Scientific Name: Juniper
Other Names: Enebro, Genevrier, Ginepro, Juniperus communis, Kuli, Wacholder

Who is this for?

Uses

Traditionally, juniper berries and products derived from them have been taken by mouth to treat conditions of the gastrointestinal (GI) tract. Juniper berries are believed to promote the secretion of stomach acid to help relieve GI complaints, such as gas, indigestion, and poor appetite, that are related to low stomach acid levels. Additionally, juniper berries have some antiseptic action that may help to eliminate GI parasites and bacteria--including H. pylori, which causes stomach ulcers. Recent laboratory studies show that juniper berry preparations may also stop or slow down the spread of some organisms that contaminate foods. Under laboratory conditions, they have shown some effects against certain kinds of cancer cells, as well.

Juniper berry is also thought to increase slightly the loss of water from the body. This mild diuretic action may be useful for relieving excess water accumulation. In animal studies, oral juniper berry preparations lowered blood sugar levels, possibly by increasing insulin production and/or by increasing sugar utilization. Neither of these possible effects has been well studied in humans, however.

Juniper contains volatile oils, also called essential oils, which have a characteristic turpentine-like smell and give the plant a bitter taste. Juniper oil should not be taken by mouth, but it may be applied to the skin to relieve minor injuries such as burns, cold sores, insect bites, razor burn, scrapes, and sunburn. In parts of the Middle East, juniper oil is used to treat fungal and parasitic infections of the skin. Juniper oil may also be rubbed on aching muscles or joints. Some evidence from case reports suggests that juniper oil may have anti-inflammatory effects, but no clinical studies support its use for inflammatory conditions.

Allowing juniper oil to evaporate, boiling the berries, or adding the oil to boiling water creates a vapor that may be inhaled to lessen bronchial congestion. Its possible anti-inflammatory effect may also help relieve inflammation in the lungs. Due to the same anti-inflammatory potential, juniper may be included in bath oils used in treating arthritis and other conditions.

Juniper tar (also called cade oil) is a thick topical preparation made from the wood of some juniper species. It has been used for psoriasis and other inflammatory skin conditions, but it has also been associated with potentially cancer-causing changes in the DNA of human skin. Because of this very serious potential risk and lack of proof that juniper it is effective, juniper tar has been banned from over-the-counter sales by the U.S. Food and Drug Administration (FDA). It should be used only under the close supervision of a healthcare professional.

In studies of female animals, juniper has caused the muscles of the uterus to tighten. In addition, it appears to interfere with fertility. Therefore, juniper should not be taken, applied, or inhaled by women who are pregnant or trying to become pregnant.

Juniper may cause irritation to the stomach in individuals who have gastroesophageal reflux disease (GERD), stomach ulcers, and other gastrointestinal (GI) disorders that result from excess acid secretion. Therefore, juniper should be avoided by individuals with GI conditions. Juniper can also irritate the kidneys, so it should be avoided in individuals with kidney disorders.

Precautions

Very little information is available on how juniper might affect an infant or a small child. Therefore, its use is not recommended while breastfeeding or during childhood.

Allergic reactions such as rashes and breathing difficulties have been reported after using juniper products, handling juniper plants, or inhaling juniper pollen. Limited scientific literature suggests that individuals of Oriental heritage may be more likely to have juniper allergies than Europeans or Americans.

Because juniper has been shown to reduce blood levels of sugar in both diabetic and non-diabetic laboratory animals, individuals who have diabetes should monitor their blood sugar levels more closely while taking juniper.

A tar derived from juniper oil occasionally is used to treat inflammatory skin conditions such as psoriasis. It should be used only with close medical supervision, though, due to to limited effectiveness and a possible association with skin cancers.

What side effects should I watch for?

Major Side Effects

Seizures or kidney damage have been reported by some individuals who took more than 10,000 mg (10 grams) of juniper per day or who took high doses of juniper for longer than 4 weeks.

Reportedly, one individual who took a small amount of juniper tar by mouth suffered a sudden drop in blood pressure followed by fever and damage to the kidneys and liver. A baby given an enema of juniper tar stopped breathing because of severe swelling in the lungs. After intensive treatment, both patients recovered.

Less Severe Side Effects

Purplish or reddish urine may result if large amounts of juniper are taken by mouth.

Using juniper on the skin may result in:

• Irritation
• Redness
• Swelling

Rarely, breathing juniper vapors or steam may cause stomach cramps.

What interactions should I watch for?

Prescription Drugs

The possible mild diuretic effect of juniper could increase the effectiveness of diuretics, also called "water pills". Individuals who take a diuretic drug, such as furosemide or hydrochlorothiazide, should talk to a doctor or pharmacist before using juniper.

Diuretics may also promote the loss of potassium from the body. Since taking juniper may lead to potassium loss, as well, the levels of potassium in the blood may become too low if juniper is taken at the same time as a diuretic. Low blood potassium is called hypokalemia. Symptoms of hypokalemia can include:

• Abdominal cramps
• Constipation
• Low blood pressure
• Muscle weakness
• Nausea
• Vomiting
• Hallucinations
• Respiratory failure
• Cardiac arrest

Individuals with diabetes should avoid taking large amounts of juniper because it can lower blood sugar levels, potentially resulting in hypoglycemia (blood sugar that is too low). Symptoms of low blood sugar may include shakiness, sweating, confusion, distorted speech, and loss of muscle control. If not corrected, low blood sugar can lead to unconsciousness and even death. Taking juniper may interfere with insulin and oral drugs for diabetes, such as:

• acarbose
• Avandia
• glimepiride
• glipizide
• glyburide
• Glyset
• metformin
• Prandin

Herbal Products

Because juniper may decrease blood sugar levels, taking it with other blood sugar-lowering herbal products potentially may result in hypoglycemia--blood sugar that is too low. Herbals that may reduce blood sugar include:

• Eleuthero
• Fenugreek
• Ginger (in high amounts)
• Kudzu
• Panax ginseng

The potential loss of water from juniper's diuretic effect may decrease blood levels of potassium, as well. When juniper is taken with other potassium-depleting herbals such as horsetail or true licorice, the chances of potassium deficiency may increase slightly. Low potassium levels may result in symptoms such as drowsiness, heart rhythm changes, nausea, and vision disturbances.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how juniper interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

Should I take it?

The juniper family includes more than 60 species of generally slow-growing evergreens. Some species are ground covers; others get as tall as 30 feet. They grow well in most cool climates of the Northern Hemisphere. Since junipers are fragrant and low-maintenance, they are used frequently in gardens and landscaping. Female plants bear pale blue flowers in the late spring. Green berries or tiny pine-cone-shaped fruits develop, but they do not mature into a dark blue or purple color until the second year.

Mature juniper berries are collected in the fall to be used fresh, dried, or crushed to extract their oil. With a spicy, slightly bitter taste, juniper berries are used to flavor foods and beverages--for example, they give the alcoholic drink gin its distinctive taste. They are also used as a spice or a food preservative in some parts of the world. Juniper oil provides a distinctive fragrance for bath salts, candles, cosmetics, perfumes, and soaps. In some areas, juniper oil is used as a natural pesticide, sprayed onto standing water to kill mosquitoes. For medicine, juniper berries are usually taken by mouth in their dried form. Their oil is applied to the skin surface, often added to massage oils. Either the berries or the oil can be added to boiling water and the steam inhaled to open breathing passages.

Juniper tar is distilled from the burnt wood of certain juniper species, which are known as cade trees in the Mediterranean areas where they are most common. Juniper tar is thick and oily, but not gummy like tar. It ranges in color from tannish orange to dark brown. It is more commonly used as a medical agent in Europe and the Mediterranean area than it is in North America. Although it is available in skin products that are sold to Americans and Canadians over the internet, juniper tar was required to be removed from non-prescription drug products in the United States. Because it was not found to be effective and because similar products pose a cancer hazard, the FDA banned the medical use of juniper tar in the early 1990s. However, juniper tar is still used to give a smoky flavor to foods and a leathery or musty scent to cosmetics.

Dosage and Administration

Note: Juniper should never be used for longer than 4 weeks at a time due to the possibility that it may cause kidney damage. Doses should be limited to a maximum of 10,000 mg (10 grams) of dried juniper berries by mouth or 100 mg of topical juniper oil per day. Juniper oil and juniper tar should not be taken by mouth.

Juniper tea may be made by soaking one teaspoonful of dried juniper berries in about 6 ounces of boiling water for 10 minutes to 15 minutes and then straining out the solid parts before drinking. Juniper tea may be taken up to four times a day. A usual dose of dried juniper berries is 1,000 mg to 2,000 mg (one gram to 2 grams) up to three times a day. Juniper is also available in other oral dose forms, with different recommended doses. Individuals who decide to use juniper should follow the directions on the package of the product that is purchased. No more than the recommended amounts should be taken.

For application to the skin, juniper oil should be used sparingly. A small amount may be applied to minor skin irritations once or twice a day for a few days, at the most. Juniper tar should not be used topically unless a healthcare professional oversees its use. Both juniper oil and juniper tar should be stored where children and pets cannot reach them.

Juniper berries or juniper oil may be added to warm bath water to help relieve arthritis pain or muscle aches. The berries may also be boiled in water and the resulting steam may be inhaled to treat bronchitis and other upper respiratory complaints. Care should be taken to see that the steam is not hot enough to cause burns on the face or in the respiratory tract.

Summary

Juniper berries or tea may be taken orally to treat stomach conditions. They may also promote water loss from the body. On the skin, juniper oil may be used for minor injuries. Vapors from the oil or steam from the boiling berries may be inhaled to relieve lung congestion.

Risks

Pregnant women and women attempting to become pregnant should not use juniper because it may cause uterine spasms and it may decrease fertility. Due to irritating effects on the stomach and kidneys, juniper should also be avoided by individuals who have stomach or kidney diseases. Not enough is known about juniper's effects to recommend it for children or breast-feeding women. Individuals with diabetes should watch their blood sugar levels closely if they take juniper due to its possible reducing effect on blood sugar.

Side Effects

Oral doses of juniper over 10,000 mg (10 grams) per day or for longer than 4 weeks have caused kidney damage and seizures. Topical juniper oil may result in irritation and swelling at the sites where it is applied. Juniper tar (cade oil) has been linked to skin damage that eventually may lead to skin cancer.

Interactions

Orally, juniper may interfere with diuretics and drugs or herbals used to treat diabetes.

Last Revised July 28, 2008

References

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Last Revised July 28, 2008

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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