Nature has provided a wealth of natural remedies that can both alleviate symptoms of a cold and strengthen your immunity.
that has perhaps received more than its fair share of exposure is
Echinacea - purple coneflower - used for centuries to treat the common
cold, coughs, bronchitis, upper respiratory tract infections (URTIs)
and some inflammatory conditions.
Different parts of the plant
are thought to work in a number of ways to prevent the spread of
viruses and enhance the immune system (see Viewpoint, p 4). But herbs
contain dozens of (often unidentified) constituents with beneficial
properties that behave synergistically, so we still don’t fully know
which of Echinacea’s many chemical components are responsible for its
effects, despite over 350 studies so far (Biochem Pharmacol, 2000; 60:
In mice, root extracts from Echinacea purpurea, E.
pallida and E. angustifolia enhanced phagocytosis - where an immune
cell consumes and destroys a ‘foreign invader’ such as a virus or
bacteria (Arzneim Forsch, 1988; 38: 276-81). Phagocytosis activation
has also been found in humans (Int J Immunopharmacol, 1991; 13:
931-41). Thus, Echinacea may also guard against the development of
arthritis, allergies and other immune-related disorders.
of the effectiveness of Echinacea against colds have produced mixed
results (Antimicrob Agents Chemother, 2000; 44: 1708-9; Am J Med, 1999;
106: 138-43; Arzneim Forsch, 2001; 51: 563-8; Phytomedicine, 1999; 6:
But overall, the results suggest that some Echinacea
preparations may be better than placebo for URTIs and may be
particularly beneficial in their early treatment, reducing the number
of symptomatic days (Cochrane Database Syst Rev, 2000; 2: CD000530;
Arzneim Forsch, 2001; 51: 563-8). There is only a small body of
evidence supporting its prolonged use for URTIs.
root and leaf extracts have also demonstrated antioxidant properties (J
Agric Food Chem, 2000; 48: 1466-72; J Pharm Pharmacol, 2001; 53:
Several compounds in Echinacea may be relevant to the
herb’s actions. Caffeic acid, found in both E. purpurea and E.
angustifolia, is the backbone of a number of medicinal compounds from
other plants as well.
Echinacoside, the first compound
believed to be unique to Echinacea, was eventually found to be composed
of caffeic acid. This substance accumulates in the roots and, in
smaller concentrations, in the flowers as well (Helv Chim Acta, 1950;
Other important caffeic-acid derivatives include
cichoric and chlorogenic acids. Cichoric acid is found in much higher
concentrations in E. purpurea than in E. pallida and E. angustifolia,
both of which, however, contain greater amounts of other caffeic-acid
Various varieties of Echinacea, especially the
above-ground (aerial) parts of E. purpurea, also contain high
concentrations of polysaccharides - large sugar molecules essential for
the plant’s primary life structures - plus lipophilic (fat-attracting)
But no type of Echinacea is necessarily better
than another and many combinations are available. Supplements are made
from the aerial and root portions of the plant, depending on species.
By using the leaf and root of two varieties of Echinacea, manufacturers
are trying to ensure that all of the important compounds are included
in their product.
But which is the most important active
ingredient? No one really knows. Clinical studies are thin on the
ground and many laboratory studies have been misinterpreted or
overblown. Nevertheless, in-vitro evidence provides some important
clues. It is commonly believed that echinacoside is the most important
ingredient, prompting manufacturers to extract high levels of this.
Yet, no test has shown it to have any specific immunological activity,
and the literature suggests that it may be an inactive compound (Altern
Med Rev, 1997; 2: 87-93).
In the lab, cichoric acid has been
shown to stimulate phagocytosis, and other studies have shown that
lipophilic alkylamides aid Echinacea activity on the immune system
(Arzneim Forsch, 1988; 38: 276- 81).
And what is better: dried
preparations or those preserved in alcohol (tinctures)? Again, no one
knows for sure. Some suggest that you might be better off with a
tincture, although these usually use far less herbs. The lipophilic
components are prone to oxidation, so any powdered preparation from the
plant’s roots shouldn’t be stored for a lengthy time as it will lose
its potency (Altern Med Rev, 1997; 2: 87-93).
is also evidence that the all-important cichoric acid, which breaks
down easily due to enzymes, is most stable in preparations made from
dried E. purpurea, as these enzymes have usually been inactivated
(Altern Med Rev, 1997; 2: 87-93).
The logical conclusion is that dried products may be superior, provided you purchase them well before the sell-by date.
myth is that tinctures containing ethanol don’t work, but the evidence
for this is based on tainted studies of tainted samples. In one study,
products containing high concentrations of ethanol (alcohol) in root
extracts markedly enhanced immune system function compared with
water-soluble tinctures (Z Phytother, 1989; 10: 43-8).
What this means is that both types of Echinacea work, and you should choose the product that most suits your requirements.
of the products in our test use standardised extracts of the active
ingredients - what we think makes the herb effective - extracted from
the whole plant, measured and sometimes concentrated, then packaged.
This guarantees that the product contains what it should in amounts
sufficient to produce the desired effect. There isn’t a yes-or-no
answer as to whether standardised herbs are better than whole
(non-standardised) herbs. Even herbalists are split on the subject (see
As vitamins A, D and E are measured in terms of
potency (effect produced by their actives) as international units (IU),
so are standardised herbal extracts measured in actives delivered
rather than weight.
Although we can’t say what an Echinacea
product ought to contain, we can use the various actives as markers to
evaluate the quality of the product, as was done by the lab in our
Our six products (three liquid, three dry) were
tested by high-performance liquid chromatography (HPLC) assay by a
private laboratory (which wishes to remain anonymous as it tests for
industry). But unlike vitamins, it’s difficult to know which active
ingredients are present in each preparation. Analyses can only be based
on markers - the caffeic-acid derivatives found in the raw material and
finished product, if we’re lucky. Specifically, the lab tested for
caftaric acid, echinacoside and cichoric acid.
value for money, we considered all the markers identified by the lab
and divided by the price. Given the generally lower levels of markers
in the liquid products (except for Nature’s Answer), we evaluated the
products as two groups. We also awarded extra points for high levels of
cichoric acid, the one marker with scientific evidence of activity.
Echinacea Herb Extract
Manufacturer: Solgar Vitamin and Herb
Price: £13.05 for 60 vegicaps
product has the most Echinacea per capsule. With 2185 mg of cichoric
acid per 512-mg capsule, Solgar also offers more than twice as much of
this marker as Viridian and more than three times Kudos’ product. For
efficacy alone, we give Solgar top marks.
Despite the high price
tag of £13.05, the high levels of markers place it first for value for
money of our dry products, with 17,710 mcg of marker ingredients for
Extracts of both the leaf and root of E. purpurea and E.
angustifolia have been used to ensure that all the important compounds
are present in the product (echinacosides and polysaccharides are
standardised to 4 per cent and 15 per cent).
vegans, this also contains the whole root/leaf as a powder to
compensate for standardisation - which may cause loss or distortion of
the herb’s natural properties - ensuring synergy as Nature intended.
company claims that each one-a-day capsule has the equivalent of 425 mg
of Echinacea. It also has a PHYTO2X base, a mix of antioxidants
(tocopherols, carotenoids, rosemary and vitamin C) to maintain the
freshness of the herb in the capsule, rather like vitamin E does in
If you’re looking for a high-potency capsule, Solgar’s product takes some beating.
Echinacea Root and Leaf
Manufacturer: Viridian Nutrition
Price: £5.90 for 30 capsules
this product has only the second highest amount of markers of our dry
products, a low price tag means that it offers a close runner-up for
best value for money, offering 9895 mcg of our test ingredients per £.
It also has the second highest level of cichoric acid per capsule.
Viridian Nutrition uses raw Echinacea leaf powder as well as root and
leaf extract (standardised to 4 per cent echinacosides and 15 per cent
polysaccharides) in this preparation. Each 468-mg one-a-day vegetarian
capsule claims to provide the equivalent of 257 mg of Echinacea, and
uses a naturally beneficial blend of bilberry, alfalfa and spirulina as
This young company operates a ‘green’ recycling
programme (you get 25 p back on the empty bottle), and gives 50 per
cent of its available profit each year to charity - which was £15,000
last year. Viridian is also vehemently opposed to animal testing, and
will not use suppliers who do so.
Echinacea 900 mg High Potency
Manufacturer: Kudos Vitamins
Price: £19.53 for 60 capsules
its claim of high potency, Kudos’ offering came last among the dry
products tested, although it does contain a respectable collection of
the test markers.
This four-year-old company has its own manufacturing facility in north London.
Like Solgar and Viridian, Kudos uses both raw herb and standardised extract of
E. purpurea (4 per cent echinacosides and 15 per cent polysaccharides), which again may not be the most important ingredients.
calls this a 900-mg product - from the amount of powdered raw herb or
its equivalent in extract that it contains - but each one-a-day 445-mg
capsule contains only 1573 mcg of our test markers.
mcg of active markers per £, this high-potency product is the most
expensive of the dry herbs tested, but is of reasonable value if you
plan to take only one capsule a day, as this will at least stretch the
purchase out over two months.
Manufacturer: Nature’s Answer
Price: £6.45 for 30 mL
Answer says its Fresh Echinacea is a 'holistically balanced product,
suitable for vegans, and which contains all of the active constituents
of the fresh plant as found in Nature'. The company also sells
Echinacea capsules standardised to 4 per cent echinacosides and 2 per
cent cichoric acid.
Of the three liquid products, this offers a
very high concentration of markers right across the board - more than
four times the second-place preparation. It is also spectacular value
for money - 15,521 mL of test markers for your £. A single dose
provides 1846 mcg of cichoric acid, not far from Solgar’s daily dosage,
making this product our runner-up for overall favourite.
fluid herbal-extract formula claims a 1-mL dose equivalent to 1000 mg
of Echinacea, and contains the root of E. angustifolia and the whole of
E. purpurea. Extracting the plant constituents requires the use of
alcohol, but this is a low (organic) alcohol preparation (15-20 per
cent), which the evidence shows doesn’t matter. Coconut glycerin is
used to bind the plant constituents.
Price: £6.99 for 50 mL
Echinaforce Drops and Tablets both contain the root and aerial parts of
organic E. purpurea, and are made from the fresh herb extract. The
growing and extraction procedures are carried out at Bioforce AG in
Echinaforce Drops contains relatively low marker
values - only 297 mcg of cichoric acid per dose three times a day (half
the amount of Nature’s Answer product). The company maintains that the
15-drop (0.6 mL) dose is equivalent to 285 mg of the whole fresh plant
or 64.5 mg of dried plant.
Despite the low price tag, Bioforce
also offers poor value for money compared with Nature’s Answer - 6234
mcg of marker ingredients for every £ you spend.
claims to operate a system of holistic, rather than chemical,
standardisation that considers a whole spectrum of active constituents.
Its herbs are tested by various assays to ensure that the products
contain the range of constituents found in the whole plant. The company
says that the E. purpurea in Echinaforce is as close to the original
plant as can be.
Bioforce also uses ethanol as an excipient, which they say is no more harmful than taking 100 mg of grated apple.
is clearly a quality product produced with great care, but it may be
more suitable for children or if you only wish to give your immune
system a gentle lift rather than a jolt into hyperdrive.
Price: £7.95 for 100 mL
Ortis’ Organic Echinacea is made up of a tincture of E. purpurea, and each 20-drop
(1-mL) dose is claimed to be the equivalent of 100 mg of the whole dried plant.
preparation trailed a long way behind the others in third-best place in
terms of value for money, with a series of low marker values, including
only 166 mcg of cichoric acid in a 1-mL dose. Overall, the product only
gives you 3384 mcg of test markers per £.
Ortis is based in
the Hautes-Fagnes - an environmentally protected region of Belgium -
and proud of its ‘green’ credentials as well as its humble beginnings.
founder Adolphe Horn (who died in 1982) began as a baker but, after
World War II, became a timber merchant. In 1958, he was forced to leave
the wood business, but this allowed him to pursue his lifelong interest
in natural health foods.
With his wife Irene’s help, it took
him only a few months to perfect his first product, based on royal
jelly - Api Regis. They used the family farm’s dairy as a workshop and
their first deliveries to customers were made by public transport.
Initially, their clientele was limited to some 15 chemists and
healthfood shops scattered the length and breadth of Belgium.
Nevertheless, by 1964, Ortis had expanded to supply markets in France
and the UK.
Irene died in 1999, and the company is now run by
Adolphe and Irene’s two sons, Michel and Philippe Horn, and Michel’s
wife Solange. They say that they can successfully combine intimacy and
family feeling with the managerial efficiency needed to run a modern
Despite the folksy mom-and-pop image of the
company, the bottom line is that, compared with our other test
products, you don’t get much from Ortis for your money.
Herbs don’t have to be standardised to be effective, and
manufacturers like Solgar and Bioforce produce a range of
non-standardised herbs as well. However, in non-standardised products,
it is difficult to be certain of the amount of active ingredients they
All you can really say is that the extract is of a
certain strength. Thus, a 5:1 extract means there are five units of
starting herb to one unit of extract, but this doesn’t tell you the
amount of active ingredients in the extract. In fact, batches of raw
herb vary, resulting in a variably active extract. Standardised herbs
are blended to contain uniform levels of compounds (echinacosides and
polysaccharides in the case of Echinacea) that research shows to be the
main actives for a herb’s particular function (for example, immune
stimulation or sleep induction). Scientists use standardised extracts
to ensure a repeatable experiment.
Says Paul Chamberlain,
Solgar’s technical services manager, 'Standardised extracts may be
stronger than their non-standardised equivalent, but it is impossible
to say by how much. All we can say with certainty is that every single
batch of a standardised extract will be the same, and therefore give
the same results - something that is harder to achieve with the natural
variability of non-standardised herbal products.
- Clinical studies show that Echinacea is safe in the short or
longer term (Phytomedicine, 1999; 6: 1-6; Arzneim Forsch, 1991; 41:
1076-81; Arzneim Forsch, 2001; 51: 563-8). An eight-week study showed
no significant differences in side-effects with Echinacea versus
placebo (Am J Med, 1999; 106: 138-43). Another found that '. . .
adverse events on oral administration [of Echinacea] for up to 12 weeks
are infrequent and consist mainly of unpleasant taste.' (Phytomedicine,
1996; 3: 95-102). Echinacea safety for longer than 12 weeks has not
been evaluated, although one review says that, traditionally, it was
used for chronic conditions such as psoriasis, diabetes, cancer and
even syphilis. Indeed, Echinacea was used in a study for up to nine
months with a positive outcome and no untoward effects (Altern Med Rev,
1997; 2: 451-8).
- To obtain maximum benefit, take Echinacea
as early as possible (Curr Med Res Opin, 1999; 15: 214-27; J Altern
Complement Med, 2000; 6: 327-34). Although not much in the way of
therapeutic dosages has yet been established, according to Melvyn
Werbach (Botanical Influences on Health, Third Line Press, 1994), the
following dosages are recommended three times daily:
- Dried root (or as tea) 0.5-1 g
- Freeze-dried plant 325-650 mg
- Juice of aerial portion of Echinacea purpurea in 22 per cent ethanol 1-2 mL
- Tincture (1:4) 2-4 mL (1-2 tsp)
- Fluid extract (1:1) 1-2 mL (0.5-1 tsp)
- Solid (dry powder) extract (6.5:1 or 3.5 per cent echinacoside) 100-250 mg