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ACEP Now: Vol 37 – No 06 – June 2018Answer: Eye Candy
Three species, Echinacea angustifolia, Echinacea pallida, and Echinacea purpurea, are used medicinally.1
Toxins
Like most unrefined drugs from plant origin, the content and composition of chemicals contained within Echinacea are complex. These consist of a wide variety of chemicals of variable effect and potency that have been explored for antiviral, antibacterial, antifungal, mosquitocidal, antioxidant, and antianxiety effects with mixed results.
It is generally thought that no single constituent or group of constituents is responsible for its activities but that these groups and their interaction contribute to beneficial activity. These include alkamides, caffeic acid derivatives, polysaccharides, and alkenes.
The amount of these complexes in different commercially available Echinacea products is variable as the preparation of the plant differs greatly among products. Different parts of the plant are used, different manufacturing methods (drying, alcoholic extraction, or pressing) are employed, and sometimes other herbs are added.
Traditional/Historical Use
Echinacea has a long history of medicinal use, mainly recommended as a broad-base, nonspecific “anti-infective” because of its purported immune-stimulator effects. Indications for its use have included syphilis, septic wounds, and “blood infections” from bacterial and viral sources. Other traditional uses include for nasopharyngeal congestion/infection and tonsillitis and as a supportive treatment for influenza-like infections and recurrent infections of the lungs or urinary tract.
It has been recommended for skin conditions including boils, carbuncles, and abscesses and also as a snakebite treatment and a laxative.
Effectiveness for Upper Respiratory Infections
A 2007 meta-analysis in The Lancet Infectious Diseases reported a positive effect. However, most studies before and after, including a Cochrane review from 2014, did not show significant or consistent improvement of illness.3 Without credible scientific evidence to the contrary, this plant probably should not be promoted to cure colds or upper respiratory infections. It looks like this pretty sunflower falls short on its medicinal value, making it nothing more than horticultural eye candy.
Other Facts
- Some people are allergic to Echinacea (like ragweed).
- As with upper respiratory infections, there are no objective data to show that Echinacea has any effect on avoidance of or efficacy for the treatment of urinary tract infections.
Dr. Hack (Oleander Photography) is an emergency physician and medical toxicologist who enjoys taking photographs of beautiful toxic, medicinal, and benign flowers that he stumbles upon or grows in his garden. Contact him at ToxInRI@gmail.com.
References
- Barnes J, Anderson LA, Gibbons S, et al. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt., Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties. J Pharm Pharmacol. 2005;57(8):929-954.
- Shah SA, Sander S, White CM, et al. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007;7(7):473-480.
- Karsch-Völk M, Barrett B, Kiefer D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014;(2):CD000530.
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