Rhubarb: benefits, dosage, contraindications

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Rhubarb, classified under the Polygonaceae family, originates from the high plateaus of Central Asia. It has now acclimated in Europe. It is distinguished by a hollow stem which can reach up to 2 meters, topped with large lobed leaves and paniculate flowers. The parts used are the roots or rhizomes, harvested between 6 and 10 years for their concentration in hydro-anthracene derivatives, notably rhein. The major constituents also include aloe-emodin, dianthrones, and various flavonoids and organic acids. Rhubarb was valued in traditional Chinese medicine to improve digestion, and today it is mainly used for its laxative properties aiding in the management of constipation.

Other name(s) 

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Scientific name(s)

Rheum palmatum L, Rheum officinale

Family or group: 

Plants, Super Food

Active ingredients:

Rhein

Emodin


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Menopause
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Rhubarb, used in the form of a specific dry extract of its root (ERr 731, Estroease, Lupin Pharmaceuticals), has proven effective in improving menopause symptoms. Administered at a dose of 4 mg daily for 3 to 27 months, this preparation improved symptoms by 46% to 83% compared to less than 20% improvement with a placebo. The improvements observed concern anxiety, hot flashes, sweating, sleep disorders, mood problems, quality of life, fatigue, sexual problems, urinary issues, vaginal dryness, and joint and muscle pain. The underlying mechanism for these effects seems related to the hydroxystilbenes in rhubarb extract which activate estrogen receptor beta, but not alpha, thus offering potential benefits for managing menopause and dysmenorrhea symptoms via this pathway.

Posologie

posologieOral route: root

posologie4 mg

formulationERr 731, standardized extract


Constipation
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Rhubarb could have beneficial effects for treating constipation. A study on middle-aged adults shows that rhubarb extract at 12.5 mg or 25 mg, taken at bedtime for a month, improves stool frequency and consistency compared to a placebo. According to ESCOP, rhubarb may be considered for its laxative effect in standardized preparations for short-term use.

Posologie

posologieOral route: root

posologie15 - 50 mg

formulationdry extract


Canker Sores
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An open study in adults with mild canker sores showed that a topical application of a product containing 5% rhubarb extract and salicylic acid reduced symptom resolution time by about 3 days compared to a water control.

Posologie

posologieTopical, oral: root

posologie5 %

formulationtopical solution


Herpes
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Clinical research shows that a cream containing rhubarb and sage applied to cold sores is as effective as acyclovir cream, healing lesions in about 7.2 days compared to 6.3 days for acyclovir.

Posologie

posologieTopical: root

formulationcream


Synergies


Renal Insufficiency
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Meta-analyses indicate that rhubarb may improve serum creatinine and blood urea nitrogen in patients with chronic kidney disease, although these results are limited by the methodological quality of the studies.

Posologie

posologieOral route: root

posologie1 - 7 g

formulationdry extract


Properties


Laxative

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Rhubarb acts as a laxative due to its anthraquinone compounds, especially at high doses where they predominate, promoting relief from constipation and potentially inducing diarrhea. At low doses, its astringent effect gently regulates the gastrointestinal tract, thereby preventing excessive irritation.

Usages associés

Constipation

Hypolipidemic

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Rhubarb aids in reducing cholesterol levels, particularly in patients with hypercholesterolemia or non-alcoholic fatty liver disease. Its richness in fiber might bind to bile salts, accelerating cholesterol excretion. Rhubarb components also reduce cholesterol synthesis.


Nephroprotective

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Rhubarb extract promotes kidney health, reducing blood urea and serum creatinine, which can slow the progression of kidney diseases. Tannins, emodin, and epicatechin gallate improve renal markers and renal blood circulation.

Usages associés

Renal insufficiency


Safety dosage

Adult from 18 years: 15 g - 50 g (standardized extract)

Preparations equivalent to 15-50 mg of hydroxyanthracene derivatives (calculated as rhein) per day, preferably in a single intake in the evening. ERr 731 is a proprietary rhubarb extract formulation manufactured by Anderson Global Group. The powder is standardized to contain 54% rhaponticin and 27% desoxyrhaponticin. It also contains the aglycones rhapontigenin and desoxyrhapontigenin and does not contain the laxative anthraquinones emodin or rhein.

Child from 10 to 18 years:

Preparations equivalent to 15-50 mg of hydroxyanthracene derivatives (calculated as rhein) per day, preferably in a single intake in the evening.


Contraindications

Child up to 10 years: prohibited

Rhubarb (used therapeutically) is not recommended for children under 10 years.

Pregnant women: prohibited

Breastfeeding women: prohibited

Intestinal obstruction: prohibited

Do not use in case of intestinal obstruction and appendicitis, or abdominal pain of unknown origin.

Chronic inflammatory bowel diseases: prohibited

Do not use in cases of inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis).