White horehound (Marrubium vulgare Labiatae)
 
White horehound (Marrubium vulgare Labiatae)
Background
Since ancient Egypt, white horehound ( Marrubium vulgare L.) has been used as an expectorant (to facilitate removal of mucus from the lungs or throat). Ayurvedic, Native American and Australian Aboriginal medicines have traditionally used white horehound to treat respiratory (lung) conditions. The United States Food and Drug Administration (FDA) banned horehound from cough drops in 1989 due to insufficient evidence supporting its efficacy. However, horehound is currently widely used in Europe, and can be found in European-made herbal cough remedies sold in the United States (for example, Ricola®).
There is no well-defined clinical evidence to support any therapeutic use of white horehound. The expert German panel, the Commission E has approved white horehound as a choleretic, for lack of appetite and dyspepsia (heartburn). There is promising early evidence favoring the use of white horehound as a hypoglycemic agent for diabetes mellitus, and as a non-opioid pain reliever.
There is limited evidence on safety or toxicity in humans. White horehound has been reported to cause hypotension (low blood pressure), hypoglycemia (low blood sugar), and arrhythmias (abnormal heart rhythms) in animal studies
Synonyms
Andorn, blanc rubi, bonhomme, bouenriblé, bull's blood, common hoarhound, eye of the star, grand bon-homme, grand-bonhomme, haran haran, herbe aux crocs, herbe vierge, hoarhound, horehound, hound-bane, houndsbane, Labiatae (family) , Lamiaceae (family), Llwyd y cwn, maltrasté, mapiochin, mariblé marinclin, marrochemin, marroio, marroio-blanco, marromba, marrube, marrube blanc, marrube commun, marrube des champs, marrube officinal, marrube vulgaire, marrubii herba, marrubio, marrubium, Marrubium vulgare , maruil, marvel, mastranzo, mont blanc, Ricola®, soldier's tea, seed of horus, weisser andorn.
Note : White horehound should not be confused with black horehound ( Ballota nigra ) or water horehound ( Lycopus americanus , also known as bugleweed).
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*Cough
Since ancient Egypt, white horehound has been used as an expectorant. Ayurvedic, Native American and Australian Aboriginal medicines have traditionally used white horehound to treat respiratory (lung) conditions. The United States Food and Drug Administration (FDA) banned horehound from cough drops in 1989 due to insufficient evidence supporting its effectiveness. However, horehound is currently widely used in Europe, and can be found in European-made herbal cough remedies sold in the United States (for example, Ricola®).
C
Intestinal disorders/antispasmodic
White horehound has been used traditionally to treat intestinal disorders. However, there are few well-designed studies in this area, and little information is available about the effectiveness of white horehound for this use.
C
Heartburn/poor appetite
In Germany, white horehound is approved for the treatment of heartburn and lack of appetite, based on historical use. There is not enough information from scientific studies to evaluate the effectiveness of white horehound for these conditions.
C
Diabetes
White horehound has been used for diabetes in some countries, including Mexico. Animal studies suggest that white horehound may lower blood sugar levels. However, there are no reliable studies available in humans.
C
Pain
White horehound has traditionally been used for pain and spasms from menstruation or intestinal conditions. There are no reliable human studies on safety or effectiveness for this use.
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.
Asthma, bile secretion, bloating, bronchitis, blood vessel relaxation, cancer, cathartic, colic, congestion, constipation, chronic obstructive pulmonary disease (COPD), debility, diarrhea, digestive aid, fever reduction, flatulence, food flavoring, gallbladder complaints, heart rate abnormalities, indigestion, intestinal parasites, jaundice (yellowing of the skin), laxative, liver disease, lung congestion, morning sickness, pneumonia, rabies, respiratory (lung) spasms, skin conditions, snake poisoning, sore throat, sweat stimulation, tuberculosis, upper respiratory tract infection, vomiting stimulant, warts, water retention, wheezing, whooping cough, wound healing.
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. There is no widely accepted standardization for white horehound. The maximum average concentration in candy is reported as 0.073%. Crude white horehound has previously been an official compound for pharmacists and listed in the United States Pharmacopia (USP). Strengths of extracts can be expressed in terms of flavor intensities or weight-to-weight ratios.
Caution : Black horehound ( Ballota nigra ) may be found in compounds reported to contain only white horehound.
Adults (18 years and older)
Cough/throat ailments : Doses that have been used include 10 to 40 drops of extract in water up to three times a day, or lozenges dissolved in the mouth as needed. Ricola® drops are recommended by the manufacturer at a maximum of 2 lozenges every 1 to 2 hours as needed.
Heartburn/appetite stimulant : Doses recommended by the expert German panel, the Commission E, include 4.5 grams daily of cut herb or 2 to 6 tablespoons of fresh plant juice. Other traditional dosing suggestions are 1 to 2 grams of dried herb or infusion three times daily.
Children (younger than 18 years)
There is not enough information to recommend the safe use of white horehound in 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.
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 In theory, white horehound may cause an allergic reaction in persons with known allergy or hypersensitivity to members of the Lamiaceae family (mint family) or any white horehound components.
Side Effects and Warnings
White horehound is generally considered to be safe when used as a flavoring agent in foods. However, there is limited scientific study of safety, and most available information is from animal (not human) research. Reported side effects include rash at areas of direct contact with white horehound plant juice, abnormal heart rhythms, low blood pressure, and decreased blood sugar (seen in animals with high blood sugar). White horehound may cause vomiting and diarrhea. Caution is warranted in people with heart disease or gastrointestinal disorders. Caution may also advisable in persons 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.
Theoretically, white horehound may interfere with the body's response to the hormone aldosterone, which affects the ability of the kidneys to control the body's levels of water and electrolytes. These theoretical effects may cause high blood pressure, high blood sodium, low potassium, leg swelling, and muscle weakness. Individuals who have high or unstable blood pressure, high sodium, or low potassium or who are taking medications that reduce the amount of water in the body (diuretics, or "water pills") should use caution. White horehound may contain estrogen-like chemicals that either have stimulatory or inhibitory effects on estrogen-sensitive parts of the body. It is unclear what effects may occur in hormone-sensitive conditions such as some cancers (breast, ovarian, uterine) and endometriosis, or in people using hormone replacement therapy/birth control pills.
Pregnancy and Breastfeeding
White horehound is not recommended during pregnancy or breastfeeding. Animal studies suggest that white horehound may cause miscarriage.
References
1. Cahen R. [Pharmacologic spectrum of Marrubium vulgare L]. C R Seances Soc Biol Fil 1970;164(7):1467-1472.
2. De Jesus RA, Cechinel-Filho V, Oliveira AE, et al. Analysis of the antinociceptive properties of marrubiin isolated from Marrubium vulgare. Phytomedicine 2000;7(2):111-115.
3. De Souza MM, De Jesus RA, Cechinel-Filho V, et al. Analgesic profile of hydroalcoholic extract obtained from Marrubium vulgare. Phytomed 1998;5(2):103-107.
4. El Bardai S, Morel N, Wibo M, et al. The vasorelaxant activity of marrubenol and marrubiin from Marrubium vulgare. Planta Med 2003;69(1):75-77.
5. El Bardai S, Wibo M, Hamaide MC, et al. Characterisation of marrubenol, a diterpene extracted from Marrubium vulgare, as an L-type calcium channel blocker. Br J Pharmacol 2003;140(7):1211-1216.
6. Karriyvev MO, Bairiyev CB, Atayeva AS. [On the curative properties and phytochemistry of Marribum vulgare]. Izvestiia Akademii Nauk Turkmenskoi SSR, Seriia Biol Nauk 1976;3:86-88.
7. Karryvev MO, Bairyev CB, Ataeva AS. Some therapeutic properties of common horehound. Chem Abstr 1977;86:2355.
8. Roman RR, Alarcon-Aguilar F, Lara-Lemus A, et al. Hypoglycemic effect of plants used in Mexico as antidiabetics. Arch Med Res 1992;23(1):59-64.
9. Saleh MM, Glombitza KW. Volatile oil of Marrubium vulgareand its anti-schistosomal activity. Planta Med 1989;55:105.
10. Schlemper V, Ribas A, Nicolau M, et al. Antispasmodic effects of hydroalcoholic extract of Marrubium vulgareon isolated tissues. Phytomed 1996;3(2):211-216.
January 01, 2004 
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