Don’t Use Echinacea for This Season’s Flu

echinaceaIt looks like last year’s rather mild flu may turn more virulent this season.  It already is killing large numbers of people in unusual ways, especially those of Asian or Native American descent.  The most vulnerable seem to be not the aged or the young, but healthy young adults.  And it has killed people during the summer, a time when influenza deaths are all but unheard of. The 1918 flu pandemic which killed millions worldwide started out mild too.

If the flu acts like the 1918 pandemic, it will cause a cytokine storm, where your immune system can overreact, rapidly killing you.  In cases like this you do not want to use immune system stimulants like echinacea.  You are better off with Vitamin D and immune modulators which will not hype up your system if you don’t need it.

We cannot tell whether the H1N1 Swine flu will cause cytokine storms, but it has shown some troublesome characteristics.  In the summer when the flu does not show up, this flu has killed.  The dead have exceedingly high virus levels in the lung tissue, a thousandfold higher than normal, and have compromised the alevoli, getting into the blood stream and causing organ failure.  Many of the dead have no underlying weaknesses that should predispose them:  a healthy 48 year old woman suddenly came down with the flu which killed her within 72 hours.  A mother of 10 in Israel, a young woman in her mid 30s, suddenly died.
AstragalusOPT
Not all epidemics or pandemics are deadly, but they are widespread.  The degree of virulence determines whether or not people die.  We do not know how virulent this flu will be.  But even if it has the same virulence as a normal flu, it will be widespread enough to overwhelm our hospitals and primary care doctors.
People born after 1957 do not have any exposure to this virus or variations of it.  They form a virgin field.  When a virulent virus hits a virgin field it can have a devastating impact:  90% of the native American population was wiped out after the European contact because they lacked the antibodies to the virulent diseases carried by the explorers.  If the H1N1 virus becomes virulent, it could have a serious impact on a human population that has not been exposed to it.

So what should you do to prevent the flu?

  • Get your blood Vitamin D levels up to 50.  Don’t look at “high”, “medium” and “low” on the reference ranges because they are based on a population that is low.  There is not even close to enough in your multi or calcium pill.  Take Vitamin D3 alone and well over  2000 iu.    It takes time:  in 6 months of 10,000 iu I only got into the mid 30s.  Since the flu season is upon us I am using 50,000 iu a day to load, then will go back to 10,000 iu.
  • Wash your hands all the time and keep your fingers out of your eyes or mouth, which people tend to do 47 times an hour.  Use soap and water or a simple alcohol gel like Purell or one you make with essential oils.  Use it after using doorknobs, telephones in public places, subway banisters.  Keep it by your door, in your office and in your purse.  Don’t touch doorknobs or banisters if you can avoid them.  Avoid antibacterial soaps with triclosan because they kill your protective skin bacteria.
  • handwashing

  • Take Jade Wind Screen,  or even just astragalus or reishi to strengthen your immune system without being a stimulant.  This is akin to raising your energy with ginseng, which nourishes, instead of coffee, which will stimulate you even when you don’t need it.  Jade Wind Screen is a traditional Chinese formula which was designed to prevent respiratory illness.  It is not a treatment.
  • Make up some Thieve’s Vinegar and take a tablespoon daily, more if you are sick.
  • Get enough sleep.  That means 8 hours, more if you need it.
  • Exercise will strengthen your lungs and help your resistance.
  • Consider the vaccine if you are in the risk group.  It is true that there is higher Guillain Barre syndrome in response to the vaccine that may be due to the adjuvant squalene.  It is also true that more people will be protected than hurt.  There are two vaccines around, one for the seasonal flu and one that should be out shortly for the Swine flu.  A third flu for viral pneumonia is also available, although only about 20% of those autopsied had pneumonia.

If you feel like you are coming down with something then do this:

  • Up your Vitamin D to 50,000 iu daily.  You can purchase this strength or just take lots of the 5000 iu pills.
  • Mince up a clove of garlic, stick it on a spoon, coat it in honey, turn the spoon upside down and swallow, chasing it with water.  Do this every four hours, especially if you get pneumonia or other lung distress.
  • Keep a bottle of Pedialyte around because this flu has diarrhea and you don’t want to become dehydrated.  Keep it on a low shelf so you can get it if you are crawling.  Also keep oral rehydration salts on hand, but you may not be able to mix them up if you are alone and sick.
  • The hospitals may be overwhelmed, so consider whether it would be better to have preparations at home.  These could include antibiotics- talk to your doctor in advance.
  • Do NOT take echinacea or immune stimulants.  Instead have a bottle of Yin Chaio (Yin Qiao) ready.  Yin Qiao is a traditional Chinese formula for epidemic heat diseases, also created when access to doctors was limited.
  • You can also take astragalus or reishi, but I will be making up tinctures of:  Gardenia fruit, Forsythia buds, Lomatium root, Andrographis herb, Boneset herb, Phellodendron and Astragalus.

Also see earlier posts:  http://www.acupuncturebrooklyn.com/2009/04

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10 thoughts on “Don’t Use Echinacea for This Season’s Flu”

  1. Hi Karen,
    I very much respect your skills and expertise but I must debate this issue with you. What is your evidence for making this claim? The fear that Echinacea will cause a cytokine storm is like saying yarrow will cause a fever or chamomile tea will cause anaphylactic shock. There just isn’t enough evidence, traditional or scientific, to make this claim.

    I am unaware of any evidence that shows that Echinacea can stimulate a cytokine storm. There is very little evidence that H1N1 swine flu causes a cytokine storm, for that matter. There IS evidence that the H1N1 swine flu causes a viral pneumonia, which is a very different pathology.

    I’m groaning at your claim because I STILL see the myth passed on that Echinacea doesn’t work after 5 weeks, which is a fallacy based on a mistranslation of a German research study in which the immune measures decreased after 5 weeks BECAUSE the researchers STOPPED giving Echinacea to the study participants. Yet, ever since then, the myth keeps getting passed on and on.

    Or the myth that Echinacea shouldn’t be used in autoimmune conditions. But that’s another issue. There are so many myths being claimed about Echinacea! Like the one that Echinacea contains liver toxins. I can show you the exact source of this myth – a chemistry inaccuracy published in a medical journal.

    Echinacea is, in fact, one of the best preventatives for colds and flus and the best herbs to use to heal tissues after having a cold or flu. How many people will suffer because they didn’t use Echinacea? What is the risk vs. benefit?

    I’m sorry to challenge you on this. I am on your side. But I feel you need to show some good evidence for this claim you are making. Do you have any studies? Any case histories?

    Thanks for your patience. Best Regards, Robyn Klein

  2. Hi Robyn,

    First off I am starting from a clinical rather than a research premise. I cannot recommend herbs that have a good chance of being inappropriate. So while I concur that it is not proven beyond a doubt that echinacea causes a cytokine storm, I think there is good clinical evidence that it could do so and other herbs are available.

    I do have clinical experience where people with combination hypofunctioning and hyperfunctioning immune systems get hyperreactive with echinacea. Echinacea is classified as an immunostimulant, rather than an immunomodulator. The main difference between those two classes is that a stimulant will continue to stimulate even after the immune system is functional. An immunomodulator will bring up a hypofunctional immune system and will downregulate a hyperactive immune system. The coffee versus ginseng analogy is relevant here.

    In the current situation where we are dealing with a novel virus that has killed off several young healthy people within a few days, I think it is appropriate to use immunomodulators instead of immunostimulants. This flu may or may not develop into predominant strains with cytokine storms, but it is a novel virus in a largely virgin field that has shown the potential, as it also shows potential to cause pneumonia. We do not have a choice between echinacea and nothing. There are a number of other herbs that are more appropriate.

    Immunomodulators include astragalus, which is great alone or combined with atractylodes, peony root and siler as in Jade Windscreen, a time tested preventative formula. Other immunomodulators are reishi, maitake, eleuthero, cordyceps, ginseng, ashwaganda, ligustrum, ginseng (in small amounts) and licorice. For illness I would combine them with heat-clearing medicinals like coptis, cultivated goldenseal, forsythia buds, gardenia fruit, phellodendron bark, scute, boneset, lomatiuim and andrographis to have a stronger effect. For pneumonia, I would add garlic or isatis.

    I do not use echinacea preventatively and don’t think it is appropriate. In the three grade system, where there are food grade, medicinal grade and low dose toxic grade herbs, echinacea falls in the middle class. I only reserve it for disease. Astragalus or elder are better preventative herbs. I also early stage infections with herbs that help use the body’s own immune function, inducing sweating as with boneset, ginger or siler.

    I don’t think the myths that echinacea shouldn’t be given past 5 weeks or that it causes liver toxins are relevant here. (Does anyone even believe the five week myth anymore?)

    As for autoimmune conditions, I would tend to avoid it because I have seen bad reactions, although not universally. Roswitha had a full fledged flare using echinacea at an AHG conference, witnessed by many of our colleagues, although our Australian friend who uses it for the autoimmune refused to take a look at her when informed by his staff who had administered it.

    I like echinacea and I use it often. But I don’t think this season is one when it should be used. We know too little about the mechanisms of this flu and the little we know is not encouraging. There are a number of readily available herbal formulas designed for this type of condition such as Yin Qiao (Yin Chao), Gan mao ling, Gan mao qing and heck, even Airborne (although the strength isn’t spelled out.)

    But thank you for your questions.

    Karen Vaughan

  3. The idea that Echinacea modulates the immune system has strong scientific support; modulating the immune system and supporting a balanced response.

    Yet many herbal practitioners define Echinacea as a stimulant, meaning strong stimulation of the immune system. Yet science does not support this view.

    This definition of stimulant is where people get confused. Most do not understand the complexity of either immunology or herbal energetics. So they decide based on fear and caution. Health care providers must resist playing on people’s fears and they must provide balanced and informed information so that people can make good decisions.

    A recent paper in Pharmaceutical Biology, “Echinacea and anti-inflammatory cytokine responses: Results of a gene and protein array analysis” shows that Echinacea has the effect of reversing pro-inflammatory signals (cytokines) caused by cold viruses.

    In this study, Echinacea had a modulating effect on the immune system, not a stimulating one. There are many other studies like this.

    Many people have food allergies and asthma and for some, a very few, Echinacea irritates and sets off their allergies and asthma. But most people find that when they use Echinacea regularly, they do not catch colds and flus as often.

    I think Echinacea is being thrown out with the bathwater because of some negative reactions of a few people, along with the belief that swine flu can cause a cytokine storm.

    Yet, there has been no indication that swine flu causes a cytokine storm. Even so, the recent paper and other research suggest that Echinacea would help counter a cytokine storm, not worsen it.

    In fact, the deaths caused by this swine flu so far look very much like a viral-caused pneumonia or ARDS, acute respiratory distress syndrome. But many of the fatalities also involved ventilators…which can cause ARDS. But not all fatalities. Some people who were healthy have succumbed within days and not been hospitalized. We still don’t know why.

    This pandemic virus seems to be binding to cells deeper in the lungs and is replicating faster than the current seasonal flu strains. Researchers now think this is how the swine flu out-competes the other flu strains and why 98% of all flu right now is the pandemic swine flu.

    We don’t know what it will do in this second and subsequent waves. But it doesn’t help to make people afraid of Echinacea, an herb that is used by millions of people daily with no ill effect.

    Perhaps a calmer recommendation would serve people better. If you’ve had a negative experience with Echinacea, don’t use it. Seek other herb formulas or combinations. If you have allergies or asthma, be careful of all herbs, especially those you’ve never used before.

    I know one thing we both agree on. Vitamin D3 research strongly supports a role in prevention and treatment of influenza. And Americans are all too deficient in vitamin D3.

  4. With all due respect, you are perpetuating an urban myth .. or should I say an herbal myth? First of all … Show me the science. Your limited “clinical experience” is a far cry from proving Echinacea’s supposed contraindication in an actual scientifically controlled clinical trial. Also, read the scientific literature on he pharmacology of Echinacea where it is most often referred to as an immunomodultor … not an immune stimulant. FWIW.

    I know you mean well, but you are doing people a disservice my making such a definitive statement of your personal opinion. Respectfully, Ed Smith

  5. I see lots of studies where specific constituents of echinacea are immunomodulators, and I do see some studies where there seems to be a “we don’t know exactly what it does to the immune system but it does something, so we will call it an immunomodulator,” without defining what each does. David Winston’s new materia medica lists it as an immune stimulant instead of as an immune modulator. and he teaches it that way. PubMed has 67 papers listing it as an immune stimulant.

    I am hardly the only herbalist who has found this particular herb does more than regulate the immune system, nor the only one who finds that it sets off cytokine reactions in the autoimmune. I agree that it may not be problematic in all cases, but it isn’t like we only have one herb to use for influenza. Since this has the potential for harm with the unusual aspects of the H1N1 flu, I think we should let the herb sit out for the next couple of seasons and use the broader materia medica.

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