Studies of Echinacea Show More Harm Than Good
Echinacea is a group of American coneflowers in the Family Asteraceae Compositae.
There are nine species of the plant included in the genus.
Three of these are typically seen in herbal preparations: Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida.
Common preparations consist of freshly pressed or ethanolic extracts of the roots, leaves, and flowers as well as dried portions of the plants.
E.
purpurea is the most commonly used species, although it is often seen in combination with E.
angustifolia.
Echinacea was first used by Native Americans for treatment of many conditions.
These included pain relief, cough and sore throat, fever, smallpox, mumps, measles, rheumatism, arthritis, and as an antidote for poisons and venoms.
As early as 1762, Echinacea was mentioned for use on saddle sores on horses.
Until 1885, no further study is documented in the literature.
That year marked the beginning of the rise of Echinacea into mainstream medicine.
H.
C.
F.
Meyer, a Nebraska physician, began promoting the product for conditions such as syphilis, hemorrhoids, and rabies, among many other claims.
This same year the Lloyd Brothers pharmaceutical company was finally persuaded to produce and market an Echinacea product.
They began producing a number of products containing Echinacea and had a great deal of success with their line of products.
In a survey conducted on preference and use of phyto-pharmaceuticals early in the 20th century, 6000 physicians ranked Echinacea 11th overall out of a list of several hundred products.
Antibiotics and the push for patentable medicines led to the fall of Echinacea and herbal medicine in the United States and Europe.
In recent years, Echinacea has made a comeback in the United States and, in 2002, it was the second-bestselling herbal product.
Numerous forms of Echinacea are available in the United States.
Dried herb and concentrated extracts in oral dosage forms make up the bulk of the products available.
There are also available fresh, freeze-dried, and liquid alcoholic extracts, which come in a variety of forms including tablets, capsules, lozenges, liquids, teas, and salves.
A good number of these products are combined with other herbs such as ginseng, goldenseal, and various other supplements to enhance the efficacy of Echinacea.
Consumer Reports analyzed 19 different Echinacea products in its February 2004 issue to determine content and potency.
As a primary standard they used the phenolic content as a measure of potency.
The products varied with their phenolic content, some from bottle to bottle of the same manufacturer.
Some of the combination products that were tested were found to have unacceptable lead levels according to California standards.
Only three of the products were deemed to have adequate labeling with regards to precautions.
A randomized, double-blind, placebo-controlled study was done in 48 healthy patients Treatment was continued for 7 more days after the inoculation.
They did not find a statistically significant decrease in the rate of infection.
Because of the small sample size, power analysis did not detect any differences in the frequency and severity of the illness that ensued after inoculation.
However, their findings did show a trend of reduced symptoms consistent with previous studies relative to prevention of upper respiratory infections.
In another study a single center, prospective, double-blind, placebo-controlled, crossover trial investigated the activity of Echinacea in humans for the treatment of recurrent genital herpes.
The 1-year study involved 50 patients who were each given the product Echinaforce for 6 months and placebo for 6 months.
The study found no statistically significant benefit in using Echinaforce vs placebo for frequently recurrent genital herpes.
Side effects that have been observed with administration of Echinacea are generally mild and uncommon.
Infrequent adverse effects include abdominal upset, nausea, unpleasant taste, and dizziness.
Echinacea has been thought to have potential for liver toxicity because of the presence of pyrrolizidine alkaloids, and some authors have warned about its concurrent use with known hepatoxic drugs.
The importance of this purported toxicity has been questioned, as Echinacea lacks the 1,2-unsaturated necrine ring system that is associated with the hepatoxicity of pyrrolizidine alkaloids.
A case report describing a 41-year-old male who took Echinacea routinely at the start of influenza-like illness recalled taking it before each of four clinical episodes of erythema nodosum.
These episodes lasted anywhere from a few days to 2 weeks and each time they resolved when the Echinacea was stopped.
He was followed a year later and had not had any more recurrences of erythema nodosum.
He had other bouts of intermittent influenza illness similar to the previous episodes, which he treated with Echinacea, but the patient was unwilling to rechallenge with Echinacea.
A 36-year-old patient started taking a combination of herbal products including Echinacea, and 2 weeks later she presented with generalized muscle weakness that limited her ambulation and ability to use her hands.
After her serum electrolytes were corrected, her muscle weakness improved rapidly.
She was diagnosed and treated for Sjögren's syndrome and her condition rapidly improved.
The researchers suggested that her use of the immunostimulant Echinacea could have contributed to the activation of her autoimmune disease, which ultimately caused her severe metabolic disturbances.
In a prospective, controlled study, 206 women who reported use of Echinacea during their pregnancy were compared to a group of 206 women who were matched to the study group with regards to maternal age, alcohol, and cigarette use.
In comparing the rates of major and minor malformation, it was found that there were no statistical differences in number of live births, spontaneous abortions, therapeutic abortions, or major malformations.
This study suggests that use of Echinacea during organogenesis is not associated with any detectable increased risk for any major malformations.
In a study of human sperm, Echinacea was found to inhibit the motility of the sperm only at high concentrations and after 24 hours.
One potential effect of Echinacea is thought to be the inhibition of hyaluronidase activity.
Another study of human sperm and oocytes showed that Echinacea at high concentrations had adverse effects on oocytes and suggested that Echinacea damages reproductive cells.
There are nine species of the plant included in the genus.
Three of these are typically seen in herbal preparations: Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida.
Common preparations consist of freshly pressed or ethanolic extracts of the roots, leaves, and flowers as well as dried portions of the plants.
E.
purpurea is the most commonly used species, although it is often seen in combination with E.
angustifolia.
Echinacea was first used by Native Americans for treatment of many conditions.
These included pain relief, cough and sore throat, fever, smallpox, mumps, measles, rheumatism, arthritis, and as an antidote for poisons and venoms.
As early as 1762, Echinacea was mentioned for use on saddle sores on horses.
Until 1885, no further study is documented in the literature.
That year marked the beginning of the rise of Echinacea into mainstream medicine.
H.
C.
F.
Meyer, a Nebraska physician, began promoting the product for conditions such as syphilis, hemorrhoids, and rabies, among many other claims.
This same year the Lloyd Brothers pharmaceutical company was finally persuaded to produce and market an Echinacea product.
They began producing a number of products containing Echinacea and had a great deal of success with their line of products.
In a survey conducted on preference and use of phyto-pharmaceuticals early in the 20th century, 6000 physicians ranked Echinacea 11th overall out of a list of several hundred products.
Antibiotics and the push for patentable medicines led to the fall of Echinacea and herbal medicine in the United States and Europe.
In recent years, Echinacea has made a comeback in the United States and, in 2002, it was the second-bestselling herbal product.
Numerous forms of Echinacea are available in the United States.
Dried herb and concentrated extracts in oral dosage forms make up the bulk of the products available.
There are also available fresh, freeze-dried, and liquid alcoholic extracts, which come in a variety of forms including tablets, capsules, lozenges, liquids, teas, and salves.
A good number of these products are combined with other herbs such as ginseng, goldenseal, and various other supplements to enhance the efficacy of Echinacea.
Consumer Reports analyzed 19 different Echinacea products in its February 2004 issue to determine content and potency.
As a primary standard they used the phenolic content as a measure of potency.
The products varied with their phenolic content, some from bottle to bottle of the same manufacturer.
Some of the combination products that were tested were found to have unacceptable lead levels according to California standards.
Only three of the products were deemed to have adequate labeling with regards to precautions.
A randomized, double-blind, placebo-controlled study was done in 48 healthy patients Treatment was continued for 7 more days after the inoculation.
They did not find a statistically significant decrease in the rate of infection.
Because of the small sample size, power analysis did not detect any differences in the frequency and severity of the illness that ensued after inoculation.
However, their findings did show a trend of reduced symptoms consistent with previous studies relative to prevention of upper respiratory infections.
In another study a single center, prospective, double-blind, placebo-controlled, crossover trial investigated the activity of Echinacea in humans for the treatment of recurrent genital herpes.
The 1-year study involved 50 patients who were each given the product Echinaforce for 6 months and placebo for 6 months.
The study found no statistically significant benefit in using Echinaforce vs placebo for frequently recurrent genital herpes.
Side effects that have been observed with administration of Echinacea are generally mild and uncommon.
Infrequent adverse effects include abdominal upset, nausea, unpleasant taste, and dizziness.
Echinacea has been thought to have potential for liver toxicity because of the presence of pyrrolizidine alkaloids, and some authors have warned about its concurrent use with known hepatoxic drugs.
The importance of this purported toxicity has been questioned, as Echinacea lacks the 1,2-unsaturated necrine ring system that is associated with the hepatoxicity of pyrrolizidine alkaloids.
A case report describing a 41-year-old male who took Echinacea routinely at the start of influenza-like illness recalled taking it before each of four clinical episodes of erythema nodosum.
These episodes lasted anywhere from a few days to 2 weeks and each time they resolved when the Echinacea was stopped.
He was followed a year later and had not had any more recurrences of erythema nodosum.
He had other bouts of intermittent influenza illness similar to the previous episodes, which he treated with Echinacea, but the patient was unwilling to rechallenge with Echinacea.
A 36-year-old patient started taking a combination of herbal products including Echinacea, and 2 weeks later she presented with generalized muscle weakness that limited her ambulation and ability to use her hands.
After her serum electrolytes were corrected, her muscle weakness improved rapidly.
She was diagnosed and treated for Sjögren's syndrome and her condition rapidly improved.
The researchers suggested that her use of the immunostimulant Echinacea could have contributed to the activation of her autoimmune disease, which ultimately caused her severe metabolic disturbances.
In a prospective, controlled study, 206 women who reported use of Echinacea during their pregnancy were compared to a group of 206 women who were matched to the study group with regards to maternal age, alcohol, and cigarette use.
In comparing the rates of major and minor malformation, it was found that there were no statistical differences in number of live births, spontaneous abortions, therapeutic abortions, or major malformations.
This study suggests that use of Echinacea during organogenesis is not associated with any detectable increased risk for any major malformations.
In a study of human sperm, Echinacea was found to inhibit the motility of the sperm only at high concentrations and after 24 hours.
One potential effect of Echinacea is thought to be the inhibition of hyaluronidase activity.
Another study of human sperm and oocytes showed that Echinacea at high concentrations had adverse effects on oocytes and suggested that Echinacea damages reproductive cells.
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