Negative Echinacea Study Draws Unfair Editorial Comment--an Opinion
A recent study in the New England Journal of Medicine (2005;353:341–8) has received wide public attention for claiming that certain echinacea preparations do not prevent or reduce the severity of the common cold, despite a larger body of research that has found echinacea to be an effective cold treatment.
This study by itself did not negate the many positive echinacea studies that preceded it, because the new study used an experimental method that does not resemble the way people catch colds in the real world. In this study, a cold virus (rhinovirus) was instilled directly into the nose of healthy volunteers, causing nearly everyone in the study to become ill. In earlier research, vitamin C also failed to provide benefit to people who were infected in this manner, even though most other vitamin C studies have produced a positive outcome. The American Botanical Council also pointed out that the dose of echinacea used in the new study may have been too low. Previous studies of echinacea as a treatment for infections have produced mixed results, but a critical review of these studies concluded that some echinacea preparations may be an effective treatment for the common cold.
This new study will probably not be remembered for its minimal contribution to our understanding of echinacea, but, rather, for the scathing editorial that accompanied it. The editorial, which was titled “Studying herbal remedies,” actually consisted of a broad-spectrum attack on alternative medicine and the people who practice and study it. Using such terms as “distortion,” “implausible,” “irrational,” and “erroneous thinking,” the editorial writer characterized alternative medicine as an “errant social-medical trend.” Regarding echinacea, he argued that the teachings of traditional herbalists are of little or no value, because our ancestors had no concept of disease. He then summarily dismissed more than 200 clinical trials of echinacea as “industry funded,” while at the same time chastising the industry for not performing a larger, more definitive trial. He further claimed that a well-respected review of echinacea (Cochrane Review; Cochrane Database of Syst Rev 2000;2:CD000530) showed essentially no beneficial effect. Finally, he stated that it was a waste of taxpayers’ money to have performed the new echinacea study, because there was no plausible reason to have expected the herb to work.
In my opinion, most of the comments that appeared in that editorial were themselves distortions, which would not even deserve comment, were it not for the widespread publicity that the editorial achieved. Regarding our ancestors, it is difficult to comprehend how they could have brought us acupuncture, digitalis, milk thistle, licorice root, and the many other herbal remedies that have been validated by modern science, if they had been as out of touch as the editorial writer claimed. The demand that echinacea manufacturers fund a large, definitive study is unreasonable. Because echinacea is unpatentable and is priced as a commodity, the many diverse manufacturers of this herb could not possibly afford the cost of such a trial. Finally, the editorial writer misrepresented the findings from the Cochrane Review. While he claimed that the review showed “positive and negative results distributed around the zero-effect line,” the review actually stated, “Overall, the results suggested that some echinacea preparations may be better than placebo.”
The editors of the New England Journal of Medicine were wrong to have allowed a well-known opponent of natural medicine to use the negative echinacea study as a platform from which to perform a mugging of everything with which he disagrees. When was the last time a medical-journal editorial used a negative drug study to argue that no one should take, or even conduct scientific research on, pharmaceutical products? Finally, the coverage of this story once again highlights a bias in the news media, which typically publicizes negative findings while ignoring the overwhelming evidence of the benefits of natural treatments.
An expert in nutritional therapies, Chief Medical Editor Alan R. Gaby is a former professor at Bastyr University of Natural Health Sciences, where he served as the Endowed Professor of Nutrition. He is past-president of the American Holistic Medical Association and gave expert testimony to the White House Commission on Complementary and Alternative Medicine on the cost-effectiveness of nutritional supplements. Dr. Gaby has conducted nutritional seminars for physicians and has collected over 30,000 scientific papers related to the field of nutritional and natural medicine. In addition to editing and contributing to The Natural Pharmacy (Three Rivers Press, 1999), and the A–Z Guide to Drug-Herb-Vitamin Interactions (Three Rivers Press, 1999), Dr. Gaby has authored Preventing and Reversing Osteoporosis (Prima Lifestyles, 1995) and B6: The Natural Healer (Keats, 1987) and coauthored The Patient's Book of Natural Healing (Prima, 1999).
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