Side effects, Echinacea

Echinacea appears to be a very safe herb, producing only minor gastrointestinal (GI) side effects and an occasional allergic reaction, usually in atopic patients already sensitized to other members of the Compositae plant family. Anaphylaxis has occurred rarely. Use in HFV is discouraged because of the concern that long-term therapy may eventually suppress the immune system. 

In general, herbal remedies, including St. John s wort, echinacea, kava kava, and ginkgo, should be avoided. St John s wort is considered an herbal remedy with some serotonergic reuptake inhibition properties and is purported to be helpful with depression. It is sometimes used concurrently with SSRI medications by patients who assume it is relatively free of adverse side effects. 

Echinacea is derived from the root and seeds of the Echinacea plant that grows in parts of the Midwestern United States. This herb is used primarily to stimulate or support the immune system, and is often used to treat cold symptoms and other relatively minor respiratory tract infections.8 38 Although the exact reasons for beneficial effects are unclear, there is considerable evidence that echinacea preparations can reduce symptoms of the common cold when taken soon after symptoms appear.5,71 The ability of echinacea to prevent colds and other infections, however, is less well defined.49 Echinacea can also be administered topically to treat burns and other localized wounds. The most common side effects associated with echinacea are gastrointestinal (GI) upset, skin rash, and other allergic or hypersensitivity reactions.36... 

Side effects that have been observed with administration of Echinacea are generally mild and uncommon. Infrequent adverse effects include abdominal upset, nausea, unpleasant taste, and dizziness. Rarely seen effects are anaphylaxis, exacerbation of asthma, and angioedema (28). 

Allergic reactions to Echinacea products have been reported see Adverse Events and Side Effects, below). Some authorities have suggested that the reactions may be due to the presence of Echinacea poUen in products, as allergies to pollens in the Asteraceae family are common. Ingestion of products made from the flowering top of Echinacea are thus more likely to result in allergic reactions than products made from the root and leaf (Mills and Bone 2005 Upton and Graff 2004). 

The safety of Echinacea preparations has repeatedly stimulated polemic public discussions. Large-scale drug-monitoring studies which would allow a reliable estimate of the occurrence and frequency of side-effects do not exist. Cases of severe anaphylactic reactions, mainly after parenteral application, have been reported [1, 3] however, in some of the cases a causality seems highly questionable. Nevertheless, there can be little doubt that the parenteral application of Echinacea extracts or combinations containing Echinacea bears some risk in susceptible individuals. Therefore, the majority of the manufacturers in Germany have withdrawn the... 

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