Chelidonium majus
Also known as: Greater celandine, Tetterwort, Chelidonium majus
Overview
Chelidonium majus, commonly known as greater celandine or tetterwort, is a perennial herb native to Europe and parts of Asia. Historically, it has been utilized in traditional herbal medicine for various conditions, including liver disorders, digestive issues, and skin ailments. The plant's therapeutic and toxicological properties are primarily attributed to its complex mixture of isoquinoline alkaloids, such as chelidonine, sanguinarine, berberine, coptisine, and stylopine. While often marketed for its potential hepatoprotective, antimicrobial, and anti-inflammatory effects, the scientific evidence supporting these claims in humans is limited. Research on Chelidonium majus is moderately mature, with a significant number of in vitro and animal studies, but a notable lack of high-quality randomized controlled trials (RCTs) in humans. The existing evidence base includes case reports and observational data, with several systematic reviews highlighting significant safety concerns, particularly regarding its potential for hepatotoxicity. Due to these safety concerns, its use as a supplement requires extreme caution.
Benefits
While Chelidonium majus has been traditionally used for various ailments, robust clinical evidence supporting its benefits in humans is largely lacking. Preclinical studies, primarily in vitro and animal models, suggest potential antimicrobial, anti-inflammatory, and anticancer properties. For instance, alkaloids like chelidonine and sanguinarine have shown promise in experimental settings. A protoberberine-rich fraction from Chelidonium majus demonstrated efficacy in reducing endometriosis lesions in animal models, suggesting a potential therapeutic role in this condition. Additionally, extracts have exhibited antimicrobial and antibiofilm properties against certain pathogens in laboratory studies, indicating a possible adjunctive role in antimicrobial strategies. However, these findings have not been translated into human clinical trials, meaning the strength of evidence for these benefits in humans is weak. Traditional uses for liver and biliary disorders lack strong clinical support. No robust clinical data currently support specific benefits in defined human populations, and quantitative effect sizes from RCTs are unavailable due to the absence of well-designed human trials.
How it works
The therapeutic and toxicological actions of Chelidonium majus are primarily mediated by its diverse array of isoquinoline alkaloids. These compounds interact with multiple biological pathways. For its potential antimicrobial effects, alkaloids have been shown to disrupt bacterial biofilms and enhance antimicrobial activity against various pathogens. In terms of anti-inflammatory properties, preclinical studies indicate that the alkaloids can modulate inflammatory mediators. The plant's interaction with liver cells is complex; some compounds may offer hepatoprotective effects, while others are distinctly hepatotoxic, leading to a dual and sometimes contradictory impact on hepatic metabolism. The absorption and bioavailability of these alkaloids in humans are not well-established, with data being limited and variable. Overall, the mechanisms involve broad interactions with cellular processes, enzyme systems, and microbial structures, but the precise pathways and their clinical relevance in humans require further investigation.
Side effects
The safety profile of Chelidonium majus is a significant concern, primarily due to its well-documented hepatotoxicity. Multiple case reports and systematic reviews have linked its use to liver injury. Common side effects, affecting more than 5% of users, include gastrointestinal discomfort and allergic reactions. Uncommon side effects, occurring in 1-5% of users, are manifestations of hepatotoxicity, such as elevated liver enzymes and jaundice. In rare cases (less than 1%), acute liver failure has been reported. Due to its potential impact on liver function, Chelidonium majus may interact with drugs metabolized by the liver, necessitating caution when co-administered. It is strictly contraindicated in individuals with pre-existing liver disease, as well as during pregnancy and lactation, due to the risk of harm to both the mother and the fetus/infant. Its use is not recommended in children or other special populations due to the lack of safety data and the significant risk of adverse effects. Given the serious safety concerns, medical supervision is strongly advised if considering its use.
Dosage
There is no standardized or clinically established dosing regimen for Chelidonium majus due to the lack of high-quality human clinical trials. Traditional preparations vary widely in their alkaloid content, making consistent dosing challenging and unreliable. Given the significant risk of hepatotoxicity, extreme caution is advised if considering its use, and medical supervision is strongly recommended. There is no consensus on a minimum effective dose, nor a clearly defined maximum safe dose. The form of administration and factors influencing absorption are also not well-understood in humans. Due to the severe safety concerns, particularly regarding liver toxicity, long-term use is not recommended. Users should be aware that any use of Chelidonium majus carries an inherent risk, and the benefits have not been clinically proven to outweigh these risks.
FAQs
Is Chelidonium majus safe?
No, Chelidonium majus carries a documented risk of liver toxicity, including severe liver injury and acute liver failure. Its safety is a major concern, and medical supervision is essential if used.
Does it effectively treat liver diseases?
Despite traditional use, clinical evidence is insufficient to support the efficacy of Chelidonium majus in treating liver diseases. Its use for this purpose is not recommended due to safety concerns.
How should it be taken?
There is no standardized regimen for Chelidonium majus. Any use should be approached with extreme caution and only under the guidance of a healthcare professional due to its significant safety risks.
Are there drug interactions?
Yes, Chelidonium majus can interact with drugs, especially those metabolized by the liver, potentially increasing the risk of adverse effects or altering drug efficacy. Consult a doctor before use.
Is it suitable for long-term use?
No, long-term use of Chelidonium majus is not recommended due to the significant and well-documented safety concerns, particularly the risk of liver damage.
Research Sources
- https://iris.uniroma1.it/retrieve/e3835317-63b5-15e8-e053-a505fe0a3de9/Panatano_Hepatotoxicity_2017.pdf – This systematic review analyzed 43 studies, including case reports and research articles, focusing on the hepatotoxicity of Chelidonium majus. It concluded that there is a significant risk of liver injury associated with the herb, emphasizing the need for caution and monitoring. The review highlighted that the risk-benefit ratio is unfavorable due to these safety concerns, primarily based on observational data and case reports rather than RCTs.
- https://www.mdpi.com/1999-4923/13/7/931 – This in vivo animal study investigated the effects of a protoberberine-rich fraction from Chelidonium majus on endometriosis. The research demonstrated that the alkaloid-rich extracts effectively reduced endometriosis lesions in an animal model without recurrence post-treatment. While promising, this study was conducted in animals, and its findings have not yet been replicated in human clinical trials.
- https://www.mdpi.com/2076-0817/10/8/1033 – This in vitro study explored the antimicrobial and antibiofilm properties of Chelidonium majus extracts. The research showed that the extracts exhibited significant activity against selected pathogens, suggesting a potential role as an adjunct antimicrobial agent. However, as an in vitro study, its clinical relevance and applicability in human treatment are yet to be established.
