Immune-boosting herbs in autoimmune disease: dangerous or necessary?

If you have an autoimmune disease such as rheumatoid arthritis, multiple sclerosis, Hashimoto’s thyroiditis, Crohn’s disease, lupus, or ulcerative colitis, chances are you’ve been warned against taking herbs that boost the immune system.

But are immune herbs actually bad for autoimmune disease?

The suggestion that immune-boosting herbs are detrimental in autoimmune disease assumes that enhancing any aspect of immune function is detrimental. However, our immune system is extraordinarily complex, and immune herbs might be safe or even beneficial in autoimmunity.

Even though the true cause of autoimmune disease is still in question, there is growing evidence that it may be caused by an inappropriate response to infectious microorganisms (bacteria and viruses especially). If this is the case, immune-boosting herbs could be extremely helpful because they can decrease the chronic presence of any triggering microorganisms.

But there is another aspect of why popular immune herbs might help in autoimmune diseases. They are also anti-inflammatory. This doesn’t detract from their immune effects. On the contrary, the anti-inflammatory action probably regulates immune responses, making them more sustained and focused.

You don’t have to take my word for it. The evidence from clinical trials and case reports speaks for itself. The following four herbs have demonstrated that they are both safe and effective in treating autoimmune diseases.

Andrographis for arthritis and ulcerative colitis

A 14-week randomised, double-blind, placebo-controlled clinical trial in 60 patients examined the impact of a 75 per cent ethanolic extract of Andrographis (300 mg/ day corresponding to 3 g of herb and containing 90 mg of andrographolides) in active rheumatoid arthritis.1 All trial patients were given the drug methotrexate and were allowed to continue taking prednisone or chloroquine if it had already been prescribed.

Compared with the measures taken at baseline, the Andrographis group experienced significant improvements by week 14. And even though the results weren’t statistically significant when compared with the placebo group, the important point to make here is that Andrographis improved the patients’ condition from baseline – it certainly did not make them worse.

Andrographis has also been shown to be safe and effective for patients suffering from active ulcerative colitis. In a randomised, double-blind trial, researchers compared a standardised extract of Andrographis with the non-steroidal anti-inflammatory drug mesalazine (4.5 g/day, in slow-release form) in patients with mildly to moderately active ulcerative colitis.2

Treatment with Andrographis extract demonstrated similar efficacy to the drug, with fewer side effects. Only 13 per cent of patients in the Andrographis group, versus 27 per cent of patients in the mesalazine group, had at least one adverse event, and most of these appeared to be related to the underlying disease itself. (You can read more about this study in the October 2011 issue of Nutrition & Healing.)

Astragalus for nephrotic syndrome

The Chinese herb Astragalus has also been the subject of two intriguing case reports from the US. A group of doctors described two separate cases in which patients suffering from a condition known as idiopathic membranous nephropathy (IMN, most probably autoimmune in origin) experienced remission after therapy with Astragalus.

The first case described a 77-year-old woman suffering from nephrotic syndrome due to IMN. (Nephrotic syndrome is a condition in which the kidneys are damaged, causing them to leak large amounts of protein from the blood into the urine.) One of the main symptoms of this condition is proteinuria (excess serum proteins in the urine).

Although she had been largely unresponsive to conventional treatments, the patient experienced a marked decrease in proteinuria after beginning treatments with Astragalus (15 g/day as part of the formulation Shen Yan Siwei Pian).3 When she stopped taking the formula, the nephrotic syndrome returned, and when she began taking it again, she experienced complete remission. Remission persisted even after stopping the herbal treatment.

The second case was a 63-year-old man with nephrotic syndrome due to IMN. In addition to conventional treatments (which had not resolved his proteinuria), he took Astragalus (15 g/ day herb equivalent of a 4:1 extract – presumably aqueous) for around 12 months, after which he experienced complete remission of nephrotic syndrome.4

Echinacea for autoimmune diabetes

There is now a considerable body of clinical observations, including my own, that long term Echinacea root is at least not harmful in autoimmunity, and it probably helps.

In fact, Echinacea has demonstrated benefits in both a lab study and in a clinical trial. Mice with autoimmune diabetes did not show any adverse effects when fed Echinacea purpurea root.5 And in a controlled clinical trial, patients with autoimmune uveitis (inflammation of part of the eye) were able to reduce their time on prednisone when given Echinacea purpurea.6

Cat’s claw for rheumatoid arthritis

Finally, cat’s claw has shown to be effective in rheumatoid arthritis patients. In the clinical trial, 40 patients undergoing conventional drug therapy for active rheumatoid arthritis were enrolled in a randomised 52-week study.7 During the first phase (24 weeks), patients were treated with cat’s claw extract or placebo under double-blind conditions. In the second phase (28 weeks), all patients received the herbal extract.

After the first phase, the cat’s claw group experienced a significant reduction in the number of painful joints as compared with the placebo group. Patients who started on the placebo in the first phase, and then received cat’s claw in the second phase of the study, also experienced a highly significant reduction in the number of painful and swollen joints. Only minor side effects were observed, and they occurred in both the active and placebo groups.

The bottom line is that if you’re suffering from an autoimmune disease, you have no reason to fear taking immune herbs. Based on the research, the risk of having an adverse reaction to the herbs is no greater than for someone who is in good health, and as the trials show, they could deliver some real benefits as well.

To your better health,

Kerry Bone
Nutrition & Healing

Volume 6, Issue 1 – January 2012

Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.

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