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Yarrow

Scientific Name(s): Achillea millefolium L.
Common Name(s): Green arrow, Milenrama, Milfoil, Millefolli herba, Nosebleed plant, Thousand-leaf, Wound wort, Yarrow

Medically reviewed by Drugs.com. Last updated on Jul 20, 2022.

Clinical Overview

Use

Clinical studies are limited.

Dosing

Traditionally, yarrow herb 4.5 g/day has been used for various conditions. However, there are no quality clinical studies to validate this dosing.

Contraindications

Yarrow use is contraindicated in known allergies to any members of the Aster family. Data for reported contraindications in epilepsy are lacking.

Pregnancy/Lactation

Avoid use. Documented adverse effects.

Interactions

None well documented.

Adverse Reactions

Contact dermatitis is the most commonly reported adverse reaction, but high doses may be associated with anticholinergic effects.

Toxicology

Yarrow is not generally considered toxic; however, an antispermatogenic effect has been reported, and safety data are insufficient to support use of the herb in cosmetic products.

Scientific Family

Botany

The name yarrow applies to approximately 80 species of daisy plants native to the north temperate zone. A. millefolium L. has finely divided leaves and white, pink, or red flowers. It can grow up to 1 m in height. This hardy perennial weed has invasive fibrous rhizomes and blooms from June to November. The whole aerial plant part is used medicinally. Golden yarrow belongs to a distinct genus in the Aster family, Eriophyllum confertiflorum.Khan 2009, USDA 2015 Yarrow is a member of the daisy (Asteraceae) family that includes aster, chamomile, chrysanthemum, feverfew, ragweed, sunflower, and tansy.

History

The use of yarrow in food and medicine dates back at least to 1200 BC.Nemeth 2008 The genus name Achillea is derived from the Greek myth of Achilles who was said to carry A. millefolium (also known in antiquity as herba militaris) into battle to treat wounds.Nemeth 2008 Yarrow leaves have been used for tea, and young leaves and flowers have been used in salads. Infusions of yarrow have served as cosmetic cleansers and medicines. Sneezewort leaves (Achillea ptarmica) have been used in sneezing powder, while those of A. millefolium have been used for snuff.Brinker 1998 Yarrow has been used as a "strengthening bitter tonic" and astringent. The fresh leaves have been used to relieve toothaches and to heal wounds, and may have anti-inflammatory effects.Benedek 2007, Nemeth 2008 Fresh yarrow and dried herb are also used in China for dog and snake bites and to alleviate menstrual bleeding.Khan 2009

Chemistry

The constituents of yarrow have been reviewed in detail, particularly the essential oil.Bisset 1994, Duke 1992, Newall 1996 The plant yields approximately 1% essential oil containing azulene, alpha and beta pinenes, borneol, cineole, and other compounds including chamazulene (also found in chamomile) and trace amounts of thujone, although the composition varies.Duke 1992, Khan 2009 Other constituents identified include sesquiterpene lactones, flavonoids, tannins, sterols, alkanes, and fatty acids, among others.Duke 1992, Khan 2009

Uses and Pharmacology

Anti-inflammatory activity

Animal data

Anti-inflammatory activity has been described in animal and in vitro studies.(Dall'Acqua 2011, Jonsdottir 2011, Vazirinejad 2014, Zaidi 2012, Zolghadri 2014) A review of the antioxidant and anti-inflammatory effects of A. millefolium has been published, attributing the majority of effects observed in the in vitro and animal studies to be due to the flavonoid content.(Ayoobi_2017)

Clinical data

A small (N=49) randomized clinical trial evaluated the efficacy of ethanol-extracted aerial Achillea wilhelmsiii plant parts in ulcerative colitis. No significant difference was observed for stool frequency, rectal bleeding, or symptom scores over placebo. Caffeic acid content of the extracted was measured. No significant adverse effects of the treatment were observed; one case of rash was reported in the treatment group.(Amiri 2019) A study conducted among people with irritable bowel syndrome (N=90) found no difference for A. wilhelmsii over placebo. No adverse effects were reported in either group.(Derakhshande 2019)

A 12 month clinical study evaluated the effect of 250 mg and 500 mg Achillea millefolium flower extract (equivalent to 2 to 4 g dry flowers) on mean annualized relapse rate among people with multiple sclerosis (N=75). For both dosages, lower relapse rates and longer time to relapse were reported.(Ayoobi 2019)

Antimicrobial/Antiprotozoal activity

In vitro studies have shown that the essential oil of yarrow possesses limited antibacterial and antiviral (Newcastle disease virus) activity. Because of the association of Helicobacter pylori with gastritis, peptic ulcer, and gastric cancer, in vitro experimentation was conducted in H. pylori-infected gastric epithelial cells with 24 medicinal plants indigenous to Pakistan to evaluate their effect on secretion of interleukin (IL)-8 and generation of reactive oxygen species (ROS) in order to assess anti-inflammatory and cytoprotective effects. Although no significant direct cytotoxic effects on the gastric cells or bactericidal effects on H. pylori were found, yarrow was observed to have mild and moderate inhibitory activity on IL-8 at 50 and 100 mcg/mL, respectively, and significant suppression on ROS generation in H. pylori-infected gastric cells.(Zaidi 2012)

Animal data

Activity against trypanosomes, Leishmania, and malarial parasites has also been demonstrated,(Akram 2013, Freires 2015, Nemeth 2008, Rezatofighi 2014, Santos 2010, Vitalini 2011) and yarrow’s role in protection against gastric ulcers has been examined in rats.(Cavalcanti 2006) Insect repellent activity has also been demonstrated.(Nemeth 2008)

Clinical data

A clinical study evaluated the effectiveness of vaginal Achillea millefolium cream in women with vulvovaginal candidiasis compared to clotrimazole (N=80). In both groups, vulvar pruritus improved compared with baseline, with clotrimazole showing superiority. Negative Candida cultures were found in 77% of clotrimazole patients and 53% in the A. millefolium group (P<0.05).(Zakeri_2020)

Cancer

Animal data

The cytotoxicity of yarrow extracts has been examined.(Nemeth 2008) In vitro studies suggest that the activity of casticin, sesquiterpene compounds, and other extracts exerts apoptotic and antitumor activity against various human cancer cell lines.(Belščak-Cvitanović 2014, Dias 2013, Düsman 2013, Li 2011, Peng 2014, Zaidi 2012)

Clinical data

Current research reveals only inconclusive clinical data regarding the use of yarrow extracts in cancer. A study evaluated the additive effect of A. millefolium (12 ppm distillate mixed with standard therapy mouthwash) in oral mucositis in 56 patients with cancer for 14 days, and found clinically significant healing rates.(Miranzadeh 2015)

Cardiovascular

Animal data

An effect on rat vascular smooth muscle cells has been demonstrated in vitro.(Dall'Acqua 2011) The flavonoid artemetin extracted from A. millefolium was hypotensive in normotensive rats.(de Souza 2011) Diuretic effects of certain yarrow extracts have also been demonstrated.(de Souza 2013) Other studies have demonstrated hypotensive effects in rats, as well as negative inotropic and chronotropic effects of crude yarrow extracts in isolated guinea pig atrial tissue.(Khan 2011)

Clinical data

Research reveals no clinical data regarding the use of A. millefolium in cardiovascular conditions; however, a related plant, Achillea wilhelmsii, produced antihypertensive and lipid-modifying effects in a clinical study.(Nemeth 2008)

Renal effects

Animal data

A study evaluating orally administered extracts of A. millefolium for diuretic effects in rats found that diuresis was effectively increased. The study found the effect to depend on both the activation of bradykinin B2 receptors and the activity of cyclooxygenases.(de Souza 2013) Extracts of the plant have also been shown to protect against induced nephrolithiasis in rats.(Bafrani 2014) Additionally, antioxidant effects have been demonstrated in rat systems, including the kidney.(Baggio 2015)

Clinical data

Administration of the aerial plant parts of A. millefolium were studied in a clinical trial involving(Zolghadri 2014) patients with chronic kidney disease. Reductions in plasma nitrite and nitrate content were observed and compared with placebo; however, statistical significance was not reached.(Vahid 2012)

Other uses

Traditional uses as a hemostatic agent and for cerebral and coronary thrombosis are without clinical validation. In one study, A. millefolium tea consumed 3 times daily for 3 days reduced pain severity in primary dysmenorrhea.(Jenabi 2015)

Anxiolytic effects in mice have also been described.(Baretta 2012, Sarris 2013)

Dermatological applications have been evaluated.(Pain 2011) Wound healing has been studied in rodents.(Nemeth 2008) A clinical study evaluated the effect of topically applied A. millefolium as an ointment on episiotomy wound healing. Reduced pain, redness, edema, and ecchymosis of the episiotomy wound was reported, but no effect on discharge and dehiscence incidence could be shown.(Hajhashemi 2018)

Relaxant effects on smooth muscle tissue have been studied in animals.(Benedek 2007, Feizpour 2013, Koushyar 2013)

Dosing

Traditionally, yarrow herb 4.5 g/day has been used for various conditions, including inflammatory disorders appetite loss, and dyspepsia.Duke 2002, Khan 2009 However, there are no quality clinical studies to validate this dosing.

Pregnancy / Lactation

Avoid use. Although present in small amounts, thujone is an abortifacient.Brinker 1998, Duke 2002, Newall 1996 Toxic reproductive effects in rats have not been proven.Boswell-Ruys 2003

Interactions

None well documented. Interactions may occur with diuretic medicines.Duke 2002

Adverse Reactions

Contact dermatitis is the most commonly reported adverse reaction from yarrow, and its use is contraindicated in known allergies to any members of the Aster family.Doğan 2013, Khan 2009 Data for reported contraindications in epilepsy are lacking.Duke 2002 One case report exists documenting anticholinergic adverse effects associated with the consumption of 5 cups of yarrow tea per day for a 1 week.Calapai 2014

Toxicology

Yarrow is not generally considered toxic; however, an antispermatogenic effect has been reported.(Khan 2009) Safety data are insufficient to support safe use of the herb in cosmetic products.(Khan 2009, Yarrow 2001) Weak genotoxicity has been reported,(Yarrow 2001) and toxic reproductive effects in rats have not been proven.(Boswell-Ruys 2003)

Commercial preparations must be thujone-free because, although present in small amounts in yarrow, thujone is an abortifacient.(Khan 2009, Newall 1996) A report from the Cosmetic Ingredient Review Expert Panel in 2016 states A. millefolium cosmetic products are “safe in the present practices of use and concentration in cosmetics when formulated to be nonsensitizing."(Becker 2016)

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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