What are the advantages and disadvantages of Echinacea (Echinacea spp.)?

From the Guidelines

Echinacea has no significant benefits for treating or preventing colds, although some products may have a weak, clinically questionable benefit.

Advantages and Disadvantages of Echinacea

The advantages of Echinacea are limited, with some studies suggesting a possible weak benefit in reducing the risk of recurrent respiratory infections, including virologically confirmed cases, and otitis media (OM) 1. However, these benefits are not consistently supported by high-quality evidence.

• The potential benefits of Echinacea are:
  • Possible weak benefit in reducing the risk of recurrent respiratory infections and OM
  • May have some immunomodulatory and mild antiviral effects
• The disadvantages of Echinacea are:
  • Lack of significant benefits for treating or preventing colds 1
  • Potential effects are of questionable clinical relevance 1
  • May have adverse effects, although these are not well-documented In contrast to other treatments for the common cold, such as zinc lozenges, which have been shown to significantly reduce the duration of colds when taken within 24 hours of onset at a dose of >=75 mg/day 1, Echinacea products have not been shown to provide significant benefits. Similarly, vitamin C may be useful for people exposed to brief periods of severe physical exercise, and probiotics may have some benefits in reducing the risk of respiratory symptoms and OM, although more research is needed to confirm these findings 1.

From the FDA Drug Label

Echinacea angustifolia 6C (**contains 0.443 mg of the active ingredient per pellet) Stop use and ask a doctor if symptoms persist for more than 3 days or worsen If pregnant or breast-feeding ask a health professional before use

The advantages and disadvantages of Echinacea are not explicitly stated in the provided drug labels.

• No direct benefits are mentioned in the labels.
• Potential precautions include:
  • Stopping use and consulting a doctor if symptoms persist or worsen 2
  • Consulting a health professional before use if pregnant or breast-feeding 2 The FDA drug label does not answer the question.

From the Research

Advantages of Echinacea

• Echinacea has been shown to reduce the duration and severity of symptoms of acute respiratory tract infections, including the common cold 3, 4, 5
• It has anti-inflammatory properties, which can help alleviate symptoms of infections and inflammatory conditions 6, 7
• Echinacea may enhance innate and adaptive immune functions, increasing the body's ability to fight off infections 7
• It has been found to decrease the levels of pro-inflammatory cytokines, which can contribute to the progression of cytokine storm and Acute Respiratory Distress Syndrome (ARDS) 5

Disadvantages of Echinacea

• The efficacy of Echinacea can vary depending on the species, preparation, and dosage used 3, 4
• More research is needed to fully understand the mechanisms of action and potential interactions with other medications 3
• Echinacea may not be effective for prevention of illnesses, but rather as a treatment for existing symptoms 3
• There is limited research on the use of Echinacea for specific conditions, such as COVID-19, and more studies are needed to determine its potential benefits and risks 5

Potential Risks and Interactions

• Echinacea can increase immune function, which may be a concern in cases of over-activation of the immune system, such as cytokine storm 5
• However, clinical trials have shown that Echinacea decreases levels of immune molecules involved in cytokine storm, suggesting that it may be safe to use in these cases 5
• Few adverse events have been reported with the use of Echinacea, suggesting that it is reasonably safe when used as directed 5