Is echinacea good for upper respiratory tract infections?

The Bottom Line

  • Echinacea is a popular dietary supplement that is used for the prevention and treatment of upper respiratory tract infections (URTIs) such as the common cold. 
  • Echinacea may reduce the risk of getting a URTI by a little bit and with no significant side effects, but differences in how echinacea preparations/products are made and adhered to can impact how meaningful this benefit is. 
  • The duration of a URTI does not appear to be reduced by the use of echinacea.
  • Make sure you're aware of how echinacea could interact with you as an individual, taking into account existing health conditions and possible interactions with other supplements or medications that you take. Always complement your own research with input from your health care provider.  

From selenium for cancer, to vitamin D for diabetes, to fish oil capsules for high blood pressure, more and more people are turning to dietary supplements to prevent and treat all sorts of health woes (1–3). Upper respiratory tract infections (URTIs) such as the common cold, which affect the pharynx (throat), larynx (voice box), sinuses, or nose, are certainly no exception (4–5).

To treat or prevent URTIs many people are flocking to echinacea, a group of North American wildflowers belonging to the daisy family (4;6-9). Three species in particular—E. angustifolia, E. purpurea, and E. pallida—are used for medicinal purposes. Echinacea products vary in the combination of species they contain (4), the part of the plant they use (i.e., the entire plant, versus the root, flower, stem, or leaves), how the medicinal compounds are extracted, and whether other natural components are included (10). They also come in many forms, such as capsules and tablets, juices, teas, extracts, drops, and powders (4).

Just how many people are on the echinacea bandwagon? With annual sales in the U.S. ranging from $10–100 million, it’s safe to say…“a lot.” Given this dedicated fan base, you may be surprised to learn that echinacea’s safety and effectiveness are still up for debate (4;11–16). One recent systematic review weighed in on the discussion, specifically looking at whether echinacea can prevent or treat URTIs (4).

What the research tells us

The review compared people using echinacea in a variety of doses and forms (e.g., capsules, juices, and more) to people using a placebo such as vegetable oil, beeswax, herb powder, or chocolate-flavoured syrup. The review found that echinacea had a small effect, reducing the chances of developing a URTI by 12%–22%. In contrast, echinacea had no effect on how long a URTI lasted once an infection had taken hold.

It’s worth noting that the studies included in the review were not always of high quality, and there were large differences in how they were conducted. This makes it difficult to pinpoint the type of echinacea products to recommend and how much to take. Variation in how echinacea products are prepared and how people use them could also affect how well echinacea works in the real world, outside of a research setting. Fortunately, short-term use of echinacea doesn’t appear to come with an increased risk of negative side effects, but more research is needed into how safe these products are if used long-term (4).

So, does echinacea deserve a spot in your medicine cabinet? Ultimately, folks should keep in mind that it’s important to weigh echinacea’s limited benefits against the uncertainty around its long-term safety. As with any other supplement, in addition to doing your own research, make sure to consult with your health care provider to understand how echinacea might interact with any existing health conditions or other medications and supplements you are taking, as well as any other potential risks with its use.

DISCLAIMER: Given the current situation around COVID-19, it’s important to note that none of the studies included in the review looked at COVID-19 specifically and should not be used to guide actions to reduce your risk of COVID-19. In order to reduce your risk of contracting and spreading COVID-19 and other respiratory illnesses, please follow current public health guidelines including physical distancing, proper hygiene (e.g., handwashing, not touching your face, covering coughs or sneezes, cleaning surfaces), limiting travel, and more. Learn about these guidelines in detail via the Government of Canada’s website: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html.

Featured Resources

Get the latest content first. Sign up for free weekly email alerts.
Author Details


  1. Vinceti M, Filippini T, Del Giovane C, et al. Selenium for preventing cancer. Cochran Database Syst Rev. 2018; 1:CD005195. doi: 1002/14651858.CD005195.pub4.
  2. Wu C, Qiu S, Zhu X, et al. Vitamin D supplementation and glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Metabolism. 2017; 73:67-76. doi: 10.1016/j.metabol.2017.05.005.
  3. Campbell F, Dickinson HO, Critchley JA, et al. A systematic review of fish-oil supplements for the prevention and treatment of hypertension. Eur J Prev Cardiol. 2013; 20:107-120. 
  4. David S, Cunningham R. Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis. Complement Ther Med. 2019; 44:18-26.
  5. Mayo Clinic. Throat cancer. 2018. [cited Mar 2020]. Available from https://www.mayoclinic.org/diseases-conditions/throat-cancer/symptoms-causes/syc-20366462
  6. Clarke TC, Black LI, Stussman BJ, et al. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Rep. 2015; 10:116. 
  7. Craft R, Kindscher K. Echinacea. 2016; 177-187.
  8. Richters. World production of Echinacea. 1998. Available from  https://www.richters.com/show.cgi?page=QandA/Commercial/19980331-13.html
  9. Saper RB. Clinical use of echinacea. 2019. [cited March 2019]. Available from https://www.uptodate.com/contents/clinical-use-of-echinacea
  10. Karsch-Volk M, Barrett B, Kiefer D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014; 2:CD000530. doi: 1002/14651858.CD000530.pub3.
  11. Schapowal A, Klein P, Johnston SL. Echinacea reduces the risk of recurrent respiratory tract infections and complications: A meta-analysis of randomized controlled trials. Adv Ther. 2015; 32:187-200.
  12. Shah SA, Sander S, White CM, et al. Evaluation of echinacea for the prevention and treatment of the common cold: A meta-analysis. Lancet Infect Dis. 2007; 7:473-480.
  13. Schoop R, Klein P, Suter A, et al. Echinacea in the prevention of induced rhinovirus colds: A meta-analysis. Clin Ther. 2006; 28:174-183.
  14. Barrett B, Vohmann M, Calabresse C. Echinacea for upper respiratory infection. J Fam Pract. 1999; 48:628-635.
  15. Anheyer D, Cramer H, Lauche R, et al. Herbal medicine in children with respiratory tract infection: Systematic review and meta-analysis. Acad Pediatr. 2018; 8-19. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use