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Updated 18 February 2013

Lady's slipper (Cypripedium acaule, Cypripedium calceolus)

Lady's slipper is a wildflower in the orchid family (Orchidaceae). Yellow lady's slipper (Cypripedium calceolus), named American valerian after Indian valerian (Valeriana wallichii), which comes from India, shares similar medical properties with pink lady's slipper. Once commonly used to treat various nervous disorders, it is a mild stimulant and is antispasmodic. Lady's slipper has been described in the folklore as a stimulant and a sedative, and no reports are currently available to confirm these opposite proposed actions. It is also often used to treat depression related to female problems. Having been almost wiped out by collectors for such medical use, it is now too rare to be used medically.

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RELATED TERMS

American false-hellebore (Veratrum viride), American valerian, bleeding heart, Cyripedium, Cypripedium acaule, Cypripedium calceolus, Cypripedium californicum, Cypripedium candidum, Cypripedium fasciculatum, Cypripedium flavum, Cypripedium guttatum, Cypripedium japonicum, Cypripedium montanum, Cypripedium pubescens, Cypripedium tibeticum, English lady's slipper (Cypripedium calceolus), Indian valerian, Japanese lady's slipper (Cypripedium japonicum), ladies slipper, lady's slipper, moccasin flower, monkey flower, Noah's ark, Orchidaceae (family), pink lady's slipper (Cypripedium acaule), ram's-head lady's-slipper (Cypripedium arietinum), queen's lady slipper, showy lady's slipper (Cypripedium reginae), slipper root, spotted lady's slipper (Cypripedium guttatum), stemless lady's slipper (Cypripedium acaule), two lips, venus shoe, virgin's shoe, yellow lady's slipper (Cypripedium calceolus), yellows, nerve root.

Note: Do not confuse Calypso bulbose (Cypripedium bulbosum) and Cypripedium parviflorum, which are related species also known as lady's slipper.

BACKGROUND

Lady's slipper is a wildflower in the orchid family (Orchidaceae). Yellow lady's slipper (Cypripedium calceolus), named American valerian after Indian valerian (Valeriana wallichii), which comes from India, shares similar medical properties with pink lady's slipper. Once commonly used to treat various nervous disorders, it is a mild stimulant and is antispasmodic. Lady's slipper has been described in the folklore as a stimulant and a sedative, and no reports are currently available to confirm these opposite proposed actions. It is also often used to treat depression related to female problems. Having been almost wiped out by collectors for such medical use, it is now too rare to be used medically.

Pink lady's slipper (Cypripedium acaule) was considered a substitute for the preferred yellow lady's slipper as a medicinal plant. Used as a sedative and antispasmodic, it was substituted for the European valerian. It has also been used for male and female disorders.

Presently, there are no high quality human clinical trials available evaluating the safety and efficacy of lady's slipper. However, traditional users and some herbal experts suggest that more research may be warranted to investigate the antispasmodic and sedative/stimulant actions of lady's slipper.

EVIDENCE TABLE

Conditions

Uses
disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*

*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Antispasmodic, anxiety, astringent, cramps, delirium tremens ("the shakes," an acute episode of delirium that is usually caused by withdrawal), depression (mild), diaphoretic (promotes sweating), diarrhea, enhancing recovery from surgery or illness, hypnotic, hysteria, insomnia, menorrhagia (heavy menstrual bleeding), mood (elevate), muscle spasms, nervousness, pain, pruritus (severe itching), sedative, stimulant, stress, styptic (stops bleeding), tension (emotional), tooth pain.

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older):

There is no proven safe or effective dose of lady's slipper. Traditionally, 2-4 grams dried rhizome/root or as tea (2-4 grams dried rhizome/root steeped in 150 milliliters of boiling water for 5-10 minutes, and then strained), has been used three times daily. A liquid extract (1:1 in 45% alcohol) of 2-4 milliliters has also been used three times daily. In capsule form, one or two 570-milligram capsules of 100% lady's slipper have been taken up to three times each day with water at mealtimes.

Children (younger than 18 years):

There is no proven safe or effective dose of lady's slipper in children, and use is not recommended.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to lady's slipper. Contact with the leaves of lady's slipper may cause contact dermatitis. The stem of the showy lady's slipper, Cypripedium reginae, is covered with hairs containing a fatty acid that may cause blistering similar to that caused by poison ivy.

Side Effects and Warnings

Adverse effects of lady's slipper are not well documented in the available literature. Dermatitis (inflammation of the skin), hallucinations, and restlessness are possible side effects, although the frequency and duration of these effects are unknown. Large doses have been associated with giddiness, restlessness, headache, and mental excitement. The stem of a related species, the showy lady's slipper (Cypripedium reginae), is covered with hairs containing a fatty acid that may cause blistering similar to that caused by poison ivy, although it is unclear if other species would have the same effect.

Pregnancy and Breastfeeding

Lady's slipper is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Ladies slipper contains quinines, which may have an additive effect when taken concomitantly with other quinine-containing agents, often used to treat malaria.

Lady's slipper is thought to contain tannins, glycosides, resins, and quinines. Patients taking cardiac glycosides or digoxin should use with caution.

Based on traditional use, lady's slipper may have additive effects when used with other sedatives.

Interactions with Herbs and Dietary Supplements

Lady's slipper is thought to contain tannins, glycosides, resins, and quinines. Patients taking herbs with cardiac glycoside-like effects, such as foxglove, should use with caution. Also, those taking herbs with high tannin content should also use with caution.

Lady's slipper contains quinines, which may have an additive effect with other quinine containing herbs.

Based on traditional use, lady's slipper may have additive effects when used with other sedatives. Caution is advised in patients taking herbs such as valerian or chamomile.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

  • Liu D, Ju JH, Zou ZJ, et al. Isolation and structure determination of cypritibetquinone A and B, two new phenanthraquinones from Cypripedium tibeticum. Yao Xue.Xue.Bao. 2005;40(3):255-257. View abstract
  • Schmalle H, Hausen BM. A new sensitizing quinone from lady slipper (Cypripedium calceolus). Naturwissenschaften 1979;66(10):527-528. View abstract
disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)
 
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