Echinacea: Everything You Need to Know

Getty Images / Nancybelle Gonzaga Villarroya

Medically reviewed by Allison Herries, RDN

Echinacea is a genus of flowering herbaceous plants in the Asteraceae (daisy) family. These plants are native to North America and abundant in the United States.

The Echinacea genus is made up of nine species of perennial plants. Three species of the flowering herb echinacea (Echinacea purpurea, Echinacea pallida, and Echinacea angustifolia) are commonly used medicinally. Most of the research on echinacea focuses on the species Echinacea purpurea.

Echinacea plants contain several bioactive compounds, including:

Alkamides (also known as alkylamides)

Glycoproteins

Polysaccharides

Antioxidants

These compounds are thought to provide various health benefits, including:

Anti-inflammatory

Immunomodulatory (immune system modifying)

Anxiolytic (anxiety-reducing)

Antimicrobial

Antiviral

Echinacea has been used medicinally for centuries, but research on its benefits is limited.

This article provides an overview of the potential health benefits of echinacea. It also discusses side effects, precautions, dosage, drug interactions, storage tips, and other information on echinacea supplements.

Getty Images / Nancybelle Gonzaga Villarroya

Dietary supplements are not regulated the way drugs are in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. Whenever possible, choose a supplement tested by a trusted third party, such as U.S. Pharmacopeia (USP), ConsumerLab.com, or NSF International.

However, even if supplements are third-party tested, they are not necessarily safe for all or effective in general. Therefore, it is important to talk to your healthcare provider about any supplements you plan to take and ask about potential interactions with other supplements or medications.

Supplements Facts

Active ingredient(s): Alkylamides, polysaccharides, glycoproteins, flavonoids, phenolic compounds (including caffeic acid)

Alternate name(s): Purple coneflower, coneflower, American coneflower, Echinacea purpurea, Echinacea angustifolia, Echinacea pallida

Legal status: Available over the counter in the United States

Suggested dose: Dosage can vary. There is not enough reliable information for standardized dosage recommendations.

Safety considerations: Side effects may include upset stomach, diarrhea, constipation, skin rash, and allergic reaction.

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Echinacea has been used by Native Americans for centuries due to its perceived health benefits. These days, fresh or dried herbs and extracts of the echinacea plant are available for use.

Traditionally, echinacea has been used as a remedy for conditions such as:

Toothaches

Stomach pain

Snake bites

Skin disorders

Chronic arthritis

Cancer

Echinacea is thought to be an immunomodulator, which is why it is also commonly used to treat the common cold.

As a whole, though, reliable research supporting these and other health claims surrounding echinacea is lacking.

Some of the health conditions that may be treated by echinacea are outlined below.

Probably one of the most popular uses of echinacea is for the common cold.

Despite this popularity, research results have been mixed, and there isn't solid evidence that echinacea provides any benefits to people with colds.

One 2014 review looked at more than 20 studies with more than 4,000 participants on various species of echinacea to learn if any were beneficial for the common cold. Researchers found that echinacea was more effective than a placebo (an intentionally ineffective treatment given to a control group) in treating a cold. However, no echinacea species played a significant role in the treatment or prevention of the common cold.

A 2019 review seemingly confirms that echinacea may not be as beneficial for colds as previously believed. According to this review, no studies considered of high quality have proven that echinacea can shorten the duration or reduce the severity of a cold. Echinacea's use in children with colds has also not been proven.

Echinacea may be useful for certain skin conditions, including eczema and pruritus.

Although human trials of using echinacea for eczema don't exist, laboratory research has exhibited some positive effects of the herb.

In one such in vitro study (performed in a lab and not on living subjects), an extract of Echinacea purpurea was found to reduce symptoms of eczema. Researchers felt that the echinacea extract showed anti-inflammatory effects that warrant further investigation.

In a small human trial, Echinacea purpurea emulsions and shampoos were studied for their potential benefits for pruritus (itchy skin).

Adult participants used emulsions or shampoos that contained echinacea extract for four weeks. All forms of topical echinacea showed significant reductions in pruritus as well as other parameters, including skin dryness.

More research should be conducted to further explore the potential benefits of echinacea for skin conditions.

Dating back centuries, echinacea has been used to treat both pain and inflammation.

A 2021 systematic review revealed that echinacea may decrease proinflammatory cytokines (substances secreted by immune cells) and increase anti-inflammatory cytokines.

This may be especially helpful in a cytokine storm, which is an instance when proinflammatory cytokines are rapidly released due to an infection.

Echinacea may also help reduce pain, which often happens simultaneously with inflammation.

In one animal study, rats were induced with osteoarthritis (OA), a painful condition of the joints. After OA onset, some rats were given Echinacea purpurea extract while others were not. The rats given the echinacea extract showed signs of pain relief, including more willingness to walk and move compared with those who had not received the extract.

Unfortunately, most studies on the use of echinacea for pain and inflammation have been performed in labs or on animals and not in humans.

And while much can be learned from these types of studies, their results are not guaranteed to also occur in humans. Human trials are still needed.

Another perceived benefit of echinacea is an anxiolytic (antianxiety) effect.

Participants in one trial took 40 milligrams (mg) of either Echinacea angustifolia or a placebo twice daily for one week before a period of three weeks of not receiving anything.

According to the results, anxiety scores were significantly improved in the echinacea group compared to the placebo group, especially in participants with high anxiety at the start of the study.

In another human trial, participants with mild-to-moderately severe anxiety received either a placebo, 40 mg of Echinacea angustifolia, or 80 mg of Echinacea angustifolia daily for six weeks.

By the end of the study, all treatments (including the placebo) were found to reduce anxiety.

However, those who took the echinacea doses had greater improvements in emotional well-being and positive and negative affect (emotions or mood).

Echinacea is well-tolerated by most people, but some may experience side effects. Echinacea side effects may be mild or severe, and some are more common than others.

The most common side effects of echinacea affect the gastrointestinal system. Common side effects of echinacea include:

Upset stomach

Diarrhea

Constipation

Skin rash

Allergic reaction

Nausea has also been reported as a possible side effect of echinacea.

Stop using echinacea if you experience side effects while taking it. Talk with a healthcare provider if side effects persist or don't improve over time.

In rare cases, echinacea use may lead to a severe allergic reaction.

In a now-dated article, cases of severe allergic reactions to echinacea were reported. In two cases, anaphylaxis occurred, while two other patients experienced severe asthma attacks soon after taking echinacea.

It's worth noting that some patients in the report may also have experienced environmental allergens when taking echinacea that may have worsened their side effects.

It's also important to mention that this report is from 2002, and additional information regarding possible severe side effects of echinacea is unavailable.

To prevent side effects when using echinacea, use it only as directed and speak with a healthcare provider regarding proper use.

Echinacea is considered safe for most adults to use for short durations. However, the safety of long-term use of echinacea is unknown.

There are some concerns that certain populations should avoid using echinacea altogether.

The safety of echinacea during pregnancy or breastfeeding is uncertain. More research is needed to determine if the herb is safe for these populations.

Parents should take precautions before providing their children with echinacea. In one clinical trial, children using echinacea developed skin rashes.

Remember that research on echinacea as a whole is limited. For this reason, it's recommended that you talk with a healthcare provider before using echinacea or any other herbs or supplements. This is especially true if you have any health conditions or take any prescription medications.

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.

Currently, there are no dosage guidelines for echinacea. More reliable scientific data are needed before standardized dosage recommendations can be made for the herb.

Various studies on echinacea have used a wide range of dosages. For example, studies on echinacea for the common cold have used anywhere from 40 mg to 6 grams (g) daily. In these studies, echinacea supplementation lasted between five days and four months.

Echinacea dosage may vary from one product to another. For this reason, it's best to follow dosage directions as listed on the product label. A healthcare provider may also be able to help you determine the proper echinacea dosage for you.

It's important to be aware of possible interactions among any herbs, supplements, or medications you take.

There is limited evidence regarding possible interactions for echinacea. In fact, the risk of interactions between echinacea and most medications is categorized as low.

More research is needed to determine whether medications or supplements interact with echinacea. Always talk with a healthcare provider about any medications, herbs, or supplements you take.

It's best to review supplement labels with a healthcare provider to discuss any potential interactions with other supplements or medications. It's also vital that you carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients are included.

Proper storage of echinacea supplements will help maintain their quality.

You can store your echinacea supplements in a cool, dry place. They should also be kept out of direct sunlight. It's best to keep supplements in their original bottle or packaging.

Be sure to keep echinacea supplements out of reach of pets and small children.

Discard echinacea supplements once they reach their expiration date or as indicated on the packaging.

Echinacea supplements can be purchased online or in some brick-and-mortar stores. Various grocery stores carry echinacea supplements, as well as certain health or specialty shops.

Echinacea supplements are commonly found as capsules, gummies, liquid extracts, fresh herbs, and dried herbs. Additionally, there are some supplements available that contain a blend of echinacea and other nutrients or herbs.

Naturally, echinacea is gluten-free and vegan, and many echinacea supplements are as well. However, some echinacea supplements may include gelatin-based capsules, which are not vegan. Always read the product label to ensure it meets your dietary preferences.

Whenever you're shopping for a new supplement, remember that supplements are not well-regulated in the United States. To avoid purchasing a supplement that is of poor quality, look for a product that has been approved by a third-party organization, like USP, ConsumerLab.com, or NSF International. These organizations provide quality assurance for supplements that have successfully undergone their testing.

With so many supplements on the market, there are sure to be plenty that provide similar potential benefits. Certainly, other supplements may work similarly to echinacea.

Some supplements that are similar to echinacea include:

Elderberry: Like echinacea, elderberry may be useful in the treatment of the common cold. According to one systematic review, elderberry may be safe and somewhat effective in treating respiratory illnesses, especially in terms of shortening the duration of a cold. However, research results on its efficacy are mixed.

Evening primrose oil: Both oral and topical forms of evening primrose oil have been linked to improved skin hydration in people with eczema and dry, itchy skin. These effects are thought to be due to the polyunsaturated fats found in evening primrose oil.

Turmeric: Turmeric is a spice that contains anti-inflammatory compounds, including curcumin. Due to these anti-inflammatory effects, turmeric is sometimes used to treat osteoarthritis, a condition marked by pain and inflammation. Some research has shown that turmeric may have a similar effectiveness to nonsteroidal anti-inflammatory drugs (NSAIDs), which include Advil or Motrin (ibuprofen) and Aleve (naproxen).

Valerian root: Valerian root is another herb that may help with anxiety. A review and meta-analysis found that valerian root reduced anxiety in various people, including those with human immunodeficiency virus (HIV) and people about to undergo dental surgery. According to the review, though, not all studies have reported any anxiolytic effects of valerian root.

Typically, it's recommended that you only use one supplement at a time for a health condition. It's always smart to consult with a healthcare provider before starting any new supplement, especially if you're unsure which ones are right for you.

Echinacea is a genus of herbaceous, flowering plants. Three species of echinacea, Echinacea purpurea, Echinacea pallida, and Echinacea angustifolia, are most commonly used for medicinal purposes, with Echinacea purpurea being the most researched.

Echinacea has been used for centuries in traditional medicine for ailments like the common cold, anxiety, inflammation, and itchy skin. And while some scientific evidence supports these and other health claims for echinacea, more research is needed on the herb.

Talk with a healthcare provider first if you have more questions about echinacea or are interested in trying it.

Can I take echinacea every day?

Echinacea is thought to be safe for most adults for short-term use. However, the safety of long-term use of echinacea is unknown.

Taking too much echinacea or using it for too long may increase the risk of side effects. Be sure to use echinacea only as directed and never take more than you should.

Who should not use echinacea?

People who are pregnant or breastfeeding may need to avoid echinacea. There isn't enough reliable information to know whether echinacea is safe for these populations.

Some children have experienced rashes after using echinacea. Take caution when giving your child echinacea.