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n Colege oi Physrcans
Aa:iae.::pper respiratory inJeatisns, rsually referled ic as colds, are common around the.,.r.rlC
and in every age grnup. Al:llough these iilnesses rarely resxlt in serious consequeraes, tliey
cause itnpleasant synptolls, ircluding nlnny tose, sore thrcaa, nasal stuffiness, ald cough,
and lead to 1cs: cf work and schooi tine. Various prescrlption, cver-the-counter, and
aliernative 1,eCicttions are used l.ssen symptsrrs. Echinacea, an he:bal preparation, is a
ao
To deae:mire whether echinacea could Cec:ease the severity of cold symptolr:s or shortetr the
time that persons experienced ccld symptoms. Tbey also !,xanted to explore how echinacea
ln:ght ite.act with the imr.rune system in fighting a cold.
More tlran 7oo persons ia aither sex in Dane County, Wiscorsin, aged 12 to go years, with no
current syrnptoms frrn aliergic rhinitts (a hay lever-like disease) or asthma, who w:re
expe:ielcir]g symptoms ahat they a;ld the in\rest:gators deaerminel were probably due to a
conxarn coid. pregnant lyomen aud those with immunosltp!,ressive conditions, s:::cli as
persons receiving cance: chemotherapy, were not etltered iito the str]dv.
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htlp:/annals.org/aim/iullanicblT 46678/ech racea-common-cotd I /5
7i22l2A1A Echinacaa forlhe Common Cold lAnnals ol lniernalliedicne lAnerican College of Physiclans
Pafticipar:ts we:€ :ardomly assigned to receive no pill; a pill that they knew contained
e.iinacea; cr a p::1 that could be either e.:rinacea or a placebo, but they were not told lvhich.
Patients recorded iheir symptoms tw:.e a alay.
Paraicipants who recelved echll}acea had a very slight (7- to 10-hoLr) decrease in tl]e duratioll
and severity of their coid syrr-rptoms (out of approximately 1\^/eek) and a minor decrease in
how severe the colai see..ed. However, these s:nali differences conld have occutred by chance.
Echinacea caused no apparent side effects, and immune lunction did not significantly dille:
between pe:sons who did or did not rcaeive echinacea.
The study was dore in a single geogrelJhic area. Il wrs also dole during ahe winter, arC some
of al:e pa:ticipants may have 1.rad influenza (the flu) rather than a co:d. The severity aid iength
of symptoms varied more widely tiran the investigators had preCicted when they planned the
study, whi.h r.ay have preventerl them {rom more p:e.isely detecting the effect of echinac.e.
]]eopie who take echilacea to treat colds may e;perience a decrease in the length and severity
of aheir cold symptoas but to such a small deg.ee that thsy may not care abon, the differenc€.
Although many str:dles of echinacea have been performed, researchers still disagree about its
l.refia in treaihg the common cold. This study is unlikely to change minds about \,llether to
take :iis rei1]edy.
tt crrAroNs
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htlpJ/an.als.oro/aim/fulla.ticle,a46678/ech nacea-common cotd
I
72212418 Echinacea lor lhe Common Cold Annasollnlerna lr,Iedicine lAn6rcan Colieqe of Phvsicians
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ScienceDaily
Your source for the latest research news
Summary: Echinacea, the most popular herbal supprement in the united states, cuts the chances of catching
the common cold by 58 percent and reduces the duration ofthe common cold by 1.4 days,
according to a new University of Connecticut study to be published in the July issue oflhe
prominent British medicaljournal, The Lancet lnfectious Diseases.
Share: Ivs-PinV
FULL STORY
Echinacea, the most popurar herbar supprement in the united states, cuts the chances
of
catching the common cold by 58 percent and reduces the duration ofthe common cold
by 1'4 days, according to a new university of connecticut study to be pubrished in the
July issue of the prominent British medicar journar, The Lancet rnfectious Diseases. and
to be published online Monday, June 25 UK time.
The new uconn Iindings stand in contrast to a study pubrished recenfly in the New
Engrand Journar of N,4edicine,
which discounted Echinacea's cold-fighting effects, the researchers report.
lnstead, the Uconn research bolsters a previous stLrdy that found Echinacea to be
an effective treatment for the
common cold and also provides new evidence of Echinacea,s added cold prevention
benefits.
Because of the size and scope of the uconn meta-anarysis. which incruded onry randomized,
pracebo-controled,
peer-reviewed studies, the researchers were able to observe effects the smallet
individual studjes, including the
New England Journal of Medicine study which was included in the uconn review,
were not able to determine
alone. The UConn researchers also were able to examine Echinacea's effects w th and without the presence of
additional supplements and whether exposure to viruses occurred natura y or study sublects were nocu ated wilh
a cold virus.
They determined:
. Ech nacea reduced the incidence of contaacting the common cold whether t was taken alone or n
combination with other herba supplements.
. Echinacea reduced the chance of catch ng the common cold whether study subjects were exposed to
vlruses naturally or noculated with a part clrlar virus as part of the study
"The take home message irom our study is that Echinacea does ndeed have powerful cold prevention and cold
treaiment benefis ' sa d Assistant Professor of Pharmacy Pracltce Cratg Colernan, the lead author of ihe study
'The significance ofthat finding becornes clear when you consider ArneTicans suffer from one billion co ds annr.rally
and spend about $1.5 billion annually for doctor s visits and another g2 bill on annually on non-paescr pt on cough
and co d treatments."
ln add tion to being smaller in size than the uConn meta-analysis. the New England Journa of I\,4edicine study
used the east comraon of the three species of Ech nacea and administered it at a dose more than three t mes
lower than recomrnended, Coleman exp ained. The study also inocu ated subjects with rhinovirus, which is one of
the most common cold_inducing virlrses, but there are more than 200 viruses capable of causing the co]l rnon
cold Coleman added.
coleman and his fellow researcheTs, however, stop short of endorsing Ech nacea as the staadard practrce for
preventing and keating colds based on existing research.
More than 800 products containing Echinacea are currently available n d fferent forms, containing different
species of the plant, d fferent parts of the plant and differeni doses and it has yet to be determined whelher it is
one. a few or the combined effe.ls of multiple Echinacea conslltuents that enhance the immune system. the
researchers wroie.
colernan said future studies are needed to control for variab es such as Echinacea species and product
preparat on as well as to determlne the propel dose before Echinacea can become the first line prevention and
keatment for the common cold.
uconn Associate Professor of Pharmacy practice c. N,4ichael white and school of pharmacy Tesearch fe lows
Sachin A. Shah and Mrke Rinaldi and forrner research fellow Stephen Sanders also collaborated on thts research
Story Source:
Materials provided by University of Connecticul. Nate: Cantent may be edited fot style and lenqth
universrty of connect cut. "Echinacea coutd cut chance of catching cold By l\4ore Than Ha f, study suggests.,
scienceDaily scienceDairy, 26 June 2007. <www.sc enceda ly.com/releases/2007/06/07o626r 52B09.htm>
RELATED STORIES
I
7122t2014 Ech nacea forpreveol ng and treal nq the.ommo. cold LCochrane
C) Cochrane [r':;1:;'r::ffi'
Preparations of the planl Echinocea arc widely used in some European countries and in North America for
common coids. Echlnoceo preparations available on the market differ greatty as differenttypes (species) and
parts (herb, root or both) of the plant are used, different manufacturing methods (drying, alcoholic extraction
or pressing out the juice from fresh plants) are used and sometimes also other herbs are added.
We reviewed 24 controtled clinicaltrials with 4631 pafticipants investigating the effectiveness of several
difterent Echinocea preparations for preventing and treating common cotds or induced rhinovirus infections.
Our review shows that a variety of products prepared from different Echrnoceo species, different plant pa rts
and in a different form have been compared to placebo in randomized trials. Due to the significant differences
in the preparations tested, it was difficult to draw strong conclusions. Five trials were rated as having a low risk
of bias in altfive categories ofthe cochrane 'Risk of bias' tool. Five more trials were rated as low risk oJ bias,
having an unclear risk of bias in only one category. Eight trials were rated as having a high risk of bias in at least
one category and the remaining six as having an unclear risk of bias.
The majority oftrials investigated whether takiogEchinoceo preparations after the onset of cold symptoms
shortens the duration, compared with placebo. Although it seems possible that some Echinoceo products are
more effective than a placebo for treating colds, the overaLl evidence for clinically relevant treatment effects ;s
weak. ln general, trials investigating Echinoceo for preventing colds did not show statisticalty significant
reductions in illness occurrence. However, nearly all prevention trials pointed in the direction of small
preventive effects. The num ber of patients d ropping out or reporting adverse effects d id not d iffer significa ntly
between treatment and control groups in prevention and treatment trials. However, in prevention trials there
wasatrendtowardsalargernumberofpatientsdroppingoutduetoadverseeventsinthetreatmentgroups.
Authors' .onclusions:
E.hiro.eo products have not here been shown to provide benefits ior trea|ng colds, although, :t ts
possible there is a weak benelit from sorne E.hrno.eo products; the results of individral prophylaxis trials
consistently Show positive (if non-significantl trends, although potential effects are of q uestion3ble
clinicalrelevance.
hltps:rlw\rw.cochrane orglCD000530/ARl ech na.ea foFpreve.tng and trcal ng rhe common cotd ii4
7D2t2A1A Ech nacea forp.evenlng and trealfg rhe common cod Cochra._a
Backgroundi
Objectives:
Search strategy:
Selection criteria:
Main results:
Twenty-fou r double-blind trials with 4631 participants including a totaLof 33 comparisonsol Echinoceo
preparations and ptacebo met the inctusion criteria. A variety of d iffercnt Echinoceo preparations based on
different species and parts of plant were used. Evidence from seven triats was availabte for preparations
based on the aerial pafts of Echinoceo purpureo.
Ten trials were considered to have a low risk of bias, sixto have an unclear risk of bias and eight to have a
high risk of bias. Ten triats with 13 comparisons investigated prevention and 15 trials with 20 comparisons
investigated treatment of cotds (one ariaIaddressed both prevention and treatment).
Due to the strong clinical heterogeneity ofthe studies we refrained from pooling for the main anatysis.
None of the 12 prevention comparisons reporting the number of patients with at least one cotd episode
found a statistically significant difference. However a post hoc pooling oftheir resu lts, suggests a relative
risk reduction of 10o/o to 20olo. Of the six treatment trials reporting data on the duration of colds, only two
showed a significant effect ofEchlnoceo over placebo. The number of patients dropping out or reporting
adverse effects did not d;ffer significantly between treatment and control groups in prevention and
treatment trials. However, in prevention trials there was a trend towards a larger number of patients
dropping out due to adverse events in the treatment groups.
cold&titte=Echinacea%2Cfcr/020p--rCyeftt-ng!./r20ando/o2Oireat;ngolo20the%20commono/o2Oco:d)
Published:
Z0 Febtuaty 20:.4
Primary ReviewGroup:
Ac!te Resp,ilsigttL:cl|gGggllp_lh:lpt//ari.cocl lane.org/)
Karsch vdlk 1.4. Barrett B, Kiefer D, Bauer R. Ardjomand woelkarl K, Llnde K. Echinacea for prevert:ng an.l treaiins
ihe
common cold. Cochrane Database ofSysr€matic Reviews2014, tssu€ 2.Art No.:CD000530 DOI:
lrttps:liwww .och.ane orO1CD00O530/ARi ech naceajor preve.inq afC-lrealinq the,commo. cod
I
l22l2a1A Ech nacea,or prevenlng and treal.g the.ommon cod Cochra.e
10.1002,i t,+651858.CD000530. pub3
https:rrwww co.h rane.org/CD000530/AR _e.h nacea ioFpreve.rnq and lreatino the commo. cod
7t22J2014
mN .-r.- ,.,:enrerior
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Echinacea
Background
Keep in Mind
Key References
This {act sheet provides bas c information about echinacea-common names, usefulness and safety, and
resources for more information-
There are n ne known species of ech nacea, arr of which are native to Norrh Arnerica. They were used by
Native Americans of the Great Pla ns region as traditional medicines.
Ech nacea is Lrsed as a dietary supplemeni for the common cold and other infections. based on the dea that t
m ght stinrulaie the immune system to more effectively f ght nfection. Ech nacea preparatlons have been used
topically (applled to lhe skin) for wounds and skin problems.
The roots and above-ground parts of the ech nacea plant are used iresh or dried to make teas, squeezed
(expressed)iuice. extracts. capsules and tablets, and preparations for external use. Several spec es
of
echinacea. most commanly Echinacea purpurea ot Echinacea angustifalla, mav be inciuded in
dietary supplements.
T
72212414
N,4anystudies have been done on echinacea and the common cold. Much less research has been done on the
use of echjnacea for other health purposes,
Tak ng ech nacea af(er you catch a cold has not been shown to shorten the time that you'll be s ck.
Tak ng echlnacea while you're well may slightly reduce your chances of catchlng a cold. However, the
ev dence on this point isn't completely certa n. Currently, the Nationa Center for Compler.entary and
lniegrative Health (NCCIH) is fund ng research to identifi/ the active constituents in echinacea and to study the
effects on the human immune system oI substances n bacteria that live with n ech nacea plants.
For most people, short-term ora (by mouth) use of ech nacea s probab y safet the safety of long-term use
is Lrncertain.
The most cornmon side effects of echinacea are digestive tract symptoms, such as nausea or stomach pain.
Some people have allergic react ons to echinacea, which may be severe. Some children pad cipating in a
clinical trial of echinacea developed rashes. whrch may have been caused by an allergic reaction. people w th
atopy (a genetic iendency toward allerg c react ons) may be more likely to have an ajlerg c react on when
taking echinacea.
Current evldence ndlcates that the r sk of inieract ons between ech nacea supplements and most medications
s low.
: -::. : 'i'l'i -- I
Know the Science: I Quest ons To Help You l\,4ake Sense of Health Research
.
The NCCIH Clearinghouse prov des information on NCCIH and complementary and integrative health
approaches, nclud ng publications and searches of Federal databases oi sc entific and med ca literature. The
clearinghouse does not provide medical advrce, treatment recommendat ons, or referrals io practitioneis.
Toll-free in the U.S.: 1 8A8-644-6226
TTY lfor deal and hard-of-hearing callers): 1 866-464-3615
A service of the Nationai Library of lMedicine. Publ\,4ed@ conta ns publication informat on and (in most cases)
brief sumrnaries of ari cles from scient fic and med cal lournals. For gu dance from NCCIH on us ng publvled, see
How To Find lnformation About Coraplementary Health Approaches on PubNled.
Website: www.ncbi.nlm.nth.gov/pubmed
ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating sc entific
nformation, support ng research, sharing research results, and educattnq the Oublic. lts resources inc ude
publ cat ons (such as Dietary Supplements: What Yau Need ta Know), fact sheets on a var ety of specif c
suppiement rngredients and products (such as v tamin D and rnultivitamin/m neral supplements), and the
PubMed D etary SLrpplement Subset
Barrett B, Brown R, Rake D, et al. Echinacea lor treating ihe comr.on cold: a ran dom zed tial- Annals af
lnternal Medicine- 201O:1531,12):7 69 777.
Bauer B. Woelkart K. Echrnacea specres. lni Coates pM, Betz JM, Blackman MR , et al., eds. Encyclopedia af
Dietary Supplements.2nd ed. New York. Ny: lnforma Healthcare: 20fi:226-234.
Echinacea. lni Blumenthal M. Goldberg A, Brinckmann J. eds. Herbal Medicine: Expanded Cammissian E
Monogruphs- Newton. MA: lntegrat ve l\ledicine Cornmunrcationsi 2OOO:BB-102.
Echrnacea. Natural I\,4edic nes Web site. Accessed at naturalmed cines.therapeui cresearch.com on Apr ! S,
2015. [Database subscript on].
Gur ey BJ, Fifer EK, Gardner Z. Pharmacokinetic herb-drLrg interactions (part 2)i drug nteract ons nvolv ng
popular boian cal d etary supplements and their clinical relevance. p/a nta Medica_ 2012;78(T 3):1490
i 5t :1.
Karsch vdlk M, Barrert B, Kiefer D, er ar. Echinacea fot wevent ng and treatrng the common cord. cochrare
Database of Systematic Revlews. 2O14;\21CD000530. Accessed at http://www.thecochranelibrary.com on
April 6. 2015.
Karsch Vdlk M, Barrett B, Linde K_ Echlracea for preventing and treating the cornmon cold.
JAMA. 2015;313(6):6T 8-61L
Taylor JA, Weber W, Standish L, e'i al. Efficacy and safety of echinacea in treating upper respiraiory tract
infectrons rn chidren: a random zed controlled Ir al_ JAMA. 2AA3;2qA?1):2A21-283O.
https:/inccih.n h 9ov/hearth/ech.acea/ataqrance.htm
314
'12212414
aris publicalion is tlol copyrighted and is in the public dornain. D.tpia.2tl.t1 is eficouraged.
Xtel ias provided this material lor your information. lt is,.4 i.:ended to substilui€ to. the medical
erpeatin6 and advise oJ your primary hsalth care providet. ttr *':aourage you to d,3ra]5s any decisiaaa alrout
a.aaaa:*t !a rare w.lh your health ar,r i:.arider. I:re m''aian oI any product, asartae. or therapy ia nrl an
{r.dorserflenl by NCCIH,
,.i. Dr..r:m-..l .i Hiaft. A HrmarS.ai..i N.:.-.ilns 1r..s.tH.2l:h. N.!l.,t a,,.i.er i+r C.'nple,.err: r-..:: r.i.n:xiire t"€:ttl
nccih.nih.gov
llr,s Faoe last modilied November 30 2016
lrtlps/'nc.ih nih.gov/heath/echnacea/atagancehrm