Wormwood
Artemisia annua.
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The use of wormwood in beverages dates back perhaps as far back as the Saracens. Various methods of consumption have been used through history, including mixing the essential oil with beer or adding wormwood seeds to the distillation of whisky. 1 Most famous however is the mixing of the wormwood drug absinthol with anise to produce the intoxicating beverage known as absinthe. Overuse of this drink had devastating effects in Europe in the 18th century, with overindulgence bringing about paralysis. 1 Wormwood is employed today in the making of vermouth, accounting for this drink’s characteristic bitter flavor. 1
Historically wormwood has been used as a parasitic worm killer, an aphrodisiac, tonic and to induce perspiration. 2 Other traditional applications include regulating menstruation and reducing fever. 3 Duke’s handbook of Medicinal Herbs lists antibacterial and antifungal properties for wormwood. 4 In times past wormwood was thought to counteract poison. It was also strewn about chambers to repel moths, fleas and other insects. When rumors of plague breaking out in London hit the streets in 1760, merchants reported running out of wormwood due to the huge public demand. 1 Orally wormwood is taken for loss of appetite, indigestion and gastrointestinal problems. 5 6 It is often used in conjunction with other herbs to deal with gallbladder disorders and flatulence. 2
The constituents of wormwood include absinthin, anabsinthin (both bitter compounds), and a volatile oil that is 70% thujone. 2 Habitual large doses of wormwood can cause restlessness, insomnia, nightmares, vomiting, abdominal pains, dizziness, tremors, convulsions and urinary tract dysfunction. Thujone’s toxicity can cause various effects as the amount of wormwood consumed increases, including seizures, delirium and hallucinations in extreme cases. Some researchers believe that thujone’s mind altering effects are similar to THC in marijuana. 2 There are some beneficial uses of this wormwood constituent however, as thujone shows promise as an antioxidant. It also appears to have moderate antimicrobial and antifungal properties. 7
Without doubt the most famous therapeutic use of wormwood is the expulsion of parasitic worms. Many reference works continue to list wormwood as an effective vermifuge, and some also list it for its antibacterial and antifungal actions. 3 4 8 9 10 Artemisinins also have a broad-spectrum of trematocidal activity in laboratory animals. 11
Artemisia annua was rediscovered during the Vietnam War by Chinese researchers looking for a solution to malaria. Records were uncovered outlining this herb’s use as an antimalarial dating back to 341A.D. 12 A. annua’s has anti-malarial properties have since been confirmed clinically, with animal tests confirming that alcohol extracts of the dried leaves have considerable anti-malarial potential, 13 showing far greater anti-malarial potential than extracts from over 30 other species in lab tests. 14 While discredited by WHO in comparison to Artemisinin Combination Therapies, studies have shown that orally ingested, powdered dried leaves of whole herb A. annua kill malaria parasites more effectively than a comparable dose of the pure drug. 15
A. annua has been shown to kill Mycobacterium tuberculosis (Mtb) regardless of the carbon source used for its growth (Mtb metabolizes a variety of difference sources of carbon that it likely encounters during infection). 16
Derivatives of A. annua show activity against cancer cells, schistosomiasis, 17 and certain viruses (including human cytomegalovirus, and hepatitis B and C viruses), and artemisinin has a broad therapeutic power against many other infectious agents, including the protozoan parasites Leishmanania trypanosoma and T. gondii. 18 Antileishmanial activity of more than 70 artemisinin derivatives against L. donovani promastigotes has been observed. 19 20 Further, artemisinin compounds are effective against T. cruzi and T brucei rhodesiense, offering “unique opportunities to exploit artemisinins as therapeutic agents for these life-threatening pathogens.” 21
Wormwood is generally regarded as safe when used appropriately and for short durations. Wormwood should not be taken in large amounts or long-term. This herb has been declared unsafe for use during pregnancy due to its uterine and menstrual stimulating effects. Due to the lack of sufficient reliable information, wormwood should not be used while breastfeeding.
A study of all TGA-listed complimentary medicines containing Wormwood species in Australia in 2021 identified only 1 product out of 46 as containing levels of artemisinin over the recommended safety levels for pregnant mothers during their first trimester, and this was clearly labelled as a high-dose artemisia supplement. 22
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References:
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Gordon L. A Country Herbal. Devon, England: Webb & Bower (Publishers) Ltd. 1980.
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Jellin JM, Batz F, Hitchens K. Natural Medicines Comprehensive Database. Third Edition. Stockton, California: Therapeutic Research Faculty, 2000.
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Gruenwald J, et.al. PDR for Herbal Medicines. First Edition. Montvale, NJ: Medical Economics Company, Inc., 1998.
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Duke JA, et. al. Handbook of Medicinal Herbs. Second Edition. Boca Raton, FL: CRC Press. 2002.
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Blumenthal M, et. al. ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council, 1998.
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British Herbal Pharmacopoeia (1996). Fourth Edition. British Herbal Medicine Association Scientific Committee, West Yorks, England.
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McGuffin M, et. al. American Herbal Product’s Association’s Botanical Safety Handbook. CRC Press. 1997.
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Lueng AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. Second Edition. New York, NY: Wiley & Sons, 1996.
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Bisset NG. ed. Herbal Drugs and Phytopharmaceuticals. Translated from Second Edition. Boca Raton: CRC Press, 1994.
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Moerman, DE. American Medical Ethnobotany: A Reference Dictionary. New York, NY: Garland Publishing. 1977.
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Keiser J, Utzinger J. Food-borne trematodiasis: current chemotherapy and advances with artemisinins and synthetic trioxolanes. Trends Parasitol. 2007 Nov;23(11):555-62. doi: 10.1016/j.pt.2007.07.012. Epub 2007 Oct 22. PMID: 17950667.
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Faurant C. From bark to weed: the history of artemisinin. Parasite. 2011 Aug;18(3):215-8. doi: 10.1051/parasite/2011183215. PMID: 21894261; PMCID: PMC3671478.
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“Artemisia absinthium.” Clarkia. (Accessed May 1, 2003). http://www.drclarkia.com/wormwood.asp
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Abdin MZ, Israr M, Rehman RU, Jain SK. Artemisin, a Novel Anti-malarial Drug: Biochemical and Molecular Approaches for Enhanced Production. Planta Med 2003;69: 289-29
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Elfawal MA, Towler MJ, Reich NG, Golenbock D, Weathers PJ, Rich SM. Dried whole plant Artemisia annua as an antimalarial therapy. PLoS One. 2012 Dec 20;7(12):e52746. doi: 10.1371/journal.pone.0052746. Epub 2012 Dec 20. PMID: 23289055; PMCID: PMC3527585.
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Kiani BH, Alonso MN, Weathers PJ, Shell SS. Artemisia afra and Artemisia annua Extracts Have Bactericidal Activity against Mycobacterium tuberculosis in Physiologically Relevant Carbon Sources and Hypoxia. Pathogens. 2023 Feb 1;12(2):227. doi: 10.3390/pathogens12020227. PMID: 36839499; PMCID: PMC9963027.
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Utzinger J, Xiao S, Keiser J, Chen M, Zheng J, Tanner M. Current progress in the development and use of artemether for chemoprophylaxis of major human schistosome parasites. Curr Med Chem. 2001 Dec;8(15):1841-60. doi: 10.2174/0929867013371581. PMID: 11772354.
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Efferth, T. (2009). Artemisinin: A Versatile Weapon from Traditional Chinese Medicine. In: Ramawat, K. (eds) Herbal Drugs: Ethnomedicine to Modern Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79116-4_11
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Avery MA, Muraleedharan KM, Desai PV, Bandyopadhyaya AK, Furtado MM, Tekwani BL. Structure-activity relationships of the antimalarial agent artemisinin. 8. design, synthesis, and CoMFA studies toward the development of artemisinin-based drugs against leishmaniasis and malaria. J Med Chem. 2003 Sep 25;46(20):4244-58. doi: 10.1021/jm030181q. PMID: 13678403.
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Sen R, Bandyopadhyay S, Dutta A, Mandal G, Ganguly S, Saha P, Chatterjee M. Artemisinin triggers induction of cell-cycle arrest and apoptosis in Leishmania donovani promastigotes. J Med Microbiol. 2007 Sep;56(Pt 9):1213-1218. doi: 10.1099/jmm.0.47364-0. PMID: 17761485.
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Mishina YV, Krishna S, Haynes RK, Meade JC. Artemisinins inhibit Trypanosoma cruzi and Trypanosoma brucei rhodesiense in vitro growth. Antimicrob Agents Chemother. 2007 May;51(5):1852-4. doi: 10.1128/AAC.01544-06. Epub 2007 Mar 5. PMID: 17339374; PMCID: PMC1855540.
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Genesis Health Products Updates TGA and Wormwood (March 2021)​​
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