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Bugleweed - Drug Interactions, Side Effects and Precautions of Use
Taxonomic Class
LamiaceaeCommon Trade Names
Bugleweed Extract, Bugleweed Motherwort Compound
Common Forms
Available as a dried herb, liquid extract, and tincture.
Source
Pharmacologically active compounds are extracted from the roots, stems, leaves, and flowers of Lycopus virginicus and Lycopus europaeus. These members of the mint family are native to Europe and North America.
Chemical Components
Active constituents of L. europaeus include lithospermic, chlorogenic, caffeic, ellagic, and rosmarinic acids as well as the flavone glycoside luteolin7-glucoside. Other compounds include amino acids, minerals, sugars, tannin, ursolic acid, and sinapinic acid. L. virginicus was found to contain rosmarinic and caffeic acids. L. europaeus was found to contain catechol oxidase from diterpene metabolites.
Actions
Certain active compounds in Lycopus species have demonstrated complex endocrine effects in animal models, including a dose-related decrease in immunoglobulin G (IgG) antibody activity. The plant also inhibits IgG stimulation of adenylate cyclase in human thyroid membranes and thyroid iodine release in mice in vivo. It is unclear why bugleweed extracts interact with thyroid-stimulating hormone (TSH) and IgG antibody activity.
A study in horses found that oxidized Lycopus plant constituents inhibited serum gonadotropin levels in pregnant mares. These constituents also inhibited human chorionic gonadotropin (HCG) and prolactin in vitro .
Reported Uses
Bugleweed is claimed to have astringent and mild narcotic qualities and has been used for years in the symptomatic treatment of Graves' disease. Lycopus was compared with digitalis during the 19th century and was found to lower the pulse rate without accumulating in the system. .L. europaeus has also been used as a remedy for intermittent fever.
Dosage
For antithyroidal and antigonadal effects, 25 to 50 mg/kg parenterally or 200 to 1,000 mg/kg P.O. in animals .
Adverse Reactions
Metabolic: hyperthyroidism (controversial).
Interactions
Beta blockers: May mask symptoms of hyperthyroidism. Avoid administration with bugleweed.
Thyroid hormone replacement: May interfere with thyroid replacement therapy. Avoid administration with bugleweed.
Contraindications And Precautions
Bugleweed is contraindicated in pregnant or breast-feeding patients; effects are unknown. Use with extreme caution in patients with primary or secondary hypopituitarism, pituitary adenoma, primary or secondary hypogonadism, TSH-stimulating tumors, or related disorders. Use cautiously in patients with systolic dysfunction or heart failure.
Special Considerations
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Bugleweed suppresses follicle-stimulating hormone (FSH), luteinizing hormone (LH), HCG, and TSH levels. Depending on the patient's hormone levels, concurrent Lycopus administration could enhance or antagonize the effects of these hormones.
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Bugleweed has not been evaluated in other thyroid conditions, such as multinodular goiters and subacute thyroiditis.
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Lycopus and related species should not be substituted for antithyroid drugs, such as propylthiouracil and methimazole.
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No adverse effects have been reported in animal studies with L. europaeus; L. virginicus inhibits testicular growth in rats .
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Instruct the patient with a history of thyroid or cardiac disease or osteoporosis to consult a health care provider before taking bugleweed because of its unclear effect on thyroid function.
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Advise the patient taking oral contraceptives or fertility drugs to consult a health care provider before taking bugleweed.
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Advise women to avoid using bugleweed during pregnancy or when breast-feeding.
Points of Interest
L. europaeus is frequently sold as L. virginicus.
Commentary
Knowledge of bugleweed's physiologic effects is derived from in vivo and in vitro animal studies using freeze-dried extracts. Although the results of animal studies do not necessarily apply to humans, they should inspire caution. This agent inhibits various hormones, such as FSH, TSH, LH, and HCq, but the level of inhibition has not been evaluated. It is difficult to determine the place, if any, of bugleweed in the treatment of Graves' disease, but research suggests that this plant should be investigated more thoroughly.
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