Echinacea and Training

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As the days get shorter and the evenings longer, it seems that the size of my group exercise class also begins to dwindle. Two or three people who are real regulars will be absent for a few days and then return, only to be followed by a few others, off and on until the spring. It's cold and flu season and most of us will fall prey to a cold or the flu at least once (if not more) during the next six months.

The United States Centers for Disease Control and Prevention estimates that every year Americans suffer from 425 million episodes of cold and flu. The result is $2.5 billion in medical costs and lost school and workdays. Adults usually have two to three colds in a year, and children suffer from six to seven every year. Seasonal occurrences of colds are greatest in the fall and winter months and lowest during the summer months.

Dodging The Bullets

Is there any way to dodge the cold virus bullet, or are we just destined to dread the coming of fall? There are some tried-and-true methods for avoiding contact with cold viruses, like using only clean tissues instead of used handkerchiefs and frequently washing hands with soap and water to disinfect the virus. But if these were foolproof, many of us wouldn't be catching colds anymore.

Whether you are going to get sick once you have been shot by the cold virus bullet really depends on the status of your immune system. A healthy and robust immune system might be able to fight off the common cold without much more than a throat tickle. But a weakened immune system will easily be defeated when faced with an onslaught of cold virus. Aging, cigarette smoking, mental stress, poor nutrition and lack of sleep have all been associated with impaired immune function and increased risk of infection.

The best strategies for maintaining a well-tuned immune system are to eat a well-balanced diet, lose bodyweight slowly, minimize the stress in your life, get enough rest and exercise. But all exercise is not created equal in its immune-boosting effects. While moderate exercise does boost immune function, researchers know that intense training can suppress it.

Exercise And Immune Function

Physical activity affects all the systems in the body, including the immune system. Scientists have known for years that exercise overtraining has a negative impact on immune function. Too much exercise alters the ratios of anabolic to catabolic hormones in the body, causing a breakdown of protein and suppression of the specialized cells of the immune system. When an athlete overtrains, lymphocytes, granuloctyes and macrophages– the soldiers of the immune system assigned to eliminate or neutralize foreign invaders– are not available for duty and infection sets in...most commonly, upper respiratory tract infections (URTI).

High levels of intense exercise and competition, even without overtraining, also negatively affect immune function. Several research studies have reported that marathon runners have a higher incidence of URTI after running a marathon when compared to similarly trained runners who did not race. In fact, elite athletes with higher levels of training have an increased incidence of URTI when compared to other exercising individuals.

Echinacea And Training

Since risk of a cold is not a deterrent for those of us who love to run faster and jump higher, the search for something that will give us an immune boost is an ongoing research proposition for nutrition and exercise scientists. The herbal supplement echinacea has been around the research block several times and it has recently returned with better news than the last time we heard about it.

Echinacea is a member of the sunflower family. There are three species used medicinally: purpurea, augustifolia and pallida. The German Commission E, Germany's equivalent to the U.S. Food and Drug Administration (FDA), has approved echinacea purpurea as supportive therapy for colds and chronic infections of the respiratory tract. The commission's monograph notes that echinacea preparations increase the number of white blood cells in the body. White blood cells destroy invading organisms, including cold viruses.

A stringent scientific review study of echinacea conducted in 2006 analyzed 16 trials of the herb. It concluded that some evidence has found that the aerial parts of echinacea purpurea are effective for the early treatment of colds in adults, but that these results are not fully consistent.

This past September (2007) in the International journal of Sports Medicine, Dr. Heather Hall and colleagues from Elmhurst College investigated the influence of echinacea purpurea supplementation on immune function and incidence of URTI in subjects following an exercise protocol known to reduce immunity. Thirty-two healthy and active subjects aged 19 through 46 completed a randomized, double-blind, placebo-controlled parallel group study. Immune function was tested by salivary collection of mucosal immune factors and completion of medical history forms designed to assess the incidence and duration of signs and symptoms of URTI.

Distinctions were made between symptoms from allergies and URTIs. Subjects were tested after a strenuous exercise protocol, before and after a 28-day dietary supplementation period of either echinacea purpurea or a placebo. The supplement (with an identical protocol for the placebo) consisted of eight capsules per day– two with each meal and two at bedtime. Subjects completed standardized logs documenting the type, frequency, duration and severity of any symptoms of URTI unrelated to allergies.

At the beginning of the study, both groups showed significant exercise-induced reductions in immune function. After 28 days of supplementation, only the placebo group still showed a significant exercise-induced immunosuppression. While reports of incidence of URTI were the same between the two groups, the reported duration was significantly different. The supplemented group reported 3.4 day-long bouts of URTI symptoms and the placebo group reported 8.6 daylong bouts. According to the researchers, "The results suggest that echinacea may attenuate the mucosal immune suppression known to occur with intense exercise and reduce the duration of URTI that subjects incur."

Immune-Boosting Recommendations

The results from this study are encouraging, because the research was so specific to what we are interested in: immune function and high-intensity exercise. So you might add, or add back in, echinacea to your immune-boosting arsenal. Be aware that if you suffer from hay fever, taking echinacea puts you at risk for a severe reaction. Don't supplement with echinacea if you have an autoimmune disease such as lupus or a progressive illness such as multiple sclerosis, because the herb may overstimulate your immune system and do further damage. Also, don't supplement with echinacea for longer than eight weeks. Here are some more tips on how to prevent or treat the common cold:

Eat a well-balanced diet and stay well-hydrated.
Get daily, moderate exercise.
Get plenty of rest.
Minimize mental and emotional stress.
Wash hands frequently with soap and water.
Disinfect telephones, faucets and other surfaces that might be infected with virus.
Use clean tissues rather than used handkerchiefs.
Spend time outdoors in the fall and winter when airborne viruses are commonly inhaled in enclosed spaces and there is more person-to-person contact.
Vitamin C supplementation may slightly reduce the severity and duration of symptoms.
Echinacea purpurea supplementation may slightly reduce the severity and duration of symptoms.
Use antihistamines, decongestants, cough medicines and analgesics for temporary relief of symptoms.

Echinacea Boosts EPO

Echinacea is a popular supplement for treating and preventing the common cold, speeding wound healing and fighting infections. Unfortunately, scientific studies haven't supported these claims. University of Virginia School of Medicine researchers found that echinacea supplements had no effect on the risk or severity of upper respiratory infection or cold symptoms (N Engl J Med, 353:341-348, 2005). However, it may boost endurance performance.

Researchers from Southern Mississippi University found that echinacea increased erythropoietin (EPO; stimulates blood cell production) and interleukin-3 (important immune system chemical), but did not increase red blood cells, hematocrit (percent red blood cells) or hemoglobin (transports oxygen). A study presented at the American College of Sports Medicine meeting in June 2007 found that echinacea increased EPO, maximal oxygen consumption and running economy. Echinacea might benefit intensely training endurance athletes, but we need more research before we can recommend it. (International Journal Sports Nutrition Exercise Metabolism, 17: 378-390, 2007

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