is not helpful for preventing the common cold. Most experts do not recommend chronic use of Echinacea for preventing the common cold.

Respiratory tract infections

Study results of Echinacea for preventing or treating respiratory tract infections are mixed. Further research is needed before a conclusion can be drawn.

Other

Echinacea has also been studied as a treatment for the toxic effects of cancer X-ray therapy (radiation-induced leukopenia), for skin wound healing and for genital herpes, but there are no clear answers in these areas. Early evidence suggests that when Echinacea is used at the same time as the prescription cream econazole nitrate (Spectazole), vaginal yeast infections (Candida) may occur less frequently.

Unproven Uses    

Echinacea has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care professional before taking Echinacea for any unproven use.

Abscesses Bacterial infections Bee stings Boils Burns Cancer Diphtheria Dizziness Eczema Hemorrhoids HIV/AIDS Malaria Migraine headache

Pain Psoriasis Rheumatism Skin ulcers Snakebites Stomachaches Syphilis Tonsillitis Typhoid Urinary disorders Urinary tract infections Whooping cough (pertussis)

Potential Dangers    

Allergies

• People with allergies to plants in the Asteraceae or Compositae family (ragweed, chrysanthemums, marigolds, daisies) are more likely to have allergic reactions to Echinacea. Multiple cases of anaphylactic shock (severe allergic reaction) and allergic rashes have been reported; these problems may occur more commonly in people with asthma or other allergies. Echinacea injections have caused severe reactions and are not recommended.

Side Effects

• Few side effects have been reported from Echinacea at the recommended doses. The most common complaints include stomach discomfort and nausea, although these are unusual. Rarely, skin rash, drowsiness, headaches, dizziness or muscle aches may occur. There have been several cases of hepatitis (liver inflammation) in people taking echinacea, although it is not clear that echinacea was the cause.
• Some natural medicine experts discourage the use of Echinacea by people with conditions affecting the immune system, such as AIDS or HIV, some types of cancer, multiple sclerosis, tuberculosis and rheumatologic diseases (rheumatoid arthritis, lupus, etc.). However, there are no specific studies or reports in this area, and the risks of Echinacea use with these conditions are not clear.
• Long-term use of Echinacea may cause low white blood cell counts (leucopenia).

Pregnancy And Breast-Feeding

Echinacea cannot be recommended during pregnancy or breast-feeding. Many experts believe that oral Echinacea is safe, but currently there is not enough information. Pregnant women should absolutely avoid tinctures because of the high alcohol content (15 percent to 90 percent).

Interactions    

Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with a health care professional or pharmacist before using herbs or dietary supplements.

Interactions With Drugs

• People taking amoxicillin may want to avoid Echinacea based on one published case of a life-threatening reaction, although the details of this case are not very clear. The high alcohol content in some echinacea tinctures may lead to vomiting if used with the drugs disulfiram (Antabuse) or metronidazole (Flagyl). Because Echinacea is believed to affect the immune system, people taking immunosuppressants, such as corticosteroids, drugs for rheumatologic diseases (rheumatoid arthritis, lupus, etc.) or drugs to prevent rejection of transplanted organs, should consult a health care professional or pharmacist before using Echinacea. Examples of such drugs are azathioprine, cyclosporine and prednisone. People should use caution when taking Echinacea with acetaminophen (Tylenol) because liver and kidney damage may occur.
• Echinacea may affect the way that certain drugs are broken down by the liver.

Interactions With Herbs And Dietary Supplements

Very few interactions between Echinacea and herbs and supplements have been reported. Echinacea is sometimes sold in combination with goldenseal (Hydrastis canadensis), and goldenseal may reduce the body's ability to absorb vitamin B. Echinacea may affect the way that certain herbs and supplements are broken down by the liver.

Dosing    

The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient, and may not be effective. The appropriate dosing should be discussed with a health care professional before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

In general, experts suggest using Echinacea for no longer than eight weeks. There is limited scientific information about use for longer periods of time.

For The Common Cold

Adults (Aged 18 Or Older)

• Capsules (of powdered herb): A dose of 500 to 1,000 milligrams three times per day for five to seven days has been taken by mouth.
• Expressed juice: A dose of six to nine milliliters per day, divided into two or three doses, for five to seven days has been taken by mouth.
• Tincture: A dose of 0.75 to 1.5 milliliters (1:5) has been gargled and swallowed two to five times per day for five to seven days.
• Tea: A tea made by simmering two teaspoons of coarsely powdered herb (four grams of Echinacea) in one cup of boiling water for 10 minutes has been consumed daily for five to seven days.

Children (Younger Than 18):  The dosing and safety of Echinacea have not been studied thoroughly in children. Discuss doses with a health care professional before your child starts therapy. Some natural medicine practitioners recommend basing children's doses on weight; take the child's weight in pounds, divide by 150, then multiply that number by the recommended adult dose (that will give the child's dose). However, there is no scientific support or safety data for this formula.

For Other Conditions

Echinacea is also available in preparations for the skin (called topical preparations), but no specific doses have been shown to be safe or effective.

Summary    

Although Echinacea has been suggested for many conditions, it has been most studied as a treatment for the common cold. Study results of Echinacea for reducing the length and severity of symptoms if taken at the first sign of a cold are mixed. Echinacea has not been proven effective for any other health conditions. It should be avoided by pregnant women and by individuals taking amoxicillin. Remember that tinctures can contain large amounts of alcohol and may cause nausea or vomiting if taken with the drugs disulfiram (Antabuse) or metronidazole (Flagyl). Echinacea should be used in recommended doses for no longer than eight weeks. Consult a health care professional immediately if you experience side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources    

Selected Scientific Studies: Echinacea

Natural Standard reviewed more than 525 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

Last updated August 01, 2005