[HSI] If Only Echinacea Could Sue For Libel

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Misty L. Trepke

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Knockout Punch

 

Health Sciences Institute e-Alert

 

December 16, 2003

 

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Dear Reader,

 

Here's a story with more sequels and repetitive plot lines than

Rocky...

 

A study concludes that an herbal formula or a vitamin supplement

is ineffective. Press releases are sent out from the organization or

school that sponsored the research. News items appear in newspapers,

television reports and other media outlets most of them lifted

directly from the press release. Supplement fails! The headlines and

sound bites make their impression and the mainstream media machine

moves on.

 

We've seen it with St. John's wort, with ginkgo biloba extract, with

beta-carotene, and any number of other supplements. This time the

supplement is echinacea; an extract of an American wildflower that's

used to help prevent the symptoms of common colds, influenza, and

other infections.

 

And this time - just as with those other studies - the research is

flawed. But you'll never hear about the flaws on the evening news.

As HSI Panelist Jon Barron put it, " If an herb could sue for libel,

echinacea would be able to sue and win. "

 

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The evidence

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Here are the basic nuts and bolts of the University of Washington

(UW) study, as reported in the Journal of the American Medical

Association.

 

The trial was designed to determine if echinacea is effective in

reducing the duration or severity of upper respiratory infection

(URI) in children. Over a period of four months, more than 400

children, aged 2 to 11 years, were given either echinacea or a

placebo whenever symptoms of upper respiratory infection (URI)

occurred. Parents of the children were directed to begin

" medication " at the onset of symptoms, and to continue the daily

dosage for a maximum of 10 days, or until symptoms subsided.

Parents recorded the duration and severity of symptoms.

 

A total of 707 URIs were recorded. In the echinacea group 337

URIs were treated, and 370 were treated in the placebo group.

Overall, there was no significant difference between the two

groups in the duration of URIs, the severity of symptoms, number

of days of peak symptoms, or the number of days with fever.

Conclusion: The echinacea was not effective.

 

In addition, about 7 percent of the children in the echinacea

group experienced rashes, while only about 3 percent of the

children in the placebo group reported rashes. So the typical

headline/sound bite that the media focused on stated two

conclusions: The echinacea was ineffective, and its use was

linked to rashes.

 

No doubt about it; that's a pretty poor showing for echinacea.

Unless, of course, you happen to be aware of one critical

detail.

 

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The cow in the ointment

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The echinacea in the UW study was ineffective because it was

inferior.

 

In his Baseline of Health newsletter last week, Jon Barron

pointed out that within the community of herbalists it's well

known that the most potent part of the echinacea plant is the

root. Jon writes, " In fact, potency runs from seed to root to

leaf to almost none in the flower. " And you know exactly where

I'm going with this: The echinacea used in the study was mostly

extract from the flower of the plant.

 

If you REALLY want to test echinacea, then for goodness sake,

use the most potent part!

 

The use of echinacea flower may also have a lot to do with the

rash problem. Mark Blumenthal, the executive director of the

American Botanical Council, told NutraIngredients.com that

rashes are not normally associated with Echinacea. He believes

that the rashes could very well have been an allergic reaction

to pollen in the flowers. But when echinacea root is used -

guess what? - no pollen! So again, if the researchers had used

the proper echinacea type, there would probably have been no

rash issue at all.

 

But then this begs an obvious question about the placebo in this

study: What kind of placebo causes a rash?

 

Unless each child was informed that the " medication " might cause

a rash (which seems highly unlikely), it's inconceivable that

the resulting rashes in the placebo group could be due to a

placebo effect. As I told you in the e-Alert " Aiming to Please "

(7/21/03), the placebos used in each individual study are unique

and often contain some active ingredients. So what in the world

did they put in the placebo that caused rashes? The fact that

this is not addressed isn't surprising. Studies never discuss

the contents of placebos.

 

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A fluke by any other name

----------------------------

 

Here's my favorite part of this study: The children in the

echinacea group had 33 fewer URIs than the children in the

placebo group. Mr. Blumenthal suggests that the occasional

echinacea dosing that the kids in the echinacea group received

may have helped prevent subsequent URIs.

 

But because the study was not intended to analyze prevention,

this result can't be assessed as a primary outcome. Fair enough.

But the lead researcher, Dr. James Taylor, perhaps revealed his

true colors when he simply dismissed the information about the

possible URI prevention, telling the Associated Press that those

results could be just a " fluke. "

 

Sure, it could be a fluke. Or (given the fact that there are

studies that support the use of echinacea as a preventive agent

for colds), this " fluke " could also be seen as a significant

indicator that something important is going on. At the very

least, this secondary result ought to be compelling enough to

refrain from portraying the study as a failure for echinacea.

 

And as long as Dr. Taylor is on the subject of flukes, maybe he

could explain how his study's placebo gave kids rashes.

 

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Read your label

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Putting aside the glaring flaws of this study and the typically

inept media reaction to it, the study serves a purpose for those

who are inclined to give echinacea a try to help prevent colds

and other viral infections this season.

 

As Jon Barron's comments illustrate, when shopping for an

echinacea product, you should read the label carefully. If the

source of the product is the root of the plant, you'll probably

enjoy better protection than if the source is the flower. In

addition, echinacea can cause allergic reactions, mostly to

those who are allergic to sunflowers, as echinacea is in the

sunflower family. Herbalists also recommend that echinacea

should not be taken daily for long periods of time. Among the

several references I've read, some herbalists say two weeks

should be the maximum, while others say a few weeks longer is

fine.

 

And if anyone offers you a placebo, just say no.