Background:
Dandelion is a flowering plant that can be found throughout the northern hemisphere, is rich in various nutrients such as vitamin A and fiber, and has demonstrated “choleretic, diuretic, antirheumatic, and anti-inflammatory properties,”(3,4,6) which is why it has been used as medicine as far back as 10th century Arabia (7). Specifically, it has been used in Mexican, Chinese, and Native American medicines to treat ailments such as sore throats, viral and bacterial infections, liver disorders, cancer, and leukemia (2,5,7). Leukemia, particularly Chronic Myelomonocytic Leukemia (CMML), has exhibited a trend of high resistance to treatment and the treatments that are available often have serious adverse effects. As a result, researchers are exploring various alternative treatments with better patient prognoses and fewer adverse effects. Dandelion root extract (DRE) is one of these alternative treatments due to its theorized antineoplastic action via inducing apoptosis in human hepatoma cells by increasing the number of Inflammatory cytokines (1,2,3).
Side Effects: Diarrhea, Heartburn, Upset Stomach.
Drug Interactions: Potassium-sparing diuretics – can potentially increase the chance of hyperkalemia. Quinolone antibiotics – Could lower fluoroquinolone levels.
Clinical Evidence:
Taraxacum officinale is the official botanical name of Dandelion, and its name reflects its roots in traditional Chinese medicine. The Greek root taraxos means disease and the root akos means to remedy. Dandelion is thought to have originated from the Mediterranean and, according to records, was used extensively by ancient Egyptians, Romans, and Greeks. Original uses were to rid the bloodstream of toxins and was likely used for this purpose due to its mild diuretic effects (8). Due to this effect, it has been used to improve renal and hepatic function, treat inflammation, and lower blood pressure (8,9).
A current question remains regarding the medicinal benefit potential from Dandelion; can Dandelion be used as a natural chemotherapy agent in humans for the treatment of Leukemia? High-quality human studies are often not performed for herbal supplements, making data interpretation difficult. Thankfully, several human studies do exist and used in vitro methods to pave the way for in vivo studies in the future. In vitro studies using human cells have been performed for the exploration of the potential for Dandelion to be used as a chemotherapy agent. The rationale for these studies is likely due to the strong cytotoxic and antioxidant effects observed on human cells in an in vitro environment10. In one recent study, aqueous DRE was capable of inducing leukemia cell line apoptosis using the proteolytic enzyme Caspase mechanism in a dose and time-dependent manner without adversely affecting non-cancerous cells (4). A more recent study concluded that Dandelion root extract could induce extrinsic cell death in human chronic myelomonocytic leukemia cells without affecting non-cancerous neighboring cells1. These studies offer a potential glimpse into safer and more natural alternatives to our current chemotherapy agent arsenal. However, these studies only demonstrate preliminary evidence and higher quality in vivo studies have not been described in the literature.
Conclusions:
After review of the literature, we conclude that dandelion root extract selectively destroyed human leukemia cells and avoided damaging healthy cells and, therefore, has the potential to treat Leukemia, but current data using high-quality human studies for these effects are currently lacking. More testing needs to be done before this treatment can be considered as a mainstream option (8,9). This future testing will likely need to focus on clinical trials to examine in vivo scenarios and isolate the side effect profile of DRE in real patients with leukemia.
References:
- Ovadje P, Hamm C, Pandey S. Efficient induction of extrinsic cell death by dandelion root extract in human chronic myelomonocytic leukemia (CMML) cells. PLoS One. 2012;7(2):e30604. doi: 10.1371/journal.pone.0030604. Epub 2012 Feb 17. PMID: 22363452; PMCID: PMC3281857.
- Ovadje P, Chatterjee S, Griffin C, Tran C, Hamm C, Pandey S. Selective induction of apoptosis through activation of caspase-8 in human leukemia cells (Jurkat) by dandelion root extract. J Ethnopharmacol. 2011 Jan 7;133(1):86-91. doi: 10.1016/j.jep.2010.09.005. Epub 2010 Sep 16. PMID: 20849941.
- Natural Medicines Comprehensive Database. https://naturalmedicines-therapeuticresearch-com.ezproxy.lib.utah.edu/databases/food,-herbs-supplements/professional.aspx?productid=706. Accessed on 21 07 2021
- Marta González-Castejón, Francesco Visioli, Arantxa Rodriguez-Casado, Diverse biological activities of dandelion, Nutrition Reviews, Volume 70, Issue 9, 1 September 2012, Pages 534–547, https://doi.org/10.1111/j.1753-4887.2012.00509.x
- Huang Y, Wu T, Zeng L, Li S. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev. 2012 Mar 14;(3):CD004877. doi: 10.1002/14651858.CD004877.pub3. PMID: 22419300.
- “ET-chem.com.” Natural ingredients, https://www.et-chem.com/dandelion-extract-manufacturer-taraxacum-officinale-supplier/. Accessed 02 08 2021
- “Dandelion.” Drugs.Com, 5 July 2021, www.drugs.com/npp/dandelion.html.
- Clare BA, Conroy RS, Spelman K. The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day. J Altern Complement Med. 2009 Aug;15(8):929-34.
- Mascolo N, et al. Biological screening of Italian medicinal plants for anti-inflammatory activity. Phytotherapy Res. 1987:28-29.
- Hu C, Kitts DD. Antioxidant, prooxidant, and cytotoxic activities of solvent-fractionated dandelion (Taraxacum officinale) flower extracts in vitro. J Agric Food Chem. 2003;51(1):301-10.
Responses
Hello Trevor, Michael, and Clint – what are the two main things you learned from preparing and developing this topic?
Personally, the two main things I was surprised to learn was first that dandelion had any medicinal properties or was used as medicine at all. I grew up blowing dandelion seeds in the weed and eating my neighbors home made dandelion jelly so I thought it was just an obscure food and a nuisance plant that my dad hated finding in the garden. I found it interesting that it has a long history of medicinal use. The other thing I learned that I found interesting was that, at least in a lab setting, there is potential for Dandelion to be used in leukemia treatment. I fully expected this to be an old wives’ tale or exaggeration when I saw it listed as a possibility in natural medicines and we would answer our question by saying definitively that there were no grounds to continue looking into it. I was surprised at the end of the two studies to see that there is reasonable evidence to at least examine its effects in clinical trials.
I learned that there is presently in vitro data demonstrating Dandelion root extract is capable to inducing Leukemia cell line apoptosis without inducing apoptosis in non-leukemia cells. In addition, we learned that Dandelion has widely known weak diuretic effects and has been used for this purpose for centuries.
I was the one that came up with the idea of presenting on dandelions. I have to be honest I was very surprised to learn it was more than just a weed. I thought it was interesting to learn that dandelion presented an option to aid in the treatment of leukemia. I never would have thought the annoying weed that grew all over my yard had the potential to fight cancer. I thought it was interesting to learn that dandelion had been used to tackle inflammation and as a potent antioxidant.
Interesting topic. Any evidence at all in human studies? How is the length of treatment determined in these studies? What would you say to a patient that is interested in using this product for leukemia?
There is currently only in vitro studies conducted using human cell lines but currently no studies have been conducted in vivo. The length of treatment was not described in the short study article but rather just the effects of the Dandelion root extract. I would tell a patient that this is a potential possibility in the future but currently no studies have demonstrated it’s efficacy in a full human model and the results from the in vitro study can not be compared to a full human model until future studies examine this possibility.
As far as I could tell there is only one in vivo study which was a singular case study of a 76-year-old male with previously untreated CMML and he had positive results. The two studies we chose for our poster while being in vitro studies were performed on both healthy human cells and cells infected with leukemia. As of now treatment length is unclear, I imagine it would be one of the topics that would be examined if clinical trials were to occur. However, since the known adverse effects are generally mild I think patients could use it for as long as they like if they believe it is beneficial to them. I would tell a patient that if they are interested in using dandelion to treat their leukemia they should first and foremost continue with the treatment that has been prescribed by their doctor and if they want to try dandelion in addition to the treatment they likely will not have any major side effects. I would also advise them of potential allergic reactions if they’ve never eaten dandelion before.
Currently, there are no human studies. We were able to find two in vitro studies that are promising. As far as I could tell there was no mention of dosing in the studies and neither was there any information about the length of treatment. The authors did mention that dandelion root extract acted in a dose and time-dependent manner. Personally, if a patient came up to me and asked about using dandelion root extract for their leukemia I would have to tell them I could not recommend its use. There are some promising studies but not that have involved humans directly.
Hi Trevor, Michael, and Clint! Can patients with a history of seasonal allergies take dandelion?
Great question, in our research I never saw any explicit guidelines regarding seasonal allergies, but people can be allergic to dandelion specifically. It can cause dermatitis and in rare cases, anaphylaxis. So if a patient knows that there allergies are often caused by dandelions specifically I would recommend against its use, but if there seasonal allergies are more general I imagine they could at least try under supervision to see if they have a reaction.
Have they been able to nail down a specific mechanism of action for the destruction of leukemia cells?
Dandelion root extract was able to activate the caspase enzymatic apoptosis pathway in leukemia cells.
All, I was wondering how dandelion root would be delivered if it does provide evidence for leukemia treatment? I eat dandelion salads in the spring time and I know people that make dandelion wine so I was curious if those were options, or what it’s mode of delivery into the body would be?
Great question and I had the same thought. In the studies we looked at they used dandelion root extract which is a strongly concentrated form. In the one case study I saw the patient used DRE capsules so most likely a similar delivery method would be used unless clinical trials showed it to be unsafe, ineffective, or less effective than other methods.
Dandelion root extract has currently only been studied using in vitro models. Presently, the effects of the active compounds after human digestion are still not currently known. From a home-brewing perspective, active fermentation causes many chemical changes to the terpenes found within hops and hop additions during and after fermentation are recommended if more depth from the hop profile is desired. I would assume that the medicinal benefits found in Dandelions would be drastically diminished in Dandelion wine.
Hello Trevor, Michael, and Clint!
Are there any disease states or comorbidities where the use of dandelion is contraindicated?
None that I know of from my research. There are a few though that should use caution before using it. Individuals with atopic dermatitis or ragweed allergies may be more likely to have allergic sensitivity to dandelion and dandelion may increase bleeding risk so patients taking anticoagulants should consult there doctor before taking a dandelion supplement.
From what I saw there was a few disease states you would want to be cautious with using dandelion. If you are allergic to dandelion you would not want to use it, or if you experience seasonal allergies you would want to be cautious in using it since you could potentially experience anaphylactic shock. Also if you are going to have surgery done you would want to discontinue using dandelion 2 weeks prior due to its antiplatelet and hypoglycemic effects.
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