Echinacea (E. angustifolia DC, E. pallida, E. purpurea)

background

Echinacea species belong to the aster family (Asteraceae) that originated in eastern North America. Of the nine identified species, only three are used as medicine. The roots and herbs of the species have been studied for potential immune benefits.
Echinacea has been taken by mouth in Europe and the United States to help prevent or treat the common cold. In the United States, echinacea sales are thought to make up 10 percent of the dietary supplement market. Although much research has been done on the potential cold-fighting effects of echinacea, results are conflicting. There have been reports of a lack of benefit and rash caused by echinacea in children.
Early studies looking at the potential benefits of echinacea for herpes and radiation poisoning have found a lack of evidence. Applying echinacea juice to the skin has been suggested for wound healing, and taking echinacea by mouth or injecting it has been suggested for vaginal yeast infections. However, clear evidence is lacking in these areas.
Echinacea use has been discouraged in people who have autoimmune disease. However, more research is needed before further conclusions can be made.

Related Terms

Alkamides, alkylamides, American coneflower, Asteraceae (family), black sampson, black susan, caffeic acid derivatives, caffeoyl derivatives, cichoric acid and polysaccharides, cock-up-hat, combflower, compositae, cynarin, dodeca-2E,4E,8Z,10Z(E)-tetraenoic acid isobutylamide, dodecanoic acid derivatives, EC31J0, Echinacea® (Strong Nature, Serbia), Echinacea angustifolia, Echinacea laevigata, Echinacea Moench, Echinacea pallida, Echinacea Plus®, Echinacea purpurea, Echinacea purpurea L. Moench, Echinacea simulata, Echinacea tennesseensis, Echinacin®, Echinacin® EC31, echinacoside, Echinaforce®, Echinaforce® Forte, EchinaFresh® (Enzymatic Therapy, Green Bay, WI), Echinaguard®, Echinilin® (Factors R & D Technologies, Burnaby, BC, Canada), echino (Greek), EFLA® 894, glycoconjugates, hedgehog, hydrophilic polysaccharides, Igelkopf (German), Indian head, Kansas snake root, Kegelblume (German), narrow-leaved purple coneflower, N-isobutyldodeca-2E,4E,8Z,10Z-tetraenamide, Pascotox®, pentadeca-(8Z,13Z)-dien-11-yn-2-one, Polinacea™, polysaccharide, purple coneflower, red sunflower, rudbeckia, SB-TOX, scurvy root, sea urchin, snakeroot, solhat (Danish), sonnenhut (German), sun hat, undeca-2-ene-8,10-diynoic acid isobutylamide, undecanoic acid derivatives, unsaturated N-alkylamide lipids.
Combination product examples: ChizukitTM, an echinacea product that contains 50mg/mL of the extract of the upper plant parts of Echinacea purpurea and roots of Echinacea angustifolia, 50mg/mL of propolis, and 10mg/mL of vitamin C; Cold-X® (Vitamin C 100mg, Echinacea purpurea root extract 20.1mg, eucalyptus leaf extract 12.3mg, fennel seed extract 10.3mg); Kan Jang® (Adhatoda vasica, Echinacea purpurea, and Eleutherococcus senticosus); Esberitox® liquid (ethanolic-aqueous extracts of herba Thuja occidentalis 2mg, radix Echinacea 7.5mg, and radix Baptisia tinctoria 10mg); Esberitox® tablets (vitamin C 20mg, Thuja occidentalis 2mg, radix Echinacea 7.5mg, and radix Baptisia tinctoria 10mg); the transmucosal herbal periodontal patch, provided by Izun Pharmaceuticals (New York, NY) (plant extracts from Centella asiatica (gotu kola), Echinacea purpurea, and Sambucus nigra (elderberry)); Erbavita® (Andrographis paniculata, Echinacea, grapefruit, papaya, Tabebuia, and Uncaria); Imoviral® Junior (an herbal combination therapy that contains Echinacea angustifolia, arabinogalactan, vitamin C, beta-glucan, and zinc).

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
Common cold (treatment in adults) (Grade: B)
Taking echinacea by mouth is often suggested as a treatment for the common cold. Echinacea may help reduce the length and severity of the common cold. Much research has focused on the potential benefits of echinacea for this purpose. Although most studies report positive effects, some recent high-quality trials found negative results in adults and children. More research is needed before a firm conclusion can be made.
Anxiety (Grade: C)
Early study suggests that echinacea may help reduce anxiety. Although results are promising, more research is needed in this area.
Blood pressure control (Grade: C)
Early study suggests that taking a single dose of echinacea by mouth may lack effect on blood pressure. At this time, evidence showing benefit on blood pressure is lacking. More research is needed in this area.
Cancer (general) (Grade: C)
At this time, there is not enough evidence to support the use of echinacea for any type of cancer. Evidence of benefit is lacking and more study is needed.
Common cold (prevention in adults and children) (Grade: C)
There is conflicting evidence on the effectiveness of echinacea for preventing the common cold. Although some studies report that echinacea may have this benefit, other results suggest that effects of echinacea are lacking. More studies are needed in this area.
Common cold (treatment in children) (Grade: C)
Early research suggests that echinacea may lack benefit in treating symptoms of the common cold in children. This may be due to parents not recognizing symptoms soon enough to begin treatment, or due to the dose of echinacea for use in children not being clear. It is also possible that echinacea is more effective in adults than children due to differences such as whether illness is caused by viral or bacterial infection, different viruses, different sites of infection, etc. Rash has been reported with echinacea use in children. More research is needed before a conclusion may be made.
Ear infection (Grade: C)
Limited research suggests that using echinacea to treat colds in children who tend to have ear infections may increase the risk of acute ear infection. More studies are needed before a conclusion may be made.
Exercise performance (Grade: C)
Early research suggests that taking echinacea by mouth may increase red blood cell production and oxygen intake in healthy men. These effects may be linked to improved athletic performance. However, more studies are needed before conclusions may be made.
Eye inflammation (Grade: C)
Early study reports that taking echinacea by mouth may help treat mild eye inflammation. More research is needed to confirm these findings.
Gastrointestinal inflammation (stomach and intestine inflammation) (Grade: C)
A combination therapy containing echinacea has been used to reduce inflammation after stomach and intestine surgery. Limited results suggest that this may reduce the duration of complications related to stomach and intestine inflammation. However, further details are lacking at this time.
Genital herpes (Grade: C)
Taking echinacea by mouth has been studied for the treatment of recurrent genital herpes. Esberitox®, a German combination product containing echinacea, has been studied for herpes treatment. However, early research found a lack of benefit. More studies are needed in this area.
Gum disease (Grade: C)
Early research suggests that herbal patches containing echinacea may help improve gum health in people who have gum disease. However, the effect of echinacea alone is still unclear. Further study is needed before a conclusion may be made.
Herpes (cold sores) (Grade: C)
Research suggests that Esberitox® may treat herpes infection of the mouth. However, more research is needed before conclusions can be made.
Human papillomavirus (HPV) (Grade: C)
A study found that Erbavita®, a combination therapy containing echinacea, may reduce anal warts after surgery, compared to a lack of treatment. However, the effect of echinacea alone is unclear. More studies are needed before a conclusion may be made.
Immune stimulant (Grade: C)
Echinacea has been studied alone and in combination therapies for immune system stimulation. It has been studied in people undergoing chemotherapy for cancer. However, evidence of benefit is unclear. More research is needed in this area before conclusions can be made.
Inflammation (head and neck) (Grade: C)
Esberitox® has been studied for middle ear and tonsil inflammation. Echinacea has been used together with the antibiotic erythromycin. This combination may help improve symptoms, recovery time, and well-being of people with tonsil inflammation. However, the effect of echinacea alone is unclear at this time. More research is needed before a conclusion may be made.
Lymphoma (cancer of the immune system) (Grade: C)
Esberitox® N has been studied for its potential effects on immune cell activity. The herbal supplement was shown to affect the immune system and natural resistance in people with lymphoma. However, the effects of echinacea alone are unclear. More research is needed before a conclusion may be made.
Radiation side effects (Grade: C)
Early studies have found conflicting results for the use of echinacea in treating low white blood cell count caused by radiation. The combination product Esberitox®, which contains echinacea, and the dry extract product Echinacea® have both been studied. More research is needed in this area.
Skin wounds (Grade: C)
Echinacea has been used to treat skin wounds. Esberitox® has been studied for skin conditions. Further research is needed before a conclusion may be made.
Sore throat (Grade: C)
A throat spray containing echinacea and sage may be as effective as other sprays for sore throat relief. However, more studies are needed in this area.
Vaccine adjunct (increase response to vaccine) (Grade: C)
Early research reports that the herbal product Esberitox® N may improve response to the hepatitis B vaccine. However, the effect of echinacea alone is unclear at this time. More studies are needed before a conclusion may be made.
Vaginal yeast infections (Grade: C)
Some research suggests that using echinacea together with Spectazole®, a prescription cream, may result in less frequent vaginal yeast infections. Studies also suggest that that echinacea extract may block yeast growth. Although not well studied in humans, Polinacea™, which contains echinacea root extract, may stimulate the immune system. More research is needed.
Warts (Grade: C)
Early study suggests that echinacea may lack an effect in the prevention and treatment of warts on the skin. More well-designed research is needed in this area.