Sarsaparilla
Scientific Name(s): Smilax aristolochiifolia Mill. (Mexican sarsaparilla), Smilax china, Smilax febrifuga Kunth (Ecuadorian sarsaparilla), Smilax glabra, Smilax officinalis Kunth (Honduran sarsaparilla), Smilax ornata Lem., Smilax regelii Killip et Morton (Honduran, Jamaican sarsaparilla)
Common Name(s): Ba Qia catbrier, Carrionflower, China root, Chob cheeni, Greenbrier, Jin Gang Teng, Khao yen, Rhizoma Smilacis Glabrae, Sarsa, Sarsaparilla, Smilace, Smilax, Tufuling, Zarzaparilla
Medically reviewed by Drugs.com. Last updated on Jul 24, 2023.
Clinical Overview
Use
Various smilax extracts have demonstrated anti-inflammatory and antimicrobial properties, as well as effects on cardiovascular risk factors and metabolic syndrome; however, evidence is based largely on animal and in vitro studies, and clinical trials are limited. Sarsaparilla has been traditionally used for treating syphilis, leprosy, and psoriasis; however, clinical evidence to support these uses is lacking. Evidence is also lacking for purported ergogenic/adaptogenic effects. Due to limited clinical study data, use of sarsaparilla cannot be recommended for any indication.
Dosing
Clinical trials are lacking to provide guidance on therapeutic dosages.
Contraindications
Contraindications have not been identified.
Pregnancy/Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Estrogenic and antiestrogenic activities have been described for extracts of at least one of the species.
Interactions
None well documented.
Adverse Reactions
Clinical studies are lacking. GI irritation and increased diuresis have been reported. Occupational asthma caused by sarsaparilla root dust has been reported.
Toxicology
No data.
Scientific Family
- Liliaceae (lily)
- Smilacaceae (catbrier)
Botany
Many Smilax species are very similar in appearance, regardless of origin. Sarsaparilla is a woody, trailing vine that can grow to 50 m in length. The nectar-rich flowers are used in honey production, and the root is used for medicinal purposes. The root has a pleasant fragrance and spicy sweet taste and is used as a natural flavoring agent in medicines, foods, and nonalcoholic beverages; however, the sarsaparilla root should not be confused with the sassafras tree, the source of the distinctive flavoring of American root beer.Duke 2002, Newall 1996, USDA 2020
History
The Spanish physician Nicolás Monardes described using sarsaparilla to treat syphilis in 1574. In 1812, Portuguese soldiers suffering from syphilis recovered faster with use of sarsaparilla versus mercury, the standard treatment for syphilis at the time.Murray 1995 Sarsaparilla has been used for treating syphilis and other sexually transmitted diseases throughout the world.Rollier 1959 Sarsaparilla has been used by many cultures for other ailments, including skin disorders, arthritis, fever, digestive disorders, leprosy, and cancer.Murray 1995, Newall 1996 Late 15th century accounts first identifying and describing American drugs included sarsaparilla.Estes 1995 Sarsaparilla was used as a medicinal plant in American and European remedies in the 16th century.Elferink 1979 Sarsaparilla was documented as an adjuvant for leprosy treatment in 1959.Rollier 1959 S. china (Ba Qia or Jin Gang Teng) was included in the 2010 Chinese Pharmacopoeia.Chen 2012
Chemistry
The rhizomes and roots of the Smilax genus are of primary interest. Due to the diversity of the species, standardization of preparations is difficult.Martins 2013
Smilax species contain a number of steroidal saponins, including sarsaponin, smilasaponin (smilacin), sarsaparilloside and its aglycones sarsasaponin (parillin), sarsasapogenin (parigenin), and smilagenin.Liang 2015, Murray 1995, Newall 1996, Xu 2014 Other saponins include diosgenin, furostanol, tigogenin, and asperagenin,Liang 2015, Newall 1996 as well as the phytosterols sitosterol, stigmasterol, and pollinastanol.Duke 2002, Newall 1996 At least 50 phenolic compounds and flavonoids have been described.Bernardo 1996, Jia 1992, Ju 1992, Kubo 1992, Okanishi 1965, Sashida 1992, Xu 2013 Flavonol glycosides, such as isoastilbin, isoengetitin, and astilbin, have been identified.Diao 2014 Other constituents in sarsaparilla include starch (50%), resin, cetyl alcohol, volatile oil, caffeoylshikimic acid, shikimic acid, ferulic acid, sarsapic acid, kaempferol, and quercetin. Minerals reported in the genus include aluminum, chromium, iron, magnesium, selenium, calcium, zinc, and others.Chen 1996, Duke 2002, Li 1996, Lu 2015, Newall 1996
The berries contain large amounts of carotenoids (up to 375 mcg/g fresh weight), including lycopene, beta-carotene, and cryptoxanthin,Delgado-Pelayo 2012 while the leaves contain phenolic and flavonoid compounds.Huang 2013
Uses and Pharmacology
Anti-inflammatory/Analgesic activity
Animal and in vitro data
In vitro studies report effects on inflammatory markers.Lu 2014, Lu 2015, Ruangnoo 2012
Extracts of Smilax species have been shown to inhibit induced paw inflammation in rats.Ageel 1989, Khan 2019, Khan 2020, Ruangnoo 2012 Specifically, S. glabra alone and combined with Bolbostemma paniculatum downregulated interleukin (IL)-1beta, tumor necrosis factor alpha, and IL-6 levels in animal models of inflammatory arthritis.Bao 2018, Dong 2017 In a murine model, the methanol (200 mg/kg and 400 mg/kg) and ethyl acetate (400 mg/kg) extracts of S. ornata exerted anti-inflammatory activity, with an onset of action of 210 minutes, 150 minutes, and 120 minutes, respectively, and a duration of action of 2 hours, 2 hours, and 3.5 hours, respectively. The 200 mg/kg methanol extract dose also exerted analgesic effects, with an onset of 60 minutes and a duration of 2 hours. The 400 mg/kg dose of methanol extract and 400 mg/kg dose of ethyl acetate extract exerted analgesic effects, with an onset of 30 minutes and a duration of 2.5 hours.Khan 2019
In a murine model of psoriasis, astilbin 25 to 50 mg/kg ameliorated keratinocyte proliferation, elevations in circulating CD4+ and CD8+ cells, elevations in inflammatory cytokines, and infiltration of CD3+ cells to lesions. Th17 cell differentiation was inhibited by astilbin in an in vitro model.Di 2016
Antioxidant activity
Animal and in vitro data
Experiments report antioxidant activity for extracts of the Smilax genus.Huang 2013, Park 2014, Xia 2010, Yoon 2014 Protective effects against oxidative stress and hepatotoxicity have been demonstrated in rats.Murali 2012, Xia 2013
Antimicrobial activity
In vitro data
Antimycotic activity was described in a screening study.Caceres 1991 In vitro antimicrobial activity has been described for S. glabra rhizome extracts and Smilax campestris, including activity against Candida albicans.Morais 2014, Xu 2013 Butanol extracts of S. china showed activity against HIV in vitro.Wang 2014
Cancer
Animal and in vitro data
Studies of various Smilax species extracts have investigated cytotoxic activity against human cell lines (including cervical, hepatic, breast, gastric, and colon cancer) and induced tumors in mice.Cao 2013, Gao 2011, Wang 2013, Wu 2010, Wungsintaweekul 2011, Xu 2014 In castrated mice with induced benign prostatic hyperplasia, extracts from S. china reduced dihydrotestosterone levels, and histopathological examination reveals a possible protective effect against prostate enlargement.Chen 2012 In another study, sarsaparilla promoted adhesion and blocked migration of HepG2, MDA-MB-231, and T24 cell lines in vitro, as well as blocked metastasis of MDA-MB-231 cells in an in vivo model.She 2015
Cardiovascular risk factors/Metabolic syndrome
Animal and in vitro data
In vitro studies suggest modulatory effects on endothelial dysfunction.Sang 2014
Hypoglycemic effects have been demonstrated in mice, possibly via effects on inflammatory aspects of metabolic syndrome and inhibition of carbohydrate hydrolyzing enzymes.Amaro 2014, Fukunaga 1997, Perez-Najera 2018 Astilbin protected against induced reperfusion injury in rats, possibly via modulation of proinflammatory markers.Diao 2014 However, astilbin and smitilbin from S. glabra did not stimulate insulin secretion.Nguyen 2012 A reduction in blood glucose was noted in a rat model administered 50 mg/kg of gold nanoparticle synthesized from S. glabra.Ansari 2019 In a murine model of obesity, weight gain and fat mass were attenuated with an ethanolic extract of S. china. Specifically, the extract was found to inhibit lipid synthesis and promote lipolysis.Yang 2019 In saline-challenged mice, Smilax canariensis (Canary Islands) increased diuresis in a manner similar to hydrochlorothiazide and furosemide.Abdala 2012 S. glabra flavonoids inhibited induced intracellular calcium ion release in cardiomyoblast cells.Shou 2013
In an in vitro study, a water-soluble fraction of S. china reduced lipid accumulation in adipocytes. It also induced the release of glycerol and cyclic adenosine monophosphate production in the adipocytes.Kang 2015
CNS effects
Animal data
A study in mice with induced seizures reported an antiepileptic effect (increased seizure latency) for extracts of the S. china rhizome.Vijayalakshmi 2011 Smilagenin, a compound derived from S. ornata, prevented dopaminergic neuron impairment in a murine model of Parkinson disease.He 2019 Astilbin was found to exert neuroprotective effects in another murine model of Parkinson disease; these effects resulted from suppression of gliosis, oxidative stress, and alpha-synuclein overexpression.Zhu 2019
Gout
Animal data
Several studies in hyperuricemic and hyperuricosuric rats receiving various Smilax species have reported positive findings, such as reduction in uric acid levels.Chen 2011, Hou 2015, Huang 2019, Liang 2019, Wu 2014
Clinical data
Rhizoma Smilacis Glabrae, in combination with ash bark, has been studied in patients with gout. The Rebixiao combination preparation was effective in reducing serum uric acid levelsJi 2005; however, the study had methodological limitations.Li 2013
Enzyme inhibitory effects
In vitro data
In vitro data determined that fractions of S. china exhibited inhibitory effects against acetylcholinesterase, alpha-glucosidase, urease, tyrosinase, lipase, and butyrylcholinesterase enzymes.Ahmad 2019, Lee 2017
Dosing
Clinical trials are lacking to provide guidance on therapeutic dosages.
Pregnancy / Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Estrogenic and antiestrogenic activities have been described for extracts of Smilax corbularia (Thai sarsaparilla).Wungsintaweekul 2011
Interactions
Case reports are lacking. Hepatic induction of CYP2A6 has been described for extracts of S. china species.Kim 2014 Increases in absorption of digitalis and elimination of hypnotics may be expected.Vogel 2005 An additive effect with diuretics and allopurinol might also be anticipated, based on animal studies.Abdala 2012, Wu 2015 Animal data suggest a reduction in the area under the curve and maximum plasma concentration of methotrexate when given with S. glabra.Li 2017
Adverse Reactions
Clinical studies are lacking to provide evidence (or lack of evidence) of harm; however, traditional use of sarsaparilla, eaten raw or in soups and used in Chinese medicine, suggests safety at usual dosages.Cao 2013, Duke 2002 GI irritation and increased diuresis have been reported.Duke 2002, King 2012 Occupational asthma caused by sarsaparilla root dust has been reported.Vandenplas 1996
Toxicology
Information regarding toxicity with the use of sarsaparilla is limited.
References
Disclaimer
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