Herbal Medicine

Seyed Javad Kia et al. (2020) · BMC complementary medicine and therapies

This double-blinded randomised trial with 57 adults who have oral lichen planus (OLP) explored whether nano-curcumin, a highly absorbable form of the turmeric compound curcumin, could ease the condition as effectively as the steroid prednisolone. OLP is an autoimmune condition in which T cells attack the lining of the mouth, producing white streaks, erosions, burning and pain; steroids are the standard treatment but cause side effects when used long term. Curcumin has anti-inflammatory and antioxidant properties, but ordinary curcumin is poorly absorbed, so the researchers tested a nano-sized version taken by mouth. At an oral medicine department in Iran, 60 patients with erosive or atrophic OLP were randomly assigned to take either one 80 mg nano-curcumin capsule or one 10 mg prednisolone capsule each morning after breakfast for 4 weeks. An examiner who did not know the groups measured lesion size with calipers and a lesion-grading scale and asked patients to rate pain and burning from 0 to 10 at the start and at weeks 1, 2 and 4. Fifty-seven patients were analysed. Both treatments helped. Pain fell from 4.65 to 2.69 with nano-curcumin and from 4.89 to 2.33 with prednisolone (p < 0.001 over time), and lesions shrank from 3.83 to 2.34 versus 3.61 to 1.83 (p < 0.001 over time). The two groups did not differ significantly at any visit (pain p = 0.428, lesion size p = 0.568), although prednisolone was ahead on lesion size at week 4 by a margin that did not reach significance (p = 0.117). Curcumin's pain relief became significant from week 2, prednisolone's from week 1. The trial had no placebo arm, lasted only 4 weeks, and followed no one after treatment, so recurrence could not be measured. The authors suggest nano-curcumin may be an option for people who cannot take corticosteroids and that its dose may matter more than treatment length, and they call for longer studies.

Fatemeh Bourbour et al. (2026) · Endocrinology, diabetes & metabolism

This double-blind randomised trial with 57 adults who have Hashimoto's thyroiditis explored whether curcumin, the yellow polyphenol in turmeric (Curcuma longa), adds benefit to an anti-inflammatory diet. Hashimoto's thyroiditis is an autoimmune condition in which the immune system attacks the thyroid gland, shown in blood tests by anti-thyroid peroxidase antibodies (anti-TPO) and treated in many patients with lifelong levothyroxine. Because many people with the condition carry extra weight and chronic inflammation, the researchers asked whether an anti-inflammatory eating pattern plus curcumin could shift thyroid markers, body measurements and cholesterol. Researchers in Tehran, Iran, enrolled adults aged 20 to 70 with a confirmed diagnosis. Every participant ate the same structured anti-inflammatory diet of whole grains, olive oil, berries, nuts, legumes, vegetables and fatty fish. For 12 weeks, half also took 1,320 mg of curcumin daily as three capsules with meals, and half took look-alike rice-flour placebo capsules. Blood tests measured anti-TPO, thyroid-stimulating hormone (TSH), T3, T4 and lipids, and tape measures tracked waist and hips. Anti-TPO antibodies fell significantly more with curcumin than with placebo (p = 0.006), where antibodies rose numerically (within-group change not significant), which points to a possible effect on thyroid autoimmunity. Within the curcumin group waist circumference dropped 4.2 cm (p = 0.042) and TSH dropped 2.38 mIU/L (p = 0.014), but neither difference was significant against placebo after adjustment, so these changes may come partly from the diet. T3 fell in both groups, which supports that interpretation. Cholesterol, triglycerides and T4 did not differ between groups, and HDL-C moved only toward significance (p = 0.053). The curcumin group's gains held when men were excluded (anti-TPO p = 0.010). The authors call the results preliminary and note the small sample, the short 12-week window, and reliance on self-reported food recalls. Because both groups changed their diets, the trial cannot fully separate curcumin from the diet itself. Lower antibody levels may also fluctuate over time and do not prove long-term disease change. Larger, longer studies with designs that separate diet from supplement are needed before any treatment role for curcumin in Hashimoto's thyroiditis can be judged.

Sandra Utz et al. (2025) · Biomedicines

This prospective observational study followed 101 adults with long-standing fibromyalgia syndrome (FMS) through a two-week integrative inpatient stay in Bamberg, Germany, with no control group. FMS is a chronic condition marked by widespread pain, fatigue, sleep problems, anxiety and depression, and the authors describe it as the third most common rheumatic disease. The program was built on classical European naturopathy: water-based therapies and heat, exercise, plant-based nutrition or medical fasting, herbal remedies and mind-body practices such as relaxation. The question was whether such a combined approach would ease symptoms at discharge and six months later. Of 134 patients who joined (127 women, ages 22 to 80), 101 returned questionnaires on admission, at discharge and after six months. During the stay they took part in meditative movement, physical therapy, hydrotherapy, lectures and cooking classes, and some had whole-body heat sessions or a 5-day fast on under 300 kcal a day. Pain, fatigue, anxiety, depression, stress and quality of life were measured with standard questionnaires (such as the HADS for anxiety and depression and the MFI-20 for fatigue) and compared over time with repeated-measures statistics. Overall pain intensity dropped from 71.5 to 63.0 on a 0-100 scale at discharge (a moderate effect, dz = 0.62) and was still lower at six months (64.4). Current pain fell sharply during the stay (6.56 to 4.37 out of 10) but crept back to 5.96 at six months. Fatigue improved from 71.1 to 63.3 and then partly returned (68.0). Anxiety and depression scores each fell by roughly 2.5 points at discharge and were still lower than baseline at six months. Stress and feelings of helplessness improved mainly after discharge, and mental quality of life rose between discharge and follow-up. Patients who fasted kept their pain gains at six months (p = 0.006), whereas non-fasters did not (p = 0.062), although this difference was borderline (interaction p = 0.050) and not randomised. The results come from an uncontrolled, single-centre sample in which a quarter of the participants did not complete the six-month questionnaire, so the changes cannot be attributed to the program alone. More than half the patients reported obstacles to continuing the methods at home, such as lack of time and exhaustion. The authors call for randomised trials with long-term follow-up and propose a follow-up day-clinic programme to help consolidate the learned self-management skills and everyday routines.

Sedighe Esmaeilzadeh et al. (2025) · Reproductive biology and endocrinology : RB&E

This systematic review and meta-analysis combined 17 randomized controlled trials (15 pooled, 996 women) to ask whether antioxidant supplements ease the pain of endometriosis, a chronic inflammatory condition in which tissue like the uterine lining grows outside the uterus. Oxidative stress (damage from unstable oxygen molecules called free radicals) is thought to feed the inflammation and pain, so antioxidants such as melatonin, vitamins C, D, and E, curcumin (from turmeric), garlic, silymarin (from milk thistle), and resveratrol have been tested. Results across individual trials have been inconsistent, and earlier reviews were narrower, so this one searched seven sources through January 2025 and graded the certainty of the evidence. Included trials enrolled women aged 18 to 49 with confirmed endometriosis, mostly in Iran, plus Egypt, Brazil, the United States, China, and Sweden. Women took an oral antioxidant or a comparator (placebo, standard care, or nothing) for 8 to 24 weeks. The review pooled three pain outcomes using standardized mean differences (a way to combine different pain scales into one measure): painful periods (dysmenorrhea), painful intercourse (dyspareunia), and chronic pelvic pain. Study quality was graded with Cochrane RoB 2, and evidence certainty with GRADE. For painful periods, 12 trials (706 women) showed lower pain with antioxidants (SMD -1.26; 95% CI -2.19 to -0.32, equal to about 3 points on a 0 to 10 scale), but results varied enormously between trials (I² = 90.1%), so the evidence was rated low certainty. Melatonin stood out (SMD -1.89; 95% CI -2.48 to -1.31), while vitamin D, vitamins C plus E, omega-3, resveratrol, and curcumin did not reach significance. Painful intercourse showed no significant effect (SMD -1.01; 95% CI -2.27 to 0.24). Chronic pelvic pain fell in the pooled analysis (SMD -1.07; 95% CI -1.71 to -0.42), but the evidence was very low certainty and the effect vanished when trials with conflicts of interest were removed. Single trials of garlic powder and silymarin reported lower pain, whereas curcumin did not. Only 7 of 17 trials had low risk of bias. The authors say the findings do not support routine antioxidant use for endometriosis pain, and describe melatonin as the most promising candidate for painful periods, pending confirmation. Limitations include very high heterogeneity, small trials, different antioxidants and doses, bigger effects in weaker studies, and little control of baseline vitamin levels or diet. The paper did not report adverse events. The garlic and silymarin findings come from single trials, and publication-bias testing found no small-study effects for chronic pelvic pain. The authors call for larger, standardized trials.

Monira Alwhaibi et al. (2017) · Evidence-based complementary and alternative medicine : eCAM

This cross-sectional survey of 178 mothers of young children in the Central Appalachian Region of the United States explored how many use herbal remedies and which factors are linked to that use. Herbal remedies are plant-based products taken for health purposes, and they are the most common form of complementary and alternative medicine (CAM, health approaches used alongside or instead of conventional care) among American adults. The authors framed the work with the Comprehensive Model of Information Seeking, which holds that a person's background, past experiences, mood and beliefs shape where information is sought and, in turn, whether action follows, here the use of herbal remedies. The participants were women aged 18 or older with at least one child under three years of age, living in Central Appalachia and mostly in West Virginia, with a mean age of 31.3 years. They were recruited through social media groups, listserv emails, daycares and physician's offices, and completed an online survey. One item asked whether any herbal remedy had been used in the past six months, with follow-ups on which remedy and which condition. Two new five-point scales captured how often six information sources were used and how strongly herbal remedies were believed to be safe and effective. One-third of the women (33.5%) reported using herbal remedies in the past six months. Fenugreek was the most widely used remedy (35.1%), followed by honey (8.8%), chamomile (5.3%) and ginger (5.3%). The main reasons were stimulating or increasing breast milk production (38.6%) and treating cold or flu symptoms (26.3%). Women with the highest information seeking scores had 3.61 times the odds of using herbal remedies compared with those with the lowest (95% CI 1.433-9.77), meaning that more active information seeking went with more use. Women with the highest belief in herbal safety and efficacy had 4.02 times the odds (95% CI 1.468-9.57). Part-time or unemployed women had 2.98 times the odds of full-time employed women (95% CI 1.05-8.47), while education, income and Appalachian identity showed no association. The internet was the most frequently used information source (mean 3.2 out of 5). The authors conclude that herbal remedy use is common in this region and propose that public health efforts and communication from health care providers could raise awareness of the safety and efficacy of herbal remedies. The survey recorded use and beliefs only; it did not test whether any remedy worked, and safety was not assessed. Limitations include a sample drawn mostly from West Virginia, self-selection in an internet-based survey, self-reported answers open to recall bias, and no data on whether use was regular or occasional. The authors call for further research, including qualitative work, on what health information women seek.

Vahid Reisi-Vanani et al. (2025) · The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale

This double-blind, randomized trial of 66 hospitalized COVID-19 pneumonia patients in Shahrekord, Iran, tested whether pomegranate tea added to standard hospital care improves recovery. Pomegranate (Punica granatum) is rich in plant polyphenols such as punicalagin and anthocyanins, compounds that antioxidant and antiviral lab studies suggest could dampen inflammation and block the virus's spike protein from binding to its human receptor, ACE2. Lab results do not always carry over to patients, so the researchers tested the idea in a placebo-controlled clinical trial. Patients aged 18 or older with a positive SARS-CoV-2 test, low blood oxygen (SpO2 of 93% or less) and pneumonia on imaging were randomly assigned, balanced by how much oxygen support they needed. Half received a freeze-dried pomegranate fruit extract syrup (110 mg per 10 cc), dissolved in warm water as a tea, four times a day; the rest received a matching coloured placebo syrup. Treatment continued through the hospital stay and after discharge until symptoms eased. The team tracked recovery, hospital days, deterioration, death, symptom severity on a four-point scale, blood tests and side effects. The results were flat. By day 14, 84.8% of the tea group and 83.3% of the placebo group had improved (p = 1.0, meaning no difference). Median time to improvement was 6 versus 5 days (p = 0.83), and hospital stay 6 versus 5 days (p = 0.87). Deterioration occurred in 18.2% versus 20.0% (p = 1.0). Death at 28 days was 18.2% versus 6.7%, a gap that was not statistically significant (p = 0.26) in groups this small. Cough, fever, fatigue, breathlessness and other symptom scores did not differ, and day-14 blood markers such as CRP, ferritin and ESR were similar between groups. Some serious events such as ARDS (15.2% versus 3.3%) and liver dysfunction (15.2% versus 6.7%) were numerically more common with pomegranate but not significantly different, and no allergic reactions were reported. The authors conclude that pomegranate tea did not help in COVID-19. The small trial had unevenly matched groups at baseline, including time since symptom onset, and used an extract that was not chemically standardized. They recommend standardized extracts and adaptive trial designs, noting that laboratory activity does not guarantee clinical benefit. Nearly all patients in both groups also received antivirals (93.9% and 93.3%), and only 63 completed follow-up, so larger trials would be needed to detect modest effects or rare harms.

Valérie Dormal et al. (2025) · Nutrients

This randomized, double-blind, placebo-controlled trial with 180 adults in Belgium asked whether two plant extracts, saffron and Chinese skullcap (Scutellaria baicalensis), help people with mild-to-moderate depressive symptoms, alone or together. Saffron's compounds crocin and safranal are thought to keep the brain chemicals norepinephrine, dopamine and serotonin active for longer, a mechanism similar to common antidepressants. Skullcap's flavonoids, mainly baicalin, had shown calming and mood-lifting effects in animal studies, but had never been tested for mood in people. The researchers also wanted to see whether combining the two gave extra benefit. Participants aged 18 to 75, all with a recent depressive episode and Beck Depression Inventory (BDI) scores of 14 to 28, were split into four groups of 42 to 48. For six weeks each person took one capsule every morning: 30 mg saffron extract, 20 mg skullcap extract, both together, or a placebo of 450 mg maltodextrin. Depression was scored with the BDI and the clinician-rated Hamilton scale, anxiety with the STAI-S, and mood and well-being with PANAS, WHO-5 and other short questionnaires at weeks 0, 3, 6 and 8. Everyone improved, including the placebo group: BDI fell significantly in all four groups (p < 0.001), with no difference between them. Differences appeared only in the second half of treatment. Between week 3 and week 6, depression scores kept dropping in the saffron group (-2.4 points, p = 0.036) and combination group (-3.5 points, p = 0.004) but not placebo, and the Hamilton score fell more with saffron than placebo (p = 0.024). Anxiety fell in all three active groups, and well-being (WHO-5) rose more with skullcap and the combination than placebo. Compliance was about 99% in every group, and two weeks after stopping, scores had mostly held steady. The authors attribute the large placebo gains partly to participants being engaged in a study that encouraged them to talk about their problems and act to improve their well-being. Side effects were mostly minor, such as headaches and gastrointestinal complaints. The authors suggest saffron, skullcap and their combination may help mood, and propose a synergistic effect. The strong placebo response, scarce between-group differences, six-week duration, self-report measures and exclusion of severe depression limit how far the results reach. An author works for an ingredient supplier, and whether the findings extend beyond French-speaking adults at one Belgian center is not established. Longer trials, higher doses, severe depression and objective biomarkers such as stress hormones or neurotransmitter levels are recommended for future work, since long-term safety remains unestablished.

Adrian L Lopresti et al. (2022) · Journal of the International Society of Sports Nutrition

This randomized, double-blind, placebo-controlled trial with 62 recreationally active adults tested whether a standardized saffron extract changes how much people enjoy exercise, how they feel, how they sleep and how their heart rate varies. Saffron comes from the dried stigmas of the Crocus sativus flower, and its extract affron® is standardized to contain safranal and crocin, compounds studied for mood-enhancing effects at about 28-30 mg a day in adults with low mood or anxiety. Heart rate variability (HRV), the beat-to-beat variation in heart rate, serves as a marker of the body's calming parasympathetic activity. Adults aged 18 to 65 who exercised more than three times a week were randomly assigned for six weeks to take either 14 mg of saffron extract or a matching placebo tablet twice daily (28 mg of saffron a day). They kept exercising as usual. The main measure was the Physical Activity Enjoyment Scale, an 18-item questionnaire. The team also tracked mood with a 40-item survey, sleep and HRV with a WHOOP wrist strap, and blood levels of three brain-related chemicals at the start and end. Across everyone, saffron did not beat placebo on any measure (exercise enjoyment p = 0.276, mood p = 0.787, HRV p = 0.502, sleep time p = 0.598, meaning no real difference between groups). Enjoyment did climb within the saffron group, from 107.99 to 114.44 points (p = 0.001), but placebo also drifted upward. In an exploratory split by sex, the 22 men on saffron gained more enjoyment than the 15 men on placebo (113.81 versus 106.20 points, p = 0.009), and their HRV rose about 9% while placebo men's fell 5.7% (p = 0.001). No such differences appeared in the 9 women on saffron or the 16 on placebo. Side effects were mild and uncommon. The authors describe the male-only findings as preliminary, since the groups were small and uneven by sex, and the headline result was null. Healthy, already-active volunteers may leave little room for improvement, women's hormonal cycle phase was not controlled, and the wrist-worn tracker is less precise than laboratory sleep and heart measures. They recommend larger trials with varied doses and durations.

Hamed Delam et al. (2023) · BMC complementary medicine and therapies

This randomized controlled trial of 72 postmenopausal women in Iran asked a simple question: does drinking saffron tea every day make women feel happier? Menopause marks the end of menstruation and fertility, and falling estrogen levels combined with changes in family roles and aging are linked in the paper to low mood, anxiety and depression. Saffron (Crocus sativus L.), a spice from the dried stigmas of a purple crocus flower, contains crocin and safranal, compounds that laboratory work suggests affect the brain chemicals dopamine, norepinephrine and serotonin, which govern mood and motivation. The 72 women, averaging about 54 years old, were recruited through community health centers in Larestan, Iran, in 2021 and randomly placed into two groups of 36. One group drank a cup of saffron tea each morning for six weeks, made by steeping 30 mg of dried stigmas in 300 ml of hot water and served with white rock candy. The comparison group drank lukewarm water with rock candy. Happiness was measured with the Oxford Happiness Questionnaire, a 29-item survey scored from 29 to 116, at the start and after two, four and six weeks. Both groups began at almost the same level (about 43 points). The saffron group climbed steadily to 51.4 after two weeks, 55.5 after four weeks and 61.6 after six weeks (a rise of roughly 19 points, p < 0.001, meaning the change is very unlikely to be chance). The water group did not move, ending at 42.8 (p = 0.861, no real change). The gap between groups at week six was statistically significant (p < 0.001), and it held after the researchers adjusted for demographic variables. The paper does not report any side effects data, only that the dose was small. The authors suggest saffron tea may be useful as a complementary approach alongside conventional care. The study has clear limits: participants knew which drink they received, happiness was self-reported, only 72 women from one region took part, the trial lasted six weeks, and it overlapped with a COVID-19 wave in Iran. Depression was not measured directly, and how saffron might produce the effect was not tested. The authors recommend larger trials in other populations and research into the mechanism.

Shujie Wang et al. (2022) · Gut microbes

This randomized trial with 365 adults who had newly diagnosed type 2 diabetes explored whether combining berberine, a plant compound extracted from the Chinese herb Coptis chinensis (Huanglian), with a probiotic mix lowers postprandial lipidemia, the rise in blood fats and cholesterol after a meal. The authors note that cholesterol measured after eating is also an important heart-disease risk marker, that after-meal blood fats are common in diabetes, and that very few treatments target them. Berberine was already known to lower fasting cholesterol, but whether it helps after meals was unknown. Probiotics are live bacteria, and the nine-strain mix here included Bifidobacterium breve. This analysis came from a 12-week, double-blind, placebo-controlled trial at 20 centers in China, with 365 participants split into four groups: placebo (91), probiotics alone (92), berberine alone (84), and both (98). Participants were drug-naive adults aged 20 to 70, averaging about 52. They took berberine pills twice daily before meals, and probiotic powder once daily at bedtime. After a standard 100 g carbohydrate meal, blood drawn 120 minutes later measured cholesterol and triglycerides, and stool samples tracked gut bacteria. Only the combination significantly cut after-meal total cholesterol (24.29 mg/dL drop versus 8.66 with placebo, adjusted P = .001, a gap that chance is very unlikely to explain) and after-meal LDL cholesterol (16.54 versus 7.35 mg/dL, P = .043). Berberine alone and probiotics alone did not differ significantly from placebo for these two measures. After-meal triglycerides fell with berberine alone (P = .037) and the combination (P = .035) equally, so probiotics added nothing there, and HDL (good) cholesterol did not differ between groups. Thirty-one blood lipid molecules changed only with the combination, versus eight with berberine and two with probiotics. In stool, B. breve rose with the combination, and higher levels went with lower after-meal cholesterol. In lab dishes, berberine slowed B. breve growth but switched on its fatty-acid-uptake genes (called fadD). Adverse events were not reported in this paper. The authors conclude that berberine plus probiotics acts synergistically on after-meal blood fats, with the probiotic replacing Bifidobacteria that berberine suppresses and berberine activating the bacteria's fat-handling genes. They state the limits plainly: only 13 weeks and no heart-attack or stroke outcomes, testing only after a carbohydrate meal, and unknown applicability to people already on statins. The authors propose that probiotics containing Bifidobacterium may be needed when berberine is used as a lipid-lowering agent. They suggest studying fatty meals and other gut-related pathways in future work.

Teresa Vezza et al. (2024) · Nutrients

This randomized trial with 66 healthy volunteers explored whether a daily capsule combining garlic powder and a concentrated onion extract lowers LDL cholesterol, the "bad" cholesterol that builds up in artery walls and drives heart and blood vessel disease. Medicines such as statins are usually kept for people with clearly raised LDL cholesterol or several risk factors, so people with slight elevations are generally pointed toward diet and lifestyle changes. Garlic and onion contain organosulfur compounds (sulfur-rich plant chemicals), which the authors say are linked to cholesterol-lowering, antioxidant and anti-inflammatory effects. To the authors' knowledge, human research had mostly looked at garlic alone, and none had combined the two plants in one capsule. Volunteers living in Granada, Spain, with LDL cholesterol between 100 and 190 mg/dL were split at random into two groups of 33. One group took a capsule called Aliocare daily with lunch, holding 86 mg of onion extract and 14 mg of garlic powder, and the other took an identical-looking placebo of plain cellulose. Neither participants nor researchers knew who received which. Blood samples and blood pressure were checked at the start and after 2, 4 and 8 weeks, including markers of oxidation and inflammation, liver and kidney function. After 8 weeks, LDL cholesterol was 6% lower in the capsule group (4% lower at 4 weeks), and total cholesterol about 6% lower. Among those starting above 110 mg/dL, LDL cholesterol dropped 12% by week 8. Triglycerides (blood fats) also fell, while good HDL cholesterol stayed unchanged and glucose did not differ. Oxidized LDL, a form of LDL damaged by oxidation and linked to artery disease, fell about 32% by week 8. Blood pressure was about 5% lower, and no adverse events were reported, with liver and kidney tests staying in the normal range. Compliance exceeded 95%, and participants did not guess their group assignment. Interleukin-6, an inflammation marker, tended to fall with the capsule without reaching significance, and malondialdehyde, another oxidation marker, did not differ. The authors conclude the capsule was safe and improved several heart-related measures, and they suggest garlic and onion may act together, though the study did not test each plant separately. They state plainly that the volunteers were mostly young with LDL cholesterol at the low end of the range, the pandemic limited recruitment, the sample was small and the 8-week duration short. The authors add that recruiting under different conditions would likely have produced higher baseline values and more robust results. They plan larger, longer studies in people with higher LDL cholesterol.

S B Erickson et al. (2011) · Phytomedicine : international journal of phytotherapy and phytopharmacology

This small randomized trial with 10 people explored whether Cystone, an Ayurvedic herbal tablet sold for kidney stones, changes the urine chemistry that drives stone formation or reduces the amount of stone in the kidneys. Kidney stones are painful and often recur, and the available prevention options (diet changes and medicines such as thiazides, potassium citrate and allopurinol) have drawbacks. Cystone is a blend of seven plants plus purified Shilajeet and a mineral preparation (bhasma), traditionally used for urinary problems, but the authors say earlier studies of it were small and poorly controlled. Ten adults from the Mayo Stone Clinic who repeatedly formed calcium oxalate stones took two Cystone tablets twice a day, or matching placebo, for six weeks each in a crossover design, switching after a one-week break. All then took Cystone openly for another 48 weeks. Urine collected over 24 hours measured how saturated it was with stone-forming minerals. CT scans at the start and after a year, scored with the same method used for heart-artery calcium, measured stone volume, and a radiologist reviewed them without knowing the timing. Cystone did not change urinary measurements in the short term (6 weeks) or the long term (52 weeks). Average stone burden per kidney actually rose from 93 to 114 cubic millimetres (P = 0.07) and from 108 to 136 on the Agatston scale (P = 0.10), neither statistically significant. The radiologist counted 8 kidneys with more stone, 8 unchanged and 2 with less, and four kidneys passed stones spontaneously. No participant described side effects they attributed to Cystone. The authors conclude the trial does not support Cystone for preventing calcium oxalate stones, while noting the sample was tiny, participants had stones that standard treatment had not controlled, and some factors that inhibit stone formation were not measured. They say a longer study with more patients would be needed to look at stone passage or other stone types.

Dan Wang et al. (2026) · JAMA network open

This phase 3 randomized trial of 606 adults in China explored whether Guang Jing, a capsule made from the total flavonoids (plant pigment compounds with antioxidant activity) of the traditional Chinese herb Desmodium styracifolium, helps ureteral stones pass out of the body. A ureteral stone is a mineral deposit lodged in the tube that carries urine from the kidney to the bladder. Treatment that encourages passage is called medical expulsive therapy, and the authors note that alpha-blocker drugs, the guideline option, have shown mixed results in large trials. No oral medicine is currently approved for urolithiasis, and Guang Jing is already approved in China for ureteral stones. Participants were adults aged 18 to 70 with a newly diagnosed ureteral stone of 5 to 10 mm and a traditional Chinese medicine pattern called damp-heat accumulation (urethral burning, lower back pain or blood in the urine). At 34 hospitals, three of every four received 3 capsules (0.6 g) of Guang Jing three times daily for 28 days, and the rest received identical placebo capsules. Neither participants nor investigators knew who received which. Passage was confirmed by CT scan on day 28, read by blinded investigators. By day 28, 44.6% of the Guang Jing group (204 of 457) had passed their stone versus 33.8% of the placebo group (50 of 148). That is a 10.9 percentage point difference (relative risk 1.32, so passage was about one-third more likely; P = .03). At day 14 the groups did not differ significantly (29.1% vs 22.3%; P = .14), and stone movement distance was almost identical (29.5 vs 29.7 mm). Among those with 0.6 to 1.0 cm stones, passage was 37.2% vs 24.4% (a larger gap in the bigger stones), and 66.2% of Guang Jing participants with distal stones, the lower part of the ureter near the bladder, passed them. Adverse events were similar (19.3% vs 18.2%, meaning side effects were about as common with the capsule as with placebo), with no medication-related serious events. The authors describe the absolute benefit as modest, since 55.4% of the Guang Jing group did not pass a stone by day 28. The trial enrolled a fairly uniform group, mostly from southern China, and the subgroup results were exploratory. The authors state that this homogeneous population limits how far the findings generalize, and that CT slice thickness may have missed small differences in stone movement. They plan further trials in Europe and North America and call for studies to identify who benefits most and to establish how the extract works in humans.

Nayon Hur et al. (2026) · Nutrients

This randomized, double-blind, placebo-controlled trial with 112 women explored whether an oral Centella asiatica extract, taken as a daily tablet, changes measurable signs of skin aging. Centella asiatica, also called gotu kola, is traditionally used in Asian and Ayurvedic medicine for wound healing and skin problems. Skin aging here means deeper wrinkles, lower hydration, a weaker skin barrier (measured as water loss through the skin, TEWL) and less elasticity. The authors note that evidence for taking Centella by mouth for skin was limited and often based on small or subjective studies. Women aged 30 to 60 with visible crow's feet and fairly dry cheek skin were randomly assigned in Seoul to take either 200 mg a day of a standardized leaf extract (InnerCica, with asiaticoside as the marker compound) or an identical placebo for 12 weeks. Neither participants nor assessors knew who received which. Wrinkle depth, volume and roughness were measured with 3D skin imaging, and hydration, TEWL, elasticity and skin color with non-invasive probes at baseline, 6 and 12 weeks. After 12 weeks, average wrinkle depth fell by 5.87 micrometres with the extract versus 1.96 with placebo (p = 0.018; an 11.1% drop from the extract group's baseline). The deepest wrinkle, wrinkle volume and roughness also improved more than with placebo. Cheek hydration rose and cheek water loss fell more with the extract (p < 0.001 and p = 0.005), but gains in elasticity and brightness were only about 0.7%, which the authors call modest. Three mild adverse events (one extract, two placebo) were judged unrelated, and blood tests stayed normal. The authors treat wrinkle depth as the confirmed result and everything else as supportive. They note the study included only women, tested one dose for 12 weeks, did not measure how the extract might work, and did not adjust for testing many outcomes, so long-term effects remain unknown. They call for longer, more diverse studies.

Qiaoyun Liu et al. (2026) · Frontiers in endocrinology

This systematic review and meta-analysis of 56 randomized controlled trials (4,605 participants) examined whether herbal formulae containing Smilax glabra, known in Chinese as Tufuling, help people with acute gout. Gout is a painful inflammatory arthritis caused by uric acid crystals depositing in joints. In traditional Chinese medicine, many acute flares are classed as dampness-heat accumulation, a pattern defined by red, swollen, hot, painful joints and dark urine, and treated by clearing heat and resolving dampness. The authors also used computer-based network pharmacology to predict which plant compounds and proteins might explain the effects. All 56 trials took place in China and enrolled adults, with ages ranging from 18 to 80 years, diagnosed with gout and the dampness-heat pattern. Participants received a Tufuling-containing herbal formula, sometimes with external applications or acupuncture, either alone or added to standard drugs such as NSAIDs, colchicine, allopurinol or benzbromarone, for 14 days or less. Comparison groups received the standard drugs alone. Pain was measured on a 10-point visual analog scale, and blood uric acid, C-reactive protein and erythrocyte sedimentation rate (inflammation markers) were also tracked. Herbal formulae added to standard drugs reduced pain by 0.94 points on the 10-point scale (a modest but statistically significant gain across 17 trials), raised the chance of a treatment response by 15% (risk ratio 1.15), and lowered blood uric acid by 57 micromoles per litre. Herbal formulae alone did not beat standard drugs for pain (a 0.33-point difference, not significant) but did lower uric acid. Adverse events, mostly stomach and intestinal complaints, totalled 73 in herbal groups versus 161 in comparison groups, all mild to moderate. Certainty of evidence was rated low to moderate, and heterogeneity was very high for pain (I² = 93.2%). Network analysis predicted 49 gout-related protein targets for Tufuling, centred on PTGS2, IL1B, PPARG and TP53 (proteins governing inflammation and metabolism), and docking suggested diosgenin binds PTGS2 strongly (-11.6 kcal/mol). The authors suggest Tufuling-based formulae may be a useful adjunct in acute gout, but the evidence carries clear limits. Most trials lacked blinding and trial registration, all came from China, treatment lasted at most 14 days, a quarter of trials did not report adverse events, and only four reported follow-up. The findings do not extend to chronic gout or other traditional patterns, and the network predictions are untested hypotheses. The authors call for larger, rigorous trials with longer follow-up and laboratory validation of the predicted targets.

Moegi Tanaka et al. (2021) · PloS one

This randomized controlled trial with 77 analyzed women explored whether Yokukansan, a traditional Japanese Kampo herbal formula, can reduce anxiety around breast cancer surgery. Kampo is the Japanese adaptation of traditional herbal medicine, and Yokukansan combines seven herbal extracts that are traditionally prescribed for irritability, restlessness, and insomnia. Perioperative anxiety (anxiety in the period around an operation) matters because the authors link it to faster heart rate, higher blood pressure, longer postoperative pain, and a higher risk of postoperative delirium. Common anxiety medicines such as benzodiazepines can cause sedation, which is why a short-course herbal option was tested. Women aged 20 to 60 undergoing partial or total mastectomy at two Niigata hospitals in Japan were randomly assigned to a Yokukansan group or a control group. The Yokukansan group took two 2.5 g doses of a standardized extract granule, one at bedtime the night before surgery and one 2 hours before anesthesia; the control group received water. Anxiety was measured objectively with salivary alpha-amylase (an enzyme that rises with stress) and subjectively with two questionnaires, the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory. Pain was rated on a 100-mm scale the day after surgery. Salivary alpha-amylase just before surgery was lower in the Yokukansan group than in controls (0.88 versus 1.14 on a log scale, p = 0.03), meaning a smaller physiological stress signal at that moment. HADS-Anxiety scores dropped by 2.77 points with Yokukansan and 1.43 points in controls (both significant, though the difference between groups did not reach significance, p = 0.083), and the authors suggest part of the drop may reflect reassurance once surgery was complete. Trait anxiety on the STAI fell by 4.23 points with Yokukansan and did not change in controls (p = 0.92), with a significant group-by-time interaction (p = 0.009). On both questionnaires higher scores mean more anxiety, so falling scores indicate improvement. Pain scores were nearly identical (1.4 versus 1.36, p = 0.70), and no adverse events were observed. The authors suggest two preoperative doses may reduce perioperative anxiety and that further research is justified. Several limitations apply. Patients knew which group they were in because no matching placebo exists for Kampo medicines, so reassurance may explain some of the effect. Salivary alpha-amylase measures stress generally, and the analyzed groups fell short of the planned size, leaving statistical power at 0.708. Pain was low in both groups, so any pain effect remains untested. Larger double-blind, placebo-controlled trials, including more invasive surgeries, are called for.

Massimo Chiaretti et al. (2020) · Scientific reports

This randomized clinical trial with 199 adults at an Italian university proctology clinic compared two plant-based venotonic products, called phlebotonics, with routine care for hemorrhoidal disease (swollen anal cushions that cause bleeding, itching or irritation, and pain) and for recovery after hemorrhoid surgery. One product was a flavonoid preparation containing rutin, borage, horse chestnut and witch hazel. The other was a Centella asiatica (gotu kola) preparation containing triterpenic acids, asiaticoside, arnica and aloe. Flavonoids are plant antioxidants reported to improve venous tone and reduce inflammation, while Centella is reported to stimulate collagen and repair connective tissue. Participants aged 18 to 85 were randomized to three groups. Group A (73 people) took 300 mg flavonoid tablets twice daily for 15 days and applied a 3 g ointment inside the anus once daily. Group B (66 people) took 60 mg Centella tablets twice daily for 15 days and used a 3 g Centella-based ointment. Group C (60 people) received routine care only. Everyone followed a water- and vegetable-rich diet and used a medicated soap for 42 days. Time until bleeding stopped was tracked, and irritation or pain was rated on a visual analogue scale. Among 130 people with hemorrhoidal disease, bleeding stopped after a median of 2 weeks with flavonoids and 3 weeks with Centella or routine care (flavonoids versus routine care p < 0.001, meaning a clear difference; Centella versus routine care p = 0.152, meaning no significant difference). Irritation scores were lower than routine care for both products (flavonoids p = 0.007; Centella p = 0.041), and the two products did not differ (p = 0.782). After hemorrhoidectomy (31 people), bleeding time did not differ significantly between groups, and pain differed only for flavonoids versus routine care (p = 0.045). In 34 people with thrombosed hemorrhoids, pain fell faster with either product (all p < 0.001). Tissue examination linked flavonoids to fibrosis, a fibrous tissue change in the excised piles (p = 0.008). No adverse reactions were reported except burning from the Centella ointment in one person, which led to suspension of that ointment. The authors interpret the results as favouring flavonoids for bleeding and irritation, with Centella comparable on irritation. Limitations are stated plainly: a single centre, only 42 days of follow-up, small surgical and thrombosis subgroups added after the original protocol, no described blinding of participants, and multi-ingredient products that prevent attributing effects to individual plants. A medicated soap containing Centella was also given to every group. The authors suggest longer trials to test whether the benefits last.

Elham Akhtari et al. (2014) · Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences

This randomized, double-blind, placebo-controlled trial of 67 randomized women (60 analyzed) explored whether an extract of Tribulus terrestris, a low-growing plant also called puncture vine or bindii, affects sexual desire in women of childbearing age. The condition studied, hypoactive sexual desire disorder (HSDD), is a persistent lack of sexual thoughts and desire that causes personal distress, and the authors cite a prevalence of about 1 in 10 adult women in the USA and 30% in Iran. No drug is approved by the US Food and Drug Administration for it. In Iranian Traditional Medicine, texts including Avicenna's Canon of Medicine describe Tribulus as a remedy that boosts libido. The women, all married and living with a partner, were recruited at two medical centers in Tehran Province, Iran, between June 2012 and July 2013, with an average age of 36 years. After random assignment in a 1:1 ratio, one group took a syrup made from an ethanol extract of Tribulus leaves, 7.5 ml twice a day for four weeks, and the other took a look-alike sucrose syrup. Sexual function was scored with the Female Sexual Function Index (FSFI), a 19-item questionnaire covering desire, arousal, lubrication, orgasm, satisfaction and pain, completed at baseline and four weeks after treatment ended. Desire, the primary outcome, rose from 3.06 to 3.90 points in the Tribulus group but only from 2.66 to 2.86 with placebo, an adjusted difference of 0.71 points (95% CI 0.41 to 1.01, p < 0.001, meaning the gain was unlikely to be chance). Several other domains also favored Tribulus: satisfaction by 1.10 points, orgasm by 0.85, arousal by 0.75, lubrication by 0.50 and pain by 0.37 (p-values between < 0.001 and 0.041). The total FSFI score improved from 21.25 to 26.80 with Tribulus versus 20.89 to 22.41 with placebo (p = 0.040 in the results text, although the abstract gives p < 0.001). Only one participant reported a side effect, a mild (grade 1) abdominal cramp. Dropouts cited the very sweet taste and anxiety about taking an investigational drug. The authors interpret the results as supporting the traditional libido-boosting reputation of Tribulus and call for larger studies. Limitations include the small sample, only four weeks of treatment with a single follow-up, one country, and a cultural setting in which women may be reserved about reporting sexual matters. The dose is stated inconsistently between the abstract and the methods, and menopausal women were excluded, so the findings do not extend to them. The mechanism was not tested; the authors only propose a possible link to follicle-stimulating and luteinizing hormones.

Ana Luiza Cabrera Martimbianco et al. (2020) · Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia

This systematic review of five randomized controlled trials (279 women) examined whether Tribulus terrestris, a creeping herb used as a natural sexual stimulant, improves female sexual dysfunction (FSD) and what safety data exist. All participants had hypoactive sexual desire disorder (HSDD, persistently low sexual desire that causes distress) or loss of libido. Tribulus extracts contain protodioscin, a steroidal saponin (plant compound with hormone-like structure) proposed to increase luteinizing hormone, the pituitary hormone that stimulates androgen production. The review cites estimates that 30 to 50% of women experience FSD during their lifetime, and notes that the effects of Tribulus had not been established. Reviewers searched six databases and trial registries up to February 2019 for trials comparing Tribulus with placebo or another treatment. The trials took place in Brazil (four) and Iran (one) and enrolled 172 postmenopausal women (43 to 65) and 107 premenopausal women (18 to 44). Four trials gave 250 mg by mouth three times daily for 90 to 120 days; one gave a syrup twice daily for 30 days. Sexual function was measured with the Female Sexual Function Index (FSFI, scored 2 to 36) and the Sexual Quotient Female Version (SQ-F, scored 0 to 100); higher scores mean better function. Differences between trials prevented pooling results. One trial in 67 premenopausal women found a higher FSFI total score after one month on Tribulus (mean difference 4.39 points; 95% CI 2.90 to 5.88, a statistically reliable gain), driven by arousal, lubrication, orgasm and satisfaction rather than desire or pain. Two other FSFI trials at three months found no significant difference (p = 0.19 and p = 0.44). In 60 postmenopausal women, SQ-F scores rose by 16.40 points (95% CI 7.67 to 25.13) at three months. Testosterone rose in premenopausal women (mean difference 6.60; 95% CI 0.27 to 12.93) but not in postmenopausal women (2.50; 95% CI -1.79 to 6.79, a range that includes no effect). Only one trial reported adverse events: none serious, and one case of abdominal cramps. No trial measured quality of life. The authors rate the certainty of the evidence as very low, meaning future studies are likely to change the estimates. Trials were small, selection methods were unclear, and two trials lost 20% and 37.5% of participants. The authors state that current evidence does not support routine clinical use and call for more well-designed randomized trials in pre- and postmenopausal women. They note the main limitation was that only one of the contacted trial authors supplied additional data, and that this is the first systematic review of Tribulus for FSD.

José de Oliveira Vilar Neto et al. (2025) · Nutrients

This systematic review of 10 clinical studies (483 men in total) examined whether Tribulus terrestris supplements improve erectile dysfunction (ED, difficulty achieving or keeping an erection) and testosterone levels. Tribulus is a plant used for centuries in India and China as a sexual stimulant. Its steroidal saponins (plant compounds with hormone-like structure) are proposed to raise testosterone and to boost nitric oxide, a molecule that relaxes blood vessels and supports erections, though the authors note the mechanism is not fully understood. The review asked whether the evidence supports either claim, and it looked at men with and without low testosterone. Researchers searched 13 databases for studies in which men took Tribulus on its own, without other supplements or drugs. Ten studies qualified: nine clinical trials and one study without a control group, conducted in Egypt, Bulgaria, Brazil, Australia, India, China and Spain. Participants were aged 16 to 70: healthy men, men with ED (some also with low testosterone), and men with low sperm counts or unexplained infertility. Doses ran from 400 mg to 12 g per day for 4 weeks to 3 months. Study quality was graded with the Jadad scale, a 5-point checklist of randomization, blinding and dropouts. Three of the five studies that measured erectile function found improvement, and all three enrolled men with ED. One trial using 500 mg daily for 3 months raised International Index of Erectile Function (IIEF-5) scores against placebo, with significance already at 4 weeks (p = 0.0119) and stronger by the end (p < 0.0001). Eight of ten studies found no significant testosterone change, and those men did not have low testosterone at the start. Two studies in men with low testosterone found rises of about 58 to 71 ng/dL (27 to 33%), a small increase in clinical terms (roughly from 215 to 273 and 213 to 284 ng/dL), and both scored poorly for methodological quality (Jadad 2 and 0). None of the studies reported side effects, and lipid and liver tests showed no impairment. The authors conclude that evidence for improved erectile function at 400 to 750 mg per day is of low level and that no solid evidence shows Tribulus raises testosterone. Half of the studies had a high risk of bias, samples were small, saponin content varied between products, and no meta-analysis was possible. The authors state that Tribulus is not a substitute for first-line treatment of severe ED and call for well-controlled randomized trials to define dose and duration, including trials in men with low testosterone.