Health Care Professional Information

Scientific Name
Urtica dioica
Common Name

Stinging nettle, common nettle, greater nettle

Clinical Summary

Nettle is a perennial herbaceous flowering plant, native to Asia, Europe, and North America. The root is widely used to treat benign prostatic hypertrophy (BPH), allergies, arthritis, and inflammation. Nettle is usually combined with herbs such as saw palmetto and pygeum for the treatment of BPH. Several compounds have been isolated from nettle including flavonoid glycosides that appear to contribute to its biological effects, although the precise mechanism of action is unclear.

In vitro and animal studies indicate that nettle extract has reno- (20) and hepatoprotective (21) properties, and is effective against colitis in mice (16).
Data from a few clinical trials suggest benefits of nettle in the treatment of osteoarthritis of hip, knee (10) and hand (14) and in ameliorating symptoms associated with benign prostatic syndrome (BPS) (8) (11) (12).
In another study nettle improved glycemic control in type-2 diabetic patients (22).

Nettle may also have anticancer potential. It demonstrated anti-proliferative effects in human prostate cancer cells (6), and protected against cisplatin-induced toxicity (15).

Purported Uses
  • Allergies
  • Arthritis
  • Benign prostatic hypertrophy (BPH)
  • Chest congestion
  • Dysuria
  • Inflammation
  • Oily skin
  • Promote urination
  • Spasms
  • Urinary tract disorders
Constituents
  • Acids: Carbonic acid, formic acid, silicic acid, citric acid, fumaric acid, glyceric acid, malic acid, oxalic acid, phosphoric acid, quinic acid, succinic acid, and threonic acid
  • Amines: Acetylcholine, betaine, choline, lecithin, histamine, and serotonin
  • Flavonoids: Flavonol glycosides (isorhamnetin, kaempferol, quercetin)
  • Choline acetyltransferase, scopoletin, B-sitosterol, and tannins
  • Essential Oil: Carvacrol (38.2%), carvone (9.0%), naphthalene (8.9%), (E)-anethol (4.7%), hexahydrofarnesyl acetone (3.0%), (E)-geranyl acetone (2.9%), (E)-β-ionone (2.8%) and phytol (2.7%)
    (1) (23)
Mechanism of Action

In vitro studies show that nettle extract inhibits several inflammatory events that are responsible for the symptoms of seasonal allergies (2). They include the antagonist and negative agonist activity against the histamine-1 (H(1)) receptor and inhibition of prostaglandin formation via inhibition of cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and hematopoietic prostaglandin D(2) synthase (HPGDS), key enzymes in pro-inflammatory pathways (2).
A methanolic extract of nettle reduced experimentally induced prostatic hyperplasia in mice (17).

Adverse Reactions
  • A case of gynecomastia has been reported in a man following consumption of nettle tea (13).
  • Galactorrhea was reported in a woman after ingestion of nettle tea (13).
  • A breastfed, 17-day-old infant developed urticaria following the mother’s use of water boiled with stinging nettle to heal nipple cracks (5).
  • Hypoglycemia has been reported in a 78-year-old man after taking an herbal remedy containing nettle for benign prostatic hypertrophy (18).

     
Herb-Drug Interactions
  • Cytochrome P450 substrates: Nettle inhibits cytochrome P450 enzymes and may affect the intracellular concentration of drugs metabolized by these enzymes (9).
  • Diuretics: Theoretically nettle may have additive effect due to its diuretic activity (19).
  • Hypotensives: Nettle has hypotensive action and may enhance the effects of hypotensive drugs (19).
Literature Summary and Critique

Lopatkin N, Sivkov A, Schläfke S, et al. Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled, double-blind, multicenter trial. Int Urol Nephrol. 2007;39(4):1137-46.
In this study 257 patients with LUTS caused by BPH were randomized to receive 2 capsules (160 mg Sabal fruit extract WS 1473 and 120 mg Urtica root extract WS 1031 per capsule) or a placebo, daily for 24 weeks. This was followed by a 24-week control period, and a 48-week follow-up period during which all patients received the Sabal + Urtica capsules. LUTS [International Prostate Symptom Score ((I-PSS) self-rating questionnaire] and uroflow and sonographic parameters were assessed in 219 patients. Between baseline and end of observation period (week 96), the I-PSS total score was reduced by 53% (P < 0.001), peak and average urinary flow increased by 19% (P < 0.001), and residual urine volume decreased by 44% (P = 0.03).
Researchers concluded that Sabal + Urtica is safe and has clinically relevant benefits in patients with LUTS.

Dosage (Inside MSKCC Only)
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References
  1. Urtica dioica; Urtica urens (nettle). Monograph. Altern Med Rev. 2007 Sep;12(3):280-4.
  2. Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009 Jul;23(7):920-6.
  3. Brinker F. Herb Contraindications and Drug Interactions, 2nd ed. Sandy (OR): Eclectic Medical Publishing; 1997.
  4. Schulz V, et al. Rational Phytotherapy: A Physician's Guide to Herbal Medicine, 3rd ed. Berlin (Germany): Springer; 1998.
  5. Uslu S, Bulbul A, Diler B, Bas EK, Nuhoglu A. Urticaria due to Urtica dioica in a neonate. Eur J Pediatr. 2011 Mar;170(3):401-3.

  6. Konrad L, et al. Antiproliferative effect on human prostate cancer cells by a stinging nettle root (Urtica dioica) extract. Planta Med 2000;66:44-7.

  7. Fagelman E, Lowe FC. Herbal medications in the treatment of benign prostatic hyperplasia (BPH). Urol Clin N Am 2002;29:23-9.
  8. Schneider T and Rubben H. Stinging nettle root extract (Bazoton-uno) in long term treatment of benign prostatic syndrome (BPS). Results of a randomized, double-blind, placebo controlled multicenter study after 12 months. Urologe A. 2004;43(3):302-6.
  9. Ozen T, Korkmaz. Modulatory effect of Urtica dioica L. (Urticaceae) leaf extract on biotransformation enzyme systems, antioxidant enzymes, lactate dehydrogenase and lipid peroxidation in mice. Phytomedicine 2003;10(5):405-15.
  10. Jacquet A, Girodet PO, Pariente A, et al. Phytalgic(R), a food supplement, vs placebo in patients with osteoarthritis of the knee or hip: a randomised double-blind placebo-controlled clinical trial. Arthritis Res Ther. 2009;11(6):R192.
  11. Safarinejad MR. Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study. J Herb Pharmacother. 2005;5(4):1-11.
  12. Lopatkin N, Sivkov A, Schläfke S, et al. Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled, double-blind, multicenter trial. Int Urol Nephrol. 2007;39(4):1137-46.
  13. Sahin M, Yilmaz H, Gursoy A, et al. Gynaecomastia in a man and hyperoestrogenism in a woman due to ingestion of nettle (Urtica dioica). N Z Med J. 2007 Nov 9;120(1265):U2803.
  14. Randall C, Randall H, Dobbs F, Hutton C, Sanders H. Randomized controlled trial of nettle sting for treatment of base-of-thumb pain. J R Soc Med. 2000 Jun;93(6):305-9.
  15. Ozkol H, Musa D, Tuluce Y, Koyuncu I. Ameliorative influence of Urtica dioica L against cisplatin-induced toxicity in mice bearing Ehrlich ascites carcinoma. Drug Chem Toxicol. 2012 Jul;35(3):251-7.
  16. Genc Z, Yarat A, Tunali-Akbay T, et al. The Effect of Stinging Nettle (Urtica dioica) Seed Oil on Experimental Colitis in Rats. J Med Food. 2011Dec;14(12):1554-61.
  17. Lichius JJ, Renneberg H, Blaschek W, Aumüller G, Muth C. The inhibiting effects of components of stinging nettle roots on experimentally induced prostatic hyperplasia in mice. Planta Med. 1999 Oct;65(7):666-8.
  18. Edgcumbe DP, McAuley D. Hypoglycaemia related to ingestion of a herbal remedy. Eur J Emerg Med. 2008 Aug;15(4):236-7.
  19. Tahri A, Yamani S, Legssyer A, et al. Acute diuretic, natriuretic and hypotensive effects of a continuous perfusion of aqueous extract of Urtica dioica in the rat. J Ethnopharmacol. 2000 Nov;73(1-2):95-100.

  20. Sayhan MB, Kanter M, Oguz S, Erboga M. Protective effect of Urtica dioica L. on renal ischemia/reperfusion injury in rat. J Mol Histol. 2012 Dec;43(6):691-8.
  21. Oguz S, Kanter M, Erboga M, Ibis C. Protective effect of Urtica dioica on liver damage induced by biliary obstruction in rats. Toxicol Ind Health. 2013 Oct;29(9):838-45.
  22. Kianbakht S, Khalighi-Sigaroodi F, Dabaghian FH.Improved glycemic control in patients with advanced type 2 diabetes mellitus taking Urtica dioica leaf extract: a randomized double-blind placebo-controlled clinical trial. Clin Lab. 2013;59(9-10):1071-6.
  23. Gül S, Demirci B, Başer KH, Akpulat HA, Aksu P.Chemical composition and in vitro cytotoxic, genotoxic effects of essential oil from Urtica dioica L. Bull Environ Contam Toxicol. 2012 May;88(5):666-71.

Consumer Information

How It Works

Bottom Line: Nettle may be effective in relieving symptoms of benign prostatic hyperplasia (BPH).

Researchers are still unsure how nettle works. It has been suggested that nettle might reduce the activity of testosterone by altering the amount of testosterone circulating in the blood, or by inhibiting one of the key enzymes in testosterone synthesis. However, none of these theories has been conclusively proven. Other actions of nettle include acting as a diuretic (causing water loss from the body through the urine) and lowering blood pressure. Some compounds in nettle also reduce inflammation.

Purported Uses
  • To treat allergies
    No scientific evidence supports this use.
  • To treat arthritis
    Clinical trials support the topical use of nettle sting for arthritis of the hip, knee, and hand. Larger studies are needed to confirm these data.
  • To treat benign prostatic hypertrophy (BPH)
    When combined with other herbs, nettle has shown positive results in clinical trials.
  • To clear up chest congestion
    There is no evidence to back this claim.
  • To promote urination
    Nettle is a known diuretic.
  • To reduce inflammation
    Nettle may have anti-inflammatory activities, but clinical trials have yet to be conducted.
  • To treat oily skin
    No scientific evidence supports this use.
  • To calm muscle spasms
    This use is not backed by research.
  • To treat urinary tract disorders and relieve difficult or painful urination
    Nettle was shown to have beneficial effects in clinical studies.
Research Evidence

Benign Prostatic Hyperplasia:
In this study 257 patients with LUTS caused by BPH were randomized to receive 2 capsules (160 mg Sabal fruit extract WS 1473 and 120 mg Urtica root extract WS 1031 per capsule) or a placebo, daily for 24 weeks. Thsi was followed by a 24-week control period, and a 48-week follow-up period during which all patients received the Sabal + Urtica capsules. At follow-up, researchers observed that LUTS improved significantly. Sabal + Urtica is safe and benefits patients with LUTS.

Do Not Take If
  • You are taking diuretics (nettle can have additive effects).
  • You are taking hypotensive drugs (nettle has hypotensive action and may have additive effects).
  • You are taking drugs that are substrates of Cytochrome P450 (nettle may increase the risk of side effects of these drugs).

Side Effects
  • A case of gynecomastia has been reported in a man following consumption of nettle tea.
  • Galactorrhea was reported in a woman after ingestion of nettle tea.
  • A breastfed, 17-day-old infant developed urticaria following the mother’s use of water boiled with stinging nettle to heal nipple cracks.
  • Hypoglycemia has been reported in a 78-year-old man after taking an herbal remedy containing nettle for benign prostatic hypertrophy.
E-mail your questions and comments to aboutherbs@mskcc.org.