Star anise(Illicium verum)
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.
Anice stellato, anis de la Chine (French), anis estrellado, anise étoilé (French), anise stars, aniseed, Anisi stellati fructus, ba chio, badain, badaine, badian, badiana, ba(ht) g(h)ok, bart gok, bunga lawang, Chinese anise, Chinese star anise, eight-horned anise, eight horns, I. anisatum, Illicium anisatum L (Japanese star anise), Illicium verum, Illiciumreligiosum, Illicium verum Hook f, pa-chiao, pak kok, peh kah, star anise, sternanis, Tamiflu®.
Chinese star anise (Illicium verum) should not be confused with anise (Pimpenella anisum), a member of the carrot family, or with Japanese star anise (Illicium anisatum). Chinese star anise (star anise) is native to China and Vietnam and has been used for its carminative (reduces gas), stomachic (digestive aid), stimulant, and diuretic medicinal properties. Star anise is used by the Malays to combat stomachache due to the accumulation of intestinal gas, headache, and to promote vitality.
Shikimic acid extracted from the pods (which wraps the seeds) of star anise is the starting material of Tamiflu®. Tamiflu® (Roche Laboratories) is an antiviral drug which has gained popularity with the recent spread of the bird flu (H5N1). Roche Laboratories and its partners mainly use the shikimic acid extracted from Chinese star anise. However, they are developing new technologies that use an E. coli bacteria that produces shikimic acid when overfed glucose.
In September 2003, the U.S. Food and Drug Administration (FDA) advised consumers not to consume teas containing star anise. Such teas have been linked with serious neurological effects such as seizures, vomiting, jitteriness and rapid eye movement. Some reports have found Chinese star anise (Illicium verum) to be contaminated with Japanese star anise (Illicium anisatum), which is a known neurotoxin. Chinese star anise is recognized as safe for food use by the FDA, as acknowledged in the FDA's advisory. Chinese star anise is believed to help with colic in infants; however, the FDA is unaware of scientific evidence to support this claim. In addition, the FDA has not identified the specific type of star anise associated with the adverse effects. Similar reports of adverse effects have been found in Florida, Illinois, New Jersey and Washington in the United States as well as the Netherlands, Spain, and France.
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.
Analgesia (inability to feel pain), antibacterial, antimicrobial (bacteria, yeast, fungus), appetite stimulant, arthritis, bronchitis, child birth, cough, cramps (intestinal), digestive aid, diuretic, emmenagogue (promotes menstruation), flatulence (gas), flavoring agent, galactogogue (promotes lactation), gastrointestinal distress, indigestion, insecticide, libido, male climacteric symptoms, paralysis (facial), respiratory congestion (inhaled), respiratory tract infections, rheumatism, stimulant, stomachache.
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 star anise. Products containing 5-10% of essential oil have been inhaled. Typical doses of star anise may include one cup of tea, or 0.5-1 grams of the coarsely ground seed boiled in 150 milliliters water for 120 minutes and then straining. Ground star anise has been taken in a dose of 3 grams daily. The essential oil of star anise in a dose of 300 milligrams daily has also been reported.
Children (younger than 18 years):
There is no proven safe or effective dose for star anise in children, and use is not recommended. There have been many case reports of neurologic and gastrointestinal toxicities in infants with home administration of star anise tea. In some of the cases, adulteration or contamination of Chinese star anise with Japanese star anise may have caused the poisoning. Avoidance or extreme caution is recommended before using Chinese star anise to treat infant colic due to the possible contamination with Japanese star anise.
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 Chinese star anise. There are reports of allergy to star anise and its constituents (anethole, alpha-pinene, limonene and safrole); patients have had positive skin patch tests to star anise.
Side Effects and Warnings
Chinese star anise is recognized by the U.S. Food and Drug administration (FDA) as GRAS (generally recognized as safe); however, patients should use caution when using Chinese star anise as a tea, and verify its contents. In 2003, the FDA issued a consumer warning about consumption of teas containing Chinese star anise (Illicium verum) due to reports of contamination with the toxic Japanese star anise (Illicium anisatum). There are reports of allergy to star anise and its constituents (anethole, alpha-pinene, limonene and safrole). Nausea, vomiting, tremors, spasms, hypertonia (muscle tension), seizures, convulsions, rapid eye movement, general malaise and hypothermia have been reported after taking star anise herbal tea. It is not clear whether these toxic effects are caused by Chinese star anise, or Japanese star anise, which may contaminate some of the herbal teas.
In patients with convulsive disorders, such as epilepsy, Chinese star anise should be avoided based on its theoretical convulsive effects.
Star anise may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.
Pregnancy and Breastfeeding
Star anise 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
Star anise 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 (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Interactions with Herbs and Dietary Supplements
Star anise 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.
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.
Chang KS, Ahn YJ. Fumigant activity of (E)-anethole identified in Illicium verum fruit against Blattella germanica. Pest.Manag.Sci 2002;58(2):161-166. View Abstract
De M, De AK, Sen P, et al. Antimicrobial properties of star anise (Illicium verum Hook f). Phytother Res 2002;16(1):94-95. View Abstract
Garzo Fernandez C, Gomez Pintado P, Barrasa Blanco A, et al. [Cases of neurological symptoms associated with star anise consumption used as a carminative]. An.Esp.Pediatr. 2002;57(4):290-294. View Abstract
Gil Campos M, Perez Navero JL, Ibarra De La Rosa I. [Convulsive status secondary to star anise poisoning in a neonate]. An.Esp.Pediatr. 2002;57(4):366-368. View Abstract
Iauk L, Lo Bue AM, Milazzo I, et al. Antibacterial activity of medicinal plant extracts against periodontopathic bacteria. Phytother Res 2003;17(6):599-604. View Abstract
Ize-Ludlow D, Ragone S, Bernstein JN, et al. M. Chemical composition of Chinese star anise (Illicium verum) and neurotoxicity in infants. JAMA 2-4-2004;291(5):562-563. View Abstract
Ize-Ludlow D, Ragone S, Bruck IS, et al. Neurotoxicities in infants seen with the consumption of star anise tea. Pediatrics 2004;114(5):e653-e656. View Abstract
Johanns ES, van der Kolk LE, van Gemert HM, et al. [An epidemic of epileptic seizures after consumption of herbal tea]. Ned.Tijdschr.Geneeskd. 4-27-2002;146(17):813-816. View Abstract
Lee SW, Li G, Lee KS, et al. Preventive agents against sepsis and new phenylpropanoid glucosides from the fruits of Illicium verum. Planta Med 2003;69(9):861-864. View Abstract
Lee SW, Li G, Lee KS, et al. A new phenylpropanoid glucoside from the fruits of Illicium verum. Arch Pharm Res 2003;26(8):591-593. View Abstract
Minodier P, Pommier P, Moulene E, et al. [Star anise poisoning in infants]. Arch Pediatr. 2003;10(7):619-621. View Abstract
Nam NH, Kim HM, Bae KH, et al. Inhibitory effects of Vietnamese medicinal plants on tube-like formation of human umbilical venous cells. Phytother Res 2003;17(2):107-111. View Abstract
Park IK, Shin SC. Fumigant activity of plant essential oils and components from garlic (Allium sativum) and clove bud (Eugenia caryophyllata) oils against the Japanese termite (Reticulitermes speratus Kolbe). J Agric.Food Chem 6-1-2005;53(11):4388-4392. View Abstract
Sy LK, Brown GD. Novel phenylpropanoids and lignans from Illicium verum. J Nat Prod 1998;61(8):987-992. View Abstract
Zhou J, Lu G, Zhong X, et al. [Quantitative determination of anethole in the fruit of Illicium verum from various places of Guangxi province]. Zhong Yao Cai 2005;28(2):106-107. 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