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Echinacea

Echinacea

Description

Echinacea, commonly known as the purple coneflower, is a perennial herb of the Composite family, commonly known as the daisy family. Most often referred to as the purple coneflower, this hardy plant is also known as Sampson root, Missouri snakeroot, and rudbeckia. The prominent, bristly seed head inspired the generic name of the plant, taken from the Greek word, echinos meaning hedgehog.

Echinacea is a North American prairie native, abundant in the mid west and cultivated widely in ornamental and medicinal gardens. The purple-pink rays of the blossom droop downward from a brassy hued center cone composed of many small, tubular florets. The conspicuous flowers bloom singly on stout, prickly stems from mid-summer to autumn. Flower heads may grow to 4 in (10.16 cm) across. The dark green leaves are opposite, entire, lanceolate, toothed, and hairy with three prominent veins. The narrow upper leaves are attached to the stem with stalks. The lower leaves are longer, emerging from the stem without a leaf stalk, and growing to 8 in (20.32 cm) in length. The plant develops deep, slender, black roots. Echinacea propagates easily from seed or by root cuttings. However, due to its increasing popularity as an herbal supplement, echinacea is numbered among the 19 medicinal plants considered at risk by the Vermont nonprofit organization United Plant Savers.

General use

Three species of echinacea are useful medicinally: Echinacea augustifolia, Echinacea purpurea, and Echinacea pallida. The entire plant has numerous medicinal properties that act synergistically to good effect. Echinacea is most often used to boost the immune system and fight infection. Research has shown that echinacea increases production of interferon in the body. It is antiseptic and antimicrobial, with properties that act to increase the number of white blood cells available to destroy bacteria and slow the spread of infection. As a depurative, the herbal extract cleanses and purifies the bloodstream, and has been used effectively to treat boils . Echinacea is vulnerary, promoting wound healing through the action of a chemical substance in the root known as caffeic acid glycoside. As an alterative and an immuno-modulator, echinacea acts gradually to promote beneficial change in the entire system. It has also been used to treat urinary infection and Candida albicans infections . Echinacea is a febrifuge, useful in reducing fevers. It is also useful in the treatment of hemorrhoids . A tincture, or a strong decoction of echinacea serves as an effective mouthwash for the treatment of pyorrhea and gingivitis.

Native American plains Indians relied on echinacea as an all-purpose antiseptic. The Sioux tribe valued the root as a remedy for snake bite, the Cheyenne tribe chewed the root to quench thirst, and another tribe washed their hands in a decoction of echinacea to increase their tolerance of heat. European settlers learned of the North American herb's many uses, and soon numerous echinacea-based remedies were commercially available from pharmaceutical companies in the United States. Echinacea was a popular remedy in the United

States through the 1930s. It was among many medicinal herbs listed in the U.S. Pharmacopoeia, the official U.S. government listing of pharmaceutical raw materials and recipes. The herb fell out of popular use in the United States with the availability of antibiotics. In West Germany, more than 200 preparations are made from the species E. purpurea. Commercially prepared salves, tinctures, teas, and extracts are marketed using standardized extracts. Echinacea is regaining its status in the United States as a household medicine-chest staple in many homes. It is one of the best-selling herbal supplements in U.S. health food stores.

Clinical studies have found that the entire plant possesses medicinal properties with varying levels of effectiveness. Echinacea is of particular benefit in the treatment of upper respiratory tract infections. Some research has shown that echinacea activates the macrophages that destroy cancer cells and pathogens. When taken after cancer treatments, an extract of the root has been found to increase the body's production of white blood cells. Echinacea has been shown to be most effective when taken at the first sign of illness, rather than when used as a daily preventative. Other research has demonstrated the significant effect of E. purpurea root on reducing the duration and severity of colds and flu. Some herbal references list only the root as the medicinal part, others include the aerial parts of the plant, particularly the leaf. Most research has been done on the species E. pallida and E. purpurea. All three species of echinacea are rich in vitamins and minerals. Echinacea is an herbal source of niacin, chromium, iron, manganese, selenium , silicon, and zinc .

While echinacea has proven effective for treating or preventing upper respiratory tract infections, scientific research proving its effectiveness for other uses still lacks, according to a report released in early 2002. The report says that data for other uses of the herb are inconclusive or don't exist.

Preparations

The quality of any herbal supplement depends greatly on the conditions of weather and soil where the herb was grown, the timing and care in harvesting, and the manner of preparation and storage.

Decoction is the best method to extract the mineral salts and other healing components from the coarser herb materials, such as the root, bark, and stems. It is prepared by adding 1 oz (0.028 kg) of the dried plant materials, or 2 oz (560 g) of fresh plant parts, to one pint of pure, unchlorinated, boiled water in a non-metallic pot. The mixture is simmered for about one half hour, then strained and covered. A decoction may be refrigerated for up to two days and retain its healing qualities.

An infusion is the method used to derive benefits from the leaves, flowers, and stems in the form of an herbal tea. Twice as much fresh, chopped herb as dried herb should be used. It is steeped in one pint of boiled, unchlorinated water for 10-15 minutes. Next, it is strained and covered. The infusion is drunk warm and sweetened with honey if desired. A standard dose is three cups per day. An infusion will keep for up to two days in the refrigerator and retain its healing qualities.

A tincture is the usual method to prepare a concentrated form of the herbal remedy. Tinctures, properly prepared and stored, will retain medicinal potency for two years or more. Combine 4 oz (112 g) of finely cut fresh or powdered dry herb with one pint of brandy, gin, or vodka, in a glass container. The alcohol should be enough to cover the plant parts and have a 50/50 ratio of alcohol to water. The mixture should be placed away from light for about two weeks and shaken several times each day. It should be strained and stored in a tightly capped, dark glass bottle. A standard dose is one 4 ml of the tincture three times a day.

Precautions

Echinacea is considered safe in recommended doses. Pregnant or lactating women, however, are advised not to take echinacea in injection form. Because the plant has proven immuno-modulating properties, individuals with systemic lupus erythmatosus, rheumatoid arthritis, tuberculosis, leukemia, multiple sclerosis , or AIDS should consult their physician before using echinacea. Echinacea should not be given to children under two years of age and it should only be given to children over two in consultation with a physician. Research indicates that echinacea is most effective when taken at first onset of symptoms of cold or flu, and when usage is continued no longer than eight weeks. There is some indication that the herb loses its effectiveness when used over a long period of time. It is necessary to interrupt use for a minimum of several weeks in order to give the body's immune system the opportunity to rest and adjust.

Side effects

No side effects are reported with oral administration of echinacea, either in tincture, capsule, or as a tea, when taken according to recommended doses. Chills, fever , and allergic reactions have been reported in some research studies using an injection of the plant extract. Different brands of echinacea vary considerably in effectiveness.

Interactions

Those taking drugs to suppress the immune system should check with their doctors before taking Echinacea. When used in combination with other herbs, dosage should be lowered.

Resources

BOOKS

Foster, Steven and James A. Duke. A Field Guide to Medicinal Plants. New York: The Peterson Field Guide Series, Houghton Mifflin Company, 1990.

Hoffmann, David. The New Holistic Herbal. Massachusetts: Element Books Inc., 1986.

Kowalchik, Claire and William H. Hylton, editors. Rodale's Illustrated Encyclopedia of Herbs. Pennsylvania: Rodale Press Inc., 1987.

McIntyre, Anne. The Medicinal Garden. Henry Holt and Company Inc., 1997.

Official Proceedings. Medicines from the Earth, Protocols for Botanical Healing. Massachusetts: Gaia Herbal Research Institute, 1996.

Ondra, Nancy, editor. "200 Herbal Remedies." Excerpted from The Complete Book of Natural & Medicinal Cures. Pennsylvania: Rodale Press Inc., 1994.

Weed, Susun S. Wise Woman Ways, Menopausal Years. New York: Ash Tree Publishing, 1992.

PERIODICALS

Deneen, Sally and Tracey C. Rembert. "Stalking Medicinal Plants, An International Trade Imperils Wild Herbs." E Magazine (July/August 1999).

Schardt, David and Barbara Sorkin. "Echinacea." Nutrition Action Newsletter 29, no. 2 (March 2002):16.

Wallace, Phil. "Popular Herbal Supplements Get Mixed Reviews in Journal." Food Chemical News (January 7, 2002):30.

OTHER

Herb World News Online, Research Reviews. http://www.herbs.org. Herb Research Foundation, 1999.

Clare Hanrahan

Teresa G. Odle

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Echinacea

Echinacea

Definition

Echinacea, or purple coneflower, is a perennial herb of the Composite family, commonly known as the daisy family. Most often referred to as the purple coneflower, this hardy plant also known as Sampson root, Missouri snakeroot, and rudbeckia. The prominent, bristly seed head inspired the generic name of the plant, taken from the Greek word echinos meaning hedgehog.

Description

Echinacea is a North American prairie native, abundant in the Mid-west, and cultivated widely in ornamental and medicinal gardens. The purple-pink rays of the blossom droop downward from a brassy hued center cone composed of many small, tubular florets. The conspicuous flowers bloom singly on stout, prickly stems from mid-summer to autumn. Flower heads may grow to 4 in (10.16 cm) across. The dark green leaves are opposite, entire, lanceolate, toothed, and hairy with three prominent veins. The narrow upper leaves are attached to the stem with stalks. The lower leaves are longer, emerging from the stem without a leaf stalk, and growing to 8 in (20.32 cm) in length. The plant develops deep, slender, black roots. Echinacea propagates easily from seed or by root cuttings. However, due to its increasing popularity as an herbal supplement, echinacea is numbered among the 19 medicinal plants considered at risk by the Vermont nonprofit organization, United Plant Savers.

Purpose

Three species of echinacea are useful medicinally: Echinacea augustifolia, Echinacea purpurea, and Echinacea pallida. The entire plant has numerous medicinal properties that act synergistically to good effect. Echinacea is most often used to boost the immune system and fight infection. Research has shown that echinacea increases production of interferon in the body. It is antiseptic and antimicrobial, with properties that act to increase the number of white blood cells available to destroy bacteria and slow the spread of infection. As a depurative, the herbal extract cleanses and purifies the bloodstream, and has been used effectively to treat boils. Echinacea is vulnerary, promoting wound healing through the action of a chemical substance in the root known as caffeic acid glycoside. As an alterative and an immuno-modulator, echinacea acts gradually to promote beneficial change in the entire system. It has also been used to treat urinary infection and Candida albicans infections. Echinacea is a febrifuge, useful in reducing fevers. It is also useful in the treatment of hemorrhoids. A tincture, or a strong decoction of echinacea serves as an effective mouthwash for the treatment of pyorrhea and gingivitis.

Native American plains Indians relied on echinacea as an all-purpose antiseptic. The Sioux tribe valued the root as a remedy for snake bite, the Cheyenne tribe chewed the root to quench thirst, and another tribe washed their hands in a decoction of echinacea to increase their tolerance of heat. European settlers learned of the North American herb's many uses, and soon numerous echinacea-based remedies were commercially available from pharmaceutical companies in the United States. Echinacea was a popular remedy in the United States through the 1930s. It was among many medicinal herbs listed in the U.S. Pharmacopoeia, the official United States government listing of pharmaceutical raw materials and recipes. The herb fell out of popular use in the United States with the availability of antibiotics. In West Germany, over 200 preparations are made from the species E. purpurea. Commercially prepared salves, tinctures, teas, and extracts are marketed using standardized extracts. Echinacea is regaining its status in the United States as a household medicine-chest staple in many homes. It is one of the best-selling herbal supplements in United States health food stores.

Clinical studies have found that the entire plant possesses medicinal properties with varying levels of effectiveness. Echinacea is of particular benefit in the treatment of upper respiratory tract infections. Some research has shown that echinacea activates the macrophages that destroy cancer cells and pathogens. When taken after cancer treatments, an extract of the root has been found to increase the body's production of white blood cells. Echinacea has been shown to be most effective when taken at the first sign of illness, rather than when used as a daily preventative. Other research has demonstrated the significant effect of E. purpurea root on reducing the duration and severity of colds and flu. Some herbal references list only the root as the medicinal part, others include the aerial parts of the plant, particularly the leaf. Research studies in Europe and the United States have concluded that the entire plant is medicinally effective. Most research has been done on the species E. pallida and E. purpurea. All three species of echinacea are rich in vitamins and minerals. Echinacea is an herbal source of niacin, chromium, iron, manganese, selenium, silicon, and zinc.

Preparations

The quality of any herbal supplement depends greatly on the conditions of weather and soil where the herb was grown, the timing and care in harvesting, and the manner of preparation and storage.

Decoction is the best method to extract the mineral salts and other healing components from the coarser herb materials, such as the root, bark, and stems. It is prepared by adding 1 oz (28.4 g) of the dried plant materials, or 2 oz (56.7 g) of fresh plant parts, to 1 pt (0.47 l) of pure, unchlorinated, boiled water in a non-metallic pot. Simmer for about one half hour. Strain and cover. A decoction may be refrigerated for up to two days and retain its healing qualities.

An infusion is the method used to derive benefits from the leaves, flowers, and stems in the form of an herbal tea. Use twice as much fresh, chopped herb as dried herb. Steep in 1 pt (0.47 l) of boiled, unchlorinated water for 10-15 minutes. Strain and cover. Drink warm, sweetened with honey if desired. A standard dose is three cups per day. An infusion will keep for up to two days in the refrigerator and retain its healing qualities.

A tincture is the usual method to prepare a concentrated form of the herbal remedy. Tinctures, properly prepared and stored, will retain medicinal potency for two years or more. Combine 4 oz (114 g) of finely cut fresh or powdered dry herb with 1 pt (0.47 l) of brandy, gin, or vodka in a glass container. The alcohol should be enough to cover the plant parts and have a 50/50 ratio of alcohol to water. Place the mixture away from light for about two weeks, shaking several times each day. Strain and store in a tightly capped, dark glass bottle. A standard dose is 0.14 oz (4 ml) of the tincture three times a day.

Precautions

Echinacea is considered safe in recommended doses. Pregnant or lactating women, however, are advised not to take echinacea in injection form. Because the plant has proven immuno-modulating properties, individuals with systemic lupus erythmatosus, rheumatoid arthritis, tuberculosis, leukemia, multiple sclerosis, or AIDS should consult their physician before using echinacea. Echinacea should not be given to children under two years of age, and it should only be given to children over two in consultation with a physician. Research indicates that echinacea is most effective when taken at first onset of symptoms of cold or flu, and when usage is continued no longer than eight weeks. There is some indication that the herb loses its effectiveness when used over a long period of time. It is necessary to interrupt use for a minimum of several weeks in order to give the body's immune system the opportunity to rest and adjust.

Side effects

No side effects are reported with oral administration of echinacea, either in tincture, capsule, or as a tea, when taken according to recommended doses. Chills, fever, and allergic reactions have been reported in some research studies using an injection of the plant extract.

KEY TERMS

Alterative A medicinal substance that acts gradually to nourish and improve the system.

Antimicrobial A plant substance that acts to inhibit the growth of harmful microorganisms, or acts to destroy them.

Febrifuge A plant substance that acts to prevent or reduce fever.

Glycoside An herbal carbohydrate that exerts powerful effect on hormone-producing tissues. The glycoside breaks down into a sugar and a non-sugar component.

Lanceolate Narrow, leaf shape that is longer than it is wide, and pointed at the end.

Macrophage Specialized cells present throughout the lymphoid tissues of the body that circulate in the bloodstream. Macrophages have a surface marker that stimulates other cells to react to an antigen.

Interactions

None reported. When used in combination with other herbs, dosage should be lowered.

Resources

PERIODICALS

Deneen, Sally, and Tracey C. Rembert. "StalkingMedicinal Plants, An International Trade Imperils Wild Herbs." E Magazine July-August 1999.

OTHER

Herb World News Online, Research Reviews. Herb Research Foundation. 1999. http://www.herbs.org.

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coneflower

coneflower, name for several American wildflowers of the family Asteraceae (aster family). The purple coneflowers (genus Echinacea), found E of the Rockies, have purple to pinkish petallike rays; some cultivated forms have white flowers. The herb echinacea, derived from the purple coneflower, is taken for colds and other ailments; the plant was used medicinally by Native Americans. Other coneflowers include the yellow coneflowers, or rudbeckias (see black-eyed Susan), and the praire coneflowers (genus Ratibida), which have yellow or purplish rays. Many species are grown as garden plants. Coneflowers are classified in the division Magnoliophyta, class Magnoliopsida, order Asterales, family Asteraceae.

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echinacea

echinacea (ĕk´ənā´shēə), popular herbal remedy, or botanical, believed to benefit the immune system. It is used especially to alleviate common colds and the flu. Several controlled studies using it as a cold medicine have failed to find any benefit from its use, but a 2007 review of 14 different studies said that echinacea could have modest to marked effects against cold viruses. Echinacea is extracted from the roots and flowering tops of the purple coneflower (Echinacea angustifolia and E. purpurea).

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Echinacea

Echinacea (subphylum Echinozoa, class Echinoidea) A superorder of regular echinoids that have rigid tests, gill slits, complete perignathic girdles, and keeled teeth. They first appeared in the Upper Triassic.

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Echinacea

Echinacea

Definition

Purpose

Description

Precautions

Interactions

Complications

Parental concerns

Resources

Definition

Echinacea is a perennial plant native to North America that is farmed in both the United States and Europe for use in dietary supplements . Echinacea is a genus in the aster family containing nine plant species. Three species, Echinacea angustifolia, E. purpurea, and E. pallida are used in complementary and alternative medicine in the United States and Europe.

Echinacea species are commonly called cone-flowers. The common name for E. purpurea is purple coneflower. E. pallida is known as pale purple cone-flower and E. angustifolia as narrow-leaf coneflower. Echinacea is sold as an herbal dietary supplement under a variety of trade names. It is also a common ingredient in many supplements containing multiple ingredients.

Purpose

Echinacea has been used as a medicinal herb in North America for more than 400 years. Native Americans used echinacea to treat wounds, snakebites, infections, and as a general booster of health. In the 1930s the herb was very popular in both the United States and Europe, as it was thought to fight infection by boosting the immune system. It was used to treat conditions as diverse as colds, influenza, eczema, many different types of infections, malaria, syphilis, cancer , and diphtheria. As antibiotics became more widely available after World War II, echinacea’s popularity declined, only to rise again in the 1980s. It is one of the most frequently used herbal remedies in the North America and Europe. Echinacea is especially popular in Germany, where many practitioners of conventional medicine accept it as a safe and effective treatment for cold symptoms. In 2003, echinacea was one of the top three selling herbs in the United States, and in 2006 it was estimated to account for 10% of all dietary supplement sales in the United States.

Description

Echinacea is a perennial herb with slender, rough leaves arranged opposite each other on a stem that grows to a height of about 18 in (45 cm) and produces a single large purplish flower. Both the above ground parts of the plant and the roots are used in dietary supplements. Fresh leaves are pressed and the resulting juice is used in extracts or tinctures, or it is combined with other ingredients to make a paste that can be applied to the skin. Dried leaves and roots are Echinacea flowers , also called purple coneflowers.

powered and made into tea or capsules. An injectable form of echinacea is available in Europe, but not in the United States. The active ingredients of echinacea have not been adequately identified. As a result, it is difficult to compare the strength and potency of different forms of the herb or the same formulation made by different manufacturers.

Safety and effectiveness of Echinacea

Although echinacea has been used for hundreds of years, only recently have researchers started to examine its effectiveness in large, independent, rigorously controlled studies. Many early studies done in Germany suggested that the herb was effective in treating certain conditions. In the United States, the National Center for Complementary and Alternative Medicine (NCCAM), a government organization within the National Institutes of Health, is currently conducting studies on the safety and effectiveness of echinacea in treating a variety of conditions.

In the United States, the Food and Drug Administration (FDA) regulates dietary supplements such as echinacea using the same laws that regulate food, rather than the laws that regulate prescription and over-the-counter medications. Unlike conventional drugs, dietary supplements are not required to undergo rigorous testing to show that they are safe and effective before they are marketed to the public. One consequence of this is that there are many fewer

KEY TERMS

Alternative medicine —A system of healing that rejects conventional, pharmaceutical-based medicine and replaces it with the use of dietary supplements and therapies such as herbs, vitamins, minerals, massage, and cleansing diets. Alternative medicine includes well-established treatment systems such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine, as well as more-recent, fad-driven treatments.

Complementary medicine —Includes many of the same treatments used in alternative medicine, but uses them to supplement conventional drug and therapy treatments, rather than to replace conventional medicine.

Conventional medicine —Mainstream or Western pharmaceutical-based medicine practiced by medical doctors, doctors of osteopathy, and other licensed health care professionals.

Dietary supplement —A product, such as a vitamin, mineral, herb, amino acid, or enzyme, that is intended to be consumed in addition to an individual’s diet with the expectation that it will improve health.

Perennial herb —A plant that lives for several years with new growth appearing each year.

Placebo —A pill or liquid given during the study of a drug or dietary supplement that contains no medication or active ingredient. Usually study participants do not know if they are receiving a pill containing the drug or an identical-appearing placebo.

studies of dietary supplements, and some of those studies are sponsored by the manufacturers who have an economic investment in positive outcomes. Too often, studies of dietary supplements are small, poorly designed, poorly controlled, or incompletely reported, making it is difficult to draw hard conclusions about the effectiveness and safety of the product.

The most common use of echinacea in the United States and Europe is to prevent or shorten and reduce the severity of symptoms of the common cold, including sneezing, runny, nose, cough, and fever. Natural Standard, an independent organization that evaluates studies, scientific evidence, and expert opinion on complementary and alternative treatments and makes impartial judgments concerning their safety and effectiveness has found that the evidence of effectiveness of echinacea in treating cold symptoms is mixed. Some studies have shown that individuals who take echinacea during cold season are less likely to catch a cold, but more have found that echinacea has no effect on whether an individual catches a cold. On the other hand, more than half of a substantial number of well-designed European studies found that people who take echinacea at the first sign of a cold feel better sooner than those who take a placebo or who take nothing. These results have been contradicted by several large, well-designed American studies, including one in 2005 of children ages 2-11 that found on average echinacea did not reduce the length of time the children showed cold symptoms. Two studies sponsored by NCCAM also found echinacea did not shorten the symptoms of colds or influenza or prevent colds.

For years, echinacea has been taken to improve general health and to treat a variety of infections because it is thought to boost the immune system. Laboratory analyses of the ingredients in echinacea and some animal studies have suggested that echinacea does stimulate immune system cells. However, this result has not been confirmed in humans. Research continues on this use of echinacea.

Claims have also been made that individuals with AIDS, cancer, and genital herpes can benefit from taking echinacea. Although there is some theoretical basis for these claims, there is no clear evidence that echinacea has an effect on these conditions in humans.

Despite mixed evidence about the effectiveness of echinacea, the herb generally appears to be safe when taken by adults in moderate amounts. There is no standardization of the amount of active ingredient in products containing echinacea. Guidelines of normal doses for a 150 lb (70 kg) adult taken three times a day are:

  • 1-2 g dried leaves or root brewed into tea
  • 2-3 mL tincture
  • 200 mg powdered extract

Lower doses of echinacea for children, based on the weight of the child, are generally thought to be safe, although in the cold study mentioned above, children showed an increased risk of developing a rash. One study of pregnant women using echinacea found that moderate use of the herb during the first three months of pregnancy did not increase the likelihood of the baby being born with major birth defects. The safety of echinacea use in breastfeeding women has not been adequately studied.

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Precautions

Individuals interested in taking echinacea should consult their health care provider and other reputable sources of information before starting the herb. Pregnant or breastfeeding women should be especially careful to discuss the use of echinacea and all other drugs and supplements with their health care provider. One animal study indicated that the increase in white blood cells normally seen during pregnancy was reduced or eliminated in women who took echinacea during pregnancy. This suggests that women who should avoid the drug during pregnancy. A separate study designed to evaluate the safety of echinacea during pregnancy failed to show any harm to either the mother or the fetus. In addition, care should be taken in giving children echinacea. Few studies have been done specifically on children.

As with any medication, more is not necessarily better, and the words “natural” or “organic” on the label do not mean the product is safe. Overdose can cause serious side effects. In the event of side effects, echinacea should be stopped immediately and the side effects reported to a health care professional. People with autoimmune diseases (e.g., AIDS, multiple sclerosis) are often counseled to avoid echinacea, because of theoretical, but unproven, negative effects on the immune system.

Interactions

Echinacea may interact with both conventional drugs and other herbs or dietary supplements, but few rigorous studies have been done on potential interactions. Individuals should tell their health care provider about all the conventional drugs and dietary supplements they are taking before beginning any new drug or supplement.

Since echinacea may stimulate the immune system, it is recommended that individuals who are taking immune system suppressant drugs following cancer treatment or organ transplant avoid echinacea. This interaction has not been verified experimentally, and some trials suggest that echinacea can actually benefit cancer patients.

Echinacea may also interact with econazole, an antifungal drug. Individuals who take echinacea while taking econazole to treat fungal infections appear more likely to have reoccurrence of the fungal infection.

Complications

People who are allergic to ragweed, chrysanthemums, marigolds, daisies, and related plants have a greater chance of being allergic to echinacea. Allergic reactions have on rare occasions been reported to be severe and cause breathing difficulties, especially in people with asthma. Much more common are allergic reactions consisting of a rash, sneezing, or runny nose.

Parental concerns

Parents should be aware that the safe dose of many herbal supplements has not been established for children. Accidental overdose may occur if children are give adult herbal supplements.

Resources

BOOKS

Miller, Sandra C. and He-ci Yu, eds. Echinacea: The Genus Echinacea. Boca Raton, FL: CRC Press, 2004.

PDR for Herbal Medicines, 3rd ed. Montvale, NJ: Thompson Healthcare, 2004.

Pierce, Andrea. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: William Morrow, 1999.

Wildman, Robert E. C., ed. Handbook of Nutraceuticals and Functional Foods, 2nd ed. Boca Raton, FL: CRC/Tay-lor&Francis, 2007.

PERIODICALS

Dugoua, Perri D, E. Mills, and G. Koren. “Safety and Efficacy of Echinacea (Echinacea angustifolia, E. pur-purea and E. pallida) During Pregnancy and Lactation.” Canadian Journal of Clinical Pharmacology 13, no.3 (2006): e262-7.

Klinger, Benjamin. “Echinacea.” American Family Physician 67, no. 1 (2003): 77-80.

Messina, B. A. “Herbal Supplements: Facts and Myths— Talking to Your Patients About Herbal Supplements.’” Journal of PeriAnesthesia Nursing 21, no 4 (2006): 268-78.

Taylor, J. A., et al. “Efficacy and Safety of Echinacea in Treating Upper Respiratory Tract Infections in Children: A Randomized Controlled Trial.” Journal of the American Medical Association 290, no.21 (December 3, 1003): 2824-30.

ORGANIZATIONS

Alternative Medicine Foundation. P.O. Box 60016, Potomac, MD 20859. Telephone: (301) 340-1960. Fax: (301) 340-1936. Website: http://www.amfoundation.org>.

National Center for Complementary and Alternative Medicine Clearinghouse. P.O. Box 7923, Gathersburg, MD 20898. Telephone: (888) 644-6226. TTY: (866) 464-3615. Fax: (866) 464-3616. Website: http://nccam.nih.gov>.

Natural Standard. 245 First Street, 18th Floor, Cambridge, MA 02142. Telephone: (617) 444-8629. Fax: (617) 444-8642. Website: <http://www.naturalstandards.com>.

Office of Dietary Supplements, National Institutes of Health. 6100 Executive Blvd., Room 3B01, MSC 7517, Bethesda, MD 20892-7517 Telephone: (301)435-2920. Fax: (301)480-1845. Website: <http://dietary-supplements.info.nih.gov>.

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OTHER

“Echinacea.” A.D.A.M. Inc., September 22, 2005. [cited May 5, 2007]. http://www.umm.edu/altmed/ConsHerbs/Echinaceach.html>.

“Echinacea.” Drugs.com Wolters Kluwer Health, Inc. November 1, 2006. [cited May 5, 2007]. http://www.drugs.com/cdi/echinacea.html>.

“Echinacea (E. angustifolia DC, E. pallida, E. purpurea)”Medline Plus. U.S. National Library of Medicine. January 23, 2007. [cited May 5, 2007]. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-echinacea.html>.

Mayo Clinic Staff. “Echinacea (E. angustifolia DC, E. pallida, E. purpurea).” MayoClinic.com [cited May 5,2007]. http://www.mayoclinic.com/health/echinacea/NS_patient-echinacea>.

“Echinacea.” National Center for Complementary and Alternative Medicine. July 2005. [cited May 5, 2007]. http://nccam.nih.gov/health/echinacea>.

Tish Davidson, A.M.

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