Wise Mind Herbs

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English Ivy - Hedera helix

Hedera helix, commonly known as English ivy, common ivy, or European ivy, is a species of flowering plant in the family Araliaceae. It has been used in traditional medicine for centuries, particularly for respiratory conditions. This review examines the scientific evidence for its health benefits, applications, dosages, and side effects based on peer-reviewed literature.

Common Names and Botanical Classification

Hedera helix is known by several common names:

• English ivy
• Common ivy
• European ivy
• True ivy
• Woodbine (though this name is also applied to other plants)

Plants sometimes confused with Hedera helix include:

• Boston ivy (Parthenocissus tricuspidata) - not related to true ivy, belongs to the grape family
• Poison ivy (Toxicodendron radicans) - unrelated to true ivy, causes allergic skin reactions
• Swedish ivy (Plectranthus verticillatus) - unrelated, belongs to the mint family
• Devil's ivy/Golden pothos (Epipremnum aureum) - belongs to the Araceae family
• Other Hedera species (H. canariensis, H. hibernica, H. colchica) - closely related but distinct species

Bioactive Compounds

The medicinal properties of Hedera helix are attributed to several bioactive compounds:

• Saponins (hederasaponins, α-hederin, hederacoside C) - primary active constituents
• Flavonoids (rutin, kaempferol, quercetin)
• Polyacetylenes
• Sterols
• Essential oils
• Phenolic compounds

Evidence-Based Health Benefits

Scientific research has identified several potential health benefits of Hedera helix:

1. Respiratory Conditions

The strongest evidence supports ivy leaf extract for respiratory conditions:

• Bronchitis (acute and chronic) - reduces viscosity of bronchial secretions and promotes expectoration
• Productive cough - demonstrated efficacy comparable to synthetic expectorants in multiple clinical trials
• Asthma - bronchodilatory effects that may reduce frequency and severity of asthmatic episodes
• COPD - modest improvements in lung function parameters in some studies

A meta-analysis of randomized controlled trials found that ivy leaf extract significantly improved respiratory symptoms compared to placebo, with particular efficacy for productive cough.

2. Anti-inflammatory Properties

Preclinical studies have demonstrated anti-inflammatory effects:

• Reduced production of pro-inflammatory cytokines
• Inhibition of NF-κB pathway activation
• Decreased neutrophil migration in inflammatory models

However, high-quality clinical trials confirming these effects in humans are limited.

3. Antimicrobial Activity

In vitro studies have shown activity against:

• Several bacterial strains (including some antibiotic-resistant strains)
• Certain fungal pathogens
• Selected viruses (limited evidence)

The clinical relevance of these findings remains uncertain without robust clinical trials.

4. Other Potential Benefits

Preliminary evidence suggests possible benefits for:

• Antioxidant effects - primarily observed in laboratory studies
• Analgesic properties - traditional use supported by some preclinical data
• Anxiolytic effects - very limited evidence from animal models
• Anticancer potential - early-stage research on certain saponins, particularly α-hederin

These applications require further clinical investigation before definitive conclusions can be drawn.

Recommended Dosages

For respiratory conditions (based on clinical studies):

• Adults: 25-70 mg of dried ivy leaf extract daily, standardized to contain 5-7.5% hederacoside C
• Children (6-12 years): 25-35 mg of standardized extract daily
• Children (2-5 years): 15-25 mg of standardized extract daily

Typical formulations include:

• Liquid extracts (1:1): 0.5-1 mL, 2-3 times daily
• Tinctures (1:5): 1-2 mL, 2-3 times daily
• Standardized dried extract (tablets/capsules): 25-50 mg, 1-2 times daily
• Syrup formulations: dosage varies by product concentration

Duration of treatment typically ranges from 7 days for acute conditions to 2-3 weeks for chronic respiratory issues.

High-Dose Studies and Knowledge Gaps

Limited research has been conducted on doses exceeding the standard therapeutic range. Studies examining doses up to 150 mg daily of standardized extract have not demonstrated significantly enhanced efficacy compared to standard doses, while potentially increasing the risk of gastrointestinal side effects. There is a notable knowledge gap regarding the long-term effects of sustained high-dose ivy extract administration, with most clinical trials limited to 1-4 weeks of treatment. Safety data for extended use beyond 4-6 weeks is insufficient, particularly for higher-than-recommended doses.

Side Effects and Contraindications

Hedera helix is generally well-tolerated when used as directed, but potential side effects include:

• Gastrointestinal disturbances (nausea, vomiting, diarrhea) - most common, reported in 2-5% of users
• Allergic reactions - particularly in individuals with pre-existing allergies to plants in the Araliaceae family
• Contact dermatitis - from topical application or handling the fresh plant
• Potential drug interactions - theoretical concerns with sedatives, anticoagulants, and digoxin

Contraindications:

• Pregnancy and lactation (insufficient safety data)
• Known hypersensitivity to ivy or other Araliaceae family plants
• Children under 2 years (unless specifically prescribed)
• Pre-existing gastritis or gastric/duodenal ulcers

The raw plant contains falcarinol and related polyacetylenes that may cause contact dermatitis. The berries contain saponins that are toxic if ingested in large quantities and can cause gastrointestinal distress.

Commercial Pharmaceutical Products

Several standardized ivy leaf extract products are commercially available in various markets:

• Prospan® - syrup and effervescent tablets, one of the most widely studied
• Hedelix® - syrup and drops
• Bronchipret® drops - combination with thymol
• Sedotussin Ivy® - syrup for children and adults
• Hedecton® - film-coated tablets

These products are primarily available in Europe, particularly Germany, Austria, Switzerland, and Eastern European countries. Availability varies by region, with fewer registered pharmaceutical products in North America where ivy extract is more commonly marketed as a dietary supplement rather than a medicine.

Conclusion

Hedera helix extract has demonstrated promising efficacy for respiratory conditions, particularly as an expectorant for productive cough and bronchitis. The strongest evidence supports its use in standardized pharmaceutical formulations for these indications. Other potential benefits require further clinical investigation. While generally safe when used as directed, caution is warranted in specific populations, and the plant itself (particularly berries) should not be consumed due to potential toxicity.

References

Bedir, E., Kırmızıpekmez, H., Sticher, O., & Çalış, İ. (2000). Triterpene saponins from the fruits of Hedera helix. Phytochemistry, 53(8), 905-909.

Greunke, C., Hage-Hülsmann, A., Sorkalla, T., Keksel, N., Häberlein, F., & Häberlein, H. (2015). A systematic study on the influence of the main ingredients of an ivy leaves dry extract on the β2-adrenergic responsiveness of human airway smooth muscle cells. Pulmonary Pharmacology & Therapeutics, 31, 92-98.

Holzinger, F., & Chenot, J. F. (2011). Systematic review of clinical trials assessing the effectiveness of ivy leaf (hedera helix) for acute upper respiratory tract infections. Evidence‐Based Complementary and Alternative Medicine, 2011(1), 382789.

Lang, C., Röttger-Lüer, P., & Staiger, C. (2015). A valuable option for the treatment of respiratory diseases: review on the clinical evidence of the ivy leaves dry extract EA 575®. Planta medica, 81(12/13), 968-974.

Shokry, A., El-Shiekh, R., Kamel, G., & Ramadan, A. (2022). Phytochemical contents, biological activities and therapeutic applications of hedera helix (ivy leaf) extracts: a review. The Natural Products Journal, 12(4), 22-32.

Süleyman, H., Mshvildadze, V., Gepdiremen, A., & Elias, R. (2003). Acute and chronic antiinflammatory profile of the ivy plant, Hedera helix, in rats. Phytomedicine, 10(5), 370-374.

Zeil, S., Schwanebeck, U., & Vogelberg, C. (2014). Tolerance and effect of an add-on treatment with a cough medicine containing ivy leaves dry extract on lung function in children with bronchial asthma. Phytomedicine, 21(10), 1216-1220.