Pine Bark Extract (Pycnogenol)

A controlled study reported that 150 mg per day of Pycnogenol improved symptoms of chronic venous insufficiency (CVI) and reduced associated leg swelling. Double-blind trials have also found that 100 mg of Pycnogenol two to three times daily reduced symptoms of CVI and improved measurements of blood flow and pressure inside of the veins. A controlled trial found that 150 mg per day of Pycnogenol was more effective for CVI than use of elastic stockings alone, but that a combination of the two was better than either treatment alone. Several preliminary studies of CVI have investigated pycnogenol in comparison to or combined with other flavonoid extracts. These studies reported that Pycnogenol (150 to 300 mg per day) was more effective than 1,000 mg per day of a flavonoid mixture of 90% diosmin and 10% hesperidin, that 360 mg per day of Pycnogenol was more effective than 600 mg per day of horse chestnut seed extract, and that a daily combination of 40 mg Pycnogenol and 940 mg hydroxyethylrutosides was more effective than 1,200 mg per day of hydroxyethylrutosides alone.

Pine bark extract (often referred to by the trademark name Pycnogenol®) is high in the same polyphenols as grape seed extract—proanthocyanidins. Controlled clinical trials have found pine bark extract can reduce blood pressure in those with metabolic disease and pre-hypertension. Results from meta-analyses of clinical trials have suggested supplementing with pine bark extract for longer than 12 weeks can result in small reductions in systolic and diastolic blood pressures; nevertheless, high-quality trials have indicated no effect on systolic blood pressure. Another meta-analysis that included data only from double-blind placebo-controlled trials found no effect of pine bark extract on systolic or diastolic blood pressures.

Preliminary and double blind studies have shown that Pycnogenol slows the progression of retinopathy and improves vision when given in typical amounts of 120 to 150 mg per day.

A double-blind study of healthy senior people reported that 150 mg per day of Pycnogenol improved some measures of memory after three months, compared with a group taking a placebo.

In a double-blind trial, supplementing with Pycnogenol significantly improved lung function and asthma symptoms and significantly reduced the need for rescue medication in a group of children (ages 6 to 18 years) with asthma. In contrast, no significant changes were seen in the placebo group. The amount of Pycnogenol used was 1 mg per pound of body weight per day, in two divided doses, for three months.

A double-blind study in Slovakia reported that 1 mg daily per 2.2 pounds body weight of Pycnogenol reduced symptoms of hyperactivity and improved attention, coordination, and concentration after one month in a group of children with ADHD. However, a double-blind study in adults with ADHD did not find 1 mg Pycnogenol per pound of body weight daily was effective for ADHD symptoms.

Preliminary research reported that 60 mg Pycnogenol twice daily for two months reduced abdominal and back pain during menses. A double blind trial by the same researchers using 60 mg Pycnogenol per day confirmed these findings for women with more severe pain, but not for those whose menstrual pain was mild.

In a double-blind study of men with erectile dysfunction, supplementing with 120 mg per day of Pycnogenol improved erectile function, whereas placebo treatment had no effect.

In a double blind trial, people with gingivitis chewed six pieces daily of a gum, each containing 5 mg Pycnogenol. While a group chewing gum without pycnogenol experienced continued gum bleeding and plaque formation after 14 days, the pycnogenol group had less gum bleeding and no additional plaque formation.

In controlled studies, 150 mg of Pycnogenol was taken for two days before and five days after air travel. Jet lag symptoms were milder and lasted for a shorter period of time compared with untreated control groups.

In a small, controlled study, people with SLE were given medication and either a placebo or Pycnogenol in the amount of 120 mg per day for 30 days followed by 60 mg per day for another 30 days. SLE disease activity, measured with a combination of signs, symptoms, and blood measurements, declined further in the group taking Pycnogenol.

In a double-blind trial, perimenopausal women who took 200 mg per day of Pycnogenol experienced reduction of menopausal symptoms as measured by a women’s health questionnaire. Improvement in menopausal symptoms was also reported in another double-blind trial, in which women took 30 mg of pycnogenol twice a day for three months.

In a double-blind trial, 100 mg per day of Pycnogenol reduced pain and other osteoarthritis symptoms, improved walking performance, and reduced the use of pain-relieving medication. Another double blind trial found that 150 mg per day also improved symptoms and reduced use of pain-relieving medication.

In a controlled study, diabetic skin ulcers were treated with standard medications plus either 150 mg per day of Pycnogenol orally, 100 mg Pycnogenol topically applied to the ulcers daily, or a combination of oral and topical Pycnogenol treatment. All treatments produced complete healing in more subjects after six weeks compared with a control group receiving no Pycnogenol treatment, but the group receiving oral and topical Pycnogenol had the greatest reductions in ulcer size and in pain and other associated symptoms. In a small controlled study of venous skin ulcers, the same combination of oral and topical Pycnogenol was more effective for healing than oral Pycnogenol treatment alone.

Proanthocyanidins (OPCs) are a group of flavonoids found in pine bark, grape seed, and other plant sources. In a preliminary trial, volunteers were supplemented with Pycnogenol, an extract of French maritime pine bark rich in OPCs, in the amount of 1.1 mg per 2.2 pounds of body weight per day for the first four weeks, and 1.66 mg per 2.2 pounds of body weight per day for the next four weeks. Compared with ultraviolet sensitivity before supplementation, the lower amount of Pycnogenol was found to significantly increase the amount of ultraviolet rays necessary to cause sunburn, and the higher amount was significantly more effective than the lower amount.

Preliminary research has suggested that pycnogenol may help lower blood glucose levels in people with type 2 diabetes. In a placebo-controlled trial with 48 subjects with type 2 diabetes, 125 mg of pycnogenol per day for 12 weeks led to reductions in fasting blood glucose and LDL-cholesterol levels, as well as blood pressure and HbA1c. In another 12-week placebo-controlled trial with 77 subjects with type 2 diabetes, 100 mg per day of pycnogenol lowered blood glucose levels, but improvement in HbA1c was not statistically significant.

Pycnogenol has been shown to be helpful for improving small vessel health and restoring healthy blood flow in people with type 2 diabetes and related vascular symptoms. Clinical trials have also reported its benefits in treating microvascular complications of type 2 diabetes, such as diabetic retinopathy, skin ulcers, and neuropathy. The doses of pycnogenol used in these studies are 100 to 200 mg per day.

In a controlled study, people at risk for venous thrombosis during plane travel were shown a video explaining in-flight exercises to prevent venous thrombosis and also followed a regimen of 200 mg of pycnogenol two to three hours before the flight, 200 mg six hours later, and 100 mg on the following day. Compared with a similar group who only viewed the video, the group taking pycnogenol experienced fewer episodes of venous thrombosis.

In a preliminary study, symptoms of endometriosis gradually declined when women took 60 mg per day of Pycnogenol, which is high in flavonoids. Double-blind research is needed to confirm these findings.

A patented extract from French maritime pine bark known as has demonstrated strong antioxidant properties and clinical trials have examined its effects on cholesterol levels. However, a meta-analysis of results from seven controlled trials with a total of 422 participants failed to find a cholesterol-lowering effect for pycnogenol.

A preliminary study of people experiencing at least four episodes per week of leg cramps due to either athletic activity, circulatory disorders, or unknown causes reported that 200 mg per day of Pycnogenol significantly reduced episodes of leg cramps. Double-blind research is needed to further explore this use of Pycnogenol.

Melasma is a disorder of increased skin pigmentation. In a preliminary study, 80% of women with melasma who took 75 mg per day of Pycnogenol experienced lightening and shrinking of the pigmented area of the skin. More research is needed to evaluate Pycnogenol for this condition.

In a controlled study, pregnant women who took 30 mg per day of Pycnogenol reported some relief of pain in the legs, pelvis, hip, and low back. Double-blind research is needed to confirm these findings.