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The inspiration for aspirin though with contrasting benefits

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Meadowsweet

Filipendula ulmaria (L) Maxim Rosaceae

Meadowsweet is one of the first remedies to consider for stomach problems, especially when accompanied by acid or digestive damage. It is almost specific for acid reflux problems. It is also a popular remedy for arthritic and other inflammatory conditions where its benefits are enhanced by a diuretic effect.

  • How does it feel?

    When you crush the flowerbuds of meadowsweet between your fingers you get the characteristic wintergreen smell of methyl salicyate. This is also the prominent taste of the whole herb in tea or tincture accompanied by a slightly slimy sweetness and astringency.

    Distilling these traditional organoleptic insights, it is clear this is a remedy with soothing and astringent properties with prominent presence of inflammation-modulating salicylates.

  • What can I use it for?

    Meadowsweet is most valued for its benefits in the upper digestive tract, notably in reducing the effects of acid dyspepsia and acid reflux.

    Contrary to common belief such problems are not caused by excess acid, but by unhealthy access of acid to surfaces where it should not be and/or by hypersensitivity to acid or bile.

    As we discuss in our Insight article on antacids reducing acid levels often reduces symptoms but at the cost of compromising a major defence measure.

    Meadowsweet appears to work as a true healing agent on the lower oesophagus or gullet where it connects to the stomach and is ideal for reflux problems like hiatal hernia and GORD/GERD.

    It contributes importantly to the relief of other acid dyspepsia complaints, gastritis and gastric ulcer along with slippery elm powder, licorice, aloe vera and Iceland moss.

    Use meadowsweet also for its diuretic and inflammation-modulating properties in arthritis and more widely in chronic inflammatory diseases. It can be seen as a convenient detox remedy in such cases.

    It was also widely used for urinary infections and stones.

  • Into the heart of Meadowsweet

    This is a perfect example of the way in which plants transcend their prominent constituents. By rights the obvious content of salicylates in meadowsweet should make it a plant to be used with caution for stomach conditions and also as a potential blood-thinning agent.

    Indeed none of these concerns are borne out. It is likely that the very high levels of polyphenols, including tannins bring different benefits, including reducing inflammatory pressures from the gut. A postbiotic effect, in which the microbiome converts meadowsweet constituents into even more useful metabolites, is an intriguing prospect.

  • Traditional uses

    Meadowsweet has been used for its astringent property in the treatment of diarrhoea, and it is almost a specific for children’s diarrhoea.It has also been used in the management of arthritis and rheumatism, oedema, cellulitis, kidney disorders, cystitis, urinary stones.

  • Traditional actions

    Anti-inflammatory

    Anti-inflammatory herbs reduce inflammation in the body. There are different systems in the body that anti-inflammatory plants target. For example for the gastrointestinal tract chamomile, fenugreek and meadowsweet are useful. For the musculoskeletal system rosehips, turmeric and celery seed are useful. For inflammation against immune mediated inflammation gotu kola (centella asiatica), rehmannia (rehmannia glutinosa) and feverfew (tanacetum parthenium) can be useful.

    Antitussive

    Antitussive is a substance that reduces the amount of, or severity of, coughing. Licorice, peppermint and bupleurum are examples of this.

    Astringents

    Astringents contain tannins that act to precipitate proteins and draw tissues together, tightening and toning them to reduce secretions and discharge. Astringents also tend to stop bleeding and can act on tissues with which there is no direct contact. Examples include Raspberry leaf (Rubus ideaus), Lady’s Mantle leaf (Alchemilla vulgaris), Agrimony leaf (Agrimonia eupatoria), Shepherd’s Purse leaf (Capsella bursa-pastoris), Witch Hazel leaf (Hamamelis virginiana) and Yarrow leaf (Achillea millefolium).

  • What practitioners say

    Digestion: Meadowsweet is used to treat conditions of the upper gastrointestinal tract. Its tannins appear to provide protection to the oesophageal and gastric mucosa while allowing the salicylates to modulate inflammation without causing the harm associated with aspirin derivatives. It is used principally for reflux other acid-associated problems of the gastroesophageal sphincter (such as hiatal hernia, and GERD/GORD), and more widely to a range of acid dyspepsia symptoms and gastritis. Its tannin astringency makes it a useful component in reducing diarrhoea that originates as a reflex from the stomach such as in gastro-enteritis and especially children’s diarrhoea.

    Urinary: meadowsweet is widely regarded as an effective diuretic, as a component of a detox regime especially in the case of arthritic problems (see below), and also to reduce oedematous inflammatory conditions. It was also used in kidney or urinary stones and urinary infection.

    Musculoskeletal: although its aspirin-equivalence is low there is a tradition of incorporating meadowsweet in formulations to help with arthritic disease. This may have more to do with its reputation as a urinary remedy and the old tradition of using remedies (like nettle, clivers and birch) that were seen to help eliminate acid metabolites from the body.

    Skin: there is a reputation for the use of meadowsweet as an external application for skin and mucosal lesions – in a similar way to other salicylate-based treatments with some observations of benefits for acne and cervical dysplasia.

  • Research

    There is very little human research on the effects of meadowsweet. One review of the literature supported its traditional use in inflammatory conditions, including evidence of COX-1 and COX-2 inhibition (6), with others well demonstrating a reduction of other inflammatory markers (7), and with indication that flavonoid and tannin components are partially responsible for the demonstrated pharmacological activities (8).

    Laboratory studies have additionally indicated that the high tannin levels are assocatied with elastase inhibiting activities (9).  In vivoantimutagenic activity has been identified (10,11), and in vitro effects have been demonstrated against Helicobacter pylori (12), and Staphylococcus aureus (13).

  • Did you know?

    The brand name aspirin was derived from the former botanical name for meadowsweet, Spiraea ulmaria. In the late 19th Century the German company Bayer was looking for a medicine that could replicate the traditional benefits in arthritis of willow bark (Salix spp.), without the stomach-harming properties of the chemical initially derived from it, salicylic acid.

    Walking by the river one day, one of their scientists reputedly squeezed the flowerbuds of meadowsweet, with a longstanding reputation for healing stomach problems, and noticed the strong aroma of methyl salicylate (familiar from wintergreen oil): it gave him an idea.

    Back in the laboratory Bayer revisited the earlier work by the French scientist Charles Gerhardt who first generated acetylsalicyclic acid in the laboratory, and marketed it as having comparable properties to salicylic acid without as much harm to the stomach wall. They called their new medicine, now the most widely used in the world, after the Latin ‘a spiraea’ (from meadowsweet).

Additional information

  • Botany description

    Meadowsweet is a perennial herb up to 120 cm tall, with long petioled leaves up to 65 cm long and composed of 2 to 5 pairs of 8 cm-long ovate leaflets with double-toothed margins and a tomentose underside. The small creamy white flowers are arranged in dense, many flowered, cymose panicles with many protruding stamens.

    Alternate botanical names:

    • Spiraea ulmaria L

  • Common names

    • Queen of the meadow
    • Meadwort (Engl)
    • Mädesüssblüten (Ger)
    • Spierblumen (Ger)
    • Fleur d’ulmaire (Fr)
    • Reine des prés (Fr)
    • Ulmaire (Fr)
    • Ulmaria (Ital)

  • Safety

    Meadowsweet is widely judged to be safe even for long term use. No significant adverse effects are expected, even in the case of theoretical gastric reactions to salicylates (high tannin levels are postulated as one protective mechanism). However caution is advised in cases of salicylate sensitivity and in patients taking warfarin or other anticoagulants. Large doses may also be inappropriate in or may even exacerbate constipation or iron-deficiency anaemia, due to the high tannin levels.

    A herbal syrup including salicylate-rich ingredients willow and meadowsweet was withdrawn from the Italian market after being associated with gastrointestinal bleeding in a child (14). Meadowsweet extracts have not shown genotoxic activity (15), and have even demonstrated antigenotoxic effects in vivo and in vitro (16).

  • Dosage

    Between 2-6g a day in an infusion or tea, with higher doses traditionally used for short term benefits.

  • Constituents

    Phenolic constituents are the most prominent actives in meadowsweet (1,2), including the following

    • Ellagitannins (10 to 15%), especially rugosin-D.
    • Phenolic (salicylaldehyde) glycosides, including methyl salicylate (spiraein) in the flowers, monotropitin (gaultherin) in the flowers and leaves, and a salicyll alcohol glycoside.
    • Flavonoids (up to 3-5%) consisting of spiraeoside, hyperoside and other glycosides of quercetin and kaempferol.
    • Essential oil (0.2% from the flowers) notably salicylaldehyde (75%) (3).

    There is evidence of postbiotic transformation of meadowsweet metabolites by the microbiome. Protective urolithins have been generated from meadowsweet elagitannins in human faecal cultures (4), and in the case of cultures of pig microbiota (which are similar to humans) polyphenol metabolites were detected demonstrating anti-inflammatory and diuretic activity (5).

Meadowsweet

  • References

    1. Bijttebier S, Van der Auwera A, Voorspoels S, et al. (2016) A First Step in the Quest for the Active Constituents in Filipendula ulmaria (Meadowsweet): Comprehensive Phytochemical Identification by Liquid Chromatography Coupled to Quadrupole-Orbitrap Mass Spectrometry. Planta Med. 82(6): 559-72. doi: 10.1055/s-0042-101943.
    2. Katanić J, Boroja T, Stanković N, et al. (2015) Bioactivity, stability and phenolic characterization of Filipendula ulmaria (L.) Maxim. Food Funct.  6(4): 1164-75. doi: 10.1039/c4fo01208a
    3. Valle MG, Nano GM, Tira S. (1988) The Essential Oil of Filipendula ulmaria. Planta Med. 54(2): 181-2. doi: 10.1055/s-2006-962390.
    4. Piwowarski JP, Granica S, Zwierzyńska M, et al. (2014) Role of human gut microbiota metabolism in the anti-inflammatory effect of traditionally used ellagitannin-rich plant materials. J Ethnopharmacol. 155(1): 801-9. doi: 10.1016/j.jep.2014.06.032.
    5. Popowski D, Zentek J, Piwowarski JP, Granica S. (2021) Gut Microbiota of Pigs Metabolizes Extracts of Filipendula ulmaria and Orthosiphon aristatus-Herbal Remedies Used in Urinary Tract Disorders. Planta Med. doi: 10.1055/a-1647-2866
    6. Katanić J, Boroja T, Mihailović V et al. (2016) In vitro and in vivo assessment of meadowsweet (Filipendula ulmaria) as anti-inflammatory agent. J Ethnopharmacol.193: 627-636. doi: 10.1016/j.jep.2016.10.015.
    7. Drummond EM, Harbourne N, Marete E, et al. (2013) Inhibition of proinflammatory biomarkers in THP1 macrophages by polyphenols derived from chamomile, meadowsweet and willow bark. Phytother Res. 27(4): 588-94. doi: 10.1002/ptr.4753. 
    8. Samardžić S, Arsenijević J, Božić D, et al (2018). Antioxidant, anti-inflammatory and gastroprotective activity of Filipendula ulmaria (L.) Maxim. and Filipendula vulgaris Moench. J Ethnopharmacol. 213: 132-137. doi: 10.1016/j.jep.2017.11.013. 
    9. Lamaison JL, Carnat A, Petitjean-Freytet C. (1990) Teneur en tanins et activité inhibitrice de l’élastase chez les Rosaceae [Tannin content and inhibiting activity of elastase in Rosaceae]. Ann Pharm Fr. 48(6): 335-40. French. PMID: 2131766.
    10. Bespalov VG, Alexandrov VA, Vysochina GI, et al. (2018) Inhibitory Effect of Filipendula ulmaria on Mammary Carcinogenesis Induced by Local Administration of Methylnitrosourea to Target Organ in Rats. Anticancer Agents Med Chem. 18(8): 1177-1183. doi: 10.2174/1871520618666180402125913.
    11. Bespalov VG, Alexandrov VA, Semenov AL, et al. (2017) The inhibitory effect of meadowsweet (Filipendula ulmaria) on radiation-induced carcinogenesis in rats. Int J Radiat Biol. 93(4): 394-401. doi: 10.1080/09553002.2016.1257834.
    12. Cwikla C, Schmidt K, Matthias A, Bone KM, et al. (2010) Investigations into the antibacterial activities of phytotherapeutics against Helicobacter pylori and Campylobacter jejuni. Phytother Res. 24(5): 649-56. doi: 10.1002/ptr.2933.
    13. Rauha JP, Remes S, Heinonen M, et al  (2000) Antimicrobial effects of Finnish plant extracts containing flavonoids and other phenolic compounds. Int J Food Microbiol. 56(1): 3-12. doi: 10.1016/s0168-1605(00)00218-x.
    14. Moro PA, Flacco V, Cassetti F, et al (2011) Hypovolemic shock due to severe gastrointestinal bleeding in a child taking an herbal syrup. Ann Ist Super Sanita. 7(3): 278-83. doi: 10.4415/ANN_11_03_07.
    15. Pukalskienė M, Slapšytė G, Dedonytė V, et al. (2018)  Genotoxicity and antioxidant activity of five Agrimonia and Filipendula species plant extracts evaluated by comet and micronucleus assays in human lymphocytes and Ames Salmonella/microsome test. Food Chem Toxicol. 113: 303-313. doi: 10.1016/j.fct.2017.12.031.
    16. Matić S, Katanić J, Stanić S, et al. (2015) In vitro and in vivo assessment of the genotoxicity and antigenotoxicity of the Filipendula hexapetala and Filipendula ulmaria methanol extracts. J Ethnopharmacol. 174: 287-92. doi: 10.1016/j.jep.2015.08.025.

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Aromatic
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent taste
The puckering taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (eg from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitter
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Blue-purple colouring
Any fruits with a blue-purple colouring contain high levels of the polyphenols known as anthocyanins. These work 1) on the walls of small blood vessels, helping to maintain capillary structure to reduce a key stage in inflammation, and improving the microcirculation to the tissues; 2) to improve retinal function and vision; 3) to support connective tissue repair around the body.
Cooling
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Hot
Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradich or wasabi, generate warmth when taken. In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage. Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold. .
Mucilaginous
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol. .
New-mown hay aroma
The familiar country odour of haymaking, of drying grass and other plants, is largely produced by coumarins (originally isolated from tonka beans – in French coumarou) and widely used in perfumery. They are chemically categorised as benzopyrone lactones and are important phytochemicals, with strong antioxidant activity in the laboratory and likely effects in modulating inflammation. They were most often associated with the calming effect linked to their use in stuffing mattresses and pillows and plants, high In coumarins were commonly used for these properties.
Resinous
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
Salty
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
Sharpness
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
Sweet
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.

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