Cascara Sagrada

Plant Part Used

Aged bark

Introduction

Native Americans in California introduced this herb, which they called sacred bark, to 16th-century Spanish explorers. Being much milder in its laxative action than the herb buckthorn, cascara became popular in Europe as a treatment for constipation and has been in medical use in the U.S. since 1890.

Cascara traditionally has been used to treat certain gallbladder disorders, digestive problems, hemorrhoids, skin problems, intestinal parasites, jaundice, and colitis.

Interactions and Depletions

Interactions


Depletions

Dosage Info

Dosage Range

100-300mg daily; do not recommend taking longer than 7-10 days without seeking medical advice.

Tea: One cup, 2 times daily using 2 gm fresh herb per cup. (1)

Most Common Dosage

100mg daily; do not recommend taking longer than 7-10 days without seeking medical advice.

Tea: One cup 2 times daily using 2 gm fresh herb per cup.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 20-30mg of hydroxyanthracene derivatives per dose.

Reported Uses

Cascara is chiefly known for its traditional use as a natural laxative. In fact, cascara is similar in composition to ingredients that are widely used in nonprescription stimulant laxatives.

In addition to its laxative effects, cascara may, according to several studies, contain a component that may have antiviral properties. (2) , (3) Yet another component may have anti-inflammatory, antibiotic, and anti-tumor properties. (4) , (5)

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

This dietary supplement is considered safe when used in accordance with proper dosing guidelines. (6)

Do not take this dietary supplement longer than 7-10 days without seeking medical advice.

Health Conditions

If you have an intestinal obstruction, appendicitis, ulcerative colitis, diarrhea or dehydration do not use this dietary supplement. (7)

Side Effects

Animal studies have reported a potential role of anthranoid laxatives in both the initiation and promotion of tumorigenesis in the GIT; however, a recent human study reported no adverse effects on GI health. (8) , (9) , (10) Short-term use of cascara sagrada is generally safe, long-term use cannot be recommended.

Pregnancy/ Breast Feeding

To date, the medical literature has not reported any adverse effects related to fetal development during pregnancy or to infants who are breast-fed. Yet little is known about the use of this dietary supplement while pregnant or breast-feeding. Therefore, it is recommended that you inform your healthcare practitioner of any dietary supplements you are using while pregnant or breast-feeding.

Age Limitations

This dietary supplement should not be used in children under 12 years of age unless recommended by a physician.

References

  1. PDR for Herbal Medicines, 2nd edition. Montvale, NJ: Medical Economics Company; 2000:155.
  2. View Abstract: Andersen DO, et al. In vitro virucidal activity of selected anthraquinones and anthraquinone derivatives. Antiviral Res. Sep1991;16(2):185-96.
  3. View Abstract: Sydiskis RJ, et al. Inactivation of enveloped viruses by anthraquinones extracted from plants. Antimicrob Agents Chemother. Dec1991;35(12):2463-6.
  4. View Abstract: Goel RK, et al. Antiulcerogenic and anti-inflammatory effects of emodin, isolated from Rhamnus triquerta wall. Indian J Exp Biol. Mar1991;29(3):230-2.
  5. View Abstract: Jin ZH, et al. Study on effect of emodin on the isolated intestinal smooth muscle of guinea-pigs. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih. Jul1994;14(7):429-31.
  6. LaValle JB, et al. Natural Therapeutics Pocket Guide. Hudson, OH: LexiComp Inc;2000:404.
  7. View Abstract: Izzo AA, Sautebin L, Rombola L, Capasso F. The role of constitutive and inducible nitric oxide synthase in senna- and cascara-induced diarrhoea in the rat. Eur J Pharmacol. Mar1997;323(1):93-7.
  8. View Abstract: Nadir A, Reddy D, Van Thiel DH. Cascara sagrada-induced Intrahepatic Cholestasis Causing Portal hypertension: Case Report and Review of Herbal Hepatotoxicity. Am J Gastroenterol. Dec2000;95(12):3634-7.
  9. View Abstract: Van Gorkom BA, et al. Review article: anthranoid laxatives and their potential carcinogenic effects. Aliment Pharmacol Ther. Apr1999;13(4):443-52.
  10. View Abstract: Nusko G, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut. May2000;46(5):651-5.