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Lovage

Scientific Name(s): Levisticum officinale ´╗┐Koch.
Common Name(s): Lovage, Maggi plant, Smellage

Clinical Overview

Use

Lovage has been used historically as an antiflatulent and diuretic, but there are no clinical trials to support these uses. Lovage extracts are used in flavorings and fragrances.

Dosing

Lovage has traditionally been used at a daily dose of 4 to 8 g. The tincture has been administered at 0.5 to 2 mL 3 times daily. The tea is prepared by decocting 2 to 3 g of the root in a closed cup of water for 15 to 20 minutes and has traditionally been consumed 3 times daily.

Contraindications

Contraindicated in pregnancy, renal impairment, and renal inflammation.

Pregnancy/Lactation

Avoid use. Documented adverse reactions include emmenagogue effects.

Interactions

Lovage root may increase the risk of bleeding in patients receiving anticoagulants such as warfarin.

Adverse Reactions

Lovage can cause photosensitivity with resultant dermatitis at harvest, but not when used as a therapeutic agent. A case report described contact dermatitis caused by lovage essential oil.

Toxicology

There are no known reports of toxicity.

Botany

Lovage is an aromatic umbelliferous perennial similar in appearance to angelica. It carries yellow-green flowers arranged in dense clusters that bloom from July to August on top of the thick, hollow stems. The plant grows up to 2 m tall,1 and its leaves are divided by sharply toothed leaflets. The characteristically strong aromatic odor resembles that of celery, and it has a "spicy-sweet" and slightly bitter taste. Lovage is native to Europe, but is also found throughout the northeastern United States and Canada. Angelica levisticum Baillon. and Hipposelinum levisticum Britt. and Rose are synonymous in older texts. Lovage should not be confused with Oenanthe cocata L., known commonly as "water" lovage or with Oenanthe aquatica (L.) Lam. (water fennel), toxic members of the family Apiaceae.

History

Lovage has been used in folk medicine for over 500 years, primarily for its GI effects as a carminative and antiflatulent, but has also been used as a diuretic and for the management of sore throats and topical boils. Additional uses as a breath lozenge and as a skin wash and lotion have been described. The name "lovage" is derived from the Latin word ligusticum meaning "from Liguria" because, at one time, the herb flourished in this region of Italy. Translated to English, it evolved into "love parsley," a descriptive name that led to the inclusion of lovage in numerous OTC "love tonics." Lovage is a common ingredient in commercial herbal teas, and extracts are used as flavorings for liqueurs, spice extracts, and bitter spirits, and in fragrances for cosmetics. Cooked leaves and roots have been eaten.2

Chemistry

Lovage contains approximately 2% of a volatile oil responsible for its characteristic flavor and odor. This oil is composed primarily of phthalide lactones (70%) (eg, 3-butylphthalide [32%], cis- and trans-butyldenephthalide, cis- and trans-ligustilide [24%], sen-kyunolide, angeolide). Limited amounts of certain compounds, such as terpenoids, volatile acids, and furocoumarins, also contribute to the flavor of the extract. Other compounds include camphene, bergapten, and psoralen, as well as caffeic, benzoic, and other volatile acids.3 High-performance liquid chromatography analysis has been performed to determine glycoside content in lovage.4 Other reports discuss isolation and identification of phthalides from the roots of the plant by chromatographic and spectrometric methods.5, 6 Chemical composition of lovage oil has been reported.7

Uses and Pharmacology

Urological effects

In vitro/Animal data

There are no in vitro/animal data regarding the use of lovage for its urological effects.

Clinical data

In an open label study of 59 patients with diabetic nephropathy receiving enalapril, the herbal combination product Canephron N, containing lovage root, rosemary leave, and centaury herb, decreased microalbuminuria as compared with the control group following 6 months of administration. The herbal product also improved antioxidant defense parameters. Because Canephron N is a combination product, it is difficult to discern the direct effects of lovage on diabetic nephropathy based on findings from this study.8

A review of the literature found that Canephron N was effective at decreasing the frequency of cystitis relapses in adults, preventing acute pyelonephritis in children, restoring kidney function in children undergoing surgical correction of vesicoureteral reflux, and increasing the rate of kidney stones in adults.9

Other uses

Although lovage teas have been used primarily for their GI effects, documentation for these indications is limited. In general, many volatile oils, including that of lovage, induce GI hyperemia, resulting in a carminative effect; other oils have reduced gas within the GI tract. Lovage extracts probably exert their GI effects through common mechanisms, increasing saliva and gastric juice production by their aroma and mildly bitter taste.

Lovage has also been used to dissolve phlegm in the respiratory tract. Two constituents of lovage, butylphthalide and ligustilide, have been shown to have spasmolytic action.3 The phthalides have had a sedative effect in mice, and the furocoumarins have been associated with a phototoxic reaction following ingestion or contact. Following parenteral administration, extracts of lovage exerted a diuretic effect in rabbits, presumed to be caused by a mild irritation of the renal tubules by the volatile oil.10 Lovage has been indicated for pedal edema in humans.3

Lovage may be useful for treating insomnia. A review of the literature analyzing patterns of herbal use for insomnia in China found positive outcomes with lovage.11

Lovage may also have a role in the treatment of depression. In a study of rats, the combination product Kaiyu granule, which contains lovage among other herbal ingredients, improved depression through its effects on G protein-coupled inwardly-rectifying potassium 1 channel expression.12

Houshiheisan compound, containing lovage and other herbs, protected neurovascular units after cerebral ischemia in rats. The compound specifically reduced postischemic neurological deficit scores at 24, 48, and 72 hours. The necrotic tissues decreased and amyloid-beta 42 protein expression was lower in rats receiving Houshiheisan. Because this compound contained numerous herbals, discerning the role of lovage on neuroprotection is difficult.13

Methanolic extracts of Levisticum officinale inhibited acetylcholinesterase (97.6%) in vitro in a noncompetitive manner. Therefore, lovage may play a role in patients with Alzheimer disease.14

L. officinale essential oil demonstrated inhibition against the human head and neck squamous carcinoma cell line.15

Various components of lovage root yielded antimycobacterial effects.16, 17 Clinical studies are needed to determine the effects of lovage in the treatment of tuberculosis.

Dosing

Classical use of the herb was at a daily dose of 4 to 8 g. The tincture should be administered at 0.5 to 2 mL 3 times daily. The tea is prepared by decocting 2 to 3 g of the root in a closed cup of water for 15 to 20 minutes. The tea should be consumed 3 times daily.18

Pregnancy / Lactation

Documented adverse reactions include emmenagogue effects. Generally, avoid use.19 A combination of lovage with other phytochemicals marketed as Canephron N was found to be safe and well tolerated during pregnancy, with no teratogenic effects; however, the dosage and component of lovate contained in this product would need to be taken into consideration.9

Interactions

Because lovage root contains coumarin derivatives, it may increase the risk of bleeding in patients receiving anticoagulants such as warfarin.20

Adverse Reactions

Furocoumarins in plants of the Umbelliferae family may cause photosensitivity, resulting in dermatitis.21 A case report described a 27-year-old woman who developed intense itching and erythema within hours of harvesting lovage on a sunny day. She developed bullae and vesicles within 36 hours of exposure that later turned into hyperpigmented spots on the exposed areas.22

Another case report described contact dermatitis caused by lovage essential oil. A 31-year-old female developed sharply demarcated, red, and scaly patches on her arms and right shoulder 2 weeks after applying lovage and fifth Chakra essential oils. Topical and systemic steroids resulted in resolution of the patches. Patch testing confirmed the reaction.23

Toxicology

Research reveals little or no information regarding toxicology with the use of lovage.

References

1. van Wyk BE, Wink M. Medicinal Plants of the World. Portland, OR: Timber Press Inc; 2004.
2. Dobelis I, ed. Reader's Digest Magic and Medicine of Plants. Reader's Digest Association, USA; 1986;239.
3. Bisset N. Herbal Drugs and Phytopharmaceuticals. Stuttgart, Germany: CRC Press; 1994;295-297.
4. Cisowski W. Acta Poloniae Pharmaceutica. 1988;45(5):441-444.
5. Gijbels M, et al. Planta Med. 1980;39(suppl 1):41-47.
6. Gijbels M, et al. Planta Med. 1982;44(Apr):207-211.17402120
7. Lawrence B. Perfumer & Flavorist. 1990;15(Sep-Oct):57-60.
8. Martynyuk L, Martynyuk L, Ruzhitska O, Martynyuk O. Effect of the herbal combination Canephron N on diabetic nephropathy in patients with diabetes mellitus: results of a comparative cohort study. J Altern Complement Med. 2014;20(6):472-478.24738695
9. Naber KG. Efficacy and safety of the phytotherapeutic drug Canephron N in prevention and treatment of urogenital and gestational disease: review of clinical experience in Eastern Europe and Central Asia. Res Rep Urol. 2013;5:39-46.24400233
10. Tyler VE. The New Honest Herbal. Philadelphia, PA: GF Stickley Co; 1987.
11. Zhou XZ, Zhang RS, Shah J, et al. Patterns of herbal combination for the treatment of insomnia commonly employed by highly experienced Chinese medicine physicians. Chin J Integr Med. 2011;17(9):655-662.21910065
12. Jin X, Zhang Y, Li Q, Zhao J. Mechanisms underlying the beneficial effects of Kaiyu Granule for Depression. Neural Regen Res. 2013;8(34):3241-3248.25206645
13. Wang H, Wang L, Zhang N, Zhang Q, Zhao H, Zhang Q. Houshiheisan compound prescription protects neurovascular units after cerebral ischemia. Neural Regen Res. 2014;9(7):741-748.25206882
14. Gholamhoseinian A, Moradi MN, Sharifi-Far F. Screening the methanol extracts of some Iranian plants for acetylcholinesterase inhibitory activity. Res Pharm Sci. 2009;4(2):105-112.21589805
15. Sertel S, Eichhorn T, Plinkert PK, Efferth T. Chemical composition and antiproliferative activity of essential oil from the leaves of a medicinal herb, Levisticum officinale, against UMSCC1 head and neck squamous carcinoma cells. Anticancer Res. 2011;31(1):185-191.21273597
16. Guzman JD, Evangelopoulos D, Gupta A, Prieto JM, Gibbons S, Bhakta S. Antimycobacterials from lovage root (Ligusticum officinale Koch). Phytother Res. 2013;27(7):993-998.22899555
17. Schinkovitz A, Stavri M, Gibbons S, Bucar F. Antimycobacterial polyacetylenes from Levisticum officinale. Phytother Res. 2008;22(5):681-684.18350523
18. Yarnell E. Botanical medicines for the urinary tract. World J Urol. 2002;20(5):285-293.12522584
19. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
20. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000;57(13):1221-1230.10902065
21. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicine. Austin, TX: American Botanical Council; 1998.
22. Ashwood-Smith MJ, Ceska O, Yeoman A, Kenny PG. Photosensitivity from harvesting lovage (Levisticum officinale). Contact Dermatitis. 1992;26(5):356-357.1395606
23. Lapeere H, Boone B, Verhaeghe E, Ongenae K, Lambert J. Contact dermatitis caused by lovage (Levisticum officinale) essential oil. Contact Dermatitis. 2013;69(3):181-182.23948036

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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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