there was no effect for treatment of this experimental rhinovirus using Echinacea. A perspectives article in the same issue of the journal by Wallace Sampson went so far as to conclude that Echinacea is ineffective in boosting the immune system in any way whatsoever. This seems like a rather broad claim for an herb that has, in fact, been used effectively for hundreds of years and has dozens upon dozens of positive journal studies in its favor! I wonder what Sampson's theory is for why tens of millions of people over hundreds of years have used Echinacea successfully and repeatedly for treating colds if it is as worthless a plant as he suggests in his piece?

Understanding the study and how it was set up will show why the experiment "failed" (how it was designed to fail, in fact). So, let's look at what is wrong with this study and why real conclusions cannot be drawn from it:

• The group being treated with Echinacea was given 1.5 ml of a 1:5 tincture of Echinacea angustifolia three times per day. Echinacea for the immune system is like gasoline in a car. The harder and faster you run your car, the more gas you have to put in it.
  • Without having to understand extraction ratios and what tinctures are, etc, suffice to say that 4.5 ml of a 1:5 extract is a very small amount of Echinacea, particularly when being given to a patient in the acute stages of an infection. It would not be uncommon for an American herbalist to use about 0.5 ml of this strength of tincture every 15-30 minutes for a patient who is acutely sick!
  • The dosage equaled about 900 mg of Echinacea angustifolia root per day. Kerry Bone, researcher at MediHerb, Inc. and probably the world's leader in the cultivation and extraction of Echinacea, gives a guideline of using 2,000 mg per day of high quality root, over twice what the NEJM study used.
  • Like pharmaceutical medicine, dosage is critical for herbal medicine, both in terms of the quality of the extract, amount given, the form given (liquid versus tablet), as well as the timing of the dosages.
• One of the authors of the study, Dr. David Gangemi, stated "I think in retrospect if we go back and we look at some of the other products that are out there maybe we’re only one tenth the level we should be."
  • The question that herbalists ask repeatedly when so-called "negative" studies on herbs are presented in medical journals is why real, practicing herbalists are not consulted in designing the study. How much credence would be given a study on a medication if it used a poor grade of the medicine, less than a therapeutic dosage, etc? None at all, yet this same lack of standards is applied to herbal medicine all the time, resulting in conflicting evidence about the efficacy of the herb.
• This study, despite being poorly designed and using a flawed clinical method, is one of a mountain of evidence that has been compiled about Echinacea over the last hundred years. The research really shouldn't even be considered since its design is so flawed, but one needs to only open a textbook like Kerry Bone's Principles and Practice of Phytotherapy or David Hoffmann's Medical Herbalismto see dozens of well-designed clinical trials that do, in fact, show a measurable effect of Echinacea on the human immune system.

Unfortunately, mainstream medicine, particularly the medical journals, have a grave misunderstanding of herbal medicine and therefore approach any study having to do with it with a negative bias. In recent years these same journals have discredited Kava needlessly (interestingly, reports of problems with kava originated in Germany, where kava had for the first time outsold Prozac for use in depression), St John's Wort (also through poorly designed studies) and others.