Guest guest Posted December 16, 2003 Report Share Posted December 16, 2003 Tue, 16 Dec 2003 09:56:51 -0500 HSI - Jenny Thompson Knockout Punch Knockout Punch Health Sciences Institute e-Alert December 16, 2003 ************************************************************** Dear Reader, Here's a story with more sequels and repetitive plot lines than Rocky... A study concludes that an herbal formula or a vitamin supplement is ineffective. Press releases are sent out from the organization or school that sponsored the research. News items appear in newspapers, television reports and other media outlets - most of them lifted directly from the press release. Supplement fails! The headlines and sound bites make their impression and the mainstream media machine moves on. We've seen it with St. John's wort, with ginkgo biloba extract, with beta-carotene, and any number of other supplements. This time the supplement is echinacea; an extract of an American wildflower that's used to help prevent the symptoms of common colds, influenza, and other infections. And this time - just as with those other studies - the research is flawed. But you'll never hear about the flaws on the evening news. As HSI Panelist Jon Barron put it, " If an herb could sue for libel, echinacea would be able to sue and win. " ---------------------------- The evidence ---------------------------- Here are the basic nuts and bolts of the University of Washington (UW) study, as reported in the Journal of the American Medical Association. The trial was designed to determine if echinacea is effective in reducing the duration or severity of upper respiratory infection (URI) in children. Over a period of four months, more than 400 children, aged 2 to 11 years, were given either echinacea or a placebo whenever symptoms of upper respiratory infection (URI) occurred. Parents of the children were directed to begin " medication " at the onset of symptoms, and to continue the daily dosage for a maximum of 10 days, or until symptoms subsided. Parents recorded the duration and severity of symptoms. A total of 707 URIs were recorded. In the echinacea group 337 URIs were treated, and 370 were treated in the placebo group. Overall, there was no significant difference between the two groups in the duration of URIs, the severity of symptoms, number of days of peak symptoms, or the number of days with fever. Conclusion: The echinacea was not effective. In addition, about 7 percent of the children in the echinacea group experienced rashes, while only about 3 percent of the children in the placebo group reported rashes. So the typical headline/sound bite that the media focused on stated two conclusions: The echinacea was ineffective, and its use was linked to rashes. No doubt about it; that's a pretty poor showing for echinacea. Unless, of course, you happen to be aware of one critical detail. ---------------------------- The cow in the ointment ---------------------------- The echinacea in the UW study was ineffective because it was inferior. In his Baseline of Health newsletter last week, Jon Barron pointed out that within the community of herbalists it's well known that the most potent part of the echinacea plant is the root. Jon writes, " In fact, potency runs from seed to root to leaf to almost none in the flower. " And you know exactly where I'm going with this: The echinacea used in the study was mostly extract from the flower of the plant. If you REALLY want to test echinacea, then for goodness sake, use the most potent part! The use of echinacea flower may also have a lot to do with the rash problem. Mark Blumenthal, the executive director of the American Botanical Council, told NutraIngredients.com that rashes are not normally associated with Echinacea. He believes that the rashes could very well have been an allergic reaction to pollen in the flowers. But when echinacea root is used - guess what? - no pollen! So again, if the researchers had used the proper echinacea type, there would probably have been no rash issue at all. But then this begs an obvious question about the placebo in this study: What kind of placebo causes a rash? Unless each child was informed that the " medication " might cause a rash (which seems highly unlikely), it's inconceivable that the resulting rashes in the placebo group could be due to a placebo effect. As I told you in the e-Alert " Aiming to Please " (7/21/03), the placebos used in each individual study are unique and often contain some active ingredients. So what in the world did they put in the placebo that caused rashes? The fact that this is not addressed isn't surprising. Studies never discuss the contents of placebos. ---------------------------- A fluke by any other name ---------------------------- Here's my favorite part of this study: The children in the echinacea group had 33 fewer URIs than the children in the placebo group. Mr. Blumenthal suggests that the occasional echinacea dosing that the kids in the echinacea group received may have helped prevent subsequent URIs. But because the study was not intended to analyze prevention, this result can't be assessed as a primary outcome. Fair enough. But the lead researcher, Dr. James Taylor, perhaps revealed his true colors when he simply dismissed the information about the possible URI prevention, telling the Associated Press that those results could be just a " fluke. " Sure, it could be a fluke. Or (given the fact that there are studies that support the use of echinacea as a preventive agent for colds), this " fluke " could also be seen as a significant indicator that something important is going on. At the very least, this secondary result ought to be compelling enough to refrain from portraying the study as a failure for echinacea. And as long as Dr. Taylor is on the subject of flukes, maybe he could explain how his study's placebo gave kids rashes. ---------------------------- Read your label ---------------------------- Putting aside the glaring flaws of this study and the typically inept media reaction to it, the study serves a purpose for those who are inclined to give echinacea a try to help prevent colds and other viral infections this season. As Jon Barron's comments illustrate, when shopping for an echinacea product, you should read the label carefully. If the source of the product is the root of the plant, you'll probably enjoy better protection than if the source is the flower. In addition, echinacea can cause allergic reactions, mostly to those who are allergic to sunflowers, as echinacea is in the sunflower family. Herbalists also recommend that echinacea should not be taken daily for long periods of time. Among the several references I've read, some herbalists say two weeks should be the maximum, while others say a few weeks longer is fine. And if anyone offers you a placebo, just say no. ************************************************************** ... and another thing " Does This Smell Bad? " That was the question posed by last Wednesday's e-Alert (12/10/03) about the way the Centers for Disease Control (CDC) has embraced the use of the nasal flu vaccine FluMist in the wake of the shortages of the conventional vaccine. In response to that e-Alert I received an e-mail from an HSI member named Franco who asked, " Why are you so negative? " And: " What is your basis for criticizing attenuated vaccines? Have you any credible study to outlaw that method? " Franco makes an excellent point. No one has any credible study that indicates that FluMist is unsafe for most of those in the approved user group. There ARE, however, studies that show FluMist is unsafe for children under five and adults over 49, which is why the FDA has not approved this vaccine type for people in those age groups. Furthermore, the Baltimore Sun reports that, according to the FDA, common FluMist side effects include " nasal congestion, runny nose, sore throat and cough. " Clearly, those are indications of a compromised immune system. So you have to ask: Is this the safest way to protect yourself from the flu? There are also no studies that demonstrate what we can expect when people who are infected with FluMist's weakened flu strains come into contact with a population on the verge of a flu epidemic. In fact, people who receive the FluMist vaccine are advised to stay away from people at risk of infection for at least one week. So my primary question with FluMist is this: Given all of these unknowns, and given the fact that FluMist is only approved for those who essentially need it the least (healthy people between the ages of 6 and 49), is it really wise for the CDC to press people to get this alternate vaccine? Early last week we heard reports that supplies of the conventional flu vaccine had run out. All of it had been shipped. Then late last week - wait a minute! - the Associated Press reported as many as 400,000 doses of the vaccine may be available from England, and that 250,000 doses of the flu shot had been " set aside " at the request of the CDC " when it became clear that shortages might develop. " Might develop? It was reported far and wide that the shortages were a reality - not that they " might " develop. Meanwhile, FluMist enjoyed a nice boost of free publicity, courtesy of the CDC. To return to Franco's original question - " Why are you so negative? " - I don't think it's the least bit negative to point out the potential problems that may affect our health. If these problems aren't highlighted, all we'll hear are the bright, candy-coated reassurances from the mainstream medical establishment that their vaccines and medicines pose no real dangers. To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " Efficacy and Safety of Echinacea in Treating Upper Respiratory Tract Infections in Children " Journal of the American Medical Association, vol. 290, no. 21, 12/3/03, jama.ama-assn.org " Study Finds Herbal Treatment Ineffective " Lindsey Tanner, Associated Press, 12/2/03, story.news. " Echinacea Fails to Reduce Severity of Colds But May Cut Frequency " NutraIngredients.com, 21/3/03, nutraingredients.com " Killer Flu and Echinacea " Jon Barron, Baseline of Health newsletter, 12/8/03, jonbarron.org " Flu Spreads to All 50 States " Associated Press, 12/12/03, msnbc.com Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C. 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