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Scientific Name: Wormwood
Other Names: Absinthe, Ajenjo, Armoise, Artemisia absinthium, Green Ginger, Madderwort, Wermut
Who is this for?
The U.S. Food and Drug Administration has placed wormwood in the Unsafe category. It contains thujone, a chemical with structure and effects similar to tetrahydrocannibinol (THC), the active chemical in marijuana. If it is taken by mouth, thujone may cause nerve damage and other serious side effects, including death. Wormwood should not be taken by mouth for any reason.
For topical use, oil may be extracted from fresh wormwood leaves. Alternately, the dried aerial or "above ground" parts (flowers, leaves, and stems) of wormwood may be soaked in olive oil, vinegar, or water. The resulting oily rub or watery wash may be applied directly to the skin or used as a poultice to relieve minor skin surface irritations such as insect bites, scrapes, and sunburn. A poultice usually consists of a soft cloth that has been soaked in a medication, possibly heated, and applied to an injured area of skin surface. Wormwood contains chemicals that promote healing by increasing blood flow to areas where it is applied. Chemicals contained in wormwood may have also mild anti-infective properties that may help keep skin injuries from becoming infected.
When should I be careful taking it?
Wormwood is not considered safe to take by mouth. While it is not recommended for oral use by any individuals, members of certain groups should be particularly careful to avoid taking wormwood:
Wormwood belongs to the same family of plants that also includes chrysanthemums, daisies, and ragweed. Individuals who are sensitive to any of these types of plants may also be sensitive to topical wormwood oil or wash.
What side effects should I watch for?
Wormwood should not be taken by mouth due to the possibility of severe side effects.
In the past, many individuals who consumed large amounts of wormwood or the absinthe liquor made from it developed a set of severe symptoms known as absinthism. Symptoms of absinthism include:
Recently, at least one case of kidney failure has been associated with the oral use of wormwood.
Less Severe Side Effects
If it is taken orally, wormwood may also cause:
Cases of itching and rash have been reported from touching or handling the growing wormwood plant.
What interactions should I watch for?
The effectiveness of drugs that prevent seizures may be decreased if oral wormwood is taken at the same time. Drugs to prevent seizures include:
If wormwood is taken by mouth, it may increase the production of stomach acid, potentially interfering with Histamine-2 (H-2) receptor blockers and proton pump inhibitors.
The possibility that wormwood can increase the production of stomach acid could interfere with the effectiveness of antacids and over-the-counter medications such as Pepcid AC and Zantac AR.
The thujone in wormwood is known to intensify the effects and side effects of drinking alcohol if they are consumed at the same time.
Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.
Should I take it?
As a highly aromatic perennial shrub, wormwood is often included in ornamental landscaping. In Africa, Asia, and India, some types of wormwood are grown on farms. Thriving in mild climates, it grows easily, reaching about 3 feet tall. Wormwood has gray-green leaves covered with fine hairs that give them a silvery look. Yellow flowers bloom during the summer and early fall. Insects are repelled by its smell, so wormwood oil or wash may be rubbed onto human skin, animals, or garden plants as a natural insect repellant. In some parts of Europe, wormwood sprigs are placed in closets and cupboards to keep away moths, weevils, and other insects.
Wormwood and other species of Artemisia contain substances with a bitter taste. Some of these substances, which have been proven to treat malaria and jaundice, are included in drugs that are used in Asia and Africa. Some research into their use for a wider variety of drugs is in early stages. In the past, wormwood was used to treat conditions of the gastrointestinal tract, including indigestion and intestinal worms. It was also a major ingredient in a strong alcoholic drink known as absinthe, which had a bright green color. Often called by names such as Green Fairy, absinthe was outlawed in the early part of the 20th century, after drinking it was shown to cause hallucinations, coma, and death. Currently, a thujone-free derivative of wormwood may be used to flavor vermouth. Generally, however, the oral use of wormwood is discouraged strongly.
Dosage and Administration
Wormwood should not be taken by mouth due to the possibility of severe side effects.
Oil of wormwood or other topical forms of wormwood may be applied to unbroken skin as often as needed. If the skin blisters or irritation develops at the site of application, however, wormwood should be stopped.
Taking wormwood by mouth is not safe. Oral use of wormwood is discouraged.
Liquid preparations made by pressing oil from wormwood leaves or by soaking wormwood flowers, leaves, and stems in oil, vinegar, or water may be applied to minor skin injuries.
A cannabinoid-like chemical known as thujone in wormwood makes it unsafe to take by mouth particularly for pregnant women and individuals who have epilepsy or gastrointestinal disorders. Applying wormwood products to the skin or touching the plants may result in allergic reactions for individuals who have allergies to plants in the daisy family.
Absinthism, a condition caused by chronic ingestion of wormwood or absinthe (a type of liquor made from it), may produce numbness, hallucinations, seizures, and death. Less serious side effects may include dizziness and insomnia from oral wormwood and rash from topical wormwood.
Taken by mouth, wormwood may interfere with drugs that thin the blood, drugs that reduce stomach acid, and drugs that prevent or lessen seizures. The effects and side effects of drinking alcohol may be intensified by consuming wormwood.
Anon: Wormwood. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. April 1991.
Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. Journal of Neurology. 1999;246(8):667-670.
Chiasson H, Belanger A, Bostanian N, Vincent C, Poliquin A. Acaricidal properties of Artemisia absinthium and Tanacetum vulgare (Asteraceae) essential oils obtained by three methods of extraction. Journal of Economic Entomology. 2001;94(1):167-171.
Crabb, C. Science meets tradition and identifies herbal treatment for jaundice. Bulletin of the World Health Organization. 2004;82(2):154.
del Castillo J, Anderson M, Rubottom GM. Marijuana, absinthe and the central nervous system. Nature. 1975;253(5490):365-366.
Eckstein-Ludwig U, Webb RJ, Van Goethem ID, et al. Artemisinins target the SERCA of Plasmodium falciparum. Nature. 2003;424(6951):957-961.
Gambelunghe C, Melai P. Absinthe: enjoying a new popularity among young people? Forensic Sciences International. 2002;130(2-3):183-186.
Hold KM, Sirisoma NS, Casida JE. Detoxification of alpha- and beta-Thujones (the active ingredients of absinthe): site specificity and species differences in cytochrome P450 oxidation in vitro and in vivo. Chemical Research and Toxicology. 2001;14(5):589-595.
Hold KM, Sirisoma NS, Ikeda T, Narahashi T, Casida JE. Alpha-thujone (the active component of absinthe): gamma-aminobutyric acid type A receptor modulation and metabolic detoxification. Proceedings of the National Academy of Sciences (U S A). 2000;97(8):3826-3831.
Holstege CP, Baylor MR, Rusyniak DE. Absinthe: return of the Green Fairy. Seminars in Neurology. 2002;22(1):89-93.
Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.
Juteau F, Jerkovic I, Masotti V, Milos M, Mastelic J, Bessiere JM, Viano J. Composition and antimicrobial activity of the essential oil of Artemisia absinthium from Croatia and France. Planta Medica. 2003;69(2):158-161.
Lee SH, Lee MY, Kang HM, et al. Anti-tumor activity of the farnesyl-protein transferase inhibitors arteminolides, isolated from Artemisa [sic]. Bioorganic and Medicinal Chemistry. 2003;11(21):4545-4549.
McNeil DG. Herbal drug is embraced in treating malaria. The New York Times. May 10, 2004.
Meschler JP, Howlett AC. Thujone exhibits low affinity for cannabinoid receptors but fails to evoke cannabimimetic responses. Pharmacology, Biochemistry and Behavior. 1999;62(3):473-480.
Mueller MS, Runyambo N, Wagner I, Borrmann S, Dietz K, Heide L. Randomized controlled trial of a traditional preparation of Artemisia annua L. (Annual Wormwood) in the treatment of malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2004;98(5):318-321.
Muto T, Watanabe T, Okamura M, Moto M, Kashida Y, Mitsumori K. Thirteen-week repeated dose toxicity study of wormwood (Artemisia absinthium) extract in rats. Journal of Toxicologic Science. 2003;28(5):471-478.
Peirce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: Stonesong Press; 1999.
Prisinzano T. Thujone. Department of Medicinal Chemistry. Medical College of Virginia. Virginia Commonwealth University. Posted December 3, 1997. Available at: http://www.phc.vcu.edu/Feature/oldfeature/thuj/thujone.html. Accessed August 13, 2003.
Scientific Committee on Food. European Commission Health and Consumer Protection Directorate. Opinion of the Scientific Committee on Food on thujone. February 2, 2003. Available at: http://europa.eu.int/comm/foods/fs/sc/scf/ index.html. Accessed August 13, 2003.
Sirisoma NS, Hold KM, Casida JE. alpha- and beta-Thujones (herbal medicines and food additives): synthesis and analysis of hydroxy and dehydro metabolites. Journal of Agricultural and Food Chemistry. 2001;49(4):1915-1921.
Weisbord SD, Soule JB, Kimmel PL. Poison on line-acute renal failure caused by oil of wormwood purchased through the internet. New England Journal of Medicine. 1997;337:825-827.
(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)