Juniper (Juniperus communis)
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.
Cade oil, cedar, cedarwood, cedron, common juniper berry, Cupressaceae (family), empyreumatic oil, enebro, Geniévre, ginepro, juniper bark, juniper berry, juniper bush, juniper oil, juniper tar, juniper wood, Juniperi Fructus, Juniperus californica, Juniperus communis, Juniperus deppeana, Juniperus mexicana, Juniperus occidentalis, Juniperus oxycedrus, Juniperus phoenicea, Juniperus scopulorum, Juniperus therifera, Juniperus virginiana, pencil cedar, Pinaceae, red cedar, Sabina, Wacholderbeeren, zimbro.
Juniperus species have been used by many people around the world, but have also been recognized as toxic plants. Juniper is a flavoring in gin and other drinks and is used as a spice in small amounts. The plant displays significant toxicity to the kidneys and skin, which limits its use in medicine, except in small amounts. Juniper is safely used as a fragrance in soaps, shampoos, cosmetics, sachets and other products.
Juniper has been used in dyspepsia (upset stomach) as a berry tea, in eczema and other skin diseases as cade oil or juniper oil. Juniper is thought to be more effective and less irritating when combined with uva ursi, manzanita or pipsissewa. There is a long history of juniper use in Europe and China, but no published clinical trials.
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.
Abortions, analgesic, anti-rheumatic, arthritis, astringent (leaves), bladder infections, bladder stones, bloating, blood purification, cancer, carminative, colds, constipation, cosmetics, cystitis (bladder infection), disinfectant (berries), diuretic, dyspepsia (upset stomach), eczema, flatulence (gas), fumigant (pesticide), gastrointestinal infections, heartburn, hypoglycemia (low blood sugar), inflammation (volatile oil), intestinal worms, kidney infections, kidney stones, loss of appetite, plague, regulate menstruation, snakebites, stimulate stomach secretions, soaps, urethritis (inflammation of the urethra), urinary tract infections (UTIs), wounds.
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 (over 18 years old)
There is no proven safe or effective dose for juniper. Tinctures, tablets, capsules and other forms of berry extracts are commercially available. As an infusion, 2-3 grams of dried berries in 150mL of hot water, has been taken by mouth 3-4 times daily. For dyspepsia, 20-50 milligrams of the berry essential oil has been taken twice daily (for up to a maximum of 100 milligrams). This is usually taken as juniper berry tea.
Cade oil (juniper tar) or juniper oil has been typically used pure or partially diluted. It should be noted that application to the skin may be irritating or toxic to the skin. Volatile oil has been applied on the skin three or more times per day.
Children (under 18 years old)
There is no proven safe or effective dose for juniper in children, and use is not recommended
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 juniper. Repeated exposure to juniper pollen may cause occupational allergies that can affect the skin and respiratory tract.
Side Effects and Warnings
The juniper berry has generally recognized as safe (GRAS) status in the United States. The maximum level used in food is 0.006% for the oil and 0.01% for the extract.
Overdose may lead to kidney and skin damage. Overdose symptoms include albuminuria (excessive protein), hematuria (blood in the urine), purplish urine, tachycardia (increased heart rate), hypertension (high blood pressure), convulsions, and metrorrhagia (non-menstrual bleeding from the uterus).
Other possible adverse effects include hypotension (low blood pressure), irritation, blisters, burns, liver toxicity, kidney damage or kidney failure.
Juniper may also lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar), and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Although not well studied in humans, juniper may also increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Pregnancy and Breastfeeding
Juniper is not recommended in pregnant or breastfeeding women due to the potential for abortions and/or the induction of labor contractions.
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
Juniper 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 such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Juniper 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.
Interactions with Herbs and Dietary Supplements
Juniper 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.
Juniper 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.
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.
Adams RP. Systematics of Juniperus section Juniperus based on leaf essential oils and random amplified polymorphic DNAs (RAPDs). Biochem.Syst.Ecol. 7-1-2000;28(6):515-528. View Abstract
Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital.Med Int 2000;15(2):139-143. View Abstract
Asakura K, Matsuo Y, Oshima T, et al. omega-agatoxin IVA-sensitive Ca(2+) channel blocker, alpha-eudesmol, protects against brain injury after focal ischemia in rats. Eur.J Pharmacol. 4-7-2000;394(1):57-65. View Abstract
Barrero AF, Arseniyadis S, Quilez del Moral JF, et al. First synthesis of the antifungal oidiolactone C from trans-communic acid: cytotoxic and antimicrobial activity in podolactone-related compounds. J Org.Chem. 4-19-2002;67(8):2501-2508. View Abstract
Buckle J. Use of aromatherapy as a complementary treatment for chronic pain. Altern.Ther.Health Med 1999;5(5):42-51. View Abstract
Cool LG, Adams RP. A pregeijerene isomer from Juniperus erectopatens foliage. Phytochemistry 2003;63(1):105-108. View Abstract
Gardner DR, Panter KE, James LF, et al. Abortifacient effects of lodgepole pine (Pinus contorta) and common juniper (Juniperus communis) on cattle. Vet.Hum.Toxicol. 1998;40(5):260-263. View Abstract
Johnson W. Final report on the safety assessment of Juniperus communis extract, Juniperus oxycedrus extract, Juniperus oxycedrus tar, Juniperus phoenicia extract, and Juniperus virginiana extract. Int J Tox 2001;20 (sup 2):41-56.
Johnston WH, Karchesy JJ, Constantine GH, et al. Antimicrobial activity of some Pacific Northwest woods against anaerobic bacteria and yeast. Phytother Res 2001;15(7):586-588. View Abstract
Koruk ST, Ozyilkan E, Kaya P, et al. Juniper tar poisoning. Clin.Toxicol.(Phila) 2005;43(1):47-49. View Abstract
Leitner J, Hofbauer F, Ackerl M. [Poisoning with a podophyllin-containing wart-treating tincture]. Dtsch.Med Wochenschr. 7-12-2002;127(28-29):1516-1520. View Abstract
Martin AM, Queiroz EF, Marston A, et al. Labdane diterpenes from Juniperus communis L. berries. Phytochem.Anal. 2006;17(1):32-35. View Abstract
Nakanishi T, Iida N, Inatomi Y, et al. Neolignan and flavonoid glycosides in Juniperus communis var. depressa. Phytochemistry 2004;65(2):207-213. View Abstract
Salido S, Altarejos J, Nogueras M, et al. Chemical studies of essential oils of Juniperus oxycedrus ssp. badia. J Ethnopharmacol 2002;81(1):129-134. View Abstract
Sanchez de Medina F, Gamez MJ, Jimenez I., et al. Hypoglycemic activity of juniper "berries". Planta Med 1994;60(3):197-200. 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