Epimedium Grandiflorum

Epimedium Grandiflorum

Epimedium is a plant that is deeply rooted in traditional Chinese medicine. There it is used for various health purposes, for example as a tonic, aphrodisiac, and antirheumatic, primarily in a preventive manner. Epimedium belongs to the Berberidaceae family and is the most frequently used species within its genus when it comes to medicinal use. It is also known under the names: Horny Goat Weed, Herba epimdii, fairy wings, yin yang huo, rowdy lamb herb, or Elfenblume.

What benefits does Epimedium offer?

Studies suggest that Epimedium can potentially have aphrodisiac, antiatherogenic, anti-inflammatory, antiviral, and immunomodulating effects (1,2). In addition, supplementation with Epimedium over an intake period of several weeks showed a significant improvement in sexual health in the participants of one study (3). Several investigations showed positive effects on various health measures (1,4,5). One study found that in women after menopause, horny goat weed increases estrogen levels and can lower cholesterol and triglyceride levels (6). Another effect that could be associated with Epimedium was an improvement in bone strength and density. Studies have shown that Epimedium appears to improve bone mineral density (BMD) and pain perception in people with osteoporosis. This effect could be observed both in combination with standard medications and as an alternative treatment (7). In vitro and in vivo studies suggest that Epimedium could also be useful in the treatment of cardiovascular diseases, including atherosclerosis and coronary heart disease (8). In addition, there is more recent evidence of neuroprotective properties of the plant (9). These neuroprotective mechanisms in humans could include the upregulation of antioxidant activity (10) and the inhibition of inflammation and oxidative stress in the brain (11,12). However, human studies are required to confirm these effects.

How does Epimedium work?

The pharmacological benefit of Epimedium is primarily based on its active constituent, the flavonoid icariin. However, the plant also contains a range of various other active compounds such as polysaccharides and sterols, all of which can contribute to the overall therapeutic effect of Epimedium. Icariin acts similarly to PDE5 inhibitors (such as sildenafil) by promoting blood flow and increasing nitric oxide production (13,14). Horny goat weed could benefit ED through its inhibition of phosphodiesterase-5 (PDE-5). The same mechanism also comes into play, for example, with medications such as Viagra (15). PDE-5 inhibition increases the level of cyclic GMP, which in turn can support the relaxation of smooth muscle and improve blood flow to the genital region and thus promote an erection. The potentially cardioprotective properties of Epimedium are likely related to a decrease in the proliferation of vascular smooth muscle cells as well as reduced platelet activation, lipid modulation, and an improvement in endothelial function (8).

Are there side effects when taking Epimedium?

The oral intake of Epimedium is generally considered safe, and only few adverse effects could be identified. In the rare cases in which side effects were observed, they involved gastrointestinal complaints such as diarrhea, nausea, and vomiting. High doses may possibly cause a racing heart or skin rashes (16,17); however, both were observed with intake together with other herbal active ingredients. Since Epimedium can have blood pressure-lowering and anticoagulant effects in the body, taking it at the same time as medications that lower blood pressure or prevent blood clotting (e.g., antiplatelet agents or anticoagulants) can cause unwanted side effects. In addition, the promoting effect on estrogen levels can also represent a side effect and not only have positive impacts (6). In in vitro studies, icariin and some of its metabolites have shown inhibitory effects on certain isoforms of UDP-glucuronosyltransferase (UGT) in the gastrointestinal tract. These enzymes play a crucial role in the metabolism of orally administered drugs such as opioids, naproxen, paracetamol, and amitriptyline by facilitating their metabolic first-pass clearance (18). However, further studies are still needed here to show which interactions with medications exist. In any case, it is advisable to consult a doctor before taking Epimedium, especially in the case of existing health problems or when taking medications.

Sources:

  1. Qian, H. Q., Wu, D. C., Li, C. Y., Liu, X. R., Han, X. K., Peng, Y., Zhang, H., Zhao, B. Y., & Zhao, Y. (2024). A systematic review of traditional uses, phytochemistry, pharmacology and toxicity of Epimedium koreanum Nakai. Journal of ethnopharmacology, 318(Pt B), 116957. https://doi.org/10.1016/j.jep.2023.116957
  2. Yang, X., Cui, Y., Zhou, Z., Zhao, H., & Zhang, Y. (2021). Analysis of pharmacological mechanisms of Yinyanghuo as treatment of erectile dysfunction with network pharmacology-based strategy. Andrologia, 53(2), e13943. https://doi.org/10.1111/and.13943
  3. Long, H., Jiang, J., Xia, J., & Jiang, R. (2018). Icariin improves SHR erectile function via inhibiting eNOS uncoupling. Andrologia, 50(9), e13084. https://doi.org/10.1111/and.13084
  4. Bi, Z., Zhang, W., & Yan, X. (2022). Anti-inflammatory and immunoregulatory effects of icariin and icaritin. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 151, 113180. https://doi.org/10.1016/j.biopha.2022.113180
  5. Zhang, J., Zhao, Q., Qin, Y., Si, W., Zhang, H., & Zhang, J. (2023). The Effect of Epimedium Isopentenyl Flavonoids on the Broiler Gut Health Using Microbiomic and Metabolomic Analyses. International journal of molecular sciences, 24(8), 7646. https://doi.org/10.3390/ijms24087646
  6. Yan FF, Liu Y, Liu YF, Zhao YXHerba Epimedii water extract elevates estrogen level and improves lipid metabolism in postmenopausal women.Phytother Res.(2008-Sep)
  7. Shi S, Wang F, Huang Y, Chen B, Pei C, Huang D, Wang X, Wang Y, Kou S, Li W, Ma T, Wu Y, Wang ZEpimedium for Osteoporosis Based on Western and Eastern Medicine: An Updated Systematic Review and Meta-Analysis.Front Pharmacol.(2022)
  8. Fang J, Zhang YIcariin, an Anti-atherosclerotic Drug from Chinese Medicinal Herb Horny Goat Weed.Front Pharmacol.(2017)
  9. Wang S, Ma J, Zeng Y, Zhou G, Wang Y, Zhou W, Sun X, Wu MIcariin, an Up-and-Coming Bioactive Compound Against Neurological Diseases: Network Pharmacology-Based Study and Literature Review.Drug Des Devel Ther.(2021)
  10. He XL, Zhou WQ, Bi MG, Du GHNeuroprotective effects of icariin on memory impairment and neurochemical deficits in senescence-accelerated mouse prone 8 (SAMP8) mice.Brain Res.(2010-Jun-02)
  11. Li WW, Gao XM, Wang XM, Guo H, Zhang BLIcariin inhibits hydrogen peroxide-induced toxicity through inhibition of phosphorylation of JNK/p38 MAPK and p53 activity.Mutat Res.(2011-Mar-15)
  12. Liu B, Zhang H, Xu C, Yang G, Tao J, Huang J, Wu J, Duan X, Cao Y, Dong JNeuroprotective effects of icariin on corticosterone-induced apoptosis in primary cultured rat hippocampal neurons.Brain Res.(2011-Feb-23)
  13. Chung BH, Kim JD, Kim CK, Kim JH, Won MH, Lee HS, Dong MS, Ha KS, Kwon YG, Kim YMIcariin stimulates angiogenesis by activating the MEK/ERK- and PI3K/Akt/eNOS-dependent signal pathways in human endothelial cells.Biochem Biophys Res Commun.(2008-Nov-14)
  14. Xu HB, Huang ZQIcariin enhances endothelial nitric-oxide synthase expression on human endothelial cells in vitro.Vascul Pharmacol.(2007-Jul)
  15. Ning H, Xin ZC, Lin G, Banie L, Lue TF, Lin CSEffects of icariin on phosphodiesterase-5 activity in vitro and cyclic guanosine monophosphate level in cavernous smooth muscle cells.Urology.(2006-Dec)
  16. Partin JF, Pushkin YRTachyarrhythmia and hypomania with horny goat weed.Psychosomatics.(2004)
  17. Metz D, Weston P, Barker DCase report of vasculitic rash induced by Ginkgo biloba and/or Horny Goat Weed.BMJ Case Rep.(2009)
  18. Cao YF, He RR, Cao J, Chen JX, Huang T, Liu YDrug-Drug Interactions Potential of Icariin and Its Intestinal Metabolites via Inhibition of Intestinal UDP-Glucuronosyltransferases.Evid Based Complement Alternat Med.(2012)