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Wormwood (Artemisia absinthium)

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Also listed as: Artemisia absinthium, Common wormwood, Absinthe
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 3,6-Dihydrochamazulene, 3-rhamnoglucoside, 5,6-dihydrochamazulene, absinthe, absinthic acid, absinthin, absinthinin, absinthium, absinthol, acetylenes, ai ye, alpha-thujone, Ambrosia elatior, Ambrosia tenuifolia, anabsinthin, angry wormwood, annual wormwood, arabsin, argy wormwood, artabsin, artabsinolides, artelinic acid, artemether, artemetin, Artemisia absinthium, Artemisia afra, Artemisia annua, Artemisia argyi, Artemisia camphorate, Artemisia japonica, Artemesia maritime, Artemisia mendozana, Artemesia pontica, Artemisia princeps, Artemisia roxburghiana, Artemisia tangutica, Artemisia verlotorum, artemisinin, artemolin, artemotil, artenimol, artesunate, Asteraceae (family), azulenes, beta-pinene, beta-thujone, bisabolene, C13 trans-spiroketal enol ether, C14 trans-spiroketal enol ether, cadinene, camphene, camphor, chamazulene, Chinese wormwood, cineole, diayangambin, dihydroartemisinin (DHA), epiyangambin, fenchone, flavonoids, green fairy, Japanese wormwood, isoabsinthin, isovalerianic acid, lignans, liqueur absinthe, malic acid, matricin, monoterpene ketones, mugwort leaf, nitrate of potash, Parthenium hysterophorus, p-coumaric, phellandrene, phenolic acids, p-hydroxyphenylacetic, pinene, pinocamphone, protocatechuic, pulegone, qinghao (Chinese), qinghaosu (Chinese), quercetin 3-glucoside, quercetin 3-rhamnoglucoside, resin, Roxburgh wormwood, sabinene, sabinylacetate, sesquiterpene lactone peroxide, sesquiterpene lactones, sodium artesunate, spinacetin 3-glucoside, spinacetin 3-rhamnoglucoside, starch, succinic acid, sweet wormwood, syringic, Tangut wormwood, tannin, tenacetone, thujone, thujyl alcohol, trans-dehydromatricaria ester, trans-sabinylacetate, vanillic acid, vintage absinthes, volatile oils, Wermutkraut (German).
  • Combination product examples: SedaCrohn® (wormwood, rose, cardamom seeds, and mastic resin), Riamet® (artemether and lumefantrine), and Coartem® (artemether and lumefantrine).
  • Note: This monograph focuses on common wormwood (Artemisia absinthium) and does not specifically include clinical trials investigating the effects of isolated constituents or derivatives of wormwood, such as absinthinin, artemisinin, or artemether.

Background
  • Wormwood (Artemisia absinthium) is an active ingredient of absinthe, a liqueur, and, in the 18th and early 19th Centuries, it acquired a reputation for triggering psychotic events, called absinthism. Absinthe was banned throughout Western Europe. Modern analyses suggest that the hallucinogenic properties of absinthe are a myth and that the early studies confused the effects of drinking an excessive amount of absinthe from drinking absinthe. Absinthe has consequently returned to the market.
  • Wormwood and several of its derivatives, including absinthinin, artemether, artesunate, and artemisinin, have been studied for their effects on various conditions. Artemisinin has been studied for treating malaria, including highly drug-resistant strains. Currently, preferred treatments for malaria are combination therapies that include artemisinin derivatives (artemisinin-combination therapies, or ACTs). Use of artemisinin alone is strongly discouraged by the World Health Organization (WHO), due to the potential for malarial parasites to develop resistance to the drug.
  • At this time, there is insufficient available evidence on the use of Artemisia absinthium for any condition. More high-quality research is needed before firm conclusions can be made.

Evidence Table

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 *


In clinical research, wormwood has been found to improve treatment and mood in patients with Crohn's disease. More high-quality studies are needed in this area.

C


Artemisinin has been identified as an active ingredient of wormwood and is undergoing further analysis, especially for its properties in treating malaria, including highly drug-resistant strains. Currently, preferred treatments for malaria include combination therapies that include artemisinin derivatives (artemisinin-combination therapies, or ACTs).

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 for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. 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 healthcare provider. There may be other proposed uses that are not listed below.

  • Anorexia nervosa, antihelminthic, anti-inflammatory, antiseptic, antispasmodic, antitumor, atherosclerosis (hardening of the arteries, prevention), back pain, bloating, cancer, carminative (gas reliever), cholagogue (promotes bile flow), convulsions, depression, diuretic, dropsy (water retention), emmenagogue (promotes menstrual flow), fibromyalgia, flavoring, hemorrhoids, herpes, hypnotic, improvement of mental state, insect and spider bites, insecticidal, jaundice, labor pains, mood, neonatal jaundice, neurasthenia (nervous breakdown), pain relief, parasitic worm infections, preservative, schistosomiasis (parasite infection), skin wounds, stimulant, stomach ailments, tonic.

Dosing

Adults (18 years and older)

  • Wormwood has been taken by mouth as juice of wormwood leaves, as an herbal blend, as tea made of dried wormwood, as a tincture, or in pill form. Juice of wormwood leaves has been applied to skin wounds.
  • For Crohn's disease, 750 milligrams of an herbal blend of wormwood has been taken two times daily for 10 weeks.
  • For malaria, tea traditionally prepared from nine grams of Artemisia annua leaves per one liter of water has been taken by mouth.

Children (under 18 years old)

  • There is no proven safe or effective dose of wormwood 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 with known allergy or hypersensitivity to Artemisia, its constituents, or members of the Asteraceae family.

Side Effects and Warnings

  • Abdominal cramps, drooling, and vomiting have been reported with use of wormwood by mouth. Wormwood may also cause dizziness, effects on vision, gastrointestinal symptoms, or insomnia and may counteract alcohol-induced reduced anxiety.
  • Use cautiously, as adverse effects may occur following excessive consumption of Artemisia absinthium or after drinking the essential oil of wormwood.
  • Use cautiously in patients with heart conditions, as abnormally slow heartbeat has been reported in a comatose patient with severe absinthe intoxication.
  • Use cautiously in patients with gastrointestinal disorders, musculoskeletal disorders, or neurological conditions.
  • Use cautiously in individuals with kidney dysfunction, as, according to a case report, a man who drank about 10 milliliters of oil of Artemisia absinthium developed kidney failure, which resolved within a few days after he stopped ingesting the oil.
  • Avoid in pregnant or breastfeeding women, due to a lack of available scientific evidence and safety information.
  • Avoid in individuals with known allergy or hypersensitivity, including atopic asthma and contact dermatitis, to Artemisia, its constituents, or members of the Asteraceae family.
  • Note: Confusing the liquor absinthe and the oil of absinthe led one person to drink the oil; initial confusion followed by incomprehensibility, seizures, and violent behavior ensued. Haloperidol quickly improved his mental condition.

Pregnancy and Breastfeeding

  • Avoid in pregnant or breastfeeding women, due to a lack of available scientific evidence and safety information.

Interactions

Interactions with Drugs

  • Wormwood may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medication should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Wormwood may interact with agents that affect the immune system, agents that affect the blood, agents that damage the kidney, agents that prevent formation of new blood vessels, alcohol, agents that affect heart rhythm, anticancer agents, anti-inflammatory agents, antimalarial agents, antimicrobials, butyric acid, cannabinoids, drugs that affect GABA, gastrointestinal agents, hormonal agents, neurologic agents, serotonin receptor antagonists, or skeletal muscle relaxants.

Interactions with Herbs and Dietary Supplements

  • Wormwood may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high or too low in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.
  • Wormwood may interact with anticancer herbs and supplements, anti-inflammatory herbs and supplements, antimalarial herbs and supplements, antimicrobials, antioxidants, cannabinoids, gastrointestinal herbs and supplements, herbs and supplements that affect GABA, herbs and supplements that affect heart rhythm, herbs and supplements that affect the blood, herbs and supplements that damage the kidney, herbs and supplements that affect the immune system, herbs and supplements that prevent formation of new blood vessels, hormonal herbs and supplements, neurologic herbs and supplements, serotonin receptor antagonists, skeletal muscle relaxants, or vitamin E.

Attribution
  • 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).

Bibliography
  1. Chung MJ, Kang AY, Park SO, et al. The effect of essential oils of dietary wormwood (), with and without added vitamin E, on oxidative stress and some genes involved in cholesterol metabolism. Food Chem Toxicol 2007;45(8):1400-1409.
  2. Dettling A, Grass H, Schuff A, et al. Absinthe: attention performance and mood under the influence of thujone. J Stud Alcohol 2004;65(5):573-581.
  3. Efferth T. Willmar Schwabe Award 2006: antiplasmodial and antitumor activity of artemisinin--from bench to bedside. Planta Med 2007;73(4):299-309.
  4. Krebs S, Omer TN, Omer B. Wormwood () suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn's disease - A controlled clinical trial. Phytomedicine 2010;17(5):305-9.
  5. Krishna S, Bustamante L, Haynes RK, et al. Artemisinins: their growing importance in medicine. Trends Pharmacol Sci 2008;29(10):520-527.
  6. Lachenmeier DW. [Absinthe - history of dependence to thujone or to alcohol?]. Fortschr Neurol Psychiatr 2007;75(5):306-308.
  7. Lachenmeier DW. [Thujone-attributable effects of absinthe are only an urban legend--toxicology uncovers alcohol as real cause of absinthism]. Med Monatsschr Pharm 2008;31(3):101-106.
  8. Lundh K, Hindsen M, Gruvberger B, et al. Contact allergy to herbal teas derived from Asteraceae plants. Contact Dermatitis 2006;54(4):196-201.
  9. Meschler JP, Howlett AC. Thujone exhibits low affinity for cannabinoid receptors but fails to evoke cannabimimetic responses. Pharmacol Biochem Behav 1999;62(3):473-480.
  10. Mueller MS, Runyambo N, Wagner I, et al. Randomized controlled trial of a traditional preparation of L. (Annual Wormwood) in the treatment of malaria. Trans R Soc Trop Med Hyg 2004;98(5):318-321.
  11. Olsen OT, Frolund L, Heinig J, et al. A double-blind, randomized study investigating the efficacy and specificity of immunotherapy with or /. Allergol Immunopatho (Madr) 1995;23(2):73-78.
  12. Omer B, Krebs S, Omer H, et al. Steroid-sparing effect of wormwood () in Crohn's disease: a double-blind placebo-controlled study. Phytomedicine 2007;14(2-3):87-95.
  13. Rath K, Taxis K, Walz G, et al. Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of L. (annual wormwood). Am J Trop Med Hyg 2004;70(2):128-132.
  14. Sundar SN, Marconett CN, Doan VB, et al. Artemisinin selectively decreases functional levels of estrogen receptor-alpha and ablates estrogen-induced proliferation in human breast cancer cells. Carcinogenesis 2008;29(12):2252-2258.
  15. Weisbord SD, Soule JB, and Kimmel PL. Poison on line--acute renal failure caused by oil of wormwood purchased through the Internet. N Engl J Med 1997;337(12):825-827

Copyright © 2011 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.


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