White willow

White willow (Salix alba)
White willow (Salix alba)

White willow (Salix alba) is a large tree that grows in Central and Southern Europe, Asia, and North America.

Also known as European willow or baywillow, this tree prefers to root near streams and rivers and grows to a height of 35–75 ft (11–25 m). In the spring, the slender branches first sprout tiny, yellow flowers and then long, thin green leaves.

White willow belongs to the Salicaceae family. There are over 300 species of willow, but only several species are used medicinally: white willow (S. alba), purple willow (S. purpurea), violet willow (S. daphnoides), and crack willow (S. fragilis).


General use

White willow is the oldest recorded analgesic, or painkiller, in human history. Chinese physicians have used white willow since 500 B.C. to relieve pain and lower fevers. White willow was also used in ancient Assyrian, Egyptian, and Greek medicine as well. The Greek physicians Dioscorides, Hippocrates, and Galen recommended white willow to remedy fevers and pain.

Native American tribes, including the Cherokee, Blackfoot, Iroquois, and Eskimo peoples, created a tea from closely related species of the bark to relieve headaches, fever, sore muscles, chills, rheumatism, and general aches and pains. White willow was used in Europe to stop vomiting, remove warts, and suppress sexual desire in addition to treating fevers and pains.

In the mid-1700s, white willow was used in Britain as a remedy for malaria since the bark was similar to cinchona bark, a South American bark used to treat malaria. In 1828, European chemists extracted the constituent salicin from white willow bark and converted it to salicylic acid.

At the end of the nineteenth century, acetylsalicylic acid was synthetically produced and aspirin was born. Due to the cheap and easy production of aspirin, white willow eventually lost its popularity as a pain and fever reliever.

In modern times, however, white willow is being recalled as nature’s aspirin and gaining popularity around the world as an alternative treatment for fevers and inflammatory and painful conditions such as bursitis, tendinitis, headaches, rheumatoid arthritis, back pain, osteoarthritis, menstrual cramps, and muscle aches. White willow has been approved by the German Commission E for treating fevers, rheumatic ailments, and headaches.

In France, white willow is used to remedy headaches, toothache pain, tendinitis, and muscle sprains. The British Herbal Compendium has administered white willow as a treatment for rheumatic and arthritic conditions, colds, and influenza.

How white willow works

The inner bark contains tannins, flavonoids, phenolic glycosides, and anti-inflammatory and fever-reducing salicylates. The high concentration of tannins may be responsible for relieving gastrointestinal disturbances and reducing tumors of the esophagus, stomach, colon, and rectum.

White willow’s analgesic effect works to inhibit the production of prostaglandins, a hormone-like chemical that is produced by the body in response to injury and causes aches, pains, and inflammation.

Thus, white willow is beneficial in treating acute and chronic pain and inflammation in conditions such as painful menstruation, arthritis, and neuralgia. White willow is best when used over long periods of time and can take days to improve conditions.

The active ingredient in white willow is salicin. Salicin is gradually converted along with other compounds in white willow into salicylic acid in the intestine and liver.

Because of this conversion process, white willow generally takes longer to act than aspirin, but the effects may last for an extended period of time. As a result, white willow is mild on the stomach and usually does not cause bleeding or other gastrointestinal discomfort that often occurs with aspirin usage.

White willow vs. aspirin

White willow bark
White willow bark
Herbalists claim that white willow can sometimes be used in the same conditions as aspirin. One benefit to white willow use is that the natural salicylic acid present in white willow reportedly produces fewer side effects than the synthetically produced acetylsalicylic acid of aspirin.

Aspirin has been recommended as a treatment to reduce the risk of heart attacks and stroke by lessening the chance of internal blood clots. Preventative benefits of white willow in these cases have not been determined, primarily because the salicin content of the bark varies. Herbal experts believe that most willow bark samples contain enough salicin to have a similar effect.

Preparations

The bark of young tree branches (two or three years old) is harvested during the early spring. The grayish bark is separated from the tree, then either dried or used fresh. White willow is commercially available in tincture, tablet, capsule, powder, or tea forms. When choosing a commercial preparation, it is recommended to use a standard product that contains 200–250 mg of white willow per dose.

The recommended daily dosage is 100–250 mg of white willow every four hours. To relieve arthritic, back, and muscle aches and pains, the recommended dosage is 225 mg of white willow bark four times daily.

A decoction made from willow bark is used both internally and externally. To make a decoction, combine 1 tsp chopped or powdered white willow bark with 8–10 oz of water.

Bring to a boil, then simmer for five minutes. Drink three or four times daily. This mixture can also be gargled to help inflamed gums and tonsils. Cooled and applied externally, the decoction helps aid healing of sores, burns, or cuts.

Tincture dosage: 2 ml three times daily.

Precautions

Persons with tinnitus should not take white willow.

Pregnant or breastfeeding women should consult their healthcare practitioner before taking white willow.

Persons who are sensitive to aspirin should use caution when taking white willow as it may irritate their stomachs.

Administration of aspirin to children under the age of 16 to relieve symptoms of cold, flu, or chickenpox may cause a rare condition called Reye’s syndrome. Reye’s syndrome is characterized by vomiting, swelling of the brain, and liver damage; and may be fatal.

Reye’s syndrome is a medical emergency and requires immediate treatment by qualified medical professionals. The toll-free hot line number of the National Reye’s Syndrome Foundation is listed below.

While white willow is metabolized differently from aspirin, there is still a similarity between the two, and it is recommended that white willow not be given in these situations.

Persons with a bleeding disorder, ulcer, colitis, Crohn’s disease, kidney or liver disease, or diabetes should not take this herb.

Children over 12 and persons over 65 should take white willow in low initial doses. Children under the age of 12 should not use white willow at all.

Side effects

Excessive doses of white willow may cause stomach upset, diarrhea, nausea, or ringing in the ears. If this occurs, should be stopped white willow.

Interactions

White willow bark ilustration
White willow bark ilustration

In general, persons considering taking white willow preparations should first consult a physician or registered pharmacist, as white willow interacts with a number of nonprescription as well as prescription medications.

Persons who are allergic to aspirin should not use white willow.

White willow should not be taken in combination with aspirin or such nonsteroidal anti-inflammatory drugs (NSAIDs) as ibuprofen or naproxen, alcohol, or blood-thinning medications.

White willow has been reported to have adverse interactions with bismuth subsalicylate (Pepto-Bismol), celecoxib (Celebrex), repaglinide (Prandin), and ticlopidine (Ticlid). It increases the action of metaclopramide (Reglan), but reduces the effectiveness of diclofenac (Voltaren, Cataflam), ketoprofen (Orudis), and nadolol (Corgard).