Scientific Name(s): Peumus boldus Molina
Common Name(s): Boldea, Boldo, Boldoa, Boldu, Boldus
Medically reviewed by Drugs.com. Last updated on Dec 14, 2020.
In vitro and animal studies suggest boldo leaf extract and its constituent, boldine, possess antioxidant, anti-inflammatory, and antimicrobial effects, as well as potential applications in diabetes, GI disorders, and cancer. However, clinical trials are lacking to support any therapeutic application.
No quality clinical trials exist to support therapeutic dosing of boldo leaf extract. Traditional doses include 1 to 2 teaspoons (2 to 3 g) of dry leaf per cup of water; 0.1 to 0.3 mL of liquid extract (1:1 in 45% alcohol) 3 times a day. Commercial preparations may contain ascaridole, a toxic constituent.
Contraindicated in liver disease and diseases of the bile duct, including gallstones.
Avoid use. Adverse effects have been noted in animal studies.
Boldo ingestion may enhance the anticoagulant effect of warfarin; caution is warranted.
Boldo-related adverse events described in case reports included anaphylaxis, prolonged QT interval and ventricular tachycardia, and hepatotoxicity.
High doses are necessary for toxic effects; animal studies documented neurotoxicity, hepatotoxicity, and mutagenicity.
- Monimiaceae (Monimia)
P. boldus is an evergreen shrub or small tree native to central Chile, Argentina, Ecuador, Bolivia, and Peru. The plant grows up to 6 m in height. The woody, bitter-smelling leaves are used medicinally. Small, green edible fruits are borne from small, pink-white flowers,1, 2, 3 which are also referred to as Boldu boldus (Molina) Lyons and Boldea fragrans Gay.
In Chile, the yellowish-green fruit is eaten, its bark is used in tanning, and its wood is used for charcoal. Explorers noticed that local South Americans used the leaves medicinally and introduced the herb to North America and Great Britain as a carminative for stomach, bladder, and liver complaints, and as a mild sedative. The name "boldu" has been attributed to the Mapuche words weltum (to sprout again) and volitum (to put out new roots). The plant is used in the treatment of digestive disorders, as a laxative, choleretic (a stimulant of bile secretion), diuretic, and for hepatic diseases. The leaves also have been used for worms, urogenital inflammations (eg, gonorrhea, syphilis), gout, rheumatism, head colds, and earaches. Boldo extract is also used as a flavoring for alcoholic beverages.2, 3, 4 A patent has been granted for the use of boldo in cosmetic or dermatological products.5
The leaves contain aporphine alkaloids (0.25% to 0.5%), volatile oil (2.5%), flavonol glycosides, resin, and tannins.
At least 17 benzylisoquinoline alkaloids are present in the leaves and include laurolitsine, reticuline, boldine, and isoboldine. Flavonoids include catechin, gallic, and tannic acids. Boldine is also present in the bark of the tree. Up to 46 compounds have been identified in the essential oil of boldo, with ascaridole, p-cymene, and 1,8-cineole as the main components.
Genetic variation of the essential oil and alkaloid content has been investigated. Variability is dependent upon season, location, sex, canopy height, leaf age, and light intensity. Various methods have been described for the analysis of boldo leaves and preparations.3, 4, 6, 7, 8, 9, 10, 11, 12
Uses and Pharmacology
There are no clinical data regarding the use of boldo as an anti-inflammatory agent.
There are no clinical data regarding the use of boldo for antimicrobial activity.
Antioxidant activity of boldine and blood leaf extracts has been demonstrated in multiple animal and in vitro studies.6, 20 Applications of the observed antioxidant effect include improved endothelial function, especially in diabetic rats,21, 22, 23 and protection against induced hepatic damage,24, 25 which may also be the mechanism of action in other observed effects.
There are no clinical data regarding the use of boldo as an antioxidant.
Both boldine alone and boldo leaf extracts have shown antiproliferative effects in vitro.6, 26, 27, 28 Protective effects against ultraviolet-mediated DNA damage has been demonstrated in melanoma cells.6, 29, 30
There are no clinical data regarding the use of boldo in cancer.
Diabetic rats given boldine for 7 days showed slight decreases in plasma glucose levels, but no effect on the plasma lipid profile. A decrease in body weight was also observed.21 In rats administered boldine over 10 weeks, a protective effect was found against increases in glucose and blood pressure while markers of renal damage improved.23 Boldine may affect adipogenesis.31 Antihypertensive effects have been shown in spontaneously hypertensive rats.32
There are no clinical data regarding the use of boldo in diabetes or related conditions.
Flavones boldoside and peumoside suppressed an induced excitation in mice and demonstrated a marked spasmolytic effect in rabbits experiencing gut spasm.33 Boldine demonstrated anti-inflammatory properties in experimental colitis models.34, 35
Dry boldo extract prolonged orocecal transit time in 12 volunteers in an older study.36 Clinical studies are lacking.
An antipyretic effect has been shown in rabbits.3 Other studies performed with boldo/boldine demonstrated neuromuscular blockade in mouse phrenic nerve-diaphragm,37 sensitization of the ryanodine receptor, and induced calcium release from storage sites in isolated skeletal muscle.38 Boldo also has been studied in the radioactive labeling of blood cells and plasma proteins, tracing uptake by cells.39, 40
No quality clinical trials exist to recommend therapeutic dosing of boldo leaf extract. Traditional doses include 1 to 2 teaspoons (2 to 3 g) of dry leaf per cup of water; 0.1 to 0.3 mL of liquid extract (1:1 in 45% alcohol) 3 times a day.4 Commercial preparations may contain ascaridole, a toxic constituent.2
Pregnancy / Lactation
Avoid use. Adverse effects have been noted in animal studies.
Hydroalcoholic extract of boldo and boldine demonstrated abortive and teratogenic actions in rats.41 Another report found no malformations in the fetus following short-term administration. At high doses, abortifacient and teratogenic effects were noted.6
A case report exists of a potential interaction with warfarin, which returned on rechallenge with a combination herbal preparation.42 Inhibition of platelet aggregation has been shown in 1 in vitro study.6 As boldo has purported diuretic effects, increased effects of cardiac glycosides due to potassium depletion are theoretically possible.43
Boldo-related adverse events described in case reports include anaphylaxis in an atopic individual.44 A combination preparation of dandelion, focus, and boldo was associated with a prolonged QT interval and ventricular tachycardia in another report,45, 46 while hepatotoxicity (increased liver enzymes) was noted following the use of boldo leaf extract as a component of a laxative preparation.47 The German Commission E cautions against the use of boldo leaf in severe liver disease and disease of the bile duct, including gallstones, and only approves the use of boldo preparations devoid of ascaridole.2
Data collected between 2004 and 2013 among 8 US centers in the Drug-induced Liver Injury Network revealed 15.5% (130) of hepatotoxicity cases was caused by herbals and dietary supplements whereas 85% (709) were related to medications. Of the 130 related cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanic/Latinos compared to non-Hispanic whites and non-Hispanic blacks. Liver transplant was also more frequent with toxicity from non-bodybuilding supplements (13%) than with conventional medications (3%) (P<0.001). Overall, the number of severe liver injury cases was significantly higher from supplements than conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, boldo was among the 22% (116) of the single-ingredient products.51
High-dose boldine is necessary to produce adverse effects, toxicity, or death. The median lethal dose in mice was 250 mg/kg. Death in animals is from sequelae, leading to respiratory failure.6 Death in rats was also from neurotoxic effects, including depletion of dopaminergic neurons.48 Long-term administration resulted in increased liver enzymes in rats, but not histological evidence of hepatotoxicity.6 Mutagenicity tests have found equivocal results.3, 6, 49, 50
- Boldea fragrans Gay
- Boldu boldus (Molina) Lyons
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