About Echinacea

By Bonnie K. McMillen, RN, BSN, College Health Nurse, University of Pittsburgh at Bradford, and Carol J. Mulvihill, RN,C, BSN, Director of Health Services, University of Pittsburgh at Bradford


coneflower Every few months, another herbal remedy seems to capture the spotlight of public attention. Ginseng, ginkgo biloba, garlic, St. John's wort, and echinacea are currently the top five best-selling herbs according to the Nutrition Business Journal.

An article in a recent issue of USA TODAY (8/25/98) stated that 60 million Americans say they have taken botanical remedies and herbal supplements and that 50 million people are current users.

Experts also speculate that herbs that are aimed at treating the ills of aging baby boomers will be the hot prospects of the future.

According to Donald Brown, a doctor of naturopathic medicine in Seattle and one of the country's top herbal experts, the botanical remedies that have the best scientific evidence behind them and the clearest definition of their uses will be the ones that become the most popular.

Many herbs have solid science behind them, according to Mark Blumenthal, founder of the American Botanical Council, a research and educational group. However he states there is always a chance that people will misuse them or use them for conditions other that that for which they have been studied.

Echinacea, an extract from the cone flower, a very common plant in North America, is touted as a favorite botanical remedy among herbal and alternative medicine experts. The medicinal part of the plant is the root stalk. Echinacea is growing in popularity because of recent media attention to its historic reputation of boosting the immune system in treating colds and flu and fighting infections. It has also been used to speed wound healing, and reduce inflammation.

Echinacea has a long and intriguing history of use. For hundreds of years, the Plains Indians used it as an antiseptic, an analgesic, and to treat poisonous insect and snakebites, toothaches, sore throat, wounds and communicable diseases such as mumps, smallpox, and measles. It was also used by the Cheyenne, Choctaw, Comanche, Dakota, Meskawaki Fox, Pawnee, Sioux, and Omaha tribes. (Wendy Pearson, Medicinal Herbs and Nutraceuticals Research, Guelph, Ontario, Canada)

Early settlers then adopted the therapeutic uses of echinacea root, and it has been used as an herbal remedy in the United States ever since. In 1762, it was used as a treatment for saddle sores on horses, (Gronovius, 1762). Dr. H.C.F. Meyer learned of the ueses of echinacea from the native Indians of Nebraska around 1870, and later introduced it to a doctor in Europe. Dr. J. S. Leachman of Sharon, Oklahoma wrote in the October 1914 issue of "The Gleaner," that echinacea root was used for nearly every sickness with good results. It was also found to be the secret ingredient in many tonics and blood purifiers of the era. Echinacea was included in the U. S. National Formulary from 1916 to 1950, although papers published by the Journal of the American Medical Association described it as a useless quack remedy.

Echinacea became known in Europe around 1895. Many research studies done by doctors in Germany indicated that echinacea is effective primarily by increasing the number of white blood cells, thus boosting the immune system and thereby increasing the body's ability to fight infections.

Since the 1930's, there have been more than 400 journal articles published on the chemistry, pharmacology, and clinical uses of echinacea. (W. Pearson, Ontario, Canada, 1998) Of the hundreds of published research papers on echinacea, the overwhelming majority confirm the effectiveness of it in treating some viral infections, bacterial infections, healing wounds, and reducing inflammation.

Some of the studies have shown that it may worsen the effects of autoimmune disorders. Studies looking at this issue are few in number and largely inconclusive. However, until sufficient evidence emerges, it is recommended that echinacea supplements should not be used by those suffering from autoimmune diseases. (Greenhills Ginsen Limited, 1998)

According to Ronald J. Brown , author of Herbal Prescriptions For Better Health, (Prima Publishing Company, 1996, Rocklin, Ca.), Echinacea is most effective when taken intensively for short periods of time, however, some have combined echinacea with other immune tonics like astragalus, reishi, and siberian ginseng for long term herbal programs. When using it for the long term, the echinacea doses are generally reduced.

Recently the media has publicized the results of one study which has cast scepticism on the medicinal value of echinacea for treating colds. The one recent new study conducted by doctors in Germany indicated no significant differences among the people given echinacea or a placebo. The study involved 289 healthy people and used two species of echinacea: Echinacea angustifolia and Echinacea purpurea. This study was published in November, 1998 in the Journal of the American Medical Association and the Archives of Family Medicine. The study's authors emphasized the need for more research. Dr. Bruce Goldberg, associate professor of family medicine at Oregon Health Sciences University who is studying echinacea, cautioned against putting too much weight on the single study, according to an article in USA TODAY (11/12/98).

Because of echinacea's history and reputation as a therapeutic remedy, and its ease of availability, it is likely to sustain its popularity with the American public, despite the recent news of the new single study which failed to prove its effectiveness in treating colds.

Research with patient outcomes and clinical trials will more clearly define the appropriate uses for these ancient remedies. But as it has been throughout many generations, personal experience with the use of herbal and botanical treatments has and will continue to influence the popularity of these historical remedies. A positive experience with echinacea is not easily forgotten. The Plains Indians learned about it from experience. So did the early settlers. So do the consumers of today who use herbal and botanical remedies.

Anecdotal comment by Bonnie K. McMillen:

I am always looking for new, reliable treatments for cold symptoms that dont leave me sleepy, dried out or feeling dopey. During the past two years I had been hearing and reading about echinacea, so I decided to give it a personal trial the next time I had a cold.

Unfortunately, I was already ill with a bad cold when I remembered it. I started taking the echinacea four or five days into the illness. Almost immediately, I began to feel better and I believe it shortened the duration and severity of the cold. Many times in the past when I had a cold, it would advance into bronchitis and I would sometimes need two courses of an antibiotic before I felt better. I took the echinacea in the dosage recommended on the label for one week. I feel the cold was milder and of shorter duration and I had no unwanted side effects. The only side effect noted in the literature is occasional nausea, and I personally didn't experience it.

I used echinacea two other times when I felt as if I might be coming down with something. I took it for a few days as directed, three times a day and I never got the cold I thought was coming.

Personal experience has convinced me that there is therapeutic benefit to using echinacea. So, like the Plains Indians and the early settlers, I'm a believer through personal experience!

I continue to be intrigued by herbal and botanical remedies, and enjoy discussing them with students as preventive and alternative care modalities.

Editorial Comment By Carol J. Mulvihill:

Self-care is not a new concept. Throughout history and in all cultures, consumers have turned to natural, nutritional, and non-prescriptive treatments as the first line treatment of many common ailments. It is not surprising that as scientific research gives some credibility to herbal remedies, informed consumers will avail themselves of the opportunity to take charge of their own health and health care treatments, and give these remedies a try. They are inexpensive, available over-the-counter, and do not require a physician office visit to commence treatment.

It is my hope that there will not be any controls or restrictions placed on the sale and use of herbs and botanicals, which are nutrient substances and not medicines. Some are therapeutic, yes, just as foods such as chicken soup and garlic can be therapeutic. But they should not become subject to governmental regulation.

I believe that consumers should take the driver's seat of their own health care when it comes to herbal remedies and natural treatment. It takes the burden off of the medical care system, and places personal responsibility on the individual. Yes, there is some potential for abuse and misuse, as there is with any over-the-counter treatment, but the opportunity for appropriate use and therapeutic outcomes should not be jeopardized or limited due to fear of misuse. Educating consumers on appropriate use should become a priority for health care providers.

I am in favor of empowering consumers to practice self-care, particularly for minor and self-limiting health problems. Herbal remedies can sometimes be a supplement to or a substitute for conventional medical care. It is important to discuss alternatives of care which fit the patient's culture, values and beliefs. I believe it is our responsibility as health care providers to help people become informed health care consumers and consider all of their options of care and treatment, whether medical, natural, herbal, wholistic, or botanical. bar

Article written in November 1998 for Connections Quarterly. May be reproduced and distributed freely.

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