Dr Clare Materia Medica

Gentian

Also Known As:

Bitter Root, Bitterwort, Gall Weed, Geneciana, Gentianae Radix, Gentiane, Gentiane Acaule, Gentiane Jaune, Gentiane Pâle, Gentiane Sans Tige, Gentiane Sauvage, Grande Gentiane, Pale Gentian, Racine Amère, Stemless Gentian, Yellow Gentian, Wild Gentian.

CAUTION: See separate listings for Canadian Hemp and Jimson Weed.

Scientific Name: Gentiana lutea; Gentiana acaulis, synonym Gentiana kochiana.

Family: Gentianaceae.

People Use This For:

Orally, gentian is used for digestive disorders, such as loss of appetite, fullness, flatulence, diarrhea, gastritis, heartburn, and vomiting. It is used orally for fever; hysteria; hypertension; and stimulating menstrual flow; and as an antispasmodic, anthelmintic, and antiseptic.

Topically, gentian is used for treating wounds and cancer.In combination with European elder flower, verbena, cowslip flower, and sorrel, gentian is used orally for maintaining healthy sinuses and treating sinusitis. It is used in combination with other products for malaria.

In foods and beverages, gentian is used as an ingredient.

In manufacturing, gentian is used in cosmetics.

Safety:

LIKELY SAFE ...when the root preparations are used in amounts commonly found in foods. Gentian root has Generally Recognized As Safe status (GRAS) for use in foods in the US (3).

POSSIBLY SAFE ...when gentian root is used orally in a specific combination that contains gentian root, elderflower, verbena, cowslip flower, and sorrel

(SinuComp, Sinupret) (1, 2).

There is insufficient reliable information available about the safety of the topical use of gentian.

PREGNANCY AND LACTATION: There is insufficient reliable information available about the safety of gentian in medicinal amounts during pregnancy and lactation; avoid using.

Effectiveness:

POSSIBLY EFFECTIVE

Sinusitis. Taking gentian orally in a specific combination product that also contains elderflower, verbena, cowslip flower, and sorrel (SinuComp, Sinupret) seems to help treat acute or chronic sinusitis Clinical studies have used Sinupret (1, 2).

There is insufficient reliable information available about the effectiveness of gentian for its other uses.

Mechanism of Action:

The applicable parts of gentian are the root and bark. The root is most commonly used. Gentian root contains triterpenoids, xanthones, and other constituents (5, 6). Preliminary research suggests gentian root has sedative effects. The xanthone gentiacaulein seems to have antidepressant activity, possibly through inhibition of monoamine oxidase (MAO)-A (6). Preliminary research suggests that gentian bark extracts might have MAO-B inhibitor effects (7).

Gentian root has been used historically as an antihypertensive. Gentian root extracts seem to have vasorelaxant properties (8, 10). Preliminary research

suggests that the xanthone constituents gentiacaulein and gentiakochianin may be responsible for vasodilation by an unknown mechanism (9).

Adverse Reactions:

Orally, gentian root in combination with other herbs can cause gastrointestinal adverse effects and allergic skin reactions (1, 2).

Interactions with Herbs & Supplements:

HERBS AND SUPPLEMENTS WITH HYPOTENSIVE EFFECTS: Gentian is thought to have hypotensive effects. Theoretically, combining gentian with other herbs and supplements with hypotensive effects might increase the risk of hypotension. Some of these herbs and supplements include andrographis, casein peptides, cat's claw, coenzyme Q-10, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.

Interactions with Drugs:

ANTIHYPERTENSIVE DRUGS <<interacts with>> GENTIAN

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

Theoretically, concurrent use might increase risk of hypotension with drugs that lower blood pressure (8, 10). These include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Interactions with Foods:

None known.

Interactions with Lab Tests:

None known.

Interactions with Diseases or Conditions:

HYPOTENSION: Theoretically, gentian use might worsen hypotension or interfere with drug therapy to increase blood pressure (8, 10).

SURGERY: Gentian might affect blood pressure. Theoretically, gentian might interfere with blood pressure control during and after surgical procedures. Tell

patients to discontinue gentian at least 2 weeks before elective surgical procedures.

Dosage/Administration: chronic

ORAL: For acute or sinusitis, a specific combination product (SinuComp Phytopharmica) containing gentian root 12 mg and 36 mgeach of European

elder flower, verbena, sorrel, and cowslip flower has been used three times daily (1, 2).

TOPICAL: No typical dosage.

Editor's Comments:

The highly toxic white hellebore (Veratrum album) can be misidentified as gentian and has caused accidental poisoning when used in home-made preparations (4).

Gentian root is unrelated to the gentian violet dye (methylrosaniline chloride).

Specific References: Ginseng

1. Neubauer N, Marz RW. Placebo-controlled, randomized,double-blind, clincal trial with Sinupret sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis. 1994;1:177-81.

2. Marz RW, Ismail C, Popp MA. Action profile and efficacy of a herbal combination preparation for the treatment of sinusitis. Wien Med Wochenschr 1999;149:202-8.

3. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: http://ecfr.gpoaccess.gov/cgi/t/text/textidx?c=ecfr&sid= 786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:3.0.1.1.13&idno=21

4. Zagler B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a report of two cases. Wien Klin Wochenschr 2005;117:106-8.

5. Toriumi Y, Kakuda R, Kikuchi M, et al. New triterpenoids from Gentiana lutea. Chem Pharm Bull (Tokyo) 2003;51:89-91.

6. Tomic M, Tovilovic G, Butorovic B, et al. Neuropharmacological evaluation of diethylether extract and xanthones of Gentiana kochiana. Pharmacol Biochem Behav 2005;81:535-42.

7. Haraguchi H, Tanaka Y, Kabbash A, et al. Monoamine oxidase inhibitors from Gentiana lutea. Phytochemistry 2004;65:2255-60.

8. Uncini Manganelli RE, Chericoni S, Baragatti B. Ethnopharmacobotany in Tuscany: plants used as antihypertensives. Fitoterapia 2000;71:S95-100.

9. Chericoni S, Testai L, Calderone V, et al. The xanthones gentiacaulein and gentiakochianin are responsible for the vasodilator action of the roots of 144 Gentiana kochiana. Planta Med 2003;69:770-2.

10. Baragatti B, Calderone V, Testai L, et al. Vasodilator activity of crude methanolic extract of Gentiana kokiana Perr. et Song. (Gentianaceae). J Ethnopharmacol 2002;79:369-72.

Also Known As:

Common Nettle, Nettle Leaf, Urtica.

Scientific Name:

Urtica dioica;

Family: Urticaceae.

People Use This For:

Stinging nettle above ground parts is used for allergies, allergic rhinitis, and musculoskeletal disease such as osteoarthritis. It is also used orally in conjunction with copious fluid intake in so-called "irrigation therapy" for urinary tract infections, urinary tract inflammation, and kidney stones. People also use the above ground parts of stinging nettle for internal bleeding, including uterine bleeding, epistaxis, and melena; anemia; poor circulation; splenomegaly; diabetes and other endocrine disorders; gastric hyperacidity; biliary complaints; diarrhea and dysentery; asthma; pulmonary congestion; rash and eczema; cancer; prevention of signs of aging; blood purification; wound healing; and as a general tonic.

In foods, young stinging nettle leaves are eaten as a cooked vegetable.

In manufacturing, stinging nettle extract is used as an ingredient in hair and skin products.

Safety:

No concerns regarding safety when used orally and appropriately.

Pregnancy and Lactation: Refer to a Medical Herbalist.

Effectiveness:

INSUFFICIENT RELIABLE EVIDENCE to RATE

Allergic rhinitis (hayfever). There is preliminary evidence that stinging nettle above ground parts might improve symptoms of allergic rhinitis. Starting stinging nettle at the first sign of symptoms seems to provide subjective improvement.²²

Osteoarthritis. There is evidence that oral or topical use of stinging nettle leaf extract might improve symptoms of pain in patients with osteoarthritis.^23,24 Some clinicians use stinging nettle leaf extract in combination with conventional nonsteroidal anti-inflammatory drugs (NSAIDs) or other analgesics. Evidence suggests that adding stinging nettle might allow for using lower analgesic doses in some patients.²⁴ Topically, stinging nettle leaf seems to improve pain and disability in patients with osteoarthritis of the thumb, according to preliminary research.²⁵

More evidence would be helpful to rate stinging nettle for these uses.

Mechanism of Action:

The applicable parts of stinging nettle are the above ground parts.

Stinging nettle leaves contain several nutrients and active constituents. The leaves are eaten as a food because of significant amounts carotene, vitamin C, vitamin K, potassium, and calcium.^26,27,28,29 There is about as much vitamin C and carotene in stinging nettle leaves as in spinach and other greens.³⁰ The leaves also contain beta-sitosterol and the flavonoids quercetin, rutin, kaempferol, and others. Stinging nettle tops seems to have a variety of pharmacological effects including analgesic,^23,31 anti-inflammatory,²⁹ local anesthetic,²³ hemostatic,³¹ antibacterial,²⁸ and antiviral.³²

For osteoarthritis and other musculoskeletal conditions, stinging nettle above ground parts might work due to potential analgesic and anti-inflammatory effects.^24,25

Some researchers think that stinging nettle might be beneficial for allergic rhinitis due to quercetin content. Quercetin is thought to have anti-inflammatory and mast-cell stabilizing effects. It decreases histamine release from basophils and mast cells.³³

Stinging nettle seems to also act as a diuretic. The leaf juice can increase urine output and slightly decrease systolic blood pressure and body weight in people with venous insufficiency.^23,28 Because of these effects, some people use stinging nettle for urinary tract disorders, including urinary tract infections (UTIs) and kidney stones. Stinging nettle also seems to decrease blood pressure and heart rate.^23,31

Adverse Reactions:

Stinging nettle above ground parts is generally well-tolerated.

Interactions with Drugs:

Lithium

Warfarin (Coumadin)

Interactions with Foods:

None known.

Interactions with Lab Tests:

None known.

Interactions with Diseases or Conditions:

Kidney disease.

Dosage/Administration:

Dr Clare’s Blends: 1 gm per day

For osteoarthritis, people typically use crude stinging nettle leaf 9 grams daily.²⁴

For allergic rhinitis, people typically use stinging nettle leaf extract 300 mg three times daily. However, in some cases, 300 mg up to seven times daily has been used.²²

Dr Clare’s Comment

Stinging nettle leaf has a long history of use. It was used primarily as a diuretic and laxative as early as the times of the Greek physicians Dioscorides and Galen.

Specific References: STINGING NETTLE

22.  Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990;56:44-7.

23.  Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.

24.  Mills S, Bone K. Principles and Practice of Phytotherapy. London: Churchill Livingstone, 2000.

25.  Randall C, Randall H, Dobbs F, et al. Randomized controlled trial of nettle sting for treatment of base-of-thumb pain. J R Soc Med 2000;93:305-9.

26.  Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

27.  Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.

28.  Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

29.  Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

30.  Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.

31.  Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

32.  The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

33.  Anon. Quercetin. Alt Med Rev 1998;3:140-3.