Medically reviewed on March 14, 2018
Linden has been used to induce sweating for feverish colds and infections, reduce nasal congestion, and relieve throat irritation and cough. Linden has sedative effects and has been used to treat nervous palpitations and high blood pressure. It has also been used in lotions for itchy skin. However, there is limited clinical information.
Linden is available in several dosage forms. There are no recent clinical studies to support a specific dosage of linden. No more than 2 to 4 g/day of linden from teas or other preparations for internal use should be consumed. Similar dosage regimens can be found on various commercial Web sites.
Although no recent clinical data has been published, the German Commission E monograph concluded that the linden flower is cardiotoxic.
Avoid use due to the lack of data.
None well documented.
Reports exist of specific toxicity such as contact urticaria, allergy from certain Tilia fruit oils in rats, seasonal pollinosis, organochlorine pesticide residues in linden-containing beverages, and occupational contact dermatitis with rhinoconjunctivitis from soft wood dust exposure.
There is no documentation supporting the belief that old linden flowers may induce narcotic intoxication. References in the German Commission E report that frequent use of linden flower teas has been associated with cardiac damage.
The most common species of linden trees are T. cordata (small-leaved linden) and T. platyphyllos (large leaved-linden). They belong to the Tiliaceae family, which consists of nearly 80 species native to Europe and found in northern temperate regions. 1 Linden trees are deciduous and fast growing, typically reaching 15 to 23 m in height and spreading 12 to 15 m wide. The 5-petaled, fragrant, yellow to white flowers are collected after spring bloom and are dried and preserved under low-moisture conditions. The leaves of the tree are heart-shaped, have serrate margins, and grow 5 to 10 cm long. Linden tree bark is smooth, gray, and fibrous. The flowers are the most valued medicinal components of the linden tree. 2 , 3 , 4 , 5 , 6
Since the Middle Ages, the flowers of the linden tree have been primarily used as a diaphoretic to promote sweating. They have also been used for a variety of other medicinal purposes in phytotherapy, including as an expectorant, diuretic, antispasmodic, stomachic, and sedative. In addition, the flowers have been used traditionally for the treatment of flu, cough, migraine, nervous tension, ingestion, various types of spasms, liver and gall bladder disorders, diarrhea, and elevated arterial pressure associated with arteriosclerosis. The linden flower is listed in the German Pharmacopoeia and is approved in the German Commission E monographs. In Germany, it is included in common cold and antitussive preparations, as well as in urological and sedative drugs. In German pediatric medicine, it is included with several other species as a diaphoretic component in a tea used to treat influenza. The flavonoid, volatile oil, and mucilage components in linden may contribute to these claimed medical properties. 2 , 4 , 7 , 8
Infusions of the flowers make a pleasant-tasting tea. Several sources report that linden flowers were believed to be so effective in treating epilepsy that one could be cured simply by sitting beneath the tree. 9 , 10 Sugar is obtained from the sap of the tree, and the seed oil resembles olive oil. 10 In Greek mythology, the nympha Philyra was transformed into a linden tree after begging the gods not to leave her among mortals. 6
Linden has numerous medicinal constituents. 2 , 7 Active ingredients in linden flowers include quercitin, rutin, kaempferol, volatile oils, mucilage, and other flavonoids. 11 , 12 The flavonoids and p -coumaric acid appear to be responsible for the diaphoretic (sweat-inducing) and antispasmodic properties of the plant. Other constituents include caffeic and chlorogenic acids, as well as the amino acids alanine, cysteine, cystine, and phenylalanine.
Volatile oil components (0.02% to 0.1%) include alkanes, esters, citral, eugenol, and limonene. Carbohydrates, such as arabinose, galactose, glucose, mannose, and xylose, are also present in the plant, as well as gum and mucilage polysaccharides (3%). The numerous tannins may account for the claimed chemotherapeutic properties of linden. 5 , 6 , 10 , 13 The ratio of tannins to mucilage appears to be important in determining the flavor of teas prepared from linden flowers. Teas with a 2% or greater tannin level and low mucilage content produce more flavorful teas. Flowers from T. cordata and T. platyphyllos contain relatively more tannin than mucilage. 9
More than 24 additional minor components have been identified in the wood, flowers, and fruits of linden. 5 , 6 , 10 The fragrant components of the flowers degrade rapidly under conditions of high moisture.
Uses and PharmacologyDiaphoretic
The diaphoretic activity of the flowers is caused by quercitin, kaempferol, and p -coumaric acid. Linden has been used mainly for feverish colds and infections to induce sweating. 5 Linden can also reduce nasal congestion and relieve throat irritation and cough. Moderate bioadhesion was demonstrated in an assay on buccal membranes, which may account for linden's therapeutic use in relieving throat irritation and cough. 5 , 6 , 14 However, no clinical data are available.Animal and clinical data
No data are available.Relaxant/Antispasmodic
Linden has sedative effects in animal models. A report documents isolation of a pharmacologically active benzodiazepine receptor ligand from Tilia tomentosa . Peritoneal administration of a flavonoid complex in mice produced an anxiolytic effect. Kaemferol binds to the benzodiazepine receptor but does not have any sedative or anxiolytic activity. 7 , 15 , 16 Another study documented how freeze-dried aqueous extracts of linden, at doses ranging from 10 to 100 mg/kg, produced sedative effects in mice. 17 In another study, both the hexane and methanol extracts of Tilia americana var. mexicana demonstrated anxiolytic and sedative effects in mice. 1
Sedative properties may be associated with the volatile oil components citral, citronellal, citronellol, eugenol, and limonene. 16 These effects were evident when mice inhaled oil from Tilia species. 18 Other sedative effects include relief of sinus headache and migraines, as well as remedies for insomnia, stress, and panic disorder.
Linden has been used to treat nervous palpitations and has lowered high blood pressure brought on by stress and nervous tension in animal models. 6 Linden extracts injected into rabbits caused vasodilation, which resulted in decreased diastolic arterial pressure leading to a hypotensive effect. 19
Folk medicine has employed linden as an antispasmodic. 2 Animal studies in vitro using rat duodenum have supported this claim. The activity was inhibited by atropine and papaverine and increased by acetylcholine. The antispasmodic properties are attributed to p -coumaric acids and flavonoids in the plant.Clinical data
No data are available.Other pharmacologic activity
An extract of Tilia species possessed in vitro antibacterial activity against organisms associated with stomatologic infections, and these extracts have been clinically useful. 20 Lime flower has been reported to have antifungal activity. 2 Linden may also have inhibitory activity against the growth of foodborne pathogens. 21
Linden's emollient quality has been used in lotions for itchy skin. 6 It also has been employed for rheumatism. One report discusses the anti-inflammatory and wound-healing properties of Tilia sylvestris . 24 Two main flavonoids, kaempferol and quercetin, in T. argentea have potent anti-inflammatory activity at 50 mg/kg in a carrageenan-induced hind paw edema model in mice. 25
The methanolic extract from the flowers of T. argentea have potent hepatoprotective effects against d-galactosamine/lipopolysaccharide-induced liver injury in mice. Six flavonol glycosides were isolated from the methanolic extract through bioassay-guided separation procedures. Tiliroside was the principle flavonol glycoside and showed the most potent activity. Astragalin and isoquercitrin also possessed strong activity. 26
An aqueous extract of T. cordata flowers exhibited a stimulatory action on the proliferation of lymphocytes at concentrations ranging from 0.5 to 20 mg/mL. The Tilia extract exerted its stimulatory action on cell proliferation by acting as a partial agonist through peripheral benzodiazepine receptors. 27 The immunomodulatory activity of coumarin scopoletin exhibits a cytostatic and cytotoxic effect on tumor lymphocytes. 28 , 29
Homeopaths use linden for enuresis, incontinence, hemorrhage, prolapsed uterus, and epilepsy. 8
Linden also has diuretic and astringent effects, 2 as well as possible antidiabetic activity. 30 T. cordata is used medicinally by a small percentage of diabetic patients according to the results from 310 interviews in a cross-sectional study in the Middle East. 31
Tilia has also promoted iron absorption in rats, which may be helpful in iron deficiency anemia. 32
Linden is available in several dosage forms, but there are no recent clinical studies to support a specific dosage. No more than 2 to 4 g/day of linden from teas or other preparations for internal use should be consumed. 4
Avoid use due to the lack of toxicological data.
None well documented. Linden contains vitamin K; however, at typical dosage regimens, linden should not interfere with warfarin or related anticoagulant therapy. 19
Many sources list few adverse reactions from linden. However, reports document specific toxicity such as contact urticaria, 33 allergy from certain Tilia species fruit oils in rats, 34 seasonal pollinosis, 35 organochlorine pesticide residues in linden-containing beverages, 36 , 37 and occupational contact dermatitis with rhinoconjunctivitis from soft wood dust exposure. 38 , 39
There is no evidence to support the belief that old linden flowers may induce narcotic intoxication. 9 References in the German Commission E document that the frequent use of linden flower teas has been associated with cardiac damage. 4 This rare event suggests that linden teas should not be ingested by patients with a history of heart disease. 4 , 9 , 10 Further review of medical literature reveals little toxicological data on linden. 40
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