
Common Names
- French Marine Pine Bark Extract
- Pine Bark
- Procyanidin Oligomers
- PCOs
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.
How It Works
Pine bark extract has been used for a variety of chronic conditions that involve inflammation, but larger studies are needed.
Pycnogenol is derived from the bark of the French maritime pine tree. Preliminary studies suggest it may improve inflammatory conditions and skin disorders because of its antioxidant and anti-inflammatory properties, but other studies are mixed on whether it benefits cardiovascular health. Large-scale studies are needed to establish the safety and effectiveness of pycnogenol in the treatment of chronic disorders.
Purported Uses
-
To treat cardiovascular disease
A few trials suggest pine bark extract may improve chronic venous insufficiency and endothelial function, but meta-analyses found no benefit with pycnogenol on blood pressure and suggest effects are small for cardiometabolic health. Additional studies are needed. -
Attention deficit hyperactivity disorder (ADHD)
One study found pycnogenol is not effective in treating ADHD in adults. -
Inflammation
Preliminary studies suggest benefit, but more clinical trials are needed. -
Erectile dysfunction
Limited studies have been conducted and more trials are needed to establish this use.
Do Not Take If
Special Point
For Healthcare Professionals
Clinical Summary
Obtained from the bark of the French maritime pine tree, pine bark extracts contain procyanidins which have antioxidant properties. Various formulations using different species have been marketed, vary in amounts of procyanidins, and are often promoted for use in chronic conditions.
In vitro and animal studies suggest that pine bark extract has antioxidant, anti-inflammatory (6), immunostimulant (1), cardioprotective (20), and neuroprotective (31) effects. It may also have antimicrobial activities (15) (16) (17).
In humans, preliminary data suggest it may reduce menopausal (8), dysmenorrheic (27), and osteoarthritic (9) (10) symptoms. Small studies suggest one pine bark extract formulation may improve oxidative stress and bone turnover markers in postmenopausal osteopenic women (39), and improve nutrition and clinical status in critically ill patients (40). Other data suggest pine bark extract may improve hyperpigmentation (11), erythema (12), and symptoms of endometriosis (13) and lupus (14).
Improvements in endothelial dysfunction (2) (33) and chronic venous insufficiency (5) have also been observed, but a meta-analyses found no benefit with pycnogenol on blood pressure (36), and determined effects were small for cardiometabolic health (37). Another meta-analyses recommended against pycnogenol and various other supplements for musculoskeletal pain (38).
Pycnogenol may enhance memory in elderly participants (7), but studies in adults and children with ADHD yielded mixed results (3) (4). When used in conjunction with L-arginine, pycnogenol improved erectile dysfunction symptoms (18) (29).
Preliminary data suggest pycnogenol may reduce some adverse effects of radiotherapy and chemotherapy (30), but further research is needed.
Systematic reviews have concluded that evidence is insufficient and that large-scale studies are needed to establish the value of various pine bark extract supplements for chronic disorders (34) (41).
Mechanism of Action
The primary constituents of pine bark extracts are procyanidins and phenolic acids (35). Pine bark extract acts as an antioxidant by scavenging reactive oxygen and nitrogen species and suppressing production of peroxides (21). It increases the activities of antioxidant enzymes by increasing the intracellular glutathione levels (22). In addition to increasing NO production which induces vasodilation (2), pine bark extract also blocks the NF-kB activation stimulated by tumor necrosis factor-alpha (TNF-alpha) and inhibits production of adhesion proteins that cause inflammation and atherosclerosis (22).
In vitro, pycnogenol induced apoptosis in human breast cancer cells (23) and reduced neuronal apoptosis, an important feature of Alzheimer’s disease, by decreasing free radical generation (24). In animal studies, cardioprotective effects were also attributed to free radical scavenging (20).
Contraindications
- Hypersensitivity to pine bark (26)
Adverse Reactions
- May cause irritability and lower energy levels (26).
Herb-Drug Interactions
- Anticoagulant and/or antiplatelet drugs: Pine bark extract can inhibit platelet aggregation and may increase risk of bleeding when used with these drugs (28).