March 10, 2025, 2:33 pm | Read time: 6 minutes
Echinacea is a traditional medicinal plant that is mainly used to support the immune system and to treat respiratory infections and superficial wounds. FITBOOK author Julia Freiberger explains the effects of echinacea, how to take it correctly, and what the study situation looks like.
Echinacea, or coneflower, originally comes from central and eastern North America. The indigenous tribes were already aware of the effectiveness of the composite plant and, therefore, used it as a painkiller for infections and wounds.
Overview
What Is Echinacea?
Echinacea belongs to the Asteraceae family and originally comes from North America. The plant is now also widespread in Europe, both as a medicinal and ornamental plant. With its distinctive flower head, echinacea is known by two names, both of which are related to its appearance: “coneflower” and — less commonly — “hedgehog’s head.” As a so-called composite flower, echinacea has an upright, hairy stem with a large “basket flower” at the end. Tongue-shaped marginal flowers then unfurl from this point — initially, these are greenish in color and grow diagonally upwards. During the flowering period, however, they take on a pink to purple-red color and tilt limply downwards. The plant thrives in warm, dry, and sunny locations. It is harvested during its flowering period; it does not tolerate drying out — its valuable active ingredients are lost if it dries out.1
The healing properties of the plant can originally be traced back to the knowledge of the North American natives. They made a poultice from the plant, which they used externally to treat wounds, burns, swollen lymph nodes, mumps, and even as an antidote to snake bites. Internally, they used the roots by chewing them to relieve general pain, toothache, and sore throat, as well as to combat cold symptoms.2
There are generally three species that are used medicinally:
- Echinacea angustifolia (narrow-leaved coneflower): Characterized by white to purple flowers, the root, in particular, is used.
- Echinacea pallida (pale coneflower): Pale pink to white flowers, the root is also medicinally relevant.
- Echinacea purpurea (purple coneflower): Purple flowers, herbs, and roots are used.
Classification of the Species
In principle, all three types of coneflower have similar therapeutic uses:
- Echinacea purpurea: In this species, the aerial parts of the plant are used for the external treatment of poorly healing superficial wounds. For internal use, the plant parts and roots are used to support chronic recurring infections of the upper respiratory tract and the urinary tract.
- Echinacea pallida and Echinacea angustifolia: Here, the roots are used to treat and prevent recurring infections of the upper respiratory tract.
However, the scientific evidence on the effectiveness of echinacea is currently limited. Some studies suggest that the medicinal plant can prevent colds, shorten their duration, or alleviate symptoms. But more on this later.
Echinacea Contains the Following Ingredients
All three species contain similar bioactive ingredients. These include polyphenols, polysaccharides, chicoreic acid, and alkylamides. The latter, in particular, is considered to be immunomodulating and anti-inflammatory.
How Is Echinacea Extract Obtained?
Echinacea extract is produced by soaking the roots of “echinacea purpurea” in water or ethanol to dissolve the active ingredients. The liquid is then evaporated, leaving behind a highly concentrated extract. This is used to make tablets and drops.
Use and Effect
As already mentioned, the use of echinacea focuses primarily on strengthening the immune system. The plant is also often used to treat viral infections of the upper respiratory tract, primarily colds. Due to its immune-stimulating properties, the medicinal plant is used for flu-like infections, a general susceptibility to infections, and also for colds. Echinacea can also have healing effects when applied externally in the form of creams or ointments. Among other things, it is said that it can be used to treat skin conditions such as eczema and burns. It is also said to have a wound-healing and anti-inflammatory effect.
Also interesting: some proponents of the plant even attribute antioxidant properties to it, which are said to protect cells from damage caused by free radicals. In addition, the plant is even said to prevent cancer and other diseases.3
The Current State of Research
Even though echinacea is used as a herbal remedy to strengthen the immune system, there are several studies that have investigated the effects of the plant — with varying results.
Strengthening the Immune System
In a study conducted in 2024, the immune-boosting effect of “echinacea purpurea” was investigated in 80 adults. The participants received 200 milligrams of echinacea extract or a placebo every day for eight weeks. It was observed that the echinacea group showed increased activity of natural killer cells (NK cells) and higher levels of certain immune markers. However, there were no significant effects on cold symptoms or fatigue.4
No Clear Evidence for Echinacea for Colds
A comprehensive review from 2014 analyzed 24 randomized, controlled trials on the prevention and treatment of colds with echinacea. The studies evaluated different echinacea preparations and dosages. It was observed that taking echinacea did not significantly reduce the frequency of colds. However, almost all prevention studies indicated a slight preventive effect. In addition, some studies suggested that certain echinacea preparations could be more effective than a placebo, but the overall assessment was not convincing.5
Can Reduce the Risk of Recurrent Infections
A 2015 meta-analysis examined six studies with a total of 2458 participants to assess the impact of echinacea on recurrent respiratory infections. The results suggest that echinacea can significantly reduce the risk of recurrent infections.6
Echinacea Could Inhibit SARS-CoV-2
A 2021 study analyzed the effect of echinacea purpurea on SARS-CoV-2 variants, including the delta variant. The results showed that echinacea can inhibit virus uptake, suggesting a broad spectrum of antiviral activity.7
There are also indications that echinacea can have anxiety-relieving effects on the psyche. However, more studies are needed to scientifically prove these effects.8
Generally speaking, it can be said that the studies suggest that the plant may be able to prevent colds or alleviate their course — but there is a lack of clear scientific evidence.
Dosage and Administration: How Is Echinacea Used?
Echinacea can be taken in various forms, including tablets, drops, teas, and ointments. The dosage depends on the composition of the respective product. It is, therefore, advisable to follow the manufacturer’s instructions.
The recommended dosage of echinacea preparations varies depending on age and dosage form. Adolescents from the age of twelve and adults generally take 2.5 milliliters of the solution three times a day, which corresponds to an equivalent amount of two milliliters of pressed juice from fresh, flowering purple coneflower.9
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What Side Effects Can Echinacea Have?
As a rule, echinacea is well-tolerated and non-toxic to humans and animals. However, side effects such as stomach pain, nausea, headaches, dizziness, and allergic reactions in people who are allergic to composite plants can often occur.
Echinacea during pregnancy & breastfeeding
Important to note: Although echinacea can naturally support the immune system, its use during pregnancy and breastfeeding is not recommended. In addition, breastfeeding women should not apply echinacea ointments to the breast area. Sufficient safety studies for risk-free use are still lacking. The same applies to the use of echinacea by children under the age of twelve.10