What Is It?
One of the most popular herbal remedies in the world, echinacea contains active ingredients thought to fight colds, flu, and other infections. There are nine species of this herb, commonly called the purple coneflower, but just three (Echinacea angustifolia, E. pallida, and E. purpurea) are used medicinally. Various parts of the plant (flowers, leaves, stems, or roots) from a variety of species appear in literally hundreds of commercial preparations. Depending on the species and plant part used, the herb will stimulate the immune system and combat bacteria, viruses, and other disease-causing microbes.
Both safe and powerful, echinacea stimulates various immune system cells that are key weapons against infection. The herb also helps boost the cells’ production of a virus-fighting substance called interferon.
Specifically, echinacea may help to:
Reduce susceptibility to and duration of colds, flu, and sore throat. Echinacea is most effective if taken at the first sign of a cold, the flu, or a sore throat. Though findings vary, in one study, those using the herb for eight weeks were 35% less likely to catch a cold than those on a placebo. If you’ve already got the aches, congestion, or fever common to colds or flu, echinacea can cause these symptoms to be less severe and to subside sooner.
Fight recurrent respiratory infections, such as bronchitis, sinusitis, strep throat, and earache. The herb’s immune-boosting properties make it particularly helpful for fighting chronic upper respiratory infections. For best results, take echinacea at the first sign of illness.
Combat vaginal yeast and urinary tract infections. As an immune-booster, echinacea can be particularly helpful for fighting these recurrent infections. For yeast infections, the herb seems to stimulate white blood cells to destroy the yeast. Urinary tract infections can be helped by consuming extra fluids, including immune-boosting echinacea tea, which helps wash away the bacteria.
Promote healing of skin wounds and inflammations, including canker sores, burns, and cuts and scrapes. As a natural antibiotic and infection fighter, echinacea promotes the healing of all kinds of skin irritations, including burns, cuts and scrapes, boils, abscesses, canker sores, and eczema, as well as herpes infections (including genital herpes, cold sores, and shingles). It can be applied topically to a wound or be taken internally to strengthen the immune system.
Treat chronic fatigue syndrome. Echinacea is currently being studied as a possible treatment for chronic fatigue syndrome, a condition marked by profound and persistent exhaustion. One theory holds that this mysterious disorder represents the body’s response to a past viral infection that managed to permanently weaken the immune system. By bolstering the immune system and fighting any further viral (or bacterial) presence, echinacea may help those who suffer from this disorder.
Build immunity during cancer treatments and possibly protect against certain forms of cancer. Rotating echinacea with extracts of medicinal mushrooms may help to strengthen overall immunity during cancer treatments. While additional research is needed to define the potential role of echinacea in fighting cancer, a small German study showed that in patients with advanced colon cancer the herb appeared to prolong survival in those who took it in conjunction with standard chemotherapy. The herb presumably boosted the immune system’s ability to fight invading cancer cells.
Note: Echinacea has also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for Echinacea.
For maximum effect, take echinacea in liquid form–either as a fresh-pressed juice (standardized to contain 2.4% beta-1, 2-fructofuranosides) or as an alcohol-based tincture (containing a 5:1 concentration of the herb).
If you don’t like the bitter taste of the liquid, try standardized extracts in pill form. Look for pills containing at least 3.5% echinacosides, the active ingredient.
The various echinacea products available–capsules, tablets, juice, fluid extract–commonly contain echinacea made from either a single or mixed species. Check the label carefully to ensure that the species–and the plant part–you need is present in the product you select. Use the following as a guide:
For long-term use as a general immune-booster: Take supplements made from the whole plant (the roots and leaves) of E. angustifolia. To get the maximum benefit, alternate echinacea (200 mg twice a day) with other immune-enhancing herbs such as goldenseal, astragalus, pau d’arco, or maitake, reishi, and/or shiitake mushrooms. Pick two of these other herbs, use each one for a week, and then return to echinacea every third week. This practice is good for chronic fatigue sufferers and for those who want to boost immunity during cancer treatments.
For cold and flu prevention: Take 200 mg a day, preferably from supplements made from the above-ground plant of E. purpurea and the root of E. pallida. Or try rotating echinacea in three-week cycles with astragalus (500 mg a day), a Chinese herb that acts on the immune system in a way similar to echinacea.
For sore throat: To lessen the symptoms, a high dose is necessary: Take 200 mg four or five times a day. For immediate sore throat relief, add 1 teaspoon echinacea tincture to 1/2 cup warm water, gargle, and swallow four or five time a day until the pain subsides. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
For chronic bronchitis: Take 200 mg twice a day. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
For earache: Take 200 mg three times a day. Use in a cycle of three weeks on, one week off for recurrent infections. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
For vaginal yeast infections: Take 200 mg three times a day. Use in a cycle of three weeks on, one week off for recurrent infections. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
For urinary tract infections: Drink 1 cup of echinacea tea several times a day. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida. To make the tea, use 2 teaspoons echinacea for each 8-ounce cup of very hot (not boiling) water. Steep for 15 minutes and strain. Sweeten to taste with honey, if desired.
For skin wounds and inflammation: Add 3 drops of liquid extract to 1 teaspoon of water and apply to the wound. Or take 200 mg three times a day to prevent infection. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
For canker sores: Take 200 mg three times a day at the first sign of a sore. Begin taking echinacea at the higher dose and reduce the dosage as the sore heals. For prevention, take 200 mg each morning for three weeks of each month. Select supplements made from the above-ground plant of E. purpurea and the root of E. pallida.
Be sure to check out our Dosage Recommendations Chart for Echinacea, which lists therapeutic dosages for specific ailments at a glance.
Guidelines for Use
Use echinacea alone for no longer than eight weeks, followed by a one-week rest period before you start taking it again. With continuous use, the herb’s immunity-enhancing effects begin to decrease. Starting and stopping echinacea, or rotating it with goldenseal and the other herbs mentioned above, may maximize its effectiveness.
You can take echinacea with or without food.
There are no known drug or nutrient interactions associated with echinacea.
Possible Side Effects
At recommended doses, echinacea has no known side effects. However, people who are allergic to flowers in the daisy family may be allergic to echinacea as well.
Echinacea is not a replacement for antibiotics or other infection-fighting drugs, but it can be used to complement them.
Because echinacea could, in theory at least, overstimulate the immune system, it could worsen the condition of lupus, multiple sclerosis, rheumatoid arthritis, and other autoimmune disorders. Consult your doctor before taking the herb if you suffer from any of these disorders.
Don’t take echinacea for progressive infections such as tuberculosis.
Bronchitis Acute: 300-500 mg standardized extract or freeze-dried whole herb or 1-2 tsp. liquid extract 4 or 5 times a day. Chronic: 300-500 mg once a day, for 1-2 weeks; use in rotation with astragalus, pau d’arco, and medicinal mushrooms.
Burns 1-2 tsp. liquid extract (dilute in 1/2 cup of water) or 325-650 mg dried herb or 90 mg liquid caps 3 times a day
Cancer 1-2 tsp. liquid extract 3 times a day or 325-650 mg freeze-dried herb capsules 3 times a day or 90 mg liquid caps 3 times a day
Canker Sores 325-650 mg of the dried root and herb as a standardized extract or the freeze-dried form 4 or 5 times a day at the first sign of sore. With a liquid extract, mix 1 tsp. in 1/2 cup water 4 times a day. For prevention, take 325 mg a day for 3 weeks each month.
Chronic Fatigue Syndrome 400-600 mg a day
Cold Sores For acute flare-up: 1-2 tsp. fluid extract 3 times a day; or 325-650 mg freeze-dried whole herb 3 times a day; or 90 mg liquid caps 3 times a day.
For maintenance: In rotation with astragalus and mushroom combination, 1 tsp. fluid extract daily; or 325-650 mg freeze-dried whole herb daily or 90 mg liquid caps daily.
Colds To lessen cold symptoms, 300-500 mg standardized extract or freeze-dried whole herb or 1-2 tsp. liquid extract 4 or 5 times a day.
For prevention, 300-500 mg a day in 1- or 2-week rotations with astragalus and medicinal mushrooms.
Cuts and Scrapes 350-650 mg freeze-dried root OR 2 tsp. liquid extract 3 times a day. Apply 1 tsp. liquid extract (diluted with 1 tbsp. water) to wound 2 or 3 times a day as alternative to aloe vera or lavender oil.
Earache 300-500 mg standardized extract or freeze-dried whole herb or 1-2 tsp. liquid extract diluted in water 3 times a day. For recurrent infections, reduce to one dose a day and use in a cycle of 3 weeks on, 1 week off.
Flu To lessen flu symptoms, 300-500 mg standardized extract or freeze-dried whole herb or 1-2 tsp. liquid extract 4 or 5 times a day.
For prevention, 300-500 mg a day in 1- or 2-week rotations with astragalus and medicinal mushrooms.
Shingles 200 mg echinacea 4 times a day during the acute phase only. To help prevent recurrences, reduce to 200 mg a day 3 weeks of each month.
Sinusitis 1-2 tsp. liquid extract or 50-90 mg liquid capsules or 325-650 mg freeze-dried herb 3 times a day
Sore Throat For an acute infection: 200 mg 4 or 5 times a day. Alternatively, as a gargle, add 1 tbsp. liquid extract to 1/2 cup warm water, gargle, and swallow. Repeat 4 or 5 times a day until pain subsides.
For prevention: 200 mg each morning in 3-week cycles, alternating with another immune-stimulating herb such as astragalus (400 mg a day).
Urinary Tract Infections 1 cup echinacea tea several times a day
Yeast Infection (Vaginal) For acute infection: 250-400 mg standardized extract 3 times a day; 350 mg freeze-dried herb 3 times a day; 1 tsp. liquid extract 3 times a day; 90 mg liquid capsules 3 times a day.
For maintenance: Same dose but once a day, in a cycle of 3 weeks on, 1 week off.
David Edelberg, M.D.
Echinacea is one of the best-known medicinal herbs and enjoys a worldwide reputation for its immune-enhancing properties. You’re actually best off with a combination of at least two of the echinacea species, E. purpurea and E. angustifolia. If your preparation contains some Echinacea pallida, that’s fine, too.
HOW IT HELPS COLDS
Remember, when you have a cold, you’re using echinacea for two purposes: first, to jump-start your own immune system to get rid of the infection, and second, to directly challenge the cold virus. This actually makes echinacea a more sensible choice than antibiotics, which don’t boost your own immune system and are utterly powerless against cold viruses. Start taking echinacea early, especially if everybody is sniffling and sneezing around you. At the first telltale signs of a cold–scratchy throat, runny nose, and so forth–be generous. If you have 100 mg capsules, take two every four hours. If you have the liquid extract, take a teaspoonful every two to three hours. Maintain these substantial doses during the first couple of days; then you can reduce your dose by about half.
WHAT TO LOOK FOR
Echinacea comes in a wide variety of forms–ranging from capsules and lozenges to liquids and dried herbs for teas. This makes choosing and buying echinacea potentially confusing.
Liquids are preferred by most herbalists. Your choices are: Fresh-pressed juice (standardized to contain 2.4% beta-1, 2-fructofuranosides) Liquid extract (5:1 concentration of echinacea) needs to be diluted in water. Pills. Pills are another fine option and are particularly useful if the somewhat bitter taste of the liquid bothers you. Your choices are: Tablets, softgels, or capsules, which also come in standardized extracts.
Look for a brand containing at least 3.5% echinacosides, the herb’s active ingredient.
If you do decide to try echinacea, here are a couple of useful pointers: About the liquids: If the product has lost its ability to make your tongue tingle, the echinacea is probably no longer effective. On a personal note: I’ve always found it a lot more convenient to stash a day’s supply of echinacea capsules–rather than a liquid-filled bottle–in my back pocket. All you need is for the bottle of liquid extract to leak just once and you’ll understand my preference for capsules. Medicinally, however, both forms work well.
David Edelberg, MD