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Supplements

pau d'arco

What Is It?
Health Benefits
Forms

Dosage Information
Guidelines for Use

General Interaction

Possible Side Effects

Cautions

References

Evidence Based Rating Scale

 

What Is It? 

To treat a host of ills ranging from fungal infections to the common cold, traditional healers in South and Central America have long brewed a tea made from the inner bark of a native evergreen tree of the Tabebuia genus. 

Today, this healing brew, variously referred to as pau d'arco or Taheebo, is readily available in North American health-food stores and sold as a "cure" for cancer and numerous other ills, including diabetes, warts, and vaginal yeast infections. Whether pau d'arco actually works for any of these conditions has been unclear and is the subject of ongoing confusion and controversy. 

During the 1970s the National Cancer Institute at the National Institutes of Health (NIH) tested pau d'arco in human studies after finding that it shrank cancerous tumors in animals. Researchers discovered that while large doses of one of the Herb's key ingredients (lapachol) could destroy cancer cells, the side effects produced in the patients—blood-clotting abnormalities, anemia, nausea—were too severe, and further studies were abandoned. (1) 

Today, the majority of practicing herbalists cite both a lack of proven efficacy and the toxicity that's associated with high doses as reasons for recommending against taking pau d’arco to treat cancer, although some consider it useful to take as an immune booster while fighting the disease. (2) 

Health Benefits 

While many health claims for pau d'arco have not been substantiated—including the far-reaching assertion that it can "cure" various forms of cancer—there are some positive findings. And some herbalists also recommend pau d'arco to strengthen immunity in the presence of such ailments as cancer, HIV or AIDS, chronic bronchitis, or chronic fatigue syndrome. 

Specifically, pau d'arco may help to: 

  • Treat cancer. Since the NIH abandoned studies involving pau d’arco to treat cancer, only a few studies have continued to investigate efficacy. A 2002 study of botanical medicines, including pau d’arco, found that while several of the herbs are popular with patients, few are beneficial and are unlikely to lead to rapid tumor regression. (3) Later laboratory studies demonstrated anti-proliferative mechanisms in prostate, colon, lung and bladder cancer cells, indicating an ability to inhibit the growth of cancer cells and stimulate cell death, and explaining potential anti-cancer benefits. (4-7) However, a 2009 review of studies found that the lack of quality control and inconsistent composition of the products available on the market make it difficult to accurately assess the therapeutic efficacy, and these variances may explain the conflicting results in studies. (8) More research is needed to confirm or refute efficacy.

  • Strengthen immunity. Researchers have detected in the inner bark of the Tabebuia trees a handful of powerful infection-fighting compounds called naphthoquinones. One of these substances (lapachol) seems to be particularly potent. Naphthoquinones appear to help kill certain disease-causing bacteria, viruses and fungi, partially justifying the name given to this herbal remedy ("tajy," meaning to have strength and vigor) by the Guarani and Tupi tribes in South America. Lapachol has been shown to inhibit certain enzymes and protect against certain viral strains, including the herpes virus, influenza, poliovirus. (9-11) The mechanism of these antiviral properties has been shown to be through the inhibition of certain enzymes, such as DNA and RNA polymerases, which may be important in the treatment of human immunodeficiency virus (HIV) – the virus that can lead to AIDS. (12) However, evidence is insufficient to rate the efficacy in specific conditions. More research is needed.

  • Treat fungal infections. Laboratory studies have demonstrated that pau d'arco has anti-fungal properties on par with a common anti-fungal prescription drug (ketoconazole). This action likely explains its effectiveness for vaginal infections caused by the yeast Candida. (11) Anti-inflammatory and anti-fungal actions in pau d'arco appear to be effective in restoring the vagina to a normal state. Herbalists recommend a pau d'arco tea douche for this purpose. (13) Pau d'arco may also be effective in fighting the fungi responsible for athlete's foot, jock itch, and other common fungal skin infections. (14) Commercially available products are available for this purpose. More research is needed to confirm or refute efficacy in treating vaginal yeast infections.

  • Eliminate warts. Historically, naturopathic medicine indicates pau d'arco as an effective remedy against warts. According to folklore and several natural remedy sources, applying pau d'arco directly to warts allows the antiviral compounds in the bark to get to work. (15-18) Once diluted, pau d'arco is even said to be safe to use on genital warts. However, be sure to see a doctor if a genital wart develops; such warts are not only transmitted sexually (and partners should be protected), but they can cause serious complications in a woman's reproductive organs. Additionally, scientific evidence is lacking in this area. Research is needed to confirm or refute efficacy of pau d’arco in treating warts.

  • Treat cough due to the common cold or smoker’s cough. Pau d’arco is touted in traditional medicine as an expectorant—an agent that increases the liquid content of bronchial secretions—thus helping to dislodge embedded mucus and contaminants in the lungs. (19) This may be useful to improve symptoms of the common cold and as a remedy for smoker’s cough. However, evidence is lacking. Research is needed to confirm or refute efficacy. 

Forms 

  • tincture
  • tablet
  • softgel
  • powder
  • ointment
  • liquid
  • dried herb/tea
  • capsule  

Dosage Information 

Pau d’arco is typically administered as a decoction, made by boiling 1 tsp of pau d’arco bark for each cup of water for 5 to 15 minutes. The standard dosage is 1 cup of this decoction two to eight times daily. 

For a more precise dosage based on a lapachol content of 2% to 4%, boil 15 to 20 g of bark in 500 ml (1 pint) of water for 5 to 15 minutes and take three to four times daily.

Aqueous, fluid and solid extracts may be used based on lapachol content with daily intake of 1.5-2.0 g/day. 

Alcohol extracts (1:2, 45% ethanol) should give total daily dosages of 3-7mls. 

With dried inner bark, use 1.5-3.5g/day. 

Guidelines for Use 

The best formulations for internal complaints are products standardized to contain 2% to 7% lapachol: these can be difficult to locate, however. An effective alternative is a product containing 3% naphthoquinones. Some herbal specialists prefer this formulation because it's made from whole pieces of the bark rather than an isolated compound (lapachol), meaning it could provide healing benefits from other still unidentified constituents. 

If a skin irritation develops while you are using pau d'arco tincture or liquid extract to treat a wart or fungal infection, dilute the tincture with a small quantity of water or vegetable oil. If irritation continues despite diluting the tincture or liquid extract, stop using it. Also, protect the skin surrounding a wart with a bit of petroleum jelly. Dilution is always necessary if treating a genital wart. 

General Interaction 

Taken internally, high doses of pau d'arco can cause prolonged bleeding times probably due to antagonism of vitamin K. Consult a doctor for guidance before taking with any kind of blood “thinner”.

Note: For information on interactions with specific drugs, see our WholeHealthMD Drug/Nutrient Interactions Chart. 

Possible Side Effects 

High doses of pau d'arco supplement or tea have been associated with nausea and vomiting. If a mild upset stomach occurs, try taking it with food. Stop taking it altogether if stomach upset continues. 

Cautions 

  • Avoid high doses of pau d'arco, which can cause nausea, vomiting, excessive bleeding, and other complications. Seek medical attention immediately if such reactions develop. 

  • Limit intake of pau d'arco to a week or so; this potent herb may pose notable health risks when taken internally for longer periods. 

  • Women who are pregnant or breast-feeding should avoid pau d'arco. While there are no reports of problems in humans, studies show fetal mortality in rats. (20) 

References

1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
2. Foster S, Tyler VE. Tyler’s Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999.
3. Vickers A. Botanical medicines for the treatment of cancer: rationale, overview of current data, and methodological considerations for phase I and II trials. Cancer Invest. 2002;20(7-8):1069-79.
4. Choi YH, Kang HS, Yoo MA. Suppression of human prostate cancer cell growth by beta-lapachone via down-regulation of pRB phosphorylation and induction of Cdk inhibitor p21 (WAF1/CIP1). J Biochem Mol Biol. 2003 Mar 31;36(2):223-9.
5. Choi BT, Cheong J, Choi YH. Beta-Lapachone-induced apoptosis is associated with activation of caspase-3 and inactivation of NF-kappaB in human colon cancer HCT-116 cells. Anticancer Drugs. 2003 Nov;14(10):845-50.
6. Woo HJ, Choi YH. Growth inhibition of A549 human lung carcinoma cells by beta-lapachone through induction of apoptosis and inhibition of telomerase activity. Int J Oncol. 2005 Apr;26(4):1017-23.
7. Lee JI, Choi DY, Chung HS, et al. Beta-lapachone induces growth inhibition and apoptosis in bladder cancer cells by modulation of Bcl-2 family and activation of caspases. Exp Oncol. 2006 Mar;28(1):30-5.
8. Gómez Castellanos JR, Prieto JM, Heinrich M. Red Lapacho (Tabebuia impetiginosa) – a global ethnopharmacological commodity? J Ethnopharmacol. 2009 Jan 12;121(1):1-13.
9. Koide SS. Inhibition of 3alpha-hydroxysteroid-mediated transhydrogenase of rat liver by various quinones and flavonoids. Biochim Biophys Acta. 1962;59:708-10.
10. Lagrota M, et al. Antiviral activity of lapachol. Rev Microbiol. 1983;14:21-26.
11. Guiraud P, Steiman R, Campos-Takaki GM, et al. Comparison of antibacterial and antifungal activities of lepachol and beta-lapachone. Planta Med. 1994;60:373-4.
12. Austin FG. Schistosoma mansoni chemoprophylaxis with dietary lapachol. Am Trop Med Hyg. 1974;23:412-19.
13. Genet J. [Natural remedies for vaginal infections]. Sidahora. 1995 Winter:40-1.
14. Portillo A, Vila R, Freixa B, et al. Antifungal activity of Paraguayan plants used in traditional medicine. J Ethnopharmacol. 2001 Jun;76(1):93-8.
15. Herbal Remedies. Pau d'arco: A Natural Wart Remedy. http://www.eherbalhealth.com/wart-remedy.html. Accessed June 15, 2009.
16. Healthy Heart & Associates. Pau D' Arco Anti-Fungal Natural Herbal Supplement. http://healthyheartht.info/paudarco.htm. Accessed June 15, 2009.
17. Rain Tree Nutrition. Database entry for Pau d'arco – Tebebuia impetiginosa. From The Healing Power of Rainforest Herbs. http://www.rain-tree.com/paudarco.htm. Accessed June 15, 2009.
18. Herbs2000.com. Warts.  http://www.herbs2000.com/disorders/warts.htm. Accessed June 15, 2009.
19. Paudarco.org. Get the facts on Pau d'Arco. http://www.paudarco.org. Accessed June 15, 2009.
20. Guerra MO, Mazoni AS, Brandao MA, et al. Interceptive effect of lapachol in rats. Contraception 1999;60:305-307.

21.  Guo, R.; Canter, P.H.; /Ernst, E.  Herbal medicines for the treatment of rhinosinusitis: a systematic review.  Otolaryngoly Head  Neck Surgery 2006 Oct;135(4):496-506.\

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies and what our clinical advisors have found to be efficacious in their personal practice into a visual and easy to interpret format. This tool is meant to simplify the information on supplements and therapies that demonstrate promise in the treatment of certain conditions.

 

Condition

Rating

Explanation

Athlete’s Foot  
Preliminary studies indicate potential efficacy of anti-fungal and anti-inflammatory properties. (11-13)
 Bronchitis  

 Traditional medicine indicates efficacy as natural remedy. But scientific evidence is lacking. Research is needed to confirm or refute efficacy. (21)
 

Cancer

   

Evidence is conflicting. More research is needed to confirm or refute efficacy. (3-8)

 Cough  
Traditional medicine indicates efficacy as natural remedy. But scientific evidence is lacking. Research is needed to confirm or refute efficacy. (19)
 Warts  
Scientific evidence is lacking. However, historic use as natural remedy indicates potential efficacy. Research is needed to confirm or refute efficacy. (15-18)


Yeast infection (vaginal)   Date Published: 04/19/2005
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