March 2011 Issue

Pycnogenol — Supplement Offers Promise for Managing a Variety of Conditions
By Jasmin Ilkay, MPH, RD
Today’s Dietitian
Vol. 13 No. 3 P. 14

Pycnogenol has recently emerged as one of the most promising dietary supplements on the market today. It ranks as one of the top-selling herbal dietary supplements in the United States.1 The proprietary herbal ingredient is noted for having anti-inflammatory, antioxidant, and immunostimulant effects.2 Perhaps what makes Pycnogenol unique is its potential to manage such a broad spectrum of conditions.

Published clinical trials have evaluated Pycnogenol for its potential use in managing conditions such as cardiovascular disease (CVD), chronic venous insufficiency (CVI), diabetes, childhood asthma, and osteoarthritis. Additional reports indicate it may help with thrombosis, hypertension, attention-deficit/hyperactivity disorder, erectile dysfunction, retinopathy, gingivitis, melasma, and muscular cramps and pain. However, these claims require additional research.

Pycnogenol is a trade name for a supplement derived from French Maritime pine bark extract. The water-soluble flavonoid extract was developed, trademarked, and patented by Horphag Research International. In spite of this, as an active ingredient, Pycnogenol is available for purchase from many supplement companies. Pine bark extract is available through other companies not using Pycnogenol, except that they may use different types of pine bark and have dissimilar formulations. Nonetheless, it is important to note that a majority of research is based on the Pycnogenol trademarked formula.

The proprietary extract comes from the bark of the French maritime pine tree Pinas pinaster, which grows on the coast of southwest France. The farming method is reported to be stable and controlled by the French government. Pine bark extract contains a group of compounds known as proanthocyanidins. These are not exclusive to Pinas pinaster, as many other plants have proanthocyanidins, including cocoa, grape seed, grape skin, bilberry, and cranberries.3 This is why supplements derived from some of these plants have been shown to have similar effects as Pycnogenol.

How It Works
According to the makers of Pycnogenol, the extract has four basic properties. It is an antioxidant, acts as an anti-inflammatory, selectively binds to collagen and elastin, and aids in the production of endothelial nitric oxide. These properties are based on more than 170 clinical trials and review articles published in the last 35 years.1 A majority of the studies reviewed in this article focus on its antioxidant, anti-inflammatory, and vasodilation properties.

Cardiovascular Health and Glucose Control
Pycnogenol may have the potential to serve as a preventative or adjunct treatment for CVD and diabetes.

A review article published in 2005 in Biomedical Reviews summarized the molecular mechanism and biological activity of Pycnogenol with a specific focus on cardiovascular health and glucose control. The author, Om P. Gulati, concluded that Pycnogenol maintains or improves cardiovascular health and glucose control by improving blood vessel relaxation and antiplatelet effects, resulting in better circulation; reducing blood pressure in mild to moderate hypertension; improving the blood lipid profile; reducing peroxidation of LDL cholesterol and thus CVD risks; reducing blood sugar levels and inhibiting oxidative stress and thus risk of diabetes; and having a capillary sealing effect, which is suggested to be the basis for reduction of retinal microbleedings and exudation in diabetic retinopathy.

Pycnogenol appears to be a safe and possibly a successful adjunct to those practicing preventative lifestyle efforts and for those wanting a complementary adjunct treatment for CVD and diabetes.

Chronic Venous Insufficiency
Pycnogenol has also been shown in a small number of studies to be effective in managing CVI.

The Pycnogenol monograph referenced five studies that met its exclusion criteria in evaluating the effectiveness of Pycnogenol for managing CVI. All five studies reported subjective improvements in CVI-related symptoms in the Pycnogenol treatment groups.1 Leg swelling was quantitatively measured in three of the studies. However, the studies were limited in their small numbers of participants and reliance on qualitative feedback from the subjects.1

Pycnogenol’s efficacy in treating CVI has not been established; however, these studies warrant continued research.

Asthma in Children
Pycnogenol may be used successfully as a complementary regimen in managing asthma in children.

Researchers from Loma Linda University conducted a randomized, placebo-controlled, double-blind study evaluating the effect of Pycnogenol as an adjunct therapy for asthma. They observed asthmatic subjects aged 6 to 18 over a three-month period. The group taking Pycnogenol had significantly improved pulmonary functions and asthma symptoms.4 Plus, the experimental group was able to reduce or discontinue using rescue inhalers and had a significant reduction in urinary leukotrienes than the placebo group.3 According to the principal investigator, the results are attributed to Pycnogenol’s anti-inflammatory, antiallergic, antioxidant, and antiviral effects. One weakness to this study was that there was no statistical comparison between Pycnogenol users and placebo treatment patients.1

This study and a handful of other studies have demonstrated Pycnogenol as being a potential adjunct treatment for asthma. It appears to be relatively safe for use among children aged 6 to 18. Parents wishing to supplement their children should do so only under medical supervision while staying abreast of trends.

Three randomized, double-blind, placebo-controlled studies reviewed in the Scientific and Clinical Monograph have demonstrated efficacy in treating osteoarthritis with Pycnogenol.1 Subjects with grade 1 or 2 osteoarthritis in one or both knees were evaluated after supplementation with Pycnogenol. Two of the studies supplemented subjects with 150 mg/day, while the latter used 100 mg/day. All three studies used the Western Ontario and McMaster Universities index, which measures 25 self-reported parameters. All of the aforementioned studies showed improvement in the symptoms of knee osteoarthritis patients treated with Pycnogenol.1

Together, the data indicate that the clinical response to the treatment was not apparent until six to eight weeks after treatment was initiated.1 While this shows promise, it’s worth noting that none of the studies evaluated Pycnogenol’s effectiveness as a sole treatment but rather as an adjunct therapy.1 Results from the three studies are promising; however, they were self-reported. More clinical trials objectively measuring Pycnogenol’s effectiveness as an adjunct and sole treatment for osteoarthritis are essential to confirm these actions.

Scientific research has studied the following oral doses5:

• for allergies: 50 mg twice daily;

• for asthma in children: 1 mg per pound of body weight given in two divided doses;

• for poor circulation: 45 to 360 mg/day or 50 to 100 mg three times daily;

• for diseases of the retina, including those related to diabetes: 50 mg three times daily;

• for mild high blood pressure: 200 mg daily; and

• for improving exercise capacity in athletes: 200 mg daily.

Dosage guidelines have not been clearly articulated, so comparing these doses with manufacturers’ recommendations should guide consumers in making informed choices.

Pycnogenol is generally recognized as safe for use in foods and dietary supplements and has no known contraindications. While no specific incidents have been reported, as an immunostimulant, Pycnogenol may increase symptoms of immune system disorders such as multiple sclerosis, lupus, and rheumatoid arthritis.5 No serious adverse effects have been reported in any clinical study or from commercial sales.1

Bottom Line
The plethora of research available regarding Pycnogenol suggests it has a promising future, particularly as a preventative and adjunct treatment for CVD, diabetes, and CVI. Scientific literature regarding its role in managing other conditions is limited. Its potential appears to outweigh its risks, as very few adverse effects have been reported. Unlike other supplement fads, this is one herbal ingredient that may be worth following.

— Jasmin Ilkay, MPH, RD, is a lecturer for the human nutrition and food science department at the California State Polytechnic University in Pomona Calif. and a freelance writer.

1. American Botanical Council. Scientific and Clinical Monograph for Pycnogenol. Austin, Tex.: American Botanical Council; 2009.

2. Memorial Sloan-Kettering Cancer Center. Pine bark extract. Available at: Accessed January 2, 2011.

3. Ilkay J. Debate on antioxidants: Some studies suggest efficacy while others question safety. Today’s Dietitian. 2010;12(4):14-17.

4. Lau BH, Riesen SK, Truong KP, et al. Pycnogenol as an adjunct in the management of childhood asthma. J Asthma. 2004;41(8):825-832.

5. MedlinePlus. Pycnogenol. Available at: Accessed January 4, 2011.