Dandelion

• How It Works

  Dandelion has not been shown to treat or prevent cancer.

  Dandelion is used in traditional medicine to treat many ailments. Laboratory studies have shown that dandelion can kill certain bacteria and other microbes. It was also found to have anticancer properties in various cancer cells, but studies have not been conducted in humans. Dandelion has estrogenic activity and therefore may increase the growth of hormone-sensitive cancer cells. Dandelion can also promote urination.

• Purported Uses
  • To treat cancer
    Laboratory studies have shown dandelion to have anticancer properties, but clinical studies have not shown this effect in humans.
  • To treat diabetes
    Laboratory studies have shown dandelion to lower blood sugar, however no clinical studies have evaluated its effects in diabetic humans.
  • To stimulate lactation
    Dandelion is used in Chinese medicine to promote lactation. Scientific evidence to support this use is lacking.
  • To treat jaundice and other liver diseases
    There are no studies to evaluate this use.
  • To promote urination
    Extracts of dandelion may increase the frequency of urination.
• Do Not Take If
  • You have hormone-sensitive cancers: In vitro studies suggest dandelion may increase the growth of these cancer cells.
  • You have chronic kidney disease: Dandelion tea contains high level of oxalates which can accumulate in patients with compromised kidney function leading to toxicity.
  • You are taking immunosuppressive agents: A case report of toxic blood levels of immunosuppressive agents in a kidney transplant patient was attributed to use of tea containing dandelion.
  • You are taking cytochrome P450 substrate drugs: In vitro and animal studies suggest dandelion may alter blood levels of CYP3A4 and CYP1A2 substrate drugs. In addition, there was a case report of toxic blood levels of immunosuppressive agents that was attributed to use of tea containing dandelion.
  • You are taking lithium: Animal and human studies suggest dandelion has diuretic activity and may increase sodium depletion.
  • You are taking diuretic drugs: Animal and human studies suggest dandelion may increase diuretic effects.
  • You are taking hypoglycemic drugs: Theoretically, dandelion may lower blood sugar levels.
• Side Effects
  • • Heartburn
    • Stomach inflammation
    • Mild diarrhea
    • Low blood sugar

    Case reports

    • Bladder inflammation: In a 33-year-old woman who used a slimming product containing dandelion. Symptoms resolved after product discontinuation.
    • Gangrene of the fingers: In a 56-year-old man with chronic kidney disease after intake of large quantities of dandelion tea due to accumulation of oxalates.
    • Rare allergic reactions: Including red, itchy bumps; children may be more prone to allergies with dandelion.
    • Toxic blood levels of immune suppressant drugs: In a kidney transplant recipient, that occurred after consumption of a tea that contained dandelion, which inhibits an enzyme used in the metabolism of these drugs.
• Special Point

  Dandelion was determined to be an important allergen in children.

• Scientific Name

  Taraxacum mongolicum, Taraxacum officinale

• Clinical Summary

  Dandelion is related to the daisy family and commonly found worldwide. The flower, leaf and root of this plant are used in traditional medicine for their diuretic, cholagogic, antirheumatic and appetite-stimulating properties ⁽²³⁾. In Chinese Medicine, the herb has been used to promote lactation. It is also used to reduce abscesses, especially in the breast and intestines ⁽²⁾.

  In vitro and in vivo studies suggest that dandelion has lipid-lowering ⁽¹³⁾, hepatoprotective ⁽¹⁴⁾, and antiviral ^(15) (16) properties. It also has anticoagulant ⁽⁵⁾, diuretic ⁽¹⁰⁾, anti-inflammatory ⁽¹⁴⁾, and antioxidant ⁽⁴⁾ activities. Dandelion root extract has anticancer effects against melanoma ⁽³⁾ and leukemia ⁽²⁶⁾, as well as pancreatic ⁽¹⁷⁾ and colorectal ⁽²⁵⁾ cancer cell lines.

  Dandelion has estrogenic activity. Preclinical studies suggest increased proliferation of hormone-sensitive breast cancer cells as well as increased uterine weight in immature female rats ⁽²⁴⁾. In addition, it can cause allergic reactions and may interact with some prescription drugs. There have been a few case reports of potential benefit in patients with blood cancers ⁽²⁹⁾, but it is unclear whether this was definitively due to dandelion supplementation. Clinical trials are needed to determine the conditions under which dandelion may be safe and effective.

• Purported Uses
  • Cancer treatment
  • Diabetes
  • Lactation stimulation
  • Liver disease
  • Promote urination
• Mechanism of Action

  The diuretic activity of dandelion may be a result of its high potassium content ⁽²³⁾. In murine models of diet-induced fatty liver disease, dandelion leaf extract exihibited hepatoprotective effects with decreased serum levels of ALT, hepatic TG, and MDA, as well as TNF-alpha and IL-6 expression ⁽¹⁴⁾. At the post-transcriptional level, antioxidant and anti-inflammatory properties were exihibited via decreased activation of procaspase-3 to active caspase-3, and JNK phosphorylation ⁽¹⁴⁾. Linoleic acid, phytol and tetracosanol have been identified as bioactive compounds, with hypolipidemic effects occurring via AMP-activated protein kinase activation in human HepG2 cells ⁽¹³⁾.

  Dandelion has been shown to decrease human hepatoma cell line viability by increasing tumor necrosis factor-alpha and interleukin-1alpha production ⁽⁹⁾. Other research has shown that the presence of luteolin and luteolin 7-glucoside in dandelion flower extract exhibits cytotoxic activities against the colon adenocarcinoma cell line (Caco-2) ⁽⁴⁾. An isolated compound identical to lupeol, a lupane-type triterpene, inhibited cell growth and induced melanogenesis in a mouse melanoma cell line ⁽³⁾.

  Sesquiterpene lactones are thought to be the allergenic compounds in dandelion ⁽⁷⁾.

• Adverse Reactions

  Oral: Heartburn, stomach inflammation, dyspepsia; mild diarrhea with overdosage ⁽²⁾; hypoglycemia ⁽¹¹⁾.
  Contact dermatitis: Can be more common in children from exposure to dandelion ⁽²²⁾.

  Case reports
  Hemorrhagic cystitis: In a 33-year-old woman following use of a slimming product containing dandelion. Symptoms resolved after product discontinuation ⁽¹²⁾.
  Toxic blood levels of immunosuppressive agents: In a kidney transplant recipient, that occurred after consumption of a tea which contained dandelion ⁽¹⁹⁾. In vitro, dandelion tea extract inhibited CYP3A4, which is used in the metabolism of these drugs ⁽²⁰⁾.
  Digital necrosis: In a 56-year-old man with chronic kidney disease, cutaneous manifestations of hyperoxaluria related to high intake of dandelion tea (10–15 cups daily for 6 months) ⁽²¹⁾.
  Contact dermatitis: In a 7-year-old boy, which improved by avoidance of handling plants ⁽⁷⁾.

• Herb-Drug Interactions
  • Diuretics: Animal and human studies suggest dandelion may have additive effects due to its diuretic activity ^(10) (23).
  • Hypoglycemics: In vitro and in vivo studies suggest dandelion may have additive effects due to its hypoglycemic property ⁽²³⁾.
  • Cytochrome P450 (CYP) 1A2, 3A4 substrates: In animal and in vitro studies respectively, dandelion inhibited CYP1A2 ⁽²⁸⁾ and CYP3A4 ⁽²⁰⁾ activities, which may result in altered blood levels of substrate drugs. In addition, a case report of toxic blood levels of immunosuppressive agents was attributed to consumption of tea containing dandelion ⁽¹⁹⁾.
  • UDP-glucuronosyl transferase (UGT) substrates: Animal studies suggest dandelion induces UGT activity ⁽²⁸⁾ and may increase blood levels of substrate drugs.
• References

  1. Barnes J, Anderson LA, Phillipson JD. Herbal Medicines. London: Pharmaceutical Press, 2002.

  2. Benky D, Clavey S, Stöger E. Chinese Herbal Medicine, Materia Medica. 3^rd Edition Seattle, WA: Eastland Press, Inc, 2004.

  3. Hata K, Ishikawa K, Hori K, Konishi T. Differentiation-inducing activity of lupeol, a lupane-type triterpene from Chinese dandelion root (Hokouei-kon), on a mouse melanoma cell line. Biol Pharm.Bull. 2000;23:962-7.

  4. Hu C,.Kitts DD. Antioxidant, prooxidant, and cytotoxic activities of solvent-fractionated dandelion (Taraxacum officinale) flower extracts in vitro. J Agric.Food Chem. 2003;51:301-10.

  5. Yun SI, Cho HR, Choi HS. Anticoagulant from Taraxacum platycarpum. Biosci.Biotechnol.Biochem. 2002;66:1859-64.

  6. Brinker F. Herb Contraindications And Drug Interactions. Sandy, OR: Eclectic Medical Publications, 2001.

  7. Wakelin SH, Marren P, Young E, Shaw S. Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy. Br J Dermatol 1997;137:289-91.

  8. Choi JH, Shin KM, Kim NY, Hong JP, Lee YS, Kim HJ et al. Taraxinic acid, a hydrolysate of sesquiterpene lactone glycoside from the Taraxacum coreanum NAKAI, induces the differentiation of human acute promyelocytic leukemia HL-60 cells. Biol Pharm.Bull. 2002;25:1446-50.

  9. Koo HN, Hong SH, Song BK, Kim CH, Yoo YH, Kim HM. Taraxacum officinale induces cytotoxicity through TNF-alpha and IL-1alpha secretion in Hep G2 cells. Life Sci. 2004 Jan 16;74(9):1149-57.

  10. Clare BA, Conroy RS, Spelman K. The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day. J Altern Complement Med. 2009 Aug;15(8):929-34.

  11. Goksu E, Eken C, Karadeniz O, Kucukyilmaz O. First report of hypoglycemia secondary to dandelion (Taraxacum officinale) ingestion. Am J Emerg Med. 2010 Jan;28(1):111.e1-2.

  12. Catania MA, Oteri A, Caiello P, et al. Hemorrhagic cystitis induced by an herbal mixture. South Med J. 2010 Jan;103(1):90-2.

  13. Liu YJ, Shieh PC, Lee JC, et al. Hypolipidemic activity of Taraxacum mongolicum associated with the activation of AMP-activated protein kinase in human HepG2 cells. Food Funct. Aug 2014;5(8):1755-1762.

  14. Davaatseren M, Hur HJ, Yang HJ, et al. Dandelion leaf extract protects against liver injury induced by methionine- and choline-deficient diet in mice. J Med Food. Jan 2013;16(1):26-33.

  15. Jia YY, Guan RF, Wu YH, et al. Taraxacum mongolicum extract exhibits a protective effect on hepatocytes and an antiviral effect against hepatitis B virus in animal and human cells. Mol Med Rep. Apr 2014;9(4):1381-1387.

  16. Liu J, Zhang N, Liu M. A new inositol triester from Taraxacum mongolicum. Nat Prod Res. 2014;28(7):420-423.

  17. Ovadje P, Chochkeh M, Akbari-Asl P, et al. Selective induction of apoptosis and autophagy through treatment with dandelion root extract in human pancreatic cancer cells. Pancreas. Oct 2012;41(7):1039-1047.

  18. Mingarro DM, Plaza A, Galan A, et al. The effect of five Taraxacum species on in vitro and in vivo antioxidant and antiproliferative activity. Food Funct. Aug 2015;6(8):2787-2793.

  19. Kwan LP, Mok MM, Ma MK, et al. Acute drug toxicity related to drinking herbal tea in a kidney transplant recipient. Ren Fail. Mar 2014;36(2):309-312.

  20. Dufay S, Worsley A, Monteillier A, et al. Herbal tea extracts inhibit Cytochrome P450 3A4 in vitro. J Pharm Pharmacol. Oct 2014;66(10):1478-1490.

  21. Moriarty B, Pinney JH, Owen-Casey MP, et al. Digital necrosis from dandelion tea. Br J Dermatol. Jul 2013;169(1):227-230.

  22. Paulsen E, Andersen KE. Sensitization patterns in Compositae-allergic patients with current or past atopic dermatitis. Contact Dermatitis. May 2013;68(5):277-285.

  23. Martinez M, Poirrier P, Chamy R, et al. Taraxacum officinale and related species-An ethnopharmacological review and its potential as a commercial medicinal plant. J Ethnopharmacol. Jul 1 2015;169:244-262.

  24. Oh SM, Kim HR, Park YJ, et al. Ethanolic extract of dandelion (Taraxacum mongolicum) induces estrogenic activity in MCF-7 cells and immature rats. Chin J Nat Med. 2015 Nov;13(11):808-14. doi: 10.1016/S1875-5364(15)30084-4.

  25. Ovadje P, Ammar S, Guerrero JA, et al. Dandelion root extract affects colorectal cancer proliferation and survival through the activation of multiple death signalling pathways. Oncotarget. 2016 Aug 22.

  26. Ovadje P, Hamm C, Pandey S. Efficient induction of extrinsic cell death by dandelion root extract in human chronic myelomonocytic leukemia (CMML) cells. PLoS One. 2012;7(2):e30604. doi: 10.1371/journal.pone.0030604.

  27. Ovadje P, Chatterjee S, Griffin C. et al. Selective induction of apoptosis through activation of caspase-8 in human leukemia cells (Jurkat) by dandelion root extract. J Ethnopharmacol. 2011 Jan 7;133(1):86-91. doi: 10.1016/j.jep.2010.09.005.

  28. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol. 2001 Oct;53(10):1323-9.

  29. Rahmat LT, Damon LE. The Use of Natural Health Products Especially Papaya Leaf Extract and Dandelion Root Extract in Previously Untreated Chronic Myelomonocytic Leukemia. Case Rep Hematol. 2018;2018:7267920.