Herbs and Autoimmune Conditions
Why some regulators advise caution with echinacea and other immune-stimulating herbs in autoimmune disease, what a 2025 review found, and what to ask your specialist before using any herb.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Ask your specialist before using an "immune support" herb. Herbs marketed to stimulate immunity are the ones regulators and reviewers flag for people with these conditions. The EU herbal monograph for purple coneflower (Echinacea purpurea) says its use is not recommended in progressive systemic disorders, autoimmune diseases, immunodeficiencies, immunosuppression and diseases of the white blood cell system. [1] Do not stop or change a prescribed medicine on your own; ask the prescriber or pharmacist.
What the question is
"Autoimmune condition" covers many different diseases; the 2025 review below deals with autoimmune skin diseases. Herbs sold for the immune system are often described as "boosting" or "supporting" immunity. How the immune system works is covered in Immunodeficiency, Autoimmune Conditions and Immunosuppressants. This page covers only what the sources we read say about herbs in people who already have one of these conditions.What the sources found
| Source | What it says | Evidence label |
|---|---|---|
| EU herbal monograph, Echinacea purpurea (L.) Moench, fresh herb (European Medicines Agency, 2015) | Not recommended in autoimmune diseases, immunodeficiencies and immunosuppression. [1] It records no reported interactions with other medicines. [1] | Regulator precaution |
| Review of echinacea species (2005) | Lists use of echinacea by patients with autoimmune diseases among its safety issues, alongside allergic reactions. [2] | Expert review; no outcome data in the abstract |
| Scoping review of immune-stimulating herbs (2025) | Found 227 herbal supplements with immune-stimulating properties; the 15 best supported included alfalfa, ashwagandha, astragalus, echinacea, garlic, ginseng, licorice and reishi mushroom. [3] | Preclinical and mixed; shows immune effects, not confirmed flares |
| NCCIH | Says there are theoretical reasons to suspect echinacea might interact with immunosuppressants. [4] | Theoretical |
How to read the 2025 scoping review
The review set out to identify herbal supplements with immune-stimulating properties that may trigger or exacerbate autoimmune skin diseases. [3] It searched published studies in lab cells, animals and people. [3] The herbs it listed shared pro-inflammatory mechanisms, such as activating toll-like receptors and raising inflammatory cytokines (immune signaling proteins). [3] Its authors present it as a reference to help clinicians counsel patients on risks. [3] It lists herbs with immune-stimulating effects; the abstract does not report that these herbs caused flares in people. So the finding is a reason for caution and a conversation, not proof of harm. Cat's claw is also named by NCCIH as possibly interacting with immunosuppressants. [5]Herbs sold for immune "support"
NCCIH reports that a 2022 review found 27 ingredients common in immune-claim supplements and located rigorous human studies for only eight of them. [6] For the claims themselves see Herbs for Immune Support: Claims Checked. Single-herb pages: Echinacea, Garlic, Cat's Claw. Adaptogens and mushrooms are in their own libraries: Adaptogens and Mushrooms.Herbs that calm the immune system
You may read that a herb "balances" or "calms" immunity. Proper evidence not found here: we searched PubMed for human data on herbs and autoimmune flares and for adverse events of herbs in rheumatoid arthritis and lupus, and found only the scoping review above. We did not find a trial-based list of herbs shown safe for people with autoimmune conditions. A herb that may lower immune activity can also interact with immunosuppressant medicines; see Herbs, Immunosuppressants and Organ Transplants.Questions to ask your specialist
Ask whether the herb could affect your condition, your immune-lowering medicine, or your blood tests. Bring the product label or container. A pharmacist can check the ingredient list for each herb. See Questions to Ask Your Pharmacist About Herbs and Supplements.Frequently asked questions
Can echinacea trigger an autoimmune flare?
We did not find a trial showing that. The EU monograph advises against echinacea in autoimmune disease, as a precaution. [1] NCCIH describes interaction with immunosuppressants as theoretical. [4]
Which herbs stimulate the immune system?
A 2025 scoping review found 227 herbal supplements with immune-stimulating properties in lab, animal or human studies. [3] The best supported included echinacea, garlic and ashwagandha. [3] That does not show they raise illness risk in autoimmune disease.
Is it safe to take herbs with immunosuppressant medicine?
This depends on the herb and the medicine. NCCIH notes theoretical reasons to suspect echinacea might interact with immunosuppressants. [4] Ask the prescriber or pharmacist before combining.
Are natural immune boosters a good idea for lupus or rheumatoid arthritis?
Proper evidence not found that they are safe or helpful in these conditions in the sources we read. The 2025 review is meant to help clinicians counsel patients on risks. [3]
Who else should avoid echinacea?
The EU monograph names people allergic to daisy-family plants and does not recommend use under age 12. [7] [1]
Related: Herbs and Hormone-Sensitive Conditions.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Allergy and other safety points
- Daisy-family allergy: the EU monograph says echinacea must not be used by people allergic to it or to other plants of the Asteraceae (Compositae) family. [7] Serious allergic reactions including anaphylactic shock have been reported, especially in people prone to allergy. [7]
- Children and pregnancy: the EU monograph does not recommend use under age 12, and says use in pregnancy and breastfeeding is not recommended unless a doctor advises it. [1]
- Quality: the 2005 review says some commercial echinacea products did not meet recognized pharmaceutical quality standards. [2] See Quality Testing and Certifications.
- Medicines in general: see How Interactions Work and Naturopathic and Integrative Care for Autoimmune Conditions.
- Surgery: tell the surgical team about every herb. See Herbs Before and After Surgery.
References
- European Medicines Agency, HMPC. European Union herbal monograph on Echinacea purpurea (L.) Moench, herba recens (EMA/HMPC/48704/2014 Corr 1, final, 2015). Available at www.ema.europa.eu. Read 2026-10-23.
- Barnes J, Anderson LA, Gibbons S, Phillipson JD. Echinacea species: a review of their chemistry, pharmacology and clinical properties. J Pharm Pharmacol. 2005;57(8):929-954. Read 2026-10-23.
- Weiner JD, et al. Identifying immunostimulatory herbal supplements that may flare autoimmune skin diseases: a systematic scoping review. Lupus Sci Med. 2025;12(2):e001803. Read 2026-10-23.
- NCCIH. Echinacea: Usefulness and Safety. Read 2026-10-23.
- NCCIH Clinical Digest for health professionals. Herb-Drug Interactions. December 2024. Read 2026-10-23.
- NCCIH. Using Dietary Supplements Wisely. Read 2026-10-23.
- European Medicines Agency, HMPC. Purple coneflower herb: summary for the public (EMA/481797/2015, 2016). Available at www.ema.europa.eu. Read 2026-10-23.