DRUGS AND SUPPLEMENTS

Mastic (Pistacia lentiscus)

March 22, 2017

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Mastic (Pistacia lentiscus)

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

  • 1,2,3,4,6-Pentagalloylglucose, aldehydes, alpha-phellandrene, alpha-pinene, alpha-terpineol, alpha-terpinolene, alpha-tocopherol, Anacardiaceae (family), anthocyanins, arabic gum, arabino-galactan proteins, arbre de mastic (French), beta-caryophyllene, beta-myrcene, beta-pinene, cadmium, chios mastic gum, chios tears, çori, copper, crude fat, delta(3)-carene, digallic acid, (E)-beta-ocimene, fatty acids, gallic acid, germacrene D, iron, legeltxor (Basque), lentisc, lentisco (Italian, Portuguese, Spanish), lentisco mastich, lentisk, lentisque (French), limonene, linalool, linolenic acid, llentiscle, manganese, mastich, mastichic acid resin, masticin resin, mastick, mastick tree, mastiek (Dutch), mastiha, Mastisol®, mastix (Danish, Czech, Slovak Swedish), Masitx (German), Mastixpistazie (German), matich, methyl oleanonate, myrcene, nickel, oleic acid, palmitic acid, p-cymene, perillyl alcohol, phytosterols, pinene, pistache, Pistacia lentiscus, Pistacia lentiscus L. (lentisk), Pistacia lentiscus L. var. chia, Pistacia lentiscus var. chia, pistheqa-pesag, sabinene, Saladin, schînos, schísei, sumac family, terpinen-4-ol, tirucallol, trans-caryophyllene, triterpenic acids, triterpenic alcohols, verbenone, (Z)-ocimene, zinc.

Background

  • Mastic is the resin of Pistacia lentiscus, a shrub of the sumac family (Anacardiaceae) found in the Mediterranean regions of France, Spain, Portugal, Greece, Turkey, and Africa. Mastic is sometimes referred to as "arabic gum," which is not to be confused with "gum arabic," a different substance consisting of hardened sap from the acacia tree (Acacia senegal, Acacia seyal). Other plant parts of Pistacia lentiscus, such as the leaf, may contain compounds not present in the resin.

  • Pistacia lentiscus has been traditionally used to treat high blood pressure and upset stomach. It has also been used for ulcers and may have antibacterial activity against the bacteria that plays a role in some ulcers (Helicobacter pylori). Further trials are needed to confirm the antiulcer activity of Pistacia lentiscus and to establish any benefit that it may have over other conventional treatments for ulcer. There is currently insufficient high-quality scientific evidence in support of Pistacia lentiscus for other uses, such as other gastrointestinal disorders and dental plaque.

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*

Crohn's disease

Although preliminary evidence suggests mastic may be beneficial for individuals with Crohn's disease, conclusions cannot be drawn at this time. Further researchis required.

C

Dental plaque

Mastic has shown antibacterial activity against Helicobacter pylori in vitro. Therefore, mastic gum may reduce the amount of dental plaque in users. However, more research is needed in this area, including studies comparing mastic gum to other forms of oral hygiene, before a recommendation can be made.

C

Duodenal ulcer

Mastic has been used by traditional Mediterranean healers to treat intestinal ulcers since the 13th Century. Mastic has been shown to have antibacterial action against Helicobacter pylori, which may help to explain its ulcer-healing properties. Additional research is needed to make a strong recommendation.

C

Dyspepsia

Early research suggests that mastic gum may help decrease symptoms associated with dyspepsia (indigestion). Further well-designed research is required before conclusions can be drawn.

C

Gastric ulcer

Mastic may decrease the severity of induced gastric ulceration, but its exact mechanism of action is unknown. Additionally, mastic has been shown to have antibacterial action against Helicobacter pylori, which may help to explain its ulcer-healing properties. Additional research is needed in this area.

C

Helicobacter pylori infection

Although not well studied in humans, mastic has been shown to have antibacterial action against Helicobacter pylori. Additional research is needed in this area.

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.

  • Abdominal pain, antibacterial, antifungal, anti-inflammatory, antioxidant, antiseptic, antispasmodic, arthritis, astringent, bad breath, boils, bronchitis, cancer, cardiovascular disease, catarrh, colds, colitis, cuts, cystitis, dental cavities (tooth fillings), diabetes, diarrhea, diuretic, expectorant, flea control, gout, hemorrhoids, high blood pressure, high cholesterol, immune function, insect repellent, lice, muscle aches, neuralgia, rheumatism, ringworm, scabies, sciatica, stimulant, ulcers, urethritis, vaginal discharge, varicose veins, whooping cough, wounds.

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)

  • For Crohn's disease, six capsules (0.37 grams per capsule) of mastic powder taken has been by mouth daily for four weeks.

  • For duodenal ulcer, one gram of mastic powder has been taken daily, before breakfast, for a period of two weeks.

  • For dyspepsia (indigestion), 350 milligrams of chios mastic gum has been taken by mouth three times daily for three weeks.

  • For gastric ulcer, one gram of mastic powder has been taken twice daily, before breakfast and at bedtime, for a period of four weeks.

Children (younger than 18 years)

  • There is no proven safe or effective dose for mastic in children.

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 mastic, or members of the Anacardiaceae family, such as pistachio, terebinth, Chinese pistache, and Schinus terebinthifolius (Brazilian pepper).

Side Effects and Warnings

  • In general, mastic has been shown to be well tolerated when taken by mouth short-term to treat gastric or duodenal ulcer. Side effects of mastic gum may include nausea, diarrhea, and constipation. Well-designed research on the effects of taking mastic long-term is currently lacking. Other plant parts of Pistacia lentiscus, such as the leaf, may contain compounds not present in the resin.

  • Blood pressure lowering and angiotensin-converting enzyme (ACE) inhibition properties of compounds from Pistacia lentiscus have been noted in early research. However, these compounds have been found to be present in the leaf of Pistacia lentiscus, not the resin, commonly referred to as mastic.

  • Mastic may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Use with caution in combination with hypolipidemic agents (drugs, herbs, or supplements that lower cholesterol or lipids in the blood) or with agents that suppress or stimulate the immune system.

  • Use with caution in patients with Crohn's disease, due to the potential for increased adverse effects.

  • Avoid in individuals with a known allergy or hypersensitivity to mastic or members of the Anacardiaceae family, such as pistachio, terebinth, Chinese pistache, and Schinus terebinthifolius (Brazilian pepper).

Pregnancy and Breastfeeding

  • Angiotensin-converting enzyme (ACE) inhibition properties of compounds from Pistacia lentiscus have been noted in early research. However, these compounds have been found to be present in the leaf of Pistacia lentiscus, not the resin, commonly referred to as mastic. Infants exposed to ACE inhibitors in the first trimester of pregnancy have been found to have major congenital malformations during the first year of life. As a result, researchers have concluded that exposure to ACE inhibitors may not be safe during the first trimester. The U.S. Food and Drug Administration (FDA) has recommended discontinuing use of ACE inhibitors as soon as possible after a patient becomes pregnant.

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

  • Blood pressure lowering and angiotensin-converting enzyme (ACE) inhibition properties of compounds from Pistacia lentiscus have been noted in early research. However, these compounds have been found to be present in the leaf of Pistacia lentiscus, not the resin, commonly referred to as mastic.

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

  • Mastic may also interact with agents that affect the immune system, anthelmintics (worm expellers), antibiotics, anticancer drugs, antifungals, anti-inflammatory agents, antilipemics (agents that lower blood lipids), antiulcer drugs, dental agents, gastrointestinal drugs, iron, and wound-healing agents.

Interactions with Herbs and Dietary Supplements

  • Blood pressure lowering and angiotensin-converting enzyme (ACE) inhibition properties of compounds from Pistacia lentiscus have been noted in early research. However, these compounds have been found to be present in the leaf of Pistacia lentiscus, not the resin, commonly referred to as mastic.

  • Mastic 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.

  • Mastic may also interact with anthelmintics (worm expellers), antibacterials, anticancer agents, antifungals, anti-inflammatory agents, antilipemics (agents that lower blood lipids), antioxidants, antiulcer herbs and supplements, berberine, dental agents, gastrointestinal herbs and supplements, herbs and supplements that affect the immune system, iron, wound-healing agents, and zinc.

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. Al Habbal MJ, Al Habbal Z, Huwez FU. A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer. Clin Exp Pharmacol.Physiol 1984;11(5):541-544. View Abstract

  2. Al Said MS, Ageel AM, Parmar NS, et al. Evaluation of mastic, a crude drug obtained from Pistacia lentiscus for gastric and duodenal anti-ulcer activity. J Ethnopharmacol. 1986;15(3):271-278. View Abstract

  3. Ali-Shtayeh MS, Abu Ghdeib SI. Antifungal activity of plant extracts against dermatophytes. Mycoses 1999;42(11-12):665-672. View Abstract

  4. Cooper, W. O., Hernandez-Diaz, S., Arbogast, P. G., et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N.Engl.J.Med. 6-8-2006;354(23):2443-2451. View Abstract

  5. Dabos, K. J., Sfika, E., Vlatta, L. J., et al. Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial. J Ethnopharmacol. 2-3-2010;127(2):205-209. View Abstract

  6. Dabos, K. J., Sfika, E., Vlatta, L. J., et al. The effect of mastic gum on Helicobacter pylori: a randomized pilot study. Phytomedicine. 2010;17(3-4):296-299. View Abstract

  7. Huwez FU, Al Habbal MJ. Mastic in treatment of benign gastric ulcers. Gastroenterol.Jpn. 1986;21(3):273-274. View Abstract

  8. Huwez FU, Thirlwell D, Cockayne A, et al. Mastic gum kills Helicobacter pylori. N.Engl.J Med 12-24-1998;339(26):1946. View Abstract

  9. Kaliora, A. C., Stathopoulou, M. G., Triantafillidis, J. K., et al. Chios mastic treatment of patients with active Crohn's disease. World J Gastroenterol. 2-7-2007;13(5):748-753. View Abstract

  10. Koutsoudaki C, Krsek M, Rodger A. Chemical composition and antibacterial activity of the essential oil and the gum of Pistacia lentiscus Var. chia. J Agric.Food Chem 10-5-2005;53(20):7681-7685. View Abstract

  11. Magiatis P, Melliou E, Skaltsounis AL, et al. Chemical composition and antimicrobial activity of the essential oils of Pistacia lentiscus var. chia. Planta Med 1999;65(8):749-752. View Abstract

  12. Sanz MJ, Terencio MC, Paya M. Isolation and hypotensive activity of a polymeric procyanidin fraction from Pistacia lentiscus L. Pharmazie 1992;47(6):466-467. View Abstract

  13. Sanz MJ, Terencio MC, Paya M. Pharmacological actions of a new procyanidin polymer from Pistacia lentiscus L. Pharmazie 1993;48(2):152-153. View Abstract

  14. Takahashi K, Fukazawa M, Motohira H, et al. A pilot study on antiplaque effects of mastic chewing gum in the oral cavity. J Periodontol. 2003;74(4):501-505. View Abstract

  15. Watanabe, H., Hagiwara, S., Fukuda, M., et al. Double blind randomized control test for the usefulness of mastic compound dentifrice against periodontitis under using sonic toothbrush 2010. Yakuri to chiryo 2010;38(10):915-925

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