HORSERADISH (Armoracia rusticana P. Gaertin., B. Mey. & Scherb.)

HERBAL 

M E D I C I N A L

HORSERADISH

(ARMORACIA RUSTICANA P. GAERTN. ET AL.) ++ BRASSICACEAE

BY 

RETTODWIKART THENU

HORSERADISH !

(hawrs’ra-dish)

(ARMORACIA RUSTICANA P. GAERTN. ET AL.) ++ BRASSICACEAE

HISTORICAL NOTE (Braun, L and Cohen, M. 2010)

Horseradish is a commonly used spice with a long history of use in traditional medicine. The leaves are used in cooking and as a salad green. Horseradish is one of the ‘five bitter herbs’ of the biblical Passover.

SUMMARY AND PHARMACEUTICAL COMMENT (Barnes, J et al., 2007)

The chemistry of horseradish is well established and it is recognised as one of the richest plant sources of peroxidase enzymes.(G48) Little pharmacological information was located, although the isothiocyanates and peroxidases probably account for the reputed circulatory stimulant and wound-healing actions, respectively. The oil is one of the most hazardous of all essential oils and it is not recommended for either external or internal use.(G58) Horseradish should not be ingested in amounts exceeding those used in foods.

SPECIES (FAMILY) (Barnes, J et al., 2007)

Armoracia rusticana P. Gaertin., B. Mey. & Scherb.

SYNONYM(S) (Duke. J. A  et al., 2003)

A. lapathifolia Gilib. ex Usteri, Cochlearia armoracia L., Nasturtium armoracia (L.) Fr.,

Radicula armoracia (L.) B. L. Rob., Rorippa armoracia (L.) Hitchc.

NOTES (HORSERADISH): (Duke, J. A et al., 2003)

The fourteenth day of the second month at even they shall keep it, and eat it with unleavened bread and bitter herbs.

Numbers 9:11 (KJV)

Although most books on medicinal plants of the Bible, including my own, do not mention the horseradish, it seems to be the most important passover herb and is mentioned in the Torah. Under several orthographic variants (marror, maror, mohror, moror, morror), the Torah mentions eating the morror (marror, maror, moror), or the bitter herb. Many of my Jewish friends consider it the bitter herb mentioned in Numbers 9:10–11 (Helen Metzman; Wayne Silverman, separate personal communications, 2007).

I find it a great spice, especially with ketchupy seafood cocktail sauces like I enjoyed last night with shrimp cocktail. I was taken aback when the first title crossing my desk as I settled back into compiling today was “Deodorization of Swine Manure using Minced Horseradish Roots and Peroxides.” Pennsylvania scientists Govere et al. (2005) removed all offensive phenolics without recurrence for 72 hours, but human panels considered the odor reduced 50% in intensity, dare I call it IC50 = 1 part horseradish to 10 parts manure + calcium peroxide (26 or 34 mM) + hydrogen peroxide (34, 52, or 68 mM). The authors conclude that using horseradish “as enzyme carriers and peroxides as electron acceptors emerges as an effective approach to phenolic (p-cresol- p-ethylphenol) and phenol odor control in animal manure,” skillfully avoiding the issue of the nonphenolic contributors (volatile fatty acid-like n-butyric, n-caproic, isobutyric, isocapoic, isovaleric, propionic, and n-valeric acids) and indoles (indole, scatole). “More work is required to find ways to increase the removal of indolic odorants and volatile fatty acids.” Govere et al. (2005)

COMMON NAMES (HORSERADISH) (Duke, J. A et al., 2003)

Aed-madaroigas (Estonia; POR); Balsamita Jaramago (Sp.; EFS); Barbaforte (It.; EFS; HH2); Bayirtupu (Tur.; EFS); Boereradijs (Dutch; POR); Chren (Rus.; HH2); Chrzan (Pol.; HH2); Chrzan pospolity (Pol.; POR); Cran (It.; EFS); Cran de Bretagne (Fr.; EFS); Cranson (Fr.; USN); Cren (It.; HH2); Grand Raifort (Fr.; POR); Great Raifort (Eng.; GMH); Hoosu radiishu (Japan; POR); Horseradish (Eng.; Scn.; AH2; CR2); Khren (Rus.; POR); Kozonseges Torma. (Hun.; POR); Kren (Ger.; POR); Krˇen (HH2); Kreno (Dutch; POR), La Gen (China; POR); Madaroigas (Estonia; POR); Makatakak (Hocak; WIN); Ma luo po (China; TAN); Meeretisch (Ger.; POR); Meerradi (Ger.; POR); Meerrettich (Ger.; POR; USN); Meredic (Fr.; HH2); Meredik (Dutch; POR), Mierik (Dutch; POR), Mierikswortel (Dutch; EFS); Morror (Heb.; ?); Mountain Radish (Eng.; GMH); Moutarde des Allemands (Fr.; GMH); Moutarde des capucins (Fr.; POR); Moutardelle (Fr.; POR); Peberrod (Den.; POR); Pepparot (Swe.; POR); Piparjuuri (Fin.; POR); Rabano Forte (Por.; HH2); Rabano Picante (Sp.; Por.; USN); Rabano Picanto (Por.; USN); Rabano Rusticana (Sp.; EFS; USN); Rabano Silvestre (Por.; POR); Rafano (It.; EFS); Raifort Cran (Fr.; USN); Raifort Sauvage (Fr.; EFS); Raiz Forte (Brazil; Por.; POR; USN); Red Cole (Eng.; GMH); Seiyo wasabi (Japan; TAN); Seiyou wasabi (Japan; POR); Taramago (Sp.; POR).

OTHER NAMES (Duke, J. A et al., 2003)

Amoraciae rusticanae radix, great mountain root, great raifort, mountain radish, pepperrot, red cole

BOTANICAL NAME/FAMILY (Duke, J. A et al., 2003)

Armoracia rusticana, synonym Armoracia lopathifolia; Cochlearia armoracia, Nasturtium armoracia, Roripa armoracia (family Brassicaceae [Cruciferae])

PLANT PARTS USED (Braun, L and Cohen, M. 2010)

Fresh or dried roots and leaves

PRODUCT AVAILABILITY (Linda,S-R. 2010)

Fresh root, paste, powder

PHARMACOPOEIAL AND OTHER MONOGRAPHS (Barnes, J et al., 2007)

Complete German Commission E(G3)

Martindale 35th edition(G85)

LEGAL CATEGORY (LICENSED PRODUCTS) (Barnes, J et al., 2007)

GSL(G37)

CONSTITUENTS

CONSTITUENTS (Barnes, J et al., 2007)

The following is compiled from several sources, including General References G40, G58 and G62.

·         Coumarins Aesculetin, scopoletin.(1)

·         Phenols Caffeic acid derivatives and lesser amounts of hydroxycinnamic acid derivatives. Concentrations of acids are

reported to be much lower in the root than in the leaf.(1)

·         Volatile oils Glucosinolates (mustard oil glycosides) gluconasturtiin and sinigrin (S-glucosides), yielding phenylethylisothiocyanate and allylisothiocyanate after hydrolysis. Isothiocyanate content estimated as 12.2–20.4 mg/g freeze dried root.(2, 3)  Other isothiocyanate types include isopropyl, 3-butenyl, 4-pentenyl, phenyl, 3-methylthiopropyl and benzyl derivatives.(4)

·         Other Constituents Ascorbic acid, asparagin, peroxidase enzymes, resin, starch and sugar.

·         Other Plant Parts Kaempferol and quercetin have been documented for the leaf.

CHEMICAL COMPONENTS (Braun, L and Cohen, M. 2010)

Horseradish root contains volatile oils: glucosinolates (mustard oil glycosides); gluconasturtiin and sinigrin (S-glucosides); coumarins (aesculetin, scopoletin); phenolic acids, including caffeic acid derivatives and hydroxycinnamic acid derivatives, ascorbic acid; asparagin; resin; and peroxidase enzymes. Horseradish is one of the richest plant sources of peroxidase enzymes, which are commonly used as oxidising agents in commercial chemical tests.

CHEMISTRY (Duke, J. A et al., 2003)

Volatile isothiocyanates, locked up temporarily as the glycosides nasturtiin and/or sinigrin, are released when hydrolyzed by the enzyme myrosinase or thioglucosidase, also present in the root. This enzymatic oxidation of the hot compounds in horseradish (and other crucifers) rather parallels what happens with some hot sulfur-containing compounds in the garlic family as well. The enzymes go into action only when the root is scratched. And these sulfur compounds seem to be very important in cancer prevention when used in moderation. Here are a few of the more notable chemicals found in horseradish. For a complete listing of the phytochemicals and their activities, see the CRC phytochemical compendium, Duke and duCellier, 1993 (DAD) and the USDA database http://www.ars-grin.gov/duke/.

Ø  Allyl – Isothiocyanate—Antiasthmic; Anticancer; Antifeedant; Antimutagenic; Antiseptic; Counterirritant; Decongestant; Embryotoxic; Fungicide MIC = 1.8–3.5 ìg/ml; Herbicide IC100 = 0.4 mM; Insectiphile; Mutagenic; Nematiovistat 50 ìg/ml; Spice FEMA 1–80 ppm; LD50 = 339 orl rat.

Ø  Isothiocyanate — Antibacterial; Anticancer; Antiseptic; Antithyroid; Antitumor; Chemopreventive; Fungicide; Hypotensive; Goitrogenic; p450-Inhibitor; Mucolytic; Nematicide; Respiradepressant; LD50 = 120.

Ø  Rutoside — Antiaggregant; Anticapillary-Fragility; Choleretic (50 mg/kg ipr); COMT-Inhibitor.

Ø  Sinigrin — Anticancer; Antifeedant; Larvicide; Mutagenic; Phagostimulant; Quinone-Reductase-Inducer 15 ìM.

USES

MEDICINAL USES (Duke, J. A et al., 2003)

Could horseradish be one of the bitter herbs of the Bible? Well, horseradish is reportedly one of the five bitter herbs, with coriander, horehound, lettuce, and nettle, during the Jewish Passover (Libster, 2002). None of my Bible books suggest that horseradish is one of the bitter herb(s). Tucker and DeBaggio (2000) tell us that horseradish was cultivated prior to the Exodus of the Hebrew slaves. But Bown (2001) suggests it may have been brought in to cultivation less than 2000 years ago, perhaps first medicinal, secondarily spice, not “becoming popular as a flavoring until the late 16th century.” It is bitter and so important, traditionally, in our modern Passover feasts. Considered antiscorbutic, antiseptic, digestive, diuretic, expectorant, rubefacient, stimulant, and vermifuge, horseradish is about as useful in the medicine chest as it is in the spice rack. In ancient times, it was used as a preventative or cure for many ailments. Eclectics said picturesquely, “It promotes all the secretions, the urinary in particular, and stimulates the stomach when this organ is enfeebled.” The hot cider infusion has been recommended for dropsy (FEL). “Locally, the vinegar infusion is said to remove tan and freckles” (FEL). The herb is approved, internally, by Germany’s Commission E for bronchosis, coughs, respiratory catarrh, and UTIs, externally in rubefacient liniments for respiratory ailments and myalgia (BGB, PH2). In the U.S., horseradish is an ingredient in the proprietary Rasapen, a UTI (BGB).

Native Americans have even incorporated the imported species into their pharmacopoeia as well (DEM), also using it for digestive and urinary disorders. Reportedly, they used it for inducing abortions as well, though probably not early on with the eclectic prescription. Eclectics made a saturated whiskey infusion of new or recent roots, of which they recommended 4 oz, 3 or 4 times a day (that’s a pint a day in my book) and continuing treatment until the abortion was obtained (FEL). The root can be chewed for toothache. Horseradish extracts are used to treat gout in Europe, where it is said to compare favorably with synthetics (WOI). Extracts are also used for hepatosis. Cooked in milk and honey, it is used folklorically for hoarseness. The juice, in vinegar, diluted with water and sweetened with glycerine, was once given to children with whooping cough. Horseradish was once given to children with worms. Also used for facial neuralgia (GMH). The pulp is good for skin cancer (WOI). Extracts inhibit growth of ascites carcinoma in mice and Jensen sarcoma in rat (WO2). The dose offered by the herbal PDR (PH2) seems a wee bit high at 20 g fresh root, that is ca. 2/3 oz, more than I could comfortably ingest at a setting. The oil is one of the most hazardous of all EOs and is not recommended for either external or internal use (CAN). Excessive doses may lead to diarrhea or night sweats. One case of a heart attack has been recorded; the patient survived (TAD).

Horseradish is one of the better sources of allylisothiocyanate (AITC), along with the mustards and other members of the cabbage family, and garlic mustard. Nielsen and Rios (2000) showed that volatiles containing AITC were most effective at inhibiting various bread molds: Penicillium commune, P. roqueforti, Aspergillus flavus, Endomyces fibuliger, and E. fibuliger. Using volatile EOs and oleoresins from various spices and herbs, they found mustard EO most efficacious, with cinnamon, clove, and garlic also highly active, oregano only slightly active.

They did not analyze horseradish, but it is almost as pungent as the mustard and loaded with AITC. The minimal inhibitory concentration (MIC) for AITC was 1.8–3.5 μg/ml for the various fungi and yeast. Whether AITC was fungistatic or fungicidal depended on its concentration and the concentration of spores. When the gas phase contained at least 3.5 μg/ml, AITC was fungicidal to all tested fungi (X11016611). Horseradish proved antiseptic to Bacillus subtilis, Escherichia coli, and Saccharomyces cerevisiae, confirming traditional uses of spices as food preservatives, disinfectants, and antiseptics (De et al., 1999).

Fearing cancer, I might seek isothiocyanates, I’d go for a cruci-fix, a solitary dish or mix of the crucifers I had on hand. A series of new studies reported on Medline indicate that feeding isothiocyanates to experimental animals protects them from cancers of the breast, esophagus, liver, lungs, mammaries, and stomach. Dr. Paul Talalay, MD, Johns Hopkins School of Medicine, reviews the mechanisms by which isothiocyanates block carcinogenesis and suggests that they are ideal for chemoprevention of cancers. The list of well-known crucifers is long and tasty: broccoli, brussels sprouts, cabbage, collards, cress, kale, kohlrabi, mustard greens, pak choy, radishes, turnip greens, and watercress. Both for flavor and other sulfur-containing cancer-preventing compounds, I’d spice up my cruci-fix with the likes of chives, garlic, leek, onions, and ramps. And to increase the flavor and the heat, I’d add a dash of cayenne and tabasco.

FOOD USE (Barnes, J et al., 2007)

Horseradish is listed by the Council of Europe as a natural source of food flavouring (category N2). This category indicates that horseradish can be added to foodstuffs in small quantities, with a possible limitation of an active principle (as yet unspecified) in the final product.(G16) Previously horseradish has been listed as GRAS (Generally Recognised As Safe).(G57) Horseradish is commonly used as a food flavouring.

HERBAL USE (Barnes, J et al., 2007)

Horseradish is stated to possess antiseptic, circulatory and digestive stimulant, diuretic and vulnerary properties.(G42, G49, G64). Traditionally, it has been used for pulmonary and urinary infection, urinary stones, oedematous conditions, and externally for application to inflamed joints or tissues.(G49)

Very little research is available on the actions of horseradish. Because the plant is poisonous, it should be used only as a fl avoring in food unless under the supervision of a qualifi ed herbalist. One study did show a hypotensive reaction in cats given horseradish IV (Sjaastad et al, 1984). Other studies (Agabeili et al, 2005; Weil et al, 2005) identifi ed inhibition of growth of colon, lung, and stomach cancer cells. It also, possesses COX-1 inhibitory actions (Linda,S-R. 2010).

OTHER USES (Duke, J. A et al., 2003)

 According to the Oracle at Delphi, “the radish was worth its weight in lead, the beet its weight in silver, and the horseradish its weight in gold.” It is hard to imagine Passover, or hot roast beef, or shrimp cocktail sauce without grated horseradish. Back around 1600, John Gerarde said, “The Horse Radish stamped with a little vinegar put thereto, is commonly used among the Germans for sauce to eat fish” (Bown, 2001). The spice is cultivated for its thick, fleshy white root which has a delicious, intense pungent and cooling taste. It is primarily used in cocktail sauces, vinegars, mustards, and mixed flavorings. In 2000, the U.S. was producing some 6 million gallons of horseradish sauce, enough to season a line of sandwiches estimated to encircle the Earth 12 times (TAD). Today, Horseradish preparations may be red (preserved in beet juice) or white (preserved in vinegar) (FAC). Polish serve a special beet/horseradish condiment at Easter with ham and/or sausage (FAC).

In Germany, where horseradish is one of the most important cultivated medicinal spice, leaves are eaten as a vegetable and in salads. Leaves can be cooked like spinach. Roots brought indoors to a dark place can give etiolated white sprouts by Christmas or better yet, Easter. Germans also cook the sliced roots as a vegetable, like parsnip. Grated roots, mixed with vinegar and salt, enhance flavor of meats and seafoods. Ethanol extracts (tinctures) of fresh or partially dried roots are more liable to be used medicinally than culinarily. Sliced horseradish in milk is said to be an excellent cosmetic; in vinegar, it helps to remove freckles (FAC, WOI, WO2). For more information on activities, dosages, and contraindications, see the CRC Handbook of Medicinal Herbs, ed. 2, Duke et al. 2002.

OTHER USES  (Braun, L and Cohen, M. 2010)

It has been used traditionally to treat both bronchial and urinary infections, joint and tissue inflammations, as well as treating gall bladder disorders, reducing oedema and as an abortifacient (Skidmore-Roth 2001). An in vivo study in mice demonstrated that allyl isothiocyanate markedly inhibited the formation of gastric lesions (Matsuda et al 2007).

HORSERADISH POULTICE (Kraft, K and Hobbs, C. 2004)

General Considerations

v Horseradish root (Armoraciae radix).

v Indications

·         Sinusitis, i. e., inflammation of the nasal and/or frontal sinuses

·         Headaches

v Contraindications: Allergy to horseradish; broken skin or inflammation in the affected area.

v Action: Increases the blood flow and dissolves mucus.

v Materials

·         2 tablespoons grated horseradish root, either freshly prepared or commercially processed without chemical additives, at room temperature

·         Compress (gauze or small linen cloth), washcloth

·         Olive oil

Procedure

v  Preparation: Spread a 1–2 cm thick layer of grated horseradish onto compress and fold over the edges securely.

v  Application: Apply the horseradish poultice to the upper neck region and cover with the washcloth.

v  Duration of treatment: 2 to 5 minutes, or as long as tolerated by the patient. The duration can be extended to a maximum of 10 to 12 minutes in later treatments.

v  Aftercare

·         The poultice will usually cause the skin to redden. After removing it, do not wash the skin with water, but wipe sparingly with olive oil. This preserves the heat and moisturizes the skin.

·         Instruct the patient to keep the feet warm (wool socks, blanket, etc.).

v Frequency of treatment: 1 to 2 times daily. Inspect the skin before the next poultice application. If redness or irritation from the previous application is still detected, treatment should be interrupted for a day. Long-term treatment is recommended in chronic disease.

Warning: Horseradish poultices can cause skin burns if left on for too long. Check the skin for redness or irritation during poultice application. Observe the patient’s reaction and remove the poultices if they cause undue burning or discomfort. Stay with the patient during first-time treatment. Carefully monitor individuals with sensitive skin, elderly individuals, and patients who are not mentally alert.

Note: Horseradish poultices are also helpful in patients with cystitis (especially when chronic), indwelling catheters, and irritable bladder. In the latter case, the poultice is applied to the bladder region.

HORSERADISH POULTICE (Kraft, K and Hobbs, C. 2004)

General Considerations

v   Horseradish root (Armoraciae radix)

➤ See Section 7.1, Urinary Tract Infection, p. 200 ff.

v  Indications: Cystitis.

v   Contraindications: Allergy to horseradish, broken skin, eczema.

v  Action: Increases cutaneous blood flow, induces a reflex increase in blood flow to the bladder, stimulates the metabolism and promotes the healing of inflammatory processes.

v  Materials

·         4 tablespoons grated horseradish root, either freshly prepared or commercially processed without chemical additives, at room temperature

·         Compress (gauze or linen material) and adhesive tape

·         Olive oil

·         Towel, flannel sheet, hot water bottle (as needed)

Procedure

v  Preparation: Spread a 1–2 cm thick layer of grated horseradish onto compress, fold over edges and secure with tape.

v  Application: Allow the patient to void before starting treatment. Apply the horseradish poultice to the stomach in such a way that there is only one layer of cloth between the compress and the skin. Place the towel over the compress and wrap the stomach region in the flannel sheet. If the patient’s feet are cold, place a hot water bottle under them.

v  Duration of treatment: No more than 4 to 5 minutes, while checking for skin irritation.

v  Aftercare: Wipe the skin with olive oil and allow the patient to rest for 30 minutes.

v  Frequency of treatment: Check the skin for irritation on the second day of treatment before reapplication. Take a day’s break in treatment if there are signs of reddening or irritation.

Figure 1. Horseradish (Armoracia rusticana).

ACTIVITIES  (Duke, J. A et al., 2003)

Abortifacient (f; DEM; FEL; LIB); Allergenic (1; CAN); Antiedemic (f; BGB); Antiinflammatory (f1; BGB; COX; X15231456); AntiMRSA (1; X17260672); Antimutagenic (1; X16250249); Antioxidant (1; FNF; PED; X15231456); Antisarcomic (1; WO2); Antiseptic (f12; APA; KOM; SKY; X17260672); Antispasmodic (f1; HHB; PHR; PH2); Antitumor (f1; FAD); Bactericide (1; BGB; FAD; X17260672); Bitter (f1; PED; WO2); Carcinostatic (f1; PHR; PH2); Carminative (f; EFS; WO2); Chemopreventive (1; X15231456); Circulatory Stimulant (f; CAN); COX-2 Inhibitor (1; X15231456); Counterirritant (f1; PED); Decongestant (f1; APA); Depurative (f; DEM); Diaphoretic (f; PNC); Digestive (f; APA; CAN; DEM); Diuretic (f; APA; FEL; LIB; PNC); Emmenagogue (f; LIB); Expectorant (f1; APA; FAD; PED); Fungicide (f1; HHB); Gram(+)-icide (1; X17260672); Gram(−)-icide (1; X17260672); Hyperemic (2; KOM; PHR; PH2); Hypotensive (1; BGB; CAN); Hypothyroid (1; CAN); Immunostimulant (f; LIB; PED); Insecticide (1; X16786497); Larvicide (1; X16786497); Laxative (f; LIB); Mucolytic (f; MAB); Orexigenic (f; DEM; EFS); Pectoral (f; EFS); Rubefacient (12; APA; SKY); Sialogogue (f; FEL; WO2); Stimulant (f; PNC); Vesicant (f1; FAD); Vulnerary (f; CAN; LIB).

MAIN ACTIONS (Braun, L and  Cohen, M. 2010)

Horseradish is widely known for its pungent burning flavour. The pungency of horseradish is due to the release of allyl isothiocyanate and butyl thiocyanate upon crushing (Yu et al 2001). These mustard oil glycosides may irritate the mucous membranes upon contact or inhalation and may act as circulatory and digestive stimulants; however, the mechanism of action has not been fully elucidated (Blumenthal et al 2000, Jordt et al 2004).

It has been found that topical application of allyl isothiocyanate to the skin activates sensory nerve endings producing pain, inflammation and hypersensitivity to thermal and mechanical stimuli due to depolarising the same sensory neurons that are activated by capsaicin and tetrahydrocannabinol (THC) (Jordt et al 2004). Allyl isothiocynate is known to have antimicrobial and antitumour properties (Pengelly 1996).

·         Circulatory stimulant  The mustard oils released when horseradish is crushed may be responsible for this activity.

·         Digestive stimulant Again, it is suspected that the mustard oils may be responsible as these act as irritants. Large doses may cause emesis (Pengelly 1996).

OTHER ACTIONS (Braun, L and  Cohen, M. 2010)

Isothiocyanates may inhibit thyroxine formation and be goitrogenic (Langer 1965), although this has not been demonstrated clinically. The peroxidase enzymes assist in wound healing, whereas the sulfur-containing compounds may decrease the thickness of mucus by altering the structure of its mucopolysaccharide constituents (Mills & Bone 2000). Antispasmodic and antimicrobial effects have also been reported (Blumenthal et al 2000, Newell et al 1996). Horseradish has been found to lower plasma cholesterol and faecal bile acid excretion in mice fed with a cholesterolenriched diet possibly due to interference with exogenous cholesterol absorption (Balasinska et al 2005).

Horseradish has also been found to contain compounds that inhibit tumour cell growth and COX-1 enzymes (Weil et al 2005). In vivo trials testing a combination of herbs, including horseradish, has been found to protect against viral transmission of avian influenza (Oxford et al 2007).

CLINICAL USE (Braun, L and  Cohen, M. 2010)

The therapeutic effectiveness of horseradish has not been significantly investigated.

Nasal congestion and sinusitis

Horseradish is widely used in combination with other ingredients such as garlic in herbal decongestant formulations. Anecdotal evidence suggests that a mild, transient decongestant effect occurs. It is reputed to eliminate excessive catarrh from the respiratory tract (Drew 2002, Tancred 2006), although clinical research is not available to confirm its efficacy.

INDICATIONS  (Duke, J. A et al., 2003)

Abrasion (f; HOO); Allergy (f1; LIB; PED); Alzheimer’s (1; COX; X15231456); Anorexia (f; APA; DEM); Arthrosis (f1; APA; BGB; CAN; COX; X15231456); Asthma (f1; BGB; DEM; FNF); Atony (f; FEL); Bacillus (1; X10548758); Bacteria (12; HHB; HH2; KOM; X17260672; X10548758); Bronchosis (f12; APA; PHR; PH2; SKY; X16618018); Bruise (f; HOO); Cancer (1; FNF; JLH); Cancer, abdomen (f1; FNF; JLH); Cancer, breast (f1; FNF); Cancer, colon (f1; FNF; JLH; X15231456); Cancer, liver (f1; FNF; JLH); Cancer, nose (f1; FNF; JLH); Cancer, spleen (f1; FNF; JLH); Cancer, stomach (f1; FNF; JLH); Cancer, skin (f1; FNF; JLH; WO2); Catarrh (1; KOM; PHR; X17260672); Chilblain (f; GMH); Cholecystosis (f; PHR; PH2); Cold (f1; DEM; SKY); Colic (f; APA; PH2); Congestion (f1; APA); Cough (f12; GMH; PHR; PH2); Cramp (f1; HHB; WIN); Cystosis (1; LIB; PHR); Debility (f; BOW); Dental Plaque (f; FAD); Diabetes (f; DEM; LIB); Dropsy (f; FEL; GMH; HHB); Dysmenorrhea (f; DEM); Dyspepsia (f; PHR; PH2; SKY); Dysuria (CAN; PED; fi PHR); Edema (f; BGB; CAN); Enterosis (1; PH2; WO2); Epistaxis (f; HOO); Escherichia (1; HH2; X17260672; X10548758); Fever (f; BOW); Flu (f1; GMH; PHR; PH2; X17260672); Freckle (f; FEL; HOO); Fungus (1; HHB; X10548758); Gastrosis (f; LIB); Glossosis (f; DEM); Gout (f; BGB; GMH; HHB; PHR; WO2); Gravel (f; DEM); Haemophilus (1; X17260672); Headache (f; HOO); Hepatosis (f; HHB; PHR; PH2); High Blood Pressure (1; LIB); Hoarseness (f; FEL; GMH; HOO; WO2); Induration (f; JLH); Infection (f12; HH2; PH2; X17260672; X16618018); Inflammation (f1; CAN; PH2); Lumbago (f; SKJ); Moraxella (1; X17260672); MRSA (1; X17260672); Myalgia (f12; BGB; KOM; PH2); Mycosis (f1; HHB; HH2; X10548758); Neuralgia (f; DEM; GMH); Pain (f1; DEM; PH2); Pericardosis (f; BOW); Pertussis (f; GMH; LIB); Pleurisy (f; BOW); Pseudomonas (1; X17260672); Pulmonosis (f12; APA; DEM; KOM; PHR; PH2; X17260672); Respirosis (f12; APA; DEM; KOM; PHR; PH2; X17260672); Rheumatism (f; DEM; HHB; PHR); Rhinosis (f1; JLH; PED); Sciatica (f; APA; BGB; GMH); Sinusitis (f12; LIB; SKY; WAF; X16618018); Sore (f; LIB; WIN); Sore Throat (f; LIB; SKY); Splenosis (f; GMH; WO2); Staphylococcus (1; HH2; X17260672); Stomachache (f; HOO; LIB); Stomatosis (f; DEM); Stone (f1; CAN; LIB); Streptococcus (1; X17260672); Swelling (f; BGB; JLH); Toothache (f; DEM; LIB); Typhoid (f1; WO2); Urethrosis (12; KOM; PH2); UTIs (urinary tract infections) (12; APA; BGB; KOM; PH2; X17260672; X16618018); Worm (f; APA; GMH); Wound (f; APA; BOW; HOO); Yeast (1; X10548758).

Horseradish for Bronchosis: (Duke, J. A et al., 2003)

§  Antibacterial: aesculetin; allyl-sulfide; caffeic-acid; gentisic-acid; kaempferol; limonene; p-hydroxy-benzoic-acid; quercetin; raphanin; sinapic-acid; vanillic-acid

§  Antihistaminic: caffeic-acid; kaempferol; quercetin

§  Antiinflammatory: aesculetin; caffeic-acid; gentisic-acid; kaempferol; quercetin; salicylates; vanillic-acid

§  Antioxidant: caffeic-acid; kaempferol; p-hydroxy-benzoic-acid; quercetin; sinapic-acid; vanillic-acid

§  Antipharyngitic: quercetin

§  Antipyretic: aesculetin; salicylates

§  Antispasmodic: caffeic-acid; kaempferol; limonene; quercetin

§  Antiviral: caffeic-acid; gentisic-acid; kaempferol; limonene; quercetin

§  COX-2-Inhibitor: kaempferol; quercetin

§  Candidicide: quercetin

§  Candidistat: limonene

§  Cyclooxygenase-Inhibitor: kaempferol; quercetin

§  Decongestant: allyl-isothiocyanate

§  Expectorant: limonene

§  Immunostimulant: caffeic-acid

§  Phagocytotic: sinigrin

Horseradish for Cancer: (Duke, J. A et al., 2003)

§  AntiHIV: caffeic-acid; quercetin

§  Antiaggregant: allyl-sulfide; caffeic-acid; kaempferol; quercetin; rutoside; salicylates

§  Anticancer: aesculetin; allyl-isothiocyanate; caffeic-acid; kaempferol; limonene; phydroxy-benzoic-acid; quercetin; sinapic-acid; sinigrin; vanillic-acid

§  Anticarcinogenic: caffeic-acid

§  Antifibrosarcomic: quercetin

§  Antihepatotoxic: caffeic-acid; quercetin; sinapic-acid

§  Antiinflammatory: aesculetin; caffeic-acid; gentisic-acid; kaempferol; quercetin; salicylates; vanillic-acid

§  Antileukemic: kaempferol; quercetin

§  Antileukotriene: caffeic-acid; quercetin

§  Antilipoperoxidant: quercetin

§  Antimelanomic: quercetin

§  Antimutagenic: 4-pentenyl-isothiocyanate; aesculetin; allyl-isothiocyanate; caffeic-acid; kaempferol; limonene; p-hydroxy-benzoic-acid; quercetin

§  Antinitrosaminic: caffeic-acid; quercetin

§  Antioxidant: caffeic-acid; kaempferol; p-hydroxy-benzoic-acid; quercetin; sinapic-acid; vanillic-acid

§  Antiperoxidant: caffeic-acid; quercetin

§  Antiproliferant: quercetin

§  Antiprostaglandin: caffeic-acid

§  Antitumor: caffeic-acid; kaempferol; limonene; quercetin; vanillic-acid

§  Antiviral: caffeic-acid; gentisic-acid; kaempferol; limonene; quercetin

§  Apoptotic: kaempferol; quercetin

§  COX-2-Inhibitor: kaempferol; quercetin

§  Chemopreventive: limonene

§  Cyclooxygenase-Inhibitor: kaempferol; quercetin

§  Cytoprotective: caffeic-acid

§  Cytotoxic: aesculetin; caffeic-acid; quercetin

§  Hepatoprotective: caffeic-acid; quercetin

§  Immunostimulant: caffeic-acid

§  Lipoxygenase-Inhibitor: aesculetin; caffeic-acid; kaempferol; quercetin

§  Mast-Cell-Stabilizer: quercetin

§  Ornithine-Decarboxylase-Inhibitor: caffeic-acid; limonene; quercetin p450-Inducer: quercetin

§  PTK-Inhibitor: quercetin

§  Prostaglandigenic: caffeic-acid; p-hydroxy-benzoic-acid

§  Protein-Kinase-C-Inhibitor: quercetin

§  Sunscreen: aesculetin; caffeic-acid

§  Topoisomerase-II-Inhibitor: kaempferol; quercetin

§  Tyrosine-Kinase-Inhibitor: quercetin

§  UV-Screen: aesculetin

DOSAGE

DOSAGE (Barnes, J et al., 2007)

Dosages for oral administration (adults) for traditional uses recommended in older herbal reference texts are given below.

Root (fresh) 2–4 g before meals.(G49)

DOSAGES (Linda,S-R. 2010)

• Adult PO fresh root: 2-4 g before meals

• Adult topical: 2% mustard oil maximum, applied prn

DOSAGES (Duke, J. A et al., 2002)

20 g fresh root (KOM); 1–2 tbsp fresh root (PED); 2–4 g fresh root before meals (CAN); 1–2 drachms grated root (FEL); 1.5–3 g dry root (PED); 2 g dry root:10 ml alcohol/10 ml water (PED); 0.5–1 tsp root 3 x/day (SKY); 2–3 ml tincture 3 x/day (SKY).

DOSAGES (Duke, J. A et al., 2003)

FNFF = !!!

Roots (and occasionally young leaves) widely eaten as spice (as pickle, potherb, or salad ingredient); sliced roots cooked and eaten like parsnips (FAC; TAN), 2–4 g fresh root before meals (CAN); 1–2 drachms grated root (FEL); 20 g fresh root (KOM); 1–2 Tbsp fresh root (PED); 1.5–3 g dry root (PED); 2 g dry root: 10 ml alcohol/10 ml water (PED); 0.5–1 tsp root 3 x/day (SKY); 2–3 ml tincture 3 x/day (SKY).

·         Hoosiers apply bruised leaves to the forehead for headache, and the stomach for stomachache (HOO).

·         Hoosiers apply leaves wet with vinegar to abrasions, bruises, sprains, and wounds (HOO).

·         Hoosiers take sweetened vinegar decoction of horseradish for hoarseness (HOO).

·         Hoosiers wash freckles regularly with a sour milk infusion (5 hours) of grated horseradish (HOO).

·         Hoosiers sniff powdered root for nosebleed (Tyler strongly discourages such) (HOO).

DOSAGE RANGE (Braun, L and  Cohen, M. 2010)

• The typical dose of horseradish is 2–20 g/day of the root or equivalent preparations.

• Topical preparations with a maximum of 2% mustard oil content are commonly used (Blumenthal et al 2000).

PHARMACOLOGICAL ACTIONS (Barnes, J et al., 2007)

IN VITRO AND ANIMAL STUDIES

A marked hypotensive effect in cats has been documented for horseradish peroxidase, following intravenous administration.(5) The effect was completely blocked by aspirin and indometacin, but was not affected by antihistamines. It was concluded that horseradish peroxidase acts by stimulating the synthesis of arachidonic acid metabolites.

CLINICAL STUDIES

There is a lack of clinical research assessing the effects of horseradish.

SIDE-EFFECTS, TOXICITY, CONTRA INDICATIONS, WARNINGS INTERACTIONS 

SIDE-EFFECTS, TOXICITY (Barnes, J et al., 2007)

There is a lack of clinical safety and toxicity data for horseradish and further investigation of these aspects is required. Isothiocyanates are reported to have irritant effects on the skin and also to be allergenic.(G51, G58) Animal poisoning has been documented for horseradish. Symptoms described include inflammation of the stomach or rumen, and excitement followed by collapse.(G33)

CONTRA-INDICATIONS, WARNINGS (Barnes, J et al., 2007)

It is stated that horseradish may depress thyroid function, and should be avoided by individuals with hypothyroidism or by those receiving thyroxine.(G42, G49) No rationale for this statement is included, except that this action is common to all members of the cabbage and mustard family.

·         Drug interactions None documented. However, the potential for preparations of horseradish to interact with other medicines administered concurrently, particularly those with similar or opposing effects, should be considered.

·         Pregnancy and lactation Allylisothiocyanate is extremely toxic and a violent irritant to mucous membranes.(G58) In view of this, use of horseradish should be avoided during pregnancy and lactation.

CONTRAINDICATIONS (Linda, S-R. 2010)

Class 2d herb (rhizome/root). Because it is an abortifacient, horseradish should not be used during pregnancy. Until more research is available, this herb should not be used during breastfeeding. It should not be given to children younger than 4 years of age. Persons with hypothyroidism, hyperthyroidism, renal disease, gastrointestinal ulcers, or hypersensitivity to this herb should avoid its use. Horseradish is toxic if used internally in large quantities.

SIDE EFFECTS/ADVERSE REACTIONS  (Linda, S-R. 2010)

EENT: Mucous membrane irritation

GI: Nausea, vomiting, anorexia, diarrhea

INTEG: Hypersensitivity reactions

INTERACTIONS  (Linda, S-R. 2010)

Drug

Thyroid replacement: Horseradish may interfere with thyroid replacement therapy (theoretical) (Jellin et al, 2008).

CLIENT CONSIDERATIONS  (Linda, S-R. 2010)

Assess

§  Assess for hypersensitivity reactions. If present, discontinue the use of horseradish and administer an antihistamine or other appropriate therapy.

Administer

§  Instruct the client to store horseradish products in a cool, dry place, away from heat and moisture. Fresh roots should be kept buried.

Teach Client/Family

§  Caution the client not to use horseradish during pregnancy because it is an abortifacient. Until more research is available, caution the client not to use this herb during breastfeeding.

§  Caution the client not to give horseradish to children younger than 4 years of age.

§  Advise the client to use horseradish internally only as a food fl avoring or under the direction of a qualifi ed herbalist. The horseradish plant is toxic if used internally in large quantities.

ADVERSE REACTIONS (Braun, L and Cohen, M. 2010)

Despite the potential for severe irritation, horseradish is generally recognised as safe for human consumption in quantities used as food. Consuming large amounts of horseradish can cause gastrointestinal upset, vomiting and diarrhoea, and  irritation of mucous membranes. Skin contact with fresh horseradish can cause irritation and blistering or allergic reactions. If used topically it should be diluted 50% with water and not applied for prolonged periods. Application to a small test area before wider application is recommended for people with sensitive skin.

SIGNIFICANT INTERACTIONS (Braun, L and Cohen, M. 2010)

None known.

CONTRAINDICATIONS AND PRECAUTIONS (Braun, L and Cohen, M. 2010)

Internal use should be avoided in people with stomach and intestinal ulcers and kidney disorders, as well as in children under the age of 4 years (Blumenthal et al 2000). Traditionally, horseradish is considered a warming herb that will exacerbate any ‘hot’ condition and is specifically indicated for ‘cold’ conditions.

PREGNANCY USE (Braun, L and Cohen, M. 2010)

The mustard oils released upon crushing are potentially toxic, therefore doses exceeding dietary intakes are contraindicated (Newell et al 1996).

PATIENTS’ FAQs (Braun, L and Cohen, M. 2010)

What will this herb do for me? Anecdotal evidence suggests that it may have decongestant effects and is a very popular treatment when combined with other herbs such as garlic, to relieve the symptoms of colds and sinusitis.

When will it start to work? It may relieve symptoms within the first few doses, but scientific tests are not available to confirm this.

Are there any safety issues? Horseradish can be quite irritating for some people due to its bitter and pungent characteristics.

PRACTICE POINTS/PATIENT COUNSELLING (Braun, L and Cohen, M. 2010)

§ Horseradish has been used as a vegetable, condiment, diuretic and treatment for bronchial and urinary infections, joint and tissue inflammation and swelling.

§ It is widely used together with other herbal ingredients such as garlic, as a decongestant in the treatment of colds and sinusitis.

§ No scientific investigation has been undertaken to support its use, although anecdotal evidence suggests that it may be useful.

§ Horseradish is generally safe when the root is ingested in usual dietary amounts, although excessive intake may cause irritation to the stomach, respiratory tract and kidneys.

REFERENCE

Barnes, J., Anderson, L. A., and Phillipson, J. D. 2007. Herbal Medicines Third Edition. Pharmaceutical Press. Auckland and London.

Braun, L and Cohen, M. 2010. Hebs and Natural Supplements An Evidence Based Guide 3R D Edition. Elsevier Australia. Australia.

Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.

Duke, J. A. with Peggy-Ann K and Judi duCellier,. Duke. 2003. Duke’s Handbook Of Medicinal Plants Of The Bible. CRC Press LLC. USA.

Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2003. CRC Handbook of Medicinal Spices. CRC Press LLC. USA.

Kraft, K and Hobbs, C. 2004 . Pocket Guide to Herbal Medicine. Thieme. Stuttgart New York.

Linda S-Roth. 2010. Mosby’s Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby Elsevier. USA.