Pycnogenol (Pinus pinaster ssp. atlantica)
  
Pycnogenol (Pinus pinaster ssp. atlantica)
Background
Pycnogenol® is the patented trade name for a water extract of the bark of the French maritime pine ( Pinus pinaster ssp. atlantica ), which is grown in coastal south-west France. Pycnogenol® contains oligomeric proanthocyanidins (OPCs) as well as several other bioflavonoids: catechin, epicatechin, phenolic fruit acids (such as ferulic acid and caffeic acid), and taxifolin.
There has been some confusion in the U.S. market regarding OPC products containing Pycnogenol® or grape seed extract (GSE), because one of the generic terms for chemical constituents ("pycnogenols") is the same as the patented trade name (Pycnogenol®). Some GSE products were formerly erroneously labeled and marketed in the U.S. as containing "pycnogenols." Although GSE and Pycnogenol® do contain similar chemical constituents (primarily in the OPC fraction), the chemical, pharmacological, and clinical literature on the two products is distinct. The term Pycnogenol® should therefore only be used to refer to this specific proprietary pine bark extract. Scientific literature regarding this product should not be referenced as a basis for the safety or effectiveness of GSE.
Synonyms
Cocklebut, condensed tannins, French maritime pine bark extract, leucoanthocyanidins, Pinus pinaster , Pinus maritima , oligomeric proanthocyanidin complexes (OPCs), Pinaceae (familty) , proanthocyanidins, pygenol, stickwort.
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidenceGrade*Chronic venous insufficiency
Chronic venous insufficiency (CVI) is a syndrome that includes leg swelling, varicose veins, pain, itching, skin changes, and skin ulcers. The term is more commonly used in Europe than in the United States. Pycnogenol used in people with chronic venous insufficiency is reported to reduce edema and pain. Pycnogenol may also be used in the management of other CVI symptoms.
B
Asthma (chronic therapy)
Pycnogenol is reported to reduce leukotriene levels in humans, suggesting possible benefits in the chronic management of asthma. Although these data are promising, well-designed controlled study is needed before a firm conclusion can be reached.
C
Gingival bleeding / plaque
Chewing gum containing 5mg of Pycnogenol is reported to minimize gingival bleeding and plaque formation. Further research is needed to confirm these results.
C
Retinopathy
Several studies report benefits of Pycnogenol in the treatment and prevention of retinopathy, including slowing the progression of retinopathy in diabetics. Reported mechanisms include improvement of capillary resistance and reduction of leakage into the retina. Improvement of visual acuity has also been reported. Better-quality research is needed before a firm conclusion can be reached.
C
Platelet aggregation
One human study reports reduced platelet aggregation in smokers. Further research is needed before a clear conclusion can be reached.
C
ADHD (Attention Deficient Hyperactivity Disorder)
Preliminary research comparing Pycnogenol vs. placebo in adults with ADHD reported improved concentration with both agents. After release of this study, Enfamol Nutraceuticals Inc. (maker of Efalex and Efalex Focus) and J&R Research (maker of Pycnogenol) settled a suit with the Federal Trade Commission agreeing to no longer advertise these supplements as treatments for ADHD. The companies were not required to pay fines. FTC officials stated they are particularly concerned about dietary supplements with unproven claims being marketed for children. Further research is necessary in this area before a firm conclusion can be reached.
C
Antioxidant
Due to conflicting study results, it is unclear if Pycnogenol has significant antioxidant effects in humans. Further research is necessary.
C
High cholesterol
One human trial reports Pycnogenol to significantly reduce low-density lipoprotein (LDL/"bad cholesterol") levels and increased high-density lipoprotein (HDL/"good cholesterol") levels. Other studies have reported decreases in total cholesterol and LDL levels with no change in HDL. Due to conflicting data and methodological problems with available research, further studies are necessary before clear conclusions can be drawn.
C
Melasma (chloasma)
Melasma (or chloasma) is a common disorder of hyperpigmentation of the skin predominately affecting sun-exposed areas in women. Formations of tan or brown patches/spots may occur. Pycnogenol has been reported to decrease the darkened area and the pigment intensity of melasma and improve symptoms of fatigue, constipation, body pains, and anxiety. Further well-designed research is needed before a clear recommendation can be made.
C
Male infertility
Human studies report that Pycnogenol may improve sperm quality and function in sub-fertile men. Further research is needed to confirm these results.
C
Sunburn
Pycnogenol, taken orally, may reduce erythema (redness of the skin) caused by solar ultraviolet light. Further study is needed before a recommendation can be made.
C
Erectile dysfunction
Pycnogenol, in combination with L-arginine, may cause an improvement in sexual function in men with erectile dysfunction. It is not known what effect each of the individual compounds may have directly on this condition. Further research is needed.
C
Systemic lupus erythematosus (SLE)
Preliminary human and non-human data suggest that Pycnogenol may be useful as a second line therapy to reduce inflammatory features of SLE. Further research is needed before a recommendation can be made.
C
* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
ACE-inhibitor activity, Alzheimer's disease, antihistamine, antiparasitic, atherosclerosis, autoimmune disorders, bone marrow production, cancer prevention, cancer treatment, cardiovascular disease, cerebral ischemia, chemotherapy side effects, exercise capacity, fat burning, G6PD deficiency, gout prevention (xanthine oxidase and dehydrogenase inhibitor), hemorrhoids, high blood pressure, hypoglycemic agent, immune enhancement, immune suppression, inflammation, inhibition of TNF-alpha, increased human growth hormone, lung cancer, premenstrual syndrome, macular degeneration, myocardial ischemia/reperfusion injury, night vision, pelvic pain, neurodegenerative diseases, prevention of fat formation, psoriasis, retinal protection, rheumatoid arthritis, sickle cell anemia, skin disorders, skin aging, vasorelaxant.
Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Standardization
Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Pycnogenol is a proprietary patented formula.
Adults (18 years and older)
Note : Pycnogenol appears to be absorbed into the bloodstream in about 20 minutes. Once absorbed, therapeutic effects are purported to last for approximately 72 hours, follow ed by excretion in the urine. Because of its astringent taste and occasional minor stomach discomfort, it may be best to take Pycnogenol with or after meals.
Antioxidant/cholesterol reduction: 150-360 mg/day for 4-6 weeks has been used.
Antiparasitic: 30 mg/kg/day has been used.
Chronic Venous Insufficiency (CVI): 100-360 mg/day in divided doses for 1-2 months has been used.
Asthma chronic therapy): 1mg/lb/day (max 200mg/day) for up to 4 weeks has been used.
Erectile Dysfunction: A regimen combining Pycnogenol and L-arginine that has been used involves 1.7 grams of L-arginine/day during month #1; 1.7 grams of L-arginine/day and 40mg of Pycnogenol 2 times/day during month #2; 1.7 grams of L-arginine/day and 40mg of Pycnogenol 3 times/day during month #3.
Sunburn: 1.10 mg/kg/day for 4 weeks, followed by 1.66 mg/kg/day for 4 weeks has been used.
Gum health (gingival bleeding/plaque): 5mg Pycnogenol in chewing gum for 14 days has been used.
Male Infertility: 200 mg/day Pycnogenol for 90 days has been used.
Platelet aggregation reduction: 100-200 mg/day has been used.
Melasma (chloasma): 25mg tablet with meals 3 times a day (75 mg /day) for 30 days has been used.
Retinopathy: 50mg taken three times a day for 2 months has been used.
Children (younger than 18 years)
Due to insufficient data, pycnogenol in not recommended for use by children.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
Individuals should not take pycnogenol if allergic to it or any of its components.
Side Effects and Warnings
Pycnogenol is generally reported as being well-tolerated. Low acute and chronic toxicity with mild unwanted effects may occur in a small percentage of patients following oral administration. Because of its astringent taste and occasional minor stomach discomfort, it may be best to take Pycnogenol with or after meals. To date, no serious adverse effects have been reported in the available scientific literature, although systematic study of safety is not available.
In theory, pycnogenol may alter blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
In theory, pycnogenol may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Pregnancy & Breastfeeding
Pycnogenol is not recommended during pregnancy or breastfeeding due to lack of scientific evidence.
References
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February 01, 2004 
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