Echinacea: Benefits, Dosage, Contraindications
Other name(s)
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Scientific name(s)
Echinacea angustifolia, Echinacea purpurea, Brauneria angustifolia, Echinacea pallida
Family or group:
Plants
Active ingredients:
Echinacoside
Cichoric Acid
Caffeic Acid
Alkylamides
Cynarine
Indications
Rating methodology
EFSA approval.
Immune Boosting ✪✪✪✪✪
Echinacea has an immunostimulant action. Its effect on the immune system has been verified in vitro and in vivo. In a randomized, double-blind, placebo-controlled trial, the total number of (cold) daily symptoms was lower with echinacea than with a placebo, and the difference was statistically significant after the third day. An increase in the total number of leukocytes, monocytes, and neutrophils, but not lymphocytes, was also observed, as well as an increase in the respiratory burst capacity of neutrophils, while a decrease in erythrocyte superoxide dismutase units was observed during echinacea treatment.
Posologie
Oral: root, aerial parts
1500 - 2400 mg
1 - month
Adults
standardized extract, dry extract
A comparison of the immunostimulatory effects of the medicinal herbs Echinacea, Ashwagandha and Brahmi.
Applications of the phytomedicine Echinacea purpurea (Purple Coneflower) in infectious diseases.
Medicinal Properties of Echinacea: A Critical Review
Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells.
A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold.
Enhancement of Innate and Adaptive Immune Functions by Multiple Echinacea Species
Common Cold ✪✪✪✪✪
The reduction of ENT infection rates observed with daily echinacea supplementation appears very effective in some cases but is subject to a high degree of variability. Meta-analyses show a modest reduction in the risk of developing a cold when taking different echinacea products. A large clinical study conducted with Echinaforce (A. Vogel) shows that adults taking 0.9 ml three times a day (providing 2,400 mg of echinacea per day) for 4 months, or 0.9 ml five times a day (4 g of echinacea per day) at the first sign of a cold, have fewer episodes and shorter duration of cold than those taking a placebo. Overall, the data confirm a weak to moderate efficacy. The EMA indicates echinacea as a herbal medicine for the prevention and short-term treatment of the common cold.
Posologie
Oral use: root, aerial parts
900 - 4000 mg
4 - months
standardized extract, dry extract
Echinacea purpurea for prevention of experimental rhinovirus colds.
Randomised, double blind, placebo-controlled trial of echinacea supplementation in air travellers.
Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis.
Echinacea in the prevention of induced rhinovirus colds: a meta-analysis.
Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections.
Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled Trial.
Echinacea for preventing and treating the common cold.
Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trial.
Echinacea purpurea and mucosal immunity
European Union herbal monograph on Echinacea purpurea (L.) Moench, radix
Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial.
An evaluation of Echinacea angustifolia in experimental rhinovirus infections.
A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections.
Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis
Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial.
Ineffectiveness of echinacea for prevention of experimental rhinovirus colds.
Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial.
Respiratory Infections, Flu ✪✪✪✪✪
Echinacea may exhibit antiviral activity against the influenza virus, rhinoviruses, and herpes simplex viruses (HSV-1 and HSV-2). Preliminary research using viruses from nasal secretions suggests that Echinacea purpurea could inhibit enveloped viruses such as coronaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial viruses, and metapneumoviruses. Clinically, a recent Cochrane systematic review analysis indicates that echinacea's efficacy could be superior to placebo in reducing the incidence of flu, suggesting its potential utility as a preventive intervention. Another large study conducted on adults with respiratory infections shows that daily intake for 5 days of a combination containing 1100 to 2200 mg of echinacea, zinc, and vitamin C reduces recovery time, though without a major effect on symptom severity compared to placebo.
Posologie
Oral use: root, aerial parts
900 - 2200 mg
5 - days
Adults, Children
standardized extract, dry extract
Synergies
Use of a Standardized Extract From Echinacea Angustifolia (Polinacea) for the Prevention of Respiratory Tract Infections
Interventions for preventing influenza: An overview of Cochrane systematic reviews and a Bayesian network meta-analysis
Echinacea Purpurea For the Long-Term Prevention of Viral Respiratory Tract Infections During Covid-19 Pandemic: A Randomized, Open, Controlled, Exploratory Clinical Study
Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial
European Union herbal monograph on Echinacea purpurea (L.) Moench, herba recens
Pharyngitis ✪✪✪✪✪
Thanks to its antiviral and antibacterial action, echinacea can be used in cases of pharyngitis and even bronchitis. An observational study examined the efficacy of an Echinacea and Sage lozenge in treating pharyngitis. The study showed a significant reduction in viral load and symptoms, such as throat pain. However, there was no control group, which limits the validity of these results. The Echinacea/Sage lozenge contained 800 mg of hydro-ethanolic extract of Echinacea purpurea (95% aerial parts and 5% root, Echinaforce®) and 378.5 mg of hydro-ethanolic extract of Salvia officinalis leaves (drug extraction ratio 1:17).
Posologie
Oral use: root, aerial parts
4000 mg
1 - days
standardized extract, dry extract
Synergies
Reduction of Viral Load in Patients with Acute Sore Throats: Results from an Observational Clinical Trial with Echinacea/Sage Lozenges
European Union herbal monograph on Echinacea purpurea (L.) Moench, herba recens
Urinary Infections ✪✪✪✪✪
Thanks to its immunostimulant and antibacterial properties, echinacea is indicated for cystitis. ESCOP indicates it as an adjunctive and preventive therapy for recurrent urogenital tract infections.
Posologie
Oral use: root, aerial parts
1500 - 2400 mg
standardized extract, dry extract
Gingivitis ✪✪✪✪✪
Preliminary clinical research shows that using a mouthwash containing echinacea, gotu kola, and elderberry 15 ml three times a day for 14 days might prevent the exacerbation of gingivitis compared to a placebo mouthwash, but it only yields minimal symptom improvement. The application of a periodontal patch containing echinacea, gotu kola, and elderberry, either in a single dose or three times a day for 1 day then once a day for 2 days, seems to reduce some measures of inflammation and gingivitis at certain times, but the effects lack consistency.
Posologie
Oral use: root, aerial parts
1500 - 2400 mg
14 - days
standardized extract, dry extract
Synergies
Localized Reduction of Gingival Inflammation Using Site-Specific Therapy With a Topical Gingival Patch
A Phase II Trial of a Transmucosal Herbal Patch for the Treatment of Gingivitis
Vaginal Infections ✪✪✪✪✪
Clinical results on the prevention of urogenital infections (fungal infections, candidiasis, herpes) in women seem mixed, despite promising laboratory results. A double-blind, placebo-controlled trial conducted over one year studied the effects of a plant and root extract of E. purpurea (Echinaforce 800 mg twice a day) on the incidence and severity of genital herpes outbreaks in 50 patients. The study did not reveal a statistically significant benefit compared to placebo after 6 months of treatment.
Posologie
Oral use: root, aerial parts
1600 - 2400 mg
standardized extract, dry extract
Echinacea purpurea polysaccharide reduces the latency rate in herpes simplex virus type-1 infections
The Recurrent Vulvovaginal Candidiasis: Proposal of a Personalized Therapeutic Protocol
Does the extract of the plant Echinacea purpurea influence the clinical course of recurrent genital herpes?
Skin Healing ✪✪✪✪✪
On wounds, echinacea extracts seem to act by inhibiting bacterial proliferation and promoting healing by stimulating collagen synthesis. The EMA recognizes echinacea as a traditional herbal medicine for treating minor superficial wounds as well as relieving spots and pimples due to mild acne. Commission E approves the external use of E. purpurea herb for poorly healing wounds and chronic ulcers.
Posologie
Topical application: root, aerial parts
1500 - 2400 mg
standardized extract, dry extract
Properties
Immunostimulant
The immunostimulant properties of echinacea seem to target both non-specific and specific immune function. The non-specific effects include increased macrophage proliferation and phagocytosis, as well as the secretion of beta-2 interferon, tumor necrosis factor (TNF), and interleukin-1 (IL-1). Constituents of echinacea believed to be involved in stimulating non-specific immune responses include high molecular weight polysaccharides like heteroxylan and arabinogalactan, and lower molecular weight compounds like alkylamides, chicoric acid, and echinacosides. Specific immune responses include the activation of other components of the complement pathway and increased levels and activity of T lymphocytes, neutrophils, and natural killer cells (NK). These effects may be due to the polysaccharides present in echinacea.
Usages associés
Antiviral
Echinacea may have antiviral activity against the influenza virus, vesicular stomatitis virus, and herpes simplex viruses (HSV-1 and HSV-2). Preliminary research using viruses from nasal secretions suggests that Echinacea purpurea could inhibit envelope viruses such as corona, flu, parainfluenza, respiratory syncytial, and metapneumoviruses. Echinacea strengthens resistance to upper airway infections by rhinoviruses. It also improves resistance during the treatment of skin wart infections. Caffeic acid and chicoric acid possess antiviral activity in vitro (lasting 24 to 48 hours).
Usages associés
Antibacterial
Echinacoside has a dose-dependent antibacterial inhibitory action in vitro on the growth of certain germs. This activity is more specific to Staphylococcus aureus, Streptococcus pyogenes, colibacillus, and the acne pathogen Propionibacterium acnes. Anti-adhesion activity to intestinal cells has also been observed with the Campylobacter jejuni pathogen responsible for diarrhea.
Usages associés
The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation
Investigations into the antiadhesive activity of herbal extracts against Campylobacter jejuni
Antifungal
Activity has been demonstrated on Candida albicans. It is supported by clinical results, particularly on the prevention of female urogenital infections. Echinacea's polyacetylenic compounds, including ketoalkenes and ketoalkynes, seem responsible for the antifungal activity, notably against the yeast Candida, including Candida albicans.
Usages associés
The Recurrent Vulvovaginal Candidiasis: Proposal of a Personalized Therapeutic Protocol
Polysaccharides isolated from plant cell cultures of Echinacea purpurea enhance the resistance of immunosuppressed mice against systemic infections with Candida albicans and Listeria monocytogenes
Anti-inflammatory
Studies on echinacea have revealed that alcohol extracts from the three species (E. angustifolia, E. purpurea, and E. pallida) possess anti-inflammatory properties. The active compounds responsible are: - Alkamides: inhibit the iNOS enzyme, which plays a role in nitric oxide production, a mediator of inflammation. - Caffeic Acid: increases the activity of arginase, an enzyme that helps reduce inflammation. - Alkylamides from E. Purpurea roots: partially inhibit COX-1 and COX-2 enzymes, which are involved in the production of prostaglandins, compounds contributing to inflammation and pain.
Endogenous levels of Echinacea alkylamides and ketones are important contributors to the inhibition of prostaglandin E2 and nitric oxide production in cultured macrophages
Healing
Research on animals suggests that echinacea extracts may accelerate wound healing, improve epithelialization, and reduce inflammation. The component echinacoside appears to protect type III collagen from damage caused by free radicals, and may have activity against bacterial hyaluronidase, which is necessary for bacteria to spread through the skin and mucous membranes. Several uncontrolled clinical studies support the topical use of echinacea to improve wound healing. A trial involving 4598 individuals studied the effects of a preparation made from the juice of E. purpurea aerial parts on various wounds, burns, skin infections, and inflammatory skin conditions. The topical application of echinacea produced an overall success rate of 85%, and the main component responsible for improving wound healing appears to be echinacoside as highlighted above.
Usages associés
Safety dosage
Adult from 18 years: 900 mg - 4000 mg (powder)
The recommended daily dose for an adult is 900 mg (equivalent to crude material). In studies, doses up to 4 g per day have been used. As a dry extract: 360 mg/day As a mother tincture (MT): 15 to 30 drops, 3 times a day.
Child from 4 to 18 years: 900 mL - 2000 mL (powder)
Dosage according to laboratory, up to 2 g equivalent fresh plant per day in acute phase. In MT (mother tincture) from 12 years: 1 drop/Kg/day, in three doses.
Interactions
Médicaments
Cyclophosphamide: moderate interaction
Echinacea seems to increase the immunostimulating effect of low-dose cyclophosphamide, which may impact autoimmune diseases.
Cyclosporine: moderate interaction
Echinacea might inhibit the effect of cyclosporine.
Immunosuppressant: moderate interaction
Theoretically, echinacea may interfere with immunosuppressive treatment due to its immunostimulant activity. Immunosuppressive drugs include azathioprine, basiliximab, cyclosporine, daclizumab, muromonab-CD3, mycophenolate, tacrolimus, sirolimus, prednisone, and other corticosteroids.
Plantes ou autres actifs
Echinacea: moderate interaction
Echinacea seems to increase plasma concentrations of caffeine by 30%. This is likely due to the inhibition of cytochrome P450 1A2 (CYP1A2) by echinacea.
Precautions
Pregnant woman: use with caution
There is preliminary evidence that mothers can safely use echinacea (Echinacea purpurea or Echinacea angustifolia), from 250 mg to 1000 mg per day, or tinctures, up to 30 drops per day for 5 to 7 days during the first trimester of pregnancy without harming the fetus. Pregnant women are advised to remain cautious and seek advice from their doctor.
Breastfeeding woman: use with caution
No available data.
Autoimmune diseases: use with caution
Echinacea seems to stimulate immune function. Theoretically, echinacea could exacerbate autoimmune diseases by stimulating disease activity. Use with caution in individuals with autoimmune diseases such as multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis, or others, to avoid or use echinacea with caution.
Atopy: avoid
Individuals with atopy (a genetic tendency for allergic conditions) may be more likely to have an allergic reaction when taking echinacea. Case reports describe several cases of allergic reactions to echinacea consistent with IgE-mediated hypersensitivity. 34% of reactions were observed in patients with atopy.
Hemochromatosis: use with caution
In the case of hemochromatosis, echinacea intake should be monitored.
