Echinacea came from the prairie and barely touched colds in big trials

Key takeaways

• Nations along the Missouri River, from the Pawnee to the Blackfeet, used echinacea root for snakebite, and others used it for toothache, burns and sore throats¹.
• In a 2005 trial, 437 adults took one of three Echinacea angustifolia root extracts or a placebo, then got a cold virus; the root did not change who got sick or how sick they got⁵.
• In a trial that tracked 707 colds in 407 children, echinacea did not shorten colds, and rashes showed up in 7.1% of treated colds versus 2.7% on placebo⁹.
• Europe’s medicines regulator accepts fresh-pressed juice of Echinacea purpurea tops for short-term cold use, but for no more than 10 days and not for children under 12¹³.
• Echinacea is on United Plant Savers’ at-risk list, so a cultivated product is the gentler choice for wild prairie¹⁵.

On December 16, 1804, at Fort Mandan, Hugh Heney of the Northwest Company handed Meriwether Lewis and William Clark a plant. Clark logged it as a cure for the bite of a rabid dog. A second sample later that winter came with word that it treated snakebite too¹.

In March 1805, Lewis sent a few pounds of the root east so the American Philosophical Society could experiment with it. His letter about the plant, meant for President Thomas Jefferson, seems never to have reached him¹.

The plant was narrow-leaved purple coneflower, Echinacea angustifolia. Two centuries later, it finally got its test. In 2005, researchers gave hundreds of volunteers echinacea root extract or a placebo for a week, then sprayed a cold virus into their noses. The root made no difference⁵.

That gap between a revered prairie medicine and a flat modern result is the echinacea story. But there is a twist. “Echinacea” is not one product. It is several species, two very different plant parts and many preparations, and they have not all performed alike.

Here is what tradition records, what the trials found, who should be careful, and how to tell what is really in your bottle.

Plains nations knew this plant long before doctors did

Echinacea is a small group of nine wildflower species, all native to North America³¹⁵. Three dominate the herb trade: E. purpurea, E. angustifolia and E. pallida³. They belong to the daisy family, the same family as sunflowers and ragweed⁴.

Researchers at the University of Kansas call echinacea the most widely used medicinal plant of the Indigenous peoples of the Great Plains. Many tribal communities still harvest and use it today³.

The historical record shows how broad that use was¹:

• Snakebite: most nations along the Missouri River, from the Pawnee to the Blackfeet.
• Toothache: Lakota, Omaha, Ponca and Pawnee healers. Lakota and Blackfeet people chewed the root to numb the mouth.
• Burns: Yankton Sioux and Ponca.
• Sore eyes: Omaha. Sore necks and backs: Cheyenne.
• Swelling and sore throat: an Arikara leader, Too Né, told Lewis that a poultice of pounded root helped.

In 1919, the ethnobotanist Melvin Gilmore wrote that echinacea seemed to treat more ailments than any other plant used by these nations¹. The National Center for Complementary and Integrative Health (NCCIH), a federal research agency, adds respiratory infections to the list of Native uses⁴.

That knowledge belongs first to the nations who built it, over generations of close attention to the prairie. A clinical trial can test a capsule. It can’t measure a living tradition, and it was never meant to.

A Nebraska “blood purifier” made it a national bestseller

Echinacea entered American medicine through a secret formula. Dr. H.C.F. Meyer of Pawnee City, Nebraska, sold a mixture he called “Meyer’s Blood Purifier,” which also held wormwood and hops. According to King’s American Dispensatory, he had used the plant since about 1870 without knowing its scientific name². University of Kansas researchers date his introduction of the root to medical use to 1885³.

The dates fit together. In the fall of 1885, Meyer sent his tincture to Professor John King of the Eclectics, a group of 19th-century doctors who favored plant medicines²³. A plant specimen followed in September 1886, and Curtis G. Lloyd identified it as E. angustifolia².

Meyer’s claims were bold. He said he had treated his own rattlesnake bite with the tincture and slept it off. He even offered to send a live rattlesnake for testing. King declined².

Eclectic doctors embraced the root anyway. Through the 1920s, doctors prescribed it more often than any other medicine drawn from a U.S. plant³. Even its champions admitted results were uneven². Sulfa drugs and antibiotics then pushed it aside³.

The revival came in the 1980s and exploded in the 1990s¹⁰. By 1997, echinacea sales reached about $320 million a year, and it was the top-selling herb in health food stores¹⁰.

Which echinacea? Species and plant part change the product

Two choices shape every echinacea product: the species and the part of the plant.

Roots. Most wild-harvested echinacea is the root of E. angustifolia or E. pallida³. Chewed, a good-quality root first tastes sweet, then leaves a long-lasting tingle and numbness on the tongue, Eclectic writers noted².

Aerial parts. These are the flowering tops: stems, leaves and flowers. Most products tested in clinical trials have been made from the aerial parts of E. purpurea⁷.

Compounds. Echinacea contains alkamides, caffeic acid compounds, polysaccharides and glycoproteins. Scientists still debate which ones matter most³. Growing conditions matter too. NCCIH-funded research found that an extract’s activity depended partly on soil conditions that shape the bacteria living in the plant⁴.

The part can change the result. In a 1999 trial summarized by the BestBETs evidence-appraisal site, two E. purpurea preparations eased cold complaints, but one made from the root had no effect⁸.

Products come as capsules, tinctures and other liquid extracts, teas, pressed juice and preparations for the skin⁴⁸¹¹¹³.

What the large trials found

The virus challenge (2005). In a study published in the New England Journal of Medicine, Ronald Turner of the University of Virginia and colleagues gave 437 healthy adults one of three E. angustifolia root extracts or a placebo⁵. The dose was 900 milligrams a day. After seven days, everyone got a cold virus by nasal spray, then stayed isolated for five days⁵.

None of the three extracts changed who got infected, how severe the colds were or how long they lasted⁵. Critics argued the dose was too low⁵. NIH’s complementary medicine center paid for the study⁵.

College students (2002). Bruce Barrett of the University of Wisconsin tested capsules that mixed E. purpurea herb and root with E. angustifolia root in 148 students with new colds⁶⁸. Colds averaged 6.27 days on echinacea and 5.75 days on placebo, no meaningful difference⁶.

The study was paid for partly by the National Institutes of Health and partly by Shaklee Technica, a company that sold echinacea. The company had no role in running or reporting it⁶. An industry-backed trial that reported a null result is worth noting.

Adults and teens (2010). Barrett’s team then enrolled more than 700 people aged 12 to 80 at the first sign of a cold¹¹. Echinacea pills shortened colds by 7 to 10 hours, a difference too small to rule out chance. Severity trended about 10% lower, also not a proven difference¹¹. Barrett said adults who felt echinacea helped them had no reason to stop based on this one trial¹¹.

Children (2003). A trial published in JAMA gave healthy children aged 2 to 11 either an E. purpurea liquid or a placebo at the start of each cold, for up to 10 days⁹. Families came through a regional practice network and an alternative medical center⁹. Across 707 colds in 407 children, colds typically lasted about 9 days, with no difference between the groups⁹. Rashes appeared in 7.1% of colds treated with echinacea and 2.7% treated with placebo⁹.

The big picture. A 2015 JAMA summary of the Cochrane review of echinacea found that four treatment trials with a low risk of bias showed no effect on how long colds lasted. The two trials that found large benefits had weaker or less clear designs⁷.

A 2019 analysis by Sholto David and Rebecca Cunningham pooled placebo-controlled trials. People taking echinacea were about 22% less likely to get a respiratory infection, but the authors doubted the effect mattered much in daily life. Echinacea did not shorten illness¹².

For the older Cochrane prevention estimate, see “Your body already detoxes itself, and a few everyday habits help it work.”

Use	What was tested	What was found	Rating
Preventing a cold after exposure	E. angustifolia root extracts, 900 mg a day for 7 days5	No change in infections or symptoms	Evidence says no, or unsafe
Lowering the odds of a cold over time	Many products, pooled in a 2019 review12	About 22% fewer infections; benefit may be too small to matter	Promising but early
Shortening a cold in adults	Capsules and pills in U.S. trials; four low-bias trials overall67811	No meaningful difference	Evidence says no, or unsafe
Easing a cold in adults	E. purpurea herb extracts and juice in several smaller trials8	Some positive results; trials were small, and at least one was company-sponsored	Promising but early
Treating colds in children aged 2 to 11	E. purpurea pressed juice for up to 10 days89	No benefit and more rashes	Evidence says no, or unsafe
Eczema and small wounds	Creams and juice used on skin413	Traditional use only; benefit unclear	Not enough evidence

Europe accepts one form, with tight limits

Europe treats echinacea differently from the U.S., where it is sold as a dietary supplement⁴. The European Medicines Agency’s herbal committee writes official monographs that spell out accepted uses, doses and warnings for herbal medicines¹³.

In its current monograph, adopted in 2014, the committee gives “well-established use” status to one preparation: juice pressed from fresh flowering E. purpurea tops, sold fresh or dried¹³. The approved use is short-term prevention and treatment of the common cold¹³. That is a stronger status than “traditional use,” which rests on long use rather than clinical proof¹⁴.

The fine print is strict¹³:

• Dose: 6 to 9 milliliters of juice a day for teens and adults.
• Timing: start at the first signs of a cold.
• Limit: no more than 10 days. See a doctor if symptoms last longer.
• Children: not recommended under 12, because safety data are lacking.

The root got the weaker status. Europe’s 2017 monograph for E. purpurea root accepts it only as a traditional-use product, for easing cold symptoms and mild acne¹⁴.

So the European approval and the failed American trials don’t contradict each other as much as it seems. They mostly tested different plants, parts and preparations. Even the approved juice promises a short course and a modest goal.

Who should skip echinacea or ask first

Short-term use of E. purpurea extracts is likely safe for most adults, according to NCCIH⁴. The most common side effects are stomach pain and nausea⁴.

Headache and a bad taste also show up in trials⁷. Some groups need more care.

• Daisy-family allergies. Europe lists allergy to the daisy family as a reason not to use echinacea at all¹³. People with atopy, an inborn tendency toward allergic conditions, face a possible risk of severe reactions and should check with a doctor first¹³. Reported reactions include rash, hives and facial swelling and, in some cases, airway spasm, asthma attacks and anaphylaxis, a life-threatening allergic reaction¹³.
• Autoimmune disease or a weak immune system. The European monograph advises against use with autoimmune diseases, immune deficiencies, white blood cell disorders or drugs that suppress the immune system¹³. NCCIH says there are theoretical reasons to expect a clash with immune-suppressing medicines⁴.
• Other medicines. Evidence conflicts on whether echinacea changes how the liver handles some drugs, and NCCIH calls a caffeine interaction a theoretical concern⁴. Show your pharmacist the bottle.
• Children. Europe does not recommend echinacea under age 12¹³. NCCIH calls short-term use possibly safe for children but advises checking with their provider, given the rashes seen in the 2003 trial⁴⁹.
• Pregnancy and breastfeeding. Some research suggests use for up to seven days in the first trimester is possibly safe. Little is known about breastfeeding⁴. Europe’s committee, citing several hundred pregnancies without harm, still advises against use unless a doctor recommends it¹³.

When to get help. See a clinician if a cold gets worse, brings a high fever or lasts beyond 10 days¹³. Swelling of the face, wheezing or trouble breathing can signal a severe allergic reaction¹³. Call 911.

Wild roots come from a shrinking prairie

Echinacea sits on the Species At-Risk List of United Plant Savers, a nonprofit that tracks native medicinal plants¹⁵. The group’s main worries are lost prairie and overharvesting¹⁵.

Mislabeling adds a twist. Most wild-dug root is sold as E. angustifolia, but diggers sometimes take other species too, including rarer ones with small ranges¹⁵.

The group lists one relative, smooth coneflower (E. laevigata), as federally endangered¹⁵.

Digging usually kills or stunts a plant, and diggers prefer the largest plants, which make the most seed³. About half of dug plants regrow from root pieces left behind³. Poachers target state parks and national forest land³.

A 1998 industry survey counted more than 90,000 kilograms of wild root harvested¹⁰. In Kansas, landowners complained about trespassing diggers, and protection rested largely on owners who limited digging and prosecuted trespassers¹⁰. Researchers say farming and habitat loss threaten echinacea more than digging does³.

For many natural-health readers, respect for plants is the whole point. Choosing cultivated echinacea is a simple way to act on it. United Plant Savers recommends cultivated sources¹⁵, and E. purpurea is now widely cultivated⁴.

How to read an echinacea label

Use the profile card for a quick summary, then check the label line by line.

Label line	What to look for	Why it matters
Species	A Latin name: purpurea, angustifolia or pallida	European approvals and trial results apply to specific species1314
Plant part	“Herb,” “aerial parts” or “flowering tops” versus “root”	Root and herb products did not perform the same in trials8
Preparation	Pressed juice, or a dry extract with a ratio such as 5.5–7.5:1	Europe’s monographs name exact preparations and doses1314
Daily amount	Compare with the amounts studied	A product far below the studied dose tells you little
Source	“Cultivated” or “organically grown” versus “wild-harvested”	Wild root comes from at-risk prairie stands15
Alcohol	Ethanol content on tinctures	Europe’s monograph requires ethanol labeling13
Other herbs	Blends with several botanicals	Each added herb brings its own cautions

If a label names no species or part, you can’t match it to any study. That alone is a reason to choose a different bottle.

Questions readers ask

The bottom line

Echinacea earned its place in Plains medicine and then in American pharmacies, and its history deserves respect. But large U.S. trials, including NIH-funded ones, found that the root extracts and capsules they tested did little or nothing to prevent or shorten a cold.

If you want to try it, match the product to the evidence: fresh-pressed E. purpurea herb, a short course started early, and no use if you have a daisy-family allergy, autoimmune disease or a child under 12. Choose cultivated plants, and treat any benefit as modest.

Related reading

• Your immune system works more like a team than a volume knob, and some habits help it
• Most health products aren’t scams, but many just haven’t been proven
• Your body already detoxes itself, and a few everyday habits help it work
• How to appreciate white sage without taking, since yours may have been poached
• Elderberry syrup rests on small, maker-funded trials, and a larger one disagreed

Sources

1. Discover Lewis & Clark (Lewis and Clark Trail Alliance). “Worthy of Notice: Echinacea.” Accessed October 2026. lewis-clark.org
2. Felter HW, Lloyd JU. “Echinacea.” King’s American Dispensatory, 1898 (reproduced by Henriette’s Herbal Homepage). henriettes-herb.com
3. Kindscher K, University of Kansas. “Echinacea Research.” Kansas Biological Survey, accessed October 2026. kindscher.ku.edu
4. National Center for Complementary and Integrative Health. “Echinacea.” NIH, updated November 2024. nccih.nih.gov
5. National Center for Complementary and Alternative Medicine. “Echinacea for the Prevention and Treatment of Colds in Adults: Research Results” (on Turner RB, et al., New England Journal of Medicine, July 28, 2005). NIH, October 2005 (archived). webarchive.library.unt.edu
6. HealthDay. “Echinacea Has No Effect on Colds” (on Barrett B, et al., Annals of Internal Medicine, 2002). December 16, 2002. healthday.com
7. Karsch-Völk M, Barrett B, Linde K. “Echinacea for Preventing and Treating the Common Cold.” JAMA, 2015;313(6):618-619 (Clinical Evidence Synopsis of Cochrane review CD000530). pmc.ncbi.nlm.nih.gov
8. BestBETs. “Echinacea for the Common Cold” (BET 1172, appraisal of randomized trials including Brinkeborn 1999, Lindenmuth 2000, Barrett 2002 and Taylor 2003). Accessed October 2026.
9. Taylor JA, Weber W, Standish L, et al. “Efficacy and Safety of Echinacea in Treating Upper Respiratory Tract Infections in Children: A Randomized Controlled Trial.” JAMA, 2003;290(21):2824-2830 (abstract via Read by QxMD). qxmd.com
10. Price DM, Kindscher K. “One Hundred Years of Echinacea angustifolia Harvest in the Smoky Hills of Kansas, USA.” Economic Botany, 2007;61(1):86-95. kindscher.ku.edu
11. University of Wisconsin–Madison News. “Study: Natural Supplement May Reduce Common-Cold Duration by Only Half a Day” (on Barrett B, et al., Annals of Internal Medicine, 2010). December 20, 2010. news.wisc.edu
12. David S, Cunningham R. “Echinacea for the Prevention and Treatment of Upper Respiratory Tract Infections: A Systematic Review and Meta-Analysis.” Complementary Therapies in Medicine, 2019;44:18-26. pubmed.ncbi.nlm.nih.gov
13. European Medicines Agency, Committee on Herbal Medicinal Products. “European Union Herbal Monograph on Echinacea purpurea (L.) Moench, Herba Recens.” Adopted November 24, 2014. ema.europa.eu
14. European Medicines Agency, Committee on Herbal Medicinal Products. “European Union Herbal Monograph on Echinacea purpurea (L.) Moench, Radix, Revision 1.” Adopted May 30, 2017. ema.europa.eu
15. United Plant Savers. “Echinacea (Echinacea spp.).” Species At-Risk List, updated August 2026. unitedplantsavers.org