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Echinacea question
Feb 7, 2000

hello Doctors - i elected to stop HAART because of the serious side effects i continued to have. currently my viral load is 88k and my tcells are 620... my question is that my best friend suggested i start taking echinacea on a daily basis which i have started..however, i have been told by another friend that taking this when you have untreated hiv and a detectable viral load will cause more problems than good and could actually make things worse. What is your take on all this? Your expert advise would be most welcome. Thanks for all your help and have a great day! scott

Response from Dr. Cohen

Hey Scott.

You might ask how your friends have such confidence in their answers to you. Since the major problem in giving advice about echinacea is how little is has been studied in terms of its potential impact with HIV infection - whether maximally suppressed or untreated.

There have been literally over 100 research studies with this important herb. As a result of them, we can see evidence that this herb is active on cells in the immune system. There are studies which show an increase in the number of white cells, and increase activation of some of these cells in terms of their function to control invading organisms... There might even be some impact on increasing reproduction of T helper cells. It might even help control the flu virus and help slow it down. For these reasons, it is often suggested for use during a cold, or viral bronchitis. However, it is recommended for use for no more than 8 weeks at a time, in part due to some concern that after that, the effects will start to wear off.

But to date there is no known study about how it impacts HIV itself, or the T helper count of those who have HIV infection. The label of several preparations of echinacea even have a general warning cautioning those who have HIV to avoid using echinacea - but even this caution is a guess and not based on any studies showing a problem.

So my take on all this is that echinacea may help if you take it, but may help only for a short period of time, and then it may wear off. You might consider taking it for some time and hopefully with the support or at least awareness of your health care provider. And you can monitor your white count and cd4 count. And in 4-8 weeks check again. And then perhaps take a break and check the numbers again in 4-8 weeks, keeping in mind that these lab tests do bounce around a lot on their own.

good luck. let us know what happens. CC



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