Echinacea for CFS: Good, bad, or indifferent?

Echinacea is an herb that is surrounded by controversy. Scientists, doctors, and the general public can't make up their minds about it. It prevents or doesn't prevent the common cold, it may or may not stimulate the immune system, it may or may not overstimulate the immune system, it should or should not be used by people with HIV, it should only be taken for 7-14 days at a time, it can be taken for 8 weeks at a time with a two week break in between, and other debates ad nauseum.

Partly due to ignorance and believing what I've heard from the mass media, I've always thought of echinacea as a useless folk medicine. You don't hear CFS doctors and researchers talk about it much, if it all. So I've never been prompted to look at the research myself--until now.

Looking at various articles and research abstracts, I can see that it is still controversial. Some HIV patients take it but many doctors and scientists believe they shouldn't--and the situation would probably be the same for XMRV. However, there have been various experiments that show echinacea stimulates Natural Killer cell production and function. It sounds like it could be a perfect match for CFS, which has been characterized by very low NK cell function. I've even heard that in Japan, CFS is called "natural killer cell disease" or something like that.

Of particular interest are three published studies on mice and a review article of them, a study on HIV patients presented at a conference, and an article appearing in Medical Herbalism.

Here are the three studies done in mice:

Natural killer cells from aging mice treated with extracts from Echinacea purpurea are quantitatively and functionally rejuvenated.

Echinacea purpurea and melatonin augment natural-killer cells in leukemic mice and prolong life span.

Enhancement of natural killer cells and increased survival of aging mice fed daily Echinacea root extract from youth.

All three studies found enhancement of natural killer cell activity. The second found significantly increased life span in mice with leukemia, and the third found it enhanced life span in mice that were fed echinacea throughout their entire lives (perhaps this one disproves the necessity of taking echinacea only in pulses). Of course, what happens in mice might not translate the same to humans.

Sandra Miller, who is a coauthor of all three of the above mouse studies, summarized her findings and contemplated their meaning in a review article "Echinacea: a Miracle Herb against Aging and Cancer? Evidence In vivo in Mice", appearing in Evidence Based Complementary and Alternative Medicine, published by Oxford Journals.

Here is a human study on HIV patients:

Dramatic increase in immune mediated HIV killing activity induced by Echinacea angustifolia.

HIV patients were given echinacea for three months. Their natural killer cell activity went up six-fold. Note the study says nothing about viral load or T-helper cells, so be cautious about drawing conclusions from this.

The Medical Herbalism article "Echinacea contraindications" puts forth some interesting arguments. The author asserts that pulsing is not necessary and that the recommendation for HIV patients to avoid it might be based on old hypothesis that HIV causes autoimmune disease. However, if you really do have an autoimmune disease or a family history of autoimmune disease, you probably should avoid echinacea.

In a previous blog post I mentioned that a component of echinacea purpurea, cichoric acid (aka chicoric acid) inhibits retroviruses. The amount of this acid per gram of echinacea is small though, at around 1 to 4 percent.

I've bit the bullet and decided to try echinacea myself. I've tried everything else I can think of, so what's one more. I can't imagine it would actually make me worse, but if it does, I'll simply stop it. At $10 per month it is one of the cheapest possibilities. I'm taking a product made by Nature's Answer that is a mixture of echinacea angustifolia and echinacea purpurea root. The dosage I am using is 900mg, three times per day.