Does Echinacea Work for Colds? A Small Prevention Signal, Little Effect Once You Are Sick
Cochrane found no single prevention trial was significant, though pooling hinted at a 10% to 20% lower risk. Treatment trials mostly missed, and two of the more positive studies have ties to an echinacea maker.
By Kymata Health Editorial Published Last checked
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Key takeaways
From 9 sources- A Cochrane review of 24 double-blind trials (4,631 people) found none of 12 prevention comparisons significant on its own; post hoc pooling suggested a 10% to 20% relative risk reduction1.
- Only 1 of 7 treatment trials that measured cold length found echinacea shortened colds1.
- An NIH-funded trial of 719 people with new colds found a non-significant half-day difference in illness length3.
- A meta-analysis of 6 trials found fewer repeat infections (RR 0.65); one of its authors received consulting fees from echinacea maker Bioforce for reviewing the work27.
- In children aged 2 to 11, echinacea did not shorten colds and rash was more common (7.1% vs 2.7%)5.
What this article covers
1 evidence profileThe evidence, graded
Pulled from the trial tables in our evidence profiles. Grades follow our evidence-grading policy.
Graded findings
2 rows- CGrade CCommon coldsMixed None of 12 prevention comparisons was significant alone (post hoc pooling suggested a 10–20% relative reduction); only 1 of 7 treatment trials shortened colds.Echinacea · Systematic review · n=4,631 · 2014 · PMID 24554461
- CGrade CRepeat respiratory infectionsImproved Recurrent respiratory infections were less likely (RR 0.65) and complications such as pneumonia and ear infection were less frequent (RR 0.50).Echinacea · Meta-analysis · n=2,458 · 2015 · PMID 25784510
Where these trials agree: Echinacea and colds, counted row by row in the Consensus finder.
The short answer
Taking echinacea regularly may slightly lower the chance of catching a cold, but the effect is small and uncertain, and starting it once a cold begins does little in most trials14. NCCIH says it may slightly reduce your chances of catching a cold and that it is unclear whether it shortens one6.
Products differ a lot by species, plant part and extraction method, which is one reason trials disagree1.
Taking it to avoid colds
The 2014 Cochrane review included 24 double-blind trials with 4,631 participants and 33 comparisons1. Because preparations varied so much, the main analysis was not pooled; none of the 12 prevention comparisons reached significance alone, and a post hoc pooling suggested a 10% to 20% relative risk reduction1. The authors called the benefit possibly weak and of questionable clinical relevance1.
A 2019 meta-analysis found a risk ratio of 0.78 (95% CI 0.68 to 0.88) for getting an upper respiratory infection with echinacea, but said whether this is clinically meaningful is debatable4.
A 2015 meta-analysis selected 6 high-quality trials (2,458 participants) and reported fewer recurrent respiratory infections (RR 0.649) and fewer complications such as pneumonia and ear infections (RR 0.503)2. It used a fixed-effect model, which assumes the trials share one true effect2.
In a 4-month trial of 755 healthy adults, an alcohol extract of Echinacea purpurea was linked to 149 cold episodes vs 188 with placebo, and 672 vs 850 cumulative episode days; the authors reported the difference in episode days as statistically significant8. Adverse events were similar (293 vs 306)8.
Taking it once a cold starts
Of 7 treatment trials in the Cochrane review that reported cold duration, only 1 showed a significant benefit1. A 2019 meta-analysis found no effect on duration (mean difference -0.45 days, not significant)4.
An NIH-funded trial enrolled 719 people aged 12 to 80 with new colds3. Illness lasted 6.34 days on blinded echinacea vs 6.87 days on blinded placebo, a 0.53-day difference that was not significant (P = 0.075)3.
In 407 children aged 2 to 11, echinacea started at symptom onset did not change the duration or severity of 707 colds, and rash occurred in 7.1% of colds given echinacea vs 2.7% given placebo (P = .008)5.
Who paid for the research
The 2015 meta-analysis reported no funding, but one author received consulting fees from Bioforce, which makes Echinaforce, for reviewing the work27. The 755-person prevention trial tested Echinaforce, made by A. Vogel Bioforce, and its corresponding author used a Bioforce address8.
The 719-person treatment trial was funded by the US National Center for Complementary and Alternative Medicine3. In the Cochrane review, several authors had worked on included trials but did not extract or assess data from their own studies1.
Who should be careful
NCCIH says short-term use of Echinacea purpurea extracts is likely safe for most adults, with stomach pain and nausea the most common side effects6. Take extra care in these situations:
- People on drugs cleared by CYP3A or CYP1A2 enzymes: in 12 volunteers, 8 days of echinacea root (400 mg four times daily) raised the systemic clearance of the CYP3A probe midazolam by 34%, shifted its gut and liver handling in opposite directions, and slowed caffeine clearance; the authors urged caution9.
- People on immunosuppressants: NCCIH notes theoretical reasons to suspect an interaction, and conflicting evidence on some drugs processed by the liver6.
- People with allergies: NCCIH says allergic reactions to echinacea can be severe6.
- Children: in a pediatric trial, rash was more common with echinacea than placebo, and NCCIH advises talking with the child's health care provider first56.
- Pregnancy and breastfeeding: some studies suggest use for up to 7 days in the first trimester is possibly safe, and little is known about breastfeeding6.
Quick answers
Common questions
3 answersWhich echinacea was studied?
Many kinds; the Cochrane review notes products differ by species, plant part and extraction, and only 7 trials used Echinacea purpurea aerial parts1.
Does echinacea shorten a cold?
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Where to buy Echinacea
Products from brands we partner with that contain Echinacea. Check the amount per serving against the doses studied, and the label for other ingredients.
Echinacea products from partner brands
1 product Paid links · we earn a commission- Quick pickHerbsProNOW Foods Echinacea, 400 mg, 100 Veg Caps
2 veg capsules: 800 mg Echinacea purpurea root
$8.12one-timeChecked Oct 14, 2026
References
9 sources. Numbers in the text link here.
Sources cited in this article
9 sources- 1Echinacea for preventing and treating the common coldCochrane Database Syst Rev, 2014 · PMID 24554461
- 2Echinacea reduces the risk of recurrent respiratory tract infections and complications: a meta-analysis of randomized controlled trialsAdv Ther, 2015 · PMID 25784510
- 3Echinacea for treating the common cold: a randomized trialAnn Intern Med, 2010 · PMID 21173411
- 4Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysisComplement Ther Med, 2019 · PMID 31126553
- 5Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trialJAMA, 2003 · PMID 14657066
- 6Echinacea (Last Updated: November 2024)National Center for Complementary and Integrative Health (NCCIH), 2024
- 7Echinacea Reduces the Risk of Recurrent Respiratory Tract Infections and Complications (article page with funding and conflict-of-interest statements)Adv Ther (Springer), 2015
- 8Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled TrialEvid Based Complement Alternat Med, 2012 · PMID 23024696
- 9The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivoClin Pharmacol Ther, 2004 · PMID 14749695
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