Echinacea Benefits and Dosing

// Sarah Cook, ND


Echinacea Benefits and Dosing

Echinacea is a genus of flowering plants in the Daisy family (Compositae). Commonly called purple coneflowers, there are nine different species of Echinacea with three of these species used for medicinal purposes: Echinacea purpurea, E. angustifolia, and E. pallida. Echinacea grows in the wild in the Rocky Mountains of the United States and is cultivated for use in dietary supplements.

Echinacea Parts and Preparations

Combining Echinacea with other ingredients may offer greater advantageEach part of the Echinacea plant contains different active compounds that provide distinct benefits. The roots of Echinacea are rich in alkylamides, which activate macrophage activity and support healthy immune responses.*2, 3 Echinacea root can also be standardized to provide a guaranteed amount of echinacosides.4 The aerial parts (flowers and leaves) of Echinacea contain arabinogalactans and other polysaccharides that are best for ongoing immune support.*5, 6

The benefits of Echinacea products depend on the parts of the plant used, the standardized compounds, and the overall formulation. Combining Echinacea with other ingredients may offer greater advantage than dosing Echinacea alone. Echinacea and Hydrastis canadensis (goldenseal), for example, support the immune response in different, but complementary ways.*7 A formulation of Echinacea purpura, Thuja occidentalis, and Baptisia tinctoria has a long history of use in Europe and a wealth of recent research to validate its immune support.*8, 9, 10

Echinacea Benefits

Echinacea is most extensively studied for its ability to support healthy immune function.* Echinacea is categorized as an immune modulator—it stimulates phagocytic activity while simultaneously modulating cytokine secretion.*11 Mechanistic studies show that Echinacea supports respiratory tract health.*12

When Echinacea is used as a single intervention, efficacy studies have been mixed. A 2014 Cochrane review of 24 randomized controlled trials and 4631 participants concluded that Echinacea offers some benefit for immune tonification but no significant benefit for temporary immune support.*13 In contrast, a 2015 meta-analysis of six clinical trials and 2458 participants found significant benefits of Echinacea over placebo at supporting immune and respiratory health.*14

When Echinacea is used in formulation with other ingredients, results are more impressive.15, 16 The combination of Echinacea, Thuja, and Baptisia (mentioned above) has shown efficacy for temporary immune support in numerous clinical trials and has been used as an adjunctive therapy along with standard care.*17, 18, 19

Echinacea Dosing

Dosing recommendations for Echinacea vary widely, depending on the preparation, standardization, formulation, delivery method, and intended purpose. Dosages are generally lower for ongoing support and higher for temporary support.*

One successful clinical trial administered an alcohol tincture at a “typical” dose of 0.9 mL three times per day for ongoing support and increased the dosage frequency to five times per day for acute support.*17 Substantially lower dosages of Echinacea appear to be effective when it is combined with other ingredients.* For example, a formulation of Echinacea, Thuja, and Baptisia has demonstrated efficacy in clinical trials at a total dosage of dry herbal extract blend of less than 60 mg per day.*10

Echinacea Interactions

Isolated case reports have raised concerns about the potential for Echinacea to aggravate or activate the autoimmune response.18 The validity of these concerns has been challenged, however, because the alkylamides in Echinacea suppress the cellular immune response.*19 Information about drug-nutrient interactions is available on this drug-nutrient interaction checker.

Sarah Cook, ND

Sarah Cook is a freelance medical writer in Westminster, CO. She has a certificate in biomedical writing from the University of the Sciences in Philadelphia, PA and a naturopathic doctorate from the Southwest College of Naturopathic Medicine in Tempe, AZ. She has previous experience in clinical practice, supplement sales, and academics. In addition to writing, she is currently a faculty member at the Nutrition Therapy Institute in Denver, CO.

  1. Aarland RC, Bañuelos-Hernández AE, Fragoso-Serrano M, et al. Studies on phytochemical, antioxidant, anti-inflammatory, hypoglycaemic and antiproliferative activities of Echinacea purpurea and Echinacea angustifolia extracts. Pharm Biol. 2017;55(1):649-56.
  2. Chen Y, Fu T, Tao T, et al. Macrophage activating effects of new alkamides from the roots of Echinacea species. J Nat Prod. 2005;68(5):773-6.
  3. Cech NB, Kandhi V, Davis JM, et al. Echinacea and its alkylamides: effects on the influenza A-induced secretion of cytokines, chemokines, and PGE₂ from RAW 264.7 macrophage-like cells. Int Immunopharmacol. 2010;10(10):1268-78.
  4. Kuang R, Sun Y, Yuan W, Lei L, Zheng X. Protective effects of echinacoside, one of the phenylethanoid glycosides, on H(2)O(2)-induced cytotoxicity in PC12 cells. Planta Med. 2009;75(14):1499-1504.
  5. Capek P, Šutovská M, Kocmálová M. Chemical and pharmacological profiles of Echinacea complex. Int J Biol Macromol. 2015;79:388-91.
  6. Göllner EM, Gramann JC, Classen B. Antibodies against Yariv’s reagent for immunolocalization of arabinogalactan-proteins in aerial parts of Echinacea purpurea. Planta Med. 2013;79(2):175-80.
  7. Rehman J, Dillow JM, Carter SM, et al. Increased production of antigen-specific immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis canadensis. Immunol Lett. 1999;68(2-3):391-5.
  8. Wüstenberg P, Henneicke-von Zepelin HH, Köhler G, Stammwitz U. Efficacy and mode of action of an immunomodulator herbal preparation containing Echinacea, wild indigo, and white cedar. Adv Ther. 1999;16(1):51-70.
  9. Hauke W, Köhler G, Henneicke-Von Zepelin HH, Freudenstein J. Esberitox N as supportive therapy when providing standard antibiotic treatment in subjects with a severe bacterial infection (acute exacerbation of chronic bronchitis). A multicentric, prospective, double-blind, placebo-controlled study. Chemotherapy. 2002;48(5):259-66.
  10. Naser B, Lund B, Henneicke-von Zepelin HH. A randomized, double-blind, placebo-controlled, clinical dose-response trial of an extract of Baptisia, Echinacea and Thuja for the treatment of patients with common cold. Phytomedicine. 2005;12(10):715-22.
  11. Hudson JB. Applications of the phytomedicine Echinacea purpurea (Purple Coneflower) in infectious diseases. J Biomed Biotechnol. 2012;2012:769896.
  12. Šutovská M, Capek P, Kazimierová I, et al. Echinacea complex--chemical view and anti-asthmatic profile. J Ethnopharmacol. 2015;175:163-71.
  13. Karsch-Völk M, Barrett B, Kiefer D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014;(2):CD000530.
  14. Schapowal A, Klein P, Johnston SL. Echinacea reduces the risk of recurrent respiratory tract infections and complications: a meta-analysis of randomized controlled trials. Adv Ther. 2015;32(3):187-200.
  15. Ross SM. Echinacea purpurea: A Proprietary Extract of Echinacea purpurea Is Shown to be Safe and Effective in the Prevention of the Common Cold. Holist Nurs Pract. 2016;30(1):54-7.
  16. Ross SM. Echinacea Formula (Echinaforce® Hotdrink): Effects of a Proprietary Echinacea Formula Compared With Oseltamivir in the Early Treatment of Influenza. Holist Nurs Pract. 2016;30(2):122-5.
  17. Jawad M, Schoop R, Suter A, Klein P, Eccles R. Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled Trial. Evid Based Complement Alternat Med. 2012;2012:841315.
  18. Lee AN, Werth VP. Activation of autoimmunity following use of immunostimulatory herbal supplements. Arch Dermatol. 2004;140(6):723-727.
  19. Ardjomand-Woelkart K, Bauer R. Review and Assessment of Medicinal Safety Data of Orally Used Echinacea Preparations. Planta Med. 2016;82(1-2):17-31.

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