Common name: Purple coneflower
Botanical names: Echinacea purpurea, Echinacea
angustifolia, Echinacea pallida
© Steven Foster
Parts used and where grown
Echinacea is a wildflower native to North America. While echinacea continues to grow and is
harvested from the wild, the majority used for herbal supplements comes from cultivated
plants. The root and/or the above-ground part of the plant during the flowering growth phase
are used in herbal medicine.
Echinacea has been used in
connection with the following conditions (refer to the individual
health concern for complete information):
Historical or traditional use (may
or may not be supported by scientific studies)
Echinacea was used by Native Americans for a variety of conditions, including venomous
bites and other external wounds. It was introduced into U.S. medical practice in 1887 and was
touted for use in conditions ranging from
colds to syphilis. Modern research started in the 1930s in Germany.
Echinacea is thought to support the immune
system by activating white blood cells.1 Three major groups of constituents may
work together to increase the production and activity of white blood cells (lymphocytes and
macrophages), including alkylamides/polyacetylenes, caffeic acid derivatives, and
polysaccharides. More studies are needed to determine if and how echinacea stimulates the
immune system in humans.
Echinacea may also increase production of interferon, an important part of the body’s
response to viral infections.2 Several double-blind studies have confirmed the
benefit of echinacea for treating colds and flu.3 4 5
6 7 Recent studies have suggested that echinacea may not be effective for the
prevention of colds and flu and should be reserved for use at the onset of these
conditions.8 9 In terms of other types of infections, research in
Germany using injectable forms or an oral preparation of the herb along with a medicated cream
(econazole nitrate) reduced the recurrence of vaginal yeast infections as compared to women given the cream
How much is usually taken?
At the onset of a cold or flu, 3–4 ml of echinacea in a liquid preparation or 300 mg
of a powdered form in capsule or tablet, can be taken every two hours for the first day of
illness, then three times per day for a total of 7 to 10 days.11
Are there any side effects or interactions?
Echinacea is rarely associated with side effects when taken orally.12 According
to the German Commission E monograph, people should not take echinacea if they have an
autoimmune illness, such as lupus, or other
progressive diseases, such as tuberculosis,
multiple sclerosis, or HIV infection.
However, the concern about echinacea use for those with autoimmune illness is not based on
clinical research and some herbalists question the potential connection. Those who are
allergic to flowers of the daisy family should not take echinacea. Cases of allergic responses
to echinacea (e.g., wheezing, skin rash,
diarrhea) have been reported in medical literature.13 In the first study to
look at echinacea’s possible effect on fetal development and pregnancy outcome, women
taking echinacea during pregnancy were found
to have no greater incidence of miscarriage or
birth defects than women not taking the herb.14
Echinacea root contains approximately 20% inulin,15 a fiber widely distributed
in fruits, vegetables, and plants. Inulin is classified as a food
ingredient (not as an additive) and is considered safe to eat.16 In fact, inulin is
a significant part of the daily diet of most of the world’s population.17
However, there is a report of a 39-year-old man having a life-threatening allergic reaction
after consuming high amounts of inulin from multiple sources.18 Allergy to inulin
in this individual was confirmed by laboratory tests. Such sensitivities are exceedingly rare.
Moreover, this man did not take echinacea. Nevertheless, people with a confirmed sensitivity
to inulin should avoid echinacea.
Are there any drug
Certain medicines may interact with echinacea. Refer to drug interactions for a list of those medicines.
1. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea
and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and
chronic fatigue syndrome or acquired immunodeficiency syndrome patients.
2. Leuttig B, Steinmuller C, Gifford GE, et al. Macrophage activation by
the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea
purpurea. J Natl Cancer Inst 1989;81:669–75.
3. Melchart D, Linde K, Worku F, et al. Immunomodulation with
Echinacea—a systematic review of controlled clinical trials. Phytomedicine
4. Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of
Echinacea pallida redix in upper respiratory tract infections. Comp Ther Med
5. Hoheisel O, Sandberg M, Bertram S, et al. Echinacea shortens the
course of the common cold: a double-blind, placebo-controlled clinical trial. Eur J Clin
6. Braunig B, Dorn M, Knick E. Echinacea purpurea root for
strengthening the immune response to flu-like infections. Zeitschrift Phytotherapie
7. Brikenborn RM, Shah DV, Degenring FH. Echinaforce® and other
Echinacea fresh plant preparations in the treatment of the common cold. A randomized,
placebo-controlled, double-blind clinical trial. Phytomedicine 1999;6:1–5.
8. Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the
prevention of upper respiratory tract infections: A double-blind, placebo-controlled
randomized trial. Arch Fam Med 1998;7:541–5.
9. Grimm W, Müller HH. A randomized controlled trial of the effect
of fluid extract of Echinacea purpurea on the incidence and severity of colds and
respiratory tract infections. Am J Med 1999;106:138–43.
10. Coeugniet E, Kuhnast R. Recurrent candidiasis. Adjuvant immunotherapy
with different formulations of Echinacea. Therapiwoche 1986;36:3352–8 [in
11. Brown DJ. Herbal Prescriptions for Better Health. Rocklin,
CA: Prima Publishing, 1996, 63–8.
12. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete
Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative
Medicine Communications, 1998, 121–3.
13. Mullins RJ. Echinacea-associated anaphylaxis. Med J Austral
14. Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following
gestational exposure to echinacea. Arch Intern Med 2000;160:3141–3.
15. Duke JA. Handbook of phytochemical constituents of GRAS herbs and
other economic plants. Boca Raton, FL: CRC Press, 1992.
16. Carabin IG, Flamm WG. Evaluation of safety of inulin and
oligofructose as dietary fiber. Regul Toxicol Pharmacol 1999;30:268–82
17. Coussement PA. Inulin and oligofructose: safe intakes and legal
status. J Nutr 1999;129:1412S–7S [review].
18. Gay-Crosier F, Schreiber G, Hauser C. Anaphylaxis from inulin in
vegetables and processed food. N Engl J Med 2000;342:1372 [letter].