If you are on vacation in the Mediterranean basin and happen upon a person gnawing on a pine tree, fear not – the person is likely treating one of a myriad of inflammatory symptoms. While Western medicine tends to eschew traditional or “natural” therapies, the alternative movement is winning more and more converts as people seek to reduce health care costs and invest in a more organic lifestyle. The latest example of non-traditional medication comes to us from the lovely western Mediterranean, home to the Pinus pinaster , more commonly known as the maritime pine. (N.B.: If at a party with ethnobotanists, be sure to not commit a conifer faux pas and call the tree by an obsolete synonym, Pinus maritima). Barking up the medicinal tree An extract of the tree’s bark provides a ubiquitous bioflavonoid called proanthocyanidin, used to treat so many conditions and diseases that the tree should be renamed Pinus Starbuckus. (You can also find this flavonoid in wine, tea, apples and other plant-derived products.) A few of the more common uses: Arthritis and inflammation (antioxidants) Vascular protection Allergies Stabilizes and strengthens skin and connective tissue Cardiovascular disease ADHD and memory The University of North Carolina-Chapel Hill’s public database Ibiblio notes the remedy can also be used for respiratory complaints – even TB! – and kidney and bladder complaints Medline Plus, a project of the NIH, features a list of uses and grades for scientific evidence, including chronic venous insufficiency, diabetes, erectile dysfunction and Systemic lupus erythematosus. Notably, the only two conditions that rate a grade ‘B’ (good scientific evidence for this use) are asthma and CVI. The remaining 21 conditions are graded ‘C’ (unclear scientific evidence for this use). [My personal favorite, from the list of uses based on tradition or theory, is cardiac mitral valve prolapse. I love trees as much as the next person, but if the ol’ ticker is affected, I’d rather take my chances with a cardiologist.] Patients hope for better joints A study published in August’s Phytotherapy Research discussed results of Pycnogenol in osteoarthritis patients. (The distributors of Pycnogenol, Horphag Research and Natural Health Science, have filed patents for Pycnogenol in COX-1, COX-2 and osteoarthritis applications.) One hundred patients with stage I or II knee osteoarthritis were randomized to receive Pycnogenol or placebo for three months. The patients filled out the Western Ontario and McMaster’s University questionnaire for joint function every two weeks, noting how their arthritis affected daily life and the level of joint stiffness. Data were collected every two weeks throughout the three months and two weeks after the medication was stopped. Patients also evaluated weekly pain using a visual analogue scale for pain intensity. The treatment group had a significant improvement (albeit barely; the p-value was less than 0.05) in the WOMAC scores and significant alleviation of pain according to the visual scale (p value less than 0.04). Placebo had no effect. Patients were allowed to continue their regular NSAIDS or analgesics but had to record every pill taken. The use of analgesics decreased in the treatment group, but increased in the placebo group. The statistical significance is similar to an osteoarthritis study done by another group in the April issue; again in a double-blind study, patients in the treatment had a barely significant improvement in WOMAC scores (p-value less than 0.05). This group only received 100 mg daily, however; the August study patients received 150 mg daily. Before you marshal the Sierra Club to prevent a run on the Pinus pinaster, check out the September issue: a double-blind, placebo controlled study looked at another bark extract and its effects on cognitive performance. New Zealand’s Pinus radiata bark provides the proanthocyanidin for Enzogenol, a formulation that, like Pycnogenol, contains proanthocyanidins, bioflavonoids and organic acids. Naturally, Enzo Nutraceuticals notes the mixture has a wide range of naturally health promoting properties in everything from migraines to oxidative stress to cardiovascular health. While the numbers are technically significant, a lot more research needs to be done on these compounds. So, if you’re pining for a “traditional” therapy for your condition du jour, I’d suggest taking a hike and get a snack in the nearest copse of conifers. See "French Pine Bark Extract Naturally Reduces Knee Osteoarthritis - Clinical Study" for the news release.