Is Echinacea Safe For People With MS?

Here is My Question:
Is there a possibility of problems taking echinacea in a mixture for allergies?

Answer:
Please see the attached posting on warnings regarding the use of Echinacea. http://www.mayoclinic.org/drugs-supplements/echinacea/safety/hrb-20059246

This warning aside, Echinacea, an extract from the root of the native american plant commonly called the Purple Coneflower, has a long history in herbal medicine as a natural stimulator of innate immune responses against viruses and possibly cancers. There is evidence that it may shorten the consequences of the flu virus and may be effective in other conditions.

Most advice for or against the use of echinacea extracts in patients with immune mediated disorders is based on the overly simplistic notion that anything that activates any part of the immune system is potentially harmful. To my knowledge this has never been demonstrated except in one case report that suggested a role of echinacea in either the development or worsening of immune mediated skin disorders such as pemphigus vulgaris and dermatomyositis.

Echinacea does stimulate the production of Natural Killer (NK) cells, an important regulator of innate and adoptive immune responses, but I am not aware of any studies characterizing the specific subtype of NK cells that are enriched in the peripheral blood or tissues of patients taking this extract. This is important since certain NK cell subpopulations may enhance cytotoxicity and injury and other NK cell populations may regulate and control immune responses in a beneficial manner. For instance, in MS there is a known enrichment of CD56bright natural killer (NK) cells in spinal fluid that may be associated with disease remissions.

A new MS therapy that may be approved by the FDA in the future called, Daclizumab, may actually work by increasing the numbers of CD56bright natural killer (NK) cells. Therefore, it will be important to learn exactly how echinacea affects NK cell subpopulations and function, and whether this effect is either beneficial or harmful in different immune mediated diseases.

Since the verdict is still out on this subject, it is probably best to avoid echinacea until we have a better understanding of the biologic and clinical effects of this phytochemical extract on immune medicated diseases.

-Rip Kinkel, MD

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