Gettysburg Medical News
 The Clinical View
 by P.E. Hoffsten, MD
14  September 2005

  “AN ALTERNATIVE MEDICATION”:  ECHINACEA   

            Distrust of healthcare providers continues to divide our society.  Pharmaceutical companies continue to be faulted for excessive prices and false claims.  Our State Health Department is attacked because 11 cases of Legionnaire’s pneumonia occurred in Rapid City.  Physicians are attacked for all kinds of reasons.  Thus, grows the concept of “alternative and complimentary medicine”.  The belief of many in society is that these alternative and complimentary remedies exceed the value of suggestions made by physicians and our mainline healthcare system.  I have heard it professed that very effective treatments are suppressed by drug companies in order to sell competing medications that are less effective.

            I could not agree less with the opinions and ideas expressed above.  These ideas are absurd.  I don’t think drug companies suppress effective products.  I think our State Health Department does a magnificent job. I believe that the remedies and medications prescribed by our nurse practitioners, physician’s assistants and physicians are the best available.  I am disappointed that newspaper’s need to maintain their circulation or TV station’s need to increase their viewers leads them to continue to bash the healthcare profession.  The distrust of the healthcare profession generated by our newspapers or TV does a disservice to our society leading individuals to avoid appropriate healthcare that could improve the quality of life or even the length of life.

            The above editorial comments stated, the thrust of this column is to put one more alternative medication to rest.  Months ago, I wrote about Vitamin E and its perceived role as an antioxidant that prevented heart attack and Alzheimer’s disease.  I indicated that multiple studies had tried to demonstrate some benefit for vitamin E and none was ever found.  In fact, on at least two occasions vitamin E was found to be detrimental by neutralizing the effect of a person’s cholesterol medication.

            The topic for today is echinacea.  This is the technical name for the purple corn flower which is a perennial wild flower in North America.  Various claims are made for its medicinal benefit.  The most prominent claim is that it prevents and treats the common cold by enhancing a person’s immune system.

            There is a national government branch called The National Institute of Health.  A division of that institute is the “National Center for Complimentary and Alternative Medicine”.  Believe it or not, they have spent 1½ billion dollars since 1999 studying “folkway uses of herbs and home remedies”.  This National Center for Complimentary and Alternative Medicine elected to study echinacea and its ability to prevent or treat the common cold.   Why?  Because of the popularity of Echinacea and its huge annual expenditure.  So what was found?

            There is a common cold virus  called “rhinovirus type-39”.  Four hundred and thirty seven college aged volunteers were involved in a trial to see if Echinacea had any demonstrable effect on the common cold.  Each person received a 5 day pretreatment with a placebo that had no perceived therapeutic benefit or with Echinacea.  The 437 volunteers were then exposed to rhinovirus type-39 followed by 5 additional days of treatment.  After the volunteers were exposed to the virus, they were isolated in a hotel room for 5 days.

            The study found that echinacea was of no value in either preventing or treating the colds that occurred in these 437 individuals.  The amount of virus that occurred in these individuals was measured and echinacea had no effect on the amount of virus that was produced in any individual.  There was no effect on the runny nose or the sinus problems.  Blood counts showed no difference between the individuals that took the echinacea and those that took the placebo.  In summary, echinacea was found to have no measurable benefit in either preventing or treating the symptoms of the common cold.

            This study punctures another hole in the concept of “alternative and complimentary medicine”.  I continue to be puzzled on why someone would think that an effective treatment would be withheld some the general public by the healthcare industry.  The healthcare providers at your local clinics spend their entire endeavor treating illness and providing comfort for their patients.  If echinacea really worked to prevent or to treat the common cold, why would people believe that healthcare providers wouldn’t prescribe this for their patients.

            To restate the mission and the purpose of the healthcare providers at your local clinics:

            1.  We strive to provide preventive medicine for the many degenerative diseases in our society today.

            2.  We strive to provide comfort for those who are symptomatic from their illness.  This includes adequate pain relief.

            3.  We strive to provide the most economical medications with the fewest side effects and the most beneficial therapeutic effect based on clinical trials where patients are tested with the medication.

            4.  We have no reason to ever withhold an effective medication from the public.  If an “alternative or complimentary medication” were found to be effective and safe and economical, we are going to use it too.

            Bottom line for this column is echinacea doesn’t work to prevent the common cold or to treat it.  It is a waste of money and a misdirection of care in dealing with the colds that people development.