Boldo (Peumus boldus)
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.
Ascaridole, asymmetric monoterpene endoperoxide, baldina, boldine ([s]-2,9-dihydroxy-1, 10-dimethoxyaporphine), Boldea fragrans, boldina, boldine, boldine houde, boldoa, Boldoa fragrans, boldoak boldea, boldo-do-Chile, boldo folium, boldoglucin, boldu, Boldu boldus, boldus, boldus boldus, bolldin, bornyl-acetate, Chilean boldo tree, coclaurine, coumarin, cuminaldehyde, diethylphthalate, eugenol, farnesol, fenchone, gamma terpinene, isoboldine, kaempferols, laurolitsine, laurotetainine, Monimiaceae (family), molina, norboldine, norisocorydine, pachycarpine, P-cymene, P-cymol, Peumus boldus, Peumus boldus Mol., Peumus fragrans, pro-nuciferine, qian-hu, reticuline, rhamnosides, sabinene, sinoacutine, tannins, terpinoline, thymol, trans verbenol.
Boldo is an evergreen shrub found in the Andean regions of Chile and Peru, and also is native to parts of Morocco. Boldo was employed in Chilean and Peruvian folk medicine and recognized as an herbal remedy in a number of pharmacopoeias, mainly for the treatment of liver ailments.
Boldine, a major alkaloidal constituent found in the leaves and bark of the boldo tree, has been shown to possess antioxidant and anti-inflammatory activity. The German Commission E has approved boldo leaf as treatment for mild dyspepsia (upset stomach) and spastic gastrointestinal complaints. Well-designed human studies on the efficacy of boldo are lacking.
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.
Anthelmintic (expels worms), anticoagulant (blood thinner), anti-inflammatory, antioxidant (free radical scavenging), antipyretic (fever reducer), antiseptic, appetite stimulant, chemoprotective, cholagogue (increase bile flow), choleretic (stimulates bile formation), congestion, cystitis (bladder infection), digestion, diuretic, dyspepsia (upset stomach), earache, food uses, gallstones, gastrointestinal disorders, gonorrhea, headache, hepatic (liver) disorders, hepatoprotection (liver protection), hypertension (high blood pressure), hypnotic, laxative, menstrual pain, nausea, neuromuscular blockade, pain, radioprotection, rheumatism, sedative, sunscreen, syphilis, urinary tract inflammation.
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 or effective dose for boldo in adults. A common dose of the liquid extract, 1:1 in 45% alcohol, is 0.1-0.3 milliliters three times daily. Traditionally, 60-200 milligrams of the dried leaf three times daily or as a tea three times a day has been used. The tea is prepared by steeping 1 gram of the dried leaf in 150 milliliters boiling water for five to 10 minutes and then straining. The average daily dose of the boldo leaf by infusion is 3 grams. A tincture, 1:10 in 60% alcohol, is usually given as 0.5-2 milliliters three times daily.
Children (younger than 18 years):
There is no proven safe or effective dose for boldo 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 boldo (Peumus boldus) or its constituents. Boldo intake has also been linked to one case of IgE-mediated anaphylactic allergic reaction.
Side Effects and Warnings
Boldo has generally recognized as safe (GRAS) status for use in foods in the United States. However, there is limited information regarding the side effects of boldo.
Use cautiously in patients taking anticoagulant or antiplatelet (blood thinning) agents. Boldo may increase the risk of bleeding.
Use cautiously in patients taking hepatotoxic (liver damaging) agents. Boldo may cause hepatotoxicity and, theoretically, concurrent use of boldo with hepatotoxic drugs may increase the risk of liver damage.
Use cautiously in patients taking diuretic drugs. Historically, boldo has been used as a diuretic and therefore may cause an additive effect when used with diuretic agents.
Use cautiously in patients with bile duct obstruction. Boldo is thought to stimulate bile flow and, theoretically, it may exacerbate bile duct obstruction.
Use cautiously in patients who drink alcohol. Boldo may cause hepatotoxicity (liver damage) and, theoretically, concurrent use of boldo with alcohol may increase the risk of liver damage. Avoid in patients with liver disease.
Pregnancy and Breastfeeding
Boldo is not recommended in pregnant or breastfeeding women. Pregnant rats taking 800 milligrams/kilogram of crude extract of boldo and boldine by mouth demonstrated anatomical alterations in the fetus. However, the German Commission E notes no contraindications to the use of ascaridole-free boldo preparations in pregnancy and breastfeeding.
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
Concomitant use of boldo and anticoagulant or anti-platelet (blood thinning) drugs may increase the risk of bleeding. Some examples of drugs that may increase the risk of bleeding include aspirin, anticoagulants 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®).
Boldo may have anti-inflammatory effects, although this has not been well studied in humans. Caution is advised when using boldo with other anti-inflammatory agents.
Historically, boldo has been used as a diuretic and therefore may cause an additive effect when used with diuretic drugs. Boldo oil may also act as an irritant.
Boldo may cause hepatotoxicity. Theoretically, concomitant use of boldo with hepatotoxic drugs (e.g. ketoconazole, ritonavir, valproic acid, etc.) may increase the risk of liver damage.
Interactions with Herbs and Dietary Supplements
Concomitant use of boldo and anticoagulant/anti-platelet (blood thinning) herbs and supplements may 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.
Boldo may have anti-inflammatory effects, although this has not been well studied in humans. Use of other anti-inflammatory herbs or supplements may have additive effects.
Historically, boldo has been used as a diuretic and therefore may cause an additive effect when used with other diuretic herbs and supplements. Boldo oil may also act as an irritant.
Boldo may cause hepatotoxicity (liver damage). Theoretically, concomitant use of boldo with other hepatotoxic herbs and supplements (e.g. chaparral, comfrey, pennyroyal oil, etc.) may increase the risk of liver damage.
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.
Almeida ER, Melo AM, Xavier H. Toxicological evaluation of the hydro-alcohol extract of the dry leaves of Peumus boldus and boldine in rats. Phytother Res 2000;14(2):99-102. View Abstract
Jang YY, Song JH, Shin YK, et al. Protective effect of boldine on oxidative mitochondrial damage in streptozotocin-induced diabetic rats. Pharmacol Res 2000;42(4):361-371. View Abstract
Jimenez I, Garrido A, Bannach R, et al. Protective effects of boldine against free radical-induced erythrocyte lysis. Phytother Res 2000;14(5):339-343. View Abstract
Kang JJ, Cheng YW. Effects of boldine on mouse diaphragm and sarcoplasmic reticulum vesicles isolated from skeletal muscle. Planta Med 1998;64(1):18-21. View Abstract
Kang JJ, Cheng YW, Fu WM. Studies on neuromuscular blockade by boldine in the mouse phrenic nerve-diaphragm. Jpn J Pharmacol 1998;76(2):207-212. View Abstract
Kubinova R, Machala M, Minksova K, et al. Chemoprotective activity of boldine: modulation of drug-metabolizing enzymes. Pharmazie 2001;56(3):242-243. View Abstract
Lambert JP, Cormier A. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21(4):509-512. View Abstract
Monzon S, Lezaun A, Saenz D, et al. Anaphylaxis to boldo infusion, a herbal remedy. Allergy 2004;59(9):1019-1020. View Abstract
Piscaglia F, Leoni S, Venturi A, et al. Caution in the use of boldo in herbal laxatives: a case of hepatotoxicity. Scand J Gastroenterol 2005;40(2):236-239. View Abstract
Rancan F, Rosan S, Boehm K, et al. Protection against UVB irradiation by natural filters extracted from lichens. J Photochem Photobiol B 2002;68(2-3):133-139. View Abstract
Reiniger IW, de Oliveira JF, Caldeira-de-Araujo A, et al. Effect of Peumus boldus on the labeling of red blood cells and plasma proteins with technetium-99m. Appl Radiat Isot 1999;51(2):145-149. View Abstract
Schmeda-Hirschmann G, Rodriguez JA, Theoduloz C, et al. Free-radical scavengers and antioxidants from Peumus boldus Mol. ("Boldo"). Free Radic Res 2003;37(4):447-452. View Abstract
Silva E, Jopia M, Edwards AM, et al. Protective effect of Boldo and tea infusions on the visible light-mediated pro-oxidant effects of vitamin B2, riboflavin. Photochem Photobiol 2002;75(6):585-590. View Abstract
Speisky H, Rocco C, Carrasco C, et al. Antioxidant screening of medicinal herbal teas. Phytother Res 2006;20(6):462-467. View Abstract
Teng CM, Hsueh CM, Chang YL, et al. Antiplatelet effects of some aporphine and phenanthrene alkaloids in rabbits and man. J Pharm Pharmacol 1997;49(7):706-711. 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