Is Echinacea Safe in Children?

One of several highly touted cold and/or flu fighters on the nutritional supplement market, which also include goldenseal, zinc lozenges, and vitamin C, echinacea is claimed to boost the immune system, thereby increasing one’s resistance to illness. The most well-studied of its actions is echinacea’s ability to stimulate phagocytosis, which is the process by which certain immune cells engulf and destroy foreign infectious organisms. Echinacea also appears to have mild antibacterial properties.

Many people who have tried echinacea, the purple coneflower (and relative of the sunflower) that grows wild on Midwestern prairies, swear by it in helping them fight off colds, flu, and other minor infections. Word-of-mouth among loyal echinacea users and extensive press coverage have helped make echinacea one of the best selling herbal supplements.

Since echinacea is sold as a nutritional supplement, which is not regulated by the U.S. Food and Drug Administration (FDA), your questions and skepticism are warranted. Many studies, most of them conducted by European researchers, have looked at the efficacy of echinacea as a remedy for colds, flu, and other minor infections. One by Braunig, B., et al. published in Zeitschrift fur Phytotherapie (13: 7-13, 1992), a German medical journal, is most commonly referred to since it shows echinacea’s ability to decrease the length and intensity of colds and flu. These researchers also found that 35 percent of the study group taking a specially prepared extract of echinacea did not become ill, as compared to 26 percent of the placebo group. However, more research is needed to see if American echinacea preparations will produce similar results, since American echinacea products may be manufactured differently or made from another part of the plant (or from a different species of echinacea altogether) than those used in European studies.

In another study published in July of 2005 in the New England Journal of Medicine, researchers at the University of Virginia found that echinacea neither prevents the common cold nor alleviates its symptoms. This study comes after a previous study published in the Journal of the American Medical Association showed that echinacea was ineffective in shortening the duration of colds or decreasing the severity of its symptoms in children between two and eleven years of age. Still, some experts call for more research with different cold viruses or species of echinacea, and/or higher doses. For more information, visit the National Center for Complementary and Alternative Medicine website.

For those who are interested in echinacea, it is considered safe for most children, adults, and pregnant women to use. Side effects may include diarrhea, rashes, wheezing, and anaphylaxis (a potentially fatal allergic reaction). Echinacea is not recommended, however, for people who have the following:

• allergy to plants in the daisy family
• asthma
• allergic rhinitis
• multiple sclerosis
• tuberculosis
• leukemia
• HIV/AIDS
• lupus
• liver disorders
• connective tissue disorders
• collagenosis
• leicosis
• other auto-immune and severe systemic disorders

Also, echinacea could damage the liver, especially if taken for longer than eight weeks (any potential benefits of echinacea would be greatly diminished or nonexistent after using it continuously for more than six to eight weeks, anyway). As such, it cannot be taken with other drugs that can harm the liver, such as anabolic steroids. Lastly, theory suggests that people are not to take echinacea with immunosuppressants, such as corticosteroids, since echinacea is supposed to enhance certain immune functions.

Echinacea is available in liquid extract/tincture (which is believed to be most effective), capsule/tablet, dried root/herb tea, and cream/gel forms. The different species of echinacea include Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida. Many people believe E. purpurea to be the most potent form of echinacea.

If you do decide to try echinacea, read the labels carefully. Choose preparations standardized to 15.0 percent of echinacasides, which are echinacea polysaccharides, the primary active ingredient of echinacea. Although most echinacea preparations are made from the whole plant, the fresh whole root extract/tincture of Echinacea purpurea manufactured by a European company, or even a large, established American company, is recommended. For liquid extracts, you may want to select alcohol-based preparations, which are generally stronger and better preserved than glycerin-based ones.

Since the strength of herbal preparations varies from one manufacturer to another, follow the label’s specific directions for use. According to the Herb Research Foundation, the recommended adult dosage for liquid extracts ranges from one to five droppersful (0.5 – 5 ml) taken three times a day. Half of the adult dosage is recommended for children under the age of ten years. Cream or gel preparations of echinacea, when applied to the skin, could help improve the symptoms of eczema, psoriasis, acne, boils, and other skin inflammations and infections, and could promote wound healing. It’s important to note that since echinacea has a short shelf life, you may want to refrigerate echinacea to help extend the time it’s effective.

As with any nutritional supplement or drug, it’s beneficial to consult your health care provider before taking echinacea. If while taking echinacea, symptoms worsen or persist after having taken echinacea for about four to seven days, stop taking it and see your health care provider for more appropriate treatment. Don’t take echinacea for pneumonia, strep throat, and other severe infections — these require a visit to a health care provider. Although some people supplement with echinacea daily to help enhance their immune systems during the cold and flu seasons, it is not recommended. After more than six to eight weeks, it becomes ineffective. Echinacea can become effective again following a break from it of at least two weeks. Of course, if you find that echinacea does not work for you at all, then discontinue using it.