Quercetin

Purported Benefits, Side Effects & More

Quercetin

Purported Benefits, Side Effects & More
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Quercetin

Common Names

  • Polyphenolic flavonoid

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?

Quercetin has not been shown to treat cancer or other diseases.

Quercetin belongs to a family of compounds called bioflavonoids, which are largely responsible for the bright colors and medicinal activities of many plants. Quercetin is the most common bioflavonoid that people consume, and is the most active of the bioflavonoids in laboratory experiments. It is known to act as an antioxidant, neutralizing free radicals that can cause cellular and DNA damage. Quercetin is thought to have anti-inflammatory properties by inhibiting the release of substances that mediate the inflammatory response, such as histamine. Presently, considerable laboratory data support the concept of quercetin as an anticancer compound, but it is still unclear from clinical trials whether this effect occurs in the human body.

Because of its antioxidant effects, quercetin may interfere with the actions of certain chemotherapy drugs.

What are the potential uses and benefits?
  • To treat allergies and inflammation
    Laboratory studies show an anti-inflammatory effect of quercetin, including inhibition of histamine release. Clinical trials have not been conducted.
  • To prevent and treat cancer
    Laboratory studies indicate anticancer activity of quercetin against a wide range of cancer cell types. A systematic review showed that it does not help reduce the risk of ovarian cancer.
  • To treat heart disease
    One study showed that quercetin, in combination with red wine extract, lowered LDL oxidation (which may contribute to atherosclerosis) in healthy volunteers. However, it is unclear how much of this effect was due to quercetin alone, and other similar studies have not found the same effect.
What else do I need to know?

Do Not Take if:

  • You are taking drugs that are substrates of cytochrome P450 3A4 or 2C19 enzymes: Quercetin may increase the risk of side effects of such drugs. Clinical relevance is not known.
  • Losartan (medication to treat hypertenion): Following concomitant administration, quercetin increased the systemic exposure of losartan in a murine model. Clinical relevance is not known.

For Healthcare Professionals

Scientific Name
3,3',4',5,7-pentapentahydroxyflavone
Clinical Summary

Quercetin is a dietary flavonoid found in fruits and vegetables including apples, black, green and buckwheat tea, onions, red grapes, cherries, raspberries, citrus fruits. It is also found in some popular medicinal plants including ginkgo biloba and St. John’s Wort (5) and is used widely for its antioxidant effects. Quercetin showed antioxidant, anti-inflammatory (13) (14) and chemopreventive effects (15) in vitro. However, it can also act as an anti-apoptotic agent (5). Animal models showed its ability to potentiate the antitumor effects of doxorubicin in liver cancer cells, while protecting normal liver cells (16). Quercetin also demonstrated neuroprotective and antidepressant effects (17), exerted pro-oxidant effects by decreasing serum homocysteine levels (18), and protected against osteoarthritis (29).

In clinical studies, long-term supplementation had wide-ranging metabolic effects in healthy subjects (19). But concomitant intake of quercetin did not attenuate postprandial metabolic responses such as lipemia and insulinemia (22) or increase the concentration of alpha linoleic acid, and its conversion to omega-3 fatty acids, which is associated with cardiovascular benefits (23). Supplementation also did not affect endothelial dysfunction biomarkers or depression levels in post myocardial infarction patients (30).

In other studies, quercetin attenuated the severity of muscle weakness caused by eccentric exercise (24), reduced oxidative damage following eccentric exercise (25), and enhanced neuromuscular performance during and after resistance training (26). In women with rheumatoid arthritis, supplementation improved clinical symptoms and disease activity (27). A quercetin containing formula was comparable to omeprazole for treating nonerosive gastroesophageal reflux disease (31).

Meta analyses determined quercetin to be among the active components in TCM formulas that improved overall survival in metastatic colorectal patients (32) and fatigue in those with gastric cancer (33). But findings from a systematic review showed quercetin obtained from a typical diet may not decrease the risk of ovarian cancer (21). It also exacerbated estrogen-induced breast tumors in a murine model (12). Further research is warranted.

Food Sources

Onions, apples, black tea, green tea, buckwheat tea, citrus fruits, red grapes, cherries, raspberries

Purported Uses and Benefits
  • Allergies
  • Inflammation
  • Cancer prevention
  • Cancer treatment
  • Cardiovascular disease
Mechanism of Action

Quercetin constitutes the major bioflavonoid in the human diet. Its antioxidant effects are due its phenolic group, which reacts with free radicals to form the more stable phenoxy radicals (1). Quercetin also exerts anti-inflammatory (13) and chemopreventive (15) properties. It also has been shown to have membrane-stabilizing capabilities and inhibits aldose reductase and low-density lipoprotein oxidation (8). The anti-cancer effects of quercetin are via down regulation of mutant p53 proteins; G1 phase arrest (1); tyrosine kinase inhibition (10); and down regulation of cell survival, proliferative and anti-apoptotic proteins (15). Preclinical data support the concept of quercetin as an anti-cancer compound (15). However, clinical studies that support these uses are few and the results are mixed (7) (9).

Herb-Drug Interactions
  • Cytochrome P450 3A4 and 2C19 substrate drugs: Quercetin was shown to significantly inhibit the constitutive CYP3A4 and CYP2C19 activity, in vitro (11) (20). Clinical relevance is not known.
  • Losartan: Following concomitant administration, quercetin increased the systemic exposure of losartan in a murine model. Clinical significance is not known (28).
  • Tamoxifen: Quercetin significantly increased the bioavailability of tamoxifen in preclinical studies. Clinical relevance has yet to be determined (34).
  • Warfarin: A 79-year-old man on stable warfarin therapy for atrial fibrillation presented with elevated INR following quercetin supplementation. His INR normalized after discontinuing quercetin (35).
Dosage (OneMSK Only)
References
  1. Lamson DW, Brignall MS. Antioxidant and cancer III: quercetin. Altern Med Rev 2000;5:196-208.
  2. Graefe EU, et al. Pharmacokinetics and bioavailability of the flavonol quercetin in humans. Int J Clin Pharmacol Therapy 1999;37:219-33.
  3. Erlund I, et al. Pharmacokinetics of quercetin aglycone and rutin in healthy volunteers. Eur J Clin Pharmacol 2000;56:545-53.
  4. Sampson S, et al. Flavonol and flavone intakes in US health professionals. J Am Diet Assoc 2002;102:1414-20.
  5. Akan Z, Garip AI. Antioxidants May Protect Cancer Cells from Apoptosis Signals and Enhance Cell Viability. Asian Pac J Cancer Prev. 2013;14(8):4611-4614.
  6. Shoskes D, et al. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999;54:960-3.
  7. Janssen K, et al. Effects of the flavonoids quercetin and apigenin on hemostasis in healthy volunteers: results from an in vitro and dietary supplement study. Am J Clin Nutr 1998;67:255-62.
  8. Chopra M, et al. Nonalcoholic red wine extract and quercetin inhibit LDL oxidation without affecting plasma antioxidant vitamin and carotenoid concentrations. Clin Chem 2000;46:1162-70.
  9. Beatty ER, et al. Effect of dietary quercetin on oxidative DNA damage in healthy human subjects. Br J Nutr 2000;84:919-25.
  10. Ferry DR, et al. Phase I clinical trial of the flavonoid quercetin: pharmacokinetics and evidence for in vivo tyrosine kinase inhibition. Clin Cancer Res 1996;2:659-68.
  11. Sergent T, Dupont I, Van der Heiden E, et al. CYP1A1 and CYP3A4 modulation by dietary flavonoids in human intestinal Caco-2 cells. Toxicol Lett. 2009 Dec 15;191(2-3):216-22.
  12. Singh B, Mense SM, Bhat NK, et al. Dietary quercetin exacerbates the development of estrogen-induced breast tumors in female ACI rats. Toxicol Appl Pharmacol. 2010 Sep 1;247(2):83-90.
  13. Askari G, Ghiasvand R, Feizi A, Ghanadian SM, Karimian J. The effect of quercetin supplementation on selected markers of inflammation and oxidative stress. J Res Med Sci. 2012 Jul;17(7):637-41.
  14. Chen YW, Chou HC, Lin ST, et al. Cardioprotective Effects of Quercetin in Cardiomyocyte under Ischemia/Reperfusion Injury. Evid Based Complement Alternat Med. 2013;2013:364519.
  15. Sharmila G, Bhat FA, Arunkumar R, et al. Chemopreventive effect of quercetin, a natural dietary flavonoid on prostate cancer in in vivo model. Clin Nutr. 2013 Sep 3. [Epub ahead of print]
  16. Wang G, Zhang J, Liu L, Sharma S, Dong Q. Quercetin potentiates doxorubicin mediated antitumor effects against liver cancer through p53/Bcl-xl. PLoS One. 2012;7(12):e51764.
  17. Rinwa P, Kumar A. Quercetin suppresses the microglial neuroinflammatory response and induces anti-depressant like effect in olfactory bulbectomized rats. Neuroscience. 2013 Oct 1. [Epub ahead of print]
  18. Meng B, Gao W, Wei J, et al. Quercetin reduces serum homocysteine level in rats fed a methionine-enriched diet. Nutrition. 2013 Apr;29(4):661-6.
  19. Cialdella-Kam L, Nieman DC, Sha W, et al. Dose-response to 3 months of quercetin-containing supplements on metabolite and quercetin conjugate profile in adults. Br J Nutr. 2013 Jun;109(11):1923-33.
  20. Rastogi H, Jana S. Evaluation of inhibitory effects of caffeic acid and quercetin on human liver cytochrome p450 activities. Phytother Res. 2014 Dec;28(12):1873-8.
  21. Parvaresh A, Razavi R, Rafie N, Ghiasvand R, Pourmasoumi M, Miraghajani M. Quercetin and ovarian cancer: An evaluation based on a systematic review. J Res Med Sci. 2016 May 9;21:34.
  22. Brüll V, Burak C, Stoffel-Wagner B, et al. Acute intake of quercetin from onion skin extract does not influence postprandial blood pressure and endothelial function in overweight-to-obese adults with hypertension: a randomized, double-blind, placebo-controlled, crossover trial. Eur J Nutr. 2017 Apr;56(3):1347-1357.
  23. Burak C, Wolffram S, Zur B, et al. Effects of the flavonol quercetin and α-linolenic acid on n-3 PUFA status in metabolically healthy men and women: a randomised, double-blinded, placebo-controlled, crossover trial. Br J Nutr. 2017 Mar;117(5):698-711.
  24. Bazzucchi I, Patrizio F, Ceci R, et al. The Effects of Quercetin Supplementation on Eccentric Exercise-Induced Muscle Damage. Nutrients. 2019 Jan 21;11(1). pii: E205.
  25. Duranti G, Ceci R, Patrizio F, et al. Chronic consumption of quercetin reduces erythrocytes oxidative damage: Evaluation at resting and after eccentric exercise in humans. Nutr Res. 2018 Feb;50:73-81.
  26. Patrizio F, Ditroilo M, Felici F, et al. The acute effect of Quercetin on muscle performance following a single resistance training session. Eur J Appl Physiol. 2018 May;118(5):1021-1031.
  27. Javadi F, Ahmadzadeh A, Eghtesadi S, et al. The Effect of Quercetin on Inflammatory Factors and Clinical Symptoms in Women with Rheumatoid Arthritis: A Double-Blind, Randomized Controlled Trial. J Am Coll Nutr. 2017 Jan;36(1):9-15.
  28. Zhao Q, Wei J, Zhang H. Effects of quercetin on the pharmacokinetics of losartan and its metabolite EXP3174 in rats. Xenobiotica. 2019 May;49(5):563-568.
  29. Yamaura K, Nelson AL, Nishimura H, et al. Therapeutic potential of senolytic agent quercetin in osteoarthritis: A systematic review and meta-analysis of preclinical studies.   Ageing Res Rev. 2023 Sep;90:101989. 
  30. Dehghani F, Vafa M, Ebrahimkhani A, et al. Effects of quercetin supplementation on endothelial dysfunction biomarkers and depression in post-myocardial infarction patients: A double-blind, placebo-controlled, randomized clinical trial.  Clin Nutr ESPEN. 2023 Aug;56:73-80.
  31. Li F, Yuan Y, Wu D, et al. Herbal Medicine Hewei Jiangni Decoction Is Noninferior to Oral Omeprazole for the Treatment of Nonerosive Gastroesophageal Reflux Disease: A Randomized, Double-Blind, and Double-Dummy Controlled Trail.  Evid Based Complement Alternat Med. 2022 Sep 22;2022:9647003. 
  32. Zhu Y, Yu J, Zhang K, et al. Network Pharmacology Analysis to Explore the Pharmacological Mechanism of Effective Chinese Medicines in Treating Metastatic Colorectal Cancer using Meta-Analysis Approach.  Am J Chin Med. 2021;49(8):1839-1870.
  33. Wang Z, Wu Z, Xiang Q, et al. Effects of botanical drugs in the treatment of cancer-related fatigue in patients with gastric cancer: A meta-analysis and prediction of potential pharmacological mechanisms. Front Pharmacol. 2022 Sep 7;13:979504.
  34. Yen C, Zhao F, Yu Z, Zhu X, Li CG. Interactions Between Natural Products and Tamoxifen in Breast Cancer: A Comprehensive Literature Review.  Front Pharmacol. 2022 Jun 2;13:847113.
  35. Patel R, Stine A, Zitko K. Enhanced Anticoagulant Effect of Warfarin When Co-administered With Quercetin.  J Pharm Technol. 2022 Dec;38(6):374-375. 
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