Pycnogenol is a patented and standardized supplement, a flavonoid mixture consisting mainly of procyandins and phenolic acids extracted from the bark of European coastal pine Pinus maritima. Procyanidins are biopolymers of catechin and epicatechin subunits which are recognized as important constituents in human nutrition. The phenolic acids are derivatives of benzoic and cinnamic acids. These substances are also found in many other herbs so it is quite possible that many of its health benefits can also be obtained from other herbs.
   J. Masquelier, in France, described in 1979, "Pycnogenols is the term put forward to designate flavan-3-ol derivatives, so as to distinguish these substances, upon chemical and pharmacological grounds, from the heterogeneous group of flavonoid compounds."

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Proanthocyanidins are believed to play an important role in maintaining good health. It is not a vitamin and does not have hormones.

Supplement Facts: Pycnogenol 50 mg  Pine, dried extract (bark)

Composition
Proanthocyanidins
Catechin, epicatechin, and taxifolin
Phenolic acids such as ferulic, caffeic, protocatechic, p-hydroxybenzoic and vanillic acid

Suggested Use: take 1 Pycnogenol tablet a few times a week, or as recommended by your health care provider.

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Pycnogenol Health Benefit - Human studies
The benefits may extend to several conditions such as diabetes, diabetic retinopathy, and diabetic blood vessel health, impotence, menopausal symptoms, asthma, osteoarthritis, dysmenorrhea (menstrual pain), reduction of thrombophlebitis during long flights, and hypertension. This nutritional product can help with blood thinning and blood vessel dilation through actions on the nitric oxide system. It has antioxidant and anti-inflammatory benefits.

Anti-inflammatory
Pycnogenol exerts effects by inhibition of eicosanoid generating enzymes which is consistent with reported clinical anti-inflammatory and platelet inhibitory effects in vivo.

Arthritis, osteoarthritis
There are several supplements that have been shown to be helpful for arthritis, including glucosamine and chondroitin. Joint Power Rx contains a number of beneficial nutrients including glucosamine, chondroitin, CMO, MSM, boswellia extract, and others. Many people who have arthritis already take natural supplements for joint health support. Would the addition of Pycnogenol or another type of pine bark extract provide added benefits?
   There are no easy answers at this time. If your doctor approves, you could add Pycnogenol to your daily regimen. The dosage used in a study was 150 mg a day. This may be an appropriate dosage in the beginning, but for long term use you may consider a maintenance dosage of 30 or 60 mg a day. Just keep in mind that we don't know the effects of Pycnogenol supplement use if taken for many years, or how this product interacts with other supplements or medications, including NSAIDs such as aspirin, naproxen or ibuprofen.

Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects.
Phytother Res. 2008.
The aim of this double-blind, placebo-controlled study was to evaluate the efficacy of 100 mg Pycnogenol oral capsules in a 3 month study in patients with osteoarthritis. The global WOMAC score decreased by 56% in the treatment group versus 9% in the placebo group. The use of drugs decreased by 58% in the treatment group versus 1% under placebo. Gastrointestinal complications decreased by 63% in the treatment group, but only 3% under placebo. Foot edema decreased in 79% of Pycnogenol patients vs 1% in controls.

An inflammation-fighting plant extract may offer some pain relief to people with mild knee arthritis, a new study suggests.
The study included 100 Slovakian adults with mild knee arthritis who were randomly assigned to take either 150 milligrams of pine bark extract or a placebo every day for three months. According to Dr. Peter Rohdewald, of the University of Munster in Germany, knee arthritis patients who took Pycnogenol pine bark extract for three months reported an improvement in their pain, while those given a placebo had no improvement. Switzerland-based Horphag Research Ltd., maker of Pycnogenol, funded the study. Phytotherapy Research, 2008.

Asthma
Pycnogenol improvements in asthma management.
Panminerva Med. 2011.
Pycnogenol inhibits expression of 5-lipoxygenase and consequently decreases leukotriene levels in asthmatic patients. This study evaluated its efficacy during a period of six months for improving allergic (mite in house dust) asthma management in patients with stable, controlled conditions. it was used at a daily dosage of 100 mg, distributed as 50 mg in the morning at 9 am and again in the evening at 9 pm). Administration was effective for better control of signs and symptoms of allergic asthma and reduced the need for medication.

Pycnogenol as an adjunct in the management of childhood asthma.
J Asthma. 2004. Department of Biochemistry and Microbiology, School of Medicine, Loma Linda University, Loma Linda, California
A randomized, placebo-controlled, double-blind study involving 60 subjects, aged 6-18 years old, was conducted over a period of 3 months to determine the effect on mild-to-moderate asthma. Compared with subjects taking placebo, the group who took Pycnogenol had significantly more improvement in pulmonary functions and asthma symptoms and was able to reduce or discontinue their use of rescue inhalers more often than the placebo group.

Brain function
Supplementation could improve cognitive function, attention and mental performance.

Diabetic microangiopathy
Improvement of diabetic microangiopathy with Pycnogenol: A prospective, controlled study.
Angiology. 2006.
This study confirms its clinical efficacy in patients with diabetic microangiopathy.

Pycnogenol for diabetic retinopathy. A review.
Int Ophthalmol. 2001.
Diabetic retinopathy is characterised by vascular lesions with exudate deposits and hemorrhages causing vision loss. Pycnogenol has been tested for treatment and prevention of retinopathy in five clinical trials with a total number of 1289 patients since the late 1960's. All of these studies unequivocally showed that it retains progression of retinopathy and partly recovers visual acuity. Treatment was shown to improve capillary resistance and reduce leakages into the retina.

Dysmehorrhea
Analgesic efficacy of French maritime pine bark extract in dysmenorrhea: an open clinical trial.
J Reprod Med. 2004.
47 patients with menstrual pain, aged 21-45 years, were given Pycnogenol at 30 mg (2 capsules) orally twice a day. Administration began on the eighth day of the first menstrual cycle and continued until the seventh day of the third menstrual cyclet. Treatment lowered the pain scores for abdominal pain. Pain relief in the second cycle of treatment was better as compared to the first cycle of treatment.

Endometriosis
A report in the Journal of Reproductive Medicine reveals that Pycnogenol reduces symptoms of endometriosis. The study, held at Kanazawa University School of Medicine, Ishokawa, Japan, sampled 58 women ages 21-38 who underwent operations for endometriosis within six months prior to the study. Patients were randomized to two groups: Pycnogenol and Gn-RHa. Patients who supplemented with Pycnogenol took 30 mg capsules orally twice daily for 48 weeks immediately after morning and evening meals. Patients who received the Gn-RHa therapy received injected leuprorelin acetate depot, 3.75 mg intracutaneously, six times every four weeks for 24 weeks. (Leuprorelin treatment completely blocks estrogen in the body and must be discontinued after 24 weeks because of side effects). After four weeks, supplementation with P slowly reduced all symptoms from severe to moderate. Treatment with Gn-RHa reduced the scores more efficiently but after 24 weeks post-treatment a relapse of symptoms occurred. Gn-RHa suppressed menstruation during treatment, whereas no influence on menstrual cycles was observed in the Pycnogenol group. "In addition, five women in the trial taking it actually got pregnant," Dr. Takafumi Kohama, a lead researcher of the study said.

Hypertension
A study published in the October journal of Clinical and Applied Thrombosis and Hemostasis shows Pycnogenol reduced edema, a side effect of antihypertensive medications. According to Dr. Gianni Belcaro, lead researcher of the study, some patients taking antihypertensive medications are believed to suffer from edema as a side-effect. This happens because the antihypertensive medications cause blood vessels to dilate, which allows easier blood flow and thus lowers blood pressure. However, as a side-effect this causes blood to pool in the vessels of the lower legs. Results of this study show Pycnogenol to improve blood circulation, avoiding blood pools and reducing edema. The study sampled 53 hypertensive patients at the G D’annunzio University in Italy. All patients suffered from edema of their ankles and feet as a result of antihypertensive medications and were taking medications at the same dosage for at least four months. Twenty-three patients were being treated with ACE inhibitors (brand names Mavik, Altace) and 30 patients were being treated with nifedipine (calcium channel blockers) (brand names Adalat, Procardia). The eight week study sampled 27 patients with 150 mg Pycnogenol treatment per day versus an equivalent dosage of placebo for the remaining 26 patients. After an eight week Pycnogenol treatment, patients treated with ACE inhibitors experienced a 35 percent decrease of ankle swelling while patients being treated with nifedipine experienced a 36 percent decrease of ankle swelling.

Impotence, erectile dysfunction, sexual enhancement
Pycnogenol enhances nitric oxide production which leads to an improvement in blood vessel dilation and an increase in blood flow and oxygen supply to muscles.

Clinical assessment of a supplement of Pycnogenol and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother Res. 2012.
A double-blind parallel group comparison design clinical study was conducted in Japanese patients with mild to moderate erectile dysfunction to investigate the efficacy of a supplement containing Pycnogenol and L-arginine. Subjects were instructed to take a supplement (Pycnogenol 60 mg/day, L-arginine 690 mg/day and aspartic acid 552 mg/day) or an identical placebo for 8 weeks. Eight weeks of supplement intake improved the total score of the IIEF-5. In particular, a marked improvement was observed in 'hardness of erection' and 'satisfaction with sexual intercourse'. A decrease in blood pressure, aspartate transaminase and γ-glutamyl transpeptidase (γ-GTP), and a slight increase in salivary testosterone were observed in the supplement group. No adverse reactions were observed during the study period.

Treatment of erectile dysfunction with Pycnogenol and L-arginine. J Sex Marital Ther. 2003.
We investigated the possibility of overcoming erectile dysfunction (ED) by increasing the amounts of endogenous NO. The study included 40 men, aged 25-45 years, without confirmed organic erectile dysfunction. Throughout the 3-month trial period, patients received 3 ampoules Sargenor a day, a drinkable solution of the dipeptide arginyl aspartate (equivalent to 1.7 g L-arginine per day). During the second month, patients were additionally supplemented with 40 mg Pycnogenol two times per day; during the third month, the daily dosage was increased to three 40-mg Pycnogenol tablets. After 1 month of treatment with L-arginine, a statistically nonsignificant number of 2 patients (5%) experienced a normal erection. Treatment with a combination for the following month increased the number of men with restored sexual ability to 80%. Finally, after the third month of treatment, 92% of the men experienced a normal erection.

Inflammatory bowel disease
Therapeutic efficacy of pycnogenol in experimental inflammatory bowel diseases.
Phytother Res. 2004.
Results suggest that pycnogenol ameliorates ethanol 2,4,6-trinitrobenzene sulfonic acid TNBS-induced inflammation by radical scavenging activity, and may have beneficial effects as a supplement in enteral nutrition for inflammatory bowel disease.

Leukemia
Pycnogenol induces differentiation and apoptosis in human promyeloid leukemia HL-60 cells.
Leuk Res. 2005.

Menopause symptoms
Panminerva Med. 2011. Supplementation with Pycnogenol improves signs and symptoms of menopausal transition.

Dr. Han-Ming Yang of Ham-Ming Hospital in Taiwan have found Pycnogenol reduces menopause symptoms such as fatigue, headache, and vaginal dryness when given over a period of several months. Scandinavian Journal of Obstetrics and Gynecology, 2007.
A randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women.
Acta Obstet Gynecol Scand. 2007.
Some 200 peri-menopausal women were enrolled in a double-blind, placebo-controlled study, and treated with Pycnogenol (200mg) daily. All menopause symptoms improved, antioxidative status increased and LDL/HDL ratio was favourably altered. No side effects were reported.

Retinal health
A study published in the 2009 Journal of Ocular Pharmacology and Therapeutics reveals that it can improve microcirculation, retinal edema and visual acuity in the early stages of diabetic retinopathy. The randomized controlled study, conducted by G D’Annunzio University in Italy, investigated a total of 46 diabetic patients over a period of three months. The treatment group consisted of 24 patients, with 22 patients placed in a placebo treatment group. Each of the patients had been previously diagnosed with diabetes for at least four years prior to participating in the study and their blood glucose was well controlled by diet and oral anti-diabetic medication. Patients had early stage retinopathy characterized by capillaries in the eye leaking fluid into the retina causing swellings. At this stage only minor bleedings into the retina occur and damage to light-sensing cells may still remain largely reversible. Patients were treated with 150 mg of Pycnogenol or placebo tablets in the morning after breakfast over a period of three months. Following treatment with Pycnogenol, there was visual improvement, which was subjectively perceived by 18 out of 24 patients in the Pycnogenol group. Testing of visual acuity using the Snellen Chart (the standard eye chart used by eye care professionals to measure visual acuity) showed a significant improvement from baseline 14/20 to 17/20 after two months of treatment. There were no improvements found in the control group. The blood flow velocity in capillaries nourishing the light sensing cells improved.

Venous Ulcers
A double-blind, placebo-controlled study investigated the healing of venous ulcers in three groups of 16 patients: one group received placebo tablets, another group received Pycnogenol tablets and the final group received both Pycnogenol tablets and local topical treatment of the wound with Pycnogenol powder. All three groups received compression stockings to counteract swelling and had their ulcers cleaned and disinfected. Over a six-week period, in the group treated with Pycnogenol tablets, the ulcer size was reduced to just 11 percent of the original size -- a major difference from the placebo group. And, the group who supplemented with Pycnogenol and used the topical powder resulted in complete healing of the ulcer. The study was published in 2005 Angiology.

Pycnogenol side effects, safety, danger
No significant Pycnogenol side effects or major risks have been reported thus far. It is possible that high dosages could cause insomnia or sleep problems. By thinning the blood it could cause adverse reactions in those who are on Coumadin (warfarin), aspirin, or other medications that cause blood thinning. At this time I do not recommend more than 30 mg a day if used for prolonged periods.

Pycnogenol Research study
Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol.
Clin Appl Thromb Hemost. 2004.
The aim of this study was to evaluate the occurrence of deep venous thrombosis (DVT) and superficial vein thrombosis (SVT) and its prophylaxis with an oral anti-edema and antithrombotic agent (Pycnogenol, Horphag, Research Management SA, Geneva, Switzerland) in long-haul flights, in subjects at moderate to high-risk of DVT and SVT. Subjects were supplemented with 100 mg Pycnogenol per capsule. Treatment subjects received two capsules between 2 and 3 hours before flights with 250 mL of water; two capsules were taken 6 hours later with 250 mL of water and one capsule the next day. The control group received comparable placebo at the same intervals. The flight duration was on average 8 hours and 15 minutes. This study indicates that Pycnogenol treatment was effective in decreasing the number of thrombotic events (DVT and SVT) in moderate-to-high risk subjects, during long-haul flights.

Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II.
Life Sci. 2004.
A double-blind, placebo-controlled, randomized, multi-center study was performed with 77 diabetes type II patients to investigate anti-diabetic effects. Supplementation with 100 mg Pycnogenol for 12 weeks, during which a standard anti-diabetic treatment was continued, significantly lowered plasma glucose levels as compared to placebo. HbA1(c) was also lowered; however, the difference as compared to placebo was statistically significant only for the first month. In the Pycnogenol-group endothelin-1 was significantly decreased, while 6-ketoprostaglandin F(1a) in plasma was elevated compared to placebo. Nitric oxide levels in plasma increased during treatment in both groups, but, differences did not reach statistical significance. Pycnogenol was well-tolerated with ECG, electrolytes, creatinine and blood urea nitrogen remaining unchanged in both groups. Mild and transient unwanted effects were reported for both groups without significant differences. Supplementation of Pycnogenol to conventional diabetes treatment lowers glucose levels and improves endothelial function.

French maritime pine bark extract, improves endothelial function of hypertensive patients.
Life Sci. 2004.
Supplementation of the patients with 100 mg Pycnogenol over a period of 12 weeks helped to reduce the dose of the calcium antagonist nifedipine in a statistically significant manner. Intake decreased endothelin-1 concentrations significantly compared to placebo while concentrations of 6-keto prostaglandin F1a in plasma were significantly higher compared to placebo.

Emails
Is Pycnogenol cream effective? What conditions is it useful in dermatology?
   I haven't seen much research on Pycnogenol cream and don't yet know what role it play in dermatology.

Q. I am interested in giving my daughter Pycnogenol supplements, I have heard its properties may be beneficial for her eyes (see signature below) with particular regard to her retinas. What strength should a five year old take and how often? Daughter aged (5), FEVR (Familial Exudative Vitreoretinopathy) which she inherited along with her good looks and charm, from her Daddy, causing progressive sight loss. Retinal detachment in left eye, with no sight, right eye severely visually impaired. Registered Blind.
   A. We have no idea what the appropriate Pycnogenol dosage would be and also no idea whether it would help.

Q. I came an article on Pycnogenol mentioned in Newsweek - Nov. 6, 2006 issue - "Today a French maritime pine bark extract called Pycnogenol — a mix of antioxidant and anti-inflammatory compounds — is a fast-growing supplement on the U.S. market, with sales up 25 percent this year to date. Unlike most supplements, which have very little research behind them, Pycnogenol (pic-NOJ-en-ol) has 36 double-blind, placebo-controlled trials. The strongest evidence relates to heart health—helping to reduce unwanted clotting, lower "bad" cholesterol and bring down mild hypertension. But the latest studies suggest benefits for diabetes, too. Diabetic patients eventually tend to develop leaky capillaries, which can lead to vision loss, leg ulcers and even amputation of toes or feet. A small study in September found that 150mg of Pycnogenol a day for four weeks helped repair blood vessels and improve capillary blood flow by 34 percent—versus 5 percent for those receiving a placebo. For general health, 25mg to 50mg a day will do. But it won't come cheap (think $30 to $50 a bottle)." Do you think it is safe to take 25 or 50 mg daily?
   A. Pycnogenol seems to have good research supporting its benefits, but then again there are hundreds or thousands of beneficial substances in various fruits, vegetables, roots, barks, herbs, etc. We certainly can't take them all. For the time being, I think it is safe to take Pycnogenol 25 mg or 50 three or four times a week with breakfast.

Q. Just want to find out from you if Prelox is natural and safe. I don't like anything like Viagra I only take natural supplements with no side effect like multivitamins. What ingredient is in Prelox?
   A. Prelox is a combination of Pycnogenol and arginine. We have not tested Prelox and therefore do not have first hand experience whether it is effective or safe. There are many more herbs and plant extracts that have a potent aphrodisiac property and we are not sure Pycnogenol falls into that category. However, Pycnogenol could perhaps be useful in dilating blood vessels.

Q. On your website, the suggested dosage is “one tablet a few times a week,” but on the bottle it says, “1 tablet for each 50-60 pounds of body weight for the first week or two. Thereafter, adjust intake to 1 tablet for each 100-120 pounds of body weight.” Which is correct? Also, if I were to follow the instructions on the bottle, and weigh 150 lbs, would 1 tablet be enough? Would 2 be too much? And would the “a few times a week” timetable still hold?
   A. There are no studies that show what the ideal dosage is for Pycnogenol supplementation. As a rule, the suggestions on a bottle tend to be on the higher end of the dosage scale, and they are often written with the understanding that this is the only supplement someone should be taking. However, most people take several supplements a day, and therefore it is safer to take less of any particular supplement when combining several. Having said this, it also depends whether the Pycnogenol is being used as a treatment for a particular condition, in this case the dosage would be higher or more frequent. In summary, there is not enough science to determine the ideal dosage of Pyconogenol and how it combines or interacts with other medicines, herbs, or nutrients, and hence it may be better to take less rather than more.

Q. Thank you for your informative web postings. In reading your post on Pycnogenol, I was interested in the article on Erectile Dysfunction responding to Pycnogenol supplementation. However, I believe you must have a typographical error. It presently says: The study included 40 men, aged 25-45 years, without confirmed organic erectile dysfunction. but then goes on as if these men, indeed, began the study with ED. Is it possible that it should actually say "The study included 40 men, aged 25-45 years, WITH confirmed organic erectile dysfunction?" just wondering, the difference could be important to readers of fine print, and to my family among them.
   A. We reviewed the actual study abstract as presented on Medline and it did say without. IF the abstract is correct as printed, this would mean that the patients had psychological impotence as opposed to organic or physical impotence.

Q. I read through your website info and found your recommendation on dosing very informative about taking it several times a week. When I contacted the manufacturers of Pycnogenol, they insisted that the herb be taken daily. My question: since 25-50 mg is suggested, why are the Pycnogenol capsules almost always sold as 50mg? (I dump some out).
   A. There is little human research with Pycnogenol and thus we do not know the appropriate Pycnogenol dosage for long term use. Furthermore, many people who take a Pycnogenol supplement also take multivitamins or antioxidants or they may take various medications. It is difficult to predict all the potential interactions. Thus, my preference is to be on the safe side and use low dosages until we learn more about the possible benefits and side effects of Pycnogenol either used by itself or combined with other supplements.

Q. I am 40 and I have some brown patches on my face which developed sometime after giving birth to my baby 4 years ago. i believe that they are more stress related rather than hormonal as they appeared after a nervous breakdown. I tried many topical natural and organic products, but nothing worked. I wonder if Pycnogol cram is effective for this hyperpigmentation on my face and if yes, how much do i need to take orally or whether i need the topical Pycnogenol as well.
   A. I am not familiar with the use of Pycnogenol cream. A search on Medline in October 2009 did not reveal any published studies regarding the use of Pycnogenol cream to correct pigment disorders although some web sites are promoting topical products for this purpose.

Q. Does Pycnogenol contain any kind of estrogen, even if plant estrogen?
   A. I don't think so. It contains mostly flavonoids, catechins, procyanidins and phenolic acids.

i am confused over the conflicting nature of two super antioxidants, alpha lipoic acid and Pycnogenol. Whilst their function is generally similar can i know which is more effective in improving skin tone, acne and dilating blood vessel? Is Pycnogenol both lipid and water soluble? Is there any side effect if i combine both together? Recently i am having difficulty sleeping after consumption of 100mg of Pycnogenol.
    These two antioxidants work in different ways. There are countless substances that have antioxidant effects and most of them work in different ways. I don't know the full details of the solubility of the pine bark extract. Side effects of combinations of supplements depends on the dosage used and each person's unique reaction.

I take blood thinners 4 mg once a day. I had genetic testing and I have to take blood thinners for the rest of my life. I've had clots in my leg and lungs twice. Are these pills going to counteract with the blood thinner?
   It's difficult to predict in any one individual. Much depends on your clotting ability, the types of blood thinners you are taking, the dosage, and other supplements used.

Pine Bark Extract 95% Proanthocyanidins