Hops

Purported Benefits, Side Effects & More

Hops

Purported Benefits, Side Effects & More
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Hops

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


What is it?

Data on hops extracts for conditions such as pain, insomnia, or menopausal symptoms are too limited to draw conclusions.

Hops are traditionally used in beer brewing as flavoring agents. Lab studies suggest that hops extracts may have antibacterial, anti-inflammatory, antidiabetic, and anticancer effects.

Studies in humans are quite limited, however. Preliminary data suggest it may help relieve pain, insomnia, or menopausal symptoms, but some of these studies use hops in combination with other herbs.

Additional studies are needed to confirm safety and efficacy. In addition, patients with hormone-sensitive cancers should consult their physicians before using products containing hops.

What are the potential uses and benefits?
  • Arthritis

    Preliminary data suggest hops extract in combination with rosemary leaf and oleanolic acid, may reduce pain in patients with osteoarthritis. More studies are needed.
  • Sleeping aid

    Preliminary data suggest hops extract in combination with valerian may improve sleep in patients with mild insomnia. More studies are needed.
  • Menopausal symptoms

    In postmenopausal women, a few studies suggest hops extracts may alleviate menopausal symptoms.
  • Diabetes

    In a small study, hops extract lowered blood glucose and improved insulin sensitivity in patients with type-2 diabetes. Larger studies are required to confirm such effects.
What are the side effects?
  • Several cases of respiratory disease have been associated with inhaling hop dust during harvest and processing.
What else do I need to know?

Do Not Take if:

  • You have a hormone-sensitive cancer: Patients should consult their physicians before using products containing hops.
  • You are taking CYP450 substrate drugs: Although lab studies suggest that hops extracts may inhibit several CYP enzymes, a standardized hops extract did not appear to cause clinically relevant interactions in humans. Still, patients should check with their doctor before taking hops.
  • You are taking paracetamol (acetaminophen): In animal models, some hops species slowed clearance of paracetamol, thereby increasing its analgesic effects. Clinical relevance has yet to be determined.

For Healthcare Professionals

Scientific Name
Humulus lupulus L.
Clinical Summary

Hops are the female inflorescences of the plant Humulus lupulus L. They are used primarily in beer brewing to add bitterness and flavor. Hops is also used as an herbal medicine for mood disturbance and insomnia (1) and to treat menopausal symptoms. In vitro studies suggest hops has antibacterial (28), chemopreventive (2) (3) (4), antitumor (5), antiangiogenic (6), anti-inflammatory (19), phytoestrogenic (29), and antidiabetic (7) properties. In murine models, hops reduced hyperlipidemia (8) and obesity (9), and protected against bone loss following estrogen depletion (21).

In clinical studies, a hops-valerian combination product was reported to improve sleep quality (10) (16) and insulin sensitivity in patients with type-2 diabetes (7). Other preliminary studies suggest hops extracts may alleviate mild depression, anxiety, and stress (23) or decrease body fat in healthy subjects (24). Data from an observational study suggest a combination of hops, rosemary extract, and oleanolic acid may help reduce arthritic pain (11). However, it is not clear whether hops alone would exert similar effects.

In postmenopausal women, a few studies suggest hops extracts may alleviate menopausal symptoms (13) (17) (25) and improve bone health (18). Some studies also indicate that derivates of hops have phytoestrogenic effects (7) (12). Patients with hormone-sensitive cancers should consult their physicians before using products containing hops.

Food Sources

Female inflorescences of Humulus lupulus L.

Purported Uses and Benefits
  • Arthritis
  • Insomnia
  • Menopausal symptoms
  • Diabetes
Mechanism of Action

Animal models suggest isomerized hops extracts may increase plasma HDL levels and decrease atherosclerosis index via PPAR-alpha activation (14). These extracts also reduced plasma triglycerides and induced hepatomegaly (8). A product containing hops extract reduced C-reactive protein in patients with inflammatory diseases (12).

Prenyl flavonoids from hops, xanthohumol, isoxanthohumol, and 8-prenylnaringen (8-PN) inhibit aromatase activity and breast cancer cell proliferation, increase apoptosis (5), and inhibit prostate cancer cell proliferation (3). 8-PN is among the potent estrogen receptor alpha phytoestrogens, which is likely responsible for relief of menopausal symptoms (29). In addition, xanthohumol exhibits antiangiogenic effects by inhibiting the NF-kB and Akt pathways (6). Isoadhumulone, isocohumulone, and isohumulone derived from hops selectively inhibited aldo-keto-reductase 1B10, which is upregulated in various cancers promoting carcinogenesis (30).

Isoxanthohumols are converted in the distal human gut into 8-PN via intestinal microflora activity (12). This process also occurs in the liver and is regulated by CYP450 enzymes (15).

Adverse Reactions
  • Several cases of respiratory disease have been associated with inhaling hop dust during harvest and processing (26).
Herb-Drug Interactions
  • Cytochrome P450 substrates: Although in vitro studies suggest hops may inhibit 1A2, 2C8, 2C9, and 2C19 (27), a standardized hops extract did not appear to cause clinically relevant interactions with 1A2, 2C9, 2D6, 3A4, or 3A5 in humans (31).
  • Paracetamol (acetaminophen): In murine models, some hops species slowed clearance of paracetamol, thereby increasing its analgesic effects. Clinical relevance has yet to be determined (20).
Herb Lab Interactions
  • Isomerized hops extracts may increase plasma HDL levels (14).
  • Hops extract in combination with rosemary extract and oleanolic acid may reduce C-reactive protein in patients presenting with elevated levels (11).
Dosage (OneMSK Only)
References
  1. Piersen CE. Phytoestrogens in botanical dietary supplements: implications for cancer. Integr Cancer Ther. Jun 2003;2(2):120-138.
  2. Dietz BM, Kang YH, Liu G, et al. Xanthohumol isolated from Humulus lupulus Inhibits menadione-induced DNA damage through induction of quinone reductase. Chem Res Toxicol. Aug 2005;18(8):1296-1305.
  3. Delmulle L, Bellahcene A, Dhooge W, et al. Anti-proliferative properties of prenylated flavonoids from hops (Humulus lupulus L.) in human prostate cancer cell lines. Phytomedicine. Nov 2006;13(9-10):732-734.
  4. Nozawa H, Nakao W, Zhao F, Kondo K. Dietary supplement of isohumulones inhibits the formation of aberrant crypt foci with a concomitant decrease in prostaglandin E2 level in rat colon. Mol Nutr Food Res. Aug 2005;49(8):772-778.
  5. Monteiro R, Faria A, Azevedo I, Calhau C. Modulation of breast cancer cell survival by aromatase inhibiting hop (Humulus lupulus L.) flavonoids. J Steroid Biochem Mol Biol. Jun-Jul 2007;105(1-5):124-130.
  6. Albini A, Dell’Eva R, Vene R, et al. Mechanisms of the antiangiogenic activity by the hop flavonoid xanthohumol: NF-kappaB and Akt as targets. FASEB J. Mar 2006;20(3):527-529.
  7. Yajima H, Ikeshima E, Shiraki M, et al. Isohumulones, bitter acids derived from hops, activate both peroxisome proliferator-activated receptor alpha and gamma and reduce insulin resistance. J Biol Chem. Aug 6 2004;279(32):33456-33462.
  8. Shimura M, Hasumi A, Minato T, et al. Isohumulones modulate blood lipid status through the activation of PPAR alpha. Biochim Biophys Acta. Sep 5 2005;1736(1):51-60.
  9. Yajima H, Noguchi T, Ikeshima E, et al. Prevention of diet-induced obesity by dietary isomerized hop extract containing isohumulones, in rodents. Int J Obes (Lond). Aug 2005;29(8):991-997.
  10. Morin CM, Koetter U, Bastien C, Ware JC, Wooten V. Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial.Sleep. Nov 1 2005;28(11):1465-1471.
  11. Lukaczer D, Darland G, Tripp M, et al. A pilot trial evaluating Meta050, a proprietary combination of reduced iso-alpha acids, rosemary extract and oleanolic acid in patients with arthritis and fibromyalgia. Phytother Res. Oct 2005;19(10):864-869.
  12. Possemiers S, Bolca S, Grootaert C, et al. The prenylflavonoid isoxanthohumol from hops (Humulus lupulus L.) is activated into the potent phytoestrogen 8-prenylnaringenin in vitro and in the human intestine. J Nutr. Jul 2006;136(7):1862-1867.
  13. Heyerick A, Vervarcke S, Depypere H, Bracke M, De Keukeleire D. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas. May 20 2006;54(2):164-175.
  14. Miura Y, Hosono M, Oyamada C, Odai H, Oikawa S, Kondo K. Dietary isohumulones, the bitter components of beer, raise plasma HDL-cholesterol levels and reduce liver cholesterol and triacylglycerol contents similar to PPARalpha activations in C57BL/6 mice. Br J Nutr. Apr 2005;93(4):559-567.
  15. Guo J, Nikolic D, Chadwick LR, Pauli GF, van Breemen RB. Identification of human hepatic cytochrome P450 enzymes involved in the metabolism of 8-prenylnaringenin and isoxanthohumol from hops (Humulus lupulus L.). Drug Metab Dispos. Jul 2006;34(7):1152-1159.
  16. Dimpfel W, Suter A. Sleep improving effects of a single dose administration of a valerian/hops fluid extract - a double blind, randomized, placebo-controlled sleep-EEG study in a parallel design using electrohypnograms. Eur J Med Res. 2008 May 26;13(5):200-4.
  17. Erkkola R, Vervarcke S, Vansteelandt S, et al. A randomized, double-blind, placebo-controlled, cross-over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts. Phytomedicine. 2010 May;17(6):389-96.
  18. Holick MF, Lamb JJ, Lerman RH,et al. Hop rho iso-alpha acids, berberine, vitamin D3 and vitamin K1 favorably impact biomarkers of bone turnover in postmenopausal women in a 14-week trial. J Bone Miner Metab. 2010 May;28(3):342-50.
  19. Akazawa H, Kohno H, Tokuda H, et al. Anti-inflammatory and anti-tumor-promoting effects of 5-deprenyllupulonol C and other compounds from Hop (Humulus lupulus L.). Chem Biodivers. 2012 Jun;9(6):1045-54.
  20. Jakovljevic V, Popovic M, Raskovic A, et al. Effect of aroma and magnum hops extracts and paracetamol on antioxidant liver parameters in mice. Eur J Drug Metab Pharmacokinet. 2009 Jan-Mar;34(1):37-41.
  21. Keiler AM, Helle J, Bader MI, et al. A standardized Humulus lupulus (L.) ethanol extract partially prevents ovariectomy-induced bone loss in the rat without induction of adverse effects in the uterus. Phytomedicine. 2017 Oct 15;34:50-58.
  22. Hege M, Jung F, Sellmann C, Jin C, Ziegenhardt D, Hellerbrand C, Bergheim I. An iso-α-acid-rich extract from hops (Humulus lupulus) attenuates acute alcohol-induced liver steatosis in mice. Nutrition. 2018 Jan;45:68-75.
  23. Kyrou I, Christou A, Panagiotakos D, et al. Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: a randomized, placebo-controlled, double-blind, crossover pilot study. Hormones (Athens). 2017 Apr;16(2):171-180.
  24. Morimoto-Kobayashi Y, Ohara K, Ashigai H, et al. Matured hop extract reduces body fat in healthy overweight humans: a randomized, double-blind, placebo-controlled parallel group study. Nutr J. 2016 Mar 9;15:25.
  25. Aghamiri V, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Nazemiyeh H. The effect of Hop (Humulus lupulus L.) on early menopausal symptoms and hot flashes: A randomized placebo-controlled trial. Complement Ther Clin Pract. 2016 May;23:130-5.
  26. Reeb-Whitaker CK, Bonauto DK. Respiratory disease associated with occupational inhalation to hop (Humulus lupulus) during harvest and processing. Ann Allergy Asthma Immunol. 2014 Nov;113(5):534-8.
  27. Yuan Y, Qiu X, Nikolić D, et al. Inhibition of human cytochrome P450 enzymes by hops (Humulus lupulus) and hop prenylphenols. Eur J Pharm Sci. 2014 Mar 12;53:55-61.
  28. Bocquet L, Sahpaz S, Bonneau N, Beaufay C, et al. Phenolic Compounds from Humulus lupulus as Natural Antimicrobial Products: New Weapons in the Fight against Methicillin Resistant Staphylococcus aureus, Leishmania mexicana and Trypanosoma brucei Strains. Molecules. 2019 Mar 14;24(6). pii: E1024.
  29. Chadwick LR, Nikolic D, Burdette JE, et al. Estrogens and congeners from spent hops (Humulus lupulus). J Nat Prod. 2004 Dec;67(12):2024-32.
  30. Seliger JM, Cicek SS, Witt LT, Martin HJ, Maser E, Hintzpeter J. Selective Inhibition of Human AKR1B10 by n-Humulone, Adhumulone and Cohumulone Isolated from Humulus lupulus Extract. Molecules. 2018 Nov 21;23(11):3041.
  31. van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. May 6 2020;68(18):5212-5220.
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