Herbs & Spices · Immune herbs

Echinacea: Benefits, Uses, Tea and Dosage for Colds and Flu

What echinacea does for colds and flu, how it works in your body, which species and part to use, how much to take and when, how to make echinacea tea, and who should skip it.

By Dr. Josh Axe, DC, DNM, CNS·23-min read

Evidence-based42 sources citedUpdated November 12, 2026

Published Nov 12, 2026Last updated Nov 12, 2026Editorial policyMedical review policyFact-checking policy

Echinacea purpurea, the purple coneflower studied in cold prevention and flu trials.

The Dr. Axe Score™

7.6/10

Overall Dr. Axe Score · Echinacea

Echinacea scores 7.6 because Native American healers relied on it for infections and wounds, placebo-controlled trials link it to fewer colds and fewer repeat respiratory infections, an echinacea-elderberry drink did as well as an antiviral drug for the flu, and reported side effects in trials have been slightly less common than on the comparison treatments.

Scientific Evidence

6.6/10

Dozens of placebo-controlled trials; meta-analyses point to fewer colds and fewer repeat infections, and an echinacea-elderberry drink matched oseltamivir for the flu; trials of echinacea started after a cold begins disagree.

Traditional Medicine

8.6/10

Used by Native American healers for infections, wounds and snakebite long before it reached Europe, a cooling herb for the lungs in Western herbal tradition, and recognized by European regulators for colds.

Clinical Effectiveness

7.4/10

A defined role in my Top 50 Healing Herbs & Essential Oils protocol, in its cold and flu kit and dosed from the first symptoms, first on my list of prescriptions for the common cold, and backed by prevention and flu trials in people.

Safety

8.0/10

Reported side effects slightly less common than on the comparison treatments across 48 trials; deductions for rare allergic reactions, mostly in people allergic to the daisy family, and a rash in one children's trial.

Why this score?

Why Echinacea scores 7.6 / 10

Weighting: Evidence 30% · Traditional Medicine 25% · Clinical Effectiveness 25% · Safety 20% (6.6×0.30 + 8.6×0.25 + 7.4×0.25 + 8.0×0.20 = 1.98 + 2.15 + 1.85 + 1.60 = 7.58, shown as 7.6). Interactions are rated separately and don't change the score. How we score

A transparent, weighted index built for supplements. See how it’s calculated →

Interaction check: Moderate. Echinacea may work against medicines that suppress the immune system, and it can change how fast some medicines are cleared. Interactions are rated separately and don't change the score.

Immune-suppressing medicines, such as tacrolimus after a transplant: echinacea stimulates immunity and may work against these drugs, so ask the doctor managing your treatment before you take it.2

Medicines cleared by the liver enzyme CYP3A, such as midazolam: echinacea root changed how fast midazolam was cleared in one of two small studies, so ask your pharmacist whether your medicine is one of them.36 37

On this page

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Echinacea at a glance

Echinacea is the purple coneflower of the North American prairie, and it helps your immune system answer a cold or flu faster, above all when you start it at the very first sign. In a placebo-controlled trial of 755 adults, four winter months of echinacea meant about 21% fewer days with a cold.1 In Western herbal tradition it's a cooling herb for the lungs, best for hot, early infections.2

What it does: fewer colds, fewer repeat respiratory infections, and in a trial of 473 people with flu, an echinacea hot drink made with elderberry did as well as the antiviral drug oseltamivir3 4
How much: 300 to 600 mg of extract two to three times a day, or 2.5 mL of tincture three times a day, while you're sick5 2
How to use it: start on the first day of a scratchy throat or sniffles, and keep going through the days you're sick2
As a tea: 1 to 2 teaspoons of the dried herb steeped for 10 minutes, 2 to 3 cups a day2

Echinacea is the purple coneflower, a North American prairie herb whose flowers, leaves and roots are taken as a tea, tincture or extract to help your body fight off colds and flu. I use it at the first sign of illness rather than long-term, at 300 to 600 mg of extract two to three times a day while you're sick, because it activates the innate immune cells that make up your first line of defense.5 2

A scratchy throat or a tickle in your nose is the first sign that a virus has landed on the lining of your airways, and how fast your immune system answers over the next few days goes a long way toward deciding how hard that cold hits you. That's why echinacea works best taken at the very first sign.2 Getting to the root cause of a rough cold season means working on both halves: fighting a cold fast the moment it starts, and building your defenses before the season with good sleep, time outdoors, vitamin D and zinc.6 For longer-term immune strengthening, my top two herbs are astragalus and reishi.6

Native American healers used the purple coneflower for infections, wounds and snakebite long before it reached Europe, and today it's one of the best-selling immune herbs on earth.2 Researchers have now tested echinacea in dozens of placebo-controlled trials,7 8 and its strongest results match how those healers used it, against infection: fewer colds and fewer repeat respiratory infections.1 3

Echinacea has been shown to be good for sore throats. That's one I recommend.Dr. Josh Axe, DC, DNM, CNSFrom How to Prevent & Heal Cold & Flu Naturally (Foods, Supplements, & Herbs for Rapid Recovery), The Dr. Josh Axe Show (2024)

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How to take each one, how it works in your body, its traditional energetics and when to be careful
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Did you know?

Each medicinal species has its own common name: Echinacea purpurea is the purple coneflower, E. angustifolia the narrow-leaved coneflower and E. pallida the pale purple coneflower.9 10
In a 2009 lab study, a standardized echinacea extract inactivated bird flu and swine flu viruses in cell culture, at concentrations from the recommended oral dose down to far lower ones.11
European regulators recognize medicines made from purple coneflower herb for the common cold in adults and teens over 12.12

What is echinacea?

Quick answer

Echinacea is a group of North American coneflowers in the daisy family, and three species are used as medicine: Echinacea purpurea, E. angustifolia and E. pallida.9 The flowering tops, leaves and roots are made into teas, tinctures, capsules and throat sprays, and E. purpurea is the species in many cold and flu products and in the prevention and flu trials on this page.9 1 4

The coneflowers grow wild on the prairies of North America, with purple petals around a raised, spiny center.13 Each species and each part of the plant carries its own mix of active compounds, including alkylamides, caffeic acid derivatives such as cichoric acid and echinacoside, and polysaccharides, and no single compound explains what echinacea does, which is why the whole plant part matters more than any one marker.9 10

A short history of echinacea

Native American tribes used echinacea for mouth sores, colds and snakebite, and prairie peoples reached for its roots for painful conditions of all kinds.14 13 Like turmeric in the healing traditions of Southeast Asia, it's one of the time-tested remedies that cultures around the world have relied on for vitality, immunity and balance.5

The prairie where it grows is a living picture of Psalm 104:14: "He causeth the grass to grow for the cattle, and herb for the service of man: that he may bring forth food out of the earth."

What is echinacea good for?

Quick answer

Echinacea is good for colds and flu: in placebo-controlled trials it meant fewer colds over a winter and fewer repeat respiratory infections, and an echinacea hot drink with elderberry did as well as the antiviral drug oseltamivir for the flu.1 3 4 A sore throat or stuffy nose means your immune system is already fighting a virus at your front line, and echinacea backs up that first response.2

Echinacea benefits, graded by evidence (updated October 2026). Evidence labels are editorial judgments that compare these uses with each other; they aren't formal certainty ratings.
Use	Evidence	Product studied	What the research shows
Fewer colds	Good	Echinacea extracts, mostly E. purpurea	About 21% fewer days with a cold over four winter months in 755 adults1
Fewer repeat infections	Good	Standardized E. purpurea extracts	About 35% lower risk across 6 placebo-controlled trials of 2,458 people3
Shorter colds	Mixed	Extracts and teas started at the first symptoms	About 1.4 days shorter across 7 studies in a 2007 meta-analysis15
Flu	Moderate	Hot drink of E. purpurea with elderberry juice	Did as well as oseltamivir in 473 people with early flu4
Sore throat	Emerging	Echinacea and sage throat spray	Did as well as a medicated throat spray in 154 people16
Calmer mood	Emerging	Low-dose E. angustifolia root extract	Less anxiety in one placebo-controlled trial and better mood in another17 18
Skin	Emerging	E. purpurea creams and gels	Better hydration and fewer fine lines in 10 volunteers; calmer eczema with an alkylamide cream19 20
Pain and inflammation	Traditional	Echinacea roots	A traditional prairie remedy for painful conditions; eased inflammatory pain in mice13

What does echinacea do for the body?

Quick answer

Echinacea works in your body by waking up your immune system's first responders and keeping their response in balance. It activates macrophages and natural killer cells, calms excess inflammation through the CB2 receptor on immune cells, and in lab studies it deactivates viruses wrapped in a fatty coat, such as flu viruses.2 21 11

Think of the lining of your nose and throat as a guard post. The macrophages and natural killer cells stationed there are the guards who meet a virus first, and echinacea helps rouse them while keeping them from overreacting, so they do their job without flooding your airways with inflammation.2 In mice, daily echinacea in the diet raised the number of natural killer cells,22 and the steps below show how its compounds reach and tune your immune cells.

1Into your bloodstream fast

In 11 healthy adults, the alkylamides from an echinacea root extract reached their peak in the blood about 30 minutes after a single dose.23

2Immune cells get the message

In lab studies, those alkylamides bound the CB2 receptor of your endocannabinoid system more strongly than the body's own endocannabinoids, and they tuned the inflammatory messenger TNF-alpha in human immune cells.21 24

3The airway's alarm settles

In human airway cells infected with a cold virus, echinacea extract blocked the alarm signals IL-6 and IL-8, whether it was added before or after the infection.25

4Bacteria lose their foothold

In flu-infected airway cells, it turned down the surface receptors bacteria use to latch on, the setup for a secondary infection.26

5Fewer, milder infections

In people, that adds up to fewer days with a cold and fewer repeat respiratory infections.1 3

Those alarm signals are cytokines, the messengers that bring on the aches, swelling and congestion of a cold, and in lab studies echinacea helps keep them in proportion while your defenses work on the virus.25 All of this happens at your front line in the first hours of an infection, so echinacea works best when it's on board from the very first sign.2

Echinacea in traditional herbal medicine

I treat echinacea the way Native American and Western herbal tradition does: as a cooling herb with a pungent, bitter taste that goes to the lungs. It's best for hot, early infections: a sore throat, swollen glands, a fever, and the tingle on your tongue that tells you a cold is coming.2

Traditional Energetic Profile

Taste

Pungent and bitter

The flavor the tradition assigns it

Temperature

Cooling

Suits a cold that runs hot

Tissue affinity

Lungs

The nose, throat and airways

Best for

Hot, early infections

Sore throat, swollen glands and fever

Timing

The first sign

The day a cold starts, not a week in

Tradition

Native American and Western

Prairie healers and herbal medicine

That makes echinacea one of the cooling foods and herbs, the ones the tradition matches to a cold that comes on hot and fast.2

Echinacea benefits

Echinacea's best-studied benefits all involve your airways: fewer colds, fewer repeat infections, shorter colds when you start early, flu recovery on par with an antiviral drug when it's paired with elderberry, and a calmer sore throat. Its research on mood, skin and pain is younger and encouraging.

Fewer colds through the season

Good evidenceHuman studyPlacebo-controlled trial of 755 adults over 4 winter months; 2007 meta-analysis of 14 studies; 2014 Cochrane review of 24 trials; 2019 meta-analysis of placebo-controlled trials

Taken through cold season, echinacea helps you catch fewer colds, and the colds you do catch take up fewer days. At Cardiff University's Common Cold Centre, 755 healthy adults took an alcohol extract of fresh E. purpurea or a matching placebo for four winter months: 2,400 mg of extract a day, raised to 4,000 mg whenever they felt a cold coming on, and neither the people nor the researchers knew who got what. The echinacea group had 149 colds against 188 on placebo, and 672 days with a cold against 850, about 21% fewer, a drop in cold days too large to put down to chance. Like several trials on this page, it had authors from the product's maker.1

The pooled studies point the same way. A 2007 meta-analysis of 14 studies found 58% lower odds of catching a cold in the 9 studies that counted new colds, from a mix of products that included some combinations,15 and a 2019 meta-analysis of placebo-controlled trials found a 22% lower risk.27 The 2014 Cochrane review of 24 trials and 4,631 people kept to single-herb products, and when its prevention trials were pooled, they pointed to a 10% to 20% lower risk of a cold.7

Study takeaway: about 21% fewer days with a cold over four winter months.

Four winter months of echinacea: about 21% fewer days with a cold

Source: Jawad et al. · Evidence-Based Complementary and Alternative Medicine, 2012 [1]Total days with a cold in each group over the four months. The echinacea group also had fewer colds, 149 against 188.

Fewer repeat infections and complications

Good evidenceHuman study2015 meta-analysis of 6 placebo-controlled trials · 2,458 people; 2024 meta-analysis of 30 trials · 5,652 people; blinded trial of children 4 to 12 against vitamin C

If you catch one cold after another, echinacea helps break the cycle, and it lowers the odds that a cold turns into something more, such as an ear infection or pneumonia. A 2015 meta-analysis of 6 placebo-controlled trials with 2,458 people found about a 35% lower risk of repeat respiratory infections on echinacea, and in the 3 studies of people who were more prone to infections, through stress or weaker immunity, the risk was cut in half. Complications such as pneumonia, ear infections and tonsillitis were about half as common as well.3

In the Cardiff trial, people on echinacea had 65 repeat colds against 100 on placebo,1 and a 2024 meta-analysis of 30 trials with 5,652 people found about 70% fewer days on antibiotics, with alcohol extracts of fresh E. purpurea showing the largest drop.28

Children showed the same pattern. In a randomized, controlled trial in Switzerland, 103 children aged 4 to 12 took 400 mg tablets of fresh-plant E. purpurea three times a day and 98 took a small daily dose of vitamin C (50 mg three times a day), for two 2-month stretches. The echinacea group had 429 days with a cold against 602, needed 6 courses of antibiotics against 24, and had 11 complications against 30.29

Study takeaway: 6 courses of antibiotics against 24 for children on echinacea.

Children on echinacea needed 6 courses of antibiotics, against 24

Source: Ogal et al. · European Journal of Medical Research, 2021 [29]Antibiotic courses needed over the trial. The echinacea group also had 429 days with a cold, against 602.

Shorter colds when you start early

Mixed evidenceHuman study2007 meta-analysis of 14 studies; placebo-controlled tea trial of 95 adults; 2010 trial of 719 people; 2014 Cochrane review; induced-cold trial of 437 volunteers

Started at the first sign of a cold, echinacea can help it clear sooner. In the 2007 meta-analysis, the 7 studies that measured cold length found colds 1.4 days shorter on echinacea,15 and in a placebo-controlled trial of 95 adults with early cold or flu symptoms, people who drank an echinacea blend tea improved sooner and were sick for fewer days than those on a placebo tea.30

The trials that tested echinacea once a cold had started don't all agree. In a 2010 trial of 719 people in Wisconsin, echinacea root tablets trended toward a half-day shorter cold, 6.34 days against 6.87 on placebo, a difference too small to be sure of, and the Cochrane review found a clear effect on the length of a cold in 1 of its 7 treatment trials.31 7 In a trial that exposed 437 volunteers to a cold virus on purpose, E. angustifolia root, rather than the E. purpurea herb used in the prevention trials, made no difference in infection or symptoms.32 Results vary with the product and the timing, so start on the first day and, as the Cardiff volunteers did, take more during the days you feel a cold coming on.1

Flu recovery on par with an antiviral drug

Moderate evidenceHuman studyRandomized trial against oseltamivir · 473 people with flu symptoms for 48 hours or less; blinded trial of children 4 to 12

Echinacea helps you get over the flu, and in a head-to-head trial, an echinacea hot drink made with elderberry did as well as the antiviral drug oseltamivir. In the Czech Republic, 473 people ages 12 to 70 with flu symptoms for 48 hours or less took either a hot drink of E. purpurea extract with fresh elderberry juice added, 5 mL stirred into hot water five times a day for 3 days and then three times a day for 7 days, or oseltamivir for 5 days, each group with a dummy version of the other treatment so no one knew which was real.4 Among the 420 who completed it as planned, 90.1% had recovered by day 10, with symptoms gone or mild, against 84.8% on the drug, and the drink caused fewer side effects, especially nausea and vomiting.4

The drug got off to a faster start, with 4.1% recovered by the end of day 1 against 1.5% on the drink, and by day 5 the two were about even, at 50.2% on the drink and 48.8% on the drug. Complications ran 2.46% on the drink and 6.45% on the drug, a gap too small to be statistically certain.4 Since elderberry was in the drink, the result belongs to the pair, and that's how I take them when I feel something coming on.33 In the children's trial, flu was confirmed 3 times in the echinacea group against 20 times in the vitamin C group.29

Study takeaway: 90.1% recovered by day 10 on the echinacea drink, against 84.8% on oseltamivir.

Echinacea-elderberry drink vs. oseltamivir: share recovered

Source: Rauš et al. · Current Therapeutic Research, 2015 [4]Share of people recovered on each treatment at days 1, 5 and 10.

Soothes a sore throat

Emerging evidenceHuman studyRandomized trial against a chlorhexidine and lidocaine throat spray · 154 people 12 and older with an acute sore throat

An echinacea and sage spray calmed a raw throat as well as a standard medicated throat spray. In 11 Swiss general practices, 154 people 12 and older with a sore throat that had started within 3 days used either the echinacea-sage spray or a spray of chlorhexidine and lidocaine, 2 puffs every 2 hours up to 10 times a day for up to 5 days, each with a dummy version of the other. Among the 133 people analyzed per protocol, 63.8% on the echinacea-sage spray had cut their symptoms at least in half by day 3, against 57.8% on the medicated spray, and the time until they were free of symptoms was about the same.16

When you feel a sore throat coming on, I recommend making Manuka honey your only sweetener, taking high doses of propolis three times a day, and adding plenty of echinacea and thyme as an herbal tea.34 Our guide to sore throat remedies covers the rest of that routine, and a warm cup of the echinacea tea below is a soothing place to start.

Calmer mood support

Emerging evidenceHuman studyPlacebo-controlled trials of a low-dose E. angustifolia root extract · adults with high anxiety scores for 7 days; 108 adults with mild to moderate anxiety for 6 weeks

A low-dose extract of E. angustifolia root has eased anxiety and lifted mood in placebo-controlled trials. In Hungary, adults with high anxiety scores took 40 mg twice a day for 7 days, and their anxiety scores fell by about 11 points against about 3 on placebo, an improvement that held through 3 weeks off the extract.17 In a 6-week trial of 108 adults with mild to moderate anxiety, 20 or 40 mg twice a day didn't lower anxiety scores more than placebo, but mood and emotional well-being improved more than on placebo.18 These are small, specific doses of a root extract, quite different from a cold-season tincture, and they fit alongside the other natural remedies for anxiety that calm a stressed nervous system.

Skin hydration and calmer skin

Emerging evidenceHuman study10 healthy volunteers for 1 month, no comparison group; randomized trials of an alkylamide cream in eczema

Applied to your skin, echinacea creams and gels have improved hydration and smoothed fine lines, and an echinacea cream calmed eczema. In 10 healthy volunteers aged 25 to 40, an E. purpurea cream and gel used for a month raised skin hydration and reduced wrinkles by 9.47% with the cream and 14.92% with the gel, with no skin irritation, in a study that had no comparison group.19 A cream made with E. purpurea alkylamides calmed inflammation in skin cells, and in randomized trials it lowered eczema scores and raised the skin's protective ceramides by day 15.20 (Our guide to eczema treatment covers the rest of a calm-skin routine.) Native American healers used the plant on wounds as well, so its place on the skin goes back a long way.2

Pain and inflammation support

Traditional useTraditional useTraditional use by prairie peoples; root extracts in cell and mouse studies

Prairie peoples reached for echinacea root for painful conditions, and its root compounds act on the body's own pain-calming system.13 In cell studies, extracts of echinacea roots and their alkylamides acted on cannabinoid receptors, and in mice they reduced inflammatory pain.13

Echinacea root vs. flower: which part to use

Quick answer

Both the root and the flowering herb of echinacea are medicine, and they carry different mixes of compounds: E. purpurea is rich in cichoric acid, the roots of E. angustifolia and E. pallida are rich in echinacoside, and alkylamides matter in E. purpurea and E. angustifolia.9 For colds, choose E. purpurea herb with a little root, the preparation used in the large prevention and flu trials on this page.1 4

For colds and flu, the preparation to reach for is an alcohol extract of fresh E. purpurea, about 95% herb and 5% root, which is what the Cardiff winter trial and the flu trial both used,1 4 and in the 2024 meta-analysis, alcohol extracts of fresh E. purpurea showed the largest drop in antibiotic use.28 Echinacea root has its own uses: the alkylamides in the blood-level study came from an E. angustifolia root extract, the mood trials used a low-dose E. angustifolia root extract, and the root is what prairie peoples used for pain.23 17 18 13

Labels matter here, because some echinacea products haven't matched their stated species or quality standards when tested.9 Look for the Latin name and the part used, and choose an extract made from fresh E. purpurea herb, with or without some root, when your goal is fewer colds.

How to use echinacea

Quick answer

Use echinacea at the very first sign of a cold or flu, a scratchy throat, a tickle in your nose or a run-down feeling, and keep taking it through the days you're sick, as a tincture, capsules or tea.2 Through cold season, it can also be taken steadily to cut how often you get sick, the way the 4-month winter trial used it.2 1

If you wake up with a little bit of a sore throat, that's the day to start. Those first 3 days are the most important time to do everything you can, so take your elderberry and echinacea and start drinking ginger and thyme herbal tea.6 When I can tell I'm starting to fight something, I start taking my elderberry, echinacea and vitamin D right away, and the last time I did that, along with a nutrient IV, I hardly had any symptoms at all.33

Elderberry and echinacea both start with an E, and in clinical studies both shorten your overall cold and flu time.6 Echinacea tincture sits in my cold and flu kit next to elderberry syrup, eucalyptus oil for steam, oregano oil capsules and holy basil tea,2 and our guide to natural cold remedies lays out the rest of the plan, from chicken bone broth to rest.

Starting early matters most over the holidays, when houses fill up with family and guests and a cold can travel from one person to the next.

If you feel like a cold or flu is coming on, fight it fast. Do everything you can in the early stages. Or if people in your house are sick, go ahead and start doing those remedies right now.Dr. Josh Axe, DC, DNM, CNSFrom How to Prevent & Heal Cold & Flu Naturally (Foods, Supplements, & Herbs for Rapid Recovery), The Dr. Josh Axe Show (2024)

Markers to check before cold and flu season

Vitamin D and zinc are two foundations of a ready immune system, and a blood test shows where you're starting. Our guide on how to boost your immune system covers the rest.

Vitamin D (25-hydroxy): The form your body stores and the one a lab measures. The optimal range is 50 to 80 ng/mL.
Zinc: A serum zinc test is the lab measure for it.

See the cellular bloodwork panel

Have results? Analyze them free →

Echinacea dosage and forms

Quick answer

At the first symptoms, take 2.5 mL of echinacea tincture three times a day, 300 to 500 mg in capsules three times a day, or 2 to 3 cups of echinacea tea, and keep going through the days you're sick.2 For an extract, my range is 300 to 600 mg two to three times a day during an acute illness.5

Echinacea tops my list of prescriptions for the common cold, at 5 mL twice a day for 10 days.35 Each form has its own amount:

Tincture or drops: 2.5 mL three times a day at the first symptoms.2 The Cardiff volunteers took 0.9 mL three times a day, raised to five times a day during a cold, with each dose diluted in a little water and held in the mouth for 10 seconds before swallowing.1
Capsules or tablets: 300 to 500 mg three times a day for acute use.2 The children's trial used 400 mg tablets three times a day.29
Tea: 1 to 2 teaspoons of the dried herb steeped for 10 minutes, 2 to 3 cups a day; the recipe is below.2
Hot drink: the flu trial's drink was 5 mL of echinacea syrup with elderberry stirred into hot water, five times a day for 3 days and then three times a day for 7 days.4
Throat spray: in the sore throat trial, 2 puffs every 2 hours, up to 10 times a day for up to 5 days.16

Echinacea works best from the first sign of illness rather than long-term.5 For prevention, it can also be taken daily through cold season rather than all year round, and daily use has been studied for up to 4 months.2

Want help fitting echinacea into your routine?

Ask Dr. Axe AI. Answers are grounded in this library, with sources shown.

Echinacea tea benefits and how to make it

Echinacea tea gives you the herb in a simple, traditional form, warm and easy on a sore throat, and the warmth and steam soothe your airways while you sip. In the placebo-controlled trial of 95 adults with early cold or flu symptoms, people drank 5 to 6 cups of an echinacea blend tea on the first day, tapering to 1 cup over 5 days, and they recovered sooner than on a placebo tea; the tea blended echinacea with other herbs, so the result belongs to the blend.30 For everyday sick-day use, 2 to 3 cups a day is the amount I recommend.2

Like other herbal teas, it's easy to make your own from dried echinacea herb or root. Sweeten it with a teaspoon of raw local honey or Manuka honey once it has cooled enough to sip, and add a slice of fresh ginger or a sprig of thyme if you like, since both belong in a sick-day cup anyway.6

Recipe

Total15 minutes

Yield1 cup

Ingredients

1 to 2 teaspoons dried echinacea herb or root
1 cup just-boiled water
A slice of fresh ginger or a sprig of fresh thyme (optional)
A squeeze of lemon (optional)
1 teaspoon raw local honey or Manuka honey (optional)

Instructions

Put the echinacea, and the ginger or thyme if you're using it, in a mug or teapot.
Pour the just-boiled water over it, cover and steep for 10 minutes.
Strain into a mug and add the lemon.
Let it cool until it's comfortable to sip, then stir in the honey.
Drink 2 to 3 cups a day while you're sick.

Echinacea side effects, allergies and who should skip it

Echinacea is well tolerated. Across 48 trials with 10,115 people, reported side effects and other health problems were slightly less common on echinacea than on the comparison treatments, 22.7% against 24.8%, and serious events were rare in both groups, 0.09% against 0.08% of the events recorded.8 Stomach upset and rash are the most common complaints.14

Allergy to the daisy family. Echinacea belongs to the daisy family, along with ragweed, chrysanthemums and marigolds, and European regulators say it shouldn't be used by anyone allergic to plants in that family.12 Serious reactions are rare, and they cluster in people with other allergies: of 51 reports of reactions in Australia, 26 pointed to a possible allergic reaction, including 4 cases of anaphylaxis, and in 100 people with allergies who had never taken echinacea, 20% tested positive on a skin test.38 If you have a ragweed allergy, react to daisies or have a history of severe allergies or asthma, skip echinacea.

Autoimmune disease. Immune-stimulating supplements, echinacea among them, were followed by autoimmune flares in three documented cases.39 With autoimmune disease, ask your practitioner before you take it, and if you're working to calm an overactive immune system, our guide to leaky gut is a good place to start.

Pregnancy and breastfeeding. In a study of 206 women who took echinacea in pregnancy, 6 babies had major birth defects against 7 among 206 matched women who didn't, and a Norwegian study of 68,522 pregnancies, 363 of them with echinacea, found no rise in birth defects.40 41 Echinacea's alkylamides were found in one nursing mother's milk, and there are no safety data in nursing mothers or babies.10 During pregnancy and nursing, avoid most concentrated herbs unless your practitioner approves, and if you do use echinacea, confirm the dose with your OB.2

Children. In a placebo-controlled trial of 407 children aged 2 to 11, a rash appeared in 7.1% of the colds treated with echinacea against 2.7% on placebo.42 For a child, ask your practitioner first and choose an alcohol-free form.

When to stop or get care. Stop at any hives, swelling of your lips or face, or wheezing, and get care right away. A cold that lasts more than 10 days needs a doctor,12 and so does one that comes with trouble breathing or a high fever.

The bottom line

Should you take echinacea?

Yes, if you want a natural way through cold and flu season. Echinacea is the purple coneflower Native American healers relied on for infections and wounds, and in modern trials it meant fewer colds over a winter, fewer repeat respiratory infections and fewer antibiotics, while a hot drink of echinacea with elderberry did as well as an antiviral drug for the flu. It has also eased anxiety in a placebo-controlled trial and improved skin hydration.

Keep a bottle of tincture or capsules at home and start the day a cold begins: 300 to 600 mg of extract two to three times a day, or 2.5 mL of tincture three times a day, through the days you're sick, alongside elderberry, a cup of ginger and thyme tea and plenty of rest. Get your sleep, sunshine and vitamin D in place before the season, and let echinacea do its work at the first sign.

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Echinacea: frequently asked questions

What is echinacea good for?

Echinacea is good for colds and flu. In a placebo-controlled trial of 755 adults, four winter months on echinacea meant 672 days with a cold against 850, and a 2015 meta-analysis of 6 placebo-controlled trials found about a 35% lower risk of repeat respiratory infections.1 3 Smaller trials, including a randomized trial of 154 people with sore throats, also point to soothing a sore throat, calming anxiety and improving skin hydration.16 17 19

Does echinacea really work for colds?

Yes, it works best for preventing colds and for cutting them short when you start early. A 2007 meta-analysis of 14 studies found 58% lower odds of catching a cold in its 9 studies that counted new colds, and colds about 1.4 days shorter in its 7 studies of cold length.15 In a placebo-controlled trial of 755 adults, people on echinacea had about 21% fewer days with a cold over four winter months.1 For the best chance of a shorter cold, start it at the first sign.

Does echinacea help with the flu?

Yes. In a randomized trial of 473 people with flu symptoms for 48 hours or less, a hot drink of echinacea with elderberry juice did as well as the antiviral drug oseltamivir: among the 420 who completed it as planned, 90.1% had recovered by day 10, against 84.8% on the drug, with fewer side effects.4 Start it within the first day or two of symptoms.

How much echinacea should I take a day?

Take 300 to 600 mg of echinacea extract two to three times a day during an acute illness, or 2.5 mL of tincture three times a day from the first symptoms.5 2 For tea, steep 1 to 2 teaspoons of the dried herb for 10 minutes and drink 2 to 3 cups a day.2

Can you take echinacea every day?

I use echinacea at the first sign of illness rather than long-term, though through cold season it can also be taken daily.5 2 Daily use has been studied for up to 4 months, including a placebo-controlled trial of 755 adults over a winter, so take it through the season or on sick days rather than all year round.1

Can you take echinacea and elderberry together?

Yes, I take them together at the first sign of a cold or flu, and in clinical studies both shorten cold and flu time.6 33 In a randomized trial of 473 people with early flu, the two together in one hot drink did as well as the antiviral drug oseltamivir.4

What are the benefits of echinacea tea?

Echinacea tea is a soothing drink for a sore throat. In a placebo-controlled trial of 95 adults with early cold or flu symptoms, an echinacea blend tea, 5 to 6 cups on the first day tapering to 1 over 5 days, brought faster recovery than a placebo tea.30 Steep 1 to 2 teaspoons for 10 minutes and drink 2 to 3 cups a day while you're sick.2

Is echinacea good for men?

Yes, the benefits on this page apply to men: the adult cold and flu trials enrolled men and women together, including the 2010 trial of 719 people with colds, which was 64% women, and none reported a separate result for men.31 1 4

Is echinacea safe for kids?

In children's trials, echinacea was well tolerated overall, and the results on benefit were mixed. In a randomized trial of children aged 4 to 12, 103 on echinacea tablets and 98 on vitamin C, the echinacea group needed 6 courses of antibiotics against 24; in a placebo-controlled trial of 407 children aged 2 to 11, echinacea didn't shorten colds, side effects overall were no more common, though a rash appeared in 7.1% of treated colds against 2.7% on placebo.29 42 Choose an alcohol-free form, and the safety section covers the rest.

What are the side effects of echinacea?

Echinacea's side effects are usually mild and slightly less common than on the comparison treatments: across 48 trials with 10,115 people, 22.7% reported side effects or other health problems on echinacea against 24.8% on the comparison.8 Stomach upset and rash are the most common, and the rare serious reactions are allergic, mostly in people allergic to ragweed, daisies or other plants in the same family.14 38

Is echinacea safe during pregnancy?

Its safety in pregnancy isn't established, though two studies found no rise in birth defects, one of 206 women who took echinacea and one of 68,522 pregnancies that included 363 with echinacea.40 41 During pregnancy and nursing, avoid most concentrated herbs unless your practitioner approves, and confirm any echinacea dose with your OB.2

Does echinacea interact with medications?

Yes, echinacea's interaction check is Moderate. It stimulates immunity and may work against immune-suppressing medicines such as tacrolimus, and in a study of 12 adults it sped the clearance of midazolam given by vein; the safety section gives what to do for each.2 36

Can echinacea help with cancer?

In mice, daily echinacea in the diet raised natural killer cells and lengthened life in aging mice and in mice with leukemia, but it hasn't been tested as a cancer treatment in people.22 For cancer support, my approach leads with diet, exercise, prayer, high-dose vitamin C, hyperthermia and nutrients like vitamin D, and the free Cancer Support Protocol lays it out.

Freshness & update log

November 12, 2026 — Rewrote the page in full under Dr. Axe's byline. The previous version, whose title promised nine benefits "from Colds to Cancer," called Echinacea purpurea the pale purple coneflower (that's E. pallida), described a mouse study as National Institutes of Health brain cancer research and quoted a call to use echinacea in place of conventional therapy, cited a guinea pig study as a clinical study of asthma, cited a cervical HPV study for vaginal yeast infections, called the summary of a Cochrane review a separate meta-analysis, said doses above 20 mg cancel echinacea's effect on anxiety, gave a 10 mg per kilogram dose from a broken link, said the NIH advises daily use, listed side effects of injected echinacea, and listed laxative, uveitis, ADHD and serious infections such as malaria and tuberculosis among its uses without trials in people. This version keeps its cold and flu, recurring infection, pain, inflammation, skin and mental health uses, each at its evidence level with each study's design and size; keeps its uses and forms and dosage sections; corrects the flu trial to name the elderberry juice in the drink; keeps cancer as one question answered from the mouse research; adds Dr. Axe's own approach, doses and traditional energetics, how echinacea works in your body, which species and part to use, an echinacea tea recipe, a Dr. Axe Score (7.6) with an interaction check (Moderate), three charts and a step diagram; and puts the allergy, autoimmune, pregnancy and children's cautions in one safety section, with 42 references.

June 2, 2026 — Previous version updated.

September 8, 2023 — Previous version published.

References

Dr. Josh Axe, DC, DNM, CNS

Doctor of Natural Medicine · Founder, DrAxe.com

Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

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This article is for educational purposes. See our medical disclaimer.

On this page

What is it?
What is it good for?
How it works
Energetics
Benefits
Root vs. flower
How to use it
Dosage
Echinacea tea
Side effects
The bottom line
Should you take echinacea?
FAQ

Quick facts

What it isThe purple coneflower of the North American prairie: Echinacea purpurea, E. angustifolia and E. pallida
Best forFewer colds, shorter colds and recurring respiratory infections
Dr. Axe's dose300 to 600 mg of extract 2 to 3 times a day, from the first sign of a cold or flu
Other formsTincture (2.5 mL 3 times a day), capsules, tea and throat sprays
Traditional energeticsCooling, pungent and bitter; goes to the lungs; best for hot, early infections
Interaction checkModerate: immune-suppressing medicines; see the safety section

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