Q. I have read in your column that Pycnogenol may be helpful for hot flashes. Now a major warehouse club is selling it as a powerful antioxidant that is supposed to have beneficial effects on cardiovascular health, osteoarthritis, skin care, asthma and allergy relief and diabetes. Has any of this been proven? Are there any health risks associated with its use? I love your columns and cut them out weekly to give to friends, family and co-workers.

A. To our surprise, there are studies suggesting that Pycnogenol, extracted from French maritime pine bark, is better than placebo in making blood vessels more flexible (Hypertension Research, Sept. 2007), improving blood sugar control and reducing cardiovascular risk factors (Nutrition Research, May 2008) and reducing knee pain from osteoarthritis (Phytotherapy Research, August 2008).

Any uses it may have for skin care or asthma and allergy relief still seem fairly speculative. Side effects are uncommon, but it may interact with important immune-suppressant drugs such as cyclosporine, CellCept, tacrolimus, sirolimus or prednisone.

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  1. Barbara F.

    I am having good results managing my cat’s asthma symptoms by administering 12.5 mg of pycnogenol to her daily (hidden in a teaspoon of raw ground turkey, which I freeze in ice cube trays and then thaw a daily portion). It does not have an overly bitter taste, so is easy to administer in her food. She weighs about 8 pounds, so I am giving her 1.5 miligrams per pound. I also give her inhaled Flovent daily, but no longer have to give her daily rescue albuterol for breakthrough coughing episodes. I may try to reduce her inhaled Flovent to see how she does.

  2. nln

    Is it safe to take Pycnogenol with a Turmeric supplement?
    People’s Pharmacy response: We don’t know of any interaction.

  3. MJB

    Can I take Pycnogenol if I have internal bleeding? I have had internal bleeding twice in three years and just had another transfusion. I can not take aspirin. I have high BP and high cholesterol. I have had twelve upper and lower GI’s and am getting ready to swallow the pill camera for the 2nd time. They can’t find where I am bleeding.
    I had a benign brain tumor in 2005 and have had my right knee replaced twice. I have had two previous sinus surgeries and am experiencing a mucus that bothers me continually. I read that grape seed also might help me. I am tired of feeling “”ill”” all the time. I am a busy person and have a lot to do. I do not sit around and feel sorry for myself. But, I do need to find something that will help me feel better. I appreciate any help you can give me.
    Thank you,

  4. Dr. Charles MD, PhD

    Pycnogenol can be used for:
    1) Venous stasis based edema of the lower legs / feet – best if combined with CoQ10
    2) Acute rhinosinusitis (the most common cause of absenteeism from manufacturing industry and probably in many work settings – if you’ve ever had an acutely stuffy nose and sinus pain with a cold you know how disabling this can be); It also can be used for rx / decongestion in chronic rhinosinusitis that can be a precursor otherwise for having sinus surgery)
    3) Erectile dysfunction when combined with Magnesium/zince/calcium + CoQ10, one of each one hour before bedtime. In the literature it is also combined with L-arginine for an anti-endothelial dysfunction effect, a major cause of Erectile Dysfunction – “ED causes ED”.
    4) Cough variant asthma (“reactive airways” where a child or adult gets severe coughing spells during and after a cold. Best combined with Buckwheat honey for a maximal anti-cough and pro-sleep effect (when coughing might otherwise cause very poor sleep, especially in children). Do not give honey to a child less than one year old because of the occurrence of a very rare form of botulism in that age group. Children love to take Buckwheat honey with Strawberries. Do not exceed 1 mg per kg body weight for the Pynogenol in kids. As noted above it can also be used as an adjunct rx for run of the mill asthma. It (Pycnogenol) can be used in acute care settings for the rx of asthma exacerbation treatment in urgent care settings – 200 mg first dose in acute care followed by 100 mg twice a day for 3-5 days. Interestingly it has an anti-virus effect and probably shortens the course of some common viral upper respiratory infections (that can induce “reactive airways” in many people.
    5) As an rx for ADHD substituting for stimulants in severe European studies. Not used typically in this country at all by physicians to substitute for stimulants. Of interest is the tendency of some would be athletes with ADHD to decline to use stimulants because of their affects (positive and negative) on athletic performance. Pycnogenol has been studied in a double blind wash-out cross-over study in young adults (20’s) and found to enhance maximum oxygen consumption by 20 to 30% in this group. It probably does it, in part, by its interaction with CoQ10 in mitochondria and thereby enhances the production of ATP in mitochondria. One hypothesis about ADHD involves altered energy production and altered regional blood flow, both of which pycnogenol can affect positively. Pycnogenol does not act as a classical stimulant such as Ritalin.
    6) Rx for disabling menopausal symptoms. This usually requires a dose of 100 mg twice a day. I have had patient come back to see me after successfully trying the 100 mg twice a day dose for severe hot flash symptoms and unsuccessfully trying the 100 mg a day dose. It can work to completely eliminate hot flash symptoms per a lot of my patients. For a significant number of my patients it spares them the risk of taking hormone therapy as long as they take the dose shown in one randomized control trial from Taiwan to work for peri-menopausal symptoms – 200 mg per day. I ask patients to take 100 mg after Breakfast and 100 mg after the evening meal that contains black pepper that helps with the absorption of Pycnogenol (in my opinion) and definitely helps with the absorption of CoQ10 according to the literature.
    7) It probably has efficacy in moderating the most common disease known to man and beast – gingivitis. It, along with CoQ10, has literally brought some of my congestive heart failure patients back from near certain death. It has not been helpful for my “pure COPD patients” with severe shortness of breath.
    How does it do all of the above and probably more? Likely, in my opinion, because of its anti-endothelial dysfunction, anti-inflammation, anti-oxidative stress effects (among other big time anti-basic pathophysiology effects such as being anti-viral and anti-coagulation of blood). It should not be combined with certain drugs as noted above and it should not be combined, usually, with warfarin or other major anti-coagulants because of potentiating an increased risk of bleeding complications with the anticoagulants. Out of the hundreds and hundreds of my patients who have used it only one had anything close to an adverse effect and that person had multiple, multiple drug and other allergies. This is not to say it could not have a serious adverse effect in some individuals. I tell my patients I take it myself for my asthma and chronic rhinosinusitis AND I tell them, “If I was stranded on a desert island and could choose to have one over-the-counter with me, it would be Pycnogenol or pine bark extract”.

  5. sanya

    Am taking pycnogenol to help with prevent thrombosis (my grand father, father and uncle have it). But have now been put on fenofibrate to increase my HDL. Will this affect in anyway? Am only on fenofibrate (fenoflex brand 160mg) 3 x a week.

  6. jj

    My daughter is 5years old. She has viral-induced asthma. She gets colds all the time. do you know if kids can take Pycnogenol? How much do they take? Where do I get the medicine? Thanks.
    PEOPLE’S PHARMACY RESPONSE: KIDS CAN TAKE PYCNOGENOL AS THEY DID IN THIS STUDY: http://informahealthcare.com/doi/abs/10.1081/JAS-200038433

  7. BA

    What brand of pine bark extract are you using and where did you get it?
    Thank you!

  8. DJ

    I have been on Evista for invasive breast cancer prevention for 2 years after surgery and radiation for DCIS (pre cancer in breast) and have suffered the whole time with terrible hot flashes. One month ago I tried pine bark extract after trying everything else from antidepressants to sleeping pills to herbs, etc. Some helped but none gave me relief at night when I most needed it. I hadn’t had a good night’s sleep for years.
    I am now taking 150 mg of pine bark extract and it has worked wonders! Good bye hot flashes!! I pray it continues to work.

  9. g.friedman

    After years of being prescribed Prednisone about every other month, I have been asthma-free for six months–a record for me. Prednisone has many ill side effects such as raising BP, BS, sleepless nights. Prednisone serves to quiet the inflammation in the lung area and it does it quite well. However, now that I am taking the Pycnogenol twice a day, it has quieted down my lungs and has greatly deceased the productive cough that I have suffered with for years.
    Although my doc poo-poos the pycnogenol (placebo effect??) I do not agree.
    He has stated that I am one of the very few in his practice that had not been sick with virus-induced asthma throughout October and November. This supplement does for me what prednisone does–but without all the side effects and may also give me some other health benefits along the way.
    In time, I will be on decreased dosages of Advair and that has been a goal all along. If I miss the pycnogenol, I can see that the mucus production immediately begins to increase! I am so happy that I have found something that also has a science-based study to show that it can, indeed, be useful in the treatment of asthma.

  10. JAS

    Pychogenol is available at GNC stores and also at many drugstores in the vitamin, etc. area. It may be available at your grocery store pharmacy as well. It is not prescription. Jo

  11. Brent B.

    I’ve also had great results with Nature’s Way products. And the benefits of Pycnogenol (including stronger blood vessels) can also be achieved with grape seed extract, which is generally less expensive. Both products are a great source of antioxidants. I believe the explorer Jacques Cartier actually used pine trees as a source of vitamin C to prevent scurvy!
    Both products definitely work well to control or eliminate my asthma symptoms, but more as part of a comprehensive supplementary arsenal. If you continue to eat inflammatory foods (like white flour and sugar), obviously you will keep getting inflammatory symptoms.
    You might also want to try cherries and ginger for pain/inflammation relief. Since discovering ginger beer years ago, I drink just a bit every day at night for a tonic. Americans would do well to emulate the majority of the world’s embrace of healthy natural medicine, rather than continue down the dead-end path of drug destruction!

  12. ginny s.

    A couple years after I retired my cholesterol level for the first time was a little higher than it should be. I started taking Pycnogenol (brand: Nature’s Life).
    When I had it tested again 6-months later I was back to a normal level. A couple years later when I moved to another town my routine was different and I was only taking the Pycnogenol maybe once a week … level back up … since then I am careful to make sure I take it daily… level back to normal. I don’t think Pycnogenol works for everyone but it does for me. I make sure I always take the same brand.

  13. Fred S.

    What is “Pycnogenol”?.. Can it be purchased over-the-counter or is it prescribed? I have painful knee problems and would like to give it a try. Hope to receive an answer by E-mail. Thanks.

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