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Echinacea is one of the most popular herbs in Europe and the United States. It has been called Nature's Antibiotic and many consider it an effective alternative to antibiotics. Native American and other traditional healers have used echinacea for hundreds of years to treat infections and wounds.
Let's Look at the Studies
There are a number of studies documenting echinacea's effectiveness. Typically echinacea is used to treat colds, flus and sore throats. Echinacea stimulates your immune system to produce an increased number of white blood cells and virus-fighting cytokines.
Echinacea Treats Flu and Prevents Complications
For example, Tamiflu is approved by the FDA to treat the flu and Tamiflu is considered the gold standard for influenza treatment. If you take Tamiflu, you get over the flu faster, and are back to work in less time. In a 2015 study, 473 patients with laboratory confirmed flu participated in a study testing echinacea against the generic version of Tamiflu. Half were given generic Tamiflu and half took echinacea. The test was double blind, meaning the patients and doctors didn't know who got which medicine. After 5 days 50.2% of those taking echinacea and 48.8% of those taking Tamiflu were better, and after 10 days 90.1% of those taking echinacea and 84.8% of those taking Tamiflu were better. Those results look like echinacea was actually better than Tamiflu, but the difference is not that big, so scientists interpret this study as showing echinacea is equivalent to Tamiflu in terms of effectiveness.
The most common complication of the flu is pneumonia. In this study, only 2.46% of those taking echinacea developed complications, versus 6.45% of those taking Tamiflu. Go to Curr Ther Res Clin Exp. 2015 Apr 20;77:66-72, to read the whole study.
Tamiflu requires a prescription and usually has a $50 to $65 copay. Without insurance it will cost up to $250 and the generic version is around $135. Echinacea is over the counter and you should expect to pay between $8 and $45 and you will probably have a lot left over after treating your flu.
Echinacea Shortens Colds by 67%
Another study published in a European journal (Arzneimittel-forschung, 01 Jan 2001, 51(7):563-568) tested echinacea in the treatment of the common cold. This was a randomized, double blind, placebo controlled study. Half the patients got echinacea and half got placebo, and neither the patients nor doctors knew who got which. Those that got echinacea were sick for 6 days, versus those taking placebo were sick for 9 days. As a randomized, double blind, placebo controlled study, this is considered the highest level of proof you can get. Shortening a cold from 9 to 6 days seems like about a 33% reduction, not 67%, but treatment didn't start on day 1. Let's say by the time they got into the clinic they didn't start treatment until day 4. That would mean the placebo patients were sick for 5 more days after starting treatment, and the echinacea patients got better in 2 days after starting treatment, which means the cold was shortened by 67% from the start of treatment.
Echinacea Reduces Antibiotic Usage by 80%
Another interesting European study looked at preventing antibiotic usage in children. This was a randomized, blinded, controlled clinical trial. They took echinacea, or placebo, to prevent viral respiratory infections and the subsequent complications of pneumonia, sinusitis and otitis media for which children often receive antibiotics. The echinacea kids experienced about 1/3 less colds than the placebo kids. Only 5.8% of the echinacea kids ended up with complications requiring antibiotics, versus 15.3% of the placebo kids. The placebo kids that needed antibiotics needed more antibiotics than the echinacea kids that needed antibiotics, so overall there was an 80% decrease in antibiotic usage in the echinacea group. (Eur J Med Res. 2021 Apr 8;26(1):33.)
Echinacea is a Potent Preventive of
Infections and Complications
Another study with 2,458 participants found that many patients reduced their incidence of recurrent respiratory infections by 50%. Complications such as pneumonia, otitis media, and tonsilitis were also reduced. The researchers concluded "Evidence indicates that echinacea potently lowers the risk of recurrent respiratory infections and complications thereof." (Adv Ther. 2015 Mar;32(3):187-200.)
Some Studies Have Shown No Benefit
These are some pretty convincing studies, but other studies have failed to find any benefit. I have looked at some of these negative studies and found obvious flaws. Researchers that aren't knowledgeable about echinacea and herbal medicine in general would have a hard time designing and executing a valid study.
Here are just 2 of the problems that might be encountered when designing a study.
Echinacea is usually sold as a tincture or liquid extract. Some tinctures will have 10 times as much echinacea extract as other tinctures, and you can't tell the difference from looking at the label. Imagine doing a study on penicillin and you aren't sure if each pill has 500 mg of penicillin or just 50 mg. It could make a difference!
Doctors that prescribe echinacea have long known that alcohol extracts are preferred and recent studies have verified that alcohol extracts are more effective (Adv Ther. 2015 Mar;32(3):187-200).
An example of a flawed study that didn't take these types of issues into consideration was published by JAMA Internal Medicine. This study used the cold pressed juice of the echinacea plant and found that echinacea was not effective. What were the flaws? Cold pressed juice sounds good, but as we know, alcohol extracts are more effective. Alcohol stabilizes the tincture, whereas cold pressed tinctures deteriorate rapidly. Hence the study was based on an inferior product. The 2nd flaw was the dose. It appears the patients received less than half the dose of echinacea other studies used. Taking these 2 facts into consideration it is not surprising the outcome was negative.
Echinacea is Effective But You
Do Need a Quality Product.
QUESTION: How do I find a quality echinacea tincture?
ANSWER: Because echinacea, and herbal medicine in general is unregulated, you may not be able to assess the quality by looking at the label. Naturopathic physicians are trained and competent in this field but for those of you that don't have a naturopathic physician in the loop, you're pretty much on your own. If you need help finding a naturopathic physician, go here.
QUESTION: Can I get a good echinacea product at a health food store?
ANSWER: Most health food stores carry a selection of echinacea products with varying levels of quality. You should be able to find a quality product, if you ask the right questions. You can ask the clerk for help in selecting a quality product and you may get good advice. It's just like asking the clerk at Home Depot a technical question about plumbing. You may get a very helpful answer, and sometimes not.
QUESTION: Can I take echinacea preventively?
ANSWER: Yes, echinacea can be taken for up to 1 or 2 weeks before you are ill, at high risk times. For example, some people always get colds when they fly, and starting echinacea 1-2 days before flying would make sense. Marathon runners frequently get colds after marathons and taking echinacea for 2 weeks after a marathon would be wise.
QUESTION: Can I just take echinacea everyday during cold and flu season?
ANSWER: That has been tried and is not advised. Echinacea stimulates the immune system, but too much stimulation for too long isn't good. Echinacea should mainly be taken when needed, IE starting with the first sign of any respiratory infection.
QUESTION: What is the correct dose?
ANSWER: That will depend entirely on the product you get.
Is Echinacea Safe For Everybody?
Echinacea is generally considered safe and is sold over the counter, without a prescription. If you are in reasonably good health, you should be able to use echinacea safely. If you haven't used echinacea in the past, or have any special medical problems, you should talk to your health care provider before using echinacea.
In summary:
Echinacea treats the flu as effectively or better than Tamiflu.
Echinacea reduces complications by 68% compared to Tamiflu.
Echinacea shortens colds by 67%.
Echinacea reduces antibiotic usage by 80%.
Echinacea is a potent preventive of cold or flu recurrence.
Echinacea greatly reduces complications including pneumonia.
If Roche, the Big Pharma company that markets Tamiflu, had a product as effective as echinacea, you would see TV adds for it every day during cold and flu season! Find a decent echinacea product, get some advice on dosage, and keep it on hand for when you need it!
Take care and BE HEALTHY!
CW Jasper
February 2023
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