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Yarrow - Achillea millefolium

Yarrow (Achillea millefolium) is a flowering plant that has been used in traditional medicine across various cultures for centuries. It belongs to the Asteraceae family and is native to temperate regions of the Northern Hemisphere. This review synthesizes current scientific understanding of yarrow's therapeutic properties based on peer-reviewed literature.

Botanical Information and Common Names

The primary species discussed in scientific literature is Achillea millefolium L., commonly known as yarrow, common yarrow, milfoil, thousand-leaf, soldier's woundwort, or nosebleed plant. Other Achillea species that have been studied include A. asiatica, A. wilhelmsii, and A. filipendulina. It's important to note that plants sometimes mistakenly identified as yarrow include Queen Anne's lace (Daucus carota) and tansy (Tanacetum vulgare), which have similar appearance but different chemical compositions and therapeutic profiles.

Bioactive Compounds

Yarrow contains numerous bioactive compounds including flavonoids (apigenin, luteolin, rutin), sesquiterpene lactones (achillein, achillin), volatile oils (chamazulene, camphor, borneol), alkaloids, coumarins, tannins, and triterpenes. The concentration of these compounds varies based on geographic location, harvest time, and plant part used.

Evidence-Based Therapeutic Applications

• Anti-inflammatory properties: Multiple studies demonstrate yarrow's ability to reduce inflammation through inhibition of pro-inflammatory cytokines and modulation of cyclooxygenase (COX) pathways.
• Wound healing: Research supports traditional use for wound healing, with studies showing enhanced tissue regeneration and reduced healing time.
• Gastrointestinal health: Clinical evidence suggests efficacy for functional gastrointestinal disorders, with antispasmodic and anti-ulcer properties.
• Antimicrobial activity: Demonstrated efficacy against various bacteria and fungi, including some antibiotic-resistant strains.
• Anxiolytic effects: Preliminary studies suggest moderate anxiolytic properties comparable to low-dose diazepam in animal models.
• Antioxidant effects: Significant free radical scavenging activity has been documented in multiple in vitro and in vivo studies.
• Hemostatic properties: Traditional use for controlling bleeding has some scientific support, with studies showing reduction in bleeding time.
• Hepatoprotective effects: Emerging evidence suggests protective effects against liver damage in animal models.

Recommended Dosages

Dosage recommendations vary based on preparation form and intended use. Current scientific literature suggests:

• Tea/infusion: 2-4 g of dried herb steeped in 150 ml of hot water, 3 times daily (equivalent to approximately 0.3-1.2 mg of flavonoids per dose).
• Fluid extract (1:1): 1-2 ml, 3 times daily.
• Tincture (1:5, 25% ethanol): 2-4 ml, 3 times daily.
• Standardized extract: Most clinical studies use extracts standardized to contain 0.12-0.42% of total flavonoids (calculated as luteolin) or 0.1-0.5% of sesquiterpene lactones.
• External application: Typically 10-15% extracts in cream or ointment bases for topical applications.

It's important to note that standardization varies significantly between commercial products, and many studies do not adequately report standardization parameters, creating challenges for establishing precise therapeutic dosing recommendations.

Side Effects and Contraindications

• Allergic reactions: Cross-reactivity with other members of the Asteraceae family (including ragweed, chrysanthemums, daisies) has been documented.
• Photosensitivity: The presence of certain compounds may increase skin sensitivity to UV radiation.
• Anticoagulant effects: Potential interactions with anticoagulant medications due to yarrow's coumarin content.
• Pregnancy/lactation: Contains compounds with uterine stimulant properties; contraindicated during pregnancy.
• Sedative effects: May potentiate effects of sedative medications and alcohol.
• Gastrointestinal discomfort: High doses may cause mild gastrointestinal distress in sensitive individuals.

Studies on High-Dose Administration

Limited research exists on doses significantly exceeding the therapeutic recommendations. A few toxicological studies have examined higher concentrations, finding:

• Chronic administration of high doses (equivalent to 10-15 times the recommended human dose) in animal models has shown potential hepatotoxicity and nephrotoxicity.
• Notable knowledge gaps exist regarding long-term safety and potential accumulative effects of high-dose administration in humans.

Currently, no evidence supports therapeutic benefits from exceeding recommended dosages, while potential risks increase. The therapeutic window appears to be relatively well-defined within the ranges outlined in the dosage section.

Conclusion

Current scientific evidence supports several traditional uses of yarrow, particularly for inflammation, wound healing, and gastrointestinal complaints. However, the quality of clinical studies varies considerably, with many being small-scale or preliminary. Further high-quality clinical trials with standardized preparations are needed to establish definitive therapeutic guidelines. The relative safety profile of yarrow at recommended doses appears favorable, though potential drug interactions and contraindications must be considered.

References

Bashir, S., Noor, A., Zargar, M. I., & Siddiqui, N. A. (2022). Ethnopharmacology, phytochemistry, and biological activities of Achillea millefolium: A comprehensive review. Edible plants in health and diseases: volume II: phytochemical and pharmacological properties, 457-481.

Choudhary, G. P. (2022, October). Pharmacological evaluation for antitussive and antiasthmatic potential of Achillea millefolium flower extracts. In Respiratory Care (Vol. 67, No. Suppl_10, p. 3771721).

Dalili, A., Ebrahimnia Milani, S., Kamali, N., Mohammadi, S., Pakbaz, M., Jamalnia, S., & Sadeghi, M. (2022). Beneficial effects of Achillea millefolium on skin injuries; a literature review. Journal of Essential Oil Research, 34(6), 479-489. Far, B. F., Behzad, G., & Khalili, H. (2023). Achillea millefolium: Mechanism of action, pharmacokinetic, clinical drug-drug interactions and tolerability. Heliyon, 9(12).

Jangjoo, M., Joshaghani, A., & Tahernejadgatabi, F. (2023). The role of Achillea millefolium in traditional medicine: A review of its use in different cultures. Journal of Multidisciplinary Care, 12(3), 152-156.

Moradi, M., Niazi, A., Abbasi, K., Mollazadeh, S., & Feizabadi, M. N. (2024). The Impact of Achillea Millefolium on Primary Dysmenorrhea and Menstrual bleeding: A Systematic Review. Journal of Midwifery & Reproductive Health, 12(2).

Satari, A. H., Bhat, M. F., Hassan, R., & Masoodi, M. H. (2021). Achillea millefolium E. Mey: Phytochemistry and Pharmacological Profile. Current Traditional Medicine, 7(3), 343-347.

Tiwari, P., Patel, A. K., Dubey, P. K., Gupta, N., Bapna, R., Pyati, A. R., ... & Sharma, J. (2021). Evaluation of Anti-anxiety activity of Achillea millefolium Linn. International Journal of Pharmacy & Life Sciences, 12(1).

Yaşar, B., Bekdaş, M., Düzcü, S. E., Çetinkaya, A., Alışık, M., Yıldırım, A. B., & Bekdaş, M. F. (2024). Effects of Yarrow (Achillea millefolium) Extract on Acute Lung Injury: An Experimental Study.

Zhang, L., Yuan, X., & Peng, Q. (2025). Therapeutic potential of Achillea millefolium L. extract on 7, 12-dimethylbenz (a) anthracene (DMBA)-induced ovary cancer in Wistar rats: a biochemical, molecular and histopathological approach. Toxicology Research, 14(1), tfae235.