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© 2018 Steven Foster

An echinacea monograph for the home

Latin Name: Echinacea purpurea, Echinacea angustifolia, Echinacea pallida

Common Names: echinacea, purple coneflower, coneflower, American coneflower

This echinacea monograph provides basic information about echinacea—common names, usefulness and safety, and resources for more information.


Echinacea Basics

  • There are nine known species of echinacea, all of which are native to North America. They were used by Native Americans of the Great Plains region as traditional medicines.
  • Echinacea is used as a dietary supplement for the common cold and other infections, based on the idea that it might stimulate the immune system to more effectively fight infection. Echinacea preparations have been used topically (applied to the skin) for wounds and skin problems.
  • The roots and above-ground parts of the echinacea plant are used fresh or dried to make teas, squeezed (expressed) juice, extracts, capsules and tablets, and preparations for external use. Several species of echinacea, most commonly Echinacea purpurea or Echinacea angustifolia, may be included in dietary supplements.

Echinacea in Health Research

  • Many studies have been done on echinacea and the common cold. Much less research has been done on the use of echinacea for other health purposes.

Echinacea Research Summary

  • Taking echinacea after you catch a cold has not been shown to shorten the time that you’ll be sick.
  • Taking echinacea while you’re well may slightly reduce your chances of catching a cold. However, the evidence on this point isn’t completely certain. Currently, the National Center for Complementary and Integrative Health (NCCIH) is funding research to identify the active constituents in echinacea and to study the effects on the human immune system of substances in bacteria that live within echinacea plants.

Preparation & Dosing *

*Always check with your doctor before taking any alternative therapy.
Application Dosage Preparation Source
Infusion 3 grams (3/4 teaspoon) Steep dried root in 8oz boiling water for 15 minutes Herbs & Natural Supplements, vol 4
Liquid Extract 1-3mL (1:2) up to 3 X daily Herbs & Natural Supplements, vol 4
Tincture 1-4mL (1:5 40% POH) up to 3 X daily Medical Herbalism

Echinacea Safety

  • There are many different echinacea products. They may contain different species of plants or different parts of the plant, be manufactured in different ways, and have other ingredients in addition to echinacea. Most of these products have not been tested in people.
  • For most people, short-term oral (by mouth) use of echinacea is probably safe; the safety of long-term use is uncertain.
  • The most common side effects of echinacea are digestive tract symptoms, such as nausea or stomach pain.
  • Some people have allergic reactions to echinacea, which may be severe. Some children participating in a clinical trial of echinacea developed rashes, which may have been caused by an allergic reaction. People with atopy (a genetic tendency toward allergic reactions) may be more likely to have an allergic reaction when taking echinacea.
  • Current evidence indicates that the risk of interactions between echinacea supplements and most medications is low.

Echinacea References


PubMed Articles About Echinacea purpurea

Source: National Center for Biotechnology Information (NCBI)[Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; [1988] – [cited 2018 Apr 5]. Available from:

De Rosa, N., Giampaolino, P., Lavitola, G., Morra, I., Formisano, C., Nappi, C., Bifulco, G., (2020) Effect of Immunomodulatory Supplements Based on Echinacea Angustifolia and Echinacea Purpurea on the Posttreatment Relapse Incidence of Genital Condylomatosis: A Prospective Randomized Study.

HPV infection is a highly infectious disease; about 65% of partners of individuals with genital warts will develop genital condylomatosis. Only in 20-30% it regresses spontaneously and relapse rates range deeply (9-80%). Echinacea extracts possess antiviral and immunomodulator activities. The aim of this study was to evaluate the efficacy of the therapy, using a formulation based on HPVADL18® (on dry extracts of 200 mg Echinacea Purpurea (EP) roots plus E. Angustifolia (EA)), on the posttreatment relapse incidence of genital condylomatosis. It is a prospective single-arm study. Patients with a satisfactory and positive vulvoscopy, colposcopy, or peniscopy for genital condylomatosis were divided into two random groups and subjected to destructive therapy with Co2 Laser. Group A (N=64) immediately after the laser therapy started a 4-month treatment with oral HPVADL18®; Group B (N=61) did not undergo any additional therapy. Patients were subjected to a follow-up after 1, 6, and 12 months. Differences in relapse incidence between the two groups during follow-up controls were evaluated by 2-test; the groups were stratified by age, gender, and condylomatosis extension degree. Gender, age, and condyloma lesions' extension degree showed no statistically significant differences between the two trial groups. The relapse incidence differs statistically between the two studied groups and progressively decreases during the 12 months after treatment in both groups. Statistically significant reduction of relapse rates has been shown in Group A in patients over 25 years old. This difference is significant for both men and women. The relapse incidence is superior in case of extended condylomatosis. In conclusion, the presence of a latent infection causes condylomatosis relapse; in order to reduce the relapse risk an induction of a protective immune response seems to be essential to allow rapid viral clearance from genital areas surrounding lesion and treatment zones. Echinacea promotes this process. EP and EA dry root extracts seem to be a valid adjuvant therapy in reducing relapse incidence of lesions in patients treated for genital condylomatosis.

Martin, TD., Green, MS., Whitehead, MT., Scheett, TP., Webster, MJ., Hudson, GM., (2019) Six weeks of oral supplementation does not enhance the production of serum erythropoietin or erythropoietic status in recreationally active males with above-average aerobic fitness.

The purpose of this study was to investigate the effect of 6 weeks of oral supplementation on serum erythropoietin (EPO) and erythropoietic status. Twenty-four males (mean ± SE; age = 25.2 ± 1.4 years, height = 178.1 ± 1.4 cm, body mass = 78.1 ± 1.6 kg, body fat = 12.7 ± 0.9%, maximal oxygen uptake = 52.9 ± 0.9 mL·kg·min) were randomly grouped using a matched-pair, double-blind design and self-administered 8000 mg·day of either ( = 12) or placebo ( = 12) for 42 consecutive days. Blood samples were collected prior to supplementation (day 0) and every 2 weeks during the supplementation period (days 14, 28, and 42) and were analyzed for EPO, red blood cell count, hemoglobin concentration, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration. Separate 2 × 4 (group × time) factorial ANOVA with repeated measures on time were used to determine statistical differences with significance set at ≤ 0.05. There were no significant interaction, group, or time effects observed for EPO or erythropoietic status markers for any of the measurement points ( ≤ 0.05). The present study indicated that 6 weeks of oral supplementation in recreationally active males with above average aerobic fitness did not enhance EPO or erythropoietic status. These findings are in contrast with previous reports of supplementation in untrained participants with average fitness levels, but consistent with observations in trained endurance athletes.

Oláh, A., Szabó-Papp, J., Soeberdt, M., Knie, U., Dähnhardt-Pfeiffer, S., Abels, C., Bíró, T., (2018) Echinacea purpurea-derived alkylamides exhibit potent anti-inflammatory effects and alleviate clinical symptoms of atopic eczema.

Atopic eczema (AE) is a chronic inflammatory and pruritic skin disease. There is still an unmet need for topical anti-inflammatory and anti-pruritic substances exhibiting an excellent safety profile. The endocannabinoid system is known to regulate various aspects of cutaneous barrier and immune functions, thus targeting it may be a valid approach for alleviating the symptoms of AE.

David, S., Cunningham, R., (2019) Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis.

Echinacea preparations are commonly used to prevent and treat upper respiratory tract infection.

Haller, J., Krecsak, L., Zámbori, J., (2020) Double-blind placebo controlled trial of the anxiolytic effects of a standardized Echinacea extract.

Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further study the issue, we performed a double blind, placebo controlled trial with a standardized Echinacea angustifolia root extract. Participants were volunteers scoring above 45 points on the state or on the trait subscale of the State Trait Anxiety Inventory (STAI). They were treated with 40 mg Echinacea or with placebo tablets twice daily for 7 days followed by a 3 week-long washout period. Participants were also administered the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS). In the Echinacea group, state anxiety scores decreased by approximately 11 points by the end of the treatment period, whereas the decrease was around 3-points in the placebo group (p< 0.01). The effect maintained over the washout period. The difference from placebo was significant from the 7th day of treatment throughout. Changes were less robust with trait anxiety scores, but the preparation performed better than placebo in patients with high baseline anxiety. Neither BDI nor PSS scores were affected by the treatments. Adverse effects were rare and mild, and all were observed in the placebo group. These findings suggest that particular Echinacea preparations have significant beneficial effects on anxiety in humans.