Gentian (Gentiana lutea)

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Amarogentin, bitter root, bitterwort, centiyane, gallweed, gelber Enzian (German), gele gentian (Dutch), genciana (Portuguese – Brazil, Spanish), gentian, Gentiana lutea Linné, Gentiana lutea subsp. symphyandra, Gentiana spathacea, Gentianaceae (family), Gentianae radix, gentiane jaune (French), gentiopicroside, gentisin, genziana maggiore (Italian), glycosides, goryczka zółta (Polish), great yellow gentian, gul ensian (Danish), gullgentiana (Swedish), gulsøte (Norwegian), hořec žlutý (Czech), Indian gentian, iridoids, isogentisin, keltakatkero (Finnish), kollane emajuur (Estonian), pale gentian, rumeni svišč (Slavic), sárga swertia (Hungarian), sárga tárnics (Hungarian), secoiridoids, stemless gentian, swert füve (Hungarian), Swertia chirata, xanthone glycosides, xanthones, yellow gentian.

  • Note: Gentiana lutea is not the source of gentian violet. Additionally, yellow gentian and the highly toxic Veratrum album (white hellebore) often grow in close proximity and are easily confused prior to flowering.

  • Combination products: Amaro Medicinale Giuliani (rhubarb extract, cascara extract, gentian tincture, boldo tincture), Sinupret® (European elder, common sorrel, cowslip, European vervain, gentian).

Background

  • Gentiana lutea is known for its bitter root. It has been used for hundreds of years for the digestive system. Supposedly, the action of gentian begins when it is absorbed by the membranes of the mouth. Particles in gentian stimulate the taste buds, causing an increase in saliva, gastric juice, and bile secretion.

  • Available human studies for the traditional uses of gentian are currently lacking. Although gentian has been used traditionally with relative safety, poisoning has been reported with homemade gentian wine contaminated with white hellebore.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Gastrointestinal disorders (stomach and intestine problems)

Herbalists have previously used gentian to stimulate digestion. Gentian also reportedly stimulates the gallbladder and the liver. A study comparing three herbal combinations found that the gentian with rhubarb was most effective at improving symptoms, including loss of appetite and nausea. Additional research is needed in this area.

Saliva production

Herbalists have previously used gentian to stimulate digestion. The bitter parts of gentian may stimulate the taste buds, causing an increase in saliva. A small study found that gentian increases salivation. Additional research is needed in this area.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Anemia (lack of red blood cells), anorexia, antibiotic, antidote to poisons, antifungal, anti-inflammatory, antimicrobial, antioxidant, appetite stimulant, bile secretion, bitter tonic, circulation improvement, conjunctivitis (pink eye), constipation, diarrhea, digestive disorders, digestive tonic, emmenagogue (increased menstruation), endurance, exhaustion, fever reduction, gallbladder disease, gastric acid secretion stimulation, helminthic infections, indigestion, infections, inflammatory skin conditions, jaundice (yellow color of the skin or eyes), liver disease, malaria, menstrual period problems/lack of menstrual period, muscle relaxant, pain relief, pregnancy-induced nausea and vomiting, smoking cessation, sore throat, stimulant, tonic, skin ulcers, urinary tract infections, vomiting, wound care.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • High-quality research on gentian dosing in humans is currently lacking.

  • Dried gentian root and stem, in a dosage of 0.6-2.0 grams, have been boiled in water have been used. Herbal experts suggest boiling one teaspoon of powdered root in two pints of water for 20 minutes.

  • As an extract, 2-10 grains (0.3-0.6 grams), 5-30 minims, or 5-30 drops (0.3-2.0 milliliters) have been used. Doses of 1-4 grams of gentian root have been taken as a digestive tonic daily, as the whole root or the powder.

  • As an alcoholic extract, gentian 20 minutes before each meal, for a total of 1/4-1/2 teaspoon (1.0-3.0 milliliters) daily, has been used.

  • To stimulate the saliva, 40 milliliters of a 2% tincture of gentian has been used daily or every other day for two weeks.

  • Secondary sources note that gentian capsules are generally not suggested, because they move quickly past taste buds and may not stimulate the taste buds.

Children (under 18 years old)

  • There is no proven safe or effective dose for gentian in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in those with known allergy or sensitivity to gentian, its constituents, or members of its botanical family.

Side Effects and Warnings

  • High-quality human studies that document the safety or adverse effects of gentian are currently lacking.

  • Gentian is generally safe when used in amounts normally found in foods. Gentian is possibly safe when used as an alcoholic extract for two weeks to increase salivation.

  • According to secondary sources, stomach irritation, nausea, vomiting, diarrhea, headache, and increased acidity in the stomach may occur.

  • Yellow gentian and the toxic white hellebore often grow closely together. They have been easily confused before flowering occurs. Five cases of acute white hellebore poisoning were reported after contamination of homemade gentian wine.

  • Gentian may raise blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

  • Use cautiously in individuals with high blood pressure, individuals taking antidepressants or monoamine oxidase inhibitors (certain drugs used to treat depression), and individuals with alcoholism, liver disease, or stomach or intestinal abnormalities.

  • Use cautiously in pregnant or breastfeeding women or in children, due to a lack of sufficient safety data.

  • Avoid in individuals with a known allergy or sensitivity to gentian, its constituents, or members of the Gentianaceae family.

Pregnancy and Breastfeeding

  • Use of gentian is not recommended, as there is currently a lack of scientific evidence on the use of gentian during pregnancy or breastfeeding.

  • Many tinctures contain high levels of alcohol and should be avoided during pregnancy.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Gentian may raise blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Gentian may interact with alcohol, antidepressants, antifungals, and monoamine oxidase inhibitors (drugs used to treat depression).

Interactions with Herbs and Dietary Supplements

  • Gentian may raise blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Gentian may interact with antidepressant herbs and supplements, antifungal herbs and supplements, and monoamine oxidase inhibiting herbs and supplements.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Aberham, A., Schwaiger, S., Stuppner, H., and Ganzera, M. Quantitative analysis of iridoids, secoiridoids, xanthones and xanthone glycosides in Gentiana lutea L. roots by RP-HPLC and LC-MS. J Pharm Biomed.Anal 11-5-2007;45(3):437-442. View Abstract
  2. Amin, A. Ketoconazole-induced testicular damage in rats reduced by Gentiana extract. Exp Toxicol Pathol. 2008;59(6):377-384. View Abstract
  3. Chen, L., Liu, J. C., Zhang, X. N., Guo, Y. Y., Xu, Z. H., Cao, W., Sun, X. L., Sun, W. J., and Zhao, M. G. Down-regulation of NR2B receptors partially contributes to analgesic effects of Gentiopicroside in persistent inflammatory pain. Neuropharmacology 2008;54(8):1175-1181. View Abstract
  4. Citova, I., Ganzera, M., Stuppner, H., and Solich, P. Determination of gentisin, isogentisin, and amarogentin in Gentiana lutea L. by capillary electrophoresis. J Sep.Sci 2008;31(1):195-200. View Abstract
  5. Garnier, R., Carlier, P., Hoffelt, J., and Savidan, A. [Acute dietary poisoning by white hellebore (Veratrum album L.). Clinical and analytical data. A propos of 5 cases]. Ann.Med Interne (Paris) 1985;136(2):125-128. View Abstract
  6. Haraguchi, H., Tanaka, Y., Kabbash, A., Fujioka, T., Ishizu, T., and Yagi, A. Monoamine oxidase inhibitors from Gentiana lutea. Phytochemistry 2004;65(15):2255-2260. View Abstract
  7. Hayashi, T. and Yamagishi, T. Two xanthone glycosides from Gentiana lutea. Phytochemistry 1988;27:3696-3699.
  8. Mathew, A., Taranalli, A. D., and Torgal, S. S. Evaluation of anti-inflammatory and wound healing activity of Gentiana lutea rhizome extract in animals. Pharm.Biol. 2004;42:8-12.
  9. Ozturk, N., Baser, K. H., Aydin, S., Ozturk, Y., and Calis, I. Effects of Gentiana lutea ssp. symphyandra on the central nervous system in mice. Phytother Res 2002;16(7):627-631. View Abstract
  10. Schmieder, A., Schwaiger, S., Csordas, A., Backovic, A., Messner, B., Wick, G., Stuppner, H., and Bernhard, D. Isogentisin–a novel compound for the prevention of smoking-caused endothelial injury. Atherosclerosis 2007;194(2):317-325. View Abstract
  11. Szucs, Z., Danos, B., and Nyiredy, S. Comparative analysis of the underground parts of Gentiana species by HPLC with diode-array and mass spectrometric detection. Chromatographia 2002;56:S19.
  12. Toriumi, Y., Kakuda, R., Kikuchi, M., Yaoita, Y., and Kikuchi, M. New triterpenoids from Gentiana lutea. Chem Pharm Bull.(Tokyo) 2003;51(1):89-91. View Abstract
  13. VanHaelen, M. and VanHaelen-Fastre, R. Quantitative determination of biologically active constituents in medicinal plant crude extracts by thin-layer chromatography-densitometry. I. Aesculus hippocastaneum L., Arctostaphylos uva-ursi Spreng., Fraxinus excelsior L., Gentiana lutea L., Glyccyrhiza glabra L., Hamamelis virginiana L., Hypericum perforatum L., Olea europea L., Salix alba L., and Silybum marianum Gaertn. J Chromatogr 1983;281:263-271.
  14. Wang, C. H., Cheng, X. M., Bligh, S. W., White, K. N., Branford-White, C. J., and Wang, Z. T. Pharmacokinetics and bioavailability of gentiopicroside from decoctions of Gentianae and Longdan Xiegan Tang after oral administration in rats–comparison with gentiopicroside alone. J Pharm Biomed.Anal 9-3-2007;44(5):1113-1117. View Abstract
  15. Wang, C. H., Wang, Z. T., Bligh, S. W., White, K. N., and White, C. J. Pharmacokinetics and tissue distribution of gentiopicroside following oral and intravenous administration in mice. Eur J Drug Metab Pharmacokinet. 2004;29(3):199-203. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.