Myrrh

• How It Works

  Myrrh has been used in traditional medicine for its anti-inflammatory effects, but studies are very limited.

  Myrrh is an extract of a tree gum resin that has been used as a fragrance for centuries. It has also been used medicinally, and recent laboratory studies in animals have shown certain biological activities. Myrrh extracts may protect against damage to the stomach mucus lining from substances such as non-steroidal anti-inflammatory drugs (NSAIDs) and alcohol. It may also have antioxidant properties and stimulate the thyroid gland. In animal studies, myrrh reduces inflammation and fevers. Other experiments suggest slowing of cancer growth in mice, and decreased spread or cell death in isolated cancer cells. It is unknown, however, if these effects can occur in humans.

  Only a few small studies have been conducted in humans, some of which were herbal preparations that included other compounds. Additional studies are needed to determine myrrh’s utility for various conditions.

• Purported Uses
  • To treat asthma
    Experiments in animals suggest that myrrh might reduce inflammation.
  • To treat coughs
    No scientific evidence supports this use.
  • To treat gastrointestinal disorders and indigestion
    Animal studies suggest myrrh extracts may protect against damage to the stomach lining.
  • To reduce inflammation
    Experiments in animals suggest that myrrh might reduce inflammation.
  • To treat sexually transmitted disease
    A small study showed that myrrh may be effective in treating trichomoniasis vaginalis.
• Do Not Take If
  • You are taking warfarin: Myrrh may reduce the therapeutic effects of warfarin.
  • You have sensitive skin: Topical myrrh products can cause irritation.
• Side Effects
  • High doses of myrrh can affect heart rate.
  • Topical myrrh products can cause skin redness, swelling, and itching.

  Case reports

  Acute abdominal pain: In a pregnant woman who used large amounts of myrrh herbs. Symptoms ended after myrrh was discontinued.

  Skin reaction after oral myrrh: Diagnosed by patch test, after taking a traditional Chinese medicine formula.

• Scientific Name

  Commiphora molmol

• Clinical Summary

  Myrrh is the oleo gum resin obtained from Commiphora species, and is well known as a fragrance used in perfumes and incense. It is also used in traditional medicine for treating inflammation, stomach problems, asthma, and other bronchial conditions.

  Preclinical studies suggest that myrrh has anti-inflammatory, cytotoxic ⁽¹³⁾, anti-trichomoniasis ⁽¹⁴⁾, and antipyretic effects ⁽²⁾. Constituents of myrrh have also been shown to inhibit certain cancers ^{(3) (4) (5) (12)}, but human data are lacking.

  A small study showed effectiveness of myrrh against trichomoniasis vaginalis in affected women ⁽¹⁵⁾. Preliminary studies of different herbal preparations containing myrrh suggest potential benefit as maintenance therapy in patients with ulcerative colitis ⁽¹⁶⁾ and in women with type 2 diabetes ⁽¹⁷⁾, but additional studies are needed.

• Purported Uses
  • Asthma
  • Cough
  • GI disorders
  • Indigestion
  • Inflammation
  • Sexually transmitted disease
• Mechanism of Action

  In animal studies, an aqueous suspension of C. molmol protected against gastric mucosal damage from NSAIDs and ethanol ⁽⁷⁾. C. molmol may have free radical-scavenging, thyroid-stimulating, and prostaglandin-inducing properties. These effects are caused by increased mucus production, and nucleic acid and non-protein sulfhydryl concentrations. Aqueous extracts of myrrh may induce hepatic microsomal enzymes, causing a more rapid metabolism of warfarin ⁽¹⁰⁾.

  C. molmol inhibits the growth of Ehrlich carcinoma cells in mice ⁽⁴⁾. The cytotoxic activities appear to be as effective as cyclophosphamide in solid tumor-bearing mice. In one study, Na, K and Ca levels in cancer cells were reduced by treatment with C. molmol, leading to inhibition of cellular proliferation and tumor growth ⁽³⁾. Another in vitro study found that myrrh gum had tumoricidal effects against a malignant murine neuroblastoma cell line ⁽⁵⁾. The antiproliferative activity of sesquiterpenoids ST1 and ST2 from myrrh in human prostate cancer cells may occur through androgen receptor signaling inhibition ⁽¹²⁾.

• Contraindications

  Patients who have sensitive skin should avoid topical products containing myrrh ⁽⁶⁾.

• Adverse Reactions
  • High doses may affect heart rate ⁽⁵⁾.
  • Topical preparations containing myrrh may cause contact dermatitis ⁽⁶⁾.

  Case reports

  Acute abdominal pain: In a 32-year-old pregnant woman with a history of infertility and miscarriages who used large amounts of myrrh herbs for 2 months based on traditional healing advice. Symptoms ended after myrrh was discontinued, and myrrh acting as a uterine stimulant was a suspected cause ⁽¹⁸⁾.

  Non-immediate cutaneous reaction to oral intake of myrrh: In the form of a traditional Chinese medicine decoction and diagnosed via patch test ⁽¹⁹⁾.

• Herb-Drug Interactions

  Warfarin: A published case report describes the antagonism of the anticoagulant effects of warfarin after a patient began concomitantly taking C. molmol ⁽¹⁰⁾.

• References

  1. DerMarderosian A, editor. The Review of Natural Products. St. Louis: Facts and Comparisons; 1999.

  2. Tariq M, et al. Anti-inflammatory activity of Commiphora molmol. Agents Actions 1986;17:381-2.

  3. Qureshi S, et al. Evaluation of the genotoxic, cytotoxic, and antitumor properties of Commiphora molmol using normal and Ehrlich ascites carcinoma cell-bearing Swiss albino mice. Cancer Chemother Pharmacol 1993;33:130-8.

  4. al Harbi MM, et al. Anticarcinogenic effect of Commiphora molmol on solid tumors induced by Ehrlich carcinoma cells in mice. Chemotherapy 1994;40:337-47.

  5. Mazzio EA and Soliman KF. In vitro screening for the tumoricidal properties of international medicinal herbs. Phytother Res. 2009;23(3):385-398.

  6. Lee TY, Lam TH. Allergic contact dermatitis due to a Chinese orthopaedic solution tieh ta yao gin. Contact Dermatitis 1993;28:89-90.

  7. al Harbi MM, et al. Gastric antiulcer and cytoprotective effect of Commiphora molmol in rats. J Ethnopharmacol 1997;55:141-50.

  8. Brinker F. Herb Contraindications and Drug Interactions, 3^rd ed. Sandy (OR): Eclectic Medical Publications; 2001.

  9. Barnes J, et al. Herbal Medicines. Second Ed. London: Pharmaceutical Press; 2002.

  10. Al Faraj S. Antagonism of the anticoagulant effect of warfarin caused by the use of Commiphora molmol as a herbal medication: a case report. Ann Trop Med Parasitol. 2005 Mar;99(2):219-20.

  11. Gruenwald J, et al. PDR for Herbal medicines, 2^nd ed. Montvale (NJ): Medical Economics Company; 1998.

  12. Wang XL, Kong F, Shen T, et al. Sesquiterpenoids from myrrh inhibit androgen receptor expression and function in human prostate cancer cells. Acta Pharmacol Sin. 2011 Mar;32(3):338-44.

  13. Tipton DA, Lyle B, Babich H, Dabbous MKh. In vitro cytotoxic and anti-inflammatory effects of myrrh oil on human gingival fibroblasts and epithelial cells. Toxicol In Vitro. 2003 Jun;17(3):301-10.

  14. El-Sherbini GT, El Gozamy BR, Abdel-Hady NM, Morsy TA. Efficacy of two plant extracts against vaginal trichomoniasis. J Egypt Soc Parasitol. 2009 Apr;39(1):47-58.

  15. El-Sherbiny GM, El Sherbiny ET. The Effect of Commiphora molmol (Myrrh) in Treatment of Trichomoniasis vaginalis infection. Iran Red Crescent Med J. 2011 Jul;13(7):480-6.

  16. Langhorst J, Varnhagen I, Schneider SB, et al. Randomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis—a double-blind, double-dummy study. Aliment Pharmacol Ther. Sep 2013;38(5):490-500.

  17. Shokoohi R, Kianbakht S, Faramarzi M, et al. Effects of an Herbal Combination on Glycemic Control and Lipid Profile in Diabetic Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Evid Based Complementary Altern Med. Oct 2017;22(4):798-804.

  18. Al-Jaroudi D, Kaddour O, Al-Amin N. Risks of Myrrh usage in pregnancy. JBRA Assist Reprod. Dec 1 2016;20(4):257-258.

  19. Xu YY, Li L, Xuan L, et al. Patch test diagnosis of non-immediate cutaneous reaction to myrrh following oral intake of a traditional Chinese medicine decoction. Contact Dermatitis. Feb 2019;80(2):135-136.