Echinacea Flu Question

October 13, 2010 Written by JP    [Font too small?]

When cold and flu season arrives each year, so do questions pertaining to natural means of defending against it. Just the other day I was asked about using echinacea to fend off influenza and/or help speed its departure. Thankfully, each year there’s additional research to factor in when coming up with an answer.

According to a recent publication in the journal Preventive Medicine, patients who regularly use alternative and complementary medicine are significantly less likely (-32%) to receive flu shots. However, there were certain limitations to the research in question. The definition of “alternative and complementary medicine” was narrowly translated to those who received chiropractic care. In addition, a study pool of only 27,000 US citizens was used to come to this conclusion. Still, I have a hunch that these figures aren’t too far off the mark based on my own experience dealing with large segments of the natural health community. (1)

The exact statistics are less important than the realization that some segments of the population will choose not to have a flu shot year after year. This same group is more likely to resort to natural alternatives to anti-viral medications. With this knowledge in mind, I’d like offer the best possible information I currently have on echinacea and influenza. (2)

  • Ironically, the latest study on echinacea and its impact on influenza infection appears in the journal Vaccine. It’s a trial that was conducted in mice which shows that an Echinacea purpurea extract, rich in polysaccharides, reduced flu-related weight loss and inflammatory markers. The authors of the experiment concluded that, “E. purpurea alters the clinical course of influenza infection in mice through modulation of cytokines and not direct antiviral activity”. (3)
  • Pro-inflammatory cytokines are also the focus of another recent study conducted on echinacea. An in-vitro examination deemed that a standardized extract (Echinaforce) has the potential of alleviating “cold and flu symptoms and, possibly, other respiratory disorders by inhibiting viral growth and the secretion of pro-inflammatory cytokines”. These findings are backed by a previously published experiment using the exact same extract. (4,5)

You may be wondering why one study found direct anti-viral activity and another did not. Variations in the phytochemical composition and concentration of the respective echinacea extracts could be responsible for this noted difference. Echinacea is composed of a great many active ingredients including alkylamides, cichoric acid and polysaccharides. How echinacea is extracted and grown are but two considerations that can affect the end product. (6)

Echinacea Extract Combats Influenza Strains Under Experimental Conditions
Source: Virology Journal 2009, 6:197 (link)

Animal and test tube studies only go so far. What most consumers and physicians want to know is whether a natural remedy will have a positive effect in a real world setting. The closest thing we currently have to an answer comes in the form of a trial published in August 2000. Researchers from York College of Pennsylvania enrolled 95 men and women with “early symptoms of cold or flu” in an experiment which provided: a) an echinacea-based tea (Echinacea Plus) or b) a placebo tea. Questionnaires quantified symptoms such as fever, runny nose and scratchy throat for 14 days after beginning each tea regimen. The participants who received Echinacea Plus reported faster relief of symptoms than those consuming the placebo tea. (7)

At the moment, there isn’t a strong scientific case to be made for using echinacea to prevent or shorten the duration of influenza. The primary reason this herbal remedy is recommended for this purpose is because of its noted ability to support the immune system. In my opinion, this is reason enough to consider using it on an “as needed” basis – especially if you’ve found positive results with echinacea in the past. In closing, I’d like to offer my best advice about how to get the most out of echinacea should you decide to use it: Opt for a clinically validated supplement such as Echinaforce, Echinacea Plus or Echinamide. Make sure to use said supplements as directed. In the case of Echinacea Plus tea, this may mean drinking up to six cups daily. Only use echinacea when your defenses are compromised or when you’re trying to overcome an infection. Finally, please consult with a qualified medical professional if you have a pre-existing disease, are uncertain about what condition you may have or the appropriateness of combining echinacea with conventional drugs. The last thing you need is to confuse influenza for a pneumonia or find yourself suffering from a drug-supplement interaction. (8,9,10,11,12,13,14,15,16,17)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Alternative Therapies, General Health, Nutritional Supplements

10 Comments & Updates to “Echinacea Flu Question”

  1. CW Says:

    I’ve used echinacea supplements, when I had a cold but I never felt like it was helping in any meaningful way. Never tried it with the flu, however.

    The history of echinacea as a treatment for anything is interesting (

    I think I’ll stick with the flu shot. It’s not just for me, but I’m around elderly folks and infants – and don’t want them to get sick.

  2. JP Says:

    Thank you, CW. Interesting.

    Be well!


  3. Pat Says:

    I have never had a flu shot and haven’t had the flu for over 20 years. If/when I feel something coming on, I start drinking echinacea tea and taking the capsules (so I don’t have to drink as many cups!). My symptoms subside in two to three days. It may be all in my head, but if it is, I’m happy with that. šŸ™‚

  4. JP Says:

    Thank you, Pat. I appreciate your input. šŸ™‚

    Be well!


  5. Amanda Says:

    CW – Not all Echinacea products are created equal. I work for Standard Process and we distribute MediHerb herbal supplements from Australia. The founder, head of R&D, & practicing herbalist Kerry Bone has created a specific formula called Echinacea Premium which contains the extracts from the correct plant parts – the roots of Echinacea angustifolia & Echinacea purpurea. Research shows that only products that contain specific amounts of the active ingredients are truly effective in supporting the immune system properly. These products are available through health care professionals only. You can visit or for additional info.
    I would encourage you to not give up on Echinacea, but try the “real” Echinacea!

  6. Anonymous Says:

    This is really interesting because usually Echinacea is tied together with the COLD not really the flu. Thanks for sharing šŸ™‚

  7. JP Says:

    Update 05/18/15:

    Wien Med Wochenschr. 2013 Feb;163(3-4):102-5.

    Efficacy and safety of EchinaforceĀ® in respiratory tract infections.

    EchinaforceĀ® is the standardised extract of Echinacea purpurea from Bioforce, Switzerland. Recent studies show immunomodulation and broad antiviral effects against respiratory tract viruses. Haemagglutinin and Neuraminidase are blocked. In contrast to Oseltamivir no resistance is caused by EchinaforceĀ®. A randomised, double-blind, placebo-controlled study over four months confirms that EchinaforceĀ® supports the immune resistance and acts directly against a series of viruses. EchinaforceĀ® is efficacious and safe in respiratory tract infections for long-term and short-term prevention as well as for acute treatment.

    Be well!


  8. JP Says:

    Update 05/18/15:

    Altern Med Rev. 2012 Mar;17(1):36-41.

    Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections.

    Echinacea preparations are extensively used for the prevention and the management of the common cold. Despite this popularity, the clinical studies on Echinacea have produced mixed results, possibly in part because of the poor characterization of the extracts investigated and the use of different species and/or plant parts for the preparations investigated in the various trials. To address this issue, Polinacea, a highly standardized extract from a well-defined botanical source (roots of Echinacea angustifolia) with a specific phytochemical profile (presence of the complex polysaccharide IDN5405, the phenylethanoid echinacoside, and substantial lack of alkamides) was developed. We have studied whether Polinacea could enhance the immune response subsequent to the influenza vaccination, and whether the use of this preparation could translate into a decreased morbidity from influenza. The preliminary results were encouraging, and suggest that Polinacea could be used for improving the immune response to influenza vaccine.

    Be well!


  9. JP Says:

    Update 05/18/15:

    Phytomedicine. 2014 Sep 25;21(11):1406-10.

    Immunomodulation mediated by a herbal syrup containing a standardized Echinacea root extract: a pilot study in healthy human subjects on cytokine gene expression.

    In this study, the immunomodulatory effect of a triply standardized Echinacea angustifolia root extract (Polinacea(Ā®)) was evaluated in 10 healthy subjects. Ten ml of syrup containing one hundred mg of extract (corresponding to 4.7 mg of Echinacoside and 8.0mg of a high molecular weight-20,000 Da- polysaccharide) were administered as a herbal syrup once a day for one month. The immunomodulatory effect was evaluated before and after herbal syrup administration evaluating the expression levels of the cytokines IL-2, IL-8, IL-6 and TNF-Ī±. Cytokine expression was studied in lympho-monocytes and in plasma samples measuring the mRNA and protein levels, respectively. The results were analysed by ANOVA and non-parametric Friedman rank sum tests; when possible it was adopted a pair-wise comparisons at different post-treatment times, using the paired t-tests with Holm correction. The correlation between the variations of cytokine plasma levels and the respective mRNA was carried out using a linear regression model. In lympho-monocytes our data indicate the up-regulation of the mRNA levels of IL-2 and IL-8 and the down regulation of the mRNA levels of the pro-inflammatory cytokines TNF-Ī± and IL6. The differential regulation was maximal after 14 days of treatment. IL-2 up-regulation and IL-6 down-regulation were also confirmed at the protein level in plasma. Finally, the up-regulation of the mRNA of IL-2/IL-8 and the down-regulation of IL-6 positively correlated with the protein levels detected in the plasma. In conclusion, this pilot study suggests a relevant role for the standardized Echinacea angustifolia root extract in the control of cytokine expression. This first demonstration of the immuno-modulating activity of Echinacea angustifolia root extract in the healthy subject, supports at least in part the common use of such products as health promoting supplement.

    Be well!


  10. JP Says:

    Update 05/18/15:

    Current Therapeutic Research – Available online 20 April 2015

    Echinaforce Hotdrink versus Oseltamivir in Influenza: A randomized, double-blind, double dummy, multicenter, non-inferiority clinical trial

    Background: Echinacea has antiviral activity against influenza viruses in vitro. This randomized, double-blind, double-dummy, multicenter, controlled clinical trial compared a new Echinacea formulation with the neuraminidase inhibitor Oseltamivir, the gold standard treatment of influenza.

    Methods: Following informed consent, 473 patients with early influenza symptoms (ā‰¤48h) were recruited in primary care in the Czech Republic and randomized to either 5 days Oseltamivir followed by 5 days placebo, or 10 days Echinaforce Hotdrink. The proportion of recovered patients (influenza symptoms rated as absent or mild in the evening) was analyzed for non-inferiority between treatment groups using a generalized Wilcoxon test with significance level Ī± = 0.05 (two-sided) and using a confidence interval (CI) approach in the per protocol sample.

    Results: Recovery from illness was comparable in the two treatment groups at 1.5% vs. 4.1% after 1 day, 50.2% vs. 48.8% after 5 days and 90.1% vs. 84.8% after 10 days treatment with Echinaforce Hotdrink and Oseltamivir, respectively. Non-inferiority was demonstrated for each day and overall (95% CI [0.487 ā€“ 0.5265], generalized Wilcoxon test). Very similar results were obtained in the group with virologically confirmed influenza virus infections and in a retrospective analysis during the peak influenza period. The incidence of complications was lower with Echinaforce than with Oseltamivir (2.46% vs. 6.45%, p = 0.076) and fewer adverse events (particularly nausea and vomiting) were observed with Echinaforce Hotdrink.

    Conclusions: Echinaforce Hotdrink is as effective as Oseltamivir in the early treatment of clinically diagnosed and virologically confirmed influenza virus infections with a reduced risk of complications and adverse events. It appears to be an attractive treatment option, particularly suitable for self care.

    Be well!


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