Echinacea Is An Inexpensive Herb That Helps With Anxiety & Candida. So Why Aren't More People Taking It?

Photo: Nadine Greeff

The popularity of using echinacea for a variety of medicinal purposes continues to increase as quickly as the popularity of taking turmeric shots. Because no one likes to be sick, and if there are things that we can do to boost the immune system, why not do it? That’s how many Americans think, which explains why so many are seeking out echinacea forits reported immune-modulating benefits. This is especially the case when it comes to the prevention and treatment of upper respiratory tract infections. These reported immune benefits have catalyzed widespread use of this North American perennial for cold and flu protection, placing echinacea among the 10 top-sellers in the botanical space of the United States and other developed countries. The real question is whether this popularity is backed by strong scientific research or a smart marketing campaign.

Before we dive into the science behind the claims, it’s important to note that all echinacea is not created equal, as there are three different species, which each have their own unique properties. The species vary in chemical structure, and the properties depend on which part of the plant it comes from. The first species, Echinacea purpurea (E. purpurea) comes from the aerial parts—also classified as the upper part of the plant—whereas the other two species, Echinacea angustifolia (E. angustifolia) and Echinacea pallida (E. pallida), can be found in the roots.

There are certain properties that are found in all three species, such as that they all contain caffeic acid esters, polysaccharides, and polyacetylenes. But aside from that, research demonstrates that the phytochemical profile for each of the species varies dramatically. For example, the roots of echinacea have a higher concentration of various volatile oils compared to the aerial part of the plant. The top half of the plant, specifically E. purpurea, is particularly rich in flavonoids such as quercetin, isorhamnetin, and anthocyanins compared to the other two species. E. purpurea also appears to have a high concentration of polysaccharides, especially arabinogalactan, in addition to other amino acids such as serine, alanine, and hydroxyproline.

Photo: Valerie Loiseleux

What are the nutritional benefits of echinacea?

Echinacea for immune-boosting.

Echinacea is one of the most commonly purchased herbs, most often used to improve immunity and prevent or treat the common cold and other upper respiratory conditions. This flower has been used for hundreds of years with a large number of individuals who have found benefit from the use of echinacea for immune-system boosting.

There are some studies that back the idea of using echinacea to treat the common cold, including a 2007 meta-analysis that reported that echinacea is an effective treatment. The study reviewed the findings from 14 previous clinical trials that involved almost 3,000 patients and found that using echinacea reduced the risk of catching a cold by 58 percent and reduced the duration of the cold by 1.4 days. They also found that the use of echinacea was effective whether the individuals in the study were naturally exposed to viruses or whether they were inoculated with a virus during the study. In addition to demonstrating its effectiveness, the authors also highlighted the importance of identifying the species and preparation methods for echinacea.

The encouraging findings from the 2007 study were not replicated in a study on echinacea. A team of researchers from the University of Wisconsin–Madison School of Medicine and Public Health conducted a randomized controlled trial in 2010 to test the efficacy of this common cold treatment. The authors noted that much of the research published in the mid-1990s was manufacturer-sponsored and of moderate to poor quality. Their study included more than 700 people who had very early symptoms of a cold. These individuals were divided into four groups with the first two groups either getting no pills or knowingly taking echinacea. The other two groups were blind; one group unknowingly took echinacea while the other took a placebo. The results demonstrated that those who took echinacea experienced a half-day reduction in a weeklong cold. This translated to a 10 percent reduction in overall severity. While there appears to be progress in the right direction for echinacea users, the findings were not statistically significant compared with the placebo group.

Echinacea has continued to be a topic of interest among researchers. Another publication was released in 2014, and this time it was a large meta-analysis. The meta-analysis reviewed 24 randomized controlled trials that included almost 5,000 participants and 33 different echinacea preparations. The researchers included research studies aimed at both preventing a cold before its onset and treating after the cold initiated. The findings from the prevention studies found no benefit to incorporating echinacea before the development of an illness. However, when looking at research on treating colds with this herbal, the researchers concluded that echinacea might reduce the relative risk of catching a cold by 10 to 20 percent. The researchers noted that the effectiveness will vary greatly based on the species and the concentration in each echinacea preparation.

Photo: @imnature

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Echinacea as an antifungal.

We know that a healthy microbiome is composed of both bacteria and fungus, and echinacea may also play a role in regulating this. While there is a need for more research, echinacea has demonstrated in preliminary research to serve as a natural therapy for a type of fungus called Candida albicans. Everyone has candida in their intestines, but there are instances in which various strains of fungus overgrow in the intestines to unhealthy levels. The overgrowth of yeast can lead to other side effects that occur not just vaginally but systemically. Echinacea purpurea has been shown to lower levels of candida and prevent recurrent vaginal yeast infections.

Echinacea for anxiety relief.

The use of echinacea for treating anxiety is a new area of interest that has been evolving in recent years. Early animal trials demonstrated that rats given an echinacea preparation experienced a decrease in levels of anxiety. This has since been tested in healthy human volunteers who were given E. angustifolia extract for one week. The paper found that those who took two capsules of echinacea per day for one week experienced a decrease in anxiety scores within three days. The lower dose of one capsule per day did not affect anxiety significantly. While clearly more research is needed, the initial study is a good sign that using echinacea for anxiety might help (and certainly wouldn't hurt!).

How to choose what type of echinacea is best for you.

Recommendations for the use of echinacea are far from straightforward for two reasons. The first is because researchers have not been able to consistently demonstrate the benefits of echinacea. The second reason is due to the wide-ranging variables that affect the dose of echinacea. Echinacea products on the market differ greatly. The following variables can influence the effectiveness of this herbal flower and need to be monitored more closely in research and when purchasing:

  1. The species used: Echinacea purpurea, Echinacea pallida, and Echinacea angustifolia
  2. Plant parts used, whether that means using the root, herb, flower, or whole plant
  3. The concentration of echinacea, which is affected by the following processes: growing, drying, and storing the plant
  4. Various methods of extraction
  5. The form in which it is consumed: tinctures, tablets, teas, capsules, etc.

While research has not been able to confidently confirm whether one strain of echinacea is significantly better than another, Echinacea purpurea has performed well in studies focusing on cold symptoms. Echinacea purpurea may be more effective when in alcoholic extracts or pressed juices. Good results have also been seen with simply drinking the tea too; you can get a full guide to that here.

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How to use echinacea.

There are many popular ways to take echinacea, especially during cold and flu season or at the very onset of any cold or flu symptoms. It’s not uncommon for a person to drink 6 to 8 fluid ounces of echinacea tea up to four times per day. This may work best from a prevention standpoint. An additional way that people incorporate echinacea into their lives is in 6 to 9 mL of pressed juice daily. Herbal extracts or a solution of alcohol is another option, which typically involves 0.75 to 1.5 mL per day.

Photo: @Ls9907

Is echinacea safe?

Overall echinacea appears to have a good safety profile. The most common concern that has been identified with the use of echinacea includes allergic reactions to the botanical. While allergic reactions have occurred for some individuals, there are no known adverse effects that occur from general use. Researchers that examined the efficacy of echinacea in a randomized controlled trial also asked participants about any potential adverse effects that took place in the placebo groups compared to the intervention. The most frequently reported symptoms included gastrointestinal upsets and rashes, but there was no statistically significant association. The authors noted that they did not identify any consistent patterns in the two groups when it came to reported symptoms such as bad taste, diarrhea, headache, nausea, rash, and stomach upset.

The only additional safety concerns were reported in a retrospective observational review published in the American Journal of Ophthalmology. The authors reported that various herbal medicines and nutritional supplements can cause ocular side effects, including echinacea. The researcher evaluated 263 spontaneous reports from the National Registry of Drug-Induced Ocular Side Effects and 60 case reports in the literature. Herbals such as Ginkgo biloba, chamomile, licorice, echinacea, and others were associated with ocular side effects such as runny, irritated eye; vision loss; ocular migraines, etc. Topical use of E. purpurea has been associated with eye irritation and conjunctivitis. While this is not a common finding, there are reports of some individuals who have experienced these conditions from the use of echinacea.

When it comes to the safety of any herbal treatment, it’s also important to consider the risk of potential drug-nutrient interactions or the ability for the herbal to alter the metabolism of a number of medications. The general consensus on this drug-nutrient topic is that echinacea appears to pose minimal risks for interacting with conventional medications.

Generally, echinacea has very few side effects, although some people have experienced things like dizziness, rashes, and gastrointestinal issues. It's always good to start small and see how your body reacts before taking more!

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So, is echinacea a good supplement?

While the research does not consistently support the use of echinacea, there are many people who have reported benefits derived from this botanical for centuries. If this is something that seems to work well, especially for cold prevention and treatment, there is little harm in incorporating it into your routine. If this is something that you are interested in trying, there is, again, very little harm that would result, based on the good safety profile of echinacea. Just keep in mind that the foundation of your immune health should be driven by a nutrient-dense, whole foods diet because you can’t supplement your way out of a bad diet. The reality is that with a solid nutrition foundation, you are still at risk of getting sick, and something like echinacea might help give that extra immunity boost. When purchasing and using this botanical, just be sure to find out which part of the plant it’s coming from (plant or roots) and which species it includes: E. purpurea, e. angustofolia, or E. pallida.

Want to know even more about echinacea? Here's our guide to drinking it as a tea.

And are you ready to learn more about what anxiety, brain health, and your diet all have in common? Register now for our FREE Functional Nutrition Webinar with Dr. Mark Hyman.

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