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Medically reviewed on Mar 16, 2018

Scientific Name(s): Pistacia vera L. Family: Anacardiaceae

Common Name(s): Pistachio


Pistachio nuts have been clinically evaluated for use in hypercholesterolemia. Limited antiviral, antifungal, and antiprotozoal activity has been demonstrated in in vitro experiments, and anti-inflammatory actions have been reported.


Hypercholesterolemia: unroasted pistachio nuts 65 to 75 g/day (equivalent to 20% of total daily calorie intake).


None identified.


Information regarding safety and efficacy in pregnancy and lactation is lacking.


None well documented.

Adverse Reactions

Most adverse reactions are associated with hypersensitivity to the plant or with allergic reactions.


Studies are lacking.


P. vera is a native of Central and West Asia, and also is distributed throughout the Mediterranean basin. It is grown in California and Arizona and other countries where it has been introduced. 1 , 2 A related species is Pistacia lentiscus , commonly known as mastic. 1

It is a spreading tree and partially deciduous and grows up to 10 m high. Leaves occur in 1 to 5 pairs of thick, oval leaflets. Tiny, brown-green flowers give way to clusters of the oblong pistachio kernel. 2 , 3 The exudate of the plant forms a gum that is traditionally used for medicinal purposes. 2


Records of the consumption of pistachios as a food date to 7000 BC. 4 Pistachio is commonly used for flavoring candy and cakes, and in toothpaste and dentistry. 2 , 4

Traditional uses include treatment of toothache and other periodontal ailments, blood clotting, dyspepsia, asthma, jaundice, diarrhea, renal stones, and as an anti-inflammatory, antibacterial, and antiviral agent. 2 , 4

The gum has been used for respiratory (anti-infective) and stomach diseases and as a lip balm. It is also used as a protectant for glass, porcelain, bone, wood, and metal objects. 2


The fruits of the pistachio are high in protein, oil, and vitamin E, compared with hazelnuts. Unsalted, they are high in potassium and low in sodium. The kernels are rich in linoleic and linolenic fatty acids. 5

The essential oil of the leaves contains alpha-pinene (30%), terpinolene (18%), and bornyl acetate (11%), while the essential oil of the fruits contains alpha-pinene (55%), terpinolene (approximately 30%), limonene, 3-carene, and beta-pinene (approximately 1% each), which is similar to mastic gum oil. Alpha-pinene and terpinolene have shown antibacterial and antifungal activity, while terpinolene has some antioxidant activity. 4

Vitamin E alpha- and gamma-tocopherol, vitamin C, proanthocyanidins, transresveratrol, isoflavones, daidzein, and genistein have been identified in the edible nut. 3 , 4 The antioxidant activity is substantially affected by toasting. 3

The essential oil of the gum contains mostly monoterpene hydrocarbons, oxygenated monoterpenes, and diterpenes, including alpha-pinene (75%), beta-pinene (9%), transverbenol (3%), camphene, limonene, and pinocarveol (approximately 1% each). 2

Uses and Pharmacology

Efficacy may be affected by the geographical source of the nuts and degree of processing. 2 , 6


In vitro studies show little action against human bacterial pathogens, but antifungal activity comparable with nystatin has been demonstrated by plant extracts and the essential oil of the gum. 2 , 5

The skin of the woody shell, fresh kernels, and unripe seeds of Turkish origin showed antiviral action against herpes simplex virus when compared with acyclovir. 5 Extracts of the branches of the plant showed activity against Leishmania donovani , while an extract from the leaves was active against Plasmodium falciparum . 6

Clinical trials are lacking.


Studies among healthy volunteers 7 and in humans with moderate hypercholesterolemia 8 , 9 , 10 have shown that inclusion of unroasted pistachio nuts in the diet affects the lipid profile.

Decreases were observed for mean plasma total cholesterol, total cholesterol/high-density lipoprotein (HDL), and low-density lipoprotein (LDL)/HDL ratios; increased HDL levels were reported. No changes were found for triglycerides or LDL levels. No change in blood pressure or body weight was found with these regimens. 7 , 8 , 9 , 10 One trial evaluated changes in apolipoproteins and reported a decrease in apolipoprotein B. 10

The effect on the lipid profile was demonstrated after 2 doses in one trial, 10 and other studies evaluated effects after 3 weeks of supplementation. 7 , 8 , 9

Animal and in vitro experiments suggest an antioxidant action may be responsible for the effects observed in clinical trials. 3 , 11 A 60% loss in antioxidant action by roasting is suggested to be due to a loss in total phenol content, with isoflavones being affected by heat. 3

Other uses
Anti-inflammatory effect

Pistachio gum has been traditionally used for its anti-inflammatory effect in stomach conditions, hemorrhoids, and asthma. In an experiment in mice, the extracts from the fruit, leaves, and branch parts, as well as the exudates, were evaluated for anti-inflammatory and antinociceptive effect. The plant part extracts were ineffective, but an extract of the gum showed a dose-dependent effect on induced abdominal contractions and induced paw edema. 12


Studies evaluating the dietary effect of unroasted pistachio nuts on lipid profiles have used doses equivalent to 20% of the total daily calorie intake. This approximates 65 to 75 g/day in most adults, 8 , 9 but up to 125 g/day has been used. 10


Information regarding safety and efficacy in pregnancy and lactation is lacking.


None well documented.

Adverse Reactions

Most adverse reactions are associated with hypersensitivity to the plant species or allergic reactions. Anaphylaxis is reported to be uncommon despite widespread use in foodstuffs. 13 Cross-sensitivity with other tree nuts has been reported. 14 , 15 , 16


Studies are lacking. One study found no cytotoxicity of plant extracts against mammalian cells. 12


1. Pistacia vera L. USDA, NRCS. 2007. The PLANTS Database ( , November 2008). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
2. Alma MH, Nitz S, Kollmannsberger H, Digrak M, Efe FT, Yilmaz N. Chemical composition and antimicrobial activity of the essential oils from the gum of Turkish pistachio ( Pistacia vera L.). J Agric Food Chem . 2004;52(12):3911-3914.
3. Gentile C, Tesoriere L, Butera D, et al. Antioxidant activity of Sicilian pistachio ( Pistacia vera L. var. Bronte) nut extract and its bioactive components. J Agric Food Chem . 2007;55(3):643-648.
4. Tsokou A, Georgopoulou K, Melliou E, Magiatis P, Tsitsa E. Composition and enantiomeric analysis of the essential oil of the fruits and the leaves of Pistacia vera from Greece. Molecules . 2007;12(6):1233-1239.
5. Ozcelik B, Aslan M, Orhan I, Karaoglu T. Antibacterial, antifungal, and antiviral activities of the lipophylic extracts of Pistacia vera . Microbiol Res . 2005;160(2):159-164.
6. Orhan I, Aslan M, Sener B, Kaiser M, Tasdemir D. In vitro antiprotozoal activity of the lipophilic extracts of different parts of Turkish Pistacia vera L. Phytomedicine . 2006;13(9-10):735-739.
7. Kocyigit A, Koylu AA, Keles H. Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutr Metab Cardiovasc Dis . 2006;16(3):202-209.
8. Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr . 1999;18(3):229-232.
9. Sheridan MJ, Cooper JN, Erario M, Cheifetz CE. Pistachio nut consumption and serum lipid levels. J Am Coll Nutr . 2007;26(2):141-148.
10. Gebauer SK, West SG, Kay CD, Alaupovic P, Bagshaw D, Kris-Etherton PM. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. Am J Clin Nutr . 2008;88(3):651-659.
11. Aksoy N, Aksoy M, Bagci C, et al. Pistachio intake increases high density lipoprotein levels and inhibits low-density lipoprotein oxidation in rats. Tohoku J Exp Med . 2007;212(1):43-48.
12. Orhan I, Küpeli E, Aslan M, Kartal M, Yesilada E. Bioassay-guided evaluation of anti-inflammatory and antinociceptive activities of pistachio, Pistacia vera L. J Ethnopharmacol . 2006;105(1-2):235-240.
13. Fernández C, Fiandor A, Martinez-Garate A, Martinez Quesada J. Allergy to pistachio: crossreactivity between pistachio nut and other Anacardiaceae. Clin Exp Allergy . 1995;25(12):1254-1259.
14. Liccardi G, Russo M, Mistrello G, Falagiani P, D'Amato M, D'Amato G. Sensitization to pistachio is common in Parietaria allergy. Allergy . 1999;54(6):643-645.
15. Goetz DW, Whisman BA, Goetz AD. Cross-reactivity among edible nuts: double immunodiffusion, crossed imunoelectrophoresis, and human specific igE serologic surveys. Ann Allergy Asthma Immunol . 2005;95(1):45-52.
16. Parra FM, Cuevas M, Lezaun A, Alonso MD, Beristain AM, Losada E. Pistachio nut hypersensitivity: identification of pistachio nut allergens. Clin Exp Allergy . 1993;23(12):996-1001.

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