Quick answer

Echinacea is a daisy-family herb, also called purple coneflower. Almost all of its human trials tested it against illness, which this site makes no claims about, so no benefit is graded here. NCCIH calls it likely safe for most adults for short periods, and European regulators limit one form to 10 days.^1,2,3

Key facts

Supplements mostly use extracts of three species: E. purpurea, E. angustifolia and E. pallida.³
Echinacea is closely related to ragweed, daisies and sunflowers, and people allergic to those plants should not use it.^1,2
Stomach upset and nausea are its most common side effects, and trouble sleeping and rashes are also reported.^1,4
The warfarin label names echinacea among botanicals that can interact with warfarin.⁵

What echinacea is

Echinacea species are perennials closely related to sunflowers, daisies and ragweed, native to areas east of the Rocky Mountains.¹

Supplements mostly use extracts of E. purpurea, E. angustifolia or E. pallida, made from the root, the parts above ground or the whole plant, and US products often mix species and plant parts.^2,3,6

Echinacea contains alkamides, polysaccharides, caffeic acid esters, terpenes and glycoproteins, but which of them are active is not well defined, and the mix differs between species.^3,7

Products differ in more than species. Some are juice pressed from the fresh plant, others are extracts of dried root, of the parts above ground or of the whole plant, and makers standardize them to different marker compounds, or to none at all.^2,3,7

Research funded by NCCIH suggests the activity of echinacea extracts depends partly on soil conditions that shape the bacteria living on the plant.¹

What the evidence shows

No benefit claim for echinacea passes our evidence rules, for two reasons.

Most studies of echinacea in people tested it against illness, and much less research has looked at any other use.^1,3

Echinacea studies have used different species, plant parts and preparations, so a result with one product may not apply to another.^3,7

This site does not make claims about illness, and a result for one echinacea product cannot be carried over to another. Very few studies have asked how echinacea affects people who are well, so there is nothing left to grade.^1,7

In the laboratory, echinacea compounds act on immune cells such as monocytes and natural killer cells. Laboratory effects like these do not show what a supplement does in a person.³

Amounts used in studies

The European monograph for juice pressed from fresh E. purpurea herb gives single doses of 1.5 to 4.5 ml, up to 6 to 9 ml a day, for no more than 10 days.²

In a 4-month trial in 755 healthy adults with an average age of 23, the daily amount was 2,400 mg of one E. purpurea extract, raised to 4,000 mg a day during any illness.³

Studies of how echinacea affects medicines used 400 mg of E. purpurea root four times a day for 8 days, and 500 mg of E. purpurea three times a day for 28 days.^6,8

There is no standard dose, because the products are not the same. The dosage guide sets these amounts side by side and explains the 10-day limit.²

What's in ours

What’s in ours

Men's Multi: Immune Support, 110 mg per serving, from the label
Immune Support: Echinacea purpurea Extract, 200 mg per serving, from the label

Neither label gives an extract ratio or a marker compound. In Men's Multi, echinacea powder is one of four ingredients in the blend shown above, with beta glucan, spirulina and garlic, and the label gives only the blend's total. We make no claim for the echinacea in either product.

Side effects, medicines, and who should avoid it

The most common side effects are digestive: stomach upset, nausea, stomach pain and diarrhea.^1,4

Trouble sleeping has been reported.^3,4

Skin rashes occur, and allergic reactions are rare but can be severe. European regulators list rash, hives, itching and facial swelling, and rarely severe reactions such as anaphylaxis, especially in people prone to allergies.^1,2,3

There are isolated reports of raised liver enzymes and liver injury linked to echinacea. NIH notes they may have been caused by a contaminant or the way the product was prepared.^3,9

No upper limit has been set for echinacea. The European monograph limits the pressed juice to 10 days at a time and reports no case of overdose, and NCCIH describes echinacea extracts as likely safe for most adults for short periods.^1,2

Ask your pharmacist or doctor first

The warfarin label names echinacea among botanicals that can interact with warfarin through CYP450 liver enzymes, and asks for more frequent INR checks whenever a botanical is started or stopped. MedlinePlus also lists echinacea among herbal products that may interact with warfarin.^5,10

On the medicine's label

Ask your pharmacist or doctor first

Echinacea might make medicines that suppress the immune system work less well, because it may stimulate immune activity. NIH and NCCIH both name this as a possible interaction on theoretical grounds.^1,3,4

Expected from how the two work, not shown in studies

NIH says echinacea might speed up some liver enzymes and so lower the levels of medicines they clear, and NCCIH calls the evidence on this conflicting. If you take any regular medicine, ask your pharmacist before adding echinacea.^1,3

Do not use it if you are allergic to ragweed, daisies, sunflowers or other daisy-family plants²
Ask first if you have an autoimmune condition, an immune deficiency or a white blood cell disorder²
Ask first if you have asthma, eczema or hay fever, which raise the risk of a severe allergic reaction²
Ask first if you are pregnant or nursing^1,3
Ask before giving it to a child, because European regulators do not recommend it under 12²

Questions people ask

What does echinacea do for the body?

In the laboratory, its compounds act on immune cells. In people, almost all trials asked whether it changes the course of illness, and the results vary with the product used. This site makes no claims about illness, so no benefit is graded for echinacea.^1,3

Are there echinacea benefits for skin?

We found no trial of echinacea taken by mouth for healthy skin. NCCIH notes that some products are sold for use on the skin and says it is unclear whether echinacea helps. Skin rashes are among its reported side effects.^1,4

Are there echinacea benefits for men?

We found no trial that reported results for men separately. The large trials NIH describes enrolled both men and women.³

Can I take echinacea every day?

Long-term daily use has not been well studied. NCCIH describes echinacea as likely safe for short periods, and European regulators limit the pressed juice to 10 days at a time, so ask your doctor before taking it continuously.^1,2

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See the Full Measure line Immune Support Men's Multi

Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.