Conflicting Reports about Echinacea

by June Russell
www.jrussellshealth.com

Echinacea, or purple coneflower, is sold over-the-counter in pills, drops and lozenges, and has a reported annual sales of more than $300 million. It is one of the most popular medicinal herbs used by people to treat colds. New research finds that taking the popular herbal remedy echinacea does nothing to prevent a cold. Fans and foes of such herbal supplements say they have long needed rigorous, scientific testing, and this study found that patients who took an echinacea plant extract fared no better than those who took a dummy treatment. This study, which appeared in the July 28, 2005, New England Journal of Medicine, was led by Dr. Ronald Turner of the University of Virginia School of Medicine. "UVa study debunks herbal cure," AP, {The Daily Progress, Charlottesville, Va. July 28, 2005}

Researchers from the University of Wisconsin whose study appeared in the Annals of Internal Medicine, says that echinacea has no effect on colds. Yet the lead author, and Assistant Professor of Family Medicine, Dr. Bruce Barrett, says that there is too much evidence from other studies that it might work and that he doesn't think it proves it doesn't work. Dr. Ronald B. Turner, Professor of Pediatrics at the University of Virginia School of Medicine pointed out that there are so many variables with the herb, three different species that are used for medicinal purposes, so that it is hard to make a recommendation just based on this study. {"Echinacea Has No Effects On Colds," healthscout.com, Dec. 2002}

MEDIA MISINFORMATION ABOUT ECHINACEA

The media information about the study in the New England Journal of Medicine, reporting that the herb echinacea (echinacea agustifolia) doesn't help colds, was just as flawed as the study.

They used the wrong species -the extracts made from the roots of Echinacea augustifolia. Studies on the flowers and the roots of E. purpurea show it is effective.

In this study, the researchers did not use enough to be effective. The college students in this study were given 300 mg of E. augustifolia daily, however, the World Health organization (WHO) says that 3 GRAMS (3,000 mg) a day is the proper dosage for this species.

The participants were young and probably had strong immune systems. A better study would have included older people with more compromised immunity. If echinacea boosts immunity, it has a greater effect on people with lowered immunity than those who are not. {"Media Misinformation About Echinacea - Another Blow to Truth in Reporting," Dr. Nan Fuchs, Women's Health Letter - July 28, 2005. Also repeated on Dr. Betty Kamen, PhD and Michael Rosenbaum, M.D., "Nutrition Hints," No. #1901 - July 30, 2005} *Over 400 subjects were tested.

Taking echinacea can cut the duration or severity of the common cold. That's the conclusion of eight of nine major placebo-controlled tests of echinacea on 2,300 subjects. It is thought that echinacea boosts the immune system, and possibly acts as an antiviral agent. It should be taken when you first notice a sore throat or the sniffles; continue taking it for as long as two weeks. "Echinacea might shorten a seven-day cold by as much as three days," says herbal expert Varro Tyler, professor emeritus, Purdue University School of Pharmacy. On the other hand, there is little evidence that taking Echinacea regularly to prevent colds does much good. Check the label for recommended dose for adults - give children half as much. {"These all-star supplements really can heal - New medical research confirms it's well worth trying these natural remedies," USA WEEKEND, March 24-26 2000}

There was a study in the December 17, 2002 issue of the Annals of Internal Medicine that found there was little difference in the group that took echinacea and the group that took a placebo at the onset of a cold. Disregard the study because there are three factors that could explain why the studies were different from the expected outcome. (1) Dried unrefined roots and whole plants (as opposed to an extract of leaves) were used in this study. This is significant because there have not been any studies to date that indicate dried leaves "work." Studies that demonstrate echinacea's efficacy used formulas containing an extract. (2) There are actually nine species of echinacea, three of which are typically combined in varying amounts and dosages in over-the-counter products. Very few studies used the compounds with the same mix of the three species - so the findings have been inconsistent. (3) There is a popular belief that healthy individuals, like the college students used in this study, do not gain much from taking Echinacea as people with a history of frequent colds or viral illnesses. It seems that the herb's secret of success is its ability to boost a weakened immune system, not the ability to fight the virus itself. {"Catch This!" Susan Lark, MD, Jan. 9, 2003 e-mail newsletter}

In Germany, over 1.3 million prescriptions are issued each year for echinacea-based products to treat minor respiratory infection ("Natural Health Bible," Bratman, 1999). More than 400 studies have attested to the safety and efficacy of echinacea, and more studies are being conducted every year. In one recent German trial designed to examine the effectiveness of echinacea in reducing flu symptoms, 180 participants received a daily dose of 450 mg of echinacea, or 900 mg of echinacea, or a placebo. Those taking 900 mg of echinacea reported a significant reduction in weakness, chills and muscle soreness. Those taking either the 450 mg dose or a placebo reported no improvement.

In a double-blind study, 120 people were given echinacea or a placebo for 10 days as soon as they started showing signs of a cold. Of those taking echinacea, fewer actually developed full-blown colds. The study showed only 40% of those taking echinacea became ill, vs. 60% of those taking placebo. Interestingly, among those who came down with colds, improvement in the symptoms started soon in the echinacea group ("Natural Health Bible," Bratman, 1999). A 1997 study found that echinacea actually stimulates macrophages (which act as filters within the body and have been shown to have greater antiviral effect than unstimulated cells) to produce cytokines, which help regulate the immune system (Int J Immunopharmacol, 1997). Another study, conducted in 1997, seemed to confirm these findings. Healthy individuals and patients with either chronic fatigue syndrome or AIDS were given extracts of echinacea. The extract actually increased the cellular immune function in all groups, leading researchers to conclude that echinacea enhances immune function in those suffering from depressed cellular immunity such as AIDS (Immunopharamacology, Jan. 1997). Even the School of Pharmacy in Richmond, Virginia found that Echinacea is safe (June 2000 issue of Pharmacotherapy).

The German researchers in a 1999 randomized double-blind, placebo controlled study concluded that the herbal remedy echinacea is effective and safe, and noted that the therapeutic benefit was a rapid onset of improvement of cold symptoms and recommended taking echinacea as soon as initial cold symptoms are detected (Curr Med Res Opin. 1999). According to Vero Tyler's "Herbs of Choice," echinacea should not be used by those suffering from severe systemic illnesses such as tubercolisis, leucosis, collagen diseases and multiple sclerosis. Germany's Commission on E, a government-established committee to determine safety and efficacy of herbal remedies (similar to our FDA), recommends that use should not exceed a period of 8 successive weeks. Infrequently allergies may occur, especially in people allergic to members of the sunflower family (Asteraceae) (Vero Tyler, "Herbs of Choice," Pharmaceutical Products Press, 1994). Echinacea has been used safely for centuries. It raises white blood cell counts and increases the body's inherent powers of resistance, stimulates killer cells and demonstrates antiviral properties (Butram, Encyclopedia of Herbal Medicine, 1995). Echinacea is the perfect choice for battling colds and flu and may even help bolster the immune system in AIDS sufferers. {"Echinacea, Bolstering Your Immune System. " Vitamin Research News, Nov. 2000}

It would appear that individuals with overactive immune systems shouldn't take this immune-enhancing herb. However, I believe that Echinacea works not by stimulating immune function, but rather by modulating it - that is the activity of some types of immune cells increases, while the activity of others decreases. As a result, I think it is safe for people with autoimmune disorders to use Echinacea on a short-term basis to deflect a cold or the flu. I would not recommend it for long-term use in cases of autoimmunity. {Dr. Andrew Weil, Self Healing newsletter, April 1998}

Echinacea does work if you use an effective product. The single most important aspect in getting results from an echinacea product is to make sure that it is guaranteed to provide sufficient levels of all three classes of all three key categories of active compounds in their proper ratio. Results can be impressive when a high quality product is used. In a double-blind study in the Feb. 2004 issue of J Clin Pharm Ther., the echinacea preparation or a placebo was given to 282 subjects aged 18-65 years with a history of two or more colds in the previous year. Subjects were instructed to start the echinacea or placebo at the onset of the first symptom related to a cold, consuming 10 doses the first day and four doses per day on subsequent days for 7 days. The total daily symptom scores were found to be 23.1% lower in the echinacea group than in the placebo. The researcher concluded that early intervention with this standardized echinacea product results in reduced symptom severity in subjects with upper respiratory tract infection. Some people cleared their cold symptoms up to three times faster than the placebo group. {"Top ten clinical research studies with natural products in
2004," Dr. Murray's Natural Facts, Doctor Murray's Newsletter, Jan. 17, 2005} Dr. Michael T. Murray, N.D., is regarded as one of the world's leading authorities in natural health, and has written many books.

Echinacea is a valuable cold treatment for kids - though it may not shorten a cold or make it less severe if given after they already have the sniffles. According to a recent study of 524 children, ages 2 to 11, researchers from Bastyr University in Washington and the Puget Sound Pediatric Research Network, say this herbal remedy appears to reduce the odds that they'll develop a secondary infection such as tonsillitis, bronchitis, sinusitis, or an ear infection. {Douglas Schar, DipPhyt, MCPP, Prevention magazine, March 2004}

Echinacea is most effective in the first 48 to 72 hours of use, less effective if used longer than 2-3 weeks. Avoid alcoholic tinctures of echinacea which destroy much of the active ingredients. We recommend glycerin extracts for children and freeze-dried extract capsules of Echinacea root complex for adults. {Mitch A. Fleisher, M.D., a board-certified family physician whose focus is classical homeopathy, nutritional and botanical medicine, chelation and bio-oxidative therapy. (www.alternativemedcare.com)}

Many herbal medications can cause negative effects when taken with alcohol. {Alcohol Research & Health, niaaa.NIH.gov - 2005}

About the Author
June Russell is a retired health educator, researcher, journalist, and writer of health articles for newspapers and websites. Click here to visit her website.