Rumors, Rumors, Everywhere. - Echinacea Gossip.

Jul 13, 2025April Graham

Heya Folks,

I heard a rumor that Echinacea is an amazing antiviral, so I thought I’d do a brain dump about that!

Actually, I’m pretty sure that everyone and their mother has heard this rumor and believes it to be gospel, and I get it, we as a society have a habit of believing a thing if it’s said often enough.

But hold up just a moment….what if I told you that Echinacea doesn't do anything to push back against viruses, and that rumor is just a totally unfounded myth?

Recently, I was “challenged” by a person who said I was constantly wrong about apparently many things in my live Q&A’s, but in particular, how I always let folks know that Echinacea is not an antiviral, so I thought welp, this is a good topic for a brain dump and you’d better believe I’m about to show my work so hold onto your seat folks things are about to get deep!

So, one way that we can become better herbalists or health advocates for ourselves is to learn on a deeper level how our body functions, and while we have many moving parts and areas we can learn about, here we’re going to zoom on in to the immune system and white blood cells because, well, it matters.

White blood cells (WBCs)—also called leukocytes—are like the body’s personal security team. They’re constantly on patrol, looking for anything suspicious like viruses, bacteria, or damaged cells. And just like any good team, each member has a specific role. Let’s break them down in simple terms:

🔥 Neutrophils – The First Responders

These are your immune system’s “emergency responders.” They’re the most common type of white blood cell and the first to show up when there’s an infection, especially from bacteria.

They attack invaders and swallow them whole (a process called phagocytosis, which just means “cell-eating”).
Once they do their job, they die off—forming what we often see as pus during an infection. That’s why the worse the infection you have, the more pus you see.

🎯 Lymphocytes – The Specialists

These are the high-tech specialists of your immune system. They include:

B cells: Make antibodies (tiny proteins that tag invaders so other immune cells know what to attack—kind of like giving them a “wanted” poster).
T cells: Come in different types:
- Helper T cells (CD4+): They’re like project managers, telling other immune cells what to do.
- Killer T cells (CD8+): These are the ones that hunt down and destroy infected cells—like a cellular bounty hunter team.
Also includes Natural Killer (NK) cells: They don’t need special instructions—they’ll just attack anything suspicious, like virus-infected or mutated cancer cells.

🧹 Monocytes – The Clean-Up Crew

These are your body’s janitors and scouts.

They travel in the blood and turn into macrophages when they move into tissues (macrophage literally means “big eater,” so think of a Pac-Man going along and gobbling things up).
Their job is to clean up dead cells, bacteria, and anything else the other cells leave behind.
They also help alert and activate other immune cells when something big is going down that they can’t manage to swallow up.

🪱 Eosinophils – The Parasite Patrol (and Allergy Aggravators)

These are less common but super important when it comes to parasites (like worms) and allergies.

They attack invaders that are too big to be eaten (like parasites), using enzymes and toxic proteins.
If they’re too active, they can contribute to allergic reactions and inflammation, and even more severe issues, such as entering the wrong areas of the body (usually the esophagus) and causing problems with swallowing. This happened to my husband.

🚨 Basophils – The Alarm System

Basophils are rare, but they play a powerful role.

They release chemicals like histamine when there’s an allergen or injury (histamine is what causes itching, swelling, and sneezing).
Their job is to alert other immune cells and get the inflammatory response going.

Now we needed this random lesson in immune function because it empowers us down the line to be curious and say something like “I wonder what part of the immune system” any given herb might have an impact on vs falling into the trap of just saying “it’s an immune stimulator so it’s obviously antiviral”. That happens 24/7 in the herbalism realms, but it’s not rooted in nuance in the very least.

So, April, what part of the immune system does Echinacea stimulate?

Well Susan, I’m so glad you asked because I’ve been wanting to clear this up for some time now (said in my best newscaster voice ha). Echinacea has been shown to exclusively boost the activity of macrophages (those big clean-up pack man eaters) and natural killer (NK) cells, and to increase levels of pro-inflammatory cytokines (chemical messengers the immune system uses to rally its forces).

I said I was going to show my work, so let’s have a little look-see here:

🧹 1. Echinacea boosts macrophage activity

Modulation of macrophage immune responses by Echinacea
A detailed review shows Echinacea extracts activate macrophages—triggering phagocytosis and prompting release of cytokines like TNF‑α and nitric oxide, both key to bacterial defense. (1)

In human speak, this means:

Echinacea tells your body's clean-up crew (macrophages) to get moving. These cells go around "eating up" bacteria and debris—kind of like immune system vacuum cleaners. When Echinacea stimulates them, they become more aggressive and start releasing chemical signals (like TNF‑α and nitric oxide) that tell other immune cells, “Hey, we’ve got a problem—get over here!” This kind of response is super helpful when dealing with bacterial infections, but it’s not the way your body handles viruses, which require a more targeted, sniper-style defense.

🛡️ 2. Echinacea enhances natural killer (NK) cell function

Immunopharmacological activity
Wiley-published research reports that Echinacea stimulates NK cells and macrophages, increasing production of TNF‑α, IL‑1, and IL‑6. (2)

In human speak, this means:

Echinacea gives a pep talk to two types of immune cells—macrophages (the clean-up crew) and natural killer (NK) cells (the assassins). These cells respond by releasing chemical messengers (like TNF‑α, IL‑1, and IL‑6), which basically tell the rest of the immune system: "Sound the alarm—there's trouble." This kind of full-force response is part of your body's inflammation defense, especially useful against bacteria—but it's not the precise, virus-hunting approach your body uses for things like colds or the flu.

Human RCT (Korean adults)
In an eight-week clinical trial, high-dose Echinacea purpurea significantly boosted NK cell cytotoxicity in healthy adults, along with rising IL‑2, IFN‑γ, and TNF‑α levels. (3)

In human speak, this means:

Real people took high-dose Echinacea for eight weeks, and their natural killer cells (the ones that destroy infected or abnormal cells) became more aggressive. Their blood also showed higher levels of certain immune chemicals (IL‑2, IFN‑γ, TNF‑α)—which are part of the body’s early immune response. Again, this is great for general immune activation and bacterial defense, but not the specialized kind of immune work your body needs to track down and destroy viruses.

⚠️ 3. Increases pro‑inflammatory cytokines

Echinacea purpurea extracts and cytokine production
A thorough in vitro study found that non-stimulated macrophages exposed to Echinacea produced TNF‑α, IL‑1β, and IL‑6—all primary messengers in bacterial defense. (4)

In human speak, this means:

In a lab (outside the body), scientists exposed immune cells called macrophages to Echinacea, and those cells immediately released a bunch of chemical messengers (TNF‑α, IL‑1β, IL‑6). These signals rally other immune cells—like a group text that says, “Hey, something’s wrong—get over here!” This response is especially tied to bacterial defense. While this particular study wasn’t done in humans, other research—like the Korean clinical trial—shows similar immune signals also increase in people taking Echinacea, meaning some of these effects do happen in real life, though still mostly as broad immune stimulation, not specific antiviral targeting.

Now, the thing to know about Echinacea is she’s so widely used that this has inevitably led to HUGE amounts of studies, and we usually aren’t so lucky with other herbs. Albeit I can usually find a handful of something or another on an herb if I really want to, but Echinacea? She has hundreds and hundreds of studies done on her, so that means I can do something cool here.

I can not only show that she’s mainly useful for bacterial infections, but I can actually show my work in another way, I can show she has outright failed to be an antiviral, many times in many studies. Let’s jump in, the waters…still sick:

Echinacea and Experimental Rhinovirus Infection (NEJM, 2005)

A randomized, double-blind, placebo-controlled trial (N=437) evaluated Echinacea angustifolia extracts for the prevention and treatment of rhinovirus (common cold) infection. The study assessed multiple endpoints: viral load, symptom severity, inflammatory markers (IL-8), and infection incidence. (5)

Outcome: No statistically significant difference between Echinacea and placebo across all clinical or virologic parameters.

In human speak:
They literally gave people the cold virus and tried to use Echinacea to stop it—didn’t work. People got just as sick, just as fast, and stayed sick just as long, whether they took Echinacea or not.

Echinacea for Treating the Common Cold (Annals of Internal Medicine, 2010)

A randomized, blinded trial (N=719) compared unrefined E. purpurea extracts, placebo, and no treatment in adults with early cold symptoms. Measured endpoints included illness duration, symptom severity scores, inflammatory biomarkers (IL-8), and neutrophil counts. (6)

Outcome: A non-significant reduction in illness duration (~0.5 days), with no change in severity or immune markers.

In human speak:
Echinacea shaved off half a day of cold symptoms—maybe—but not in a way that’s actually meaningful or consistent. No difference in how sick people felt, and no changes in immune system markers.

Echinacea for Rhinovirus Prevention (PMC 7107999)

A prospective trial assessed Echinacea purpurea for prevention of rhinovirus infection under controlled exposure conditions. Participants received Echinacea prior to intentional viral challenge. (7)

Outcome: Echinacea did not reduce infection rate, viral shedding, or immune biomarker expression.

In human speak:
They gave people Echinacea before giving them the cold virus—hoping it would stop the infection from starting. It didn’t. The virus still took hold just as easily.

RCT vs. Oseltamivir (Influenza Hot Drink Trial)

Randomized, double-blind, active-controlled trial (N=473) compared a standardized Echinacea purpurea hot drink (“Echinaforce”) to oseltamivir (Tamiflu) for symptomatic influenza. Outcome: Echinaforce was not non-inferior to oseltamivir in resolving symptoms or shortening illness duration. (8)

In human speak:
They put people with real flu on either an Echinacea drink or Tamiflu. Echinacea didn’t measure up—people didn’t recover any faster or feel better quicker.

I know this probably reads like I’m over here just cursing Echinacea’s name as useless, but I’m really not. I want people to know her, build a relationship, and use her in a way that truly supports them—rather than misusing her and missing out on actual antiviral allies like Elderberry. Elderberry has been shown in several real human trials to cut back on flu severity and duration—especially when taken at the first signs of symptoms. (9) (10)

Speaking of real human trials, please note that I have taken real effort here to mainly show real studies on real humans, because how something reacts in a test tube is not the same as how something acts in the body. It’s risky to rely on in vitro studies because they can’t take into account what happens when we digest, absorb, and metabolize a substance.

In fact, before anyone feels the need to send me a study showing me that Echinacea is an antiviral, have you checked to see if that study was them placing Echinacea in a test tube with cells or…a trial/study on how it actually impacts the human body?

I bet It’s in vitro.

Quick the more you know moment: In vitro vs. in vivo

In vitro means “in glass”—as in, a petri dish or test tube. These studies help us understand potential mechanisms, but they’re done outside a living body, without digestion, enzymes, immune interactions, or metabolism.

In vivo means “in life”—studies done inside real living organisms (like humans), where we can see how something actually behaves in the full complexity of the body. That’s why in vivo trials are the gold standard when it comes to deciding whether something really works.

Does this mean that Echinacea is totally useless for viral things like the cold, flu, “rona” virus?

Well, yes and no.

The thing to know is if a virus runs you down, you become super susceptible to secondary bacterial infection, usually in the respiratory tract (lungs, sinus) so while I would not use her from the very beginning of a nasty flu because it just puts more pressure on your immune functions (that can and will wear out) I would use her towards the tail end of being sick especially if it was a nasty case of something that feels like it’s going to linger.

It’s also really important to know that using Echinacea on a regular basis, like some do for “cold season” as a supposed, yet failed, cold prevention, can actually do harm.

How? One medical term: leukocytosis.

What in the world is that? Leukocytosis means you have too many white blood cells from chronic immune stimulation, and if you keep pushing it with no reprieve…you’ll get the gift of leukopenia, which is when your body can no longer keep up with the overproduction, so you stop making white blood cells. That means you no longer have a functioning immune system, and yes, this happens, and it can take the better part of a year for the body to recover. (11)

Just to interject something here—can I say how much leukopenia creeps me the hell out?

Do you know where your white blood cells are made? Your bone marrow.

And leukopenia? It’s what happens when that marrow gets so overworked, it taps out.

Like, your bones aren’t just tired—they’re hollowed out.

Okay, maybe not literally hollow, but close enough: you’ve pushed your immune system so hard, it's like your body started eating its own marrow from the inside out like some child eating witch LOL.

I don’t know why that gives me the full-body ick, but it does. Too much Echinacea? It doesn’t just “boost your immune system”—it hollows you out.

Okay, back to professionalism, April.

Here are the things that I love to use Echinacea for when the situation arises:

Note: I wouldn’t use her for more than 4 days on, 2 days off—that kind of rhythm keeps her effective without overstimulating your system.

🌀 Bacterial sinus infections
🌬️ Acute bacterial bronchitis (especially if it lingers past 10 days)
🫁 Bacterial pneumonia
🩹 Wound healing (topically) (especially alongside yarrow tincture—power combo!)
🚽 Bladder infections (paired with corn silk, onion broth, or uva ursi)
🦷 Tooth infections (topical + internal support)
🔥 Boils or skin abscesses (short-term immune stimulation for clearing)
🧪 Post-antibiotic immune fatigue (to kickstart sluggish recovery)
💥 Short-term “immune jolt” (after bacterial exposure like food poisoning or staph risk)

Here’s where she’s useless or dangerous:

🦠 Viral infections (cold, flu, RSV, *VID, etc.)
⚡ Autoimmune conditions (lupus, RA, MS – can worsen flare-ups)
🧯 Chronic or mystery inflammation (Echinacea can stir the pot, not calm it)
🤧 Allergies or histamine issues (can increase cytokines that aggravate symptoms)
📅 As a daily immune tonic (she’s a sprinter, not a marathoner)
🍞 Yeast or fungal infections (not antifungal—wrong tool entirely)
🏥 Severe infections needing antibiotics (she supports, but doesn’t replace antibiotics if something is already really bad)

At the end of the day, I think Echinacea has been typecast into a role she was never meant to play. And because of that, she’s often misused—and then unfairly judged when she doesn’t deliver. It’s no wonder people say, “Echinacea didn’t work for me.” That’s like being mad that a fork didn’t work for soup—wrong tool for the job, my friend.

But if they had reached for her short-term, during a clearly bacterial situation?

Well... that’s when the admiration would probably start.

Echinacea isn’t an antiviral—and that’s not a flaw, it’s just misunderstood function. When we actually take the time to learn how herbs work, and where they shine, everything clicks into place. And I’m here to help you do that—because you are absolutely smart enough to do this.

If you would like me to cover a specific health topic, herb, nutrient, and all the things in these realms, feel so very free to leave a comment with your request!