What is Artemisia annua?
Artemisia annua gained popularity due to its antimalarial constituent artemisinin, which was discovered by the scientist Youyou Tu, who received a Nobel Prize for it in 2015. This herb has a long history of use in traditional Chinese medicine.
Its genus is named after Artemis, the Greek goddess of the hunt and fertility, as it is one of the most widely distributed genera throughout the world. Artemisia annua and Artemisia absinthium are the most well-known species within this genus.[2]
What are Artemisia annua’s main benefits?
Limited research suggests that Artemisia annua might improve symptoms of osteoarthritis[6] and rheumatoid arthritis.[9]
Artemisia annua extracts are also used for hair care and in skin care as an emollient, humectant and antibacterial agent.[10]
Extracts of Artemisia annua pollen have been used as immunotherapy to reduce symptoms of allergic rhinitis during pollen season.[8]
In traditional Chinese medicine, Artemisia annua has been used for jaundice, for dysentery, for wounds and hemorrhoids, and to reduce fever.[10] However, there’s no clinical research to support these uses.
What are Artemisia annua’s main drawbacks?
Reported side effects from Artemisia annua include stomach pain, a slowed heart rate (bradycardia), diarrhea, nausea, vomiting, decreased appetite, and flu-like symptoms. However, since many of these adverse effects were reported in clinical studies for malaria, it's not clear whether these were symptoms of malaria or side effects caused by the herb.[11][10] Additionally, Artemisia annua has allergenic pollen which has been reported to cause dermatitis (rash) and other allergy symptoms in susceptible individuals.[10]
There have been rare reports of liver toxicity with Artemisia annua. In one case report, 1.25 grams of Artemisia annua powder had been consumed daily for 4 weeks.[12] In another case report, 600 mg of artemisinin (extracted from Artemisia annua) had been consumed daily for 10 days.[13] A case series reported liver toxicity in 29 adults who had taken Artemisia annua supercritical carbon dioxide extract in grapeseed oil,[14] although it was criticized for having poor reporting methods and confounded causality testing.[15]
Artemisia annua should not be used during pregnancy, as animal research shows that it has toxic effects on the embryo/fetus.[1]
How does Artemisia annua work?
Artemisia annua’s constituent artemisinin inhibits the growth of malaria parasites (Plasmodium species) by inhibiting the calcium pump necessary for protein metabolism and mitochondrial activity in Plasmodium cells. Additionally, in vitro and animal evidence suggests that Artemisia annua extracts have antimicrobial, antiviral, anticancer, anti-inflammatory and analgesic effects.[10][2] However, these effects have yet to be validated in clinical research.
What are other names for Artemisia annua
- Annual mugwort
- Annual wormwood
- Huang hua hao
- Quing hao
- Sweet Annie
- Sweet sagewort
- Sweet wormwood
- Other Artemisia species
Dosage information
In clinical research 150–300 mg of Artemisia annua extract twice daily has been used for up to 9 months for symptoms of arthritis.[6][7] In another clinical study, sublingual drops of glycerinated pollen extracts of Artemisia annua at a dosage of 2400 biological units daily for up to 32 weeks reduced symptoms of allergic rhinitis.[8] Historically, Artemisia annua leaves have been consumed as a vegetable in Western Asia.[1]
Research FeedRead all studies
Artemisia extract supplementation improved insulin resistance to a moderate–large degree in people with impaired glycemic control but did not affect other relevant outcomes (e.g., fasting plasma glucose, insulin, glycated hemoglobin). However, most of the trials analyzed in this study were of poor methodological quality.
Frequently asked questions
Artemisia annua gained popularity due to its antimalarial constituent artemisinin, which was discovered by the scientist Youyou Tu, who received a Nobel Prize for it in 2015. This herb has a long history of use in traditional Chinese medicine.
Its genus is named after Artemis, the Greek goddess of the hunt and fertility, as it is one of the most widely distributed genera throughout the world. Artemisia annua and Artemisia absinthium are the most well-known species within this genus.[2]
Limited research suggests that Artemisia annua might improve symptoms of osteoarthritis[6] and rheumatoid arthritis.[9]
Artemisia annua extracts are also used for hair care and in skin care as an emollient, humectant and antibacterial agent.[10]
Extracts of Artemisia annua pollen have been used as immunotherapy to reduce symptoms of allergic rhinitis during pollen season.[8]
In traditional Chinese medicine, Artemisia annua has been used for jaundice, for dysentery, for wounds and hemorrhoids, and to reduce fever.[10] However, there’s no clinical research to support these uses.
The World Health Organization (WHO) recommends against the use of Artemisia plants for malaria treatment or prevention. Artemisia annua herbal remedies have variable artemisinin content, which is often not sufficient to eradicate the malaria parasites. Additionally, artemisinin has a short half-life (1-3 hours), so it likely won’t stay in the body long enough to eradicate the malaria parasites even when given in a sufficient dose. These dosing issues increase the risk of malarial rebound disease and resistance to artemisinin. Many clinical studies testing herbal Artemisia annua remedies for malaria reported disease relapse and rebound parasitemia (parasites in the blood) after initial improvement in up to 70% of participants.[3]
Research has also shown that Artemisia annua is less effective than other treatments for malaria. One randomized clinical trial showed that 5–9 grams of Artemisia annua consumed as 4 cups of tea daily for 7 days resulted in a cure rate of only up to 34% at 35 days, compared to a 79% cure rate with 1500 mg of quinine daily for 7 days.[4] One randomized clinical trial comparing Artemisia annua tea to sulfadoxine-pyrimethamine, one of the standard treatments, was stopped early due to high rates of malaria recurrence in the groups taking the tea.[5]
Artemisia annua’s constituent artemisinin is used to produce semisynthetic derivatives (artesunate, dihydroartemisinin, and artemether) with standardized dosages and longer half-lives. These derivatives are formulated in combination with other antimalarial drugs to ensure the eradication of malaria parasites and to reduce the risk of the parasites becoming resistant to artemisinin. Artemisinin-based combination therapies (ACTs) are the WHO’s preferred treatment for malaria as of October 2023. There is concern about the continued effectiveness of these treatments, as resistance of the parasites to artemisinin has been increasing.[10][16]
Reported side effects from Artemisia annua include stomach pain, a slowed heart rate (bradycardia), diarrhea, nausea, vomiting, decreased appetite, and flu-like symptoms. However, since many of these adverse effects were reported in clinical studies for malaria, it's not clear whether these were symptoms of malaria or side effects caused by the herb.[11][10] Additionally, Artemisia annua has allergenic pollen which has been reported to cause dermatitis (rash) and other allergy symptoms in susceptible individuals.[10]
There have been rare reports of liver toxicity with Artemisia annua. In one case report, 1.25 grams of Artemisia annua powder had been consumed daily for 4 weeks.[12] In another case report, 600 mg of artemisinin (extracted from Artemisia annua) had been consumed daily for 10 days.[13] A case series reported liver toxicity in 29 adults who had taken Artemisia annua supercritical carbon dioxide extract in grapeseed oil,[14] although it was criticized for having poor reporting methods and confounded causality testing.[15]
Artemisia annua should not be used during pregnancy, as animal research shows that it has toxic effects on the embryo/fetus.[1]
Artemisia annua’s constituent artemisinin inhibits the growth of malaria parasites (Plasmodium species) by inhibiting the calcium pump necessary for protein metabolism and mitochondrial activity in Plasmodium cells. Additionally, in vitro and animal evidence suggests that Artemisia annua extracts have antimicrobial, antiviral, anticancer, anti-inflammatory and analgesic effects.[10][2] However, these effects have yet to be validated in clinical research.
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References
- ^Trendafilova A, Moujir LM, Sousa PMC, Seca AMLResearch Advances on Health Effects of Edible Species and Some Sesquiterpene Lactones Constituents.Foods.(2020-Dec-30)
- ^Sharifi-Rad J, Herrera-Bravo J, Semwal P, Painuli S, Badoni H, Ezzat SM, Farid MM, Merghany RM, Aborehab NM, Salem MA, Sen S, Acharya K, Lapava N, Martorell M, Tynybekov B, Calina D, Cho WCArtemisia spp.: An Update on Its Chemical Composition, Pharmacological and Toxicological Profiles.Oxid Med Cell Longev.(2022)
- ^World Health Organization, Global Malaria ProgramThe use of non-pharmaceutical forms of *Artemisia*(2019)
- ^Mueller MS, Runyambo N, Wagner I, Borrmann S, Dietz K, Heide LRandomized controlled trial of a traditional preparation of Artemisia annua L. (Annual Wormwood) in the treatment of malaria.Trans R Soc Trop Med Hyg.(2004-May)
- ^Blanke CH, Naisabha GB, Balema MB, Mbaruku GM, Heide L, Müller MSHerba Artemisiae annuae tea preparation compared to sulfadoxine-pyrimethamine in the treatment of uncomplicated falciparum malaria in adults: a randomized double-blind clinical trial.Trop Doct.(2008-Apr)
- ^Stebbings S, Beattie E, McNamara D, Hunt SA pilot randomized, placebo-controlled clinical trial to investigate the efficacy and safety of an extract of Artemisia annua administered over 12 weeks, for managing pain, stiffness, and functional limitation associated with osteoarthritis of the hip and knee.Clin Rheumatol.(2016-Jul)
- ^Hunt S, Stebbings S, McNamara DAn open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee.N Z Med J.(2016-Oct-28)
- ^Lou H, Wang X, Wei Q, Zhao C, Xing Z, Zhang Q, Meng J, Zhang S, Zhou H, Ma R, Zhang H, Liu H, Xue W, Wang C, Zhang LArtemisia Annua sublingual immunotherapy for seasonal allergic rhinitis: A multicenter, randomized trial.World Allergy Organ J.(2020 Sep)
- ^Yang M, Guo MY, Luo Y, Yun MD, Yan J, Liu T, Xiao CHEffect of Artemisia annua extract on treating active rheumatoid arthritis: A randomized controlled trial.Chin J Integr Med.(2017-Jul)
- ^Ekiert H, Świątkowska J, Klin P, Rzepiela A, Szopa AArtemisia annua - Importance in Traditional Medicine and Current State of Knowledge on the Chemistry, Biological Activity and Possible Applications.Planta Med.(2021-Jul)
- ^Mueller MS, Karhagomba IB, Hirt HM, Wemakor EThe potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects.J Ethnopharmacol.(2000-Dec)
- ^Ruperti-Repilado FJ, Haefliger S, Rehm S, Zweier M, Rentsch KM, Blum J, Jetter A, Heim M, Leuppi-Taegtmeyer A, Terracciano L, Bernsmeier CDanger of Herbal Tea: A Case of Acute Cholestatic Hepatitis Due to Tea.Front Med (Lausanne).(2019)
- ^Centers for Disease Control and Prevention (CDC)Hepatitis temporally associated with an herbal supplement containing artemisinin - Washington, 2008.MMWR Morb Mortal Wkly Rep.(2009 Aug 14)
- ^Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MVSuspected Hepatotoxicity With a Supercritical Carbon Dioxide Extract of in Grapeseed Oil Used in New Zealand.Front Pharmacol.(2019)
- ^Teschke R, Eickhoff A, Schulze J, Danan GHerb-induced liver injury (HILI) with 12,068 worldwide cases published with causality assessments by Roussel Uclaf Causality Assessment Method (RUCAM): an overview.Transl Gastroenterol Hepatol.(2021)
- ^WHO guidelines for malaria.(2021 Feb 16)