Gentian

Generic name: Gentiana Acaulis L., Gentiana Lutea L., Gentiana Olivieri, Gentiana Scabra Bunge.
Brand names: Afat, Bitter Root, Bitterwort, Felwort, Gall Weed, Gentian, Gentiana, Radix Gentianae Lutea

Usage of Gentian

Quality clinical trials evaluating the effect of gentian or its chemical constituents are lacking.(WHO 1999)

Analgesic/anti-inflammatory

Animal data

Gentianine and gentiopicroside have been shown to exert a measurable anti-inflammatory and analgesic effect in animals. Extracts of G. lutea were active in carageenan-induced rat paw edema, xylol-induced mouse ear edema, and cotton-pellet granulatoma models. In addition, the extracts were active in several wound-healing models.(Chen 2008, Mathew 2004, Ozturk 2006)

Clinical data

Clinical trials are lacking.

Antimicrobial

Radix Gentianae Lutea and gentian extracts have been shown to exert antibacterial, antifungal, and antiprotozoal effects in vitro.(WHO 1999)

Methanolic extracts of the flowers and leaves of G. lutea demonstrated a wide range of activity against gram-positive and gram-negative bacteria and yeasts. Isolated chemical constituents mangiferin, isogentisin, and gentiopicrin also demonstrated activity.(Savikin 2009, Weckesser 2007) Activity against Helicobacter pylori has been demonstrated in vitro.(Lans 2007, Mahady 2005) Amarogentin and 2 other iridoids inhibited topoisomerase I of Leishmania.(Ray 1996)

Animal data

The roots of G. lutea have been used as an anthelmintic in ethnoveterinary medicine.(Lans 2007)

Clinical data

Clinical trials are lacking.

Hepatic effects

Animal data

In rats, intragastric and intraduodenal administration of gentian extracts stimulated bile production(Liu 2002, WHO 1999) and showed a protective effect on the liver against chemical insults.(Liu 2002)

Clinical data

In an uncontrolled study, stimulation of gall bladder secretions was increased by gentian.(WHO 1999)

GI tract

Bitter substances ingested before meals are reputed to improve the appetite and aid digestion by stimulating the flow of gastric juices and bile. However, because gentian is most often consumed in alcoholic beverages, it is difficult to distinguish the effects of gentian from those of alcohol.

Animal data

Ethanol extracts of the roots and rhizomes of G. lutea have increased gastric secretions in rats and sheep.(WHO 1999)

Clinical data

In 2 uncontrolled clinical studies, stimulation of gastric secretions was increased and GI symptoms (eg, abdominal pain, constipation, dyspepsia, heartburn) were reduced.(WHO 1999)

Other uses

Gentian extracts have hydroxy radical scavenging activity(Calliste 2001, Kusar 2006) and exert a protective effect against ketoconazole-induced testicular damage in rats, assumed to be due to antioxidant effects.(Amin 2008) Gentiopicroside and the essential oil of G. lutea relax smooth muscle in isolated animal trachea and ileum.(Rojas 2000, WHO 1999) Gentian extracts prolong swimming endurance in mice.(Öztürk 2002)

Antidepressant effects were demonstrated in a chronic mild stress model in male rats with G. olivieri ethanolic extract and the positive control both showing significant improvements in appetite, liver indices, antioxidant status, proinflammatory cytokines, as well as levels of serotonin, noradrenaline, and cortisol.(Berk 2020)

G. lutea extract was found to modulate ceramide synthesis in psoriasis-like keratinocytes(Gendrisch 2020) and in healthy volunteers who applied a 5% G. lutea extract cream twice daily for 4 weeks. An increase in lipid production, glucosylceramides, and the expression of enzymes that generate long chain ceramides was observed.(Gendrisch 2020, Wolfle 2017)

Positive effects have been reported for G. lutea on glucose levels in type 1 and 2 diabetic rat models as well as atherosclerotic parameters in other diabetic rat models.(Joskic 2019)

Gentian side effects

The extract is usually taken in very small doses that do not appear to cause adverse effects; however, it may cause GI irritation, resulting in nausea and vomiting and, rarely, headache. Radix Gentianae Lutea is contraindicated in GI or duodenal ulcer. Classical texts include hypertension as a contraindication, but the reasons are difficult to substantiate.WHO 1999

Before taking Gentian

Mutagenic activity has been demonstrated in assays, and G. lutea has been traditionally used as an emmenagogue. Avoid use in pregnancy and lactation.WHO 1999

How to use Gentian

The pharmacokinetics and tissue distribution of gentiopicroside after oral and parenteral administration have been studied in mice. It was rapidly absorbed with low bioavailability and rapidly cleared.Wang 2004, Wang 2007

Infusions, decoctions, and macerations of gentian roots and rhizomes have been used as a bitter digestive tonic in doses of 1 to 4 g/day. There are no clinical studies to substantiate this dosage recommendation.WHO 1999

Warnings

Mutagenicity has been demonstrated for methanolic extracts in Salmonella assays.WHO 1999

The highly toxic white hellebore (Veratrum album L.) often grows in close proximity to gentian. Cases of acute veratrum alkaloid poisoning have been reported due to accidental contamination of gentian preparations by veratrum. Identification of esteralkaloids were the suspected cause of resulting nausea, vomiting, oral paraesthesia, hypotension, and severe bradycardia.Garnier 1985, Grobusch 2008, Rauber-Lüthy 2010

What other drugs will affect Gentian

Case reports are lacking; however, hemostatic activity has been demonstrated in vitro for extracts of G. luteaBakuridze 2009 and isogentisin and several other compounds from gentian inhibited monoamine oxidase.Suzuki 1978, Haraguchi 2004 If substantiated in a clinical setting, these properties may have implications for coadministration of anticoagulant or antidepressant medicines.

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