Bottom Line/HEALTH: Ebola, enterovirus, cold and flu. The question is always the same—how do I boost my immune system? Answer: Echinacea.

I’m Sarah Hiner, president of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m speaking to Dr. Andrew Rubman, a leading naturopathic physician and the medical director of the Southbury Clinic in Southbury, Connecticut. Dr. Rubman is also a contributing medical editor to Bottom Line. So welcome, Andy. It’s great to see you.

Dr. Andrew Rubman: Hi, Sarah.

Bottom Line: All right, the headlines—ebola, enterovirus—creepy stuff going around. And the immediate thing that always goes to my mind is immune-boosting. So echinacea, one of the classic immune boosters. Is that something people should be considering?

Dr. Rubman: Yes, very much so. It’s important to remember that it’s one of those things that works most of the time for most people, which is kind of nice. It’s also important to remember that it’s not an excuse for taking care of yourself otherwise. All of these things, as well as the antiviral drugs and the other interventions that we might come up with, rely on a person being sufficiently conscious about their diet, nutrition, lifestyle, etc.

Bottom Line: Let’s assume they should be conscious of their diet and nutrition—they may or may not be. But still, in the Western way, you still want to know what you can do to boost your immunity. Is echinacea something that you take when you’re starting to get sick…or is it something you can take prophylactically to boost your immune system in general?

Dr. Rubman: There are some people who choose to take it prophylactically, particularly if they know that they’re going to have more of a tendency to get sick when the seasons change, like from fall to winter or from winter back to spring.

There are other people who know that when there’s sufficient stress in their life coming up, like a business conference or an uncomfortable meeting that they have to take, or they have to go to a location that’s particularly challenging for them, into a city or something, they want to take something to help give them a little bit more of an edge. That’s a good time to take echinacea.

Bottom Line: Are there certain strains of disease, viruses, bacteria, whatever, that echinacea is more effective with? Or is it just in general, works well for boosting your immunity?

Dr. Rubman: I’d have to say in general, because there’s been very little specific testing against specific viruses in particular. But it seems to be one of those things that works for most people most of the time. It’s interesting that there was a misconception about echinacea, that it could only be taken for a short period of time, and beyond that it was relatively ineffective.

The problem was with the research, which was done in Germany. It was translated into English, and the work was only done for three days. Therefore, they didn’t comment on it, but the English translation said it didn’t work beyond that point.

Bottom Line: Perfect. And there was a major study about 10 years ago or so, maybe a little less, that said echinacea didn’t work at all.

Dr. Rubman: Right.

Bottom Line: What’s the truth on that?

Dr. Rubman: It was a bad extractive echinacea.

Bottom Line: A bad product or a bad choice? As I recall, actually, it was the type that they were using.

Dr. Rubman: They were extracting the whole plant when the root has the active principle in it. So therefore, the amount of active component was dramatically diluted from what one would expect in a therapeutic product. Also, the therapeutic product is oftentimes more elegantly extracted than the material that was used in the testing.

Bottom Line: Now, the interesting thing about it, as I recall, is that they chose the product they used because it was the most popular product that had the largest sales. So the important thing to know, then, is that there’s product for sale that’s not effective.

Dr. Rubman: Oh yeah. Right. As a matter of fact, the product that was chosen I think was an echinacea leaf product.

Bottom Line: All right, so if somebody wants to use echinacea, what type? They need to look for a root product? Does it say that on the label?

Dr. Rubman: It’ll say that it’s from echinacea root, yes.

Bottom Line: So there’s specifically one.

Dr. Rubman: Yeah, or it may use the Latin word radix.

Bottom Line: And it’s generally in the liquid form?

Dr. Rubman: Liquid as a tincture extract as opposed to a powdered root. The only exception to that is a freeze-dried extract of the root, which is particularly potent.

Bottom Line: Does it matter, powder or liquid?

Dr. Rubman: There are different principals that are extracted with both of the materials. Each preparation has its own particular strength. I prefer the tincture.

Bottom Line: Are there any risks to taking echinacea?

Dr. Rubman: Not that I found with any consistency. There are some people who might have some mild allergic reaction to it, but I haven’t seen any clinically in over 30 years.

Bottom Line: The bottom line on echinacea? It’s a great immune booster. You can take it at the first signs of sickness, or you can take it prophylactically if you have a lot of stress, going to be traveling or you’re just coming into cold and flu season. This is Sarah Hiner with Bottom Line.