Scutellaria baicalensis: benefits, dosage, contraindications

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Baikal skullcap, also known as "Huang Qin" in traditional Chinese medicine (TCM), is a perennial plant native to southern China and Korea. It is also found in parts of Russia. Its root is one of the 50 fundamental herbs used in TCM. Traditionally, Baikal skullcap is used to eliminate "heat and dry dampness." Heat-related illnesses are associated with symptoms such as fever, irritability, thirst, cough. This suggests that skullcap may be useful in infections and inflammations of the respiratory, digestive, and urinary systems. Research shows that skullcap constituents have antibacterial, antiviral, anti-inflammatory, hepatoprotective, anxiolytic, hypocholesterolemic, neuroprotective, and antimetastatic actions. The used parts of skullcap are the root and, to a lesser extent, the aerial parts. More than 40 flavonoids have been separated and identified from Scutellaria baicalensis. The most studied components include baicalein, baicalin, wogonin, wogonoside, scutellarein, and oroxylin A. Skullcap also contains melatonin. The flavone content in the rhizome (root) is significantly higher than that found in the aerial parts. The root of Scutellaria is recognized in the treatment of jaundice, hepatitis, diarrhea, and respiratory and gastrointestinal tract infections in China for more than 2000 years. It is also used in arthritis and arthrosis,

Other name(s) 

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Scientific name(s)

Scutellaria baicalensis Georgi

Family or group: 

Plants

Active ingredients:

Baicalin

Wogonin

Oroxylin


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.


Hepatitis
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In a multicenter, double-blind clinical study involving 222 patients with chronic active hepatitis, it was found that the herbal mixture Sho-saiko-to (Xiao-Chai-Hu-Tang) significantly decreased AST and ALT values compared to placebo. The difference in mean values between the treated group and the placebo group was significant after 12 weeks. In patients with chronic active hepatitis type B (HB), a trend towards decreasing HBe antigen and increasing anti-HBe antibodies was also observed. The Chinese herbal medicine Sho-saiko-to, or Xiao-Chai-Hu-Tang, is an officially approved prescription medicine in Japan and is currently a commonly administered medicine to patients with chronic liver diseases, especially those with chronic hepatitis and liver cirrhosis. The usual daily dose of Sho-saiko-to is 7.5 g, orally administered in three equal doses. A 7.5 g sample of Sho-saiko-to is prepared from boiled aqueous extracts of seven herbs: - 7.0 g of Bupleurum root (Chinese thoroughwax), - 5.0 g of Pinellia tuber, - 3.0 g of Scutellaria root, - 3.0 g of jujube fruit, - 3.0 g of ginseng root, - 2.0 g of licorice root - 1.0 g of ginger rhizome. The effect of Scutellaria Baicalensis alone cannot be confirmed in this study.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Fibrosis
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It has been demonstrated that the combination containing Scutellaria baicalensis (Sho-saiko-to) plays a chemopreventive role in the development of hepatocellular carcinoma in cirrhotic patients in a prospective study, and several studies have shown the preventive and therapeutic effects of Sho-saiko-to on experimental hepatic fibrosis. It has been shown that Sho-saiko-to inhibits the activation of hepatic stellate cells, the main collagen-producing cells. Sho-saiko-to has a strong antifibrotic effect by inhibiting oxidative stress in hepatocytes and hepatic stellate cells. It is proposed that the active components are baicalin and baicalein, as they both have very similar chemical structures to silybin, the active compound in milk thistle, which presents antifibrotic activities. Sho-saiko-to combined with silymarin in 90 patients suffering from hepatic fibrosis due to chronic hepatitis B virus improved liver function and serum fibrosis indices in the treated group, while the clearance of the hepatitis B virus was comparable to that of the control group.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Osteoarthritis
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A clinical study evaluated the effectiveness of a supplement containing Scutellaria baicalensis and Acacia catechu extracts (flavocoxid) on knee osteoarthritis symptoms. Participants received either 500 mg of this supplement per day or 440 mg of naproxen (a standard treatment for osteoarthritis) per day for a week. The results showed that the supplement significantly reduced pain, knee stiffness, and improved range of motion, with efficacy similar to naproxen. These results suggest that flavocoxid is effective at reducing physical symptoms associated with knee osteoarthritis.

Posologie

posologieOral: root

posologie3 g

duration12 - weeks

formulationpowder


Type 2 Diabetes
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A clinical trial conducted on patients with uncontrolled diabetes taking 500 mg of metformin per day shows that taking 3.52 g of skullcap extract in three divided doses per day for 8 weeks does not decrease fasting glucose or insulin levels, nor does it improve glycosylated hemoglobin (HbA1c) levels compared to placebo. However, taking skullcap reduces blood glucose levels during an oral glucose tolerance test at 60 minutes, but not at 120 minutes, compared to placebo.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Allergic Rhinitis
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Baicalin is one of the main constituents that regulates the TH1/TH2 balance and adjusts histamine release by mast cells. Many researchers consider allergy to be due to an excess of Th2 lymphocytes over Th1. The use of skullcap for allergic rhinitis is based on long-standing traditional use.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Asthma
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The root of this plant has been used in traditional Chinese medicine (TCM) for a variety of conditions, including asthma. Skullcap contains flavone derivatives, including baicalin, wogonin, and baicalein, which inhibit histamine release by mast cells (see properties). Reducing airway hypersensitivity and inflammation is essential for managing asthma. Its traditional use helps relieve nocturnal asthma symptoms.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Stroke
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Scutellaria exerts an antioxidant and neuroprotective effect making it a remedy used in the prevention of cerebral ischemia following a stroke or brain injury. Huang lian jie du tang is an important Chinese remedy consisting of multiple herbs, including Scutellaria baicalensis, clinically used to treat cerebral ischemia.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Cancer
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The roots of Scutellaria baicalensis contain bioactive compounds such as wogonin (WOG). Numerous in vitro and in vivo studies have revealed that WOG exhibits immense therapeutic potential against various types of cancer (bladder cancer, breast cancer, colorectal cancer, gastric cancer, liver cancer, leukemia, lung cancer). Additionally, WOG, when combined with established chemotherapeutic drugs, improves treatment efficacy and reduces toxicity. Nonetheless, human trials are necessary to validate these results.

Posologie

posologieOral: root

posologie3 g

formulationpowder


Properties


Anti-inflammatory

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Skullcap shows significant anti-inflammatory activity, supported by in vitro and in vivo research. Its key components, baicalin and wogonin, influence various inflammatory factors, including cytokines, nitric oxide, and eicosanoids. Studies on mice have confirmed its efficacy in reducing several inflammatory markers, including those involved in allergic processes. Baicalin may act by inhibiting chemokines, while wogonin may reduce microglial cell mobility, partly via NF-baB inhibition.

Usages associés

Arthrosis

Neurological

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Numerous in vitro and in vivo trials have demonstrated the neuroprotective effects of flavonoids derived from skullcap. They suggest that skullcap flavones prevent neural damage through a strong antioxidant effect (reduction in lipid peroxidation markers), moderating inflammation and enhancing GABAergic signaling (anxiolytic and anticonvulsant effect) and that wogonin (a component of skullcap) exerts a neurogenerative action, based on in vitro and in vivo evidence. An in vivo study in rats subjected to permanent global ischemia showed that daily oral doses of skullcap flavonoids (35 mg/kg) for 19 to 20 days significantly increased learning and memory capacities and attenuated neuronal damage. A follow-up in vivo study demonstrated that the flavonoid fraction also reduced neuronal damage and memory deficits after permanent cerebral ischemia. Huang lian jie du tang is an important Chinese remedy based on multiple herbs, containing Scutellaria baicalensis, which is used clinically to treat cerebral ischemia. It also appears that skullcap may play a role in neurodegenerative disorders such as Parkinson's disease.

Usages associés

Stroke

Anticancer

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Skullcap is traditionally used in alternative medicine for cancer treatment, notably prostate cancer. Scientific studies, both on animals and in vitro, have explored its anticancer properties. These studies suggest that Skullcap induces apoptosis (programmed cell death) by inhibiting certain cellular pathways and reducing inflammatory cytokines and eicosanoids. Moreover, in vitro studies indicate that Skullcap might prevent the formation of new blood vessels feeding tumors, a process known as anti-angiogenesis, possibly through influence on specific signaling pathways.

Usages associés

Cancer

Antiallergic

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Various flavonoids of Baikal skullcap, including wogonin and baicalein, have demonstrated an ability to inhibit histamine release from rat mast cells. These flavonoids also attenuate allergic reactions, both immediate and delayed, by acting on IgE antibodies in mice and decreasing histamine release in human mast cells. Moreover, compounds like luteolin and baicalin reduce histamine and other inflammatory mediators. Skullcap proves to be as effective, if not more, than some conventional antiallergic medications in suppressing allergic reactions.

Usages associés

Asthma, Allergic rhinitis

Antiviral

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Scutellaria has demonstrated significant antiviral effects. In particular, Scutellaria extract inhibits the replication of hepatitis C and influenza A viruses, including H1N1 and H3N2 strains. This inhibition occurs via baicalin, a flavonoid targeting neuraminidase, a crucial enzyme for virus replication. Baicalin inhibits other viruses: HIV-1 infection at the viral entry level and early activation of Epstein-Barr virus antigen. Additionally, Scutellaria inhibits virus replication partly by inhibiting the fusion of viral envelopes with the endosome/lysosome membrane, which occurs early in the virus infection cycle.


Hepato-protective

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Baicalin, baicalin, and wogonin, flavonoids of Baikal skullcap, have shown hepatoprotective effects. These compounds reduce toxicity related to various chemicals, as indicated by decreases in liver enzymes (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and histopathological analyses. Baicene, in particular, significantly increases TNF-b1 and IL-6 levels (inflammatory markers), suggesting potential in hepatic regeneration after induced lesions.

Usages associés

Hepatitis, Fibrosis

Anxiolytic

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Research has shown that wogonin, baicalein, scutellarein, and baicalin, all flavonoids, bind to the benzodiazepine site of the GABA-A receptor, with decreasing levels of effectiveness, which plays a role in regulating neuronal excitability and anxiety. Wogonin, taken orally, interacts with these receptors and produces an anxiolytic effect similar to diazepam (an anxiety medication), but without sedation or muscle relaxation. Other flavones like oroxylin A and K36 also act on this site and have shown anxiolytic activity. Additionally, wogonin has anticonvulsant effects mediated by GABA.


Antibacterial

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Adding baicene to standard antibiotic therapy against multidrug-resistant Staphylococcus aureus increases the efficacy of the antibiotic ciprofloxacin. This likely occurs because baicene prevents the antibiotic from being ejected out of the bacterium, a common mechanism of bacterial resistance. This discovery offers hope in the treatment of resistant bacterial strains. Furthermore, baicalin and Scutellaria baicalensis have proven effective against Helicobacter pylori, with baicalin being more effective than the complete plant extract.


Hypolipidemic

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Animal studies indicate that skullcap can reduce total cholesterol levels, triglycerides, LDL-C (bad cholesterol), while increasing HDL-C (good cholesterol) levels. Additionally, wogonin, a component of skullcap, inhibits MCP-1 production by endothelial cells, suggesting potential benefits in treating inflammatory and vascular disorders, including atherosclerosis.


Antiandrogenic

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a0Skullcap is traditionally used for prostate cancer and as an anti-inflammatory agent. In an animal model of benign prostatic hyperplasia, Baikal skullcap inhibited inflammation and cell proliferation, probably by inhibiting 5-alpha reductase.a0


Hypoglycemic

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Skullcap may be beneficial in managing diabetes. Human studies have shown that it has a moderate effect on postprandial glucose levels, but not on fasting glucose levels. In animals, baicalin, one of its components, inhibits alpha-glucosidase, an enzyme involved in carbohydrate digestion. Additionally, baicalin appears to reduce elevated insulin levels following a high-fat diet and inhibit intestinal sucrase according to in vitro research.

Usages associés

Type 2 diabetes


Safety dosage

Adult: 100 mg - 800 mg (standardized extract)

A clinical study showed that a single oral dose of baicalein tablets, ranging from 100 to 800 mg, was safe and tolerable in healthy subjects, with no serious or severe adverse effects observed.


Interactions

Médicaments

Rosuvastatin: moderate interaction

Baicalin from Baikal Skullcap may reduce plasma levels of rosuvastatin by stimulating the OATP1B1 transporter, thus increasing the delivery of rosuvastatin to the liver. This affects the concentration of the drug in the plasma and potentially the liver. Skullcap could also influence other drugs transported by OATP1B1.

Cyclosporine: weak interaction

A decoction of Scutellaria baicalensis has been reported to significantly decrease plasma levels of cyclosporine in rats. Co-administration of these two substances should be avoided until further research is available.


Precautions

Pregnant woman: avoid

Potential toxicity.

Breastfeeding woman: avoid

Potential toxicity.