Wormwood: Uses, Side Effects, Interactions, Dosage, and Warning

WORMWOOD

Absinth, Absinthe, Absinthe Suisse, Absinthii Herba, Absinthites, Absinthium, Afsantin, Ajenjo, Alvine, Armoise, Armoise Absinthe, Armoise AmГЁre, Armoise Commune, Armoise Vulgaire, Artesian Absinthium, Artemisia absinthium, Common Wormwood, Grande Absinthe, Green Fairy, Green Ginger, Herba Artemisae, Herbe aux Vers, Herbe d’Absinthe, Herbe Sainte, Indhana, Lapsent, Madderwort, Menu Alvine, Qing Hao, Vilayati Afsanteen, Wermut, Wermutkraut, Western Wormwood, Wurmkraut.

Overview Information

Wormwood is an herb. The above-ground plant parts and oil are used for medicine.

Wormwood is used for various digestion problems such as loss of appetite, upset stomach, gall bladder disease, and intestinal spasms. Wormwood is also used to treat fever, liver disease, depression, muscle pain, memory loss and worm infections; to increase sexual desire; as a tonic; and to stimulate sweating. Wormwood is used for Crohn’s disease and a kidney disorder called IgA nephropathy.

Wormwood oil is also used for digestive disorders, to increase sexual desire, and to stimulate the imagination.

Some people apply wormwood directly to the skin for osteoarthritis (OA), and healing wounds and insect bites. Wormwood oil is used as a counterirritant to reduce pain.

In manufacturing, wormwood oil is used as a fragrance component in soaps, cosmetics, and perfumes. It is also used as an insecticide.

Wormwood is used in some alcoholic beverages. Vermouth, for example, is a wine beverage flavored with extracts of wormwood. Absinthe is another well-known alcoholic beverage made with wormwood. It is an emerald-green alcoholic drink that is prepared from wormwood oil, often along with other dried herbs such as anise and fennel. Absinthe was popularized by famous artists and writers such as Toulouse-Lautrec, Degas, Manet, van Gogh, Picasso, Hemingway, and Oscar Wilde. It is now banned in many countries, including the U.S. But it is still allowed in European Union countries as long as the thujone content is less than 35 mg/kg. Thujone is a potentially poisonous chemical found in wormwood. Distilling wormwood in alcohol increases the thujone concentration.

How does it work?

Wormwood oil contains the chemical thujone, which excites the central nervous system. However, it can also cause seizures and other adverse effects. Other chemicals in wormwood might decrease inflammation (swelling).

Uses & Effectiveness ?

Insufficient Evidence for

  • Crohn’s disease. Early research shows that taking wormwood daily for 6-10 weeks improves symptoms, quality of life, and mood in some patients with Crohn’s disease. It also seems to reduce the amount of steroids needed by people with this condition.
  • A certain kidney disease called IgA nephropathy. Early research shows that taking wormwood daily for 6 months can reduce blood pressure and levels of protein in the urine in people with IgA nephropathy.
  • Osteoarthritis. Early research suggests that applying ointment or liniment containing wormwood to the knee might reduce pain in people with osteoarthritis. But it doesn’t seem to improve stiffness or function. Wormwood also doesn’t seem to be as effective as using a prescription gel containing a medicine called piroxicam.
  • Gallbladder disorders.
  • Increasing sweating.
  • Indigestion.
  • Insect bites.
  • Loss of appetite.
  • Low sexual desire.
  • Spasms.
  • Worm infestations.
  • Wounds.
  • Other conditions.

More evidence is needed to rate the effectiveness of wormwood for these uses.

Side Effects & Safety

Wormwood is LIKELY SAFE when taken by mouth in the amounts commonly found in food and beverages, including bitters and vermouth, as long as these products are thujone-free. It is POSSIBLY SAFE when applied to the skin as ointment. Wormwood that contains thujone is POSSIBLY UNSAFE when it is taken by mouth or used on the skin. When taken by mouth, thujone can cause seizures, muscle breakdown (rhabdomyolysis), kidney failure, restlessness, difficulty sleeping, nightmares, vomiting, stomach cramps, dizziness, tremors, changes in heart rate, urine retention, thirst, numbness of arms and legs, paralysis, and death. When used on the skin, wormwood can reportedly cause severe skin redness and burning.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Wormwood is LIKELY UNSAFE when taken by mouth during pregnancy in amounts greater than what is commonly found in food. The concern is the possible thujone content. Thujone might affect the uterus and endanger the pregnancy. It’s also best to avoid topical wormwood, since not enough is known about the safety of applying wormwood directly to the skin.

If you are breast-feeding, don’t use wormwood until more is known about safety.

Allergy to ragweed and related plants: Wormwood may cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many others. If you have allergies, be sure to check with your healthcare provider before taking wormwood.

A rare inherited blood condition called porphyria: Thujone present in wormwood oil might increase the body’s production of chemicals called porphyrins. This could make porphyria worse.

Kidney disorders: Taking wormwood oil might cause kidney failure. If you have kidney problems, talk with your healthcare provider before taking wormwood.

Seizure disorders, including epilepsy: Wormwood contains thujone, which can cause seizures. There is concern that wormwood might make seizures more likely in people who are prone to them.

Interactions ?

Moderate Interaction

Be cautious with this combination

Medications used to prevent seizures (Anticonvulsants) interacts with WORMWOOD

Medications used to prevent seizures affect chemicals in the brain. Wormwood may also affect chemicals in the brain. By affecting chemicals in the brain, wormwood may decrease the effectiveness of medications used to prevent seizures.

Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.

Dosing

The appropriate dose of wormwood depends on several factors such as the user’s age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for wormwood. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

www.webmd.com

How To Get The Bugs Out

Many diseases and disease syndromes source to parasites, bacteria, yeast or fungus. Here are some natural ways to prevent microorganisms from finding a home inside your body, and ways to remove them if they have already set up housekeeping.

If microbes are present, certain foods, medications, and food chemicals can stimulate them. However, you may have unknowningly contracted microbes years ago, yet they have remained dormant. Ask yourself: did you ever cut your foot in a lake, or deal with animals? Where and when could you have picked them up?

Fungus or bacteria generally refer to Candida (yeast) and a variety of bacteria or fungi. Remember to avoid all sugars, food chemicals, and fermented foods if you suspect having microbes. Fermentation feeds microorganisms. A colon cleanse is recommended when detoxing from microbes to help secure their healthy removal — all the way out of your body. At the first sign of health symptoms returning, begin another round of cleansing supplements until symptoms completely disappear.

If you suspect having parasites within you may be contributing to the root of your health concerns and to the root of many cancers, more specific nutrients may be necessary to remove them. Interestingly, I have discovered through years of performing the hair analyses that parasites (including most bacteria) attach to toxic metals (such as lead, mercury, copper or titanium) like barnacles attach to a ship! It is important to remove them all.

PARASITE DESTROYERS

BLACK WALNUT — The dried and ground green hull of the Black Walnut contains tannin, which is organic iodine, as well as juglandin, extractive matter from the juice of the green shucks of the walnut. Black walnut has been used for centuries to expel various types of worms, including parasites that cause skin irritations such as ringworm. It oxygenates the blood, which also helps kill parasites. Black Walnut is very effective against tapeworms, pinworms, Candida albicans (yeast infections) and malaria. It is also effective in reducing blood sugar levels, and helping the body rid itself of toxins.

WORMWOOD — This is one of the MOST POWERFUL tools in the parasite-killing herb kingdom. It is most effective against roundworms, hookworms, whipworms and pinworms. Wormwood contains the potent chemicals thujone and isothujone, which are the primary components that kill parasites. Wormwood also contains santonin, an effective remedy for parasitic diseases.

Wormwood is the second most bitter herb known to man and has been proven as a POWERFUL remedy for malaria. Wormwood also contains sesquiterpene lactones, which work similarly to peroxide by weakening the parasites membranes therefore killing them. Wormwood also helps produce bile, which in turn helps the liver and gallbladder.

CLOVES — Cloves contain eugenol, caryophyllene, and tannins, which are powerful antimicrobial agents. These components travel through the bloodstream, killing microscopic parasites and parasitic larvae and eggs. Eugenol has a pleasant, spicy, clove-like odor, and is the main biologically active compound in clove cigarettes.

Cloves are tremendously effective in killing malaria, tuberculosis, cholera, scabies and other parasites, viruses, bacteria and fungi, including Candida. Cloves also destroy Pseudomonas aeruginosa (a pathogen from plants), all species of Shigella, Staphylococcus, and Streptococcus.

THYME — Thyme contains flavonoids that are most commonly known for their antioxidant activity, and thymol and carvacrol, which are effective in killing bacteria, fungal infections, and yeast infections. Thyme is especially effective in killing hook-worms, roundworms, threadworms and skin parasites. Thyme also destroys Cryptococcus neoformans, Aspergillus, Saprolegnia, Salmonella typhimurium, Staphylococcus aureas, and Escherichia coli.

Used as an antibiotic, thymol is 25 times more effective than phenol (a manufactured substance found in a number of consumer products known to cause liver damage), yet less toxic to parasites. Thyme is the primary ingredient in the original LISTERINE ® MOUTHWASH because of its germ killing power.

HYSSOP — Hyssop contains essential hormone oil that is very effective in destroying a variety of parasites and is very effective against the herpes simplex virus.

GARLIC — Garlic is known to slow and kill more than 60 types of fungi and 20 types of bacteria, as well as some of the most potent viruses known to humans. Garlic has a history of killing parasites and controlling secondary fungal infections, detoxifying while gently stimulating elimination, and has antioxidant properties to protect against oxidation caused by parasite toxins.

Allicin and Ajoene are the components in garlic that kill parasites, including one-cell varieties, as well as pinworms and hookworms. Allicin is not present in garlic in its natural state. When garlic is chopped or otherwise damaged, the enzyme alliinase acts on the chemical alliin converting it into allicin. Ajoene is the principal chemical responsible for garlic’s anticoagulant properties and contributes to its strong odor.

Garlic has antimicrobial properties, including antibacterial, antiviral, antifungal, antiprotozoal, and antiparasitic, that kills: B. subtilis, E. coli, P. mirabilis, Salmonella typhi, Salmonella enteritidis, methicillin-resistant Staph aureus, Staph faecalis, and V. cholerae, Staphylococcus, Escherichia, Proteus, Salmonella, Providencia, Citrobacter, Klebsiella, Hafnia, Aeromonas, Vibrio and Bacillus genera. Garlic is also very effective against Mycobacterium tuberculosis. Garlic has also been known to eliminate Candida albicans.

FENNEL — This herb is known to be antiparasitic. Fennel seed is used to help remove and expel parasites and their wastes. Fennel is also very effective against Candida albicans.

CAYENNE — A member of the Capsicum genus, known for assisting with assimilation, healing, improved circulation, cleansing, indigestion, urinary tract health, colds, flu and other benefits too numerous to mention, cayenne also destroys parasites.

GINGER — The components of gingerol, the active constituent of fresh ginger, destroys parasites including the roundworm, the blood fluke, the anisakid worm, and the Salmonella bacteria.

GENTIAN — This herb is wonderful for ridding the body of parasites including plasmodia, which is a malaria-causing parasite. Gentian is also good for treating anemia and counteracting the effects of parasite toxins in the body by stimulating the liver to produce more bile.

BODY & BLOOD PURIFIERS THAT REMOVE TOXINS

MILK THISTLE — Silymarin is the primary component in Milk Thistle that removes liver toxins. Milk Thistle promotes liver cell regeneration, and its antioxidant action protects against cell damage from toxins. Milk Thistle is most helpful in cleansing the toxins given off by parasites.

MARSHMALLOW ROOT — Marshmallow Root contains mucilage, a gummy substance obtained from certain plants. When Marshmallow Root gets wet, it becomes soft and sticky, which soothes the mouth, throat, stomach and intestinal tract. When parasites are dislodged from body tissue, they can leave an open sore. Marshmallow Root coats these sores so there is less irritation.

PAU D’ ARCO— Pau d’Arco is used for Candida, yeast infections, fungal infections, viral infections, and
parasitic infections. It also helps relieve cystitis, prostatitis, ringworm, gonorrhea, and syphilis. Pau D’Arco is one of the most powerful antioxidants known, and stimulates the immune system. Pau d’Arco also helps relieve leaky bladder syndrome.

BURDOCK — Burdock removes accumulated waste and toxins from the skin, kidneys, mucous and serous membranes. A very effective blood purifier, Burdock is wonderful for head, face and neck skin problems including, eczema, psoriasis, boils, carbuncles, eyesores, and dermatitis.

ELECAMPANE — This herb is to the lungs what Marshmallow Root is to the digestive tract. It is a natural expectorant, which helps coat and soothe the lungs as impurities are coughed up and expelled. Elecampane also has an antibacterial effect that purifies the lungs.

FENUGREEK — This herb works very much like elecampane with an added blood purifying quality.

LICORICE — Licorice is also an expectorant and demulcent just like elecampane and fenugreek. It also is an anti-inflammatory, anti-spasmodic and mild laxative. It purifies the organs and the endocrine system, especially the liver.

COLON & BOWEL HELPERS

BARBERRY — The ingredients of Barberry, columbamine, berberine, and oxyacanthine, have antibacterial and antiviral properties. Research indicates that berberine in Barberry is specifically effective against cholera, giardia, Shigella, Salmonella and E. coli. The berberines aid in the secretion of bile and are good for liver problems.

Barberry is also a mild laxative, and helps the digestive processes. Barberry also helps with Staphylococcus, Streptococcus, Salmonella, cholera and chronic candidiasis (yeast). Berberines are highly bactericidal, amoeboidal and trypanocidal.

Barberry acts the same as chloramphenicol, a commonly prescribed antibiotic drug. Barberry helps to purify the respiratory and digestive systems, and also has an antiparasitic effect.

CASCARA SAGRADA — Also known as Buckthorn, Cascara Sagrada stimulates increased wavelike contractions of the large intestines. Cascara has also been known to expel parasites through its wavelike actions in the lower intestines, and is highly recommended during parasite removal. Cascara Sagrada is considered one of the safest laxatives, and is useful in detoxifying the colon.

SENNA — Senna is a powerful laxative that is excellent for expelling worms. Senna works best when combined with other anthelmintic herbs (used in the treatment of roundworm), such as ginger or fennel. These herbs increase regularity and reduce the chance of bowel cramps due to Senna’s strong action. Senna effectively cleans the elimination system, and has a vermifuge action that repels parasites. Senna is the ingredient in many over-the-counter laxatives, including Fletcher’s Castoriaª, Senokotª and Innerclean Herbal Laxative.

SAGE — Sage has the power to relax the muscles lining the digestive tract. Sage contains relatively high levels of thujone which is the same ingredient in wormwood that kills parasites. Sage is also used to increase circulation, and is considered an excellent remedy for poor digestion and stomach problems.

PSYLLIUM — Removes toxins from the colon and is especially useful in cleaning out all of the pockets in the colon wall. Psyllium swells up to 50 times its size, and is powerfully effective in removing waste and toxins from the colon.

YELLOW DOCK — Works as a laxative, but unlike other laxatives, yellow dock also promotes bile flow, which purifies the blood. It is rich in digestible iron that helps restore blood nutrients to the body.

CRAMP BARK — The components of Cramp Bark (Vitamin K, viburnin, isovalerianic acid, hydroquinines, coumarins, salicin, salicosides, arbutin, sterol, tannin, and resin) greatly calm gastrointestinal cramping by relaxing the smooth muscles. It also helps with general muscle cramping; reducing any cramping that might occur while the colon is working to expel parasites.

PEPPERMINT — Peppermint is well known for relieving indigestion, but it also relaxes the stomach muscles, relieves gas, and is also good for nausea and vomiting. Peppermint also has antiparasitic properties.

Posted January 2007 | Permanent Link

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Wormwood

Medically reviewed by Drugs.com. Last updated on Dec 12, 2019.

Scientific Name(s): Artemisia absinthium L.
Common Name(s): Absinthe, Absinthites, Absinthium, Aci pelin, Ajenjo, Ak pelin, Armoise, Buyuk pelin, Pelin otu, Vilayati afsanteen, Wermut, Wormwood

Clinical Overview

Wormwood was traditionally used to treat worm infestations, although no clinical data support this use. Anti-inflammatory, antipyretic, and chemotherapeutic activity are documented in nonhuman studies. Initial studies suggest that wormwood may improve Crohn disease symptoms, but information regarding the plant’s use in immunoglobulin A (IgA) nephropathy is limited. In Germany, woodworm is used to treat loss of appetite, dyspepsia, and biliary dyskinesia. Wormwood is also used as a flavoring agent.

Dosing

Wormwood is commercially available as an essential oil, as well as in capsule, tablet, tincture, and aqueous extract dosage forms. However, no recent clinical evidence supports dosing recommendations. Traditional use of the herb for treating dyspepsia was dosed as an infusion of 2 to 3 g daily.

Contraindications

Avoid use with hypersensitivity to any of the components of wormwood, particularly the essential oil. It may be contraindicated in patients with an underlying defect of hepatic heme synthesis, because thujone is a porphyrogenic terpenoid.

Pregnancy/Lactation

Avoid use. Documented abortifacient and emmenagogue effects.

Interactions

A single case report suggests that wormwood may increase the international normalized ratio (INR) with warfarin.

Adverse Reactions

The volatile oil thujone in wormwood produces a state of excitement and is a powerful convulsant. Repeated ingestion of wormwood may result in absinthism, a syndrome characterized by digestive disorders, thirst, restlessness, vertigo, trembling of the limbs, numbness of the extremities, loss of intellect, delirium, paralysis, and death.

Toxicology

Wormwood is classified as an unsafe herb by the US Food and Drug Administration (FDA) because of the neurotoxic potential of thujone and its derivatives; it is generally regarded as safe if it is thujone free. The safety of wormwood is poorly documented despite its long history as a food additive. Convulsions, dermatitis, and renal failure have been reported.

Scientific Family

Botany

Wormwood is an odorous, perennial shrub native to Europe and naturalized in the northeastern, central, and northwestern United States. Its aromatic leaves have a strong sage odor and bitter taste, and its multibranched stems are covered with fine, silky hairs. The plant has a fibrous root system and grows to about 1.2 m tall. Its small flowers, which bloom July through August, are green to yellow and arranged in large, spikelike panicles. The deeply lobed leaves are grayish-green in color. Leaves and small stems no thicker than 4 mm are used medicinally.1, 2, 3, 4

History

The name «wormwood» is derived from ancient use of the plant and its extracts as an intestinal anthelmintic. In Pakistan’s indigenous medicinal systems, the leaves and flowering tops are used as an anthelmintic, antiseptic, febrifuge, and stomachic, and to alleviate chronic fever, dyspepsia, and hepatobiliary ailments. An ethobotanical study in Turkey documented the plant’s use as an abortifacient, as a blood depurative, and in treating stomachaches. Caribbean folk medicine documents wormwood use for menstrual pain, vaginitis, and other unspecified female complaints.5 Extracts of the plant are used as a bitter seasoning for food and added to drinks such as beer, tea, or coffee, and it has also been used as an appetizer.6 In western European traditional herbal medicine, wormwood was recommended for gastric pain and cardiac stimulation, and to restore declining mental function. French and Spanish New Mexicans used the plant species along with other plants as an emmenagogue.5 In traditional Chinese medicine, practitioners treated acute bacillary dysentery by applying fresh and dried absinthium. A poultice of the plant has been used medicinally for tendon inflammation, and wormwood tea was used traditionally as a diaphoretic.7, 8, 9, 10

Wormwood extract is the main ingredient in absinthe, a toxic liquor that induces absinthism, a syndrome characterized by addiction, GI problems, auditory and visual hallucinations, epilepsy, brain damage, and increased risk of psychiatric illness and suicide. The drink has been banned in several countries, but in the 19th century, absinthe-based liquor was believed to have aphrodisiac and healing properties and was also reputed to stimulate creativity. The emerald-green color of absinthe liquor came from chlorophyll; however, copper and antimony salts were reportedly added as colorants to inferior batches, resulting in toxic consequences. Thujone-free wormwood extract is used as a flavoring, primarily in alcoholic beverages such as vermouth.2, 11, 12

Chemistry

The medicinal or active components in wormwood are the essential oils, anabsinthin, absinthin, resins, and organic acids. The bitter taste is caused by the glucosides absinthin and anabsinthin, and several related compounds.2, 13

Lactones include arabsin, artabin, ketopelenolide, and others related to santonin.1 An important isolated flavonoid is 5,6,3′,5′-tetramethoxy 7,4′-hydroxyflavone (p7F).14

Essential oils

Many Artemisia species contain monoterpenoid thujone derivatives with toxic CNS effects. Wormwood typically contains small amounts of thujone derivatives, including 0.2% (Z)-thujone and 0.5% (E)-thujone2, 15; however, the thujone content varies widely.16

The major components of wormwood oil include chamazulene (18%), nuciferol butanoate (8%), nuciferol propionate (5%), and caryophyllene oxide (4%). The essential oils also contain a large amount of aromatic compounds (41%) and a low level of oxygenated monoterpenes (24%). The plant contains a pleasant-smelling volatile oil (about 1% to 2% by weight), as well as phellandrene, pinene, azulene, and more than 6 other minor components.11 Flowers may contain oil composed of up to 35% thujones. cis— and trans-epoxycymenes account for up to 57% of the volatile oil derived from Italian absinthium. The herb is standardized based on absinthin.1, 4, 11, 16

Wormwood contains trace amounts of thymol and carvacrol, as well as other phenolic compounds with potent antioxidant and free radical-scavenging activity.15

Uses and Pharmacology

Scientific literature contains mostly phytochemical, ethnopharmacological, and ethnobotanical investigations, with little clinical investigation of wormwood.

Anthelmintic activity

The anthelmintic activity of the plant is thought to be caused by lactones related to santonin, which is found in wormseed and other species of Artemisia. In addition, thujone can stun roundworms, which can then be expelled by normal intestinal peristalsis.1, 11

Animal data

A study of plants in central Italy reported veterinary use of the plant as an anthelmintic for cows.17

Clinical data

An ethnobotanical and ethnopharmacological study documented the use of wormwood for treating intestinal worms in Dominica, West Indies.18

Antifungal activity

In vitro data

The essential oils distilled from the aerial parts of A. absinthium inhibited the growth of Candida albicans and Saccharomyces cerevisiae var. chevalieri.19

Antimicrobial activity

Thujone oils are recognized as the active constituents affecting microbial growth.16

In vitro data

The essential oils of wormwood have antimicrobial activity against Escherichia coli, Salmonella enteritidis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, C. albicans, and Aspergillus niger. The activity was comparable with that of erythromycin.16

Animal data

Hexane-, chloroform-, and water-soluble extracts of A. absinthium exhibited antipyretic activity against subcutaneous yeast injections in rabbits. No toxic effects were documented for the plant extract at doses up to 1.6 g/kg.20

Crohn disease

Clinical data

In Germany, a multicenter, double-blind, placebo-controlled trial examined the efficacy of SedaCrohn, an herbal supplement containing A. absinthium, 500 mg 3 times per day in 40 patients with Crohn disease.4 The study had 2 phases: a 10-week double-blind phase during which wormwood was administered and corticosteroid doses were tapered, and a 10-week observational phase after discontinuation of wormwood, in which corticosteroids were restarted as needed. The study enrolled stable patients treated with corticosteroids. Treatment with 5-aminosalicylates, azathioprine, and methotrexate was allowed, but the study excluded patients treated with a tumor necrosis factor (TNF)-alpha inhibitor.21 The study enrolled patients with a score of 170 or more on the Crohn Disease Activity Index (CDAI). Outcomes of the study included clinical improvement on the CDAI and Hamilton Depression scale (HAM-D). In the first phase of the study, 90% of patients treated with wormwood had an improvement in CDAI scores despite corticosteroid tapering, while CDAI scores increased in placebo-treated patients. At week 10, almost complete remission of Crohn disease symptoms was reported in 65% of patients treated with wormwood, compared with 0% with placebo. In the second phase of the study, it was necessary to restart corticosteroids in 10% of patients treated with wormwood, compared with 80% of patients treated with placebo. At week 10, HAM-D scores decreased by 9.8 ± 5.8 points with wormwood and 3.4 ± 6.6 points with placebo. A HAM-D score less than 10 was achieved by 70% of patients treated with wormwood, compared with 0% treated with placebo. No patients discontinued treatment early in this study. The study did not report adverse effect data.

A second German, multicenter, open-label trial randomized 20 patients with Crohn disease to receive SedaCrohn 750 mg 3 times per day or placebo for 6 weeks. The study included stable patients treated with a 5-aminosalicylate, azathioprine, or methotrexate, but excluded patients treated with a TNF-alpha inhibitor. Enrolled patients had a CDAI score of 200 or more. Outcomes included changes in TNF-alpha levels and clinical improvement on the CDAI and HAM-D. TNF-alpha levels decreased substantially in patients receiving wormwood (24.5 ± 3.5 pg/mL at baseline vs 8 ± 2.5 pg/mL at week 6) but did not appreciably change in patients receiving placebo (25.7 ± 4.6 pg/mL at baseline vs 21.1 ± 3.2 pg/mL at week 6). The mean CDAI score dropped in patients receiving wormwood (275 ± 15 at baseline vs 175 ± 12 at week 6) but did not decrease substantially in patients receiving placebo (282 ± 11 at baseline vs 260 ± 14 at week 6). The CDAI score dropped below 150 in 6 patients treated with wormwood. The mean HAM-D score decreased by 9.8 ± 5.8 points with wormwood compared with 3.4 ± 6.6 points with placebo. No patients discontinued treatment early in this study and no «out of the line» adverse effects were attributed to wormwood.

A meta-analysis identified 7 placebo-controlled clinical trials that evaluated the efficacy and tolerability of herbal medicines in inflammatory bowel disease. Based on 2 studies (n = 60) evaluating A. absinthium in patients with Crohn disease, a significant result was identified for induction of clinical remission (relative risk, 27).41

IgA nephropathy

Clinical data

In an uncontrolled pilot study, 10 patients with biopsy-proven IgA nephropathy were given SedaLeukin, a thujone-free wormwood preparation, 1.8 g/day for 6 months.22 Wormwood was evaluated because it may reduce TNF-alpha activity. Patients had normal renal function and protein excretion between 500 and 3,500 mg/day, despite treatment with ramipril and valsartan. Renal function and blood pressure were compared with baseline values. The urine protein-creatinine ratio decreased significantly from 2,340 ± 530 mg/g to 315 ± 200 mg/g (P Related treatment guides

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