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Holly

Scientific Name(s): Ilex aquifolium L. (English Holly)., Ilex opaca Aiton. (American Holly)., Ilex vomitoria Aiton. (Yaupon).
Common Name(s): American holly, Appalachian tea, Cassena, Christmas berry, Deer berry, English holly, Holly, Indian black drink, Indian holly, Oregon holly, Yaupon

Medically reviewed by Drugs.com. Last updated on Sep 2, 2019.

Clinical Overview

Use

Primarily used as a holiday decoration. No clinical applications exist for holly. Historically, some species have been used in teas as an emetic and CNS stimulant.

See also monograph for related 'Maté' species (Ilex paraguariensis A. St.-Hil. var.) for which limited clinical studies have been conducted.

Dosing

There are no clinical applications for holly to form a basis for dosing.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Documented adverse effects. Avoid use.

Interactions

None well documented.

Adverse Reactions

The spines of some leaves may tear or puncture skin or mucus membranes.

Toxicology

Although no fatalities have been reported, case reports exist of human toxicity. Ingestion can cause vomiting or diarrhea, and may lead to dehydration and electrolyte imbalance. Stupor has been associated with poisoning.

Scientific Family

  • Aquifoliaceae (Holly)

Botany

Ilex species are evergreen trees or shrubs with stiff leathery leaves. The flowers are often white and produce fruits that range in color from black to bright red or yellow. The genus Ilex consists of over 400 species and requires a wet and equable climate. Worldwide distribution exists, except in arctic or arid regions. The major areas of distribution are Central and South America. The North American species are largely ornamental and derived from Central and South American varieties.PLANTS.Ilex.2017, Alikaridis 1987

See also Maté monograph (Ilex paraguariensis A. St.-Hil. var.).

History

The plants in the holly family have been used as ornamentals and in herbal medicine for centuries. Historical records show pre-Christian European pagans offering holly branches as gifts during the Roman festival of Saturnalia. Early Christians decorated their homes with holly during the Christmas season, a practice that still continues today. Settlers in the southeastern United States made yaupon tea from I. vomitoria, reserving a stronger decoction for use as an emetic. I. opaca fruit tea was used as a cardiac stimulant by the American Indians; the Chinese used it to treat coronary disease. One of the most economically important species, Ilex paraguayensis or maté tea (see the Maté monograph), has long been cultivated and used in Brazil and Paraguay as a caffeine-containing beverage. The mixed leaves of Ilex cassine, I. vomitoria, and Ilex dahoon have also been used for a hot drink called yaupon or black drink. Drinkers used it ceremonially to "cleanse" themselves, probably due to its sweat- and vomit-inducing effects. Another beverage made from the leaves of I. cassine and I. vomitoria was used as a stimulant in the southern United States during the Civil War.Alikaridis 1987, PLANTS.Yaupon.2017

Chemistry

Most species contain tannins. Analyses of the leaves of I. aquifolium found tannic acid, a bitter glycoside (ilicin), ilexanthin (rutin), and ilicic acid. Some members of the genus, such as I. paraguayensis, contain xanthine alkaloids, such as caffeine, in levels as high as 2%. Other species contain saponins and triterpenes. One review of the chemistry of Ilex documented hundreds of isolated compounds. Selected examples of the various classes of chemical constituents include the following: phenols and phenolic acids (p-hydroxybenzoic acid, arbutin), anthocyanins (pelargondin 3-bioside, cyanidin 3-glucoside), flavonols and flavons (rutin, kaempferol), terpenoids (alpha-amyrin, ursolic acid), sterols (sitosterol, ergosterol), purine alkaloids (caffeine, theobromine), amino acids (aspartic acid, glutamic acid), miscellaneous nitrogen compounds (trigonelline, choline), fatty acids (oleic, linolenic), alkanes and alcohols (nonacosane, mellisyl alcohol), carbohydrates (sugar alcohols, sucrose), vitamins and carotenoids (ascorbic acid, thiamine).Alikaridis 1987, West 1977, Kashiwada 1993, Nahar 2005, Palumbo 2007

Uses and Pharmacology

Chemical studies to elucidate the constituents of the Ilex species, including I. pubescens, I. vomitoria, and I. asprella, have been published.West 1977, Kashiwada 1993, Nahar 2005, Palumbo 2007 However, clinical trials for holly are lacking.

See also monograph for related Maté species (Ilex paraguariensis A. St.-Hil. var.) for which limited clinical studies have been conducted.

Dosing

There are no clinical applications for holly to form a basis for dosing.

Pregnancy / Lactation

Documented adverse effects. Avoid use. Low birth weight, birth defects, and premature birth have been recorded for the related species I. paraguayensis (maté).Ernst 2002

Interactions

None well documented.

Adverse Reactions

The leaves of most species are generally considered to be nontoxic, although the spines of some leaves may tear or puncture skin and mucous membranes.

Toxicology

Although no fatalities have been reported, case reports exist of human toxicity. Ingestion of the holly berry can cause vomiting or diarrhea, and may lead to dehydration and electrolyte imbalance. Stupor has been associated with poisoning. Saponins are found in some species of Ilex, but their absorption through intact mucosa is minimal. Saponins generally cause severe diarrhea and GI upset.Rodrigues 1984, Arena 1979, HolidayHint 2004

References

Alikaridis F. Natural constituents of Ilex species. J. Ethnopharmacol. 1987;20(2):121-144.3657245
Arena JA. Questions and answers: are holly berries toxic? JAMA. 1979;242(21):2341.
Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
Holiday Hint: poison plant prevention. Child Health Alert. 2004;22:2.15690564
Ilex L. USDA, NRCS. 2017. The PLANTS Database (http://plants.usda.gov, August 2017). National Plant Data Team, Greensboro, NC 27401-4901 USA. Accessed August 2017.
Kashiwada Y, Zhang DC, Chen YP, et al. Antitumor agents, 145. Cytotoxic asprellic acids A and C and asprellic acid B. New p-coumaroyl triterpenes, from Ilex asprella. J Nat Prod. 1993;56(12):2077-2082.8133297
Nahar L, Russell WR, Middleton M, Shoeb M, Sarker SD. Antioxidant phenylacetic acid derivatives from the seeds of Ilex aquifolium. Acta Pharm. 2005;55(2):187-193.16179132
Palumbo MJ, Putz FE, Talcott ST. Nitrogen fertilizer and gender effects on the secondary metabolism of yaupon, a caffeine-containing North American holly. Oecologia. 2007;151(1):1-9.17048011
Rodrigues TD, Johnson PN, Jeffrey LP. Holly berry ingestion: case report. Vet Hum Toxicol. 1984;26(2):157-158.6730298
West LG, McLaughlin JL, Eisenbeiss GK. Saponins and triterpenes from Ilex opaca. Phytochemistry. 1977;16(11):1846-1847.
Yaupon. USDA, NRCS. 2007. The PLANTS Database (http://plants.usda.gov, 08 June 2010). National Plant Data Team, Greensboro, NC 27401-4901 USA. Accessed August 2017.

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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