Echinacea herb is the name of a genus of native North American plants, commonly known as the purple coneflower. Among the different species largely used in traditional medicine, Echinacea pallida, purpurea and angustifolia have been investigated. These different species, due to their difficult identification, were commonly confused in the past and probably used indifferently for the same therapeutic purposes. In fact, the three species have in common some pharmacological activities based on the presence of active compounds that act additively and synergistically. Nevertheless, the composition of each species has slight variation in the amount of each active component. Because the active component of the plant has not been fully identified, commercial echinacea products are not typically standardized to any particular component.
   The jury is still out regarding the benefit of echinacea for the prevention or treatment of the common cold. Some studies indicate that this herb could reduce symptoms or severity of the common cold while others have shown no benefit. I am hoping future research will clarify its role in the treatment of viral diseases.
   At this point I do not recommend the use of echinacea alone to treat or prevent the common cold. I believe zinc lozenges and vitamin C are more effective when taken early in the onset of a cold. If you click the above common cold link, I offer some advice on how to reduce the symptoms of this condition.

Nature's Way, Organic, Echinacea Purpurea Herb, 400 mg, 180 Capsules
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Suggested Usage: One or two echinacea tablets as recommended by your health care professional.

buy Echinacea Extract, Defense Force supplement 510 mg
Planetary Herbals
Planetary Formulas Echinacea Extract combines a concentrated Echinacea angustifolia root extract (standard to 4% echinacosides) with the roots of Echinacea pallida. This captures the full spectrum of echinacea compounds.

Supplement Facts
Echinacea Angustifolia seed extract
   Standardized root extract yielding 5.4 mg echinacosides
Echinacea Pallida root

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Echinacea side effects, safety, risk
As with most herbal products, small amounts are usually quite safe. There have been rare cases of allergic side effects to echinacea. Echinacea may in some cases worsen allergic reactions. It may be best for those with autoimmune diseases to not use it for prolonged periods.

Activation of autoimmunity following use of immunostimulatory herbal supplements.
Archives of dermatology 2004.
Evidence for the scientific basis of purported therapeutic effects and adverse effects of herbal supplements continues to grow. Many herbal supplements are touted for their immunostimulatory properties, and both in vitro and in vivo experiments have supported this claim. Although this explains their beneficial effects in preventing or curtailing disease, to our knowledge, no immunostimulatory herbal supplements have been reported to exacerbate disorders of immune system overactivity. We describe 3 patients whose autoimmune disease onset and/or flares correlated with ingestion of herbal supplements with proven immunostimulatory effects. Echinacea and the alga spirulina platensis are implicated in 2 patients' flares of pemphigus vulgaris, and a supplement containing the algae Spirulina platensis and Aphanizomenon flos-aquae was ingested by a third patient days before both onset and a severe flare of dermatomyositis. The third patient showed heterozygosity for a tumor necrosis factor alpha (TNF-alpha) promoter polymorphism (-308A), leading to increased production of TNF-alpha, which may have predisposed her to developing dermatomyositis. Immunostimulatory herbal supplements may exacerbate preexisting autoimmune disease or precipitate autoimmune disease in persons genetically predisposed to such disorders. Increased production of TNF-alpha may play a role, although more research is needed to clarify the mechanisms of such phenomena.

Recurrent erythema nodosum associated with echinacea herbal therapy.

Echinacea may cause mild or serious allergic reactions in people who use the herb to treat their allergy symptoms, according to two Australian researchers.

Benefit and review
Echinacea herb is one of the bestselling herbal remedies in the US. Does it work? Despite numerous studies, there is still no definitive answer. Studies have been inconsistently designed using a variety of methodologies and many different formulations of echinacea and extracts, and have produced mixed results. Analysis suggests that it probably does improve symptoms of the common cold but only mildly and even this claim is controversial. The best evidence appears to be for preparations from Echinacea purpurea. There is no proof that taking echinacea daily during cold season will decrease the chance of catching a cold.
   The scientific evidence regarding the benefit of in limiting common cold severity and duration is inconsistent. The research literature is difficult to evaluate because of the differences in products used in various studies. Some researchers interpret the available data to point that echinacea does help reduce symptoms of a cold, whereas other scientists looking at the same studies deny that it is helpful.
    In addition to vitamin C and zinc lozenges, an interesting potential cold and flu fighter is the herb andrographis.

Pharmacognosy Reviews 2015. Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Echinacea purpurea (Asteraceae) is a perennial medicinal herb with important immunostimulatory and anti-inflammatory properties, especially the alleviation of cold symptoms. The plant also attracted scientists' attention to assess other aspects of its beneficial effects. For instance, antianxiety, antidepression, cytotoxicity, and antimutagenicity as induced by the plant have been revealed in various studies.

Cochrane Database Syst Rev. 2014; Echinacea for preventing and treating the common cold. Echinacea plant preparations (family Asteraceae) are widely used in Europe and North America for common colds. Most consumers and physicians are not aware that products available under the term Echinacea differ appreciably in their composition, mainly due to the use of variable plant material, extraction methods and the addition of other components. To assess whether there is evidence that Echinacea preparations are effective and safe compared to placebo in the prevention and treatment of the common cold. Echinacea products have not here been shown to provide benefits for treating colds, although, it is possible there is a weak benefit from some Echinacea products: the results of individual prophylaxis trials consistently show positive (if non-significant) trends, although potential effects are of questionable clinical relevance.

Additional Herbs and supplements that influence the immune system
AHCC -- Active Hexose-correlated Compound is a mushroom extract that has been tested as an immune enhancing, liver protective and anti-cancer agent.
Andrographis paniculata herb.
Astragalus is used by traditional Chinese doctors to stimulate the immune system. In a test tube study, astragalus was found to have anti herpes simplex virus activity.
Garlic
For a fuller list or herbs and nutrients that influence the immune system.

Mechanism of action
Echinacea plant extract is widely used for the prevention and treatment of upper respiratory tract infections. Echinacea has been the subject of hundreds of studies, however, the active components in the herb, their optimal dosages and their in vivo effects are still not fully identified. The actions of echinacea are thought to be due to a number of polysaccharides called fructofuranosides, such as heteroxylan and arabinogalactan, and also to a group of lower molecular-weight polysaccharides, including alkylamides and echinacosides.
   Many of the compounds in echinacea stimulate various aspects of the immune system including macrophage and lymphocyte function. Natural killer cell activity is increased and there may be an increase in interferon production and phagocytosis.

Echinacea root or leaf?
Although more research is still required, for the time being echinacea root appears to have more of the important chemicals known as alkylamides.

Echinacea extract information
Echinacea is sold by raw material suppliers in various extracts including 4% Phenolic acids. Echinacea and goldenseal are often combined in immune formulas.

Benefits

Blood pressure, hypertension
If one takes echinacea herb daily over a period of a couple of months could this possibly result in higher blood pressure -- even when one is taking blood pressure medicine?
   We are not aware of any research that indicates it influences blood pressure.

Echinacea and the common cold
September 2006 - Use of echinacea before the onset of full-blown symptoms of the common cold reduces the incidence by more than a half and the duration by almost two full days, researchers reported here at the annual meeting of the American College of Clinical Pharmacology. Dr. Sachin A. Shah and colleagues, of the University of Connecticut, conducted a search and ultimately a pooled analysis of randomized controlled trials on the subject of echinacea and common cold. They found 14 studies that contained information on incidence in 1,356 patients and duration in 1,630 patients. The team found that echinacea use cut incidence of common cold by 58 percent. Duration was shortened by 1.9 days compared with the colds of nonusers.

2007 -  Dr. Craig Coleman of the University of Connecticut School of Pharmacy conducted a meta-analysis which found that echinacea may reduce the incidence of a cold. He cautioned that the studies involved only 1,600 people and most of the studies did not have enough patients to be fully reliable. They also involved various echinacea products, so it was still difficult to know for sure whether and how it might work to prevent colds. The study was published in the journal Lancet Infectious Diseases.

In a study with children, Echinacea purpurea was not effective in treating upper respiratory infection symptoms in patients 2 to 11 years old, and its use was associated with an increased risk of rash.

A 2004 study found taking 300 milligrams per day of Echinacea at the first sign of a cold appears to do little to reduce symptoms or speed recovery.

Stocking your medicine cabinet with echinacea may be a waste of time, as a new study shows the herbal medicine does not help prevent colds. After exposing 48 healthy adults to a virus that causes the common cold, U.S. investigators found that people who took Echinacea were no less likely to develop colds than people who took an inactive placebo pill. Consequently, people may be better off leaving echinacea off of their grocery list, says study author Dr. Steven Sperber of Hackensack University Medical Center in New Jersey. "Echinacea did not prevent infection with the cold virus," he said. The research was funded by the German company Madaus Aktiengesellschaft, which sells the Echinacea product used in the current study. In the U.S. alone, consumers spend more than $300 million each year on eEchinacea products, for the purpose of preventing and treating colds. However, recent research has also cast doubt on whether the herbal preparation can treat colds. A study published last year found that children who took echinacea as soon as they developed a cold showed no difference in the severity or duration of cold symptoms than children who took a placebo pill.

Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial.
Arzneimittelforschung 2001.
Common colds are one of the most frequent acute illnesses with major economical impact. Echinaceae purpureae herba (Echinacin, EC31J0) has shown promising results in the relief of common cold symptoms and the time taken to improvement compared to placebo. This study was aimed to confirm these findings by performing a randomised, double-blind, placebo-controlled clinical trial. A total of 80 adult male or female patients with first signs of a cold were recruited. The number of days of illness with a complete picture of the common cold (defined by the modified Jackson score of at least 5 points and experience of rhinorrhea and/or a subjective sensation of having a cold) was the primary end-point. In the verum group the median time of illness was 6.0 days compared to 9.0 days in the placebo group, assigning zero time for patients without a complete picture. EC31J0 was well tolerated and clinically effective in alleviating symptoms more rapidly than placebo in patients with a common cold.

Herpes
Echinacea at a dose of 800 mg twice daily for six months was not effective in reducing the frequency of recurrent genital herpes.

Immune system improvement
Antioxidant and immuno-enhancing effects of Echinacea purpurea.
Biol Pharm Bull. 2004.
We studied the protective effects of Echinacea purpurea against radiation by evaluating changes in the peripheral blood cell count and peripheral blood antioxidant activity. Echinacea purpurea administration had a suppressive effect on radiation-induced leukopenia, especially on lymphocytes and monocytes, and resulted in a faster recovery of blood cell counts. Mouse peripheral blood antioxidant activity was increased by Echinacea purpurea, and a relationship between the suppressive effect on radiation-induced leukopenia and the antioxidant effect was suggested. Furthermore, we reviewed the evidence of augmentation of found in this study humoral immunity. The effects of immune activation by Echinacea purpurea were investigated by measuring total immunoglobulin (IgG, IgM). The radioprotective effects of immune activation by Echinacea purpurea were investigated by measuring T lymphocyte subsets in the peripheral blood of mice following whole-body irradiation. Echinacea purpurea activates macrophages to stimulate IFN-gamma production in association with the secondary activation of T lymphocytes, resulting in a decrease in IgG and IgM production. Cytokines released from macrophages in mouse peripheral blood after E. purpurea administration activated helper T cells to proliferate. In addition, it is reported that activated macrophages in association with the secondary T lymphocyte activation increases IFN-gamma production and stimulates proliferation of cytotoxic T cells and suppressor T cells. We think that CD 4 and CD 8 subsets were more immunologically enhanced by Echinacea purpurea than helper T cells and suppressor T cell these results reflect activation. In addition, we think that these results reflect cell-mediated immune responses.

Pregnancy
This first prospective study suggests that gestational use of echinacea during organogenesis is not associated with an increased risk for major malformations.

Research study
Echinacea herbs -- purpurea -- angustifolia -- pallida. Used in common cold, coughs, bronchitis. German commission E has approved the oral use of the above ground parts of Echinacea pupurea for colds, respiratory tract infections, and urinary tract infections and its topical use for poorly healing wounds. The fresh or dried Echinacea pallida root has been approved for use in the treatment of influenza-like infections. Treatment with Echinacea Plus tea at early onset of cold or flu symptoms was effective for relieving these symptoms in a shorter period of time than a placebo.

Questions
Q. Regarding the widely publicized echinacea study that did not show benefit. I have always heard that you must take it over a long period of time in order to help prevent colds, not take it after you have a cold. It seems that this study was not done toward that end. Also, each person's immune system is different. When I get a cold I use zinc lozenges and vit. C. I don't trust any study done by groups that are already biased against natural remedies.
   A. We would be glad to mention the positive benefits of echinacea for long term use if such studies are published and show a benefit. Until then, it is difficult to be a wholehearted supporter of this herb for common cold. And we do agree that research done by groups that have an inherent bias against herbs cannot be as easily trusted as research from an independent team.

Q. I received your newsletter concerning the ineffectiveness of echinacea and your opinion to just take a large dose of Vitamin C at the onset of a cold... Have you not learned yet that recent British medical research shows that when one ingests a large dose of Vitamin C, it changes from an anti - oxidant to a pro - oxidant and, thus, cancer, etc., might be oncoming...
   A. Even if it leads to pro-oxidant activity - and that is yet to be clearly proven in actual human tissue - the use of high dose Vitamin C at the onset of the common cold is only temporary for a few hours or a couple of days. We don't see how this could be detrimental to the body, and if this helps reduce the severity or duration of a cold, then a large amount of harmful inflammation in the body due to the viral infection could be prevented or reduced, providing a great deal of health benefit.

Q. I recently heard an ad about echinamide. What is it?
     A. Echinamide is an echinacea purpurea extract made by a Canadian company called Natural Factors.

Would taking an echinacea supplement cause problems when taking together with Zinc-Lozenge supplement?
   Zinc lozenges are normally used only for a few days and I don't see any problems when echinacea herb is used the same day as zinc lozenges for brief periods.

Do graviola herb and mangosteen supplements improve the immune system? What about coq10 dietary supplement? Any interaction with echinacea herb?
   Mangosteen and graviola may have an influence, I am not sure about Coenzyme Q10 and I have not seen studies with such combinations.

Some people misspell it as echanacea