BRIEF REPORTS Possible Leukopenia Associated with Long-term Use of Echinacea

Americans spend between $3.5 and $5 billion an-nually on herbal treatments,1 and nearly 50 million individuals currently report use of botanical sup-plements.2 With so many herbal products on the market, it is imperative that physicians thoroughly question patients with regard to supplement use. Physicians must understand the benefits and risks associated with medicinal herbs and counsel pa-tients as to their safety. Echinacea is one such supplement that has gained popularity in recent years. A member of the daisy family—Asteraceae (Compositae)—Echinacea purpurea is believed to have properties that protect against upper respira-tory tract infections such as the common cold. In 1998, retail sales of the product worldwide totale