Birch (Betula spp.)
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.
Bet v 1, Bet v 1-fragments, Bet v 1-trimer, Betula, Betula 30c, Betula davurica Pall., Betula ermanii Cham., Betula grossa Sieb. et Zucc., Betula maximowicziana, Betula maximowicziana Regel, Betula nana, Betula nana L., Betula occidentalis, Betula pendula, Betula pendula Roth., Betula papyrifera Marsh., Betula platyphylla var. japonica, Betula platyphylla Sukatchev var. japonica (Miq.) Hara, Betula pubescens Ehrh., Betula verrucosa, Betulaceae (family), betulin, betulinic acid, birch pollen allergen (Bet v 1), downy birch, dwarf birch, Japanese white birch, lupeol, mountain birch, natural birch pollen extract, oleanolic acid, paper birch, rBet v 1, rBet v 2, rBet v 4, recombinant Betula verrucosa (rBet v 1), silver birch, white birch.
Note: This monograph does not cover birch immunotherapy. For more information on immunotherapy, please see the Natural Standard allergy database.
Birch tree species are common throughout temperate North American, European, and Asian areas. Birch pollen is one of the most common allergens, usually in areas where exposure to high levels of birch pollen is common. The allergen may cause atopic dermatitis, contact urticaria (hives), atopic eczema, asthma, wheezing, allergic conjunctivitis (pinkeye), eye redness, oral-pharyngeal itching, or rhinoconjunctivitis (inflammation of the lining of the nose and the mucous membrane that covers the front of the eye and lines the eyelids).
There is insufficient evidence in humans to support the use of birch for any indication. One study shows that birch bark ointment may be beneficial for actinic keratosis (precancerous condition of thick, scaly patches of skin).
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.
Birch bark contains a variety of apoptosis (cell death)-inducing and anti-inflammatory substances such as betulinic acid, betulin, oleanolic acid, and lupeol, which may be beneficial in treating actinic keratosis. More study is needed in this area.
*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.
Anti-inflammatory, antimicrobial, antioxidant, cancer, diuretic (increases urine production).
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):
IMPORTANT NOTE: Patients with allergies should not self-treat. Supervision by a trained Allergist is crucial due to the risk for serious, even life-threatening, effects. There is no proven safe or effective dose for birch.
Children (younger than 18 years):
IMPORTANT NOTE: Patients with allergies should not self-treat. Supervision by a trained Allergist is crucial due to the risk for serious, even life-threatening, effects. There is no proven safe or effective dose for birch 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 birch (Betula spp.), its pollen, its constituents, or any related member of the Betulaceae family. Birch pollen is one of the most common allergens, usually in areas where exposure to high levels of birch pollen is common. The allergen may cause atopic dermatitis, contact urticaria (hives), atopic eczema, asthma, wheezing, allergic conjunctivitis (pinkeye), eye redness, oral-pharyngeal itching, or rhinoconjunctivitis (inflammation of the lining of the nose and the mucous membrane that covers the front of the eye and lines the eyelids). Atopic dermatitis symptoms may include whealing and itching. Research also shows that children with allergic rhinitis (hay fever) are likely to develop asthma.
There has been documented cross sensitivity to other allergens, including apple, apple pollen, Himalayan tree pollen, peanut, soy and soybean, latex, avocado, kiwi, banana, hazelnuts, grass pollen, nuts, fruit, and mugwort.
Side Effects and Warnings
Birch is one of the most common allergens, and usually causes mild to severe symptoms ranging from contact urticaria (hives) to asthma. Birch-pollen immunotherapy may cause mild oral-pharyngeal itching.
There is insufficient evidence in humans to support the use of birch for any indication. Although not well studied in humans, birch may have diuretic (increase urine production) effects, and caution is advised in patients taking other diuretics.
Pregnancy and Breastfeeding
Birch is not recommended in pregnant or breastfeeding women due to a lack of scientific evidence. Maternal pollen allergy seems to have a stronger influence on the development of rhinoconjunctivitis (inflammation of the lining of the nose and the mucous membrane that covers the front of the eye and lines the eyelids) in children with a family history of atopy than the degree of allergen exposure during pregnancy.
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
Birch may interact with blood thinning agents. Caution is advised in patients with bleeding disorders or taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.
Birch may have diuretic (increase urine production) effects. Caution is advised in patients taking agents that increase the flow of urine.
Birch may be hepatotoxic (liver damaging). Caution is advised in patients with liver disorders or taking drugs that may affect the liver.
Interactions with Herbs and Dietary Supplements
Birch may interact with blood thinning herbs and supplements. Caution is advised in patients with bleeding disorders or taking herbs or supplements that may increase the risk of bleeding. Dosing adjustments may be necessary.
Birch may have diuretic (increase urine production) effects. Caution is advised in patients taking herbs or supplements that increase the flow of urine.
Birch may be hepatotoxic (liver damaging); caution is advised in patients with liver disorders or taking herbs or supplements that may affect the liver.
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.
Arvidsson MB, Lowhagen O, Rak S. Allergen specific immunotherapy attenuates early and late phase reactions in lower airways of birch pollen asthmatic patients: a double blind placebo-controlled study. Allergy 2004;59(1):74-80. View Abstract
Bez C, Schubert R, Kopp M, et al. Effect of anti-immunoglobulin E on nasal inflammation in patients with seasonal allergic rhinoconjunctivitis. Clin Exp Allergy 2004;34(7):1079-1085. View Abstract
Bist A, Kumar L, Roy I, et al. Clinico-immunologic evaluation of allergy to Himalayan tree pollen in atopic subjects in India--a new record. Asian Pac J Allergy Immunol 2005;23(2-3):69-78. View Abstract
Bolhaar ST, Tiemessen MM, Zuidmeer L, et al. C. Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy 2004;34(5):761-769. View Abstract
Bolhaar ST, Zuidmeer L, Ma Y, et al. A mutant of the major apple allergen, Mal d 1, demonstrating hypo-allergenicity in the target organ by double-blind placebo-controlled food challenge. Clin Exp Allergy 2005;35(12):1638-1644. View Abstract
Cirla AM, Cirla PE, Parmiani S, et al. A pre-seasonal birch/hazel sublingual immunotherapy can improve the outcome of grass pollen injective treatment in bisensitized individuals. A case-referent, two-year controlled study. Allergol Immunopathol (Madr.) 2003;31(1):31-43. View Abstract
Hansen KS, Khinchi MS, Skov PS, et al. Food allergy to apple and specific immunotherapy with birch pollen. Mol Nutr Food Res 2004;48(6):441-448. View Abstract
Huyke C, Laszczyk M, Scheffler A, et al. [Treatment of actinic keratoses with birch bark extract: a pilot study]. J Dtsch Dermatol Ges 2006;4(2):132-136. View Abstract
Khinchi M S, Poulsen LK, Carat F, et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004;59(1):45-53. View Abstract
Marogna M, Spadolini I, Massolo A, et al. Clinical, functional, and immunologic effects of sublingual immunotherapy in birch pollinosis: a 3-year randomized controlled study. J Allergy Clin Immunol 2005;115(6):1184-1188. View Abstract
Mittag D, Akkerdaas J, Ballmer-Weber BK, et al. Ara h 8, a Bet v 1-homologous allergen from peanut, is a major allergen in patients with combined birch pollen and peanut allergy. J.Allergy Clin Immunol 2004;114(6):1410-1417. View Abstract
Mosges R, Pasch N, Schlierenkamper U, et al. Comparison of the biological activity of the most common sublingual allergen solutions made by two European manufacturers. Int Arch Allergy Immunol 2006;139(4):325-329. View Abstract
Niederberger V, Horak F, Vrtala S, et al. Vaccination with genetically engineered allergens prevents progression of allergic disease. Proc Natl Acad Sci USA 10-5-2004;101 Suppl 2:14677-14682. View Abstract
Reisinger J, Horak F, Pauli G, et al. Allergen-specific nasal IgG antibodies induced by vaccination with genetically modified allergens are associated with reduced nasal allergen sensitivity. J Allergy Clin Immunol 2005;116(2):347-354. View Abstract
van Neerven RJ, Arvidsson M, Ipsen H, et al. A double-blind, placebo-controlled birch allergy vaccination study: inhibition of CD23-mediated serum-immunoglobulin E-facilitated allergen presentation. Clin Exp Allergy 2004;34(3):420-428. 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