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[2008 updates are highlighted in red]
| Description: |
Echinacea and several other dietary supplements are known to activate the immune system. |
| Rationale: |
In some alternative medicine books, it is erroneously stated that MS is an immune disease and that, consequently, people with MS should take echinacea and other dietary supplements that stimulate the immune system. This is incorrect and potentially dangerous information. MS is an immune disease, but it is generally characterised by excess immune system activity. Thus, most effective MS therapies decrease immune system activity. Compounds that stimulate the immune system, such as echinacea, could actually worsen the disease. |
| Evaluation: |
The immune system effects of some dietary supplements have undergone limited investigation. Generally, these studies have focused on in-vitro or animal model experiments. These studies have investigated macrophages and T cells, components of the immune system that are excessively active in MS. Activation of these cells has been produced by echinacea and several other dietary supplements, including:
• Herbs: alfalfa, Asian ginseng, astragalus, cat’s claw, garlic, maitake mushroom, mistletoe, shiitake mushroom, Siberian ginseng, stinging nettle
• Vitamins and minerals: antioxidant vitamins and minerals (see “Dietary Supplements: Antioxidants”), zinc
• Others: melatonin
Based on scientific evidence, these compounds pose theoretical risks to people with MS. Clinical studies of the effects of these compounds on people with MS are not currently available, and probably never will be. There is one report of a person who developed an MS-like disease (acute disseminated encephalomyelitis) after the injection of an herbal mixture that included echinacea.
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| Risks: |
As noted, immune-stimulating compounds pose theoretical risks to people with MS. For echinacea specifically, it may accentuate the liver toxicity of some medications, which include some MS medications such as interferons and methotrexate. |
| Costs: |
Immune-stimulating dietary supplements are of low-moderate
cost.
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| Committee opinion: |
In the opinion of the Committee, there is no documented benefit for echinacea and other immune-stimulating dietary supplements in MS. These compounds, which are of low-moderate cost, actually pose theoretical risks to people with MS. |
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