How does it feel?
Poke root is a herb restricted under Schedule 20 restrictions, so it may only be used under the guidance of medical herbalist
What can I use it for?
Poke root is not suited to beginner or home herbalists. Its uses are largely for ongoing, chronic conditions connected to the lymphatic system. It is known to produce purgative effects if taken incorrectly. Consequently, poke root is a herb restricted under Schedule 20 restrictions, so it may only be used under the guidance of medical herbalist. See ‘what practitioners say’ to learn about how professional herbalists use it in practice.
Into the heart of poke root
Poke root is one of the best herbs for lymphatic afflictions. It is used in herbal medicine to support movement of lymph, thus supporting cellular and systemic detoxification and enhancing the function of the immune system. It is often used in cases of swollen lymph nodes, tonsillitis, mastitis, swollen breasts and mumps (1,2).
In the principles of traditional Western herbal medicine where the focus is on identifying the health status of tissues, poke root is specifically useful for damp stagnation. This is most accurately described as a state of torpidity. There will be a build up of fluid or phlegm which may be stuck. This may be linked to the lymphatic system, or anywhere in the body.
This stagnation can cause pain in the muscles. There may be a wider picture of weakness and flaccidity that is not linked to poor nutrition. Digestion and liver function are also backed up. Poke root is able to promote movement where it is needed to release this stagnation in the tissues (3).
Traditional uses
Poke root (Phytolacca americana) Poke root is regarded as one of the most medicinally important plants of the Native Americans . It has long been regarded as a powerful cleansing remedy, used to help in cases when the lymphatic system has become sluggish and congested.
This may show up in the early stages as being chronically tired with slightly swollen glands. It is specific where deep congestion in the lymphatic system is an associated symptom in advanced rheumatism, respiratory disease or auto-immune disorders. All of which are conditions that poke root has traditionally been used to treat (1).
Grieves writes that “headaches of many sources are benefited by it”. It has long been used for treating chronic rheumatism and it is also stated to be of value as an internal remedy in cancer — particularly of the breast. As with all herbal authors on poke root, Grieve emphasises the need for caution describing its potential action in higher doses as a slow emetic and purgative with narcotic properties (4).
In the King’s Dispensatory 1898, it is written that “physiologically, poke root acts upon the skin, the glandular structures, especially those of the buccal cavity, throat, sexual system, and very markedly upon the mammary glands. It further acts upon the fibrous and serous tissues, and mucous membranes of the digestive and urinary tracts. In certain conditions of the system which might come under the head of dyscrasia (bad blood), it proves a most valuable alterative” (5).
Traditional actions
Herbal actions describe therapeutic changes that occur in the body in response to taking a herb. These actions are used to express how a herb physiologically influences cells, tissues, organs or systems. Clinical observations are traditionally what have defined these actions: an increase in urine output, diuretic; improved wound healing, vulnerary; or a reduction in fever, antipyretic. These descriptors too have become a means to group herbs by their effects on the body — herbs with a nervine action have become the nervines, herbs with a bitter action are the bitters. Recognising herbs as members of these groups provides a preliminary familiarity with their mechanisms from which to then develop an understanding of their affinities and nuance and discern their clinical significance.
Traditional energetic actions
Herbal energetics are the descriptions Herbalists have given to plants, mushrooms, lichens, foods, and some minerals based on the direct experience of how they taste, feel, and work in the body. All traditional health systems use these principles to explain how the environment we live in and absorb, impacts our health. Find out more about traditional energetic actions in our article “An introduction to herbal energetics“.
What practitioners say
Poke root (Phytolacca americana) Poke root is a slow-acting emetic, a purgative, and a mild narcotic. It has a long history of use in herbal medicine for a number of chronic health conditions. The use of this herb should only be attempted by qualified medical herbalists.
Immune system
Poke root has a specific action on the lymphatic system and is used to increase lymphatic drainage. It is most indicated in cases of hard lymph nodes with pale congested mucous membranes.
Is indicated in mastitis, sore nipples, cystic breast tissue or mammary abscesses. It can be applied topically as a lotion and/or taken internally for swollen glands and lymph nodes (1,5,6).
Poke root is sometimes used by herbalists to treat serious conditions such as lymphoedema, testicular inflammation, or as an adjunct treatment for cancer.
Several immune properties of poke root have been identified as a result of its polysaccharides. The actions of these compounds are mitogenic, immuno-stimulant and enhancing to B and T lymphocytes.. These compounds are also anti-inflammatory. Proteins called isoamericanin A (neo-lignan) found in poke root as well as alkaloid compounds called phytolaccines have also been shown to exhibit antiviral and antibacterial effects. The latter has been shown to be effective against gram positive organisms(9,10).
The immune supportive effects of poke root may also be partly caused by the presence of substances called mitogenic lectins, which may interact with gut associated lymphoid tissue and may be absorbed in small quantities. These lectins are used pharmacologically to stimulate cell division and increase the production of antibodies within white blood cells (7,11,).
Respiratory system
Poke may also be occasionally used for inflammatory conditions of the upper respiratory tract. Compounds called triterpene saponins (phytolaccosides) found in poke root are anti-inflammatory and anticatarrhal (7,12,13).
Musculoskeletal system
Poke root is often used in chronic rheumatism to support the removal of waste products from systemic circulation and reduce inflammation in the muscular tissue (1,7,13).
Other
Some additional indications for poke root include tonsillitis, laryngitis, adenitis and mumps. It can also be used as part of an integrated approach to treat skin infections such as scabies, tinea, sycosis and acne (1,7).
Research
Unsurprisingly, given its potential for toxicity, there are no clinical studies on human subjects using poke root. There were a number of laboratory studies carried out between the 1970s and 1990s which have not been included in this monograph (12).
Additional information
Botanical description
Poke root is a large and fleshy perennial with a hollow stem. The leaves are alternate and ovate-lanceolate. The flowers appear in racemes and consist of a white calyx with no corolla. The fruit is a beautiful deep purple berry, covering the stem in clusters (14).
Common names
- American nightshade
- Pocan
- Pokeberry
- American poke
- Red plant
Safety
Poke root may cause profuse nausea, sickness and purgation with overdose. Consequently this herb’s use is restricted in the UK under Schedule 20; so, it may only be purchased and prescribed by a qualified medical herbalist.
Poke root should not be used by children nor should it be taken whilst pregnant or breast-feeding.
Excessive doses of poke root may harm the liver and the kidneys and cause damage to the nervous system. This is a herb that should only be prescribed by a qualified herbalist who is experienced in its safe use.
Toxicity
All parts of the plant may be toxic. The alkaloid phytolaccin is responsible for its toxicity and in large doses can cause paralysis, bradycardia, decreased respiration, and decreased skeletal muscle coordination. Poke root’s alkaloids can build up in the body to potentially toxic levels; therefore, this herb is recommended for short-term use of 1–2 weeks only. If any side effects are noticed, stop the use of this herb immediately.
Toxic effects include:
- Vomiting
- Diarrhoea
- Nausea
- Stomach cramps
- Dizziness
- Hypotension
- Decreased respiration
- Headaches (1,2,7)
Fresh plant tinctures and the leaves and berries should be avoided.
Do not apply to broken skin and avoid contact with the eyes (1,2,7).
Interactions
Poke root should not be taken in conjunction with immunosuppressive medication (1,2,7)
Contraindications
Poke root should not be taken by those with kidney disease (its alkaloids are eliminated through the kidneys), GIT inflammation and irritation and lymphocytic leukaemia (1,2,7).
Preparations
- Tincture
- Poultice
- Lotion
Dosage
As this is a restricted herb it can only be prescribed by a medical herbalist. The dosage is restricted to current legal and safety guidelines. The dosage included below is based upon what a herbal practitioner may prescribe.
- Tincture (ratio 1:10 | 45%): Take between 0.2–0.6 ml twice to three times a day. Maximum weekly dose is 8 ml of a 1:5 strength tincture.
- Poultice or lotion: Poultice of root or herb can be used twice a day on unbroken skin (Caution: application of fresh root or herb can cause erythema and blistering).
Plant parts used
Root
Constituents
- Alkaloids: Betanidine, betanine, betacyanins, iso- betanine, isobetanidine, isoprebetanine, phytolaccine and prebetanine
- Lectins: Pokeweed mitogen (PWM) consisting of five glycoproteins Pa-1 to Pa-5
- Triterpenoid saponins: Phytolaccosides A-1, D2, and 0, aglycones include phytolaccagenin, jaligonic acid, phytolaccagenic acid, aesculentic acid, acinosolic acid methyl ester, monodesmosidic and bidesmosidic compounds with oleanolic acid and phytolaccagenic acids as aglycone in P. decandra
- Other constituents: Isoamericanin A (neo-lignan), pokeweed antiviral protein, a-spinasterol, histamine and GABA (1,2,12)
Habitat
Poke root is native to the southwest and eastern regions of the United States. It grows in open or edge habitats, forest edges, in fence rows, pastures, old fields and forest openings (15).
Sustainability
Poke root can grow vigorously as a result of its seed dispersion, and is sometimes considered an invasive plant. NatureServe lists poke root as secure due to its widespread population in the United states (16,17).Habitat loss and over-harvesting from the wild are two of the biggest threats faced by medicinal plant species. There are an increasing number of well-known herbal medicines at risk of extinction. We must, therefore, ensure that we source our medicines with sustainability in mind.
The herb supplement industry is growing at a rapid rate and until recent years a vast majority of medicinal plant produce in global trade was of unknown origin. There are some very real and urgent issues surrounding sustainability in the herb industry. These include environmental factors that affect the medicinal viability of herbs, the safety of the habitats that they are taken from, as well as the welfare of workers in the trade.
The botanical supply chain efforts for improved visibility (transparency and traceability) into verifiably sustainable production sites around the world is now certificated through the emergence of credible international voluntary sustainability standards (VSS).
Read our article on Herbal quality and safety: What to know before you buy and Sustainable sourcing of herbs to learn more about what to look for and questions to ask suppliers about sustainability.
Quality control
Herbal medicines are often very safe to take; however, their safety and efficacy can be jeopardised by quality issues. So, it is important to buy herbal medicines from a reputable supplier, from sources known to test their herbs to ensure there is no contamination, adulteration or substitution with incorrect plant matter, as well as ensuring that recognised marker compounds are at appropriate levels in the herbs.
Some important quality assurances to look for are certified organic labelling, the correct scientific/botanical name, and the availability of information from the supplier about ingredient origins. A supplier should be able to tell you where the herbs have come from, what contaminants are not in the herb, and what the primary compounds are.
How to grow
Poke root seeds have a hard outer coat that prevents water ingress, which inhibits germination until the seed coat is softened or weakened over time. When growing the seeds at home, using sandpaper or making a small incision will help to initiate germination.
Germination rates of non-scarified seed are said to be higher (starting after around six weeks and continuing for several weeks after that). However, with time the seed coat will soften enough to allow for water to enter the seed.
Sow seeds in trays indoors in early spring. Make sure the trays are kept moist (but not waterlogged) and expect germination to start as temperatures rise towards the end of spring.
Carefully prick out the seedlings once it has true leaves, pot up and allow it to grow to about six inches before planting out to a sunny location. Allow plenty of space for the plant to grow, as it grows voraciously and will likely spread(18).
References
- Mcintyre A. Complete Herbal Tutor : The Definitive Guide to the Principles and Practices of Herbal Medicine (Second Edition). Aeon Books Limited; 2019.
- Thomsen M. Phytotherapy Desk Reference. 6th ed. Aeon Books; 2022.
- Wood M. The Practice of Traditional Western Herbalism : Basic Doctrine, Energetics, and Classification. North Atlantic Books, Cop; 2004.
- Grieve M. A Modern Herbal | Poke Root. www.botanical.com. https://www.botanical.com/botanical/mgmh/p/pokroo57.html
- King J, Harvey Wickes Felter, John Uri Lloyd. King’s American Dispensatory. Ohio Valley Co; 1909.
- Kress H. Phytolacca. Poke Root. | Henriette’s Herbal Homepage. www.henriettes-herb.com. Published 2024. https://www.henriettes-herb.com/eclectic/bpc1911/phytolacca.html
- Fisher C. Materia Medica of Western Herbs. Aeon Books; 2018.
- Species (Family) Phytolacca Americana L. (Phytolaccaceae). Accessed November 10, 2024. https://obtrandon.wordpress.com/wp-content/uploads/2010/05/phytolacca-americana-pokeroot.pdf
- Bruna Gomes Sydor, Fernandes C, Meliana Borilli Pereira, et al. Plants of the Phytolaccaceae family with antimicrobial activity: A systematic review. Phytotherapy Research. 2022;36(9):3505-3528. doi:https://doi.org/10.1002/ptr.7557
- Domashevskiy A, Goss D. Pokeweed Antiviral Protein, a Ribosome Inactivating Protein: Activity, Inhibition and Prospects. Toxins. 2015;7(2):274-298. doi:https://doi.org/10.3390/toxins7020274
- Bekeredjian-Ding I, Foermer S, Kirschning CJ, Parcina M, Heeg K. Poke Weed Mitogen Requires Toll-Like Receptor Ligands for Proliferative Activity in Human and Murine B Lymphocytes. PLoS ONE. 2012;7(1). doi:https://doi.org/10.1371/journal.pone.0029806
- Tamirat Bekele Beressa, Clement Olusoji Ajayi, Peter EL, et al. Pharmacology, Phytochemistry, and Toxicity Profiles ofPhytolacca dodecandraL’Hér: A Scoping Review. Infectious Diseases Research and Treatment. 2020;13:117863372094350-117863372094350. doi:https://doi.org/10.1177/1178633720943509
- Bailly C. Medicinal properties and anti-inflammatory components of Phytolacca (Shanglu). Digital Chinese Medicine. 2021;4(3):159-169. doi:https://doi.org/10.1016/j.dcmed.2021.09.001
- RHS. Phytolacca americana | American pokeweed Herbaceous Perennial/RHS. Rhs.org.uk. Published 2024. Accessed September 6, 2024. https://www.rhs.org.uk/plants/12895/phytolacca-americana/details
- Royal Botanical Gardens Kew. Phytolacca americana L. | Plants of the World Online | Kew Science. Plants of the World Online. Published 2024. https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:323290-2
- Xu Y, Ye X, Yang Q, et al. Ecological niche shifts affect the potential invasive risk of Phytolacca americana (Phytolaccaceae) in China. Ecological Processes. 2023;12(1). doi:https://doi.org/10.1186/s13717-022-00414-9
- Nature Serve Explorer. NatureServe Explorer 2.0. explorer.natureserve.org. Published 2024. Accessed September 25, 2022. https://explorer.natureserve.org/Taxon/ELEMENT_GLOBAL.2.132235/Phytolacca_americana
- Earthsong seeds. Pokeroot. Earthsong Seeds. Published 2024. https://earthsongseeds.co.uk/shop/seeds/pokeroot/
