Modern research has shown echinacea to exert significant effects on immune function in over 300 scientific investigations. However, not all of the clinical studies have been positive. While some studies have been positive, others have not. Results are difficult to interpret because of the lack of quality control in the preparations used. The reason for the mixed results is most likely to the lack of consistency in the product being used. If the product, by chance, had sufficient levels of active compounds it would be effective. If not, then it would likely be no more effective than a placebo. What determines the effectiveness of any herbal product is its ability to deliver an effective dosage of active compounds. Chemical analysis of commercial Echinacea preparations has demonstrated tremendous variation in the levels of key compounds even within the same product from batch to batch.

The latest study

The most recent study on echinacea was a landmark study for several reasons. Not only was it the largest ever on an herbal treatment for children, it was the first time ever, that the medical journal JAMA (Journal of the American Medical Association) has published a research study in which Bastyr University played a key role. The study was done in collaboration between Bastyr University; the University of Washington; and Children's Hospital and Regional Medical Center.1

The results of the study were that "the form of echinacea at the dose used in the study did not lessen the length or severity of a cold, once a child has contracted it." In the study, 524 children were randomized to receive echinacea or a placebo and parents were instructed to administer as soon as the symptoms of a cold appeared. Researchers looked at both the efficacy of treatment and possible side effects of Echinacea therapy. While the echinacea product did not reduce the severity of cold symptoms as assessed by parents, those receiving echinacea experienced fewer second and third colds than children on placebo. Echinacea was observed to be generally safe, "well tolerated" according to the researchers, producing no serious adverse effects. However, there was a higher incidence of rash in the Echinacea group (7.1%) than in the placebo group (2.7%). The rashes reported in this study might be due to allergic reactions to pollens in the echinacea preparation, since the product used contained the fresh-pressed juice of the above-ground part of the echinacea rather than an extract.

My interpretation of the study

I had predicted these results as soon as I became aware of this study. First of all, cold trials in children have shown that even conventional over-the-counter cold medicines are produce little efficacy. It is simply difficult to design a trial evaluating the common cold in children. Next, I felt that the form of echinacea being used and the dosage recommended was not likely to produce any real benefit. The product used is fraught with consistency and quality control problems. It is not standardized for levels of active constituents and there is tremendous batch to batch and intra-batch batch variation of constituents.2 It is highly unlikely that due to the product used and the dosage given that the children received a sufficient level of the active compounds of echinacea. In addition, it was administered within a base of a syrup. Since sugar is known to impair white blood cell function, some of the beneficial effects of echinacea could have been hindered by giving it in a syrup.

Your question may be "why did researchers test a product if it had little chance of showing effectiveness?" My answer to that question is that the study was being funded by the manufacturer of the echinacea product. While I applaud the company for funding research, I am upset that many consumers may get the wrong message from the results of the study and how it was portrayed in the media. Keep in mind that the researchers themselves indicated that that other Echinacea preparations and dosing regimens may be effective for the treatment of colds, even though the product they tested in children was not.

The bottom line here is that echinacea is effective if you use an effective product.

Echinamide is the world's best

For assurance of an effective product, I recommend Echinamide, a patented, super-extracted Echinacea product developed and marketed by Natural Factors. Many experts now consider Echinamide to be the ultimate Echinacea product on the market. Echinamide is unique in that it not only has standardized levels of active compounds; they are in ratios that have been shown to produce the greatest effect. It is not enough to be high in any one particular component of Echinacea, for maximum benefit it is very important that the product contain all of the active components in their natural and most effective ratios. And, that is exactly what makes Echinamide different from all other Echinacea products.

Many manufacturers are not employing the necessary quality control tests required to insure that the Echinacea is being grown properly and is harvested at the exact time for maximal levels of all active compounds. It is also imperative that the Echinacea be treated properly after harvesting. First of all, it is absolutely essential to use fresh plant material versus the dried plant or roots that most manufacturers use. Studies indicate that a significant amount of the active ingredients are destroyed in the drying process.3,4

Processing time is also very important. If the fresh plant material is not processed immediately, the content of several key components - especially cichoric acid, alkylamides,- will be low (as much as 80% will be lost). It is also essential that the extraction be carried out under ideal circumstances. Natural Factors committed to finding the best conditions for extraction of Echinacea to yield the highest level of active components. They determined the best portion of the plant to use as well as the right temperature, length of time for extraction, and right concentrations for alcohol and water. And, since the active components have different solubility characteristics (some are more soluble in water, others are more soluble in alcohol), they conduct different extractions to concentrate the different active compounds and then blend the extracts together to produce Echinamide.

Dr. Rudolf Bauer of the Heinrich Heine University in Dusseldorf, Germany, has conducted and published more research on Echinacea than any other person. His research has been critical not only to the understanding of Echinacea but also to its growing acceptance as an immune enhancing agent. According to Dr. Bauer "Echinamide is unique in that it has certain standardized levels of polysaccharides, cichoric acid, and alkylamides." And, on the research conducted with Echinamide, Dr. Bauer said, "This new data which has produced pharmacological results cannot be transferred to other products." There are over 300 Echinacea products sold in the world, but there is only one with the unique chemical profile of Echinamide. Here is a brief summary of the advances made by the scientists at Natural Factors:

Improved analytical techniques
Developed the appropriate techniques in chemical analysis to isolate and measure the substances within Echinacea purpurea that are responsible for its immune enhancing effects.

Better Growing Conditions
Natural Factors has determined the optimal growing conditions using 100% organic growing standards for Echinacea purpurea to yield the highest levels of active compounds.

More Precise Harvesting
By determining the level of active compounds through the growing cycle, Natural Factors harvests the plant at the most ideal time - when it is highest in active compounds.

Use of Fresh Herb
Natural Factors uses fresh Echinacea purpurea because up to 30% of the active compounds are lost in the drying process.

Advanced Extraction Techniques
Many key compounds in echinacea are typically lost during the extraction phase or are left behind due to inappropriate extraction. Natural Factors has developed a patented extraction technique that results in a product with the highest levels and broadest range of active compounds available.

Improved Experimental Models
Natural Factors worked with leaders in pharmacology to develop the experimental models designed to better understand and measure the immune enhancing effects of echinacea.

Proper Clinical Evaluation
The encouraging results from preliminary studies with Echinamide are being followed by detailed clinical studies at major Universities.

The immune enhancing compounds in Echinamide

The most important constituents of echinacea can be divided into three major categories: (1) polysaccharides; (2) cichoric acid and other caffeic acid derivatives; and (3) alkylamides. Since echinacea contains a wide assortment of chemical constituents with confirmed immune enhancing effects, it is important for manufacturers to insure sufficient levels of all these active compounds. Unfortunately, most echinacea products on the market do not specify the levels of active compounds because they have not been analyzed for them. And, when manufacturers do state the level of a particular marker compound most consumers fail to realize that concentrating only for one particular active compound of echinacea results in loss of other constituents and, as a result, all of the synergistic effects. For example, some manufacturers standardize for "total phenolic content" or the compound echinacoside. However, although these sort of Echinacea extracts were found to have some antioxidant properties recent studies have found them to have no effect on enhancing immune function in experimental animal studies.5

Synergistic effect defined

One of the most interesting phenomena in nature is synergy. In the case of echinacea, it appears that while individual immune enhancing compounds produce significant effects when they are combined in meaningful amounts there is an additive effect. The immune enhancing components of echinacea work together in a harmonious fashion to produce the phenomena of synergy. In other words, 1 + 1 + 1 = 6. In order to appreciate this synergy, let's take a look at Echinacea's effect on white blood cells known as macrophages ("big eaters"). These cells filter the lymph and blood by engulfing and destroying bacteria, viruses, and cancer cells through a process known as phagocytosis.

One of the key manners in which echinacea enhances immune function is via enhancing the ability of macrophages to engulf and destroy particulate matter.1-4 By enhancing the activity of these "garbage collectors" of the body; in essence the blood is purified. The specific components of echinacea responsible for this effect are the polysaccharides, alkylamides, and cichoric acid. While each of these components is effective alone, the greatest degree of enhancement noted in research by Dr. Tapan Basu at the University of Alberta when the three active components are used in combination in the form of Echinamide.6 What Dr. Basu demonstrated was the phenomena of synergy along with a clear dose dependent effect. In other words, Dr. Basu demonstrated that the effects with the three actives was greater than any individual active and that the higher the dosage of Echinamide the greater the effect on enhancing macrophage function.

Dr. Basu and others have also demonstrated that in addition to enhancing the ability of the macrophages to engulf and destroy foreign molecules, the active components of Echinamide also increase the ability of the macrophage to detect the presence of foreign matter in the blood and signal the other components of the immune system to mount an attack.6,7 This signal is in the form of chemical messengers. Over a dozen different factors have been identified.

Echinamide also exerts actions on other types of white blood cells, particularly interesting is its action on another type of white blood cell known as natural killer cells. Natural killer (NK) cells got their name because they can destroy cells that have become cancerous or infected with viruses. Typically NK cell levels or activity will be reduced in individuals suffering from either chronic viral illness (such as chronic hepatitis or chronic fatigue syndrome) or cancer. Also, a decline in NK cell number or activity is also a common feature of aging.

Take Echinamide

During this cold and flu season it is a good idea to have Echinamide hand as it provides the best way to gain all of the benefits that echinacea has to offer in the fight against the common cold. Echinamide is available in several different forms. My favorite is a product called Anti-V. In this product, Echinamide is combined with other immune enhancing and antiviral herbal compounds. Although available in capsules as well, I recommend using the liquid extract version of Anti-V for maximum benefit. Each Echinamide product has clear dosage recommendations for adults and children.

Key references:

1. Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290(21):2824-30.
2. Bauer R: Standardization of Echinacea pupurea expressed juice with reference to cichoric acid and alkamides. J Herbs Spices Medicinal Plants 1999;6:51-61.
3. Perry NB, van Klink JW, Burgess EJ, Parmenter GA: Alkamide levels in Echinacea purpurea: effects of processing, drying and storage. Planta Med 2000;66:54-6.
4. Kim HO, Durance TD, Scaman CH, Kitts DD: Retention of caffeic acid derivatives in dried echinacea purpurea. J Agric Food Chem 2000;48:4182-6.
5. Rininger JA, Kickner S, Chigurupati P, et al.: Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells. Leukoc Biol 2000;68:503-10.
6. Goel, V, Chang C, Slama JV, et al.: Echinacea stimulates macrophage function in lungs and in spleens of normal rats. J Nutr Biochem 2002;13:487-92.
7. Goel V, Chang C, Slama JV, et al. Alkylamides of Echinacea purpurea stimulate alveolar macrophage function in normal rats. Int Immunopharmacol 2002;2:381-7.

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Michael T. Murray, N.D., is widely regarded as one of world's leading authorities on natural medicine. A prolific author, Dr. Murray has written over 20 books on health and nutrition including the best-selling Encyclopedia of Natural Medicine and his latest book The Encyclopedia of Healing Foods. Dr. Murray is also Director of Product Development and Education for Natural Factors one of the leading manufacturers of natural products.