Comfrey

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What other names is Comfrey known by?

Ass Ear, Black Root, Blackwort, Bruisewort, Common Comfrey, Consolidae Radix, Consound, Consoude, Consoude Officinale, Consuelda, Grande Consoude, Gum Plant, Healing Herb, Herbe aux Charpentiers, Herbe à la Coupure, Knitback, Knitbone, Langue-de-Vache, Oreille d'Âne, Salsify, Slippery Root, Symphytum officinale, Wallwort.

What is Comfrey?

Comfrey is a plant. Even though this plant contains poisonous chemicals called pyrrolizidine alkaloids (PAs), the leaf, root, and root-like stem (rhizome) are used to make medicine. The amount of PAs found in comfrey changes according to the time of harvesting and the age of the plant. The roots have 10 times higher amounts of PAs than the leaves. Some products labeled "common comfrey" or Symphytum officinale actually contain the more poisonous "prickly comfrey" (Symphytum asperum) or "Russian comfrey" (Symphytum x uplandicum) species.

Comfrey is used as a tea for upset stomach, ulcers, heavy menstrual periods, diarrhea, bloody urine, persistent cough, painful breathing (pleuritis), bronchitis, cancer, and chest pain (angina). It is also used as a gargle for gum disease and sore throat.

Comfrey is applied to the skin for ulcers, wounds, joint inflammation, bruises, rheumatoid arthritis, swollen veins (phlebitis), gout, and fractures.

Possibly Effective for...

  • Back pain. Applying a specific comfrey extract (Kytta-Salbe f by Merck Selbstmedikation GmbH) to the affected area for 5 days seems to decrease lower or upper back pain.
  • Osteoarthritis. Applying a specific comfrey extract (Kytta-Salbe f) to the affected area for 3 weeks or applying a specific cream containing comfrey extract, tannic acid, Aloe vera gel, eucalyptus oil, and frankincense oil (4Jointz) to the affected are for 12 weeks seems to decrease pain in people with knee osteoarthritis.
  • Sprains. Early research suggests that applying comfrey ointment to the affected area for up to 2 weeks improves mobility, decreases pain, and reduces tenderness and swelling of sprains. The effect of comfrey ointment in relieving pain and reducing swelling seems to be comparable to the effects of diclofenac gel. Most of the studies have used a specific comfrey ointment that is low in pyrrolizidine alkaloids (Kytta-Salbe f).

Insufficient Evidence to Rate Effectiveness for...

  • Bruises. Early research suggests that applying comfrey directly to the skin for 2 weeks might decrease pain and tenderness of bruises.
  • Skin ulcers.
  • Wounds.
  • Broken bones.
  • Heavy menstrual periods.
  • Diarrhea.
  • Cough.
  • Sore throat.
  • Gum disease.
  • Joint pain.
  • Chest pain.
  • Cancer.
  • Inflammation (pain and swelling).
  • Other conditions.
More evidence is needed to rate the effectiveness of comfrey for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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How does Comfrey work?

The chemicals in comfrey might have a healing effect and reduce inflammation when applied to the skin. However, comfrey contains toxic chemicals that can be absorbed through the skin.

Are there safety concerns?

Comfrey is POSSIBLY SAFE for most people when applied to unbroken skin in small amounts for less than 10 days. It's important to remember that the poisonous chemicals in comfrey can pass through the skin. Absorption of these chemicals increases if the skin is broken or if large amounts are applied.

Comfrey is LIKELY UNSAFE for anyone when taken by mouth. It contains chemicals (pyrrolizidine alkaloids, PAs) that can cause liver damage, lung damage, and cancer. The FDA has recommended removal of oral comfrey products from the market.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Comfrey is LIKELY UNSAFE to take by mouth or apply to the skin if you are pregnant or breast-feeding. In addition to causing liver damage and possibly cancer, the PAs in comfrey might also cause birth defects. Even topical use is unwise, since the PAs can be absorbed through the skin.

Broken or damaged skin: Don't apply comfrey to broken or damaged skin. Doing so might expose you to large amounts of the chemicals in comfrey that can cause liver damage and other serious health effects.

Liver disease: There is a concern that comfrey might make liver disease worse. Don't use comfrey if you have any problems with your liver.

Are there any interactions with medications?



Medications that can harm the liver (Hepatotoxic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Comfrey might harm the liver. Taking comfrey along with medication that might also harm the liver can increase the risk of liver damage. Do not take comfrey if you are taking a medication that can harm the liver.

Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.



Medications that increase the breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Comfrey is broken down by the liver. Some chemicals that form when the liver breaks down comfrey can be harmful. Medications that cause the liver to break down comfrey might increase the toxic effects of chemicals contained in comfrey.

Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Dosing considerations for Comfrey.

The appropriate dose of comfrey depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for comfrey. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Reviewed on 3/29/2011 12:35:40 PM

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