We use essential cookies (authentication, your saved goals/stack) by default. With your permission we'll also enable privacy-respecting analytics (Vercel Web Analytics, anonymous load-time metrics) and error-replay diagnostics (Sentry — DOM snapshots only when an error fires) so we can fix bugs faster. Learn more
Ech9.0
Echinacea Research
Probably helpsHigh safety
34 peer-reviewed studies
What the evidence says
Probably helps
Echinacea helped in about half (6/12) of the studies that measured an effect — promising, but not unanimous.
Most evidence is from high-quality meta-analyses and randomised trials published 2005–2025 with a typical study size of 153 participants.
Based on 34 studies · 9 meta-analyses · 14 RCTs · 14,902 total participants
Confidence
High
What the studies found
6helped5unclear1didn't help· 22 more without graded effect data
2Identification of immunostimulatory herbal supplementsSystematic Reviewn=469 · medium study2025
We identified 227 herbal supplements with immunostimulatory properties, of which 15 were most strongly supported by the evidence.
Weiner JD et al. · Lupus science & medicine (2025)
No clear effect
← WorseNo effectBetter →
We identified 227 herbal supplements with immunostimulatory properties, of which 15 were most strongly supported by the evidence.
This article may serve as a reference to help clinicians counsel patients with autoimmune skin diseases on the risks associated with use of specific herbal supplements.
3Maximal oxygen uptakeMeta-AnalysisCited 1×n=107 · medium study2024
Echinacea supplementation did not influence erythropoietin, hemoglobin, hematocrit, or maximal oxygen uptake in athletes; however, the evidence base is limited.
Deccy S et al. · Nutrients (2024)
No clear effect
← WorseNo effectBetter →
Could be chance
There was also no statistically significant change in erythropoietin (effect size -0.29, p = 0.05, 95% CI -0.75-0.17, I2 = 67%) or maximal oxygen uptake (effect size -0.20, p = 0.95, 95% CI -0.60-0.21, I2 = 0%).
Six studies with a total of 107 athletes were included in the analysis.
Echinacea supplementation did not influence erythropoietin, hemoglobin, hematocrit, or maximal oxygen uptake in athletes; however, the evidence base is limited.
6Herbal-drug interactions and contraindicationsSystematic ReviewCited 100×n=1,491 · large study2012
Although HDS-drug interactions and contraindications primarily concerned a relatively small subset of commonly used medications and HDS entities, this review provides the summary to identify patients, HDS products, and medications that are more susceptible to HDS-drug interactions and contraindications.
Tsai HH et al. · International journal of clinical practice (2012)
No clear effect
← WorseNo effectBetter →
Of the 882 HDS-drug interactions being described its mechanism and severity, 42.3% were due to altered pharmacokinetics and 240 were described as major interactions.
Of the 152 identified HDS contraindications, the most frequent involved gastrointestinal (16.4%), neurological (14.5%), and renal/genitourinary diseases (12.5%).
The findings would facilitate the health-care professionals to communicate these documented interactions and contraindications to their patients and/or caregivers thereby preventing serious adverse events and improving desired therapeutic outcomes.
Baidya R et al. · Naunyn-Schmiedeberg's archives of pharmacology (2025)
The ECH contents in the reported plants often own these multifaceted properties, highlighting their importance in clinical research.
Evident from its therapeutic efficacy, there is a huge potential for a comprehensive understanding of the mechanisms of actions of ECH, which underscores the need for more research in this area.
As we move toward a vision of health promotion and resilience rather than a sole focus on disease prevention and treatment, further work in this area of dietary supplements is of utmost importance.
Crawford C et al. · Nutrients (2022)
Immune health products represent approximately 10% of all US dietary supplement sales.
The studies included eight of the 27 supplement ingredients identified through a market-driven scoping review.
Those ingredients used in single ingredient products were echinacea, elderberry, garlic, vitamin A, vitamin C, vitamin D, vitamin E, and zinc.
However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.
Griffin AS et al. · Ear, nose, & throat journal (2018)
We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS.
Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence.
In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea.
A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications.
Izzo AA et al. · Phytotherapy research : PTR (2016)
A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications.
Nevertheless, potentially serious adverse events, including herb-drug interactions, have been described.
This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics or anti-inflammatory drugs, antibiotics, antihistamines, decongestants for short-term and for long-term relief, decongestants plus antihistamines, echinacea, steam inhalation, vitamin C, and zinc (intranasal gel or lozenges).
Arroll B · BMJ clinical evidence (2011)
Systematic review examining Echinacea efficacy
Further research warranted to confirm findings
12Warfarin pharmacokinetic and pharmacodynamic interactionsSystematic ReviewCited 29×2017
It was difficult to determine whether ten herbal medicines had significant effects on the PK-PD parameters of warfarin.
Choi S et al. · PloS one (2017)
Using CONSORT, the reporting percentages for the articles ranged from 36.5% to 61.5% and the mean percentage for all articles was 45.6%.
It was difficult to determine whether ten herbal medicines had significant effects on the PK-PD parameters of warfarin.
Low quality of evidence, different compounds within and different compositions of the herbs, and methodological limitations of the crossover study, which is a clinical study in which subjects receive a sequence of different interventions, made it difficult to form conclusions.
13Concurrent prescription drugs and herbal medicine use prevalenceSystematic ReviewCited 69×2017
The prevalence of concurrent prescription drugs and HMP use among older adults is substantial and potential interactions have been reported.
Agbabiaka TB et al. · Drugs & aging (2017)
No clear effect
← WorseNo effectBetter →
Prevalence of concurrent use by older adults varied widely between 5.3 and 88.3%.
The prevalence of concurrent prescription drugs and HMP use among older adults is substantial and potential interactions have been reported.
Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals in appropriately identifying and managing patients at risk.
15Jetlag following eastbound flightsMeta-AnalysisCited 5×n=10 · very small study2021
Overall, 12 of 183 ingredients contained in 199 products had evidence to support claims.
Chan V et al. · Nutrients (2021)
Large benefit
← WorseNo effectBetter →
Likely real
Meta-analysis (random effects model) indicated melatonin reduced self-reported jetlag following eastbound (n = 5) and westbound (n = 4) flights: standard mean difference -0.76 (95% CI = -1.06 to -0.45, I2 0%, p < 0.00001) and -0.66 (95% CI = -1.07 to -0.26, I2 45%, p = 0.001), respectively.
Pycnogenol also reduced edema scores (n = 3), standard mean -4.09 (95% CI = -6.44 to -1.74), I2 98%, p = 0.0006).
Of the 3842 studies identified, 23 met selection criteria: melatonin (n = 10), Pycnogenol (n = 4), various macronutrients (n = 2), caffeine (n = 2), Centella asiatica (n = 1), elderberry (n = 1), Echinacea (n = 1), fluid (n = 1), and Pinokinase (n = 1).
16Rhinovirus cold preventionMeta-AnalysisCited 65×n=234 · medium study2006
This meta-analysis suggests that standardized extracts of Echinacea were effective in the prevention of symptoms of the common cold after clinical inoculation, compared with placebo.
Schoop R et al. · Clinical therapeutics (2006)
Huge harm
← WorseNo effectBetter →
Likely real
Based on the analysis, the likelihood of experiencing a clinical cold was 55% higher with placebo than with Echinacea (OR, 1.55 [95% CI, 1.02-2.36]; P<0.043).
The absolute difference in total symptom scores between groups was -1.96 (95% CI, -4.83 to 0.90; P=NS).
This meta-analysis suggests that standardized extracts of Echinacea were effective in the prevention of symptoms of the common cold after clinical inoculation, compared with placebo.
17Meta-AnalysisCited 92×n=22 · very small study2006
Echinacea preparations tested in clinical trials differ greatly.
Linde K et al. · The Cochrane database of systematic reviews (2006)
Echinacea preparations tested in clinical trials differ greatly.
There is some evidence that preparations based on the aerial parts of Echinacea purpurea might be effective for the early treatment of colds in adults but results are not fully consistent.
While the significance of many interactions is uncertain, several interactions, particularly those with St John's wort, may have serious clinical consequences.
Izzo AA et al. · Drugs (2009)
Echinacea might affect the clearance of caffeine (a CYP1A2 probe) and midazolam (a CYP3A4 probe).
No interactions have been reported for saw palmetto (Serenoa repens).
Numerous interactions between herbal medicines and conventional drugs have been documented.
19Non-antibiotic treatment effectiveness for common coldMeta-AnalysisCited 24×2005
Most non-antibiotic treatments for the common cold are probably not effective.
Arroll B · Respiratory medicine (2005)
Some studies were statistically significant, but the Cochrane reviewers were guarded about how clinically significant they were.
Most non-antibiotic treatments for the common cold are probably not effective.
The most promising are dextromethorphan, bisolvon and guiaphenesin for cough, antihistamine-decongestant combinations for a wide range of symptoms, nasal decongestants (at least for the first dose) and possibly zinc lozenges.
This clinical trial was the first to demonstrate beneficial effects of EPE consumption on immunity in Korean adults.
Lee SK et al. · Phytotherapy research : PTR (2024)
With increasing popularity of Echinacea in Korea recently, a human clinical trial was conducted to evaluate immune-enhancing efficacy and safety of EP 60% ethanolic extract (EPE) in Koreans.
After 8 weeks of EPE consumption, a significant increase in NK cell cytotoxic activity compared to the placebo was observed.
Additionally, serum cytokine levels of IL-2, IFN-γ, and TNF-α also significantly increased following EPE consumption.