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Echinacea

Echinacea purpurea is an herb commonly used either in response to or daily for prevention of the common cold. It outperforms placebo unreliably and the amount of benefit derived is similarly unreliable.

Our evidence-based analysis on echinacea features 144 unique references to scientific papers.

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Summary of Echinacea

Primary information, health benefits, side effects, usage, and other important details

It is invalid to extrapolate from efficacy against the common cold or respiratory tract infections broadly to the novel coronavirus in particular. For more information, see this page.

What is Echinacea?

The term 'echinacea' refers to a genera of plants, and a few species in this family including purpurea and angustifolia are desired due to their alkylamide content (seen as the active ingredients). It's often taken as a tincture, but dry capsules are also common.

What are Echinacea's benefits?

Overall, echinacea appears to be somewhat effective for fighting off upper respiratory tract infections (mostly studied for the common cold), and when taken consistently as a prophylactic, it has support from research. It has also been studied for its potential ability to accelerate the rate of recovery in sickness, but the current evidence for that highly ambiguous. There are trials suggesting remarkable recovery rates, and there are trials suggesting no benefits whatsoever. Overall, it doesn't look very potent. Limited research suggests that it can increase the levels of a variety of immune cells, but more research is needed to be confident in this.

What are Echinacea's drawbacks and downsides?

Echinacea hasn't demonstrated notably, greater adverse events in trials than placebo, however, as with herbal extracts in general, there may be a risk for drug interactions, particularly for those who take multiple medications.

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How to Take

Medical Disclaimer

Recommended dosage, active amounts, other details

For dehydrated powders (including encapsulated echinacea) the species of purpuera tends to be used and oral doses are taken upwards of 300mg thrice a day (900mg daily) and 500mg thrice daily (1,500mg daily).

Tinctures of an ethanolic extract of the aerial parts (leaves and stems) appears to be used in the concentration of 2.5mL thrice a day or up to 10mL daily.

There is no much evidence as to whether these are the optimal doses, and studies seem to be very hetereogeneous in their benefits due to lack of standardization.

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Human Effect Matrix

Unlocked for Examine members

The Human Effect Matrix summarizes human studies to tell you what effects Echinacea has on your body, how much evidence there is, and how strong these effects are.

Full details are available to Examine members.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Minor High See all 14 studies
The reduction in the rate ofUPRTIs seen with echinacea as a daily supplement is highly effective in some instances, but subject to a high degree of variability. Overall, the evidence supports small-moderate efficacy, with the caveat that heterogeneity is moderate.
grade-a - - See all 13 studies
Although early studies and an early meta-analysis suggested a benefit in the common cold, a more recent meta-analysis that using a higher threshold for bias risk for study inclusion didn't find a meaningful effect for upper respiratory tract infection in general (the common cold being the most common infection observed). It's unclear when echinacea may be most potent, or if certain doses, forms, and populations modify its effects, and a lack of new, well-conducted studies limits further analysis.
grade-b Minor Very High See all 3 studies
Upper respiratory tract infections and cold symptoms seem to see a small to medium reduction when echinacea is used as a prophylactic. However, it's unclear which doses and demographics benefit more and which benefit less, and the inconsistency of studies suggests that only some people may see a benefit.
grade-b Minor - See all 11 studies
Research is quite mixed and inconsistent, but a small reduction in cold symptoms is likely for some people. The effective dose of echinacea and its active chemicals isn't clear, and more research is needed. It's also not entirely clear which symptoms are reduced, as only one study evaluated specific symptoms, and found a reduction in nasal and sinus symptoms but not cough.
grade-c Minor - See study
Lone trial noted an increase in EPO production without an accompanying increase in red blood cell count; practical significance of these results uncertain
grade-c Minor - See study
Possible effects, but study assessed salivary IgA (biomarker of immunity) and not sickness rates; hard to assess potency.
grade-c Minor - See study
Effective, but to a small degree based on one trial.
grade-c Minor Very High See all 6 studies
While not particularly potent, research generally suggests a reduction in the overall severity of the common cold, and upper respiratory tract infections as a broad category, though there is considerably less evidence for the latter. The symptom reduction, in particular, doesn't seem to extend to coughs, but only one study evaluated specific symptoms.
grade-c Minor - See study
Not an astounding increase in VO2 max, requires replication.
grade-c - - See study
No significant known effects on blood pressure
grade-c - - See study
Oddly ineffective despite an increase in erythropoetin seen
grade-c - - See study
Likely related to the inefficacy in treating symptoms, but no significant ability to aid in sleep quality during or without sickness
grade-d Notable - See study
A notable increase was found in one study.
grade-d Notable - See study
A notable increase was found in one study.
grade-d Minor - See study
An increase in the percentage of the lymphocyte population as CD4 was found in one study.
grade-d Minor - See study
One study found an increase.
grade-d Minor - See study
One study found an increase.
grade-d Minor - See study
Respiratory burst capacity was increased in one study.
grade-d - - See study
No apparent effect on the percentage of the population in one study.

Studies Excluded from Consideration

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Things to Note

Is a Form Of

Primary Function:

Also Known As

Brauneria purpurea, Echinacea intermedia, Rudbeckia purpurea, Purple coneflower herb, Coneflower, red sunflower

Caution Notice

It is possible to be allergic to echinacea as a plant, and this may be related to ragweed allergies.

  • After processing, echinacea bioactives may be sensitive to light and heat. It may be prudent to store echinacea in a cool (5°C or lower) and dark place

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Click here to see all 144 references.