An herbal remedy is earning respect Health: Echinacea, or purple coneflower, has become a top-selling aid for for colds, strep throat, burns, even herpes. Lots of research supports it. It tastes awful.

April 15, 1997|By Judy Foreman | Judy Foreman,BOSTON GLOBE

The Cheyenne used it for sore gums, the Comanches, for toothaches and sore throats. Other Native Americans kept it on hand for snakebites or syphilis.

Modern Americans seem to love the stuff, too, even if we can't pronounce it. In fact, echinacea -- that's eck-in-EH-shia -- is now the top selling herbal remedy in health food stores, though garlic and ginseng claim top honors in overall sales.

Unlike many medicinal herbs, this daisy-like flower, also known as purple coneflower, quite literally has its roots in America, not Asia. And compared to many plant medicines, there's a fair amount of research on it -- 350 studies by some counts.

Some people swallow the nasty-tasting liquid form of echinacea or sip it as tea at the first sign of a cold or flu. Others use it as a salve on burns or wounds that won't heal. Others gargle it for strep throats or take it, internally and externally, for herpes. Some even give it, in small doses, to their kids.

But at $10 to $20 a bottle for the liquid stuff -- depending on how much you use, a bottle may last three weeks -- should we?

The answer, say many pharmacognocists, or scholars of medicinal herbs, is a hearty "why not?" It appears safe for many people and may, as advertised, stimulate the immune system. If you're allergic to ragweed, though, or have HIV/AIDS or an autoimmune disease like lupus or multiple sclerosis, you should probably pass on it.

While some of the research on echinacea may still not meet rigorous scientific standards, researchers in Germany -- where doctors prescribed echinacea 2.5 million times in 1994 alone -- have come up with provocative findings in recent years.

In one double-blind, placebo-controlled study of 180 volunteers, a German team found in 1992 that high doses of an alcohol-based extract of Echinacea purpurea root seemed to reduce the severity and duration of cold and flu symptoms.

Dosage is crucial

But the dose appeared to be crucial. People who took 900 milligrams (or 180 drops) per day showed significant improvement. Those who took half that were no better off than people given a placebo, or dummy drug.

In another 1992 double-blind, placebo-controlled study of 108 people with chronic upper respiratory infections, those given 4 milliliters of E. purpurea in liquid form twice a day for eight weeks had fewer infections than those taking a placebo.

But caveats are in order. The studies involved three types of echinacea, as well as combinations of types, and the quality of some studies was low, warns Steven Foster, an Arkansas plant photographer who writes on herbal research for the American Botanical Council, a nonprofit research and educational organization in Texas.

While echinacea does not kill bacteria, research suggests it does increase the number of white blood cells, as well as the process of phagocytosis, or the gobbling up of invading organisms by immune cells. It may also block an enzyme that helps infections spread.

There's some evidence that echinacea also helps stimulate cells called fibroblasts, which play a role in healing wounds, says Cathy Crandall, a researcher of medicinal plants at Washington University in St. Louis.

Those who study herbs seriously, among them Gail Mahady, a pharmacognocist at the University of Illinois in Chicago, say that the data on echinacea are a lot more solid than that on some herbal remedies.

"I don't think anyone could look through the literature and honestly say echinacea doesn't stimulate the immune system," she says.

No one is sure which of echinacea's constituents might account for such effects, though there's some evidence that one component, high molecular weight polysaccharides, can activate cells that gobble up invading germs.

Three varieties

A more pressing question, for most consumers, is which kind of echinacea -- E. angustifolia, E. pallida or E. purpurea -- to take, and in what formulation.

Most of the research has been done on E. purpurea, and it is this type of echinacea that the German Commission E, the leading authority on herbal remedies, recommends for colds and respiratory infections and for urinary tract infections as well.

The Germans endorse the above-ground parts of E. purpurea -- not the roots -- taken either as pressed juice in an alcohol solution or as an injection. (Injections of echinacea are not available in this country, though they are in Germany.)

There has been less study of E. angustifolia, notes Tyler, though he thinks the roots of this form may actually be the best product. In practice, many of the dozens of echinacea products sold in America are combinations of all three types.

If you do take a combination product, says Mahady of Chicago, try to get one that contains the above-ground parts of E. purpurea and the roots of E. angustifolia and E. pallida. Some products give this information on the label.

Mahady takes the stuff herself -- the 22 percent liquid formulation, not the capsules -- whenever she feels a cold coming on. "It tastes terrible," she says, but seems to help.

And if you take echinacea, the German Commission E suggests, don't take it for more than eight weeks because it loses effectiveness over time.

For adults, the usual recommendation is 90 drops a day -- you quickly learn how to gauge how many drops are in a dropperful -- spread over three doses. Manufacturers, backed by German research, often recommend as much as 150 drops a day. For small children, 10 drops a day often help, and for kids between 5 and 10 years of age, 20 drops.

Pub Date: 4/15/97

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