Wormwood has many benefits which can be applied in home herbalism; however, it should be used with some caution due to its potential toxicity as a result of the thujone content. In very large doses thujone can cause some serious side effects including convulsions (1). It is important to follow the recommended daily dosage range and check safety guidelines and contraindications before using this herb (2,3).

Wormwood has a rich history of use in herbal medicine to assist in the treatment of digestive disorders. As its name implies, it was traditionally used for eliminating intestinal parasites (3,4). This protocol however, is better achieved under the care of a clinical herbalist due to the safety concerns of taking this herb in the appropriate (higher) dosage range required to effectively treat parasitic infections (5).

It is rich in aromatic and bitter compounds which are responsible for its ability to stimulate the production of digestive fluids, thereby stimulating the appetite and absorption of nutrients (4). It can be used to treat mild gastrointestinal infections, dyspeptic complaints and acute constipation, particularly where low bile or stomach acid are the cause (5,6).

Its effects on the digestive system make it an excellent herb for convalescence. It encourages movement of blood to the periphery due to its diaphoretic, warming and circulatory action, whilst also enhancing the digestive function and nutrient absorption. These combined effects are far reaching and can amount to systemic improvements across multiple organ systems. 

Wormwood is uplifting and can help raise the spirits in depressive or lethargic mood states, helping to restore a sense of wellbeing, hope and vitality.

Wormwood can be used similarly to its relative mugwort (Artemisia vulgaris) in helping women with reproductive conditions. It can effectively ease menstrual pain and helps to increase tone of the female productive organs (3).

Wormwood can also be used for acute joint inflammation. It may be applied topically for strains, sprains and bruises in the form of a plaster or poultice.. Whilst wormwood may help with the symptoms experienced in rheumatic and arthritic conditions, these more chronic conditions are best treated under the care of a clinical herbalist to address the root cause.

Wormwood may also be useful to help address skin eruptions such as boils and rashes as well as for scabies, athletes foot and other fungal skin conditions. This can be achieved through a topical treatment which may include washes, poultices, creams and ointments (3). Wormwood is a powerful antimicrobial as well as a wound healer and can be used topically for injuries, minor skin infections and slow healing wounds (5,7).

Wormwood is a pungent bitter and aromatic tonic. Dioscorides and Galen classified wormwood as hot, dry and pungent and, in terms of traditional Western herbal energetics it is considered to be hot in the first degree (8). 

It can be fast acting in addressing acute digestive conditions and menstrual pain due to its acrid, pungent and moderating effect upon the smooth muscle and mucous membranes. Wormwood is indicated for atrophic, depressed or under functioning tissues. It has a direct stimulating action across the digestive tract, increasing the enzymatic activity and gastric secretions whilst also activating the liver and pancreas. These actions are vital for invigorating digestion which increases the assimilation of nutrients meaning it offers a secondary nutritive action upon the body overall. This action also makes it useful in cases of malnutrition or debility. 

Wormwood, like mugwort, has an effect on consciousness and dreaming. Matthew Wood discusses its ability to help encourage dreaming of solutions to our worries and problems. It may also be useful for addressing night terrors. It is sometimes also used for headaches, and for tensions held in the jaw (3). It can have a profound effect on depression and hopelessness as it activates the cerebral hemispheres  and also elicits a nervine and neurotrophic effect, such effects that can enliven and invigorate the mind (3,4,6,7).

Elisabeth Brooke writes in A Woman’s Book of Herbs that wormwood gives courage and fearlessness. Its energetic nature “engenders a zest for life for the depressed, lethargic and slow”. It is also specific for people who hold onto anger. Wormwood allows the opening out and gentle release from these emotional blockages. Brooke makes a final note in reference to wormwood’s emotional uses; “it has the effect of shattering form and then putting it back together” (9).

In Ayurvedic medicine wormwood is classified as a cooling, bitter and pungent medicine. It addresses the doshic balance in favour of vata, to which it is neutralising and it controls basic bodily functions as well as the mind. It reduces pitta and kapha excesses (10).  

Wormwood has a long standing history of use as medicine. It was one of the most important herbs in Europe during mediaeval times (3). Its bitter taste has been well documented and in many cultures is referenced commonly in the literature of this plant. In Poland, bitterness is in fact measured by the bitterness of wormwood, through the saying “bitter as wormwood”. In the historic Germanic literature on herbal medicine, its folk name ‘wermut’ gives reference to its well documented antiparasitic activities with ‘werm’ in old German meaning ‘worm’.

Ancient Greek physicians, Dioscorides (1st century AD) and Theophrastus (4th–3rd century BC) associated it with its bitterness. The name absinth in fact is thought to derive from the ancient Greek word ‘ápsinthos’ which means unpleasant, disagreeable, or ‘ápinthos’— unfit for drinking. In Dioscorides’s De Materia Medica, wormwood is described as having warming, astringent and stimulating activities. Its most ancient uses here being for stomach and abdominal pains and as an antidote against poison. 

The Roman author and naturalist, Pliny the Elder (1st century AD) recommended wormwood as a hypnotic, laxative and emmenagogue herb. He also referred to its use in healing ‘fistulas on the eyes’. There is much crossover as to the traditional uses for wormwood and mugwort although wormwood has a slightly stronger effect on the digestive system.

Absinthe, a popular alcoholic drink made using wormwood was created in the 19th century. The excessive use of such could lead to epileptic seizures and even irreversible damage to the central nervous system. In Europe, wormwood was used for ritualistic purposes by burning the herb. It was used in funeral ceremonies and to repel evil spirits (7).

Digestive system

Wormwood has many actions upon the digestive system due to its carminative and aromatic qualities. It stimulates the appetite and improves digestive processes due to a number of activities associated with its bitter and aromatic compounds (3). Its appetite enhancing effect makes it useful in anorexia and in debility where the appetite is reduced (6). 

It improves blood supply to the digestive organs which improves their overall functionality. It stimulates the production of gastric fluids and activates and supports the liver and pancreatic secretory nerves thus also stimulating bile and pancreatic fluid release (7). 

Its effect on increasing gastric secretions can be applied in cases where there is proneness to gastric infections caused by low stomach acidity (5). It has an affinity to the spleen and can help address splenomegaly (inflammation and enlargement of the spleen) (7,11). Wormwood is also believed to have an anti-ulcer effect due to its ability to protect and moderate the activity of the gastric lining (7).

Wormwood has a valuable effect on the liver as a hepatoprotective and hepatic herb. It may be used in combination with other liver herbs to support patients with hepatitis, gallbladder inflammation or obstructions which can be characterised by jaundice and constipation among other symptoms (3,7). Matthew Wood discusses wormwood for the gallbladder in the form of a fresh leaf juice. For hepatitis it may be used externally (as a poultice over the liver area) and also incorporated into an oral herbal formula (3).

Human clinical trials have shown some promising effects in patients with Crohn’s disease. This study reported many therapeutic outcomes such as symptomatic relief and reduction in steroid use, with some even achieving remission. The study suggests a possible mechanism of action which is related to reduced inflammatory cytokines involved in Crohn’s (12,13).

One of wormwood’s most historic applications is for the treatment of parasites due to its anthelmintic and vermifugal activities. It is effective against parasites like Trichinella spiralis, Ascaris suum, Haemonchus contortus and Trichostrongylus colubriformis. It has also been shown to have some antiprotozoal effects against Plasmodium spp. (malaria), Trypanosoma spp. (Chagas disease), Leishmania spp. (leishmaniasis), and Naegleria fowleri. These effects are due to its ability to reduce parasite viability and motility in both larval and adult helminths and protozoans. This is thought to be related to the effect of its volatile oils. Other compounds which have been identified as key in these properties include sesquiterpene lactones and santonin which both possess vermifugal activities (5,7).

Many herbalists successfully treat pinworms  and roundworms using wormwood in higher dosages and alongside the appropriate dietary and lifestyle changes (3,4,14).

Immune system

Wormwood is powerfully antimicrobial due to the presence of its volatile oils that can inhibit bacterial and fungal growth (7,14). Some research has suggested that wormwood may increase bacterial sensitivity to antibiotics. Studies also have also demonstrated that extracts of wormwood may be effective against both Gram-positive bacteria (e.g., Staphylococcus aureus, Bacillus spp.) and some Gram-negative bacterias. It also has some antifungal activity against Candida albicans and Fusarium spp., among other pathogenic fungi (7).

There are numerous traditional references to an application of wormwood as being used for tumours and other severe chronic inflammations. It contains compounds called sesquiterpene lactones that have been identified to exhibit antitumour effects. Azulenes, another group of compounds in wormwood, have been shown to be anti-inflammatory (5). In traditional Chinese medicine, wormwood is often used in cancer therapy due to the activities of a number of its compounds which have been shown to reduce angiogenesis (the development of new blood vessels which are produced in cancerous growths) (7).

Reproductive system

Wormwood has many similar effects to mugwort in terms of its indications for female reproductive conditions. It has not been identified as having any direct hormonal activities, however it encourages blood supply to the uterus and reproductive organs which assists in their physiological functions. It can help to return and regulate the menstrual cycle where amenorrhea is concerned. It is also useful for menstrual cramping particularly in cases of spasmodic dysmenorrhea due to its antispasmodic effect on smooth muscle (3,5).

Fisher discusses its effect as both toning and stimulating upon the uterine tissues. It can help to address menorrhagia, bringing on delayed menstruation and also encourage a healthy flow where there has been a scant but prolonged menstrual cycle with no known hormonal cause (14). 

Nervous system

Wormwood’s aromatic stimulating qualities offer a number of therapeutic effects for the nervous system (3). It has a direct stimulating action on the cerebral hemispheres (5) and may be useful for treating headaches (6,11). Herbalists often use wormwood to assist in depressive emotional states and nervous tension (3,4,14). Wood discusses a number of cases where wormwood was used in severe cases of depressive mental health, commenting on a restored sense of positivity, particularly with female patients with low mood and feelings of hopelessness. It is appropriate where there is a history of severe trauma accompanied by depression (3). 

Furthermore, wormwood has demonstrated neurotrophic and neuro-protective activities as well as some analgesic effects through a number of scientific studies. This herb has some potential in supporting neurological health, likely as a result of its cell membrane stabilising and antioxidant activities. The findings of a modern review of scientific evidence suggests that wormwood may hold benefit in the management of neurological diseases such as Alzheimer’s or Parkinson’s. It may be considered for use to help reduce symptoms of confusion and disorientation as well as for supporting the mood (3,7).

Wormwood has been the subject of some interesting research both in the form of whole plant extracts and a number of its constituents through human clinical trials, in vivo and in vitro studies. In vitro research has identified some cytotoxic activities in breast cancer, lung cancer, colon cancer and melanoma cell lines (7). It should be noted that these studies are carried out in a laboratory setting and not in human subjects with cancer. In vitro scientific findings would indicate a good cause for further investigation through human clinical trials to explore the potential of this herb in supportive treatment of cancer patients.

Note: Using herbal medicine to support patients with cancer should only be carried out under the care of an experienced integrative or herbal cancer specialist. Herbs can offer invaluable support to the patient through all stages of healing with cancer. However, considerations such as contraindications and interactions need to be taken into account. Cancer is also a complex and systemic condition that requires a specialised and personalised approach that includes nutrition, lifestyle and herbs along with any necessary conventional treatments.

Anti-inflammatory, antioxidant and hepatoprotective activities have also been identified through in vivo and in vitro research. There has been a specific interest in wormwood’s effects on the immune system and for the treatment of various types of infections (7).

It has been shown through in vivo research to have immunomodulatory effects due to its ability to promote the maturation of dendritic cells and also promoting the effects of T-lymphocytes while enhancing IL-10 production (these are all types of white blood cells that are important in the immune response to pathogens). Wormwood’s compounds and extracts have also shown a variety of other potential therapeutic effects through in vitro research such as; neuro-protective, analgesic, antidepressant, cognitive enhancing and neurotrophic activities (7).

Animal studies are not condoned by Herbal Reality, however for the purpose of including research from which some understanding of therapeutic actions can be confirmed, some animal studies have been included herein.

Wormwood clinical trial and follow up trial in Crohn’s disease patients

Two small scale clinical studies have been carried out to investigate the effects of wormwood in patients with Crohn’s disease. A study carried out in 2007 recruited 40 patients with active Crohn’s disease. The patients were given either a wormwood capsule containing 250 mg of powdered wormwood or a placebo three times daily. The study results showed a significant improvement in symptoms with 65% reducing or withdrawing from steroid medications which did not occur in the placebo group. Patients also reported improved mood and quality of life with some patients achieving remission. The study suggests a possible mechanism of action which is related to reduced inflammatory cytokines, notably TNF-alpha which is implicated in the inflammatory processes of Crohn’s disease (11).

A follow up study was conducted in 2010 to assess 20 of the patients from the initial 2007 cohort who had continued taking wormwood capsules at the same dosage. This study compounded the positive outcomes of the former study whilst also showing that prolonged use of wormwood helped maintain symptom relief and overall quality of life. This included a lower relapse rate compared to placebo. The study concludes that ongoing use of wormwood may help to reduce the severity of Crohn’s disease whilst also providing a sustained quality of life by reducing steroid dependency.The study results showed a reduction in serum TNF-alpha levels after six weeks of wormwood supplementation at 750 mg three times daily. This contrasts to the control group in which a minimal reduction was seen (12).

These works afford us a deeper insight into the medicinal activities of this fascinating plant and show it has significant potential beyond many of its current uses. Further human studies should be followed up to deepen our understanding of these findings and their potential.

Topical effects of Artemisia absinthium ointment and liniment in comparison with piroxicam gel in patients with knee joint osteoarthritis: A randomised double-blind controlled trial

A randomised double- blind controlled trial was carried out to compare the effects of topical formulations of wormwood and piroxicam gel (a non-steroidal anti-inflammatory drug used to treat pain and help relieve symptoms of arthritis) among patients with knee osteoarthritis. Ninety subjects aged between 30–70 years were randomly assigned into three groups to receive either 3% wormwood ointment, a 3% wormwood liniment or piroxicam gel; three times a day for four weeks. The study showed wormwood ointment and liniments alleviated pain as effectively as the piroxicam. The piroxicam group found further improvements in stiffness over the wormwood groups (14).

The essential oil of wormwood was used to make the famed drink absinthe. Absinthe was later deemed to be toxic due to the presence of thujone and since the early 20th century its production has been entirely banned. 

Artist, Vincent van Gogh was known to have consumed absinthe regularly. Many of his masterpieces were created under the influence of wormwood absinthe.

Thujone content of absinthe is considered to be mostly responsible for the condition ‘absinthism’ — symptoms of which include hallucinations, sleeplessness and convulsions (7).

Wormwood is native to the British Isles and Europe. It has naturalised in Canada and the northern United States. It grows naturally in dry, open waste areas, pastures and overgrazed rangeland (18).

Wormwood can still be found across regions of the English Midlands, but declines have been reported outside of this area. Since 2002 it has been observed to have become more scarce. It is considered a threatened species in Ireland (20,21).

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.

The quantity of thujone in any given wormwood preparation or product should fall below 6.0 mg to ensure it does not exceed toxic quantities (2). 

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.

Wormwood thrives best in full sun and loamy-sandy or chalky, well-drained soils. It may be planted in rock gardens or near a wall/ border. It is tolerant in lower-nutrient soils.  Wormwood is, however, a solitary plant and must be planted with sufficient distance from other plants.

Wormwood can be sown in February to July in trays. Plant in damp, nutrient-poor growing soil in trays, gently pressing seeds down so that there is contact with the substrate. 

Place the trays in a bright location without direct sunlight ensuring to keep the soil moist. Germination should occur at 10 to 18 °C after two to three weeks, if the temperature is low, you may use a clear plastic cover for insulation. 

Once the seedlings reach about 5 cm tall they may be transplanted.

It is simpler to grow through propagation by splitting the eyes in spring and replanting them directly. They can also be propagated by cuttings (20).

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2. European Union Herbal Monograph on Artemisia Absinthium L., Herba Final Initial Assessment Discussion in Working Party on European Union Monographs and List (MLWP) Adoption by Committee on Herbal Medicinal Products (HMPC) for Release for Consultation.; 2008. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-artemisia-absinthium-l-herba_en.pdf
3. Wood M. The Earthwise Herbal : A Complete Guide to New World Medicinal Plants: Volume 2. Berkeley, Calif. North Atlantic Books; 2009
4. Hoffmann, D. 2003 Medical herbalism : the science and practice of herbal medicine. Healing Arts Press.
5. Mills SY. The Essential Book of Herbal Medicine. Editorial: Penguin; 1993.
6. British Herbal Medicine Association. Scientific Committee. A Guide to Traditional Herbal Medicines : A Sourcebook of Accepted Traditional Uses of Medicinal Plants within Europe. British Herbal Medicine Association; 2003.
7. Szopa A, Pajor J, Klin P, et al. Artemisia absinthium L.—Importance in the History of Medicine, the Latest Advances in Phytochemistry and Therapeutical, Cosmetological and Culinary Uses. Plants. 2020;9(9):1063. doi:https://doi.org/10.3390/plants9091063
8. Touwaide A, Appetiti E. Herbs in History: Wormwood. www.ahpa.org. Published 2023. Accessed April 11, 2024. https://www.ahpa.org/herbs_in_history_wormwood
9. Brooke E. Woman’s Book of Herbs.; 2018.
10. Frawley D, Vasant Lad. The Yoga of Herbs : An Ayurvedic Guide to Herbal Medicine. Motilal Banarsidass; 2016.
11. Batiha GES, Olatunde A, El-Mleeh A, et al. Bioactive Compounds, Pharmacological Actions, and Pharmacokinetics of Wormwood (Artemisia absinthium). Antibiotics. 2020;9(6). doi:https://doi.org/10.3390/antibiotics9060353
12. Omer B, Krebs S, Omer L, Noor T. Immune modulation by Wormwood (Artemisia absinthium) – results of a double blind, placebo controlled trial on Crohn’s disease patients. Planta Medica. 2007;73(09). doi:https://doi.org/10.1055/s-2007-986789.
13. Krebs S, Omer TN, Omer B. Wormwood (Artemisia absinthium) suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn’s disease – A controlled clinical trial. Phytomedicine. 2010;17(5):305-309. doi:https://doi.org/10.1016/j.phymed.2009.10.013
14. Fisher C. Materia Medica of Western Herbs. Aeon Books; 2018.
15. Zahra Basiri, Fatemeh Zeraati, Farzaneh Esna-Ashari, et al. Topical Effects of Artemisia Absinthium Ointment and Liniment in Comparison with Piroxicam Gel in Patients with Knee Joint Osteoarthritis: A Randomized Double-Blind Controlled Trial. Iranian Journal of Medical Sciences. 2017;42(6):524. Accessed November 12, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC5684373/
16. Table of herb-drug interactions based on the monographs of ESCOP. ESCOP. https://www.escop.com/interactions/
17. RHS. Artemisia absinthium | wormwood Herbaceous Perennial/RHS Gardening. www.rhs.org.uk. Published 2024. Accessed March 11, 2024. https://www.rhs.org.uk/plants/1625/artemisia-absinthium/details
18. 18. Royal Botanical Gardens Kew. Artemisia absinthium L. | Plants of the World Online | Kew Science. Plants of the World Online. Published 2019. Accessed November 21, 2024. https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:300106-2
19. Absinth wormwood identification and control: Artemisia absinthium – King County, Washington. Kingcounty.gov. Published 2024. https://kingcounty.gov/en/legacy/services/environment/animals-and-plants/noxious-weeds/weed-identification/absinth-wormwood
20. PlantAtlas. Plantatlas2020.org. Published 2024. Accessed November 12, 2024. https://plantatlas2020.org/atlas/2cd4p9h.w2
21. Regina. Wormwood: cultivation, harvest & uses. Plantura. Published August 3, 2022. https://plantura.garden/uk/herbs/wormwood/wormwood-overview