Guide to Echinacea

Echinacea, popularly known as the purple coneflower, is a traditional herbal remedy used by native Americans to treat infections such as boils and fevers. Within the UK, it falls under the Traditional Herbal Registration scheme and is classed as an herbal medicine. Products containing Echinacea therefore undergo extensive quality assurance testing in the same way as conventional pharmaceutical drugs. These manufacturing standards are strictly enforced by the Medicines and Healthcare products Regulatory Agency (MHRA).

What does Echinacea do?

Echinacea contains unique substances known as echinacins. These antioxidants stimulate the immune system by increasing the number and activity of white blood cells involved in fighting viral, fungal and bacterial infections. 1 This makes it a useful herbal treatment for respiratory infections such as colds, laryngitis, tonsillitis and middle ear infections (otitis media). It is also used to help prevent colds during times of stress.

Common cold

Echinacea can almost double the length of time between infections compared with those who do not, and when infections do occur, they tend to be less severe. A large analysis of data from 14 studies, published in The Lancet Infectious Diseases journal, found that Echinacea decreased the odds of developing a cold by 58%, and shortened the duration of a cold by 1.4 days. 2 Another analysis of three trials found that taking Echinacea reduced the likelihood of a cold by 55%. 3


Echinacea has been shown to reduce the production of inflammatory cell chemicals (cytokines, chemokines, prostaglandins) in human scavenger cells (macrophages) infected with H1N1 influenza A virus in the laboratory. 4 Echinacea purpurea extracts have also been shown to inactivate influenza viruses in cell cultures, including highly pathogenic strains such as H1N1 avian flu, and H1N1 swine flu . 5


In a study involving 60 women with recurrent vaginal Candida infections, all were treated with a prescribed anti-fungal cream (econazole) and half were also given an oral Echinacea herbal medicine. Recurrences developed in 60% of those using just the cream, compared with only 16 percent of those also taking oral Echinacea.

Getting Echinacea from your diet

Echinacea is not eaten in a normal diet.

Correct dosage

176mg dried pressed juice, equivalent to 3,500 – 5000mg fresh flowering Echinacea, purpurea. One to two capsules daily, at the first signs of a cold.

Some sources recommend that Echinacea is only taken for ten-days, although there is no scientific evidence to support this. Echinacea boosts the activity of white blood cells and, as these typically only survive in the circulation for up to four days, they are unlikely to adapt to its presence. Long-term use is therefore unlikely to become less effective over time. However, follow the instructions provided by the manufacturer as products may vary.


Echinacea should not be used during pregnancy.
Parents should not give Echinacea to children under the age of 12 because of the risk of allergic reactions.

Three species of Echinacea are used medicinally, Echinacea purpurea, Echinacea angustifolia and Echinacea pallida. Some products only contain Echinacea root or leaf extracts, but those made from the pressed juice of fresh, flowering Echinacea purpurea have the highest level of active ingredients and are most effective for treating respiratory infections.

Dr Sarah Brewer

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.



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