Summary
Wormwood trees are native to Europe, Asia, and northern Africa. Wormwood can help cure bloating and stomachaches. It can also help soothe wounds and insect bites. It can also help regulate irregular menstruation.
Description
Medicinal Parts
The medicinal parts are the aerial shoots and leaves of the plant.
Flower and Fruit
The numerous flower heads are short-stemmed and hang in a many-flowered panicle. The capitula are small, globular, inclined and nearly as long as their 3 to 4 mm width. The bracts are gray and silky-pubescent with a rounded tip. The outer bracts are linear-oblong and pubescent, while the inner ones are ovate, obtuse, broad and have a transparent, membranous margin. The receptacle is rough-haired. The flowers are yellow and fertile. The disc florets are androgynous; the ray florets are female with an extending style stem. The fruit is about 1.5 mm long.
Leaves, Stem, and Root
This semishrub grows from 60 to 120 cm in height with a woody, hardy rosette and a high-branch bearing stem. The stem is usually erect and leafy. The alternate, long-petioled leaves are silky pubescent on both sides. The lower leaves are abrupt pinnate and the upper ones simple. The leaf tips are lanceolate to linear-lanceolate, obtuse to acuminate, and 2 to 3 mm wide.
Characteristics
The plant has an aromatic odor and a very bitter taste.
Habitat
Wormwood grows in Europe, northern Africa, parts of Asia, and North and South America.
Production
Wormwood consists of the fresh or dried upper shoots and leaves, the fresh or dried basal leaves, or a mixture of the aerial plant parts from Artemisia absinthium, harvested during flowering season from cultivated or wild plants.
Other Names
Absinthe, Green Ginger
Actions & Pharmacology
Compounds
Volatile oil: with a high level (varies a great deal among different strains) of (+)-thujone, cis-epoxy ocimene, trans-sabinyl acetate or chrysanthenyl acetate
Sesquiterpene bitter principles: including absinthine, anabsinthine, artabsine, and matricine
Effects
The cholagogic, digestive, appetite-stimulating, and wound-healing effects ascribed to the drug are attributed to the essential oils and amaroids. A significant increase of alpha-amylase, lipase, bilirubin, and cholesterol has been observed during the 70 to 100 minutes during which patients with liver disorders were given a suspension of 20 mg extract in 10 mL water via a duodenal probe. In rabbits, fever induced through yeast injection was reduced by using an esophageal probe to administer diverse fractions of the drug. In vitro, a watery extract of the whole drug is supposed to retard the growth of Plasmodium falciparum. The essential oil of the drug may possess an antimicrobial effect. The drug also stimulates the bitter receptors in the taste buds of the tongue. When bitter agents are introduced into the mouth, they trigger a reflexive increase of stomach secretion with higher acid concentration.
Anticancer Effects
A combination of dihydroartemisinin (200 mcmol) and halotransferrin (12 mcmol) selectively killed tumor cells over control cells. Addition of dihydroartemisinin to tumor cell (molt-4 lymphocytes) culture resulted in 50% decreased growth in 8 hours. Dihydroartemisinin alone had a similar effect on normal cells (lymphocytes) but cell death was not enhanced by the addition of halotransferrin. This technique may be effective for the treatment for cancers that express a large number of transferrin receptors because it allows the concentration of iron in the tumor cells. This allows a more directed approach in that free radicals are formed preferentially in the tumor cells where cell killing is wanted. This formation of free radicals is dependent on the endoperoxide bridge of artemisinin (Lai & Singh, 1995).
Antiparasitic Effects
Artemisia compounds become concentrated in parasite-infected erythrocytes where they are thought to cause free-radical damage to parasite membranes. The parasite is then phagocytosed and cleared by leukocytes. Drug activity is potentiated by oxidant drugs and oxygen. Derivatives of artemisinin (arteether, artesunate, and artemether) are 20x to 100x more active in vitro than artemisinin (Hien & White, 1993).
Clinical Trials
Crohn's Disease
Results of a five-center, randomized, placebo-controlled, and double-blind trial in 40 individuals with Crohn's disease (CD) strongly suggest that wormwood has a steroid-sparing effect. All participants began with 3 x 500 mg/daily capsules of an herbal blend containing Wormwood or placebo in addition to continuing basic CD treatment. Tapering of a daily and stable equivalent of 40 mg or less of corticosteroids (prednisone) started after week 2 and was completed at week 10 in 90 percent (18) of the participants assigned to wormwood treatment. At week 10, 65% (13) of patients in the Wormwood-treatment group had almost complete remission of symptoms as compared to zero in the placebo group. In a sub-group of these patients, a possible “curative” effect was observed given that there was no need to restart corticosteroids in the follow-up weeks, and no remission of disease over the ensuring 10 weeks of wormwood treatment. Results also suggest improvement in mood and quality of life with wormwood treatment (Omer, 2007).
Malaria
A randomized, double-blind study adults found artemether more rapid than quinine in treating apparent drug-resistant malaria in 560 adults. Quinine provided a more rapid recovery for patients with cerebral malaria. Patients received 4 mg/kg artemether intramuscularly, followed by 2 mg/kg every 8 hours, or 20 mg/kg intramuscular quinine, followed by 10 mg/kg every 8 hours for a minimum of 72 hours. There was no significant difference in mortality between groups, with an overall rate of 15%, but multiple logistic-regression model associated artemether with a lower mortality (p=0.028). Parasite clearance times were 72 hours for artemether and 90 hours for quinine. Fever resolution times were 127 hours for artemether and 90 hours for quinine. Recovery from coma was 66 hours for artemether and 48 hours for quinine. Side effects for quinine included hypoglycemia. Culture negative pyuria was a side effect in the artemether group (Hien et al, 1996).
A randomized study involving 160 children found intramuscular artemether to be effective in treating cerebral malaria. This study compared artemether (3.2 mg/kg on day 1, followed by 1.6 mg/kg daily) with intravenous quinine (20 mg/kg on day 1, followed by 10 mg/kg every 8 hours) and found both to be equally effective. One hundred percent parasite clearance time was 39.5 hours for artemether and 48 hours for quinine. Fever clearance was 32 hours in both groups. Coma resolution was 12 hours with artemether and 13 hours with quinine. Mortality was 20% in the artemether group and 11.3% in the quinine group (not significant). Most deaths in the artemether group were in patients with respiratory distress. Both treatments were given until parasitemia had cleared (at least 3 doses), after which pyrimethamin-sulfadoxine was given. This study was done in Africa where quinine resistance is not a significant problem. The authors recommend that quinine be the drug of choice for treating severe malaria in African children (Murphy et al, 1996).
Indications & Usage
Approved by Commission E:
- Loss of appetite
- Dyspeptic complaints
- Dyskinesia of the bile ducts
Unproven Uses
In folk medicine, wormwood preparations are used internally for gastric insufficiency, intestinal atonia, gastritis, stomachache, liver disorders, bloating, anemia, irregular menstruation, intermittent fever, loss of appetite, and worm infestation. Externally, the drug is applied for poorly healing wounds, ulcers, skin blotches and insect bites. Efficacy in the above-mentioned popular uses is insufficiently documented.
Contraindications
Wormwood is contraindicated in people with a history of seizures, and stomach or intestinal ulcers.
Pregnancy
Wormwood should not be used during pregnancy.
Breastfeeding
Wormwood should not be used while breastfeeding.
Precautions & Adverse Reactions
Continuous use of wormwood is not advisable. Due to the drug's thujone content, the internal administration of large doses can lead to vomiting, stomach and intestinal cramps, headache, dizziness and disturbances of the central nervous system.
Drug Interactions
Moderate Risk
Phenobarbital
Wormwood contains thujones, which may lower the seizure threshold, thereby reducing the clinical efficacy of phenobarbital (Tyagi & Delanty, 2003; Miller, 1998). Clinical Management: Avoid coadministration of Wormwood and phenobarbital.
Potential Interactions
Iron
The tannin content of wormwood may complex with concomitantly administered iron, resulting in nonabsorbable insoluble complexes and may result in adverse sequelae on blood components. Clinical Management: Until more is known, patients who need iron supplementation should be advised to separate administration times of these compounds by 1 to 2 hours.
Dosage
Mode of Administration
Comminuted herb is used for infusions and decoctions. Powdered herb, extracts and tinctures in liquid or solid forms are used for oral administration. Combination with other bitters or aromatics is common.
Preparation
To prepare an infusion, pour 150 mL boiling water over 1/2 teaspoonful of the drug, strain after 10 minutes. A decoction is prepared by adding 1 handful of drug to 1 liter of boiling water for 5 minutes. To prepare a tea, use 1 g drug in 1 cup water.
Daily Dose
The total daily dose is 3 to 5 g of the herb as an aqueous extract. Internal dose of the infusion is 1 cup freshly prepared tea taken 30 minutes before each meal. The tincture dosage is 10 to 30 drops in sufficient water taken 3 times daily. The liquid extract dosage is 1 to 2 ml taken 3 times daily. Externally, a decoction is used for healing of wounds and insect bites.
Storage
Wormwood must be kept in sealed containers and protected from light.
