Is Echinacea Safe?

• Pet Safety
• Precautionary Interactions

Used for medicinal reasons for hundreds of years, echinacea has been deemed safe enough for clinical trials with humans. Oral consumption of echinacea does not usually cause any side effects, but those that do experience side effects are typically allergic to plants like daisies and ragweed.^(8, 9)

Echinacea Side Effects

Common side effects include:

• Constipation⁽¹⁵⁾
• Dizziness⁽¹⁵⁾
• Headache^(3, 15)
• Nausea⁽¹⁵⁾
• Rash⁽¹⁵⁾
• Temporary numbness of tongue^(3, 9)

Some experts report these as rare occurrences, however.⁽¹¹⁾

Uncommon and rare side effects include:

• Anaphylactic shock⁽¹⁵⁾
• Asthma⁽¹⁶⁾
• Canker sores⁽¹¹⁾
• Dermatitis⁽¹⁵⁾
• Eye irritation and conjunctivitis after topical use⁽¹⁵⁾
• Fever⁽¹¹⁾
• Insomnia⁽¹¹⁾
• Itchy eyes⁽¹⁶⁾
• Runny nose⁽¹⁶⁾

There has been a handful of case reports of serious conditions linked to echinacea use, including:

• Abnormal increase in eosinophils, a type of white blood cell with granules.^(15, 17)
• Acute hepatitis and liver failure in a few cases of people using echinacea. However, most cases reported using echinacea in conjunction with other herbal supplements, so it was unclear which caused the liver damage.^(15, 16)
• Decreased platelet or white blood cell count. The latter involved one case of a patient who was also taking Wellbutrin SR®, which also affects white blood cell count.^(15-17)
• Erythema nodosum, a painful skin condition was reported in a patient who took both echinacea and St. John's Wort.^(3, 9, 16)
• Pemphigus vulgaris, a serious autoimmune skin disease.^(15, 17)
• Stevens-Johnson syndrome, a serious and sometimes fatal painful disease that affects the skin and mucous membranes (including the eyes). Four cases have been reportedly linked to echinacea use. Symptoms include fever, peeling skin, and sores.^(16, 18)
• Sjögren syndrome, with symptoms of dry mouth and eyes, fatigue, and joint stiffness was reported in one patient who took other herbal and vitamin supplements as well as echinacea.⁽¹⁶⁾
• Thrombotic thrombocytopenic purpura (a severe blood disorder) was reported in one person and believed to be linked to Echinacea pallida. This condition responds to steroid therapy.^{(15, 16, 19)}

Pet Safety

If you have a kitten or cat with an immunodeficiency disorder or diabetes, do not try to treat with echinacea without the advice of a trained veterinarian. Many healthy cats experience mild to severe reactions if they consume echinacea.⁽²⁰⁾

Precautions

Although generally considered nontoxic, researchers and the medical community have raised some concerns about echinacea's safety in a few areas:

• Ear infections(21)
• Liver damage^(19, 22)
• Potential drug interactions^(23, 24)
• Pre-surgery⁽¹⁾

While some preliminary animal studies suggest that high doses of echinacea may reduce fertility, this has not been demonstrated in humans.⁽¹¹⁾