Nutritional Supplement

Echinacea

Side Effects

Echinacea is rarely associated with side effects when taken orally.51 There is one case report of acute hepatitis occurring in a person taking echinacea, but a cause-and-effect relationship was not proven.52 According to the German Commission E monograph, people should not take echinacea if they have an autoimmune illness, such as lupus, or other progressive diseases, such as tuberculosis, multiple sclerosis, or HIV infection. However, the concern about echinacea use for those with autoimmune illness is not based on clinical research and some herbalists question the potential connection. Those who are allergic to flowers of the daisy family should not take echinacea. Cases of allergic responses to echinacea (e.g., wheezing, skin rash, diarrhea) have been reported in medical literature.53 In the first study to look at echinacea’s possible effect on fetal development and pregnancy outcome, women taking echinacea during pregnancy were found to have no greater incidence of miscarriage or birth defects than women not taking the herb.54

Echinacea root contains approximately 20% inulin,55 a fiber widely distributed in fruits, vegetables, and plants. Inulin is classified as a food ingredient (not as an additive) and is considered safe to eat.56 In fact, inulin is a significant part of the daily diet of most of the world’s population.57 However, there is a report of a 39-year-old man having a life-threatening allergic reaction after consuming high amounts of inulin from multiple sources.58 Allergy to inulin in this individual was confirmed by laboratory tests. Such sensitivities are exceedingly rare. Moreover, this man did not take echinacea. Nevertheless, people with a confirmed sensitivity to inulin should avoid echinacea.

References

1. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997;35:229-35.

2. Leuttig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75.

3. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

4. Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of Echinacea pallida redix in upper respiratory tract infections. Comp Ther Med 1997;5:40-2.

5. Hoheisel O, Sandberg M, Bertram S, et al. Echinacea shortens the course of the common cold: a double-blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261-8.

6. Braunig B, Dorn M, Limburg E, et al. Echinacea purpurea radix for strengthening the immune response in flu-like infections. Z Phytother 1992;13:7-13 [in German].

7. Brikenborn RM, Shah DV, Degenring FH. Echinaforce® and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo-controlled, double-blind clinical trial. Phytomedicine 1999;6:1-5.

8. Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial. Arch Fam Med 1998;7:541-5.

9. Grimm W, Mueller HH. A randomized controlled clinical trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43.

10. Coeugniet E, Kuhnast R. Recurrent candidiasis. Adjuvant immunotherapy with different formulations of Echinacea. Therapiwoche 1986;36:3352-8 [in German].

11. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997;35:229-35.

12. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

13. Melchart D, Linde K, Worku F, et al. Results of five randomized studies on the immunomodulatory activity of preparations of echinacea. J Alt Compl Med 1995;1:145-60.

14. Braunig B, Dorn M, Limburg E, et al. Echinacea purpurea radix for strengthening the immune response in flu-like infections. Z Phytother 1992;13:7-13 [in German].

15. Beuscher N, Kopanski L. Stimulation of immunity by the contents of Baptisia tinctoria. Planta Med 1985;5:381-4.

16. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997;35:229-35.

17. Brown D. Echinacea root fails to prevent upper respiratory tract infections. Healthnotes Rev Compl Integr Med 1999;6:6-7 [review].

18. Hoheisel O, Sandberg M, Bertram S, et al. Echinagard treatment shortens the course of the common cold: A double-blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261-8.

19. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

20. Henneicke-von Zepelin H, Hentschel C, Schnitker J, et al. Efficacy and safety of a fixed combination phytomedicine in the treatment of the common cold (acute viral respiratory tract infection): results of a randomised, double blind, placebo controlled, multicentre study. Curr Med Res Opin 1999;15:214-27.

21. Turner RB, Bauer R, Woelkart K, et al. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med 2005;353:341-8.)

22. Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA 2003;290:2824-30.

23. Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers, 1997, 43-5.

24. Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of Echinacea pallidae radix in upper respiratory tract infections. Compl Ther Med 1997;5:40-2.

25. Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study. J Altern Comp Med 2000;6:327-34.

26. Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial. Arch Fam Med 1998;7:541-5.

27. Grimm W, Mueller HH. A randomized controlled clinical trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med 1999;106:138-43.

28. Brikenborn RM, Shah DV, Degenring FH. Echinaforce® and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo-controlled, double-blind clinical trial. Phytomedicine 1999;6:1-5.

29. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997;35:229-35.

30. Luettig B, Steinmuller C, Gifford GE, et al. Macrocytic activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669-75.

31. Elsasser-Beile U, Willenbacher W, Bartsch HH, et al. Cytokine production in leukocyte cultures during therapy with Echinacea extract. J Clin Lab Anal 1996;10:441-5.

32. Berman S, See DM, See JR, et al. Dramatic increase in immune mediated HIV killing activity induced by Echinacea angustifolia. Int Conf AIDS 1998;12:582 [abstract no. 32309].

33. Serfaty R, Itic J. Comparative trial with natural herbal mouthwash versus chlorhexidine in gingivitis. J Clin Dent 1988;1:A34-7.

34. Yamnkell S, Emling RC. Two-month evaluation of Parodontax dentifrice. J Clin Dentistry 1988;1:A41.

35. Serfaty R, Itic J. Comparative trial with natural herbal mouthwash versus chlorhexidine in gingivitis. J Clin Dent 1988;1:A34-7.

36. Yamnkell S, Emling RC. Two-month evaluation of Parodontax dentifrice. J Clin Dentistry 1988;1:A41.

37. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

38. Coeugniet EG, Kuhnast R. Recurrent candidiasis: adjuvant immunotherapy with different formulations of Echinacin®. Therapiewoche 1986;36:3352-8.

39. Hudson T. Women's Encyclopedia of Natural Medicine. Lincolnwood, IL: Keats, 1999, 54.

40. Coeugniet E, Kuhnast R. Recurrent candidiasis: Adjuvant immunotherapy with different formulations of Echinacin®. Therapiewoche 1986;36:3352-8.

41. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 213-4 [review].

42. Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers, 1997, 43-5.

43. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 213-4 [review].

44. Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers, 1997, 43-5.

45. Hobbs C. Echinacea: A literature review. HerbalGram 1994;30:33-48 [review].

46. Blumenthal M, Busse WR, Goldberg A, et al (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston: Integrative Medicine Communications, 1998, 122-3.

47. Hobbs C. Echinacea: A literature review. HerbalGram 1994;30:33-48 [review].

48. Blumenthal M, Busse WR, Goldberg A, et al (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston: Integrative Medicine Communications, 1998, 122-3.

49. Coeugniet EG, Kuhnast R. Recurrent candidiasis: adjuvant immunotherapy with different formulations of Echinacin®. Therapiewoche 1986;36:3352-8.

50. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 63-8.

51. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 121-3.

52. Kocaman O, Hulagu S, Senturk O. Echinacea-induced severe acute hepatitis with features of cholestatic autoimmune hepatitis. Eur J Intern Med 2008;19:148 [Letter].

53. Mullins RJ. Echinacea-associated anaphylaxis. Med J Austral 1998;168:170-1.

54. Gallo M, Sarkar M, Au W, et al. Pregnancy outcome following gestational exposure to echinacea. Arch Intern Med 2000;160:3141-3.

55. Duke, JA. Handbook of Phytochemical Constituents of GRAS Herbs and Other Economic Plants. Boca Raton, FL: CRC Press, 1992.

56. Carabin IG, Flamm WG. Evaluation of safety of inulin and oligofructose as dietary fiber. Regul Toxicol Pharmacol 1999;30:268-82 [review].

57. Coussement PA. Inulin and oligofructose: safe intakes and legal status. J Nutr 1999;129:1412S-7S [review].

58. Gay-Crosier F, Schreiber G, Hauser C. Anaphylaxis from inulin in vegetables and processed food. N Engl J Med 2000;342:1372 [letter].

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.