The best cold & flu remedy known to man (Echinacea)

Member Name: totally_organic

Product:	Echinacea
Date:	27/01/09 (472 review reads)
Rating:

Advantages: Really does get on top of colds and gets you back on your feet

Disadvantages: You never really know what you're buying

As a doctor, it is almost within my nature to assume that anything that involves the word 'herbal' is to be ignored. It is a fact that in the medical profession, the majority of us just don't like herbal remedies. They don't have evidence behind them, and we cannot prescribe them, so they cannot work. Yet Echinacea is one of the few things that I always keep stocked in my otherwise relatively empty bathroom cupboard - next to the paracetamol, Ibuprofin, and rennie. So why? Let me first tell you the basics, then tell you about the medical evidence for it, and then say why I take it!

Please note that the information below is mainly taken from research papers - regardless, as with all herbal remedies, it is taken at your own risk as it has not been through thorough safety testing.

What is it supposed to help with?
Mainly for prevention & treatment of Upper Respiratory Tract Infections - ie Colds & Flu, but there are also many claims for different uses of it such as wound infections.

What is it?
Its basically an extract from a flower native to North America. The echinacea you buy in the shops come from one or a combination of 3 species: Echinacea Angustifolia, Echinacea Pallida, and Echinacea Purpurea. It is only the Purpurea variety that that have any remotely convincing medical evidence.

What is it supposed to do?
It is supposed to "boost" your immune system. There is some evidence to suggest it increases the amount of TNF-alpha & interleukins (infection fighting bits of the immune system produced by cells called macrophages).

What forms does it come in?
Tablets - this is the only form I've tried
Capsules
Effervesant Tablets
Root extract (add the drops to water and drink)

Any side effects?
There are reports of GI disturbance, headaches, rashes. These are all rare (about 1% at most).

Duration?
Don't take for more than 8 weeks due to theoretical effects it could have on immune system. I usually just take it when I think I'm likely to get a cold, or feel like I'm starting to get one and then stop once I'm over it.

How often?
Check side of packet for each preparation - some say once a day, some 4 times a day.

Contraindications? Ie if you have these you probably shouldn't take it:
Systemic progressive illnesses such as HIV, collagen disease, MS, TB, and autoimmune diseases.

How much does it cost?
Many different prices but expect to pay about £6 for 60 tablets. Check doses of actual echinacea in the tablet though - my current ones are 500mg, some ones you can buy are only 60mg so you'd need to take about 8 tablets to get the same amount down your throat.

How is it made?
This is part of the problem - it is made in different ways (dried, pressed, extracted with alcohol), from different parts of the plant (herb, root, combination of both), from the 3 different species I mentioned earlier. Thus depending which one you buy, you might get different results. None of this helps medical researchers look into it properly.

Why do you keep mentioning "evidence" and how much of it is there?
The world of medicine is supposed to follow "Evidence Based Practice" - in essence, meaning that we should treat people only with things that have been proven to work in a proper medical study. If the wealth of "evidence" suggests we should use a certain drug, then we should use it unless we know of a good reason why it wouldn't be right, or if its too expensive - that's when we get on the front page of the news of the world.
There have been quite a few studies on it Echinacea though - enough for a Cochrane review (basically considered the don of medical research, a Cochrane review reviews all the different studies that have been performed on something, chucks out the ones that don't have good methodology behind them, and then puts whats left together to see if something works or not). It looked at 16 clinical trials - the conclusion? There is some evidence that if taken once symptoms start, it decreases the duration & severity of upper respiratory tract infections (ie colds). There was no "significant" evidence that taking Echinacea daily as a preventative treatment actually worked,, although its always worth remembering that "Significant" is an important word in medical studies. It doesn't mean there wasn't any difference between the group of people on placebo and the group on Echinacea, it just means that the difference wasn't great enough to rule out the idea of chance just causing it. The Echinacea groups did quite well compared to placebo groups, but the difference wasn't quite enough. But the evidence is not consistent and some studies don't find any difference- but then they didn't all use the same form of Echinacea so it all becomes a little difficult to compare.

To summarise all that evidence bit then:
There probably is some evidence it works at preventing colds, but its not impressive enough for the Cochrane people to endorse Echinacea. It is rare for herbal remedies to have any evidence whatsoever though, so thats not bad really.

Why do I use it?
Simple - the darn stuff works for me. Regardless of what I've just written about evidence, if I start taking this the day I think a colds coming on, it really does hit it on the head. I've taken it a few times when my girlfriend has a cold as I know I'm bound to catch it - sure enough, I do catch it but when she's had a week off work, I've had a snuffly nose for 3 days and then been fine. I do usually still get a cold once I've taken it, but it seems to go away a lot sooner and not be as bad when I've got it. I also take vitamin C as well as Echinacea when I think I'm getting a cold - I'm not sure the vitamin C helps as much, but I just quite like the effervescent tablets it comes in.

In my eyes, this is a hidden secret - I am forever telling my patients with a viral infection to give it a go. Word of caution though - its not recommended for children.

Summary: Give it a go, side effects are rare and it really does work!