Echinacea – cui bono? The herbal community here has been disappointed by the Irish Medicines Board’s recent statement advising that the herb echinacea is unsuitable for children. Echinacea is a very popular herb and widely self-prescribed for the prevention and alleviation of colds and flu. The decision seems to have been made based on a small number of adverse events reports, the vast majority of which are in the low-risk category. In my view, this is taking fears about safety to an extreme. Many of the studies which have reviewed the use and safety of echinacea conclude that this herb has a good safety record, with an estimated risk of a reaction calculated at 1:100,000. Moreover, the vast majority of the reactions deemed to have been caused by echinacea i.e. rashes, were minor and reversible.

Let us remember that this herb is no less safe today than before this announcement was made. Herbalists often prescribe echinacea, and remain free to do so, as this advice is only for the retail herbal sector. No known reactions have been recorded when echinacea has been prescribed by qualifed herbalists either here or in the UK. During a consultation, a herbalist screens for potential allergies by taking a careful history and noting anything that might suggest a sensitivity to a particular plant species or to certain foods. Herbalists also prescribe their medicines at dosage levels appropriate to a child’s age. This is simply good practice and minimises the risk of problems. However I have difficulty with the fact that decisions like these raise concerns in the public mind, particularly for parents and guardians, who after all, are the people who have to decide what is the best thing to give their sick child. It is the practitioers who then have to reassure parents and point to the overall very good safety record of herbs like echinacea.

What are the likely consequences of this declaration by the IMB? Without the benefit of echinacea, children are likely to get more respiratory infections. Rather than helping them resist such infections they will be administered more Calpol or Neurofen and prescribed more antibiotics (despite the HSE’s campaign that they are NOT appropriate for colds and flu). So….who really benefits in all of this? Not children, not practitioners of herbal medicine and certainly not a confused and more disempowered public.