BLOODROOT

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Parts used and where grown: Bloodroot grows primarily in North America and in India. The rhizomes and root of the plant contain an orange-red latex.

Bloodroot has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Gingivitis (periodontal disease)
	Cough Halitosis (rinse)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): Native Americans employed bloodroot extensively in ritual and medicine. The dye was used as a body paint.¹ Sore throats, cough, rheumatic pains, and various types of cancer were all treated with bloodroot.

Active constituents: Alkaloids—principally sanguinarine—constitute the primary active compounds in bloodroot. These are sometimes used in toothpaste and other oral hygiene products because they inhibit the growth of oral bacteria.^{2 3} Not all trials have found sanguinaria-containing dental products helpful for gum disease, however.⁴

How much is usually taken? Sanguinarine-containing toothpastes and mouth rinses should be used according to manufacturer’s directions. Bloodroot tincture is sometimes included in cough-relieving formulas, and 10 drops or less may be taken three times per day.⁵ However, bloodroot is rarely used alone for this purpose.

Are there any side effects or interactions? Although previous studies have suggested the long-term use of dental products containing sanguinarine is safe,⁶ a recent report suggests that use of dental preparations containing blood root may be associated with leukoplakia—a condition characterized by white spots or patches in the mouth that is thought to be precancerous.⁷ Only small amounts of bloodroot should be taken internally, since amounts as small as 1 ml (approximately 20–30 drops) of tincture or 1 gram (approximately 1/30th ounce) can cause nausea and vomiting.^{8 9}

Long-term use or overdose of bloodroot can also cause stomach pain, diarrhea, visual changes, paralysis, fainting, and collapse.¹⁰ Long-term oral intake of sanguinarine-contaminated cooking oils has been linked in India to glaucoma, edema, heart disease, miscarriage, and diarrhea.¹¹ The sanguinarine in these cases came from plants other than bloodroot. Nevertheless, bloodroot should not be used long term. The plant is unsafe for use in children and should not be used by pregnant or lactating women.

Recently the practice of applying ointments containing bloodroot, such as the so-called “black salve,” has been promoted for treatment of skin and other types of cancer.¹² These ointments have never been tested in clinical studies, so their efficacy for treating cancer is unknown. They can cause severe pain, burns, and damage to healthy skin. It is imperative to seek professional diagnosis and treatment for all forms of cancer.

At the time of writing, there were no well-known drug interactions with bloodroot.

1. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 424–5.

2. Dzink JL, Socransky SS. Comparative in vitro activity of sanguinarine against oral microbial isolates. Antimicrob Agents Chemother 1985;27:663–5.

3. Hannah JJ, Johnson JD, Kuftinec MM. Long-term clinical evaluation of toothpaste and oral rinse containing sanguinaria extract in controlling plaque, gingival inflammation, and sulcular bleeding during orthodontic treatment. Am J Orthod Dentofacial Orthop 1989;96:199–207.

4. Mauriello SM, Bader JD. Six-month effects of a sanguinarine dentifrice on plaque and gingivitis. J Periodontol 1988;59:238–43.

5. British Herbal Medicine Association Scientific Committee. British Herbal Pharmacopoeia. West Yorks, UK: British Herbal Medicine Association, 1983.

6. Frankos VH, Brusick DJ, Johnson EM, et al. Safety of Sanguinaria extract as used in commercial toothpaste and oral rinse products. J Can Dent Assoc 1990;56(suppl 7):41–7.

7. Eversole LR, Eversole GM, Kopick J. Sanguinaria-associated oral leukoplakia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:455–64.

8. British Herbal Medicine Association Scientific Committee. British Herbal Pharmacopoeia. West Yorks, UK: British Herbal Medicine Association, 1983.

9. McGuffin M, Hobbs C, Upton R, Goldberg A (eds). American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997.

10. Felter HW, Lloyd JU. King’s American Dispensatory 18th ed. Sandy, OR: Eclectic Medical Publications, 1898, reprinted 1983.

11. Hakim SA. Sanguinarine—a carcinogenic contaminant in Indian edible oils. Indian J Cancer 1968;5:183–97.

12. Naiman I. Cancer Salves: A Botanical Approach to Treatment. Santa Fe: Seventh Ray Press, 1999.

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