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Updated 18 February 2013

Peony

Peony root has been used in traditional Chinese medicine (TCM) for centuries. Peony flowers are also used medicinally, for example, in cough syrups and in herbal teas. In combination with other herbs, peony has been used to treat a wide variety of health conditions, including menstrual problems, kidney problems, pulmonary heart disease, uterine fibroids, and pneumonia. Peony has been applied to the skin to prevent wrinkles and has been taken by mouth to treat pulmonary heart disease and liver problems caused by chronic hepatitis.

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RELATED TERMS

European peony, mudanpi (Chinese), Paeonia, Paeonia emodi Wall, Paeonia L., Paeonia lactiflora, Paeonia lactiflora Pallas, Paeonia mascula, Paeonia officinalis, Paeonia radix, Paeonia rubra, Paeonia suffruticosa Andrews, Paeonia veitchii, Paeoniaceae (family), paeoniae flos, paeoniflorgenin (PG), paeoniflorin, paeony, partially purified paeoniflorin (PF), peony flower, peony root, PG, PGG, phenolic glycoside, piney, Quilinggao, Ranunculaceae (family), red peony root, resveratrol, Shakuyaku, stilbenes, total glucosides of Peony (TGP), Unkei-to.

Note: Peony root is not to be confused with peony flower.

BACKGROUND

Peony root has been used in traditional Chinese medicine (TCM) for centuries. Peony flowers are also used medicinally, for example, in cough syrups and in herbal teas. In combination with other herbs, peony has been used to treat a wide variety of health conditions, including menstrual problems, kidney problems, pulmonary heart disease, uterine fibroids, and pneumonia. Peony has been applied to the skin to prevent wrinkles and has been taken by mouth to treat pulmonary heart disease and liver problems caused by chronic hepatitis.

There is good scientific evidence of an effect of peony in the treatment of pulmonary heart disease. There is also a growing body of research on TCM formulas containing peony for women's health conditions including menstrual problems, uterine fibroids, hormone regulation, and heart disease prevention. Higher quality studies are needed before a firm recommendation can be made.

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*

Heart disease (pulmonary)

Pulmonary heart disease is a structural problem with the heart that is caused by a problem with the respiratory system. Studies suggest peony may benefit pulmonary heart disease. More research is needed before a firm recommendation may be made.

B

Allergic skin disease

Peony root may have beneficial effects on immune function. These effects may help decrease inflammation associated with allergic skin reactions. There is currently not enough evidence to recommend for or against the use of peony in allergic skin conditions.

C

Antioxidant

Peony root may have antioxidant effects. More research is needed to better understand the antioxidant potential of peony.

C

Heart disease (prevention)

Peony may have positive effects on blood circulation and tone of the heart muscle and may help to prevent heart disease. Additional high-quality research is needed to support this traditional use.

C

Heart disease (treatment)

Human studies suggest peony may help in the treatment of heart disease. More research is needed before a recommendation can be made.

C

Hemolytic disease of the newborn

Hemolytic disease of the newborn is a condition that occurs when the blood types of the mother and the newborn are incompatible. Studies in humans have used a traditional Chinese herbal medicine containing peony to prevent this condition. More evidence is needed.

C

High blood pressure (during pregnancy)

Studies in humans have used peony for the treatment of high blood pressure that occurs during pregnancy. More evidence is needed.

C

High cholesterol

Human studies in postmenopausal women suggest peony may have beneficial effects on cholesterol levels in the blood. More research is needed to support this use of peony.

C

Hormone regulation

Human studies have shown that peony may have hormonal activity. More studies are needed before a recommendation can be made.

C

Kidney problems (crescentic nephritis)

Human studies suggest that patients with a type of kidney disease called crescentic nephritis may need less glucocorticoid medication with use of peony. More research is needed to support this use.

C

Liver inflammation (cirrhosis)

Peony has been used in traditional Chinese medicine (TCM) to treat liver disease. Larger, higher quality trials are needed to support this use of peony.

C

Lung cancer

Although not well-studied in humans, peony may have anti-cancer activity. More high-quality studies are needed in this area.

C

Menstrual problems

Traditionally, peony was used to treat menstrual problems and lack of a menstrual period. Preliminary research suggests that peony may have hormonal effects. More research is needed to support the use of peony for menstrual problems.

C

Rheumatoid arthritis

Peony's anti-inflammatory effects may benefit patients with rheumatoid arthritis. There is currently not enough evidence for or against this use of peony.

C

Stomach disorders (Campylobacter pyloridis)

Peony root may have immune-stimulating properties. These effects may be of benefit in stomach disorders caused by the bacteria Campylobacter pyloridis. High-quality studies are needed before a recommendation may be made.

C

Uterine fibroids (myomas)

Peony may have hormonal activity that may have an effect on uterine fibroids. There is currently not enough evidence for or against this use of peony.

C

Wrinkle prevention

A compound found in peony may have anti-aging properties. Additional evidence is needed before a recommendation may be made.

C

*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. Abortion inducing, anal fissures, anemia, anti-inflammatory, antimutagenic (inhibits mutations), anti-spasm, antiviral, blood clots, blood vessel dilation (relaxation), bowel disorders, cancer, chronic fatigue syndrome, circulation problems, common cold, cough, digestive system disorders, emetic (induces vomiting), epilepsy, gastritis (chronic), gout, gynecological disorders, heart disease, hepatitis B (hemolytic disease), herpes simplex virus, high blood sugar, HIV, immune function, inflammation, leukemia, liver cancer, liver disease, menopausal disorders, menstruation pain, migraine headaches, nasal inflammation, nerve pain, nervous excitability, premenstrual syndrome (PMS), skin problems, stomach pain, sterility, tonic, upper respiratory infections, whooping cough.

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)

Various doses have been studied and there is no proven effective dose for peony. Typically, peony is consumed by mouth as a tea that is made by steeping 1 gram peony flowers in 150 milliliters boiling water for 5 to 10 minutes.

A preparation containing peony has been applied to the skin for eight weeks for wrinkle prevention.

Children (under 18 years old)

There is no proven safe or effective dose for peony in children.

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 sensitivity to peony.

Side Effects and Warnings

Reported side effects of peony have included nausea, vomiting, hives, skin rash, breathing problems, and chest pain.

Peony may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Peony may have hormonal activity. Use with caution in women with estrogen-sensitive cancers or in patients taking hormonal agents, such as birth control pills and hormone replacement therapy.

Pregnancy and Breastfeeding

Peony is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Peony may have hormonal activity and has traditionally been used to induce menstruation or abortion.

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

Peony may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin©) or heparin, anti-platelet drugs such as clopidogrel (Plavix©), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin©, Advil©) or naproxen (Naprosyn©, Aleve©).

Peony may interact with tamoxifen, drugs that decrease blood vessel growth, drugs that dilate or relax blood vessels, drugs used in the treatment of HIV, drugs with hormonal activity, drugs that affect the immune system, and drugs used to treat cancer, inflammation, viruses, high blood pressure, and high cholesterol.

Peony may delay absorption of the anti-seizure drug phenytoin (Dilantin©). Peony may decrease the need for steroid drugs in some patients.

Interactions with Herbs and Dietary Supplements

Peony may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases have been reported with the use of garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Peony may interact with antioxidants, ferulic acid, herbs and supplements with hormonal activity, herbs and supplements that decrease the growth of blood vessels, and herbs and supplements used to lower cholesterol, treat viruses, dilate or relax blood vessels, lower blood pressure, stimulate the immune system, and decrease inflammation.

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).

  • Guo D, Ye G, Guo H. A new phenolic glycoside from Paeonia lactiflora. Fitoterapia 2006;77(7-8):613-614. View abstract
  • Kang JH, Park YH, Choi SW, et al. Resveratrol derivatives potently induce apoptosis in human promyelocytic leukemia cells. Exp Mol Med 12-31-2003;35(6):467-474. View abstract
  • Kang DG, Moon MK, Choi DH, et al. Vasodilatory and anti-inflammatory effects of the 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG) via a nitric oxide-cGMP pathway. Eur J Pharmacol 11-7-2005;524(1-3):111-119. View abstract
  • Kim HJ, Chang EJ, Bae SJ, et al. Cytotoxic and antimutagenic stilbenes from seeds of Paeonia lactiflora. Arch Pharm Res 2002;25(3):293-299. View abstract
  • Kim HJ, Chang EJ, Cho SH, et al. Antioxidative activity of resveratrol and its derivatives isolated from seeds of Paeonia lactiflora. Biosci Biotechnol Biochem. 2002;66(9):1990-1993. View abstract
  • Lee SM, Li ML, Tse YC, et al. Paeoniae Radix, a Chinese herbal extract, inhibit hepatoma cells growth by inducing apoptosis in a p53 independent pathway. Life Sci 9-27-2002;71(19):2267-2277. View abstract
  • Lee S, Lim JM, Jin MH, et al. Partially purified paeoniflorin exerts protective effects on UV-induced DNA damage and reduces facial wrinkles in human skin. J Cosmet Sci 2006;57(1):57-64. View abstract
  • Leem K, Kim H, Boo Y, et al. Effects of Paeonia lactiflora root extracts on the secretions of monocyte chemotactic protein-1 and -3 in human nasal fibroblasts. Phytother Res 2004;18(3):241-243. View abstract
  • Nishida S, Kikuichi S, Yoshioka S, et al. Induction of apoptosis in HL-60 cells treated with medicinal herbs. Am J Chin Med 2003;31(4):551-562. View abstract
  • Oh GS, Pae HO, Choi BM, et al. Inhibitory effects of the root cortex of Paeonia suffruticosa on interleukin-8 and macrophage chemoattractant protein-1 secretions in U937 cells. J Ethnopharmacol. 2003;84(1):85-89. View abstract
  • Prieto JM, Recio MC, Giner RM, et al. Influence of traditional Chinese anti-inflammatory medicinal plants on leukocyte and platelet functions. J Pharm Pharmacol. 2003;55(9):1275-1282. View abstract
  • Shen AY, Wang TS, Huang MH, et al. Antioxidant and antiplatelet effects of dang-gui-shao-yao-san on human blood cells. Am J Chin Med 2005;33(5):747-758. View abstract
  • Stavri M, Mathew KT, Bucar F, et al. Pangelin, an antimycobacterial coumarin from Ducrosia anethifolia. Planta Med 2003;69(10):956-959. View abstract
  • Sun WS, Imai A, Tagami K, et al. In vitro stimulation of granulosa cells by a combination of different active ingredients of unkei-to. Am J Chin Med 2004;32(4):569-578. View abstract
  • Wong AL, Chan TY. Interaction between warfarin and the herbal product quilinggao. Ann Pharmacother 2003;37(6):836-838. 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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