Many people who become interested in herbs and natural remedies began with an introduction to echinacea, an herbal remedy commonly used for treating colds. Echinacea is a perennial plant that grows 1-2 feet (0.3-0.6 meters) in height and looks something like a Black-eyed Susan. Grown both commercially and in the wild, its flower, stem, and root are marketed in pill, liquid, or powdered form.
Originally, echinacea was used by many Midwest Native Americans for a variety of medicinal purposes, including the treatment of infections and poisonous snakebites. As early as the 1880s, echinacea came into favor among American medical practitioners. Despite the fact that in 1910 the American Medical Association dismissed echinacea as worthless, it remained popular in the US until penicillin and other anti-infection drugs were discovered.
In the 1930s, a German doctor, Gerhard Madaus, began researching the medicinal properties of echinacea. He discovered that it contained certain complex sugar molecules, known as polysaccharides, which he believed might stimulate the immune system. Dr. Madaus also developed a juice form of echinacea that was derived from the plant's flower.
While echinacea has been promoted as a substance that can stimulate the immune system, this action has not been proven. There is no evidence that echinacea strengthens the immune system when taken over the long term.
However, some studies do support the use of echinacea as a treatment for colds and flu. The herb, taken at the first sign of illness, might reduce your symptoms and help you recover faster. It does not seem, though, that daily doses of echinacea will prevent you from getting sick. Echinacea has been studied for other infections, as well, like chronic bronchitis and ear infections, but more research needs to be done in these areas.
While it is not clear exactly how echinacea works, some evidence hints that echinacea acts by doing the following:
Echinacea is taken at the first sign of a cold or flu and continued for 1-2 weeks. The best tested formulations are extracts made from the above-ground parts of the Echinacea purpurea species. Echinacea purpurea root alone may not be effective. Follow label instructions for dosage. The effectiveness of other echinacea species including E. pallida and E. angustifolia has not been established.
Echinacea has not shown significant side effects in studies but mild limited side effects have been noted, including allergic reactions such as rashes and increased asthma. Other side effects include minor gastrointestinal symptoms and increased urination. People allergic to plant families such as the daisy or sunflower may have reactions.. In most cases, the effects go away once echinacea is stopped.
There is not enough data available to conclusively determine one way or the other if the herb should be avoided completely. Most warnings err on the side of caution. For example, it is not recommended that women who are pregnant or breastfeeding use echinacea.
However, if in fact echinacea stimulates the immune system, it could theoretically cause harm in people with certain conditions. These include the following:
It is important to talk to your doctor before using any herbs or supplements. They can interfere with a health condition and/or other medications you are taking.
Since echinacea is a natural growing compound, it is covered by the Dietary Supplement Health and Education Act (DSHEA) and is not regulated by the US Food and Drug Administration (FDA). DSHEA mandates that the label of a dietary supplement must contain enough information about the composition of the product so that consumers can make informed choices. The information must be presented in the FDA-specified format.
The manufacturer is also responsible for making sure that all the dietary ingredients in the supplements are safe. Manufacturers and distributors do not need to register with the FDA or get FDA approval before producing or selling dietary supplements, nor is its use or effectiveness substantiated by the FDA.
Longwood Herbal Task Force
National Center for Complementary and Integrative Health
Public Health Agency of Canada
Complementary Therapies for the Common Cold. Available at: EBSCO Patient Education Reference Center website. Available at:http://web.b.ebscohost.com/perc/detail?vid=6&sid=6206d5ff-abe6-478c-85dd-329c261ab9b2%40sessionmgr103&bdata=JnNpdGU9cGVyYy1saXZl#AN=2009805758&db=perc. Updated April 29, 2015. Accessed July 27, 2017.
Dietary supplements. US Food & Drug Administration website. Available at: https://www.fda.gov/Food/DietarySupplements/default.htm. Updated April 4, 2016. Accessed July 27, 2017.
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History of echinacea. Vanderbilt University Psychology Department website. Available at: http://healthpsych.psy.vanderbilt.edu/HealthPsych/echinacea-history.htm. Accessed July 27, 2017.
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Karsch-Volk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014;(2):CD000530.
Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med. 2008;19(2):148.
Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjögren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol. 2003;22(2):158-159.
Upper respiratory infection (URI) in adults and adolescents. DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114537/Upper-respiratory-infection-URI-in-adults-and-adolescents. Updated April 10, 2017. Accessed July 27, 2017.
Last reviewed July 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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