Monday, January 17, 2011

Echinacea - Does it quit working when used long term?

A reader inquired as follows: "Is it true that a person should take echinacea for 1-2 weeks and then lay off for a week then retake it?" She wanted to know if echinacea looses its ability to work long term and if she needed to take breaks from it so it would work better. This is an idea that has been floating around the herbal community and I often have new students ask this question.

She went on to say, "Does it really teach the body to work on its own? A few weeks ago a friend advised me to take all herbs for only awhile and then lay off so they can work right. Is this true?”

It has not been my experience that taking breaks from any herb including Echinacea, makes the herb work better when taking it long term. If I notice a person is getting worse or does not improve when taking an herb long term, I either need to increase the dose, the frequency or need to use a different treatment. Stopping and starting the herb again does not usually benefit the person from what I have seen with patients or personally.

Long term studies have shown echinacea to be beneficial without taking breaks. An 8-week double-blind study in 1989 showed echinacea was useful in prevention of respiratory infections. Another study using oral echinacea for 10 weeks showed prevention of recurrent bouts of vaginal candidiasis. These studies do show echinacea working with continuous use of the herb.

I know people who have recurrent infections such as herpes simplex, recurrent vaginal candidiasis, frequent viral infections etc that have used Echinacea as a preventative and used it over long periods finding it decreases their outbreaks when nothing else had helped. Now, I want to stipulate that these people usually have other underlying problems that could be addressed to help solve their problem, but this is how they solved it for themselves. Usually, they were coming to me to address those underlying problems and it is how I heard their stories about echinacea.

It has been thought by some people who use herbs that Echinacea should only be used short term because its effects stop after a period of 1-3 weeks.  However, there is no research that I have seen showing that long-term use of echinacea causes it to loose its effectiveness. I have not noticed that myself in using it personally or with patients.  While I don't usually recommend its long-term use, I don't think taking echinacea regularly is going to be problematic for most individuals. That being said, I would not rule out that it could be problematic for some specific individuals and indeed there have been cases of people having problems when taking echinacea long term. There are also cases of people taking echinacea short term who have had reactions. Over the 13 years of owning an herbal manufacturing company I spoke with many of our physician customers about patients who had reactions to a variety of herbs. When you serve thousands of practitioners as a provider of herbs you hear many more stories than you would ever collect as an individual physician in practice. Even the most benign herbs can cause reactions in some people and in rare cases they can be serious. So while I don’t think it is necessary to stop taking Echinacea every few weeks for it to work correctly, I also would not give it continually to a patient unless there was a good reason for it. I don’t continually give any herb to someone unless it is absolutely necessary. Indeed in some situations it is. Even when I give herbs to provide nutrients I usually like to change them around a bit for variety.

Echinacea is a wonderful herb. I have used it both internally and externally in a variety of situations with great results. I would not be without it. Although I usually use it in short term conditions, there are instances where I have used it long term with good results.

The second question about herbs teaching the body to work on its own is more complicated to answer. As with many things in life, it really depends on the individual situation. Sometimes an herb can help our bodies regain their normal healthy function and we can quit using the herb. Other times we need to continue some type of herbal support long term. 

Usually an herb is taken until the body regains healthy function. In these cases, the person can certainly stop taking the herb once they are doing better.  In some cases the person is not able to stop taking the herbs. This can be due to a variety of situations. Below are a few examples, but this is certainly not an exhaustive list.

• Perhaps the person is unable to get the correct phyto-nutrients for their bodies cells and organs to work right from their daily diet. If they can't get them from their diet they may need herbs to help support their body with vital nutrients. In this case it is necessary to take an herb or group of herbs long term.

• Living or working in a toxic environment is another situation where a person may need long term support from herbs. As toxins increase, there comes a point where our bodies become overloaded. We use up key building blocks necessary to transform toxins into less harmful chemicals that can be excreted. Using herbs can support the natural body defenses that help us to remove these toxins. In these cases the person needs to take the herb or herbs until they are out of the toxic environment.

• If the body is damaged irreparably, no amount of gentle or even vigorous support from an herb is going to get it working correctly on its own. In this situation, an herb or herbs may need to be taken on a long term basis. 

Luckily many problems will disappear when we attend to our bodies basic needs. When they don't it is good to have herbs to help us achieve a healthier state of being. If we need to use them long term, so be it.

For a more detailed look at Echinacea in pdf format: