DRUGS AND SUPPLEMENTS

Agrimony (Agrimonia eupatoria, Agrimonia procera)

March 22, 2017

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Agrimony (Agrimonia eupatoria, Agrimonia procera)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Agrimonia, Agrimonia asiatica, Agrimonia eupatoria L., Agrimonia parviflora, Agrimonia pilosa Ledeb, Agrimonia striata, Agrimonia procera, Ackerkraut, Agrimoniae herba, Agrimonia, agrimony, Agrimony eupatoria, Church Steeples, cockeburr, cocklebur, common agrimony, fragrant agrimony, Funffing, Funffingerkraut, Herba eupatoriae, herbe d'aigremoine, herbe de saint-guillaume, liverwort, longyacao, odermenning, philanthropos, Potentilla, roadside rosaceae, sticklewort, stickwort, woodland groovebur.

  • Note: There are other plants, which are not related botanically to agrimony, but are given a similar name by older herbalists due to similarities in properties. These include the common hemp agrimony (common Dutch agrimony, Eupatorium aquaticum mas, Eupatorium cannabinum) and the water agrimony (bastard agrimony, bastard hemp, Bidens tripartita, trifid bur-marigold).

Background

  • The name agrimonia may have its origin in the Greek word "agremone," which refers to plants that supposedly healed cataracts of the eye. The species name eupatoria relates to Mithradates Eupator, King of Pontus, who is credited with introducing many herbal remedies. The Doctrine of Signatures, developed in Europe in the 16th and 17th Centuries, has listed agrimony as one of the 23 substances with medicinal uses, bearing witness to the extent of its influence at the time.

  • Germany's Commission E has approved the use of agrimony (when prepared as a tea) for controlling diarrhea and as a throat gargle to reduce inflammation and relieve sore throat pain (cooled tea).

  • Agrimony was one of the most famous vulnerary (healing) herbs with anti-inflammatory and diuretic properties. The tannin content is responsible for many of its medicinal uses. The dried leaves can be used to make tea for drinking or as a throat gargle. Preliminary studies suggest that agrimony may be useful against certain bacterial and viral infections, for tumor growth inhibition, diabetes, and hypertension (high blood pressure). Available clinical trials looked at its use in treating certain skin and gastrointestinal disorders. More human studies are needed to confirm these and other reported uses for agrimony.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

Cutaneous disorders

Many skin conditions, wounds, and bruises have been treated with agrimony. However, additional study is needed in this area to make a strong recommendation.

C

Gastrointestinal disorders

Agrimony has been used for many gastrointestinal conditions such as appendicitis, mild diarrhea, stimulation of appetite and ulcers. Additional human study is needed to make a firm recommendation.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Anemia (red blood cell deficiency), antihistamine, anti-tumor agent, antiviral, appendicitis, appetite stimulant, astringent, bleeding, corns, cardiotonic (restores heart strength), diabetes (high blood sugar), diarrhea (mild and acute), diuretic, enlargement of the heart, exudative atopic dermatitis, fevers, gallbladder disorders, gargle, gout (foot inflammation), indigestion, jaundice and other liver complaints, kidney and bladder disorders, pimples, rheumatism, skin conditions such as blotches and scrofulous sores, sedative, sore throat, taeniasis (parasitic disease), tonic, ulcers, upper respiratory tract astringent, tuberculosis, upset stomach, warts.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • There is no proven safe of effective dose for agrimony. Agrimony has traditionally been given as a tea, tincture, infusion or extract. Examples of traditional doses that have been used include: 1-3 milliliters of liquid extract (1:1 in 25% alcohol) per day; 2-4 grams dried herb infusion three times per day; and 1-4 milliliters tincture (1:5 in 45% alcohol) three times daily.

  • When applied on the skin, a poultice has been applied several times daily using approximately 10% water extract, which is prepared by boiling agrimony at low heat for 10-20 minutes.

Children (younger than 18 years)

  • There is no proven safe of effective dose for agrimony in children, and use is not recommended.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in individuals with a known allergy or hypersensitivity to agrimony.

Side Effects and Warnings

  • Agrimony is likely safe since its leaves are used as a substitute for tea. It is also likely safe when applied on the skin. No significant adverse effects for agrimony have been documented. When used as recommended for a short-term, agrimony is considered to be safe.

  • Agrimony is listed by the Council of Europe as a natural source of food flavoring. This use is possibly safe since it can be added to foodstuffs in small quantities with a possible limitation of an active principle (not yet specified) in the final product.

  • Agrimony is possibly unsafe when used orally (by mouth) or topically (applied on the skin) in excessive amounts due to its high tannin content. In theory, agrimony may cause photodermatitis, low blood pressure, and nausea.

  • The high amount of tannins (up to 21%) in agrimony may lead to gastrointestinal upset, hepatic necrosis (death of liver cells), nephrotoxicity (damage to the kidneys) or increased risk of developing esophageal (of the esophagus) cancer if used chronically. Avoid in patients with diarrhea caused by an underlying disease. Agrimony should be used only for mild and acute diarrhea. Patients who tend to develop constipation very easily should also avoid agrimony.

  • Isocoumarins have been found in the roots of agrimony; there may be an increased risk for bleeding. Caution is advised in patients with bleeding disorders or taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.

Pregnancy and Breastfeeding

  • Due to a lack of toxicity data, excessive use of agrimony is possibly unsafe and should be avoided during pregnancy and breastfeeding because of the possible effects on the menstrual cycle.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Due to isocoumarins found in the roots of agrimony, agrimony may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Agrimony may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Agrimony may lower blood pressure. Therefore, it is possible that the hypotensive (blood pressure lowering) effect may be additive with drugs used to treat hypertension (high blood pressure). Excessive doses of agrimony might cause hypotension, interfering with therapy for hypertension or hypotension.

  • Agrimony may be used to treat symptoms of menopause along with other herbs so it may be likely that it contains an estrogenic-like component. Therefore, it should not be used in patients on some form of hormone-replacement therapy, such as birth control pills.

  • Since agrimony contains up to 21% tannins, chronic ingestion may result in nephrotoxicity (damage to the kidneys).

Interactions with Herbs and Dietary Supplements

  • Due to isocoumarins found in the roots of agrimony, there is a possibility that agrimony may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Agrimony may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Agrimony may lower blood pressure. Therefore, it is possible that the hypotensive (blood pressure lowerng) effect may be additive with drugs used to treat hypertension (high blood pressure). Excessive doses of agrimony might cause hypotension, interfering with therapy for hypertension or hypotension.

  • Agrimony may be used to treat symptoms of menopause along with other herbs so it may be likely that it contains an estrogenic-like component. Therefore, it should not be used in patients on some form of hormone-replacement therapy.

  • Since agrimony contains up to 21% tannins, chronic ingestion may result in nephrotoxicity (damage to the kidneys).

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Chakarski I. Clinical study of a herb combination consisting of Agrimonia eupatoria, Hipericum perforatum, Plantago major, Mentha piperita, Matricaria chamomila for the treatment of patients with chronic gastroduodenitis. Probl Vatr Med 1982;10:78-84.

  2. Copland A, Nahar L, Tomlinson CT, et al. Antibacterial and free radical scavenging activity of the seeds of Agrimonia eupatoria. Fitoterapia 2003;74(1-2):133-135. View Abstract

  3. Gao K, Zhou L, Chen J. Experimental study on decoctum Agrimonia pilosa Ledeb-induced apoptosis in HL-60 cells in vitro. Zhong Yao Cai 2000;23(9):561-562. View Abstract

  4. Gray AM, Flatt PR. Actions of the traditional anti-diabetic plant, Agrimony eupatoria (agrimony): effects on hyperglycaemia, cellular glucose metabolism and insulin secretion. Br J Nutr 1998;80(1):109-114. View Abstract

  5. Ivanova D, Gerova D, Chervenkov T. Polyphenols and antioxidant capacity of Bulgarian medicinal plants. J Ethnopharmacol 2005;96(1-2):145-150. View Abstract

  6. Lev E. [Some evidence for the use of doctrine of signatures in the land of Israel and its environs during the Middle Ages]. Harefuah 2002;141(7):651-5, 664. View Abstract

  7. Li Y, Ooi LS, Wang H, et al. Antiviral activities of medicinal herbs traditionally used in southern mainland China. Phytother Res 2004;18(9):718-722. View Abstract

  8. Miyamoto K, Kishi N, Koshiura R. Antitumor effect of agrimoniin, a tannin of Agrimonia pilosa Ledeb., on transplantable rodent tumors. Jpn J Pharmacol 1987;43(2):187-195. View Abstract

  9. Park EJ, Oh H, Kang TH, et al. An isocoumarin with hepatoprotective activity in Hep G2 and primary hepatocytes from Agrimonia pilosa. Arch Pharm Res 2004;27(9):944-946. View Abstract

  10. Patrascu V, Chebac PI. [Favorable therapeutic results in cutaneous porphyria obtained with Agrimonia eupatoria]. Revista De Medicina Interna Neurologie Psihiatrie Neurochirurgie Dermato Venerologie Serie Dermato Venerologia 1984;29(2):153-157.

  11. Petkov V. Plants and hypotensive, antiatheromatous and coronarodilatating action. Am J Chin Med 1979;7(3):197-236. View Abstract

  12. Petrovshii GA, Zapadniuk VI, Pasechnik IK, et al. [Cholagogue effect of Bupleurum exaltatum, Agrimonia asiatica, Leontopodium ochroleucum, and Veronica virginica.]. Farmakol Toksikol 1957;20(1):75-77. View Abstract

  13. Swanston-Flatt SK, Day C, Bailey CJ, et al. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33(8):462-464. View Abstract

  14. Willhite LA, O'Connell MB. Urogenital atrophy: prevention and treatment. Pharmacotherapy 2001;21(4):464-480. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017