Gui

Related Terms

ABNOBAviscum?, Abnovaviscum Quercus (AQ), all-heal, American mistletoe, Australian mistletoe, avuscumine, bird's lime, birdlime mistletoe, devil's fuge, Drudenfuss, Eurixor?, folia visci, galactoside-specfic lectin, golden bough, Helixor?, herbe de qui (French), hexenbesen, Iscador QuFrF, Iscador? Qu spezial, Isorel?, lectine standard, Leimmistel, Lektinol?, Lignum crusis (Latin), Mistelsenker, Mistlekraut (German), Mistletein, mistletoe of the appletree (Malus), mistletoe of the fir (Abies), mistletoe of the pine (Pinus), mistletoe extract PS76A2, mistletoe lectin (ML), mistrel, ML-1, mystyldene, Phoradendron leucarpum, Phoradendron serotinum (Raf.), Phoradendron flavescens (Pursh.) Nuttal, Phoradendron macrophyllum, Phoradendron tomentosum (DC) (American mistletoe), Plenosol?, PS76A2, SyvimanN? (mistletoe and comfey combination), Stripites Visci, Tallo de muerdago, VaQuFrF, Vischio (Italian), Visci, Visci albi folia, Visci albi fructus, Visci albi herba, Visci albi stipites, viscum, Viscum album Loranthaceae (family), Viscum album coloratum (Korean mistletoe), Viscus album quercus frischsaft [Qu FrF], Viscum abietis, Viscum austriacum, Viscum fraxini-2, viscumin, Vogelmistel, Vysorel?, white mistletoe.

Background

Once considered a sacred herb in Celtic tradition, mistletoe has been used for centuries for conditions as diverse as high blood pressure, epilepsy, exhaustion, anxiety, arthritis, vertigo (dizziness), and degenerative inflammation of the joints.
Beginning in the early 20th Century, mistletoe came into practice in Europe as an anti-cancer therapy and this remains a source of great popular interest. For example, in Norway, mistletoe has been considered a "non-proven therapy" or NPT but has been used as a popular method for healing.
In the last 50 years, many laboratory, animal, and human studies have been conducted on potential anti-cancer effects thought to be caused by immuno-stimulatory effects of mistletoe.
The most promising potential use is as a cancer therapy, but there is still insufficient clinical evidence to consider it a proven cancer therapy. Toxic effects seem to be rare, but have been reported. The National Cancer Institute monograph "Mistletoe Extracts" provides a complementary and alternative medicine (CAM) information summary and overview of the use of mistletoe as a treatment for cancer, indicating that: [a] in animal studies mixed results have been obtained using mistletoe extracts for slowing tumor growth; [b] well designed clinical trials using mistletoe or its components have not been sufficient to prove efficacy in the treatment of human cancer(s); [c] mistletoe plants and berries are toxic to humans and their extracts are not sold in the United States.
Mistletoe is not commercially available in the United States, but two U.S. investigators currently have Investigational New Drug approval (IND) from the U.S. Food and Drug Administration (FDA) to study mistletoe.
The German Commission E Monographs list mistletoe as a treatment for degenerative inflammation of the joints and as palliative therapy for malignant tumors.
Two major types of mistletoe, European and American, contain very similar proteins and are reputed to have different uses. European mistletoe is believed to reduce blood pressure and act as an antispasmodic and calmative agent, while American mistletoe is believed to simulate smooth muscles, increase blood pressure, and trigger uterine and intestinal contractions. However, there is little research to substantiate any of these claims.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


One retrospective case study documented potential benefits of mistletoe extract injection in the management of arthritis. Further research is needed before recommending for or against the use of mistletoe in the treatment of this condition, for which other more proven treatments are available.

 C


One retrospective case study documented potential benefits of mistletoe extract injection in the management of arthritis. Further research is needed before recommending for or against the use of mistletoe in the treatment of this condition, for which other more proven treatments are available.

 C


Mistletoe is one of the most widely used unconventional cancer treatments in Europe. Extracts have been studied for many types of human cancers, including bladder, breast, cervical, central nervous system (CNS), colorectal, head and neck, liver, lung, lymphatic, ovarian, and kidney cancers, as well as melanoma and leukemia. However, mistletoe has not been proven to be effective for any one type of cancer. Larger, well-designed studies are needed before mistletoe can be recommended for cancer patients.

C


Mistletoe is one of the most widely used unconventional cancer treatments in Europe. Extracts have been studied for many types of human cancers, including bladder, breast, cervical, central nervous system (CNS), colorectal, head and neck, liver, lung, lymphatic, ovarian, and kidney cancers, as well as melanoma and leukemia. However, mistletoe has not been proven to be effective for any one type of cancer. Larger, well-designed studies are needed before mistletoe can be recommended for cancer patients.

C


In a preliminary description in 1997, some patients achieved complete elimination of the virus after treatment with Viscum album although these studies were not well designed. A small exploratory trial investigated the effects of mistletoe on liver function, reduction of viral load and inflammation, and maintenance of quality of life by the immunomodulatory and/or cytotoxic actions of mistletoe extracts but little effect was seen. Larger, well-designed clinical trials are needed to resolve this conflicting data.

C


In a preliminary description in 1997, some patients achieved complete elimination of the virus after treatment with Viscum album although these studies were not well designed. A small exploratory trial investigated the effects of mistletoe on liver function, reduction of viral load and inflammation, and maintenance of quality of life by the immunomodulatory and/or cytotoxic actions of mistletoe extracts but little effect was seen. Larger, well-designed clinical trials are needed to resolve this conflicting data.

C


Treatment of HIV patients with mistletoe has been done in Europe since the beginning of the AIDS epidemic based on proposed immunomodulatory effects. Treatment seems to be tolerable with minimal side effects reported. Mistletoe may assist in inhibiting progression but not all mistletoe preparations have shown equal effects. Further study is needed before a recommendation can be made.

 C


Treatment of HIV patients with mistletoe has been done in Europe since the beginning of the AIDS epidemic based on proposed immunomodulatory effects. Treatment seems to be tolerable with minimal side effects reported. Mistletoe may assist in inhibiting progression but not all mistletoe preparations have shown equal effects. Further study is needed before a recommendation can be made.

 C


A few small trials found mistletoe to be promising as an immunostimulant in individuals with the common cold. Further study is needed to confirm these results.

 C


A few small trials found mistletoe to be promising as an immunostimulant in individuals with the common cold. Further study is needed to confirm these results.

 C


Studies of Iscador? (conducted by the same authors) document improved clinical symptoms and markers of immune function in children with recurrent respiratory disease (RRD) exposed to the Chernobyl nuclear accident. There is insufficient evidence to recommend for or against mistletoe therapy for RDD in general.

 C


Studies of Iscador? (conducted by the same authors) document improved clinical symptoms and markers of immune function in children with recurrent respiratory disease (RRD) exposed to the Chernobyl nuclear accident. There is insufficient evidence to recommend for or against mistletoe therapy for RDD in general.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (over 18 years old)
Traditionally, tea has been made with mistletoe leaves, hawthorn leaves and flowers, and lemon balm leaves in equal parts. Two cups daily has been prepared by infusing two teaspoons of the mixture for 5-10 minutes. Cold water infusions, dried aqueous extracts, and fluid extracts (1:1 in 25% alcohol) have been taken by mouth.
Mistletoe has been studied in multiple injectable regimens (intravenous, subcutaneous, intrapleural) and given by a healthcare provider in a controlled setting. Sometimes therapy includes an induction phase and a maintenance phase. Mistletoe should only be given by a qualified healthcare professional. No standard dose can be recommended at this time. Further research is needed as there are many potential side effects and interactions.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Mistletoe may increase the effects of blood pressure-lowering medications or have other more serious adverse effects on the heart. Busulphan and mistletoe extract (Helixor?) have been reported to cause organ fibrosis and death.
Use of mistletoe with central nervous system (CNS) depressants may increase sedative effects.
It is unclear if mistletoe interacts with drugs that affect blood sugar levels or drugs used to treat diabetes.
Elevations of liver enzymes have been reported with high doses of mistletoe. Seizure risk may be increased. Seizures have been reported to poison-control centers following the ingestion of crude mistletoe plant material. Immunomodulatory effects have also been proposed.
Theoretically, concomitant use of mistletoe and monoamine oxidase inhibitors (MAOIs) may cause a hypertensive crisis due to mistletoe containing tyramine. Blood sugar levels may be altered by mistletoe. Mistletoe may have negative side effects on the eye and interact with eye drops.
Avoid the use of mistletoe in patients with over-active thyroid glands (a condition called hyperthyroidism). Mistletoe may cause an inflammatory reaction when used in patients with untreated hyperthyroidism.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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