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Mistletoe is a practitioner-only herb because the leaves, stems and berries can be poisonous

Mistletoe

Viscum album Santalaceae

Mistletoe has many medicinal uses and it has been used for many hundreds of years. It is also one of the most well studied medicinal plants for the treatment of cancer in Europe, where it is available as an injectable prescription extract for patients with cancer.

Sustainability status

Not currently on risk lists but complete data may be missing on the status of the species. Commonly cultivated though may be sourced from the wild. Only source cultivated supplies or from certified sustainable wild collection. Read more about our sustainability guide.

Sustainability Status
Key benefits
  • Blood pressure control
  • Cancer care (clinical)
  • Immunomodulator
  • How does it feel?

    Mistletoe as a tincture has a slightly sweet taste followed by a stronger bitterness.

  • What can I use it for?

    Fresh mistletoe (Viscum album)
    Fresh mistletoe (Viscum album)

    A clinical herbalist may use mistletoe in a formula to treat a variety of conditions but it is not safe for home use. The safe prescribing of such a herb would be carefully considered in such cases. Herbalists often use mistletoe for conditions in the cardiovascular system.

    Mistletoe is also manufactured as a pharmaceutical medication for cancer and HIV care (20). This is available in some European countries in the form of an injectable drug, the most common being Helixor®, Iscador®, abnobaVISCUM®. There are a small number of mistletoe therapy centres around the UK (22). Extensive research has been carried out on mistletoe and its bioactive compounds in relation to its effects on cancer. Much of this has been focused on the pharmacological actions of chemicals called viscotoxins, as well as a group of chemicals called lectins (1).

    When mistletoe is taken orally, viscotoxins are less bioavailable, meaning that orally administered mistletoe delivers much smaller amounts of these to the body (19). Other medicinally active compounds such as flavonoids are more bioavailable as an oral medicine (19, 20).

    Whilst mistletoe has a large body of evidence for a number of benefits in cancer treatment, it is important that people seeking to integrate herbal medicines into a care plan for serious conditions like cancer do so under the guidance of a qualified specialist.

  • Into the heart of Mistletoe

    Mistletoe on a tree branch (Viscum album)
    Mistletoe on a tree branch (Viscum album)

    Energetically, mistletoe is considered warming and astringent (11). Matthew Wood (14) discusses mistletoe in his book ‘The Earthwise Herbal’ in which he writes ‘mistletoe opens up circulation to areas that have been cut off from adequate blood supply by tension. It reduces cardiovascular tension and blood pressure, while bringing in new blood, blood sugar, and healing to areas long cut off, tensed up, weakened, or damaged’.

    Mistletoe is also referenced in Wood’s writing as a nervine herb that promotes inward feeling, contemplation and reflection (14). It has a number of actions that directly affect the nervous system. It is also thought of as an antispasmodic and autonomic nervous system (ANS) balancer (15, 16). The ANS regulates automatic physiological processes such as heart rate, blood pressure, respiration and digestion as well as stress responses. 

    Mistletoe has multiple, well-referenced applications for conditions which are directly associated with the ANS, such as high blood pressure (17) arrhythmia, insomnia, nervousness, anxiety, depression and nervous tension in the abdominal organs (15, 16, 17, 26).  Mistletoe is understood to reduce overactivity in the parasympathetic nervous system (PSNS) (27). Stableford (14) adds in his book, “The Handbook of Constitutional and Energetic Herbal Medicine that mistletoe is specific for releasing emotional constraint.

  • Traditional uses

    Mistletoe in a basket (Viscum album)
    Mistletoe in a basket (Viscum album)

    According to Ms Grieve in ‘A Modern Herbal’, the traditional uses of mistletoe focused on conditions of the nervous system (9). Grieve discusses convulsions, hysteria, neuralgia, and complaints arising from ‘a weakened and disordered state of the nervous system’. A traditional formula of mistletoe, valerian, and vervain was given for ‘all kinds of nervous complaints’ (9).

    In the early times of Western herbalism, mistletoe was used as a heart tonic. Traditional uses also include some cases of typhoid fever as a substitute for foxglove due to its ability to strengthen the heartbeat and increase heart rate (10). Greek physician Hippocrates and 17th-century herbalist Culpepper both referenced Mistletoe for use in treating disorders of the spleen (11).

    The druids of ancient Britain were said to have applied mistletoe as a topical treatment for cancers. Both Pliny and Hippocrates also refer to its use for cancers and epilepsy. Pliny also comments further about the use of mistletoe by the Druids, who applied it as an antidote for all poisons. This is where it gained its folk name ‘all-heal’ (11).

    Rudolf Steiner (an Austrian scientist and respected philosopher of his time) reintroduced the use of mistletoe extracts in the form of injections for the treatment of cancer in Western Europe in 1916 and the tradition continues in cancer clinics in Germany (11,12). Now his belief systems are highly controversial but his medical discoveries remain.

  • Traditional actions

  • What practitioners say

    Mistletoe on a small tree (Viscum album)
    Mistletoe on a small tree (Viscum album)

    Nervous system

    Mistletoe has an antispasmodic action (20, 26) and therefore may be indicated for conditions that present with spasmodic symptoms such as motor twitching, spasm, and nerve hyperactivity (20). A herbalist may incorporate mistletoe into a formula for patients where these types of symptoms are associated with nervous tension relating to stress and autonomic imbalance (imbalance of the autonomic nervous system). 

    Mistletoe has a specific moderating action on the vagus nerve (20, 26). The vagus nerve is the main branch of the parasympathetic nervous system (PSNS) which is activated when we are relaxed for “rest and digest”. It is this action of the PSNS that allows mistletoe to moderate parasympathetic tone (20, 26). Some of the key roles of the parasympathetic system are to regulate the heart rate, moderate immune function and control of digestive processes.

    Mistletoe has a number of known applications that correlate with PSNS activities, such as its ability to help strengthen a weak pulse and regulate the heart rate and blood pressure (20, 24).

    Cardiovascular system

    Perhaps one of mistletoe’s most prevalent uses by herbalists is for the treatment of hypertension (high blood pressure) (20). By contrast, its actions can also be useful for hypotension (low blood pressure). It has actions that allow it to moderate and balance, depending on what is required, a quality called ‘amphoteric’ (20).

    Polyphenolics and triterpenoids are some of the major phytochemicals involved in mistletoe’s diuretic (increasing urination) and natriuretic (increasing sodium elimination in the urine) activity. These actions offer some explanation of its mechanism of action for hypertension (23).

    It may elevate the blood pressure in hypotensive patients by strengthening the heart function i.e. the strength of the heart’s pumping action, as well as support for the integrity of the vasculature (20). Flavonoids found in mistletoe have demonstrated the ability to mitigate tachyarrhythmia and restore normal electrical conduction through the Purkinje fibres (fibres located in the heart that significantly contribute to electrical conduction and the transmission of impulses to the ventricular muscle). This action contributes to a reduction in ventricular excitability. They have also been shown to reduce noradrenalin-induced aortic contractions.

    Traditionally, mistletoe has also been employed by herbalists to address symptoms associated with congestive heart failure, arrhythmia, and cardiac weakness, as well as their underlying causes, such as atherosclerosis and vascular inflammation. It exhibits the capacity to decelerate tachyarrhythmia or invigorate bradycardia. Indications for mistletoe include conditions such as cardiac enlargement, valvular incompetence, angina, shortness of breath, dyspnea, oedema, palpitation with exertion, and the inability to lie down. These symptoms collectively contribute to the broader spectrum of indications for mistletoe in the context of congestive heart disease (20).

    For serious conditions like this, a herbalist may prescribe a formula with other supportive herbs for example cardiovascular tonics like bilberry or hawthorn. This would be in conjunction with lifestyle and dietary interventions to improve the systemic health of the patient.

    Immune system

    Mistletoe has a number of immunological actions, although much of the modern findings on this relate to mistletoe as an injectable medicine, which is not included in a herbalist’s practice. Compounds called lectins and viscotoxins in mistletoe are thought to be primarily responsible for its immunologic activity (1).

    Germinating mistletoe on a tree (Viscum album)
    Germinating mistletoe on a tree (Viscum album)

    Mistletoe stimulates both innate and adaptive immune responses (1). Some of the immunological parameters observed to increase or improve with mistletoe include granulocytes (neutrophils, eosinophils, basophils), lymphocytes (T cells, B cells, NK cells), dendritic cells, cytokines and interleukins and IgG antibodies (20).

    Mistletoe lectins are believed to have anticancer, immune-stimulating, and anti-inflammatory effects. Lectins also promote the release of cytokines, contributing to anti-inflammatory effects in the heart and other tissues, particularly the endothelium (the tissue that constitutes a single layer of cells lining various organs and cavities throughout the body) (20). 

    Metabolism

    Mistletoe has a number of references for use in metabolic conditions such as diabetes mellitus and metabolic syndrome, due to its ability to improve glycemic control and reduce vascular inflammation. Proteins in mistletoe have been shown to enhance insulin secretion from pancreatic cells (20). Mistletoe may also exhibit hypoglycemic and antioxidant effects, contributing to the protection of vasculature and enhancement of circulation (20).

    This herb may be of particular use to herbalists where metabolic imbalances are accompanied by other conditions indicated for this herb.

    Cancer care

    The majority of research into the use of mistletoe in cancer care has been focused on clinically prescribed, injectable mistletoe extracts. Herbalists are not usually trained to administer injectable preparations and are more likely to use mistletoe tinctures or dried herb preparations in practice. When mistletoe is taken via oral administration it must pass through the gastrointestinal tract. The compounds most associated with mistletoe’s anti-cancer effects are lectins which are less bioavailable via oral administration. Therefore, information dealing with its effects in cancer treatment may not be applicable to the use of mistletoe by herbalists although mistletoe still possesses value in enhancing immune function via oral medications.

    As an injectable medicine, mistletoe therapy has been shown to elicit a cytotoxic (eliminating cancerous cells) action in laboratory and animal studies by triggering cell death (2). Though a number of effects have been clearly demonstrated, further research including human clinical trials would help to establish a clearer picture of the potential of mistletoe as an anti-cancer medicine (20).

    Mistletoe has however been shown to reduce the side effects of chemotherapy and radiation, as well as to improve quality of life (6). Mistletoe shows a clear effect in protecting the microcirculation against chemotherapy-induced damage (18, 20). 

    There is limited evidence for its ability to reduce the growth and metastasis of cancerous tumours, though there are numerous studies that demonstrate specific anti-cancer mechanisms such as anti-angiogenesis (stopping the creation of blood vessels) that can help cancerous tumours grow. For this reason, mistletoe has been classified as a biological response modifier and anti-angiogenic (inhibits the tumour-induced formation of new blood vessels) (7,18).

  • Research

    Mistletoe leaves and berries (Viscum album)
    Mistletoe leaves and berries (Viscum album)

    Mistletoe is one of the best-researched herbal medicines in Europe (19). There is extensive research, including a number of clinical trials on mistletoe in cancer therapy. There are also in vivo and in vitro studies that focus on particular compounds (namely viscotoxins, which, in addition to lectins, belong to the important pharmaceutically active components of mistletoe).

    Some of the mechanisms of action for cancer care have been identified in the current research. This includes immunomodulation of both innate and adaptive immune responses and direct cytotoxicity. Other actions demonstrated in laboratory studies include; increased lymphocytes (T cells, B cells, and NK cells), dendritic cells, cytokines including INF-gamma and IL6, and the presence of IgG antibodies to mistletoe lectins and viscotoxins (1).

    The most conclusive studies effectively demonstrate that mistletoe extract used intravenously in cancer care can improve overall quality of life, reduce symptoms, and reduce side effects associated with treatment when given alongside standard cancer treatments (1). However, mistletoe is not a cancer cure, nor should it be thought of as an alternative to conventional treatments and must be taken with professional guidance. Further research is required in controlled studies to further elucidate its effects on survival and recurrence risk for cancer patients (1).

    A number of these studies have been included below to demonstrate the mechanism of action for some of the medicinal actions of mistletoe discussed in this monograph, however, there is a lack of available human studies. Animal studies are not condoned by herbal reality, however, for the purpose of including research from which some understanding of therapeutic actions can be confirmed, some animal studies have been included herein.

    Cancer

    Mistletoe extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research

    A systematic review was carried out to evaluate the available clinical studies and preclinical research on the therapeutic effectiveness and biological effects of mistletoe extracts on gynaecological and breast cancers. 19 randomised (RCT) and 16 non-randomised controlled studies (non RCT) were included as well as 11 single-arm cohort studies. They included 2420, 6399 and 1130 patients respectively. 12 of the randomised control trials reported a statistically significant benefit. 

    A number of both RCTs and non-RCTs (3 and 6 respectively) demonstrated a clinically relevant change in tumour behaviour (remission or time to relapse) another 3 reported statistically significant improvements in tumour behaviour. Tumour remission was observed after high dosage and local application. 21 reported a statistically significant positive improvement in quality of life as well as tolerability of cancer treatments such as chemotherapy, radiotherapy or surgery (6). 

    A clinical trial on the use of mistletoe therapy in patients with locally advanced or metastatic pancreatic cancer

    A prospective, parallel, randomised phase 3 study was carried out to investigate the effects of mistletoe extract in patients with locally advanced or metastatic cancer of the pancreas. The study randomised 220 patients into two groups to either receive to subcutaneous injections of mistletoe extract (between 0.01 mg up to 10 mg three times per week) or a control.

    The study demonstrated that the mistletoe group showed a significant improvement in overall survival ratings. The study concludes that mistletoe is a clinically relevant second-line therapy that has demonstrated effective disease-related symptom reduction in patients with locally advanced or metastatic pancreatic cancer (5).

    Mistletoe oil (Viscum album)
    Mistletoe oil (Viscum album)

    Rectal cancer: A cohort study

    A cohort study was carried out to establish the effect of mistletoe extract on tumour response in neoadjuvant chemoradiotherapy for rectal cancer. 52 Patients were administered mistletoe subcutaneously alongside chemoradiotherapy. 

    There was a better tumour response in the mistletoe group in relation to the tumour regression grade and overall tumour–node–metastasis stage. This was also matched with a significantly improved tumour response and overall down staging. A higher level of apoptotic cells was observed in the mistletoe group samples. Overall patients treated with both chemoradiation and mistletoe had better outcomes than those who did not receive mistletoe (26).

    A Case Report of a Patient with Bilateral Asynchronous Renal Cell Carcinoma and Lung Metastases: Treated Solely With High-dose Intravenous and Subcutaneous Mistletoe Extract

    A 67-year-old man was diagnosed with grade 3/4 renal cell carcinoma in the right kidney. That patient’s history included a right nephrectomy and two lung metastasectomies in the preceding 6 years. A renal cell carcinoma lesion was later detected on the left kidney. The patient opted for treatment using only a high-dose intravenous and subsequent subcutaneous mistletoe extract after deciding to evade a further nephrectomy procedure. The patient showed no further progression during the following 2.5-year period, as well as good quality of life. This is an isolated case and the patient still showed an area of pertumeral halo surrounding an area of necrosis in the kidney tissue via ultrasound (21).

    Intravenous mistletoe extract shows promise as cancer therapy in small study

    An intravenous mistletoe extract known as Helixor M was studied in 21 patients with advanced and treatment-resistant cancers of various types. The study initially identified an optimum dose of 600 milligrams of mistletoe extract three times a week for a period of 15.3 weeks. 

    The study showed that in three participants the tutor size decreased in size and remained stable for between two to five months. The results also showed overall improvements in quality of life identified through a patient questionnaire. Some side effects were also reported to include fatigue, nausea, and chills- these were all noted as manageable (2).

    Immunosuppressed patients 

    Tolerability of an extract of mistletoe among immunocompromised and healthy individuals

    A dose-escalating phase 1 and phase 2 study was carried out to determine the biochemical effects of mistletoe extract on 32 human immunodeficiency virus (HIV) positive patients and 9 healthy participants. The mistletoe extract was standardised for its lectin and viscotoxin content.

    Patients received the extract subcutaneously twice-weekly in gradually increasing doses of 0.01 mg to 10.0 mg for a period of between 2 to 17 weeks per dose increase. The study identified some minor side effects in the lower dose range which mainly affected the HIV patients. It was concluded that no serious adverse reactions were observed and that mistletoe induces immunomodulation in HIV-positive and healthy individuals and may inhibit the progression of HIV disease (8).

  • Did you know?

    Greek mythological heroes were granted passage to the underworld with mistletoe. The druids believed that mistletoe would offer protection against evil and poisons. Mistletoe had a strong association with fertility and vitality through the Middle Ages, and is now understood to have oxytocic action (15, 25). Pagan societies thought it represented the divine male essence (4).

Additional information

  • Botanical description

    Mistletoe is a small, semi-parasitic evergreen shrub that can grow up to 1m in the shape of large spherical balls in the canopies of broadleaf or fruiting trees. The leaves are oval, and evergreen and appear in pairs at the ends of each stem. The flowers of mistletoe consist of four small white petals and grow in clusters of three to five. Mistletoe is dioecious, meaning male and female flowers are produced on separate plants.

    After the flowers have matured a waxy, white berry will emerge in winter. The seeds inside are coated in a sticky substance which sticks to the beaks of birds feeding on the fruit. After ingesting this substance the bird will deposit it onto the trees branches in their droppings. The gluey pulp around the seed hardens and fastens the seed in place. As the new plant grows, the roots penetrate the bark and start to take water and nutrients from the tree.

  • Common names

    • European mistletoe
    • White berry mistletoe
    • All-heal
    • Golden bough
    • Devil’s fuge
  • Safety

    This herb should only be used under the supervision or guidance of a qualified medical herbalist.

    Mistletoe is not recommend for use in pregnancy (15, 20). All parts of the mistletoe plant are toxic at certain doses. Some of the side effects of toxic doses of mistletoe include; vomiting, catharsis, with tenesmus and sometimes bloody stools, papillary contraction, muscular spasm, prostration, coma, convulsions, and death. These effects have been reported from eating significnat amounts of the leaves and berries.

  • Interactions

    Consult a health professional before taking mistletoe alongside immunosuppressant medications. It may interact with blood pressure and heart rate-modulating medications.

  • Contraindications

    Mistletoe is contraindicated in pregnancy.

  • Preparation

    Pharmaceutical or commercially available mistletoe extracts are usually given subcutaneously or intravenously around 2 to 3 times a week in a dose increasing manner depending on the patients response. The overall duration of treatment varies considerably based on different studies (7).

    Mistletoe grows on several types of tree, and the chemical composition of extracts derived from it depend on a number of factors such as the species of its host tree (e.g., apple, elm, oak, pine, poplar, and spruce), the time of year it is harvested and type of extract (alchohol/aqueous). 

    The two main types of commercially available mistletoe extracts used are as follows (7).

    • Iscador: This is a fermented aqueous extract of mistletoe that is prepared as a homeopathic drug. This extract is made using the leaves, stems and buds of mistletoe that are harvested in the summer as well as berries and leaves which are harvested in winter (mixed at a 1:1 ratio) (19).
    • Helixor: This is an unfermented aqueous extract of mistletoe that is standardised to the specifications of its biological effect on human leukaemia cells as demonstrated in vitro (7).

    Mistletoe extracts are prescribed to patients with cancer and sometimes for HIV in Germany and other European countries under hospital or clinical care. There are also a limited number of private clinics across the UK that offer mistletoe therapy via oral, subcutaneous, intravenous and intra-tumoural administration (22). 

    Herbalists in the UK may use mistletoe tincture in certain cases. The tinctures that herbalists use are made from the young leaf and herb of mistletoe.

  • Dosage

    Tincture (1:5, 45%): Take between 1-2ml in a little water up to twice a day.

    Powder or capsules: Used for cardiovascular issues vary from 650 mg twice per day to 4 g four times per day (20).

  • Plant parts used

    The young, leafy twigs are used.

  • Constituents

    Two groups of peptide-type toxins appear to be the key constituents in some of the effects of mistletoe on cancer. These include viscotoxins, which are able to cause cancer cell death, and mistletoe lectins which have been shown in laboratory studies to inhibit the growth of cancer cells (13).

    • Mistletoe lectins
    • Viscotoxins
    • Kuttan’s peptides
    • Oligo- and polysaccharides
    • Flavonoids
    • Thiols
    • Triterpenes (13)
Mistletoe (Viscum album)
  • Habitat

    Mistletoe is native to the United Kingdom. It grows in the canopy of trees where there is optimum light. It is commonly found in apple, lime and poplar but has also been located on blackthorn, hawthorn, rowan and willow.

  • Sustainability

    Although mistletoe is not endangered across Britain and Ireland, its population is declining. The annual Christmas harvest and trade of mistletoe has depended heavily on traditionally established English orchards. This source of mistletoe may now be threatened due to the continued decline of orchards across the British Isles (3, 4).

    Habitat loss and over-harvesting from the wild are two of the biggest threats faced by medicinal plant species. There are an increasing number of well-known herbal medicines at risk of extinction. We must therefore ensure that we source our medicines with sustainability in mind. 

    The herb supplement industry is growing at a rapid rate and until recent years a vast majority of medicinal plant produce in global trade was of unknown origin. There are some very real and urgent issues surrounding sustainability in the herb industry. These include environmental factors that affect the medicinal viability of herbs, the safety of the habitats that they are taken from, as well as the welfare of workers in the trade.

    The botanical supply chain efforts for improved visibility (transparency and traceability) into verifiably sustainable production sites around the world are now certificated through the emergence of credible international voluntary sustainability standards (VSS). 

    Read our article on  Herbal quality & safety: What to know before you buy and sustainable sourcing of herbs to learn more about what to look for and questions to ask suppliers about sustainability.

  • Quality control

    The proportion of bioactive compounds found in mistletoe varies throughout the year and also in relation to the host trees on which the mistletoe has grown. Some chemicals are present in higher concentrations in stems, others in leaves or berries, some more in female plants or in males or vice versa. The most potent are pharmacologically diverse extract of mistletoe is therefore made using a blend of plant material harvested in summer and winter and of that which grows (19).

    In the pharmacological extracts of mistletoe often the host plant from which mistletoe was grown is usually indicated in the product name by a suffix letter. For example; IscadorM (from apple trees; Malus domestica); IscadorP (from pine trees; Pinus sylvestris); IscadorQu (from oak trees; Quercus robur); IscadorU (from elm trees; Ulmus minor) (1).

    Herbal Medicines are often extremely safe to take, however it is important to buy herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

    Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific/botanical name is used and that suppliers can provide information about the source of ingredients used in the product.

    A supplier should be able to tell you where the herbs have come from. There is more space for contamination and adulteration when the supply chain is unknown.

  • How to grow

    Mistletoe seeds can be gathered during the season between November and February. To harvest your own seeds, you will need between 20-30 berries so that you can obtain a number of seeds to sow in different places to be sure you end up with both male and female plants (which makes it possible for the plant to reproduce).

    • The seeds can be cultivated soon after harvesting. If you have stored your berries, you will need to rehydrate them by immersing overnight in a bowl of water.
    • Once the berries have softened, they can be squeezed one at a time, so that a sticky jelly-like substance emerges along with the black seeds. Although the berries are harmless to touch- it is important to wash hands thoroughly after (unless gloves are worn) due to the toxic nature of the plant.
    • Choose a host tree such as apple, lime, poplar or hawthorn. Shrubs of the Rosaceae family are also suitable. Spread the jelly-like viscin, complete with the seeds, onto a number of young branches (between 5 and 10cm in diameter). The best location for mistletoe is in the branches as high up in the tree and away from the centre of the tree (avoid the trunk).
    • You may label the branches or mark them with a tag. This may also help to keep away hungry birds. No further care is required after sowing.
    • Germination may occur between March or April. Some of the seeds will be eaten by birds or other wildlife, however there should be a number of successful seedlings will appear in early spring providing enough seeds have been planted.

    Mistletoe is slow-growing and may take up to 3 years before the plant even develops its first leaves. From year 4, growth will accelerate for multiple branches will develop and finally in year 5, berries should start appearing.

  • References

    1. Healthcare Provider Resource. (n.d.). Retrieved November 9, 2023, from https://ccnmicc.ca/sites/default/files/Mistletoe-professional-monograph-2023.pdf
    2. Mone, A., Feb 23, V. M. / P., & 2023. (2023, February 23). Intravenous mistletoe extract shows promise as cancer therapy in small study. The Hub. https://hub.jhu.edu/2023/02/23/mistletoe-extract-cancer-treatment-study/
    3. Briggs, J. (2021). Mistletoe, Viscum album (Santalaceae), in Britain and Ireland; a discussion and review of current status and trends. British & Irish Botany, 3(4). https://doi.org/10.33928/bib.2021.03.419
    4. Woodland Trust. (n.d.). Mistletoe (Viscum album) – British Plants – Woodland Trust. Woodland Trust. https://www.woodlandtrust.org.uk/trees-woods-and-wildlife/plants/wild-flowers/mistletoe/#:~:text=Mistletoe%20is%20a%20small%20semi,leaves%20which%20grow%20in%20pairs.
    5. Tröger, W., Galun, D., Reif, M., Schumann, A., Stanković, N., & Milićević, M. (2013). Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: A randomised clinical trial on overall survival. European Journal of Cancer, 49(18), 3788–3797. https://doi.org/10.1016/j.ejca.2013.06.043
    6. Kienle, G. S., Glockmann, A., Schink, M., & Kiene, H. (2009). Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Journal of Experimental & Clinical Cancer Research, 28(1). https://doi.org/10.1186/1756-9966-28-79
    7. Mistletoe Extracts (PDQ®)–Health Professional Version – National Cancer Institute. (2002, December 21). Www.cancer.gov. https://www.cancer.gov/about-cancer/treatment/cam/hp/mistletoe-pdq
    8. Gorter, R. W., van Wely, M., Reif, M., & Stoss, M. (1999). Tolerability of an extract of European mistletoe among immunocompromised and healthy individuals. Alternative Therapies in Health and Medicine, 5(6), 37–44, 47–48. https://pubmed.ncbi.nlm.nih.gov/10550904/
    9. Grieve, M., & C Leyel. (1931). A modern herbal : the medicinal, culinary, cosmetic and economic properties, cultivation and folk-lore of herbs, grasses, fungi, shrubs & trees with all their modern scientific uses. Volume 1 (A-H). Stone Basin.
    10. The Medicinal Mistletoe. (2015, December 17). Herbal Academy. https://theherbalacademy.com/the-medicinal-mistletoe/
    11. Davis, A. (2017, November 22). Mistletoe. Tonic Herb Shop. https://tonicherbshop.com/mistletoe/
    12. Mistletoe Therapy. (n.d.). Path to Health Centre – Cape Town. Retrieved November 14, 2023, from https://pathtohealth.co.za/therapies/mistletoe-therapy/#:~:text=Mistletoe%20has%20been%20used%20by
    13. Liubov Skrypnik, Pavel Feduraev, Golovin, A., Pavel Maslennikov, Belov, N., Matvei Matveev, & Artem Pungin. (2022). Biotechnological Potential of Different Organs of Mistletoe (Viscum album L.) Collected from Various Host Tree Species in an Urban Area. Plants, 11(20), 2686–2686. https://doi.org/10.3390/plants11202686
    14. Wood, M. (2009). The earthwise herbal : a complete guide to New World medicinal plants. Berkeley, Calif. North Atlantic Books.
    15. Menzies-Trull, C. (2013). Herbal medicine keys to physiomedicalism including pharmacopoeia. Newcastle: Faculty Of Physiomedical Herbal Medicine (Fphm).
    16. Kenner, D., & Yves Requena. (2001). Botanical medicine : a European professional perspective. Paradigm Publications.
    17. Bone, K., & Mills, S. (2013). Principles and Practice of Phytotherapy: Modern Herbal Medicine (2nd ed.). Edinburgh Churchill Livingstone, Elsevier.
    18. Mistletoe (Viscum album) | OncoLink. (n.d.). Www.oncolink.org. https://www.oncolink.org/cancer-treatment/complementary-and-alternative-medicine/therapies/mistletoe-viscum-album
    19. Mistletoe therapy: Constituents. (n.d.). Www.mistletoe-Therapy.org. Retrieved November 15, 2023, from https://www.mistletoe-therapy.org/information-for-patients/preparations/constituents
    20. Mistletoe (Viscum album). (n.d.). Restorative Medicine. https://restorativemedicine.org/library/monographs/mistletoe/
    21. Reynel, M., Villegas, Y., Kiene, H., Werthmann, P. G., & Kienle, G. S. (2019). Bilateral Asynchronous Renal Cell Carcinoma With Lung Metastases: A Case Report of a Patient Treated Solely With High-dose Intravenous and Subcutaneous Viscum album Extract for a Second Renal Lesion. Anticancer Research, 39(10), 5597–5604. https://doi.org/10.21873/anticanres.13754
    22. Centres. (2016, March 3). Mistletoe Therapy UK. http://www.mistletoetherapy.org.uk/centres/
    23. Jadhav N, Patil CR, Chaudhari KB, Wagh JP, Surana SJ, Jadhav RB. Diuretic and natriuretic activity of two mistletoe species in rats. Pharmacognosy research. 2010;2(1):50-7.
    24. Poruthukaren, K. J., Palatty, P. L., Baliga, M. S., & Suresh, S. (2014). Clinical evaluation of Viscum album mother tincture as an antihypertensive: a pilot study. Journal of Evidence-Based Complementary & Alternative Medicine, 19(1), 31–35. https://doi.org/10.1177/2156587213507726
    25. MISTLETOE AS AN OXYTOCIC. (1892). JAMA, XIX(1), 23–23. https://doi.org/10.1001/jama.1892.02420010029007
    26. Baek, J., Jeon, Y., Han, K.-W., Dong Hae Jung, & Kim, K.-O. (2021). Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study. World Journal of Surgical Oncology, 19(1). https://doi.org/10.1186/s12957-021-02293-4
    27. Stableford, A. (2021). The Handbook of Constitutional and Energetic Herbal Medicine The Lotus Within. Aeon Books.
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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