Tormentil (Potentilla erecta, Potentilla tormentilla, Tormentilla erecta)

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

  • Agrimoniin, biscuits, bloodroot, cinquefoil, common tormentil, earthbank, elladic acid, ellagic acid, ellagitannins, English sarsaparilla, erect cinquefoil, ewe daisy, flesh and blood, gallic acid, polyphenols, potentilla, Potentilla erecta, Potentilla tormentilla, Rosaceae (family), septfoil, shepherd’s knapperty, shepherd’s knot, tannins, thormantle, tormentil, tormentil root, tormentilla, Tormentilla erecta, Tormentillae rhizome, tormentille, tormentoside, triterpene glycosides, triterpene saponins, triterpenes.

  • Select combination products: Quicklyte® (sodium chloride, potassium chloride, sodium citrate, glucose, tormentil root dry extract).

  • Note: The common name tormentil has been used for species unrelated to Potentilla erecta, such as spotted cranesbill (Geranium maculatum). The common name cinquefoil is used to refer to different species in the Potentilla genus, other than Potentilla erecta.

Background

  • Tormentil is a plant in the rose family that has been traditionally used for stomach problems, bleeding, and wound healing.

  • Some evidence suggests that tormentil may be of benefit for diarrhea. Tormentil has also been studied for other conditions. However, the available human research is limited. More studies are needed.

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.

Diarrhea

Tormentil root extract has been shown to shorten the duration of diarrhea caused by rotavirus and reduce the need for rehydration solution in children. Additional research is needed.

Skin rash (lichen planus, itchy rash in the mouth)

Tincture of Potentilla tormentilla as a gargle may be a useful adjunct, together with application of codfish oil, in the treatment of some cases of lichen planus (itchy rash in the mouth). Additional research with Potentilla tormentilla alone is needed.

Tuberculosis

In people with tuberculosis, an herbal extract containing tormentil, when used together with standard treatment, was shown to be more effective than standard treatment alone. Additional research with tormentil alone is needed.

Ulcerative colitis

In early research, tormentil extract was shown to improve some symptoms in people with ulcerative colitis (disease of the large intestine). Higher-quality studies are needed.

*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.

  • Abdominal cramps, antibacterial, antidote to poisons, antifungal, anti-inflammatory, antioxidant, antivenom, antiviral, bleeding, bleeding gums, cancer, cholera (infection of the small intestine), constipation, diabetes, dysentery, eye infections, eye inflammation, fever, hemorrhoids, inflammatory bowel disease, jaundice, laryngitis (inflammation of the voice box), liver protection, malaria, pharyngitis (throat inflammation), smallpox, sore throat, spleen disorders, stomach problems, ulcers (mouth), vaginal discharge, vaginal infections, warts, whooping cough, wound healing.

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)

  • There is little available dosing information from high-quality studies for use of tormentil alone. Tormentil has been taken by mouth as a tea, extract (powdered, liquid, or alcohol), or capsules, and has also been used in combination with other herbs or therapies. It has also been applied to the skin and used as a gargle.

  • For ulcerative colitis, tormentil capsules (containing 200 milligrams of tormentil extract) have been taken by mouth in daily doses of 1,200 milligrams (three times 400 milligrams), 1,800 milligrams (three times 600 milligrams), 2,400 milligrams (three times 800 milligrams) and 3,000 milligrams (three times 1,000 milligrams) for three weeks.

Children (under 18 years old)

  • Overall, the available evidence is insufficient for use of tormentil before 18 years of age. For diarrhea caused by rotavirus, three drops of tormentil root extract per year of life has been given by mouth three times daily until discontinuation of diarrhea or after five days. Quicklyte® (sodium chloride, potassium chloride, sodium citrate, glucose, tormentil root dry extract) has also been given by mouth. Children with diarrhea are advised to consult with a pediatrician before using tormentil.

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 with known allergy or hypersensitivity to tormentil, its constituents, or other members of the rose family.

Side Effects and Warnings

  • Tormentil appears to be safe when used in doses and durations described in currently available studies. Mild abdominal pain has been reported.

  • Tormentil may lower 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. Medication adjustments may be necessary.

  • Tormentil may alter bleeding risk. Caution is advised in people with bleeding disorders or those taking drugs that may affect bleeding. Dosing adjustments may be necessary.

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

  • Avoid with known allergy or hypersensitivity to tormentil, its constituents, or other members of the rose family.

Pregnancy and Breastfeeding

  • There is currently a lack of high-quality scientific data on the use of tormentil during pregnancy or lactation.

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

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

  • Tormentil may alter the risk of bleeding when taken with drugs that affect bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Tormentil may also interact with agents that affect the liver, agents that are toxic to cells, agents used for the lungs, agents used for the stomach, agglutinating agents, antibiotics, antielastase agents, anti-inflammatories, antivirals, growth-promoting agents, or hydrocortisone.

Interactions with Herbs and Dietary Supplements

  • Tormentil may lower 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.

  • Tormentil may alter the risk of bleeding when taken with herbs and supplements that are believed to affect bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Tormentil may also interact with agglutinating herbs or supplements, antibacterials, antielastase herbs or supplements, anti-inflammatories, antioxidants, antivirals, growth-promoting herbs or supplements, herbs or supplements that affect the liver, herbs or supplements that are toxic to cells, herbs or supplements used for the lungs, herbs or supplements used for the stomach, or hydrocortisone.

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. Bos, M. A., Vennat, B., Meunier, M. T., et al. Procyanidins from tormentil: antioxidant properties towards lipoperoxidation and anti-elastase activity. Biol.Pharm.Bull. 1996;19(1):146-148. View Abstract
  2. Drozd, J. and Anuszewska, E. The influence of plant raw materials, containing ellagic acid and selected antibiotics on immunological response in mice. Acta Pol.Pharm. 2005;62(3):237-240. View Abstract
  3. Fecka, I. Development of chromatographic methods for determination of agrimoniin and related polyphenols in pharmaceutical products. J.AOAC Int. 2009;92(2):410-418. View Abstract
  4. Huber, R., Ditfurth, A. V., Amann, F., et al. Tormentil for active ulcerative colitis: an open-label, dose-escalating study. J.Clin.Gastroenterol. 2007;41(9):834-838. View Abstract
  5. Kite, G. C., Porter, E. A., and Simmonds, M. S. Chromatographic behaviour of steroidal saponins studied by high-performance liquid chromatography-mass spectrometry. J.Chromatogr.A 5-4-2007;1148(2):177-183. View Abstract
  6. Langmead, L., Dawson, C., Hawkins, C., et al. Antioxidant effects of herbal therapies used by patients with inflammatory bowel disease: an in vitro study. Aliment.Pharmacol.Ther. 2002;16(2):197-205. View Abstract
  7. Moss, A. C. and Cheifetz, A. S. Reducing the torment of diarrhea: tormentil for active ulcerative colitis. J.Clin.Gastroenterol. 2007;41(9):797-798. View Abstract
  8. Nikitina, V. S., Kuz’mina, L. I., Melent’ev, A. I., et al. [Antibacterial activity of polyphenolic compounds isolated from plants of Geraniaceae and Rosaceae families]. Prikl.Biokhim.Mikrobiol. 2007;43(6):705-712. View Abstract
  9. Spiridonov, N. A., Konovalov, D. A., and Arkhipov, V. V. Cytotoxicity of some Russian ethnomedicinal plants and plant compounds. Phytother.Res. 2005;19(5):428-432. View Abstract
  10. Subbotina, M. D., Timchenko, V. N., Vorobyov, M. M., et al. Effect of oral administration of tormentil root extract (Potentilla tormentilla) on rotavirus diarrhea in children: a randomized, double blind, controlled trial. Pediatr.Infect.Dis.J. 2003;22(8):706-711. View Abstract
  11. Tomczyk, M. and Latte, K. P. Potentilla–a review of its phytochemical and pharmacological profile. J.Ethnopharmacol. 3-18-2009;122(2):184-204. View Abstract
  12. Tunon, H., Olavsdotter, C., and Bohlin, L. Evaluation of anti-inflammatory activity of some Swedish medicinal plants. Inhibition of prostaglandin biosynthesis and PAF-induced exocytosis. J.Ethnopharmacol. 1995;48(2):61-76. View Abstract
  13. Vennat, B., Bos, M. A., Pourrat, A., et al. Procyanidins from tormentil: fractionation and study of the anti-radical activity towards superoxide anion. Biol.Pharm.Bull. 1994;17(12):1613-1615. View Abstract
  14. Volodina, E. V., Maksimovskii, IuM, and Lebedev, K. A. [The combined treatment of lichen ruber planus of the mouth mucosa]. Stomatologiia (Mosk) 1997;76(2):28-32. View Abstract
  15. Zaiteva SI, Matveeva SL, Gerasimova TG et al. Efficacy and safety of phytoconcentrate Dzherelo (Immunoxel) in treatment of patients with multi-drug resistant TB (MDR-TB) in comparison to standartd chemotherapy. Research Journal of Medical Sciences. 2009;3(2):36-41.

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.