juniper

Juniper is an aromatic coniferous shrub, Juniperus communis, that grows in the temperate and cold regions of the northern hemisphere in Asia, Europe, and North America. Dried juniper berries, berry oil and extracts, juniper bark, and other plant parts have been used orally and topically for centuries as traditional medicine to treat a wide variety of ailments, including gastrointestinal and urinary issues, and skin and inflammatory conditions.

Studies indicate juniper has antioxidant, antimicrobial, anti-inflammatory, and anticancer, as well as blood sugar, blood fat, and blood pressure lowering properties. The therapeutic properties of juniper are believed to come from the various compounds it contains, including aromatic oils, inverted sugars, resins, catechin, organic acid, terpenic acids, leucoanthocyanidin, alkaloids, flavonoids, tannins, gums, lignins, and wax.

Juniper is available over the counter (OTC) as dried berries that can be brewed as tea, berry oil, extract, or tincture, as well as capsule supplements. Suggested medicinal uses of juniper include:

• Heartburn
• Indigestion (dyspepsia)
• Gas (flatulence) and bloating
• Loss of appetite
• Gastrointestinal infections
• Intestinal worms
• To promote urination (diuretic)
• Urinary tract infection
• Kidney and bladder stones
• Menstrual disorders
• Female contraceptive
• Diabetes
• Cancer
• Snakebite
• Inflammatory skin conditions
• Wounds
• Arthritis
• Cough
• Asthma

Although juniper has been historically used for many ailments, there are inadequate scientific studies to establish its efficacy in most of its uses. In addition to its medicinal uses, dried and crushed juniper berries are used to flavor foods such as meat, soups, sauces, and stews, and certain alcoholic beverages such as beer and gin. Juniper is used as a fragrance in soaps, skin care products, and cosmetics. The essential oil extracted from juniper berries is used in aromatherapy, massage, and during religious ceremonies to purify the air.

• Do not use if you have kidney inflammation, juniper can irritate the kidneys.
• Do not use if you are pregnant, juniper may induce uterine contraction and cause miscarriage.
• Use juniper with caution if you have diabetes mellitus and taking antidiabetic medications. Juniper may lower sugar levels excessively.
• Use with caution if you have blood pressure problems. Juniper may have effects on blood pressure and make its control more difficult.
• Topical application of juniper oil may cause irritation, burning, redness and/or swelling in some people. Use with caution and do not apply on broken or irritated skin.

Common side effects of juniper include:

• Oral use (with high doses):
  • Diarrhea
  • Stomach ache
  • Kidney ache
  • Blood in the urine (hematuria)
  • Albumin in urine (albuminuria)
  • Increase in heart rate
• Topical use and inhalation:
  • Skin irritation
  • Blisters
  • Dermatitis
  • Nasal congestion

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There is insufficient scientific information to determine appropriate dosages of juniper. Suggested dosing:

Capsules

• Follow manufacturer's instructions (e.g., 800 mg orally twice daily)

Berries

• 1-2 g of berry orally three times a day

Tea

• One cup orally three times a day
• Steep 1 tsp crushed berry (2-3 g) in 150 mL boiling water for 10 minutes.

Essential oil

• 20-100 mg; no more than 4 weeks

Liquid Extract (1:1 in 25% alcohol)

• 2-4 mL orally three times a day

Tincture (1:5 in 45% alcohol)

• 1-2 mL orally three times a day

Berry oil (1:5 in 45% alcohol)

• 0.03-0.2 mL orally three times a day

Overdose

High doses of juniper taken for prolonged periods can cause kidney problems and gut irritation, with symptoms such as diarrhea, stomach or kidney ache, blood or albumin in the urine, and increased heart rate. Overdosage may be treated with discontinuation of juniper and symptomatic and supportive therapy.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Juniper has no known severe or serious interactions with other drugs.
• Moderate interactions of juniper include:
  • amiloride
  • bendroflumethiazide
  • bumetanide
  • chlorothiazide
  • chlorthalidone
  • cyclopenthiazide
  • drospirenone
  • ethacrynic acid
  • furosemide
  • hydrochlorothiazide
  • indapamide
  • methyclothiazide
  • metolazone
  • spironolactone
  • torsemide
  • triamterene
• Juniper has mild interactions with at least 23 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

• Juniper may interfere with fertility or cause miscarriage. Avoid taking juniper if you are pregnant or planning to become pregnant.
• No information is available on the presence of juniper in breastmilk or its effects on breastmilk production or on the breastfed infant. Avoid if you are a nursing mother.
• Do not take any herbal product, including juniper, without first checking with your healthcare provider if you are pregnant or breastfeeding.

• Juniper berries and oil are possibly safe for most adults in amounts normally used in foods or if used appropriately in recommended doses for a short period.
• Use juniper exactly as per label instructions. Natural products are not necessarily safe always and following suggested dosing is important.
• Check with your healthcare provider before taking any dietary supplement, including juniper, particularly if you have any health conditions or are on regular medications.
• Herbal products often contain many ingredients. Check labels for the components in the juniper product you choose.
• Juniper is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store juniper safely out of reach of children.
• In case of overdose, seek medical help or contact Poison Control.