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.
Aristolochic acid, aristolochic acid I, Aristolochiaceae (family), Aristolochia fangchi, asarin, asarinin, asarone, asaroun, Asarum arifolium, Asarumcanadense, Asarum caudigerellum, Asarum caudigerum, Asarum europeum L., Asarum forbesii Maxim., Asarum hartwegii, Asarumheterotropoides var. mandshuricum, Asarum himalaicum, Asarum lemmonii, Asarum longerhizomatosum, Asarum marmoratum, Asarum naniflorum, Asarum sieboldii Miq., Asiasari radix, azarum, beta-sitosterol, broad-leaved asarabacca, black snakeroot, British Columbia wild ginger, Canada snakeroot, eucarvone, false coltsfoot, fang ji, Hartweg's wild ginger, hazlewort, Indian ginger, kakuol, little jug, long tail wild ginger, long-tailed wild ginger, ma dou ling, mandshuricum, marbled wild ginger, methyleugenol, mu tong, mu xiang, myristicin, N-isobutyldodecatetraenamide, naringenin, pentadecane, phenylpropanol, pluviatilol, public house plant, safrole, sangree root, sangrel, serpentaria, serpentary, sesamin, snakeroot, trans-aconitic acid, trans-isoasarone, trans-isomethyleugenol, wild ginger, wild nard, wild spikenard, xiexin, xi-xin, xixin.
Note: The Aristolochiaceae plant family contains many plant species thought to have medicinal properties. Although the plants in this family may share similar constituents, Asarum species are the focus of this monograph (except where noted). Aristolochia species are discussed in a separate monograph.
Note: Avoid confusion with bitter milkwort (Polygala amara) or senega (Polygala senega), as both are also known as snakeroot.
Asarum is known commonly as wild ginger and is in the Asarum genus, which consists of about 60 species of perennial woodland herbs. Asarum is a member of the Aristolochiaceae (birthwort) family.
Asarum has been administered by those trained in traditional Chinese medicine (TCM) for centuries as a pain relieving, anesthetic, fever inducing, antitussive, sweat promoting, diuretic (increasing urine flow), and hypotensive (blood pressure lowering) herb. Asarum has been applied on the skin to reduce premature ejaculation; however, more research is needed to assess asarum's effect on sexual dysfunction. Asarum europaeum has been used homeopathically for anxiety, excitability, nervousness, or melancholy.
Asarum does not seem well tolerated in humans, except as a homeopathic agent. Aristolochic acid found in asarum has been reported to cause severe kidney failure resulting in dialysis, transplant, and death. Aristolochic acid may also be carcinogenic (cancer-causing).
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.
No available studies qualify for inclusion in the evidence table.
*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).
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.
Abortifacient, amenorrhea (absence of menstruation), analgesia (pain-reliever), anesthetic, antifungal, antioxidant, antipyretic (reduces fever), antitussive, bronchitis, cancer, conjunctivitis, diaphoretic (promotes sweating), diarrhea, diuretic (increases urine flow), emetic (induces vomiting), expectorant (expels phlegm), eye strain/fatigue, flatulence (gas), gastrointestinal disorders, headache, homeopathy, human papillomavirus, hypertension (high blood pressure), menstrual cramps, nausea, pain, premature ejaculation, rheumatism, sinusitis, stimulant, toothache, uterine stimulant.
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)
Based on the available scientific evidence, no dose has been proven safe or effective. In general, 20-30 grains of asarum powder 2-3 times a day (not for long-term use) has been used. 0.5oz. of powdered root in 1 pint of boiling water, 2-3 times daily, for a short-term duration has been used. To induce vomiting, 0.5-1 drachms as an individual dose has been used.
Children (younger than 18 years)
There is not enough scientific evidence to safely recommend the use of asarum in children.
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.
Avoid in individuals with a known allergy or hypersensitivity to asarum, its constituents, or related plants in the Aristolochiaceae family.
Side Effects and Warnings
In general, it appears that asarum is not well tolerated in humans except as a homeopathic agent. Aristolochic acid found in asarum has been reported to cause severe renal (kidney) failure resulting in dialysis, transplant, and death.
Mild contact dermatitis was reported in an individual using Indian God Lotion®, a topical spray containing asarum root extract (0.2%), isopropyl alcohol, water, and perfume.
Asarum may reduce blood levels of zinc.
Avoid in individuals with existing renal (kidney) dysfunction or renal disease.
Pregnancy and Breastfeeding
Asarum is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
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
Aristolochic acid found in asarum has been reported to cause renal (kidney) damage resulting in dialysis, transplant, or death. Patients taking any medications that may be damaging to the kidneys, or any that are excreted through the kidneys, should consult with a qualified healthcare professional, including a pharmacist.
Interactions with Herbs and Dietary Supplements
Aristolochic acid found in asarum has been reported to cause renal (kidney) damage resulting in dialysis, transplant, or death. Patients taking any herbs and supplements that may be damaging to the kidneys, or any that are excreted through the kidneys, should consult with a qualified healthcare professional, including a pharmacist.
Asarum may reduce blood levels of zinc. Thus, asarum may interact with zinc supplements or multi-vitamin supplements. Caution is advised.
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).
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.
Cosyns JP. Aristolochic acid and 'Chinese herbs nephropathy': a review of the evidence to date. Drug Saf 2003;26(1):33-48. View Abstract
Deng Y, Feng Y, Sun J, et al. [Study on anti-HPV activity of Asarum heterotropoides]. Zhong.Yao Cai. 2004;27(9):665-667. View Abstract
Han Y, Kwon EH, Kim SJ. Protection of brain cells against AMPA-induced damage by Asiasari Radix extracts. Phytother Res 2003;17(8):882-886. View Abstract
Hashimoto K, Higuchi M, Makino B, et al. Quantitative analysis of aristolochic acids, toxic compounds, contained in some medicinal plants. J Ethnopharmacol. 1999;64(2):185-189. View Abstract
Jong TT, Lee MR, Hsiao SS, et al. Analysis of aristolochic acid in nine sources of Xixin, a traditional Chinese medicine, by liquid chromatography/atmospheric pressure chemical ionization/tandem mass spectrometry. J Pharm Biomed.Anal. 11-24-2003;33(4):831-837. View Abstract
Kim SJ, Gao Zhang C, Taek Lim J. Mechanism of anti-nociceptive effects of Asarum sieboldii Miq. radix: potential role of bradykinin, histamine and opioid receptor-mediated pathways. J Ethnopharmacol. 2003;88(1):5-9. View Abstract
Lee JY, Moon SS, Hwang BK. Isolation and antifungal activity of kakuol, a propiophenone derivative from Asarum sieboldii rhizome. Pest.Manag.Sci 2005;61(8):821-825. View Abstract
Lord GM, Tagore R, Cook T, et al. Nephropathy caused by Chinese herbs in the UK. Lancet 8-7-1999;354(9177):481-482. View Abstract
Ming HX, Liu JJ, Huang SZ. [Influence of single leaf Asarum himalaicum on renal function of rabbits]. Zhong.Xi.Yi.Jie.He.Xue.Bao. 2004;2(3):199-202. View Abstract
Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N.Engl.J Med 6-8-2000;342(23):1686-1692. View Abstract
Schaneberg BT, Khan IA. Analysis of products suspected of containing Aristolochia or Asarum species. J.Ethnopharmacol. 2004;94(2-3):245-249. View Abstract
Schaneberg BT, Applequist WL, Khan I. A. Determination of aristolochic acid I and II in North American species of Asarum and Aristolochia. Pharmazie 2002;57(10):686-689. View Abstract
Stengel B, Jones E. [End-stage renal insufficiency associated with Chinese herbal consumption in France]. Nephrologie 1998;19(1):15-20. View Abstract
Zhang F, Wang LX, Luo Q, et al. [Analysis of volatile constituents of root and rhizome of Asarum heterotropoides Fr. var. mandshuricum (Maxim.) Kitag. by gas chromatography-mass spectrometry]. Se.Pu. 2002;20(5):467-470. View Abstract
Zhang LW, Wang JS, Jiang CQ. [Spectrophotomatric determination of antioxidative activity of extractives of Chinese traditional medicine by supercritical fluid CO2 extraction technology]. Guang.Pu.Xue.Yu Guang.Pu.Fen.Xi. 2004;24(9):1103-1105. 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.
March 22, 2017