Wise Mind Herbs

The information on this page has been prepared with reference to published scientific literature, not by a medically qualified expert. It is not medical advice. Any decision to use a supplement or herb-based product is your responsibility. Consult a suitably qualified medical professional, especially if you have underlying conditions. Remember, nothing is for everyone, and not everything sold is what it claims to be. Some things work for some people, some of the time.

Birch

Birch trees, particularly Betula pendula (silver birch) and Betula pubescens (downy birch) - collectively often referred to as "common birch" - have been used in traditional medicine across Europe and Asia for centuries. This review examines the scientific evidence behind the purported health benefits based on peer-reviewed publications.

Image source and license: https://commons.wikimedia.org/wiki/File:Betula_pendula_subsp._pendula_2023-05-05_01.jpg.
Modified by Peter Jorgensen.

Botanical Classification and Common Names

The genus Betula (family Betulaceae) includes approximately 30-60 species of trees and shrubs. The most studied species for medicinal purposes include:

• Betula pendula Roth (silver birch, European white birch, warty birch)
• Betula pubescens Ehrh. (downy birch, white birch)
• Betula lenta L. (sweet birch, cherry birch, black birch)
• Betula alleghaniensis Britton (yellow birch)

Note: Birch is sometimes confused with European aspen (Populus tremula) due to similar appearance, but they are botanically distinct and have different phytochemical profiles.

Bioactive Compounds

The therapeutic properties of birch are attributed to several compounds found in various parts of the tree:

• Betulin and betulinic acid (triterpenes found in bark)
• Flavonoids (primarily in leaves): quercetin, kaempferol, myricetin derivatives
• Phenolic compounds: catechins, proanthocyanidins
• Essential oils: primarily in buds, containing methyl salicylate, sesquiterpenes
• Saponins and tannins (in bark and leaves)

Evidence-Based Health Benefits

Based on current scientific literature, birch preparations have shown potential in the following conditions:

• Anti-inflammatory conditions: Betulinic acid has demonstrated significant anti-inflammatory effects in vitro and in animal models, particularly for rheumatoid arthritis.
• Mild urinary tract infections: Birch leaf extracts have diuretic properties that may help flush bacteria from the urinary tract.
• Skin conditions: Birch bark extract has shown benefit in wound healing and treating eczema due to its anti-inflammatory and antimicrobial properties.
• Anticancer potential: Betulinic acid has demonstrated promising anticancer effects in laboratory studies, though clinical evidence remains preliminary.
• Hepatoprotective effects: Some studies suggest birch extracts may offer liver protection against toxins.

Recommended Dosages and Standardization

Dosages vary significantly based on the preparation and intended use:

• Birch leaf tea: 2-3g dried leaves (standardized to contain 1-2% flavonoids) steeped in hot water, 3-4 times daily.
• Birch leaf extract: 300-500mg (standardized to 5% flavonoids) daily, divided into 2-3 doses.
• Birch bark extract: 100-200mg (standardized to 70-80% betulin) daily for skin conditions.
• Birch sap: No standardized dosage; traditionally consumed as 100-200ml fresh or fermented sap daily during spring collection season.

Note: Most clinical studies use standardized extracts rather than whole plant materials, making direct dosage recommendations challenging. The efficacy of traditional preparations may differ from standardized extracts.

Side Effects and Contraindications

While generally considered safe when used appropriately, birch products may cause:

• Allergic reactions, particularly in individuals with known allergies to birch pollen or related plants (Betulaceae family, including hazel, alder)
• Potential drug interactions with diuretics and medications metabolized by cytochrome P450 enzymes
• Gastrointestinal discomfort with high doses
• Hypersensitivity reactions to salicylates (especially in birch essential oil)

Contraindications include pregnancy, breastfeeding, edema due to heart or kidney insufficiency, and salicylate sensitivity. Patients with birch pollen allergies should exercise caution with oral preparations.

Dosage Range Studies

Few studies have systematically investigated dose-response relationships or maximum efficacious doses for birch extracts. Most clinical trials have used fixed doses based on traditional use or preliminary studies. For betulinic acid, in vitro studies suggest cytotoxic effects at concentrations above 10 μM, but the clinical relevance remains unclear. Knowledge gaps exist regarding:

• Long-term safety of standardized extracts
• Maximum safe and effective dosages for specific conditions
• Bioavailability of active compounds from different preparations
• Potential interactions with conventional medications at higher doses

Commercial Pharmaceutical Products

Several pharmaceutical products containing birch-derived compounds include:

• Episalvan® (Birken AG): A standardized birch bark extract (betulin) formulated as a gel for treatment of wounds and skin conditions; approved in the European Union for treatment of partial thickness wounds.
• Imlan® (Pfleger Pharmaceuticals): Birch bark extract formulation for dermatological applications.

Numerous betulinic acid derivatives are in various stages of clinical development for cancer treatment, though none have received regulatory approval as of late 2024.

Research Limitations

Current scientific understanding of birch's therapeutic potential is limited by:

• Small sample sizes in many clinical trials
• Inconsistent standardization of test materials
• Limited high-quality randomized controlled trials
• Variation in extraction methods affecting bioactive compound profiles
• Publication bias favoring positive results

Conclusion

While traditional uses of birch in various health conditions have some scientific support, particularly for anti-inflammatory, diuretic, and dermatological applications, more rigorous clinical research is needed to establish optimal dosages, long-term safety, and efficacy for specific health conditions. The most promising evidence supports topical applications for skin conditions and wound healing. Individuals interested in using birch products should consult healthcare providers, particularly when taking other medications or managing chronic conditions.

References

Buko, V., Kuzmitskaya, I., Kirko, S., Belonovskaya, E., Naruta, E., Lukivskaya, O., ... & Zavodnik, I. J. P. I. (2019). Betulin attenuated liver damage by prevention of hepatic mitochondrial dysfunction in rats with alcoholic steatohepatitis. Physiology International, 106(4), 323-334.

Laavola, M., Haavikko, R., Hämäläinen, M., Leppänen, T., Nieminen, R., Alakurtti, S., ... & Moilanen, E. (2016). Betulin derivatives effectively suppress inflammation in vitro and in vivo. Journal of natural products, 79(2), 274-280.

Lombrea, A., Scurtu, A. D., Avram, S., Pavel, I. Z., Turks, M., Lugiņina, J., ... & Danciu, C. (2021). Anticancer potential of betulonic acid derivatives. International journal of molecular sciences, 22(7), 3676.

Popowski, D., Kruk, A., Pawłowska, K. A., Dolzkho, D., Korczak, M., Piwowarski, J. P., ... & Granica, S. (2024). Evaluating birch leaf tea as a functional herbal beverage: Beneficial impact on the urinary tract, and metabolism in human organism. Food Research International, 189, 114481.

Saneja, A., Arora, D., Kumar, R., Dubey, R. D., Panda, A. K., & Gupta, P. N. (2018). Therapeutic applications of betulinic acid nanoformulations. Annals of the New York Academy of Sciences, 1421(1), 5-18.

Steinbrenner, I., Houdek, P., Pollok, S., Brandner, J. M., & Daniels, R. (2016). Influence of the oil phase and topical formulation on the wound healing ability of a birch bark dry extract. PLoS One, 11(5), e0155582.