Pelargonium Sidoides Uses and Side Effects

Megan Nunn, PharmD
·6 min read

Is the South African geranium a natural cold remedy?

Medically reviewed by Meredith Bull, ND

The South African geranium (Pelargonium sidoides) is an herb traditionally used in South African medicine to treat gastrointestinal conditions and later brought to Europe as a tuberculosis treatment. Today it's typically used as an extract in cough and cold remedies as proponents claim it can help fight respiratory infections like the common cold, bronchitis, and sinusitis.

Here's what you need to know about the proven uses and benefits of Pelargonium sidoides (P. sidoides), along with potential side effects and precautions to be aware of.



Supplement Facts

  • Active ingredients: Anthocyanins, coumarins, gallic acid derivatives, flavonoids, tannins, phenols, and hydroxycinnamic acid derivatives

  • Alternate name: Pelargonium sidaefolium, Umckaloaba, Umcka, Uvendle, Kalwerbossie, Khoaara e nyenyane

  • Legal status: Over-the-counter supplement in the United States

  • Suggested dose: 20 to 30 drops of the extract three times a day

  • Safety considerations: Avoid in people with blood clotting problems; not recommended for children under age 12 or during pregnancy or breastfeeding



Uses of Pelargonium Sidoides



Explainer

Supplement use should be individualized and discussed with a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.



While the current evidence supporting P. sidoides is limited, it's most robust for the following uses:

Respiratory Infections

In a review of eight clinical trials, scientists concluded that P. sidoides helped ease cold, bronchitis, or sinus infection symptoms. However, the authors concluded that more research is needed because the quality of the evidence was low. There were only a few trials for each disease, and the supplement manufacturer was also the trial investigator, leaving room for bias.

In another review, scientists evaluated 11 studies of herbal medicines for treating respiratory tract infections in children. Reviewers determined that P. sidoides showed "moderate evidence" for treating uncomplicated respiratory infections.

A randomized controlled trial of 207 adults with the common cold used 30 or 60 drops of P. sidoides extract three times a day for up to 10 days. The treatment decreased the cold's length and the severity of symptoms.

In another randomized controlled trial, people with upper respiratory infections were given an extract of P. sidoides root for seven days. Those in the treatment group had decreased coughing and sneezing symptoms compared to those given a placebo.

Related: Natural and Herbal Cold and Flu Remedies

Chronic Obstructive Pulmonary Disease

A study of 199 people with chronic obstructive pulmonary disease (COPD) used a specific P. sidoides extract as add-on therapy for 24 weeks. Those in the treatment group had improved quality of life and decreased symptoms (cough severity, missed work) compared to those who received a placebo. The P. sidoides treatment was also well-tolerated.

Other Potential Uses

Anxiety: There's not much scientific evidence supporting this use. However, the essential oil of a related species, Pelargonium graveolens (rose geranium), is often used in aromatherapy and may help with anxiety during labor.

COVID-19: In test tube studies, P. sidoides was effective against coronaviruses. However, robust data from clinical studies is needed to determine effectiveness and safety in humans.

What Are the Side Effects of P. Sidoides?

Your provider may recommend taking P. sidoides for a cold, sinus infection, or another condition. However, consuming this herbal supplement may have potential side effects, which may be common or severe.

Common Side Effects

Commonly cited side effects include but aren't limited to the following:

Severe Side Effects

Although P. sidoides seems well tolerated, there is some concern that its long-term or excessive use may cause liver injury.

According to a study, P. sidoides was among five herbs suspected of causing liver toxicity when used for medicinal purposes. Other culprits included valerian (Valeriana), peppermint (Mentha piperita), St. John's wort (Hypericum perforatum), and Tasmanian blue gum (Eucalyptus globulus).

In one of the reported cases, liver impairment occurred after using a P. sidoides extract for five days.

Precautions

P. sidoides should not be taken by people with blood clotting problems.

Due to the lack of safety data, P. sidoides remedies should not be used by children under age 12 or people who are pregnant or breastfeeding. However, a specific preparation called EPs 7630 seems safe and may be effective for children over one year old.

There is also not enough safety data to recommend P. sidoides in people with severe kidney problems, or disorders of the adrenal glands, liver, spleen, or pancreas.

Because of the possibility of liver toxicity, you should also avoid P. sidoides if you have liver disease, are a heavy drinker, or take medications metabolized by the liver.



Explainer

Always speak with a healthcare provider before taking any supplement to ensure that the supplement and dosage are appropriate for your individual needs.



Dosage: How Much Pelargonium Should I Take?

There are no guidelines directing the appropriate use of P. sidoides supplements. Clinical trials have typically used doses of either 30 drops of a specific extract called EPs 7630, or a 20 milligram tablet. The "safe" dose can vary and may be influenced by age, sex, weight, medications, and general health.

What Happens if I Take Too Much Pelargonium Sidoides?

As a general rule of thumb, never take more than is prescribed on the product label. Even so, it is not known at what point a P. sidoides supplement may become toxic.

If you decide to take it (especially highly concentrated extracts), call your healthcare provider if you experience any signs of liver toxicity, including fatigue, stomach pain, nausea, dark urine, light stools, or yellow skin or eyes.

Interactions

One active ingredient of P. sidoides is coumarin, which may act as an anticoagulant (blood thinner). Avoid taking P. sidoides with prescription anticoagulants like warfarin as this could lead to excessive bleeding.

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.

How to Store

Store P. sidoides supplements in a cool, dry place or as directed by the manufacturer. Some products must be refrigerated. Keep out of reach of children or pets.

Discard after one year or according to package directions.

Sources of Pelargonium Sidoides and What to Look For

Food Sources of Pelargonium Sidoides

Leaves or flowers of P. sidoides may be eaten directly, but this herb is not found in commercially available food products in the United States.

Pelargonium Sidoides Supplements

Pelargonium sidoides remedies are sold as extracts, tinctures, oral suspensions, syrups, powders, or gel caps. They can be purchased online or in pharmacies or health food stores.



Takeaway

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement, look for third-party tested products (such as the U.S. Pharmacopeia (USP), Consumer Labs, or NSF) and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.



Summary

Pelargonium sidoides has been studied for cold, bronchitis, or sinus infection symptoms. It's also been used for chronic obstructive pulmonary disease (COPD). However, further scientific study must be conducted before it can be suggested.

Avoid taking Pelargonium sidoides if you're allergic to it. Always check in with your healthcare provider or pharmacist before use to avoid interactions with any medications, herbs, or supplements you are currently taking.

Read the original article on Verywell Health.