Myth-busting echinacea

Myth-busting echinacea – Part 1

Almost everyone has heard of echinacea. It’s one of the blockbusters which, along with ginseng, black cohosh and St John’s Wort, enjoyed herbal stardom in the 1990s when it was heavily marketed as a wonder herb – a panacea for all immune-related ills.

Fast forward a few years and, much like with each of the herbs above, there is a considerable amount of controversy, misunderstanding and misinterpretation surrounding the safety and effectiveness of the herb.

In this article, I bust two of the ‘myths’ that have developed surrounding the proper use of echinacea in recent years, with the help of scientific studies and some traditional common sense. Stay tuned for part two next month, which deals with the three remaining myths.

Myth nº1: Echinacea is an effective treatment for colds and flu.
Most people reach for echinacea when they feel a cold coming on and, although I do use echinacea as part of an anti-infective blend in my practice, research generally shows it is much more effective as a preventative, rather than a treatment, for infection.

The widespread use of echinacea for upper respiratory tract infections probably stems from its reputation as an immune herb that works mainly on the innate immune response – the immediate response your body mounts when it is exposed to a viral or bacterial threat.

However, the Eclectic physicians of North America, who learnt of the value of echinacea from Native American tribes, prescribed it more for bacterial infections and envenomations of various kinds, including snake bite, syphilis, typhus, septic wounds, diphtheria, tuberculosis and scarlet fever.

In my practice, I use echinacea for its lymphatic clearance properties as part of a cold and flu mix, combined with other well-researched anti-infectious upper respiratory herbs such as Andrographis paniculata, sage and elderberry.

Dosage is crucial here, however. The Eclectics used it in very high doses to treat infection (10-15g per day), whereas most echinacea products available over the counter contain low doses (commonly around 900mg), which have been shown to be relatively useless once infection set in. I prescribe the above cold and flu mix in high doses – around 10ml of a strong herbal tincture every couple of hours.

Research indicates that echinacea is best taken as a long-term preventative remedy at 1.5-4.5g dried root per day – at this dosage, it has been shown to prevent winter colds in stressed out medical students and reduce infection rates when taken before and during long-haul travel. This brings us to our next ‘myth’.

Myth nº2: Echinacea should not be taken long term.
The Eclectics were certainly not averse to using echinacea long term. It was traditionally recommended for chronic conditions like cancer, chronic mastitis, chronic ulceration, tubercular abscesses, chronic glandular indurations and syphilis. One case study in the literature documents treatment of a vaccination reaction where echinacea root was taken every two hours for six weeks.

Modern in vitro (lab) research, however, has shown that one of the ways echinacea ‘boosts’ immunity is by increasing phagocytosis – white blood cell activity – which led to its reputation as an ‘immune stimulant’ and, somehow, the notion that it should not be taken for too many days at a time. This fit in nicely with its publicity as a cold and flu herb, so the idea stuck. However, more in-depth research into echinacea’s mechanism of action paints a different picture.

In 2004, a Swiss team of researchers showed that echinacea prepares resting monocytes (white blood cells) for a quicker immune response, by inducing messenger RNA for an important inflammatory chemical called TNFα. In other words, to begin with, it acts as an immunostimulant. However, in overstimulated monocytes – cells that have already been exposed to echinacea or are overstimulated for any other reason – it first reduces and then extends their TNFα response. In other words, it modulates or adapts the cellular response depending on the pre-existing state of the immune system.

This supports modern herbalists’ clinical experience that echinacea acts as a perfectly safe immunomodulator when taken long term, and can be a very useful aspect of a treatment plan for chronic inflammatory or autoimmune conditions. This brings us to our next ‘myth’ … more on this next month!

By Poppy Burr
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Poppy is a UK-trained medical herbalist practising in Praia da Luz. She offers consultations and treatment in Western Herbal Medicine, incorporating Functional Medicine testing and nutritional strategies where appropriate. For more information, visit