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Black hellebore (Helleborus niger, Helleborus nigra)
Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
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.
Anemonic acid, anemonin, bear's-foot, cardioactive saponins, Christ Herbe, Christmas flower, Christmas herb, Christmas rose, Christmas rose plant, helleborein, helleborin, Helleborus niger, Helleborus nigra, melampode, protoanemoni, Ranunculin, ranunculosides, Ranunculaceae (family), saponins, sesquiterpene lactone glycosides, setter grass, setter wort, unsaturated lactone, winter rose.
Black hellebore (Helleborus niger, Helleborus nigra) is a perennial plant, native to Central and Southern Europe, Greece, and Asia Minor, and is cultivated largely in the United States as a garden plant. Black hellebore is not the same as false hellebore, American hellebore, white hellebore, or other Veratrum species.
Black hellebore is a poisonous plant that is toxic when taken in even small-to-moderate doses and should not be used without the supervision of a medical professional. It was formerly used for palsy, insanity, dropsy, and epilepsy but is seldom currently used for these or any other 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.
No available studies qualify for inclusion in the evidence table.
*Key to grades:
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
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.
- Abortion inducing, amenorrhea (lack of menstruation), antispasmodic, bleeding, common cold, diuretic, edema, emetic, epilepsy, headache, heart disease, irregular menstrual cycles, kidney disease, laxative, lice, local anesthesia, menstrual flow stimulant, mental illness, nausea, neurological disorders, parasitic worm infections, psychological disorders.
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 no proven safe or effective dose for black hellebore. Black hellebore has been taken by mouth as a fluid extract, solid extract, powered root, or decoction. Black hellebore is known to be toxic when taken in even small-to-moderate doses and should not be used without the supervision of a medical professional.
Children (under 18 years old)
There is no proven safe or effective dose for black hellebore, and use in children is not recommended.
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.
Avoid in patients with a known allergy or sensitivity to black hellebore, its constituents, or members of the Ranunculaceae family.
Side Effects and Warnings
Black hellebore should only be used under supervision of a medical professional due to its potential toxic effects.
Symptoms of black hellebore poisoning include scratchy throat or mouth, salivation, nausea, vomiting, diarrhea, dizziness, shortness of breath, heart rate or heart rhythm changes, and suffocation. Black hellebore may cause irritation, bruises, redness of the skin or inflammation when the skin comes in contact with the fresh plant.
Avoid in patients with heart disease or stomach irritation.
Pregnancy and Breastfeeding
Avoid in pregnant or breastfeeding women. Black hellebore may have abortion inducing properties.
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
Black hellebore may have additive effects with heart stimulants (digoxin), heart depressants (quinine), diuretics, laxatives, drugs used for the stomach, or narcotics.
Interactions with Herbs and Dietary Supplements
Black hellebore may have additive effects with heart stimulants (Foxglove, Digitalis spp.), heart depressants (Cinchona pubscens), diuretics (horsetail, licorice), laxatives, or herbs and supplements used for the stomach.
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).
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.
- Schep, LJ, Schmierer, DM, and Fountain, JS. Veratrum poisoning. Toxicol Rev. 2006;25(2):73-78. View Abstract
Copyright © 2011 Natural Standard (www.naturalstandard.com)
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.