Mullein

Over the centuries, mullein has been used in various ways. Taken internally, it has been used to treat respiratory conditions and tumours; applied topically, its use has been to relieve itch and dress wounds. It was also used to make candlewicks for casting out evil spirits. Due to its robust nature, mullein is now considered a serious weed pest of roadsides and industrial areas in countries such as the USA. Verbascum thapsus is a dicotyledonous plant that produces a rosette of leaves in its first year of growth. The leaves are large, up to 50 cm long. The second year plants normally produce a single unbranched stem usually 1–2 m tall. In the East of its range in China, it is, however, only reported to grow up to 1.5 m tall.

PLANT PARTS USED:

Dried leaves and flowers

CHEMICAL COMPONENTS:

The flower contains water-soluble mucilage, polysaccharides, flavonoids (including apigenin, luteolin, kaempferol and rutin), caffeic acid derivatives, iridoid monoterpenes, triterpene saponins (verbascosaponin), sterols and invert sugar. One of the most investigated constituents isolated from plants in the Verbascum species is verbascoside, an iridoid glucoside. Whether the pharmacological effects demonstrated for this single constituent can be extrapolated to explain those for mullein is uncertain, as the effects of any herb are due to a number of phytoconstituents and their interaction with each other and the body. As such, information about verbascoside is included here in order to provide a further insight into the herb, but it should be interpreted accordingly. Verbascoside has also been isolated from other herbs such as Verbena officinalis, Echinacea purpurea roots, Euphrasia pectinata, Phlomis longifolia, Pedicularis plicata, Duranta erecta, Marrubium alysson, Leonurus glaucescens and Balotta nigra (Calis et al 1992a, b, Deepak & Handa 2000, Ersoz et al 2000, 2001, Liao et al 1999, Seidel et al 2000, Sloley et al 2001, Takeda et al 1995).

flavonoids such as verbascoside and herperidin

mucilage

saponins

tannins

volatile oil

MAIN ACTIONS:

Mullein has not been significantly investigated under clinical trial conditions, so evidence is derived from traditional, in vitro and animal studies.

DEMULCENT AND EMOLLIENT

Traditionally, these actions were thought to occur primarily within the respiratory system, especially the lungs. However, topical preparations of mullein also exert an emollient action on the skin (Blumenthal et al 2000). This is most likely due to the herb’s high mucilaginous content.

Clinical note— Natural mucilages found in herbs

Mucilages are large, highly branched polymeric structures made from many different sugar and uronic acid units. They are hydrophilic and are capable of trapping water, causing them to swell in size and develop a gel-like consistency. The gels tend to have soothing properties and can be broken down by bowel flora when taken internally (Mills & Bone 2000). They are known to have beneficial effects on burns, wounds and ulcers when applied externally, and on gastric inflammation and irritation and diarrhoea when taken internally.

ANTIMICROBIAL

Antiviral action

Mullein extract exhibits antiviral activity against fowl plague virus, several influenza A strains and influenza B strain, as well as HSV in vitro (McCutcheon et al 1995, Serkedjieva 2000, Slagowska et al 1987, Zanon et al 1999, Zgorniak- Nowosielska et al 1991). Antiviral activity has been demonstrated for both infusions and alcoholic extracts (Serkedjieva 2000).

Antibacterial action

In vitro studies have demonstrated antibacterial activity for mullein extracts (aqueous, ethanol and methanol) against Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli (Turker & Camper 2002). Of the three extracts tested, aqueous extract exhibited the strongest antibacterial action.

ANTITUMOUR

Some plants, such as mullein, were used in folk medicine as sources of antitumour remedies. An in vitro study has identified inhibitors of protein biosynthesis in Verbascum thapsiforme flowers. Researchers found that a saponin glycoside and its aglycon, isolated from the flowers, directly inactivates ribosomes (Galasinski et al 1996). The constituent, verbascoside, has been shown to inhibit telomerase activity in human gastric carcinoma cells in test tube studies, resulting in inhibition of tumour growth (Zhang et al 2002). Cytotoxic effects for verbascoside have also been identified against rat hepatoma and sarcoma cells, and cytostatic activity on human epithelial carcinoma cells (Saracoglu et al 1995).

Expectorant, demulcent, diuretic, anti-inflammatory, nervine, anti-spasmodic, vulnerary, alterative, astringent.

Mullein is a good respiratory remedy. Also for toning the mucous membranes of the respiratory system, reducing inflammation whilst stimulating fluid production and thus facilitating expectoration. It is considered a specific in bronchitis where there is a hard cough with soreness.

Its anti-inflammatory and demulcent properties indicate its use in inflammation of the trachea and associated conditions. Externally an extract made in olive oil is excellent in soothing and healing any inflamed surface or easing ear problems.Combinations : In bronchitis it combines well with White Horehound, Coltsfoot and Lobelia.

In painful coughing, Priest & Priest recommend combining with Elder and Red Clover, and for asthma with Gumweed.

OTHER ACTIONS

The verbascoside constituent demonstrates antioxidant activity in vitro (Gao et al 1999). The saponins in mullein are thought to exert an expectorant activity; however, further investigation is required to confirm this.

CLINICAL USE:

Mullein has not been subjected to significant clinical investigation; therefore, information is generally derived from traditional usage, phytochemical research or evidence of pharmacological activity. In practice, this herbal medicine is often combined with other herbs in order to strengthen clinical effects.

CHRONIC OTITIS MEDIA

To date, no controlled studies are available to determine the clinical effectiveness of mullein as a stand-alone treatment. However, two double-blind studies that tested a herbal combination ear-drop product (containing mullein) in children have produced positive results. The first study involved 103 children aged 6–18 years and found that a naturopathic herbal ear drop known commercially as Otikon (consisting of Allium sativum, Verbascum thapsus, Calendula flowers and Hypericum perforatum in olive oil) was as effective as local anaesthetic ear drops (containing ametocaine and phenazone in glycerin) in the management of ear pain associated with acute otitis media. Treatment lasted for 3 days and produced a statistically significant improvement (Sarrell et al 2001). The second was a randomised, double-blind study involving 171 children aged 5–18 years who had otalgia and clinical findings associated with middle-ear infection (Sarrell et al 2003). Children receiving herbal ear drops containing Allium sativum, Verbascum thapsus, Calendula flowers, Hypericum perfoliatum, lavender, and vitamin E in olive oil achieved better pain relief than controls; however, the pain appeared to be self-limiting with significant improvements seen in all groups over 3 days. The dose used was 5 drops three times daily.

PRODUCTIVE AND DRY COUGH

Traditionally, mullein is combined with other demulcent or expectorant herbal medicines such as Glycyrrhiza glabra, Tussilago farfara and Althea officinalis in the treatment of productive cough. Commission E approves the use of mullein flowers for catarrhs of the respiratory tract (Blumenthal et al 2000). This is largely based on traditional use extending back to ancient times, and phytochemical investigation from in vitro and in vivo studies.

TOPICAL USE

Mullein is used topically for wounds, burns, bruises, haemorrhoids, pruritis and to soften the skin. The high mucilage and tannin content of the herb provides a theoretical basis for its use in these situations as an antipruritic and astringent agent. To date, no controlled studies are available to determine its effectiveness.

OTHER USES:

Mullein is included in herbal combination treatments for a variety of respiratory conditions such as bronchitis. Traditionally it is also used for diarrhoea, dysentery, haemorrhoids and laryngitis.

DOSAGE RANGE:

· Fluid extract (1:1): 1.5–2 mL twice daily.
· Tincture (1:5): 7.5–10 mL twice daily.
· Dried leaf: 12–24 g/day.
· Decoction: 1.5–2 g of herb in 250 mL of cold water, brought to the boil for 10 minutes, taken twice daily.

ADVERSE REACTIONS:

A case of contact dermatitis has been reported (Romaguera et al 1985).

SIGNIFICANT INTERACTIONS:

Controlled studies are not available.

CONTRAINDICATIONS AND PRECAUTIONS:

No information available. Some herbs are known to react with your medication. Please consult your physician before starting on any herb.

PREGNANCY USE:

Insufficient reliable information is available; however, Commission E states that no restrictions are known (Blumenthal et al 2000).

PRACTICE POINTS/PATIENT COUNSELLING:

· Mullein flowers have been used since ancient times as an expectorant and anticatarrhal agent in conditions of productive cough and respiratory infections.

· It is most commonly used in combination with other demulcent and expectorant herbal medicines in the treatment of productive and dry cough.

· In vitro studies have identified antiviral and antibacterial activity.

· Mullein has not been subjected to significant clinical investigation; therefore, information is generally derived from traditional usage or evidence of pharmacological activity. As such, Commission E approves its use for catarrhs of the respiratory tract.

· Used in the form of a herbal combination ear drop, significant anaesthetic activity has been demonstrated.

ANSWERS TO PATIENTS’ FREQUENTLY ASKED QUESTIONS:

What will this herb do for me?

Mullein has been used since ancient times as a treatment for productive coughs and catarrhal states. In modern times, it is also used to treat chronic otitis media, and has antiviral action against influenza virus and HSV. Currently, more scientific investigation is required to confirm efficacy for these indications.

When will it start to work?

Ear drops containing mullein within a herbal combination exerted significant anaesthetic effects within 1–2 days.

Are there any safety issues?

Although safety has not been scientifically established, a long history of use suggests that it is a safe substance when used at the recommended doses.

Other Names