Cowhage (Mucuna pruriens) seeds have been used in traditional Ayurvedic medicine to treat Parkinson's disease. This traditional use is supported by laboratory analysis that shows cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs that is a precursor to dopamine. In a few clinical trials in Parkinson's disease patients, three cowhage treatments yielded positive results. However, more research should be conducted to elucidate the treatment that is the most effective. In addition, cowhage seeds have nutritional quality comparable to soy beans and other conventional legumes, but several antinutritional/antiphysiological compounds prevent these seeds from being used as a food source.
Evidence
DISCLAIMER:
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Parkinson's disease :
Traditional Ayurvedic medicine and preliminary evidence suggests that cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs. Cowhage treatments have yielded positive results in early studies. However, more research should be conducted to determine the treatment that is the most effective.
Grade: C
Tradition
WARNING:
DISCLAIMER:
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Anticoagulant (blood thinner), diabetes, fracture healing, hyperprolactinemia (excessive prolactin in the blood).
Dosing
Adults (18 years and older):
There is no proven effective dose for cowhage in adults. For Parkinson's disease, 15 and 30 grams of a cowhage preparation has been taken by mouth for a week. Sachets containing a derivative of cowhage, called HP-200, have also been used.
Children (younger than 18 years):
There is no proven safe or effective dose for cowhage in children.
Safety
DISCLAIMER:
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Allergies
Avoid in individuals with a known allergy or hypersensitivity to cowhage (Mucuna prurient) or its constituents. Hairs on cowhage flowers and pods can cause severe pruritus (itching).
Side Effects and Warnings
Few adverse effects have been reported for cowhage. In one study in Parkinson's disease patients, a derivative of Mucuna prurient caused mild adverse effects that were mainly gastrointestinal in nature. Cowhage has also caused acute toxic psychosis, which may be due to its levodopa content. Use cautiously in patients with Parkinson's disease and/or taking levodopa, dopamine, dopamine agonists, dopamine antagonists, or dopamine reuptake inhibitors as cowhage seeds contain the dopamine precursor levodopa.
Hairs on cowhage flowers and pods can cause severe pruritus (itching), and have also been used to artificially induce pruritus.
Use cautiously in patients taking anticoagulants (blood thinners) or with diabetes or hypoglycemia, due to the potential for additive effects.
Avoid in patients with psychosis or schizophrenia, as cowhage has caused acute toxic psychosis.
Avoid in pregnant or breastfeeding patients as cowhage may inhibit prolactin secretion.
Pregnancy and Breastfeeding
Cowhage is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Two early studies indicate that cowhage may inhibit prolactin secretion.
Use cautiously in patients taking diabetes medications as cowhage may alter blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely be a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Cowhage seeds contain levodopa, which may cause high blood pressure when taken with monoamine oxidase (MAO) inhibitors. Caution is advised in patients with hypertension (high blood pressure) or taking medication that alters blood pressure due to possible additive effects.
In a case report, cowhage caused an outbreak of acute toxic psychosis. Caution is advised in patients with mental illnesses.
Based on a clinical study in Parkinson's disease patients, cowhage may increase serum levodopa concentrations. Caution is advised in Parkinson's disease patients taking levodopa, dopamine, dopamine agonists, dopamine antagonists, anticholinergics and antiparkinsonian agents due to possible additive effects.
Interactions with Herbs and Dietary Supplements
The leaves of Mucuna pruriens may dose-dependently prolong blood clotting. Use cautiously in patients with bleeding disorders or taking other blood thinning herbs or supplements due to a possible increase in the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
In a case report, cowhage caused an outbreak of acute toxic psychosis. Use cautiously in patients with mental illnesses.
Ayahuasca (Banisteriopsiscaapi) is a known MAO inhibitor; cowhage seeds contain levodopa, which may cause high blood pressure when taken with MAO inhibitors. Use cautiously in patients with hypertension (high blood pressure) or taking other herbs or supplements, such as ayahuasca, that alter blood pressure.
Ergot (Claviceps purpura) has known dopamine agonist activity; cowhage seeds contain levodopa, which is a precursor to dopamine. Use cautiously in patients with mental illnesses, such as depression, as the combination of cowhage and ergot may result in additive effects.
Jimson weed (Datura stramonium) is a known anticholinergic; cowhage seeds contain levodopa, which may interact with anticholinergics. Use cautiously in patients with Parkinson's disease as the combination of cowhage and Jimson weed may result in additive effects.
Fava beans (Vicia faba) contain levodopa, as do cowhage seeds. Use cautiously with fava beans due to possible additive effects.
Cowhage may alter blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking herbs or supplements that affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Attribution
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Emily Kyomitmaitee, PharmD (University of Rhode Island); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).
Bibliography
DISCLAIMER:
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
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Grover JK, Yadav S, Vats V. Medicinal plants of India with anti-diabetic potential. J Ethnopharmacol 2002;81(1):81-100.
Houghton PJ, Skari KP. The effect on blood clotting of some west African plants used against snakebite. J Ethnopharmacol 1994;44(2):99-108.
Infante ME, Perez AM, Simao MR, et al. Outbreak of acute toxic psychosis attributed to Mucuna pruriens. Lancet 11-3-1990;336(8723):1129.
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