Orally, echinacea is used for treating and preventing the common
cold and other upper respiratory infections. Echinacea is also
used orally as an immunostimulant for fighting a variety of other
infections, including urinary tract infections (UTIs), vaginal
candidiasis (yeast infections), and genital herpes (HSV Type 1
and 2). Echinacea is also used orally for nasal cattarh, allergic
rhinitis, gum disease and tonsillitis. Other uses include chronic
fatigue syndrome (CFS), rheumatism, migraines, dyspepsia, pain,
dizziness, rattlesnake bites and swine flu.
Topically, echinacea is used for boils, abscesses, skin wounds
and ulcers, burns, eczema, psoriasis, UV radiation skin damage,
herpes simplex, bee stings, and hemorrhoids.
No concerns regarding safety when used orally and appropriately,
short-term. Available studies validate this statement.
Several formulations of echinacea have been used safely in trials
lasting up to 12
weeks.17,18,19,20,21,22,23,24,25,26,27,28 There is not
enough scientific evidence on the safety of long term use of
echinacea to comment. There is no evidence of harm.
Children: Possibly safe. There is evidence from research that an
Echinacea purpurea juice extract is safe in children aged 2-11
years when used for up to 10 days. However, echinacea might
increase the risk of rash in some children.29,26
Pregnancy and Lactation: Refer to a Medical Herbalist
Common cold. Taking some echinacea preparations seems to modestly
reduce symptom severity and duration, possibly by about 10% to
30%.17,19,32,33,37,21,22,24,25,27,28 Echinacea seems
to be most effective if started when symptoms are first
noticed and continued for 7-10 days. Not all research is
positive. Some studies show no benefit for treating the common
cold in adults.20,23,47,55,28 A study in children aged
2-11 years also suggests that taking an Echinacea purpurea juice
extract 7.5-10 mL/day (Madaus AG, Germany) for up to 10 days also
does not significantly decrease cold symptoms.29
Taking echinacea prophylactically to prevent the development of a
cold does not seem to be
effective.19,20,34,21,56,57,50,55,28 Echinacea studies
have used different echinacea species and a wide variety of
preparation methods. Studies have also used different patient
populations and study designs. Due to these discrepancies among
studies, it's not surprising that different studies have
different results.23,31,58,30,27 The best evidence
(and the most research) appears to be for preparations of the
Echinacea purpurea species.28 Other preparations that
have been used include a variety of extracts of the herbs and
root parts of Echinacea pallida and Echinacea angustifolia
species.17,18,19,21,53 Echinacea teas and fixed
combination herbal preparations containing echinacea have also
Vaginal candidiasis. Taking echinacea orally in combination with
a topical antifungal cream seems to be effective for preventing
recurrent vaginal yeast infection. Herb juice of Echinacea
purpurea in combination with topical econazole (Spectazole)
lowers recurrence rate to 16.7% compared to 54.5% with econazole
Herpes simplex virus (HSV). Taking echinacea orally doesn't seem
to prevent or treat recurrent genital herpes infection. A
specific Echinacea purpurea extract (Echinaforce by Bioforce AG)
800 mg twice daily for six months does not seem to prevent or
reduce frequency or duration of recurrent genital herpes in
patients with herpes simplex virus (HSV) type 1 or
INSUFFICIENT RELIABLE EVIDENCE to COMMENT
Influenza. Taking echinacea orally might modestly reduce some
influenza symptoms. However, there is not enough specific
evidence to know if echinacea is effective for
Mechanism of Action:
The parts of echinacea are the roots and the above ground parts.
The composition of each of the three commonly used echinacea
species is similar, with some variation in the amounts of active
constituents. Although these species are often used
interchangeably, there is very little research comparing
Echinacea increases the assimilation of detritus into mopping up
cells (phagocytosis) and increases lymphocyte (white blood cell)
activity, possibly by promoting the release of tumor necrosis
factor, interleukin, and interferon.35,36,39
Several constituents of echinacea seem to be involved in
stimulating this non-specific immune response. However, echinacea
doesn't seem to have any effect on the immune system of healthy
volunteers.40 Echinacea's effect on
cold symptoms might result from anti-inflammatory activity.
Clinical research also suggests an anti-inflammatory
Echinacea is also reported to have antifungal properties, so
people use it for yeast infections (vaginal candidiasis).
Compounds in echinacea seem to have antifungal activity,
including activity against Candida yeast.42
For wound healing echinacea seems to protect collagen from free
radical damage. It also may have activity against bacterial
hyaluronidase. Animal research suggests that echinacea extracts
can speed would healing, enhance formation of new skin, and
reduce inflammation.38 Preliminary information
suggests that echinacea might help treat or prevent UV radiation
skin damage by protecting collagen from free radical
Preliminary research also suggests that high concentrations of
Echinacea purpurea might reduce sperm and ova
Orally, echinacea is usually well-tolerated by most
people.17,18,20,46,47,26 Gastrointestinal adverse
effects, allergic reactions, fever, heartburn, constipation,
unpleasant taste, dry mouth, sore throat, tingling sensation and
numbness of the tongue, mouth ulcers, headache, dizziness,
insomnia, and disorientation.48,47,50,25,26
Arthralgia and myalgia have also been associated with
Allergic reactions can include urticaria; erythema
nodosum;51 itchy, watery eyes; runny
nose;48 chest tightness; dyspnea; bronchospasm; acute
asthma; facial and upper airway angioedema; and
In a study of children aged 2-11 years, about 7% of children
experienced a rash after taking Echinacea compared with 2.9% of
those taking placebo. This has not been borne out by other
studies. This may have been caused by an allergic
reaction.29 or it may have been the rash was part of
the illness for which the children were taking Echinacea.
Allergic reactions seem to be uncommon.52,48
Interactions with Herbs & Supplements:
Interactions with Drugs:
Immunosuppressants: Refer to a Medical Herbalist.
Interactions with Foods:
Interactions with Lab Tests:
Interactions with Diseases or Conditions:
Atopy: Individuals a genetic tendency toward allergic conditions
may be more likely to experience an allergic reaction when taking
echinacea. It is not a reason not to use Echinacea unless a
problem has been noted.
Autoimmune Diseases: Refer to a Medical Herbalist.
Dr Clare’s Blends: 1 gm per day Echinacea purpurea
Oral: A wide variety of dosages and forms have been used. This is
one reason why it is so difficult to interpret research data.
Topical: No typical dosage.
Dr Clare’s Comment.
In ten years of regular prescribing of Echinacea I have not seen
an allergic reaction. It is very well tolerated in traditional
doses; I have never had to stop Echinacea because of side
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