Echinacea Supplements Review

Many Echinacea Supplements Fail CL's Tests. Make Sure You Know What You're Getting!

Medically reviewed and edited by Tod Cooperman, M.D.

Last Updated : 07/17/2021 | Initially Posted: 02/06/2021

Echinacea supplements reviewed by ConsumerLab.com

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Table of Contents

Summary

· What do Echinacea supplements do? Echinacea supplements may modestly help prevent colds when taken during cold season and/or reduce the severity of a cold if taken at the first onset of symptoms — although the evidence is mixed. Limited evidence suggests that a form of Echinacea may modestly reduce anxiety (See What It Does). Phenolic compounds in Echinacea may be responsible for some of the herb's effects (See What It Is).

· What did CL's tests of Echinacea find? Four products did not contain the expected minimum amounts of total phenolic compounds (one had less than 2%), and two products did not even list their amounts of Echinacea (See What CL Found).

· Which Echinacea supplements are best? Among six products Approved for Quality by ConsumerLab.com, two (an extract and a non-extract) were chosen as Top Picks.

· Which form and dose of Echinacea is best? Echinacea comes in various forms and concentrations, but most positive clinical studies used products extracted from aerial parts (leaves, flowers, stems) of E. purpurea or the roots of E. angustifolia (See ConsumerTips™).

· Is Echinacea safe? Echinacea appears to be relatively safe for short-term use (up to 12 weeks), and side-effects tend to be mild (GI symptoms, increases urination). However, be aware that some people may have allergic reactions, such as rashes, and rarely, liver damage has been reported. Although Echinacea may affect the metabolism of a variety of drugs, the effect may be small (See Concerns and Cautions).

What It Is:

Echinacea — commonly known as purple coneflower — is a group of nine related plant species indigenous to North America. Three species of Echinacea — Echinacea purpurea, E. angustifolia, and E. pallida — have been used medicinally and are commonly found in dietary supplements. Supplements can be made from the above-ground herb (aerial) and/or root portions of the plant, or a combination of both.

Compounds known as phenols (including cichoric, caftaric, and chlorogenic acids as well as echinacoside and cynarin) are known to exist in Echinacea and have been shown to inhibit steps in the development of inflammation. Cichoric acid (alternatively spelled "chicoric" acid), also shows immunostimulatory properties (Hudson, Pharmaceuticals (Basel) 2011).

Laboratory tests show that cichoric acid and other compounds from Echinacea purpurea aerial parts may inhibit the replication of certain viruses, including HSV-1 and -2, respiratory syncytial virus, rhinoviruses, and coronaviruses (Hudson, Pharmaceuticals (Basel) 2011).

According to the United State Pharmacopeia (USP), the phenols in dried aerial parts of E. purpurea make up at least 1% of the dried herb (powder), which would be about 0.25% in fresh herb (since it's about 75% water). Most of this will be cichoric acid, followed by caftaric acid. In E. purpurea root, caftaric, cichoric and chlorogenic acids make up at least 0.5% of the dried root.

In E. angustifolia root, the dominant phenols are echinacoside, cynarin, and chlorogenic acid, constituting 0.5% of dried root. In E. pallida root, the phenols are caftaric, cichoric, and chlorogenic acids as well as echinacoside and these make up 0.5% of dried root.

Other constituents that may be important in the effects of Echinacea include alkamides (such as isobutylamides), which occur at very low concentrations (0.01%) in dried E. purpurea aerial parts but at a higher concentration (0.75%) in E. angustifolia root, as well as polysaccharides (which are also found in other botanical ingredients as well as in grains, vegetables, fruit, nuts, and cereal bran) but are generally removed from extracts.

Product lists as extracts typically contain about four times the concentration of phenols expected in dried herb or root, but this can vary.

What It Does:

For colds:
Echinacea's popularity is primarily due to its reported ability to reduce the symptoms and duration of colds and flu-like illnesses. It is believed to work through modulation of the immune system. The German Commission E, World Health Organization (WHO) and Canadian Natural Health Products Directorate have all advocated the use of Echinacea for upper respiratory tract symptoms related to the common cold; however the results of clinical trials have been mixed.

A difficulty in comparing the results of clinical trials (and perhaps the reason for varying results) with Echinacea is that studies use varying doses, species and parts of the Echinacea plant. The different species and plant parts used can contain different concentrations of compounds, and even the same plant, like all plants, may contain differing levels of these compounds at different times of the year or when grown in different geographical locations (Qu, HortScience 2005). It is yet to be determined if it is one, a few, or the combined effect of many constituents that are responsible for Echinacea's immune-modulating properties.

Another difficulty is that studies employ Echinacea at varying times in the course of a cold: prophylactically before a cold begins; at the first symptoms of a cold; and/or several weeks after a cold, all of which could impact the herb's effectiveness.

In 2007, a meta-analysis (in which results of many clinical trials are pooled and analyzed) showed prophylactic use of Echinacea reduced the incidence of colds by 65%, but by only 35% if taken at the first sign of symptoms (Shah, Lancet Infect Dis 2007).

On the other hand, a 2008 report showed that taking an E. purpurea extract during the winter months did not significantly prevent the onset of upper respiratory tract infections versus placebo (O'Neil, Ann Allergy Asthma Immunol 2008). This study, however, did not list the part of the Echinacea plant used nor did it indicate analytical work to confirm the contents. A large controlled trial (Barrett, Ann Int Med 2010) giving a five-day course of Echinacea at the first sign of symptoms failed to show a substantial benefit. That study used tablets made by MediHerb (distributed in the U.S. as Echinacea Premium by Standard Process) containing dried extracts of E. purpurea and E. angustifolia root. A well-controlled study in which ethanolic extracts of E. angustifolia root and E. purpurea root were compared to placebo showed no significant benefit for either Echinacea preparation in preventing upper respiratory tract infections relative to placebo, despite participants in the Echinacea groups believing that they had more benefit than those in the placebo group. Adverse effects were much higher in the E. angustifolia group compared to placebo group (Melchart, Arch Fam Med 1998).

A placebo-controlled study among children in the Seattle, Washington area found no benefit in reducing the duration or symptoms of colds when a non-alcoholic preparation of pressed juice from E. purpurea aerial parts (apparently provided by Madaus, AG, Germany) was taken twice a day starting at the onset of symptoms and continued throughout the upper respiratory infection for a maximum of 10 days. Rash occurred in 7.1% of the children given Echinacea versus 2.7% of those given placebo (Taylor, JAMA, 2003).

The largest study of Echinacea suggests it to be modestly effective at preventing colds if taken three times daily throughout the cold season (and five times daily during a cold) (Jawad, Evid Based Compl Alt Med 2012). Compared to those taking placebo, the Echinacea-treated group experienced 26% fewer cold "events" (colds and days spent with colds, combined). In addition, there were fewer recurrent colds among those treated and they took less pain medication, such as aspirin, during colds. The study used a liquid supplement (Echinaforce from A. Vogel Bioforce AG, which is among the products tested in the review below) made from freshly harvested E. purpurea (95% aerial parts and 5% root) as alcoholic extract. Participants in the study swallowed a 0.9 mL (33 drops) dose three times per day, and, during acute stages of a cold this increased to five times per day. Oddly, the use instructions on Echinaforce sold in the U.S. when we tested it in 2016 suggested a smaller dose -- only 20 to 25 drops (about 0.6 mL) three times a day, and, when tested for the current review, the label suggested an even lower dose of just 15 drops two to three times per day, raising a question of how effective these lower doses may be. In the study, drops of Echinaforce were diluted in water and retained in the mouth for 10 seconds before being swallowed "to provide maximum local antiviral effects," according to the study, although it interesting to note that Echinaforce is 65% ethanol, which, itself, may have direct antiviral properties. Most people were not 100% compliant with the treatment, but those who were experienced even greater reductions in colds.

Several small, company-funded studies suggest that taking 6 tablets of Esberitox (distributed in the U.S. by Nature's Way and sold in Europe as Esberitox N) three times daily during a cold or respiratory tract infection may hasten improvements in symptoms (i.e. nasal congestion, hoarseness, chest pain) by about one to three days -- especially when taken at the earliest onset of symptoms (Zepelin, Curr Med Res Opin 1999; Naser, Phytomedicine 2005). Among adults with acute exacerbation of chronic bronchitis who took an antibiotic, those who also took liquid Esberitox N drops three times daily (a total daily dose of 8.8 mL) for 28 days were breathing slightly better at day 10 of treatment than those given placebo (Hauke, Chemotherapy 2002). Esberitox is a proprietary blend of extracts of E. purpurea and E. pallida root, wild indigo (Baptisia tinctorial) root, and Thuja occidentalis leaf (an ingredient that may potentially cause seizures in people with seizure disorder) (Millet, Clin Toxicol 1981). No serious adverse events were reported in these studies; mild to moderate side effects such nausea and insomnia were reported by a small number of participants.

An alcoholic extract of the root portion of E. pallida (900 mg per day) showed some promise relative to a placebo in reducing the average length of a cold (Dorn, Complement Ther Med 1997).

For anxiety:
Although it's been proposed that echinacea may have anti-anxiety effects, the evidence is weak and conflicting. Two small studies (by the same research group) showed that an E. angustifolia root extract (Anxiofit-1 from Anxiofit Ltd., standardized to 3% echinoacoside and containing 1-1.5% alkamides — which may be responsible for any anxiolytic effects) decreased anxiety scores in patients with subthreshold/mild anxiety and generalized anxiety disorder. However, a panel of the European Foods Safety Authority (EFSA) that reviewed these studies considered them insufficient to establish a cause and effect relationship and, therefore, refused to grant the product the right to claim that it could reduce subthreshold and mild anxiety (EFSA J, 2016).

A later placebo-controlled clinical study of Anxiofit-1 (marketed in the U.S. as AnxioCalm) given at a dose of 40 mg three times daily for seven days showed it to modestly reduce levels of anxiety in response to anxiety-producing situations but not underlying anxiety. The lead researcher holds a patent on the anxiolytic effects of Echinacea (Haller, Phytother Res 2020). A more recent study in which the same extract was given at a dose of 20 mg or 40 mg twice daily (total daily dosage 40 mg or 80 mg) to 93 men and women with mild to moderate anxiety for six weeks showed very modest improvements in self-reported moods and emotions, but no reduction in anxiety compared to placebo. The study was funded by EuroPharma Inc., a U.S. distributor of AxioCalm (Lopresti, J Affect Disord 2021).

Coronavirus effects:
An in-vitro study found Echinaforce (A. Vogel AG) inhibited specific common cold coronaviruses and SARS-CoV-2, the coronavirus that causes COVID-19. The study was funded by the maker of Echinaforce and authored, in part, by two A. Vogel employees as well as recipient of a grant from that company (Signer, Virology 2020). It is interesting to note that Echinaforce is 65% ethyl alcohol (ethanol) which, itself, can inhibit viruses, but, the researchers explained that they had extensively diluted Echinaforce in the experiment and showed that similarly diluted ethyl alcohol alone would not cause viral inhibition (Signer, Virology 2020 — author correction). There is no clinical evidence that taking this or any other echinacea product can prevent or treat coronavirus infections in people.

See ConsumerTips™ for information about more dosing and usage.

Quality Concerns and Tests Performed:

Neither the U.S. Food and Drug Administration (FDA), nor any other federal or state agency, routinely tests Echinacea products, nor any supplement, for quality prior to sale. A quality concern with herbal supplements is potential contamination with heavy metals such as lead, cadmium and arsenic. Even if ingested at low levels, heavy metals can accumulate and cause damage over time. Cadmium, for example, builds up in kidneys and, if it reaches a high enough level, can cause kidney damage. Lead, which accumulates in bones, can cause a variety of symptoms including abdominal pain, impaired mental functioning, high blood pressure and anemia. Another concern with herb and root powders is contamination with Escherichia coli, Salmonella spp., yeast and mold that can occur during growing, harvesting or preparation as a supplement. As a result, the WHO has established standards for Salmonella contamination of medicinal plant materials intended for internal use. Furthermore the U.S. Food and Drug Administration (FDA) has established zero tolerance levels for Salmonella.

ConsumerLab.com, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many E. purpurea and E. angustifolia supplements sold in the U.S. and tested all of them to determine whether they 1) possessed the claimed and minimum expected amount of phenols [link to What It Is section] (shown in our results as total phenolic compounds or TPCs), 2) if products containing herb or root powders or at least 250 mg of minerals per suggested daily serving were free of unacceptable levels of lead, cadmium, and arsenic, 3) if products containing herb or root powders were free of contamination with Escherichia coli, Salmonella spp., yeast and mold, and 4) all regular tablets and caplets would properly disintegrate to enable absorption of their contents (see Testing Methods and Passing Score).

What CL Found:

It's not easy to compare Echinacea products, even after analyzing them in a laboratory as we have done, because the ideal dose of Echinacea, as well as form and delivery, is not well defined. However, chemically, we can get an idea of how much Echinacea is in each product by looking for total phenolic compounds (TPCs) and, from a safety perspective, we can look at how free each product is from common contaminants. Contamination:
All products made from whole parts of Echinacea (as opposed to an extract) were tested for heavy metal contamination and pathogenic microbes (yeast, mold, Salmonella, and E. coli.). None of the products exceeded contamination limits, which is an improvement over our report in 2016 in which one product was contaminated with 2.2 mcg of lead per daily serving.

Amount of Echinacea — Based on Phenols Found:
To try to assess the amount of Echinacea in each product, ConsumerLab.com tested for total phenolic compounds (TPCs) known to exist at certain levels in various forms of Echinacea, allowing ConsumerLab.com to set minimum expectations and compare products. These amounts are shown in the both the graph below and results table further below.

As you can see in the graph, the amount of TPCs per suggested serving ranged across products from as much as 50.9 mg to as little as 0.041 mg (over a 120,000% difference!).

TPCs Found Per Serving in Echinacea Supplements

Four products were "Not Approved" because they failed to contain the minimum amounts of TPCs we would expect based on their claimed amounts and types of Echinacea:

· Gummiology Propolis & Echinacea claimed to contain 400 mg of E. purpurea herb (aerial) extract, from which we would expect a minimum of 16 mg of TPCs, but we found less than 0.25 mg — less than 2% of what we expected.

· Herb Pharm Echinacea claimed to contain the equivalent of 280 mg of fresh E. purpurea root per 0.7 ml serving (which, we assume was one dropperful, but was not noted), from which we would expect 0.7 mg of TPCs, but we found only 0.041 mg — just 6% of what we expected.

· Jamieson Echinacea claimed 400 mg of E. purpurea tops (aerial) extract equivalent to 4,000 mg of raw herb, from which we would expect 10 mg of TPCs, but we found 7.2 mg, or 72% of what we expected, although this was a higher amount of TPCs than the majority of products.

· 21st Century Echinacea claimed 250 mg of a blend of E. purpurea herb (aerial) extract and E. angustifolia root extract. When blends are listed, they must be in order of greatest to smallest, so the majority of the blend should be E. purpurea, and we would expect about 5.8 mg to 9.9 mg of TPCs per two-capsule serving. However, we found only 1.3 mg — only about 13% to 22% of what we expected.

What is also striking about these results is that the most clinically studied product, A. Vogel Echinaforce, provides a very small amount of TPCs, indicating that it is made from a very small amount of Echinacea. It does not even list an amount of Echinacea on the label -- which is why were not able to consider an approval status for it.

Interestingly, when we tested Echinaforce in 2016, its label was more descriptive than it is now: It claimed to be made from 521 mg of fresh E. purpurea herb and 27 mg of fresh E. angustifolia root per 20 drop serving (to be given three times per day). In 20 drops of that product, we found just 0.18 mg of TPCs, although we expected much more (1.37 mg) based on the fresh Echinacea it claimed, so it was Not Approved. Our recent tests of the newer product show that a serving (now listed as 15 drops) contained a higher amount of TPCs (0.48 mg) than previously, although still a relatively small amount. It's odd that the suggested serving size has changed since 2016 (as has the number of serving per day, which is now two to three, rather than three) and from the original 33 drops three times per day used in a published study -- Jawad, Evid Based Compl Alt Med 2012).

Cost
To provide a rough price comparison, we calculated how much you would need to pay to get an equivalent amount of TPCs (10 mg) from each product based on the amount of TPCs found. This cost ranged from just 4 cents to $67.97.

Cost Per 10 mg TPCs Found in Echinacea Supplements

Top Picks:

Due to a lack of consistent clinical information (see What It Does), it's not possible to say with confidence that any Echinacea product will be beneficial in preventing or treating colds, flu, or other condition. Nevertheless, should you wish to use Echinacea, those which we believe deliver the best quality and are, therefore, our Top Picks among Approved products are the following, by category:

E. purpurea herb extract:
Vital Nutrients Echinacea Extract 500 mg is our Top Pick among E. purpurea herb extracts, as it provides the largest amount of TPCs (50.9 mg) per serving (i.e., 2 capsules, providing 1,000 mg of extract). Although somewhat expensive (79 cents per serving), it is less expensive in terms of TPCs than any other product aside from BulkSupplements.com, a loose powder that we found tasted somewhat burnt (although it contained its expected TPCs). Several clinical trials in which Echinacea has shown benefit in preventing/treating colds used extracts (around 900 mg per day).

Although tinctures, such as Echinaforce, made from primarily the (aerial) above-ground plant parts of E. purpurea, have shown benefits in clinical trials, we are concerned about the low amounts of TPCs in Echinaforce as well as the variations we have seen over time in these levels and in its usage information. We would also prefer that the product state the amount of extract it is supposed to contain. For these reasons, despite the amount of studies indicating a benefit (funded by its manufacturer), this product is neither Approved nor a Top Pick.

E. purpurea herb + E. purpurea and E. angustifolia root powder"
Although there is not much clinical evidence for non-extracts, if you prefer a non-extract, our Top Pick for a mixture of dried aerial and root portions of E. purpurea with some E. angustifolia root is Oregon's Wild Harvest. It blew way past our expected minimum amount of TPCs (5.7 mg) by delivering 14.7 mg per two-capsule serving (26 cents), indicating herb powder that is rich in TPCs. If you only want E. purpurea herb powder, we suggest Nature's Bounty Echinacea 400, which provides 4.7 mg of TPCs per capsule for only 10 cents. Both of these products passed our testing for contaminants (heavy metals and microbes), to which all dried herb/root products were subjected.

Test Results by Product:

Listed alphabetically below are test results for twelve products. Ten were selected for testing by ConsumerLab.com and two others (each indicated with CL flask icon) are included for having passed the same testing through ConsumerLab.com's voluntary Quality Certification Program.

Shown for each product are the claimed amount and form of Echinacea in each serving and daily serving information from the label. Amounts of total phenolic compounds (TPCs) expected and found, special features, price, and the cost to obtain 10 mg of TPCs are also shown. To be listed as "Approved," products had to contain their expected amounts of TPCs and, if made from whole herb (as opposed to extract) had to pass tests for lead, cadmium, and arsenic, as well as for yeast, mold, Salmonella and E. coli. The full list of ingredients is available for each in the final column.

Results of ConsumerLab.com Testing of Echinacea Supplements

(Click arrows or swipe left or right to see all columns)

Approval Status

Product Name
(Suggested Serving on Label)

Echinacea Claimed Per Servingⓘ

TPCs Expected & Found

Heavy Metalⓘ & Microbial Contaminationⓘ

Suggested Daily Servings

Formⓘ

Cost for Suggested Serving

[Cost Per 10 mg of TPCs Found]

Price

Notable Features

Full List of Ingredients Per Serving

E. purpurea only Products:

NA ⓘ

A. Vogel Echinaforce®

Dist. by Bioforce (UK) Ltd

15 drops

Tinctures of fresh E. purpurea herb 95% and fresh E. purpurea root 5%. No amounts listed.

TPCs:
Expected Min: NA ⓘ
TPCs: 0.48 mg

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Adults: 15 drops in a little water 2-3 times daily. Children (6-12 yrs): 7 drops in a little water 2-3 times daily.

Liquid from bottle

$0.48/15 drops

[$10.06]

$37.99/50 ml bottle (approx. 79 servings)

Organically grown.

Caution from ConsumerLab: This tincture is 65% ethanol (grain alcohol).

Ingredients: Tinctures of fresh Echinacea purpurea (Purple Coneflower) herb 95% and fresh Echinacea purpurea (Purple Coneflower) root 5%, extracted in ethanol (65% V/V).

APPROVED

BulkSupplements.com Echinacea Extract

Dist. by BulkSupplements.com

1/5 tsp [0.5 g]

500 mg purpurea aerial extract

TPCs:
Claimed: 20 mg
TPCs: 18.2 mg ✔

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Take 500 mg (1/5 tsp) once or twice daily or as directed by a physician.

Powder in pouch

$0.06 per 1/5 tsp

[$0.04]

$12.96/3.5 oz [100 g] pouch (approx. 200 servings)

Free of: Added Sugar, Soy, Dairy, Yeast, Gluten, Additives.

1/5 tsp
Echinacea Extract (Echinacea purpurea) (Aerial part) Standardized to contain ≥4% Polyphenols) 500 mg.

Other Ingredients: None.

NOT APPROVED

Gummiology® Propolis & Echinacea - Raspberry Flavor

2 gummies

400 mg purpurea herb extract

TPCs:
Expected Min: 16 mg
TPCs: <0.25 mg

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Take 2 gummies daily.

Medium/large star-shaped gummy

$0.16/2 gummies

[>$6.35]

$8.00/100 gummies

2 gummies

Vitamin C 70 mg, elderberry extract 200 mg, propolis extract 100 mg

This product is not manufactured with milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soy or gluten.

2 gummies
Calories 15, Total Carbohydrates 4 g, Total Sugars [Includes 4 g Added Sugars] 4 g, Vitamin C (as Ascorbic Acid) 70 mg, Echinacea Extract (Echinacea purpurea) (Herb) 400 mg, Elderberry Extract (Sambucus nigra) (Herb) 200 mg, more...

NOT APPROVED

Herb Pharm® Echinacea

Dist. by Herb Pharm

0.7 ml

Extract from 280 mg of fresh E. purpurea root (root)

TPCs:
Expected Min: 0.7 mg
TPCs: 0.041 mg

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Add 1 full squeeze of the dropper bulb to 2 oz. of water or juice, 2 to 5 times per day.

Liquid from bottle

$0.28/0.7 ml

[$67.97]

$11.59/1 fl oz [30 ml] bottle (approx. 42 servings)

Certified Organic. Free (undried). Gluten-Free.

0.7 ml
Echinacea root (Echinacea purpurea) extract 814 mg. Extraction rate 280 mg fresh herb per 0.7 ml.

Other Ingredients: Certified organic vegetable glycerin & distilled water.

NOT APPROVED

Jamieson™ Echinacea

Dist. by Jamieson Laboratories

1 softgel

400 mg purpurea herb top (aerial) extract equivalent to 4,000 mg of raw herb

TPCs:
Expected Min: 10 mgⓘ
TPCs: 7.2 mg

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Take 1 softgel daily, at first sight of infection.

Medium/large softgel

$0.55/softgel

[$0.76]

$33.00/60 softgels

Non-GMO. No Starch, gluten, lactose, artificial colors, flavours or preservatives. No Animal Testing. Certified Authentic Tru-ID® seal. Helps fight colds and flu and shorten their duration: may be a drug claim

1 softgel
Echinacea (10:1) extract (Echinacea purpurea, herb top) [equivalent to 4,000 mg of raw herb] 400 mg.

Also contains: Soybean oil, glyceryl palmitostearate, polyglycerol esters of fatty acids, more...

APPROVED

Nature's Bounty® Echinacea 400 mg

Mfd. by Nature's Bounty, Inc.

$ Price Check

1 capsule

400 mg purpurea aerial powder

TPCs:
Expected Min: 4 mg
TPCs: 4.7 mg ✔

Heavy Metals: Pass

Microbial Contamination: Pass

For adults, take one (1) capsule seven times daily, preferably with meals.

Large capsule

$0.10/capsule

[$0.22]

$10.49/100 capsules

Non-GMO. No Artificial Color, No Artificial Flavor, No Artificial Sweetener, No Preservatives, No Sugar, No Starch, No Milk, No Lactose, No Soy, No Gluten, No Wheat, No Yeast, No Fish. Sodium Free.

1 capsule
Echinacea (Echinacea purpurea) (aerial) 400 mg.

Other Ingredients: Gelatin.

APPROVED

Top Pick

for E. purpurea herb extracts

Vital Nutrients Echinacea Extract 500 mg

Mfd. by Vital Nutrients

2 vegetarian capsules

1,000 mg purpurea herb extract

TPCs:
Expected Min: 40 mg
TPCs: 50.9 mg ✔

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

1 to 2 capsules 2 to 4 times daily, or as directed by your healthcare professional.

Large vegetarian capsule

$0.79/2 vegetarian capsules

[$0.15]

$23.60/60 vegetarian capsules

Excludes: Coatings, Binders, Gluten (Wheat, Rye, Barley), Milk/Dairy (Casein, Whey), Soy Protein, Egg Protein, Sugar.

2 vegetarian capsules
Echinacea purpurea Herb Extract (3-4% phenolics) 1,000 mg.

Other Ingredients: Vegetable Cellulose Capsule, Cellulose, Leucin, and Silica.

E. angustifolia only Products:

APPROVED

Hawaii Pharm Echinacea

Dist. by Hawaii Pharm LLC

1 ml

330 mg angustifolia root powder per ml

TPCs:
Expected Min: 1.7 mg
TPCs: 1.6 mg ✔

Heavy Metals: NA ⓘ

Microbial Contamination: NA ⓘ

Take about 20-30 drops (0.7-1 ml, one full squeeze of the dropper bulb) to 2-4 oz of juice or water up to 4 times per day.

Liquid from bottle

$0.25/ml

[$1.53]

$29.95/4 fl oz [120 ml] bottle (approx. 120 servings)

Contains No Alcohol. Non-GMO. Gluten Free. Contains No gluten, alcohol, artificial colors, pesticides, heavy metals.

1 ml
Echinacea (Echinacea Angustifolia) root extract 970 mg. Extraction rate: 330 mg of dry plant material per 1 ml.

Ingredients: Certified Organic Echinacea (Echinacea Angustifolia) dried root. Origin: USA, more...

Combination Products:

NOT APPROVED

21st Century® Echinacea Complex 250 mg

Mfd. by 21st Century HealthCare, Inc.

2 vegetarian capsules

250 mg (blend of purpurea herb extract and angustifolia root powder)

TPCs:
Expected Min: 5.8 mg to 9.9 mgⓘ
TPCs: 1.3 mg

Heavy Metals: Pass

Microbial Contamination: Pass

Adults take two (2) capsules daily with any meal or as directed by a healthcare provider.

Large vegetarian capsule

$0.10/2 vegetarian capsules

[$0.78]

$10.46/200 vegetarian capsules

Gluten free. 100% Vegetarian. No added Sugar, Salt, Yeast, Preservatives, Artificial Flavors or Colors.

2 vegetarian capsules
Echinacea Blend (Echinacea purpurea herb extract & Echinacea angustifolia root powder) 250 mg.

Other Ingredients: Oat Fiber, Rice Bran, Cellulose, Magnesium Silicate, Magnesium Stearate, Silicon Dioxide. Contains <2% of: Maltodextrin.

NA ⓘ

Nutrilite® Immunity Echinacea

Dist. by Amway Corp.

3 tablets

Purpurea root & aerial powder and angustifolia root powder in blend

TPCs:
Expected Min: NA ⓘ
TPCs: 25.1 mg

Heavy Metals: Pass

Disintegration: Pass

Microbial Contamination: Pass

Take three tablets daily.

Medium triangular tablet

$0.83/3 tablets

[$0.33]

$33.00/120 tablets

3 tablets

Tricalcium phosphate (in blend), citrus multiflavonoid complex 100 mg

Halal. Kosher. NSF Contents Certified seal.

3 tablets
Calories 5, Total Carbohydrate 1 g, Sugars <1 g, Triple Guard Echinacea Blend [Echinacea (purpurea root and aerial parts, angustifolia root), Corn Starch, Maltodextrin, Tricalcium Phosphate] 506 mg, more...

APPROVED

Top Pick

for a mixture of dried aerial and root portions of E. purpurea with some E. angustifolia root

Oregon's Wild Harvest Echinacea

Dist. by Oregon's Wild Harvest

$ Price Check

2 capsules

330 mg purpurea tops powder

330 mg purpurea root powder

140 mg angustifolia root powder

TPCs:
Expected Min: 5.7 mg
TPCs: 14.7 mg ✔

Heavy Metals: Pass

Microbial Contamination: Pass

Take two capsules twice daily or as directed by your healthcare professional.

Large capsule

$0.38/2 capsules

[$0.26]

$16.95/90 capsules

Certified Organic by Oregon Tilth. Gluten free. Verified Non-GMO Ingredients. Free from: Dairy, wheat, peanuts, soy, gluten and corn allergens.

2 capsules
Organic Echinacea tops (Echinacea purpurea) 330 mg, Organic Echinacea root (Echinacea purpurea) 330 mg, Organic Echinacea root (Echinacea angustifolia) 140 mg.

Other Ingredients: Non-GMO bovine capsules and nothing else.

APPROVED

Solgar® Echinacea Herb Extract

Mfd. by Solgar, Inc.

$ Price Check

1 vegetable capsule

125 mg angustifolia root extract

300 mg purpurea aerial powder

TPCs:
Expected Min: 8 mg
TPCs: 13.2 mg ✔

Heavy Metals: Pass

Microbial Contamination: Pass

As an herbal supplement for adults, take one (1) vegetable capsule up to three times daily, preferably with meals or as directed by a healthcare practitioner.

Large vegetable capsule

$0.22/vegetable capsule

[$0.17]

$13.34/60 vegetable capsules

Gluten, Wheat & Dairy Free. Suitable For Vegans. Non-GMO. Free Of: Gluten, Wheat, Dairy, Soy, Yeast, Sugar, Sodium, Artificial Flavor, Sweetener, Preservatives and Color.

1 vegetable capsule
Standardized Echinacea Extract (Echinacea angustifolia) (root) (echinacosides 5 mg [4%]) 125 mg, Echinacea (Echinacea purpurea) (aerial) 300 mg.

Other Ingredients: Vegetable Cellulose, Vegetable Magnesium Stearate, more...

Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.

ConsumerTips™:

What to Consider When Buying:
Consumers should expect the following information on Echinacea product labels, and all of this information is required by the FDA (although not all products comply):

· The species of Echinacea (i.e., E. purpurea, E. angustifolia, or E. pallida);

· The part of the plant used, such as root or the aerial (above-ground) portions, which include the stem, leaves, and flowers;

· The form of Echinacea used (e.g., whole herb or root, extract — which is usually a concentrated form, or tincture);

· The amount of Echinacea per pill or dose in grams (g) or milligrams (mg) [1 gram = 1,000 milligrams] (May not be provided for proprietary blends but preferable if it is.)

Some products may be standardized to specific substances such as cichoric acid, alkamides, and polysaccharides. The concentration of total phenols may also be indicated on the labels of Echinacea products. The total phenolic content (determined by HPLC) will vary depending on the type and part of the plant used (see What It Is), but should be about 0.5% to 1% for quality dried whole herb or root products and proportionally higher for extracts (based on their listed ratios of Echinacea to total content) but possibly lower for tinctures, particularly if made from fresh Echinacea (which is about 50% to 75% water).

Many clinical studies suggesting benefit have been conducted with products extracted from the aerial (i.e., stems, leaves, flowers) portions of E. purpurea, either as pressed juice extracts or alcohol extracts often dried into extract powders (900 mg per day) (Linde, Cochrane Database Syst Rev 2006). The United States Pharmacopeia and WHO additionally recognize the use of the root from E. purpurea and E. angustifolia.

Because echinacea products come in many forms and concentrations, the dosage will vary considerably depending on the product. While at first glance it may seem that products made with a large amount of dried herb powder (sometimes over 3,000 mg per day) are giving you "more" Echinacea than extracts (typically several hundred milligrams per day), keep in mind that dry extracts are generally 4 times the concentration of herb powders depending on the type of extract. While some herbalists believe that dried herb powders are superior to extracts because they provide a wider spectrum of plant chemicals, there is less clinical evidence for dried herb powders of Echinacea than for extracts.

Some Echinacea products may also contain the herb goldenseal (Hydrastis canadensis). While goldenseal may be useful as an antibacterial agent when applied directly on topical infections, clinical studies have not shown it to be useful in treating colds since it is not antiviral and it is specifically not to be used by pregnant women.

Elderberry is also an ingredient in some supplements that contain echinacea. Experimental pharmacological studies and a small number of clinical trials suggest that a standardized syrup made from elderberry fruits (Sambucus nigra) has an immune-enhancing effect, which can help reduce infection from colds and flus. The usual dose for the clinically-tested standardized elderberry syrup ranges from 1 teaspoon four times daily for children to 2 teaspoons four times daily for adults for intensive use; regular daily prophylactic maintenance is 1 teaspoon daily for children and 2 teaspoons for daily for adults (ABC Clinical Guide to Elderberry 2004). A standardized extract of elderberry taken in four doses of 175 mg has recently shown possible efficacy in preventing flu symptoms in a small pilot trial (Kong 2009). [Note: Although rare, be aware that a case of acute pancreatitis was reported in 2019 in a 51-year-old man after he took two to three doses of elderberry extract (Sambucol)].

No meaningful scientific studies have evaluated the combination of Echinacea with goldenseal or elderberry. However, there have been numerous positive studies of products that contain fixed combinations of Echinacea plus thuja (white cedar, Thuja occidentalis) and baptisia (wild indigo, Baptisia tinctoria), and other combinations of Echinacea preparations with propolis and vitamin C, or with the extract of the leaf of the immune-modulating herb Andrographis paniculata.

What to Consider When Using:
In general the total daily dosage of Echinacea is to be divided into two or three doses taken throughout the day. It is sometimes suggested that liquid forms be held in the mouth for 10 seconds before swallowing to provide "local antiviral effects" (Jawad, Evid Based Compl Alt Med 2012).

Some clinical trials, as well as popular use, suggest that Echinacea preparations are best used as a prophylactic during cold and flu season. They may also be effective if taken at the first signs of a cold and continued for one to two weeks. Echinacea (at least, E. purpurea juice) has not been shown to be helpful in treating colds in children, although one clinical trial showed a lower incidence of later infections with colds in children who had consumed a syrup made from the fresh juice of E. purpurea (Taylor, 2003).

Concerns and Cautions:

Echinacea taken by itself appears to be relatively safe. The herb has been used safely in trials lasting up to 12 weeks but is not recommended for long-term use. Reported side effects are minor and include non-specific gastrointestinal symptoms and increased urination.

Some people may be allergic to Echinacea, and it has been noted that people allergic to sunflowers and other flowers in the daisy family run a higher risk of having an allergic reaction. One large study found that children given Echinacea were somewhat more likely to develop a rash than those given placebo, but otherwise no harmful effects were seen.

Because Echinacea is thought to work by stimulating the immune system, this herb is generally not recommended for people with autoimmune diseases or those taking immune-suppressant drugs.

Two cases of acute hepatitis (liver inflammation) (one in Turkey and one in Greece) have been reported with the use of Echinacea root tablets (600 mg - 1,500 mg per day -- species not given) which resolved within one to three months of stopping supplementation (Kocaman, Eur J Intern Med 2008; Gabranis, J Postgrad Med 2015).

Preliminary research suggests Echinacea purpurea root could potentially increase the effects of caffeine, as it has been shown to increase blood concentrations of caffeine by as much as 30% due to an inhibitory effect on the CYP1A2 metabolic enzyme (Gorski, Clin Pharmacol Ther 2004).

Echinacea may potentially affect the metabolism of drugs metabolized by the CYP3A4 enzyme, although it has been noted that, if used per label recommendations, Echinacea supplements are not likely to have a dramatic effect (Gurley, Planta Med 2012). Drug metabolized by CYP3A4 include lovastatin (Mevacor), atorvastatin (Lipitor), simvastatin (Zocor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens and triazolam (Halcion) (Budzinski, Phytomedicine 2000). It may also affect the metabolism of warfarin (Coumadin), although clinically significant changes in INR have not been reported (Coumadin Prescribing Information 2019; Abdul, Br J Clin Pharmacol 2010).

There is little information on the safety of Echinacea for very young children or pregnant or nursing women. One review article indicates that using Echinacea during the first trimester of pregnancy may be safe, though it is not recommended during lactation until further studies are done (Perri, Can J Clin Pharmacol 2006). Women who may become pregnant while using Echinacea should keep this in mind.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.

Latest Clinical Research Updates for Echinacea Supplements

Echinacea for Anxiety?

7/17/2021

Can echinacea reduce symptoms of mild to moderate anxiety? See what a recent study found in the What It Does section of our Echinacea Supplements Review. Also see our Top Picks among echinacea supplements.

Also see our answer to the question: What are the best supplements for depression and anxiety?

Can Echinacea Prevent Colds?

10/21/2012

Although the evidence behind echinacea has been mixed, a new study -- the largest to date -- found that taking a particular type of echinacea supplement throughout cold season reduced cold "events" (catching colds and days spent with colds) by 26%. See the update to the Echinacea Supplements Review for details about this particular supplement, including the special way it is taken. More >>

Does Echinacea Help Treat a Cold?

1/02/2011

Very little, it seems. A new large, well-controlled study of a commercially sold echinacea supplement failed to show a substantial benefit when given shortly after the first sign of a cold. Evidence tends to be better (although not robust) for echinacea used to prevent a cold before it begins, as opposed to once symptoms start. Find out more (including the product that was tested) in the Echinacea Supplements Review. More >>