Pycnogenol (also known as pine bark extract), like grape seed extract and cocoa polyphenols, is a common source of proanthocyanidins and is currently a popular ingredient in many health care products due to its antioxidant and anti-inflammatory effects
Pycnogenol has traditionally been thought to have a variety of potential protective effects against chronic diseases such as metabolic syndrome, obesity, dyslipidemia, diabetes, asthma, osteoarthritis, sexual dysfunction, venous insufficiency, and including attention deficit hyperactivity disorder and cognitive impairment
In empirical medicine, what are the benefits of Pycnogenol? Are there any side effects and contraindications? See text analysis for details.
What is Pycnogenol?
Pycnogenol is a standard extract extracted from French coastal pine bark. It is also the name of a patented formula. It mainly contains two types of flavonoids, such as polymeric flavonoids (about 65%, proanthocyanidins, catechins, epicatechins, etc.) and the lesser ones are monomeric flavonoids, such as gallic acid, caffeic acid, ferulic acid, etc.
This type of pine bark extract is traditionally used, dating back to at least 400 BC, the father of medicine: Hippocrates used to treat inflammatory diseases.
The name Pycnogenol is derived from the Greek root Pycno, which refers to polymerization, which means it is a macromolecular substance composed of many bioflavonoids.
What are the recommended benefits of Pycnogenol?
- Pycnogenol is beneficial to recurrent urinary tract infections and interstitial cystitis
Urinary tract infections are one of the most common bacterial infections, affecting 150 million people worldwide each year, and about 25% of women who develop bacterial cystitis for the first time develop recurrent UTIs within 6 months, and current treatments are not ideal because the prevalence of multidrug-resistant bacteria is increasing.
Interstitial cystitis is a chronic inflammatory bladder disease characterized by pelvic pain and urinary tract symptoms such as urinary frequency, urgency and nocturia, without bacterial infection or identifiable pathologies, due to these different symptoms, patients often develop sleep disturbances, chronic stress, anxiety, depression, and sexual dysfunction.
A controlled study (2-month study of 64 patients with recurrent urinary tract infection or interstitial cystitis) found that Pycnogenol supplementation (150 mg daily) reduced symptoms or signs and was better than cranberry. Note 1
The mechanism behind it may be related to the anti-inflammatory and antioxidant activities associated with polyphenolic components, reducing bacterial adhesion to urothelial cells and infection
*Conclusion: For recurrent urinary tract infections and interstitial cystitis, supplementation with pycnogenol (pine bark extract) may bring positive help, but limited by the small sample size, more studies are needed for further verification
- Pycnogenol is beneficial for the common cold
The common cold is an acute respiratory infection of viral origin.
Symptoms are mainly related to mucosal infection, affecting the airways such as the nose, sinuses, pharynx, and larynx, including nasal congestion, runny nose, sneezing, coughing, sore throat, general malaise, and fever.
Cold symptoms may appear as early as 10 hours after infection and usually reach their maximum intensity around 3 days after the onset of illness. In particular, the cough may persist after 3 weeks.
A controlled study (146 participants with colds) showed that Pycnogenol (pine bark extract) helped reduce cold symptoms, shorten the duration of the disease, and prevent some complications such as bronchiectasis. Note 2
*Conclusion: Taking Pycnogenol (pine bark extract) at the beginning of a cold may bring positive help to improve symptoms, but limited by the small sample size, more large-scale trials with precise design are still needed for further verification
- Pycnogenol is beneficial for cardiometabolic diseases
Cardiometabolic disease describes a range of diseases that begin with insulin resistance, progress to metabolic syndrome, prediabetes, and finally more serious diseases, including cardiovascular disease and type 2 diabetes.
These diseases are classified as “cardiometabolic diseases” because they have related or common risk factors, such as overweight, obesity, dyslipidemia, and hypertension.
Sedentary, lack of exercise, poor diet, and short sleep duration are common behaviors in modern society and are independent risk factors for the occurrence of cardiometabolic diseases.
A meta-analysis (24 randomized controlled trials, 1594 participants) showed that oral administration of Pycnogenol significantly reduced fasting blood glucose (WMD: -5.86 mg/dl), glycated hemoglobin (WMD = -0.29%), systolic blood pressure (WMD: -2.54 mmhg), diastolic blood pressure (WMD: -1.76 mmhg), body mass index (WMD: -0.47 kg/m2), LDL cholesterol (WMD: -7.12 mg/dl) and increase HDL cholesterol (WMD: 3.27 mg/dl). Note 1
*Conclusion: Pycnogenol may have a positive effect on vascular health, but more large studies are needed to further validate
- Pycnogenol is beneficial for blood pressure regulation
Hypertension is an abnormal increase in arterial blood pressure, defined primarily as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. Gray areas with systolic blood pressure between 120 and 139 mm Hg and diastolic blood pressure between 80 and 89 mm Hg are defined as prehypertension.
The World Health Organization estimates that 54% of strokes and 47% of ischemic heart disease are directly related to hypertension, while about 7.5 million people worldwide die each year, accounting for 12.8% of all deaths globally, and the number of adults with hypertension is expected to increase to 1.56 billion by 2025.
A meta-analysis (12 randomized controlled trials with 922 participants) noted that supplementation with Pycnogenol (daily dose between 60 and 200 mg) reduced systolic (-3.22 mmHg) and diastolic (-1.91 mmHg). Note 2
In addition, subgroup analysis found that the systolic blood pressure lowering effect was more pronounced when used in combination with other herbs, while the diastolic blood pressure lowering effect was more pronounced in studies lasting more than 12 weeks.
*Conclusion: Pycnogenol may be helpful in blood pressure regulation, but the high heterogeneity of the included studies is limited, and more high-quality studies are needed
- Pycnogenol reduces inflammation indicators: C-reactive protein
C-reactive protein, first proposed by Tillet and Francis in 1930, is named for its ability to precipitate Streptococcus pneumoniae somatic cells C polysaccharides, and is an acute phase protein produced by liver cells during infection and tissue damage.
While C-reactive protein has traditionally been considered an important regulator of the innate immune system and acute phase response, it has also been implicated in various chronic inflammatory processes, such as certain rheumatism, cancer, and cardiovascular diseases.
A systematic literature review and meta-analysis (5 randomized controlled trials with 324 participants) suggested that Pycnogenol supplementation reduced C-reactive protein levels. Note 3
However, due to the high heterogeneity of the results, subgroup analysis also found that reduced heterogeneity was seen in the groups with doses greater than 150 mg per day and participants greater than 55 years of age.
*Conclusion: Pycnogenol supplementation may have a positive effect on reducing C-reactive protein, but more studies are needed to support it due to the heterogeneity of the studies involved
- Pycnogenol is beneficial for blood lipid regulation
Plasma lipids are important components of biofilms, energy and signaling molecules that influence fat synthesis, storage, or catabolism, creating complex metabolic networks that enable organisms to respond to nutrient availability, energy requirements, or other changing environments.
Dyslipidemia is not only closely related to coronary heart disease, but also one of the common symptoms of obesity, insulin resistance and type 2 diabetes.
A systematic literature review and meta-analysis (14 randomized controlled trials, 1065 participants) noted that Pycnogenol supplementation increased high-density lipoprotein cholesterol (HDL-C) concentrations, but there were no significant changes in other lipid levels such as total cholesterol (TC), triglycerides (TAG), and low-density lipoprotein cholesterol (LDL-C). Note 4
*Conclusion: Pycnogenol supplementation only has a positive effect on HDL cholesterol, and the effect of other indicators needs to be further verified by more studies
- Pycnogenol is beneficial to chronic venous insufficiency diseases
Chronic venous disease is a common pathological phenomenon of the circulatory system and includes a series of pathophysiological consequences caused by venous hypertension in the lower extremities, and symptoms include varying degrees and forms of leg discomfort, such as pain or, swelling, heaviness, cramping and burning, which can significantly affect quality of life
Because the venous valves are poorly functioning or insufficient, eventually leading to reduced venous return, resulting in blood stasis, hypoxia, and inflammation.
Chronic venous disease of the lower extremities can take many forms, including telangiectasias (spider angiopathy), varicose veins, edema, or skin changes (eczema, pigmentation, induration), and in more severe cases, skin or venous ulcers.
A comparative study (8 weeks, 142 patients with chronic venous insufficiency and venous microangiopathy) was divided into 3 groups: pycnogenol (daily dose 150 mg), compression stockings, compression stockings + pycnogenol (Note 5)
The results showed that compared with the subjects who used compression stockings alone, the skin flux, ankle swelling rate, skin PO2-PCO2, simulated symptom score, venous dysfunction and severity score, and microcirculatory function were significantly improved in the Pycnogenol group
*Conclusion: Pycnogenol may have a positive effect on chronic venous insufficiency-related diseases, but more research is needed to support it
- Pycnogenol is good for cognitive function
Mild cognitive impairment is a cognitive condition between normal aging and dementia, and it is estimated that the prevalence is about 10% to 20% in the elderly over 65 years old
In some states, mild cognitive impairment is an early sign of dementia (such as Alzheimer’s disease), and about 10 to 15 percent will develop dementia, with the highest risk especially in men
A 12-week study of 150 healthy people aged 55 to 70 found that taking Pycnogenol helped improve cognitive function and oxidative stress (compared to those who did not take it). Note 6
Another study (8 weeks, 33 students aged 18 to 27) also showed that taking Pycnogenol helped improve concentration, memory, executive ability and mood scores. Note 7
- Pycnogenol slows down skin aging
Among the causes of skin aging, in addition to age-related aging and physiological quality, photoaging (caused by ultraviolet rays in sunlight) is the biggest factor in skin aging.
In addition to directly or indirectly causing DNA damage, ultraviolet rays also activate the surface receptors of keratinocytes and fibroblasts, resulting in the breakdown of collagen and the inability to smoothly produce new collagen
A small study found that taking Pycnogenol (75 mg daily for 12 weeks) increased skin moisture content and elasticity, and the effect was even more obvious for those with dry skin, and the mechanism behind it was thought to be related to the production of extracellular stromal molecules, such as hyaluronic acid and collagen type I. Note 8
Another study (in 112 women under the age of 60) also pointed out that taking pine bark extract (Flavangenol’s Japanese patented formula) helped improve a number of photoaging-related indicators, such as sunburn, pigmentation and rough skin. Note 9
- Pycnogenol is beneficial to diabetes and its complications
Most people hear that diabetes is usually painless and thinks it is a chronic disease, but the truth is that diabetes is actually a progressive vascular disease that affects muscles, skin, heart, kidneys and even the brain.
Long-term can cause retinopathy, nephropathy, neuropathy, hearing impairment, cardiovascular disease, some studies also believe that Alzheimer’s disease and diabetes are very similar to each other’s pathological mechanisms, also known as type 3 diabetes.
A small double-blind controlled study found that Pycnogenol (125 mg daily for 12 weeks) helped diabetic patients reduce fasting plasma glucose by 23.7 mg/dL, compared with only 5.7 mg/dL in the control group. In addition, glycated hemoglobin decreased by 0.8% (compared to 0.1% in the control group). Note 10
Another double-blind controlled study also pointed out that Pycnogenol helped improve retinal vascularization and reduce endothelial cell permeability and leakage (while the placebo group showed increased retinopathy and decreased visual sharpness), which is speculated to be related to the antioxidant, anti-inflammatory and microangioprotective effects of Pycnogenol. Note 11
- Pycnogenol is beneficial for osteoarthritis
Osteoarthritis is the most common joint disease, most common in middle-aged and elderly people, and the biggest contributor to loss of mobility.
Age, gender (especially women), excess weight, joint overuse, bone density, muscle weakness, and joint laxity are all factors in the formation of osteoarthritis, and those who have suffered knee injuries have a 3.86-fold increased risk.
A double-blind controlled study (3 months, 37 patients with osteoarthritis) found that taking Pycnogenol (50 mg three times daily) helped improve symptoms of knee osteoarthritis, including pain (43%), stiffness (35%), physical function (52%), and osteoarthritis index (WOMAC scores/49%). Note 12
What are the side effects of pycnogenol (pine bark extract)?
Most studies have concluded that Pycnogenol is a relatively safe health ingredient (mostly at doses ranging from 50 mg to 450 mg daily for up to one year), with minimal side effects and intolerance.
Adverse effects reported include: dizziness, fatigue, gastrointestinal discomfort (mostly avoidable with or after meals), nausea, irritability, headache, drowsiness, halitosis, mouth ulcers, skin inflammation, hypoglycemia, and urinary problems.
Precautions for use
- Do not use for pregnant women, breastfeeding women, or women who are planning to become pregnant (because the relevant safety is unknown)
- Children under 6 years old should not use (because the relevant safety is unknown)
- Do not use for patients with poor liver and kidney function (because the relevant safety is unknown)
- Do not use for autoimmune patients (such as multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis, etc., because Pycnogenol may activate the immune system and affect the condition)
- It may affect the coagulation function, so patients with coagulation disorders, taking related anticoagulant drugs, do not use it two weeks before surgery
- Do not use it with hypoglycemic drugs (may affect the function of the drug)
- Do not use in combination with immunosuppressant agents, may reduce the effectiveness of the drug, related drug names are: azathioprine (imidazolthiopine), basiliximab (valiximab), cyclosporine, daclizumab, muromonab-CD3, mycophenolate, Tacrolimus, Sirolimus, Prednisone, Corticosteroids
How to eat Pycnogenol? How many doses are effective?
There is currently insufficient evidence to determine a safe and effective dose of Pycnogenol in specific situations.
The daily dose of most clinical studies varies between 50 and 360 mg, and it is best to start with as few doses as possible.