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Echinacea: Friend or Foe if You Have Arthritis?

by Barbara D. Allan
Author of Conquering Arthritis

In one of my newsletters, I addressed the question:

“It is my understanding that Echinacea strengthens the immune system. Is this a good idea for an already overactive immune system of a person (me) who has RA?”

Photo by FromSandToGlass

My answer was:

“A strong immune system is one that is in balance. In the case of RA, one part is overactive (a certain subset of helper T-cells) and another part is under active (a certain subset of suppressor T-cells). This imbalance leads to runaway inflammation.

With Echinacea, or any herb or supplement that affects the immune system, the question is whether this overall balance is improved. Because herbs generally have a holistic effect, this is a likely outcome. However, in keeping with my general approach, the best way to answer a question like this is to learn what you can about the specific effect of an herb or supplement, and then pay close attention to the specific effects of this substance on your own body.”

Here is what Medline has to say about Echinacea.


The Update

This update was prompted by reader responses. One reader let me know that for her, taking Echinacea was correlated to a worsening of specific arthritis symptoms. Another reader wrote expressing her strong opinion that Echinacea is dangerous for RA patients.

In response, I have done more research on what is known about Echinacea and how it affects autoimmune disorders such as rheumatoid arthritis.

What is most striking is how little research has been done on the issue. The University of Maryland Medical Center cautions that folks with autoimmune conditions should not use Echinacea, but they provide no references or other information explaining this caution. A search of Medline reveals no papers specifically focused on the effect of Echinacea on autoimmune types of arthritis.

The only research paper I could find on Medline that addresses the larger issue of Echinacea and autoimmune disorders in humans was published in June of 2004 in a dermatology journal. This article describes two patients with an autoimmune skin disorder (pemphigus vulgaris) who had a flare up in their condition that correlated to taking both Echinacea and Spirulina, at the same time. A third patient had both the onset and a flare up associated with taking Spirulina and another product. The Spirulina is the common agent implicated.

It isn’t clear whether the Echinacea had any role at all in the onset or worsening of these skin conditions.

Another paper published in September 2005 in the journal “Autoimmunity” looked at the effects of Echinacea on type I diabetes (an autoimmune disorder). This study was done in mice and indicated that Echinacea brought about a favorable immune response and may actually be an effective treatment for type I diabetes. Whether this effect will also be present in humans is an open question.



Because Echinacea extracts have known effects on the immune system, there is some concern about the effect of taking Echinacea when an autoimmune disorder is present. However, to date, no research has yet been published in medical journals on the effects of Echinacea on autoimmune types of arthritis. What little has been published on the effects of Echinacea on other types of autoimmune disorders is of little use in determining safety for people with arthritis.

Which brings us back to my general advice about any treatment you might be considering. Learn what you can about the specific effects of a treatment. If you decide to try it, pay close attention to the specific effects of this substance on your own body. Ultimately, what matters is whether it helps or harms YOU.

Share Your Echinacea Experience

If you have used Echinacea yourself, please write me whether it had any negative (or positive) effect on your arthritis. I’m really curious. If very many of you have had negative effects, I need to stop mentioning Echinacea as a treatment for colds and sniffles and warn folks of the possible dangers.

[Author’s note: To date reader responses are running 2/3 reporting good results using Echinacea, 1/3 negative. Responses have been primarily from readers with rheumatoid arthritis. To share your experience please leave a comment below.]

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29 Comments On Echinacea: Friend or Foe if You Have Arthritis?

Dear Jennifer, Thank you so much for sharing your experience with Echinacea. You have certainly been through an ordeal. How are you doing now? What you describe with reacting against Echinacea and shellfish is not unusual with respect that most of the clients I work with to heal arthritis react to various, supposedly healthy or even for the general public anti-inflammatory ingredients. The trick to getting well is to identify your reaction pattern, and eliminate all your triggers for long enough to heal those reaction patterns. If you are still experiencing problems and would like my help in sorting all this out, please call or email my office. The contact info is found under "contact" in the navigation bar at the top of the page.

Date : 30th May 2019   |  By : Barbara Allan
In 1997 I was working on a submission on behalf of our family business when everyone around me (I have had 6 children and they also provide an extensive network of contacts). My eldest daughter (who due to POCS was very active in choosing alternative healthcare and practicing a very strict nutritional regimen - which she still does to this day) recommended I should try echinacea. What little information was then available expounded it’s virtues so off to the chemist I went and purchased and started on a “powerful” dose of an echinacea supplement. After 4 days I thought I was coming down with the severe flu going around as every joint in my body was on fire and I could hardly get out of bed. The pain continued, but I didn’t come down with normal symptoms flu! I was too busy to pursue doctors and continued taking echinacea for a month. I went back to our family chemist to enquire had he heard of any adverse reactions from echinacea. He had not but suggested I stop taking them. The pain continued and after about 12 months I was back into my regular rpm and step classes and feeling “normal” again. I got used to having joint pain flare ups and seemed to get a more severe reaction to shellfish and hay fever than I had before I started taking echinacea. I continued seeking information I found a tiny article online about some people having an allergic reaction. To me it was like I had triggered some hyper reactive response to a whole lot of things that never bothered me before commencing echinacea. I just endured the joint pain that flared from time to time. I started to take the usual joint supplements (chondroitin etc) and that helped until they changed the formula to being derived from shellfish which I only investigated because I started to get more pain more frequently and it seemed it was no longer working at all. Over the last six years I’ve had worsening problems with the fine joints in my hands and feet and when the flare ups are worse, in it seems every joint in my body is affected. 18 months ago when I felt like I was going to need a walking frame (that’s a terrible prospect for one who loves dancing and cycling and rough and tumble with my 8 grandchildren under 9... care for my tough and feisty 90 year old dad). My research (that’s my area of study

Date : 30th May 2019   |  By : Jennifer Elliss
Dear Capt Bruce, I am glad for you the Echinacea is having such a positive effect for you. My one suggestion would be, if it stops working for you, take a break from it for a few months. Sometimes we develop an inflammatory reaction to foods or supplements that we take everyday. Taking a break can help reverse that inflammatory reaction so that we can once again experience the benefits.

Date : 23rd May 2018   |  By : Barbara Allan
I have used Euchinasea for years at the onset of cold or flu symptoms and 9.9 times out of 10 the effect of taking 4-100mg tabs is instant. About 10 days ago I started taking it without cold symptoms. My only complaint is a left hip joint that hurts at varying degrees daily and if I have strenuous work to do I take 4 Advil’s first. Since my taking Eucinasea daily for about 10 days, my hip pain has been reduced by 2/3. I am wondering if it’s the Euchinasea that’s doing it. So for now I am going to continue it’s use and try to avoid any Advil. Pretty amazing since that’s the only thing I have changed in my diet. Thoughts? Capt Bruce

Date : 23rd May 2018   |  By : Capt Bruce Blomgren
Dear Helen, Thank you for sharing your experience with Echinacea. Echinacea clearly falls in the "foe" category for you. Interestingly, of the people with arthritis who have contacted me about this issue, the tally is still running at about 50% finding that taking echinacea is health supportive and 50% finding that echinacea causes their arthritis to flare up.

Date : 21st Apr 2018   |  By : Barbara Allan
I used echinaecia many years ago for cold flu bug. Very shortly after taking it for a few days my joints became very inflamed and it got so bad i was knocked off my feet and immobile practically. It carried on for some years and i was on immune suppresssants until I took CMO which resolved it in 10 days and was dramatic in my improvement. Recently I was treated by a herbalist because due to the immune suppressants I was given previously for the arthritis i was suffering one infection after another. The herb mix had echinaecia in it. After a few weeks mt joints which have been ok now for 18 years suddenly flared and i have again become more or less immobile, do i think its due to the echinaecia? Yes i certainly do. A friend gave her young daughtr echinaecia for 3 weeks, then she started complaining that her hands hurt and she would put them on the cold sink to cool them. I immediately asked because of my own experience have you been giving her echinaecia? Yes for three weeks. I suggested she stop and she did and the symptoms went away. There needs to be studies done on this herb because I believe it is responsible for both my episodes of arthritic flare up in a previously healthy person. I will now get some CMO and hope it combats it once more

Date : 21st Apr 2018   |  By : Helen
Dear Sarah, Thanks for sharing your wise words.

Date : 6th Jun 2017   |  By : Barbara Allan
I am commenting on your article with Echinacea and arthritis. I have found that it helps as long as you take smaller than recommended doses. I first realized the connection when I was using Ricola Echinacea cough drops. My dentist recommended sugar free so I change brands. My knees got worse. From my experience, you are on target. Too much of a good thing throws everything out of balance. Too much Vitamin C has that effect on my knees (I no longer drink diet drinks because of the vit C in them. The same is provably true with Echinacea. I take two caplets (one am and one pm) when the recommended dosage is up to 6. There are new studies on the National Institute of Health website that are leaning to the use of small dose Echinacea for RA.

Date : 6th Jun 2017   |  By : Sarah Jane Deacon
I have/had pain in my neck/shoulder region for 3 months. No diagnosis of autoimmune disease (yet... ;-) When I started with Esberitox ( 3x3 Tablets/day) pain vanished. Stopped E, pain returned. Started it again, pain went away again... coincidence? So I googled Echinacea and pain, brought me here. For me it's working so far...

Date : 16th May 2017   |  By : Angelika
Dear Terry, I doubt Echinacea caused your RA, but if you happens to be an inflammatory trigger for you, it might be making it worse. The way to test is not to have any Echinacea for at least a week. This clears it out of your system and unmasks any possible reaction you are having to Echinacea. Then add it back for a single serving. Notice how you feel for the next 3-4 days. During this time do your best not do anything else that might trigger inflammation. If you feel fine during those 3-4 days, Echinacea is not an inflammatory trigger for you. It is best to test while you are feeling relatively good, to make it easier to notice any change.

Date : 17th Feb 2017   |  By : Barbara Allan
Last year I started taking Echinacea. I don't remember why or who suggested it. I have hypothyrodism so it might have been for that or someone said to try it for my migraines. In December I was diagnosed with RA. I have an appointment to see an RA Specialist soon. I woke up thinking about what I was taking and it's side effects. Googled Echinacea and found your article. If there was nothing wrong with my immune system and I took this could it have caused my RA?

Date : 12th Feb 2017   |  By : Terri Haskell-Bedgood
Dear Sharon, Thank you for sharing your experience with Echineaca and what you have discovered about how you are allergic to not only ragweed but other members of the ragweed family such as Echinacea and stevia. May this knowledge you shared help others as well. I wish you every success in discovering and elimininating all your reaction inducing foods and substances. You might also wish to look at some of the articles listed at the top of the page under the red navigation bar heading "Who Gets Well." Over time I lost all of the reactions that were triggering my arthritis. Those articles talk about how I and others have done that.

Date : 1st Sep 2016   |  By : Barbara Allan
I wanted to share a little known fact about Echinacea; it is related to ragweed... I am severely allergic to ragweed and many of its plant relatives. The sweetener Stevia is also in the same family as ragweed and I am also allergic to it. The reason that I know I am allergic is that I used to use Stevia in my coffee. I found that I developed plasma cell gingivitis and erythema in my mouth. I finally had to have patch testing done. I had them patch test me for 120 allergens and Stevia. Once I received the results, I did my own research and discovered these facts. I have had RA for 11 years now. It is under control, but I definitely have to read all labels and I use very specific products that I have found that I can tolerate. I also discovered that I am allergic to mint, cinnamon, beeswax, wool alcohol and gold among other things. I am still discovering something new as I explore the vast material out there...

Date : 1st Sep 2016   |  By : Sharon B.
Dear Safix, I'm sorry to hear that you have had continuous flu for the last month and severe pain in your feet. I am not a doctor and even if I was, I would need to see you in person before prescribing any course of treatment. You can find suggested Echinacea doses on other websites, but strongly urge you to see a good medical profession who can hopefully give you an accurate diagnosis. Without a good diagnosis first, it is difficult to know what needs to be done. Treatment that is based on mistaken thinking about what is causing your symptoms or fail to take into consideration some important component of what is causing your symptoms, may be ineffective at best and dangerous at worst.

Date : 3rd Mar 2016   |  By : Barbara Allan
I am having continuous flu for v past few month and I got severe pain on my feet can you tell me how much should I take and what type ,just to let you know that I am from v UK

Date : 3rd Mar 2016   |  By : Safix
Dear Deb, Thanks for sharing your negative experience with Echincea. It is important for people to realize that for some people with arthritis, like you, Echincea can trigger pain.

Date : 1st Feb 2016   |  By : Barbara Allan
I have had RA for 11 years, I took this and had severe pain in my neck and back. I will never take this again.

Date : 1st Feb 2016   |  By : Deb
Dear Stella, Thank you for sharing your experience. As you track it, I love to hear back from you about whether your psoriatic arthritis appears to improve while on echinacea. I actually didn't means to imply that arthritis would improve when taking echinacea. Instead what I have noticed is that all foods and supplements have the potential to trigger inflammation in some subset of people. Therefore some healthy herbs, like echinacea, are great at what they do for many people (helping the immune system fight infection) but not so great for others because they trigger inflammation of the joints, making arthritis worse.

Date : 17th Dec 2015   |  By : Barbara Allan
I have psoriatic arthritis and outbreaks of skin psoriasis, and have had them for many years. I take glucosamine-condroitan year-round for the former, and it helps ease my discomfort from arthritis. I take echinacea during "flu season" (autumn, winter, early spring) to ward off colds and flu (I don't get the shots); I also keep Esberitox on hand, and take it immediately if I get any cold or flu symptoms, in addition to the daily echinacea. I have been on this regimen for about a decade (I am 69 years old). So far, knock wood, I have not had any virus infections, nor have I noticed any increase in my arthritis pain. I haven't noticed any particular decrease either, but then I wasn't looking for any. I suspect that even if I did notice an increase in my arthritis discomfort, I would still take the echinacea...I have lived with arthritis since I was 25, and find that easier than dealing with the misery of colds and flu! As a friend of mine said, life is full of trade-offs! I hadn't really thought about echinacea improving my psoriasis, but now that I've heard of that possibility, I will monitor it. There does seem to be a lessening of outbreaks this time of year...perhaps there is a connection. You're right...someone needs to study this!

Date : 16th Dec 2015   |  By : Stella J
Dear Anita, Echinacea modulates the immune system to help fight off infection. Apparently part of its effect on your immune system is also to reduce inflammation. I'm glad it has this good effect for you!

Date : 7th Dec 2015   |  By : Barbara Allan
At Thanksgiving my daughter and grandkids came to visit us in Arkansas. One of the kids was sick with a virus. After they went home, the rest of us became sick with it. Since I am in college, I started taking Echinacea to help my body fight this virus. It helped and I didn't get very sick. I noticed after four days on Echinacea that my arthritis in my hip is not hurting and I have better mobility. I haven't had to take my Vimovo for a couple of days. Is this the effect of the Echinacea on the inflammation? This is not RA.

Date : 7th Dec 2015   |  By : Anita
Dear Nancy, I'm glad echinacea gives you such profound pain relief from your severe osteoarthritis. How much do you take and for long to you take it at a time?

Date : 26th Nov 2015   |  By : Barbara Allan
I have severe osteoarthritis in every joint in my body. I have tried every medicine there is. Every time I take Echinacea my joint pain disappears completely. However I don't take Echinacea continuously because I read where doing so could harm your immune system from overdosing. I would love to know if I could take it all the time because it sure would make my life easier.

Date : 25th Nov 2015   |  By : Nancy
I've had Ra for about 3 yrs now and I've noticed that when ever I take echinacea it causes stiffness in my neck and shoulders. I will never take this again.

Date : 24th Aug 2015   |  By : I've had Ra for about 3 yrs now and I've noticed that when ever I take echinacea it causes stiffness in my neck and shoulders. I will never take this again.
Dear Jenny, thanks for letting me know about your reaction. I’m deeply sorry to hear you are in almost unbearable pain and hardly able to walk. If the Echinaea triggered a delayed food sensitivity (the type behind chronic inflammation) then it will take about 7 days for that reaction to clear. Yes, since this is acting as an inflammatory trigger for you, avoiding all traces of will be important for you healing. My ongoing informal poll still shows about ½ of people who have responded have a strong negative reaction to echinachia and about ½ love it and swear by it. My best wishes to you in your healing process. If I can be of any assistance, please let me know.

Date : 4th Aug 2015   |  By : Barbara Allan
Yesterday I took echinachia since I felt a cold coming on. I also have been diagnosed with arthritis but I can live with it with pain meds as Pronaxen. During the night and this morning however the pain have been and is almost unbearable, I am hardly able to walk. I decided to check on echinachia and it\'s effect on arthiritis and found your article, So here is my answer re. echinachia. No more of that for me. Sincerely // Jenny (lives in Sweden)

Date : 4th Aug 2015   |  By : Jenny
Susan, Glad the Echinacea seems to be helping.

Date : 23rd Dec 2014   |  By : Barbara Allan
I have stenosis of the lumbar region caused by advanced arthritis and normally take devils claw and white willow bark for pain, My husband brought home a cold so yesterday I started taking my Echinacea as preventative. I noticed my pain had eased last night I kind of brushed it off to the weather or whatever, but today I ran out of the devil's claw and still my pain is better then it has been in quite some time, and its raining tonight. That is when I decided to look for information on Echinacea and arthritis and found your page. I think I will continue taking it.

Date : 22nd Dec 2014   |  By : Susan
I have used Echineaca for years....on the slightest chance of a cold etc...I hit my body with larger dosing of "E" for a couple days and I knock whatever could happen, OUT. Today, I had a flare up in a dental area that has been problematic and I hit my body with 800mg in 2 doses in about 3 hours and the pain is about gone. In addition, I'm feeling an improvement in the OA lower back pain I deal with, for NOW, I'm going to stay with "E" for a week or so, daily, and see if the pain (infection connection) stays away. I KNOW, "E" should not be taken ongoing as it is a natural antiobiotic type. A book, Rheumatoid Arthritis, The Infection Connection is mostly about abx therapy, low dose, long course.... I tried that for 3 months but a clump of hair came out and so I stopped.....I'm not wild about pharma abx anyway.... Again, I deal with OA and Fibro mess and I'm 75, and dealing with a mess from hip replacement 3 yrs ago.....jam

Date : 26th Nov 2013   |  By : Jam

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