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Echinacea is a group of flowering plants in the daisy family that ranks among the most popular herbal supplements in the United States, mostly sold for colds. The research is less exciting than the marketing. A Cochrane review of 24 trials found no clear benefit for shortening colds and, at most, a small possible effect on catching one. Products also vary widely: one study found that 10% of retail echinacea products contained no measurable echinacea at all. Here is what echinacea is, what the trials found, who should avoid it and how to read a label.
Peptide Labs sells one multi-herb product that lists echinacea inside a proprietary blend, covered below. This article does not recommend it or any other product. It is general information, not medical advice.
Key Takeaways
- Echinacea purpurea, E. angustifolia and E. pallida are the species most used in supplements.
- Cochrane found no benefit for cold duration and only a possible small effect on catching colds.
- Products differ in species, plant part and extraction, so one study's result may not apply to another product.
- Allergic reactions can be severe, especially in people allergic to ragweed and related plants.
- Echinacea may interact with immune-suppressing drugs and some medicines processed by the liver.
What is echinacea?
Echinacea species are perennial plants closely related to sunflowers, daisies and ragweed. NCCIH notes that they are native to areas east of the Rocky Mountains and that Native Americans used Echinacea purpurea for respiratory infections, tooth pain and snakebite. MSKCC lists three species common in herbal products, E. purpurea, E. angustifolia and E. pallida, made from the roots, the above-ground parts or both. Compounds studied in echinacea include cichoric and caftaric acids, polysaccharides and alkylamides.
You will find echinacea as capsules, tablets, liquid extracts, lozenges and echinacea tea, often mixed with other ingredients. Interestingly, NCCIH-sponsored research found that the activity of echinacea extracts is influenced by soil conditions that shape the plant’s bacterial community, one more reason products can differ.
Echinacea benefits: what the research shows
Most echinacea research looks at the common cold. Far less has been done on anything else. Here is how the main evidence stacks up.
| Question | What the research found | Evidence |
|---|---|---|
| Catching fewer colds | No single prevention trial significant; pooled data suggest a 10% to 20% relative reduction | Weak, uncertain |
| Shorter colds | Only 1 of 7 trials found a shorter cold; a 719-person NIH trial found no significant difference | No clear benefit |
| Colds after virus exposure | NEJM 2005: three root extracts had no effect on infection or symptoms | No effect in one trial |
| Colds in children | JAMA 2003: no difference in duration or severity; more rashes | No benefit, safety signal |
| Eczema and other uses | Unclear; little research | Insufficient |
The Cochrane review on colds
The 2014 Cochrane review pooled 24 double-blind trials with 4,631 participants that compared echinacea products with placebo. None of the 12 prevention comparisons found a statistically significant difference on its own, though a post hoc pooling suggested a 10% to 20% lower relative risk of catching a cold. Only one of seven trials that reported cold duration found a benefit. The authors concluded that echinacea products have not been shown to help once a cold starts, and that any preventive benefit is weak and of questionable clinical relevance. Side effects and dropouts did not differ significantly from placebo. Some review authors had worked on included trials but did not assess those studies.
Key individual trials
In a 2010 trial in Annals of Internal Medicine funded by the NIH, 719 people aged 12 to 80 with new colds in Wisconsin received echinacea, placebo or no pills. Illness duration and severity were not statistically different with echinacea. In a 2005 New England Journal of Medicine study, 437 volunteers took one of three E. angustifolia root extracts or placebo and were exposed to a cold virus; the extracts had no significant effect on infection rates or symptoms. NCCIH’s overall reading is that echinacea may slightly reduce the chance of catching a cold, and it is still unclear whether it shortens one.
Children
A 2003 JAMA trial in 407 children aged 2 to 11 found that E. purpurea did not shorten or ease colds, and rash occurred during 7.1% of colds in the echinacea group versus 2.7% with placebo. NCCIH mentions one more recent study suggesting fewer respiratory infections in children but says the overall evidence is not enough, and advises talking with a child’s healthcare provider first.
Why echinacea products vary so much
The Cochrane authors stress that products sold as echinacea differ in species, plant part, extraction method and added ingredients, so a result from one product does not transfer to another. Label accuracy is a separate problem. In a 2003 study in Archives of Internal Medicine, researchers tested 59 single-herb echinacea products from Denver stores. Six contained no measurable echinacea, the species matched the label in only 52%, and only 9 of 21 products labeled standardized met their own stated standard. A standardization claim, the authors concluded, does not mean a product is accurately labeled.
Echinacea tea adds another layer: how much of the plant’s compounds reach the cup depends on the plant material, the blend and how long it steeps, and teas rarely state a standardized content. Our guide to third-party tested supplements explains what independent seals can and cannot verify.
Echinacea side effects
NCCIH says short-term use of E. purpurea extracts, and some mixtures with E. angustifolia, is likely safe for most adults. The most common side effects are digestive, such as abdominal pain and nausea. MSKCC also lists headache, dizziness, constipation and skin rash.
- Allergies: NCCIH warns that allergic reactions may be severe. MSKCC advises caution for people with allergies or asthma, and rare cases of anaphylaxis have been reported. People allergic to ragweed or other daisy-family plants should be especially careful.
- Rare case reports: MSKCC describes isolated cases of acute hepatitis, liver failure in a young child, low white blood cell counts and a flare of the autoimmune skin disease pemphigus in a man whose condition had been controlled with immune-suppressing drugs.
- Echinacea purpurea in children: rash was more common with echinacea in the 2003 pediatric trial, and NCCIH notes concern that allergic reactions could be severe in some children.
Drug interactions
MSKCC says echinacea may make immune-suppressing drugs such as tacrolimus or cyclosporine less effective, and reports a case of very low platelets in a patient taking the chemotherapy drug etoposide. Laboratory and human studies show echinacea can affect liver enzymes that process many medicines, and MSKCC advises caution with drugs cleared by the CYP3A and CYP1A2 pathways, though the clinical importance is unknown. NCCIH calls the evidence on liver-processed drugs conflicting and notes theoretical interactions with caffeine. If you take prescription medicines, have an organ transplant, are in cancer care or live with an autoimmune condition, ask your prescriber first.
Pregnancy and breastfeeding
NCCIH reports that some studies suggest echinacea extracts are possibly safe for up to seven days in the first trimester, while MSKCC’s consumer advice says it may not be safe during pregnancy or breastfeeding. Little is known about breastfeeding. Ask your obstetric clinician before using it.
Echinacea in combination products
Echinacea often appears in cold-season blends alongside zinc, elderberry or vitamin C, and each of those ingredients has its own evidence and cautions; see our guides to elderberry and zinc. Blends can also hide echinacea deep inside a proprietary mix. In our catalog, the MIDDKUOO 18-in-1 Herbal Cleanse softgels list echinacea as one of 12 ingredients in a proprietary blend, next to red clover, thyme, turmeric, graviola, Coptis chinensis and fennel seed, plus named extracts of black walnut hull, sweet wormwood (Artemisia annua), clove, garlic, oregano and pumpkin seed. The panel gives no separate amount for echinacea, and the label asks people who are pregnant, nursing, taking medication or living with a medical condition to ask a healthcare professional before use. This label is not evidence of any immune or cleansing effect; our parasite cleanse guide covers the other herbs in this kind of formula. For another heavily marketed herb with similar evidence gaps, see our ginkgo biloba guide.
Frequently Asked Questions
What are the main echinacea benefits?
Research suggests echinacea may slightly reduce the chance of catching a cold, but trials have not shown that it shortens colds. Evidence for other uses is limited.
Does echinacea work for colds?
A Cochrane review of 24 trials found no clear benefit for cold duration and only a possible small, uncertain effect on catching a cold.
What are the side effects of echinacea?
Digestive upset, headache, dizziness and rash are the most common. Allergic reactions can be severe, especially in people allergic to ragweed and related plants.
Is echinacea tea the same as an extract?
No. Teas, tinctures and capsules use different plant parts, species and extraction methods, so their content differs and is rarely standardized.
Who should avoid echinacea?
People with daisy-family allergies or asthma, people taking immune-suppressing drugs or in cancer care, and anyone pregnant or breastfeeding should ask a clinician first.
Can children take echinacea?
A trial in children aged 2 to 11 found no benefit and more rashes. Ask your child’s healthcare provider before giving it.
Questions about a label? Contact us or read our Buyer’s Guide. Follow the label and ask a healthcare provider before starting any supplement, especially if you take medicines or are pregnant. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Last reviewed October 2026.
Related guides: Elderberry: Benefits, Research, Side Effects and Raw Berry Safety, Zinc Supplement Guide: Benefits, Side Effects and Immune Facts, Quercetin: Benefits, Side Effects, Interactions and Bromelain Combos.