Echinacea autoimmune conditions

The use of Echinacea is not recommended for patients with autoimmune conditions, such as multiple sclerosis and AIDS, or those taking drugs to suppress immune response (e.g., corticosteroids) (Blumenthal, 1998 Gruenwald et al., 2000). However, these recommendations appear to be based on speculation more than rigorous, peer-reviewed research. Research is needed to further support or refute the claim that individuals with autoimmune conditions should not use Echinacea. 

Clinical herbalists have reported differing information on the use of Echinacea species in autoimmune conditions. Exacerbation of symptoms has been reported in systemic lupus, ulcerative colitis (autoimmune etiology uncertain), glomerular nephritis, and multiple sclerosis. In "some" cases, effects reoccurred on rechallenge. In rheumatoid arthritis, treatment with Echinacea species for 10 days did not exacerbate the condition (Upton and Graff 2007). A survey of 25 medical herbalists indicated that 12 had used Echinacea species in persons with autoimmune conditions. Of these 12, 11 indicated a beneficial effect and 1 indicated a worsening of symptoms (Upton and Graff 2007). 

A 36-year-old patient started taking a combination of herbal products including Echinacea, and 2 weeks later she presented with generalized muscle weakness that limited her ambulation and ability to use her hands. She was found to have distal renal tubular acidosis and was extremely hypokalemic (K+ of 1.3). Over 4 days she received 1200 mEq of sodium bicarbonate and 400 mEq of potassium chloride along with other electrolyte supplements to correct the imbalances. After her serum electrolytes were corrected, her muscle weakness improved rapidly. She was diagnosed and treated for Sjogren s syndrome and her condition rapidly improved. The researchers suggested that her use of the immunostimulant Echinacea could have contributed to the activation of her autoimmune disease, which ultimately caused her severe metabolic disturbances. Because she had remained symptom free for more than 3 years, the authors concluded that, after review, her disease was relatively mild and was exacerbated by Echinacea (34). 

Commission E reports for all Echinacea species that they are not to be used in systemic diseases such as tuberculosis, leukosis, collagenosis, multiple sclerosis, AIDS, HIV infections, and other autoimmune diseases (Blumenthal et al. 1998). Concerns regarding the use of Echinacea species in these conditions are theoretical, and definitive data supporting or refuting an association of Echinacea with autoimmune symptom exacerbation are lacking (Mills and Bone 2005 Upton and Graff 2004). 

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See also in sourсe #XX -- [ ]

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