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Echinacea no better than placebo at decreasing cold severity, length
Barrett B. Ann Intern Med. 2010;153:769-777.
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Echinacea does not make a difference in the length or severity of the common cold, according to researchers at the University of Wisconsin.
The researchers studied 719 participants aged 12 to 80 years who had early cold symptoms. They randomly assigned the study participants to receive either no pill, a pill that they knew contained echinacea or a pill that could be either echinacea or a placebo.
Patients recorded their symptoms twice a day for approximately 1 week. Participants who received echinacea had a very slight (7-10 hour), statistically insignificant decrease in the duration of their cold symptoms. Similarly, there was no significant decrease in severity of symptoms. The study was funded by the National Center for Complementary and Alternative Medicine of the NIH.
The botanical genus Echinacea is native to North America, and many people use various Echinacea preparations for many illnesses. The results of this study, however, indicate that this dose regimen of the echinacea formulation did not have a large effect on the course of the common cold compared with either blinded placebo or no pills.
An earlier published review by the Cochrane Library concluded that echinacea has some benefits, if taken soon enough.
A typical child experiences 6 to 8 viral respiratory infections each year with symptoms from each infection lasting at least 7 days. Decongestants, antihistamines and cough suppressants have little efficacy in relieving symptoms and may be associated with undesirable side effects, especially in young children. As a result, alternative forms of treatment sometimes are used in children and adults in an effort to reduce the duration of symptoms or even to prevent upper respiratory tract infections. Echinacea is one of the most frequently advocated nonprescription herbal medications based on the theory that this plant extract potentiates the immune response and hastens recovery. Several pharmaceutical agents in use today originally were derived from plant sources including digitalis from foxglove, salicylate from willow bark and quinine from cinchona and these examples are cited as evidence to support the possible existence of other useful herbal extracts.
Unfortunately, despite the publication of many studies regarding Echinacea the efficacy of this agent in reducing the symptoms of a viral upper respiratory infection or in prevention of viral infections remains unproven. Most trials have failed to demonstrate statistically significant benefit from Echinacea. The well designed, randomized, blinded, placebo-controlled trial by Barrett et al evaluated the ability of Echinacea to reduce the duration or severity of symptoms due to the common cold in people between 12 and 80 years of age. While no difference in adverse effects was noted in this study, no statistically significant benefit was found. When talking with parents about alternative medicine, pediatricians may wish to note that herbal products are not evaluated by the FDA, concentrations may vary, contaminants may be present, most studies do not show evidence of benefit and unanticipated toxicity may be encountered.
—H. Cody Meissner, MD
Chief, Pediatric Infectious Disease, Tufts Medical Center;
Professor of Pediatrics, Tufts University School of Medicine
Disclosure: Dr. Meissner reports no relevant financial disclosures.
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