How does it feel?
Echinacea remedies come in many different forms, with two dominant species, a third (E. pallida) and others sometimes encountered, as well as significant levels of adulteration with completely different plants. It is very important first to locate a reputable supplier with a defined product. Then having been assured that the echinacea is of good quality there will still be a range of forms and tastes to encounter. In North American tradition the benchmark was provided by the root of Echinacea angustifolia, as this has the strongest characteristic ‘tingle’ effect, but it is also harder to grow in commercial quantities. Particularly in Europe the leaves and aerial parts of Echinacea purpurea are most common; the root of that species is the most widely sold worldwide.
To get the strongest impact try to obtain a product made from E. angustifolia root. The effect of even a small taste is dramatic! The first impact is fiery, a quick very sharp astringency that covers all surfaces of the mouth, even the lips. There follow waves of sour and bitter tingling, and a very persistent long acrid, dry astringent aftertaste, leading to reflex increased salivation.
With E. purpurea aerial parts the taste is gentler, initially sweet, then some bitterness and a little tingling and astringency. The root of E purpurea will be somewhere in between.
The tingling effect is produced by alkylamides, the subtle sweetness by polysaccharides. Both have been implicated in helping to improve the body’s defences.
What can I use it for?
Use echinacea as a preventative if you are prone to upper respiratory problems like frequent colds, sore throats, sinuses, middle ear pain, or viral infections like flu.
Echinacea is the herbal practitioner’s favourite for any infectious condition, where it is seen to support balanced immune responses, including moderating over-reactions (the idea that it could worsen auto-immune problems for example is based on a misunderstanding of its activity). Importantly however infections should be treated with due respect and echinacea should not be a substitute for expert medical help: consider it a great complement to frontline conventional treatments, becoming more important the more infections keep coming back or are resistant to standard antibiotic and other prescriptions
It has local action in other areas, and a brilliant mouth wash for any inflammation in the mouth, throat and gums. It is a useful remedy applied externally to boils, carbuncles and abscesses, and as a . douche for vaginal infections.
Into the heart of Echinacea
Echinacea is best understood as defending from the outside in, supporting immune functions and reducing inflammation and infection by mobilising defences on mucosal surfaces.
It contains constituents known as isobutylamides, which are types of alkylamides. They act as insecticide defences for the plant and are found particularly in the roots. They can be clearly identified when good echinacea is tasted, as they create a ‘tingling’ or numbing effect upon the tongue. From laboratory studies it appears they may directly influence inflammatory cytokine production among defensive white blood cells found close to mucosal surfaces. Among other possible mechanisms they activate a type of cannabinoid receptor (CB2) that is involved in immune and inflammatory modulation.
Echinacea is considered as one of the primary remedies for assisting the body in clearing infection and strengthening the overall efficiency of the immune system. Echinacea reduces the severity and duration of symptoms, whilst also helping the body to deal with infection and stimulate the immune response. It will effectively target microbial, bacterial and viral infections throughout the body, but has a specific focus within the upper respiratory system and in conditions such as cold and flu, tonsillitis and laryngitis.
Echinacea is effective where immune system has become compromised by being ‘run-down’ as a result of stress or over-work.
The roots of echinacea comes with a formidable reputation from the annals of the settler tradition in North America, with one writer M.R Gilmore observing the native population using it as a “remedy for more ailments than any other plant” and others reporting in often rapturous tones their own experiences with the remedy. In particular it was recommended for the bites of snakes and other venomous creatures (to the extent that one researcher publicly volunteered to allow himself to be bitten by rattlesnakes to prove the point to his colleagues!), and for infected and poisonous conditions generally, to treat burns and wounds, and for toothache and sore throats. Septic problems were widely treated with nothing more than echinacea, and most herbalists of the day would go far to ensure a good supply.
The Native Americans, and the 19th century ‘Eclectic’ physicians who adopted their use of echinacea, preferred E. angustifolia root, which is high in alkylamides that impart a persistent tingling sensation in the mouth and stimulate the flow of saliva, long used as a sign of good quality (and likely to be a key part of the echinacea reputation).
The world-wide reputation of echinacea was cemented when the German homoeopathic physician Dr Madaus visited the USA in the 1930’s and observed that it was the most popular home remedy for infections across the country. Probably because of the difficulty of mass cultivation of Echinacea angustifolia, he created a new prescription medicine from using the aerial parts of E. purpurea.
What practitioners say
Upper respiratory: use to fend off tendencies to cold, flu, tonsillitis, pharyngitis, laryngitis, general mucous and sinus congestion. The immune stimulating properties of echinacea are focussed on throat surfaces and immediately underlying lymphatic tissues, which is where most upper respiratory battles are waged.
Immune: echinacea works mainly in innate immunity (rather than the acquired immunity of antibody production) and is appropriate for any acute and chronic infections, whether due to bacterial, viral, protozoal or other organisms. It is likely to be particularly effective in infections on or near accessible surfaces, including the upper gut wall, though has also been used to modulate immune responses including in moderating allergies and hypersensitivity reactions.
External uses: echinacea is especially effective as a mouth wash for gum disease where the tingle factor from the alkylamides is most valued. It has traditionally been used to bathe infected and open wounds, bites or poisonous attack, especially when healing is impaired. It has also been used for hot and irritated skin conditions such as eczema and psoriasis, and as a douche for vaginal infections.
Because of the European adoption of the aerial parts of Echinacea purpurea the evidence base is largely linked to this version. For example a Cochrane review pointed marginally in favour of Echinacea purpurea aerial parts: “Our exploratory meta-analyses suggest that at least some Echinacea preparations may reduce the relative risk of catching a cold by 10% to 20%.
A risk reduction of 15% would mean that if 500 out of 1000 persons receiving a placebo would catch a cold this figure would be 425 of 1000 persons with an echinacea product. This is clearly a small effect of unclear clinical relevance. This review points out a familiar complaint among reviewers of the evidence: that they could not well distinguish between echinacea products (2). An earlier (more positive) Cochrane review by some of the same authors had pointed in favour of Echinacea purpurea aerial parts (3). However, a later meta-analysis by other reviewers also did not differentiate between echinacea preparations (4).
Did you know?
The name ‘echinacea’ is derived from the Greek word ‘echino’ which means ‘sea urchin’ or ‘hedgehog’. This was chosen because it aptly described the spiny central disc of the echinacea flowers. Traditionally, echinacea was used in Native American medical traditions to treat snake bites and blood poisoning.
Echinacea purpurea is a perennial growing up to 2 metres high with simple rough stems, hollow near the base and thickening slightly close to the flowerhead. The leaves are broad, ovate to ovate-lanceolate and often toothed, covered in coarse hairs and protruberances, stalked at ground level and almost sessile up the stem. The flower is in the form of a high purple cone surrounded by roughly hairy bracts and then short spreading purple, crimson, pink or white ray florets. E. angustifolia is smaller and the leaves are more more elongated, slightly elliptical with entire margins; it has relatively straight ray florets.
Both species are native to eastern and central North America where they commonly grow in moist to dry woodlands or prairies. This plant is now cultivated across the globe for both medicinal and horticultural purposes. Echinacea angustifolia is threatened in the wild and harder to grow than E. purpurea.
Alternate botanical names:
Echinacea pallida (Nutt) Britt is a separate species that has sometimes been confused with E. angustifolia (and has been seen as the parent species in some classifications). It is likely to have less efficacy than the other two species.
- Broad-leaved purple cone flower
- Narrow-leafed purple cone flower
Safe for most people, including those with immune problems, though wise to avoid if on strong immunosuppressive prescriptions.
Echinacea is in the Asteracea plant family, and occasionally people exhibit allergic reactions to plants in this family (including daisies and chamomile). If a child has a known allergy to this plant then it is best to avoid giving them echinacea.
In 2012 a warning was issued by the MHRA that as a precautionary measure the remedy echinacea should not be given to children under 12 years old, due to a small risk of a severe allergic reaction which outweighed any benefits (5). However, since this time there has been research demonstrating the significant benefits of echinacea for children in reducing RTI’s and subsequent antibiotic use with minimal allergic reactions within the study group (6). This was based on a specific extract of echinacea, but suggests that unless there is a specific known allergy to this plant family then echinacea can have many benefits to children’s immunity.
1g-3 g of the root per day.
- Alkylamides (alkamides) incl. isobutylamides
- Caffeic acid derivatives echinacoside and cynarin (E. angustifolia); chicoric acid (E. purpurea)
- Polysaccharide ‘echinacin’ (although identification and consistency of various polysaccharides not clear)
- Polyacetylenes: incl. echinalone in (E. purpurea)
- Essential oil (trace)
Of these constituents there is evidence for immunological activity of the polysaccharides though as these are quickly broken down on digestion such activity will be confined to surface defences in the mouth and throat. Most interest recently has been in the activity (1) of the alkylamides, in modulating the activity of cannabinoid receptors (CB2) which have immune-modulating activity. The alkylamides, especially the isobutylamides have a characteristic tingling effect in the mouth and have long been considered a mark of quality of echinacea and are particularly prominent in E. angustifolia. Caffeic acid derivatives from the latter have also shown antihyaluronidase activity: hyaluronidase is an enzyme that some infective bacteria use to penetrate mucosal surfaces.
Elderberry & Echinacea Winter Warmer tea
This ‘Elderberry & Echinacea Winter Warmer’ tea targets the cause of seasonal infections by strengthening both short- and long-term immunity.
- Echinacea root 2g
- Elderberry 2g
- Elderflower 2g
- Rosehip 2g
- Peppermint leaf 2g
- Orange peel 2g
- Aniseed 1g
- Ginger root powder 1g
- Licorice root 1g
- Orange essential oil a drop per cup
Put all of the ingredients (except for the orange essential oil) in a pot.
Add 500ml/18fl oz freshly boiled filtered water.
Leave to steep for 10–15 minutes, then strain.
Add a drop of orange essential oil to each cup.
This will serve 2-3 cups of good health
This recipe is from the book Cleanse, Nurture, Restore by Sebastian Pole
- Gertsch J. (2008) Immunomodulatory lipids in plants: plant fatty acid amides and the human endocannabinoid system. Planta Med. 74(6): 638-650
- Karsch-Völk M, Barrett B, Kiefer D, et al. (2014) Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2(2): CD000530.
- Linde K, Barrett B, Wölkart K, et al. (2006) Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2006;(1):CD000530
- David S, Cunningham R. (2019) Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis. Complement Ther Med. 44: 18–26
- Pizzorno J, Murray M, Joiner-Bey H, The Clinician’s Handbook of Natural Medicine. 2nded. St Loius, Missouri: Churchill Livingstone Elsevier; 2008.
- F, Paparo L, Nocerino R. et al. Specific gut microbiome signatures and the associated pro-inflamatory functions are linked to pediatric allergy and acquisition of immune tolerance. Nat Commun, 12:5958;2021. https://doi.org/10.1038/s41467-021-26266-z