Carthamus (Carthamus tinctorius L.): A Comprehensive Reference
1. Identity and Botanical Description
Botanical and Chemical Names
Carthamus tinctorius L., commonly known as safflower, is a highly branched, herbaceous, thistle-like annual plant in the family Asteraceae. The botanical genus name Carthamus derives from the Arabic verb qurtum, meaning "to dye," in reference to the usage of safflower flowers for textile dyeing, while the species name tinctorius is an adjective corresponding to the Latin noun tinctor, meaning "dyer." In Traditional Chinese Medicine (TCM), the plant is known as Honghua (红花); in Persian traditional medicine it is called Kafesheh. The dried floret used medicinally is known pharmacopeially as Carthami Flos.
Morphology and Cultivation
Plants are 30 to 150 cm tall with globular flower heads having yellow, orange, or red flowers; each branch typically bears one to five flower heads containing 15 to 20 seeds per head. Safflower is native to arid environments having seasonal rain and grows a deep taproot which enables it to thrive in such environments. Commonly known as safflower, it is an effective herbal medicine with a long history of use, and its cultivation is primarily concentrated in China, India, and Western European countries. Safflower has been cultivated in more than 60 countries all over the world.
Common Forms and Preparations
It is an annual or biennial herbal plant mainly cultivated for its seeds, meals, and flowers, which are primarily rich in the orange-red dye (carthamin) and quality oil of polyunsaturated fatty acids. The principal parts used medicinally are the dried florets (Carthami Flos) and the seed oil. Safflower-related preparations have been widely applied in clinical settings, including safflower injection, safflower yellow injection, and safflower soothing and activating collaterals liniment. A safflor yellow injection which mainly contains about 80% hydroxysafflor yellow A (HSYA) was approved by the China State Food and Drug Administration and used to treat cardiac diseases such as angina pectoris. In Western markets, safflower appears primarily as a cooking and dietary oil extracted from the seeds, as encapsulated or powdered flower extracts, and as an ingredient in topical cosmetic formulations.
2. Historical and Traditional Use
Ancient Origins
Safflower is one of humanity's oldest crops and was first cultivated in Mesopotamia, with archaeological traces possibly dating as early as 2500 BC. Safflower appears first in a number of early Bronze Age (3000 BC) sites in northern and central Syria, from where it apparently spread to Egypt, the Aegean, and south-eastern Europe. Safflowers were highly popular among the ancient Egyptians: their flowers were used to dye Egyptian textiles from the Twelfth Dynasty, and clothing made from safflowers was found on Eighteenth Dynasty mummies. Safflower's ecological adaptation to drought and salinity suited the arid conditions of its early spread, and geographically complementary archaeobotanical evidence suggests it was also used for oil from almost the beginning of its cultivation.
Traditional Chinese Medicine
The introduction of safflower to China dates back over 2,100 years. In the theory of Traditional Chinese Medicine (TCM), safflower is considered to promote blood circulation to remove blood stasis, promote menstruation, and alleviate pain. Safflower is associated with the liver and heart meridians and is effective in alleviating pain, promoting blood circulation, and removing blood stasis. The dried floret of Carthamus tinctorius L., known as Carthami flos, has gained significant popularity due to its extensive applications in the treatment of coronary heart disease, angina pectoris, gynecological conditions, stroke, and hypertension. Carthamus tinctorius is the sole source for the medicinal material in the Pharmacopoeia of the People's Republic of China.
Persian and Middle Eastern Traditional Medicine
Known as Kafesheh in Persian, safflower has been vastly utilized in traditional medicine for various medical conditions, namely dysmenorrhea, amenorrhea, postpartum abdominal pain and mass, trauma, and pain of joints. Safflower has been utilized in Persian folk medicine for treating diabetes, phlegmatic fever, melancholia, and dropsy. The seeds of safflower are described as possessing laxative properties and are believed to mitigate melancholic tendencies and enhance semen quality. The water extract of safflower is applied for painful menstruation as a sedative, serves as a laxative for constipation, and acts as an anti-inflammatory remedy in traditional medicine.
Ayurvedic and South Asian Traditions
The flowers of safflower have been used for coloring textiles in ancient times in Egypt, Persia, India, and China. In Ayurvedic tradition, the plant has been described by the Sanskrit name kusuma, with the flowers valued for medicinal oil and seeds for cardiac support. For a long time C. tinctorius has been used in traditional medicines as a purgative, analgesic, antipyretic, and an antidote to poisoning. It is a useful plant in painful menstrual problems, postpartum hemorrhage, and osteoporosis.
Use as a Dye and Food Colorant
Safflower has been grown mainly for its orange-red dye (carthamin) extracted from its flower, used in food coloring and flavoring. In food, the flowers sometimes serve as a color substitute for saffron, and recently the dye from the extract has been used in cosmetics. Carthamin, one of the main components of C. tinctorius, has been used as a yellow, orange, and pink dyeing agent for clothes and fabrics.
3. Key Chemical Constituents
Overview of Phytochemistry
From 1978 to April 2025, various active metabolites have been identified, primarily comprising flavonoids, polyacetylenes, and alkaloids, with flavonoids being the predominant group. Over 104 compounds from this plant have been isolated and identified, including quinochalcones, flavonoids, alkaloids, polyacetylene, aromatic glucosides, organic acids, and others. Bioactive constituents isolated from the plant include flavonoids, phenylethanoid glycosides, coumarins, and polysaccharides.
Quinochalcones and Pigments
Carthamin and safflower yellow are the main constituents in the flower of C. tinctorius. Carthamidin, isocarthamidin, hydroxysafflor yellow A (HSYA), safflor yellow A, safflamin C, and luteolin are the main constituents reported from this plant. Hydroxysafflor yellow A (HSYA) is one of the major bioactive and water-soluble compounds isolated from Carthami Flos, the flower of safflower. As a natural pigment with favorable medicinal use, HSYA has gained extensive attention due to its broad and effective pharmacological activities since its first isolation in 1993. HSYA is both a representative water-soluble quinochalcone C-glycoside pigment and the quality marker of Carthami Flos.
Flavonoids
Safflower is known to contain a diverse array of compounds, with flavonoids in particular demonstrating significant pharmacological activity. Notable flavonoids identified in safflower include luteolin, kaempferol glycosides, and carthamidin. Abundant in secondary metabolites like flavonoids, phenols, alkaloids, polysaccharides, fatty acids, polyacetylene, and other bioactive components, the medicinal plant is effective for treating cardiovascular diseases, neurodegenerative diseases, and respiratory diseases.
Polysaccharides
Safflower polysaccharides (SPS) are believed to be one of the most important biologically active components, with multiple pharmacological properties including anti-tumor, immune regulation, anti-oxidation, and anti-cerebral ischemia reperfusion injury effects. HH1-1, an arabinogalactan with a relative molecular weight of 70.9 kDa, has been isolated from safflower flowers; its structure comprises a backbone of 1,6-linked galactopyranose branched at the C-3 position.
Fatty Acids in Seed Oil
Safflower seed oil is highly rich in linoleic acid (an unsaturated fatty acid), which makes it highly suitable for human consumption. Like other seed oils, safflower oil contains unsaturated fatty acids, including linolenic acid and linoleic acid. High-oleic cultivars of safflower yield an oil with predominantly monounsaturated oleic acid, while the standard (high-linoleic) variety is dominated by the omega-6 polyunsaturated fatty acid linoleic acid.
Essential Oil Components
Caryophyllene, p-allyltoluene, 1-acetoxytetralin, and heneicosane were identified as the major components of the essential oil from C. tinctorius flowers.
4. Mechanisms of Action
Anticoagulant and Antiplatelet Effects
The dried flower of Carthamus tinctorius L. has the functions of promoting blood circulation and menstruation, relieving pain by removing blood stasis; modern pharmacological studies have shown that it has anticoagulation and antiplatelet aggregation effects. Studies have shown that Carthamus tinctorius L. extract had a significant inhibitory effect on ADP-induced platelet aggregation; it can significantly inhibit platelet aggregation in vivo and in vitro, and has a certain inhibitory effect on the activation of the endogenous coagulation system. Safflower yellow has anticoagulant and immunosuppressive activity, and the anticoagulant effects of safflower yellow inhibit the metabolism of warfarin, leading to increased blood concentration.
Antioxidant Mechanisms
In vivo research has demonstrated that the antioxidant effect of HSYA was involved in the prevention of angiotensin II-induced myocardial hypertrophy, which may act through the activation of the Nrf2/NAD(P)H:quinone oxidoreductase 1/HO-1 signaling pathway. Nrf-2, as the main regulator of the antioxidant system present on the cardiovascular system, is becoming a very promising pharmacological target for cardiovascular diseases.
Anti-inflammatory Mechanisms
Some studies show that the polyacetylenes from C. tinctorius inhibit NO release, thus showing their potential use as a medicine for inflammatory diseases. The therapeutic effects of HSYA against cardio-cerebrovascular diseases are presumed to reside mostly in its antioxidant, anti-inflammatory, and neuroprotective roles by acting on complex signaling pathways.
Cardioprotective Mechanisms
HSYA may directly inhibit L-type calcium channels (LTCC), which could be one mechanism by which HSYA protects against myocardial ischemia/reperfusion injury. HSYA (5 mg/kg, 30 minutes before ischemia, administered intraperitoneally) was found to improve ischemia/reperfusion injury by reducing the releases of cardiac troponin I, IL-6, LDH, and the myocardial infarction size.
Neuroprotective Mechanisms
HSYA has been reported to inhibit excitotoxicity and oxidative stress, preserve the blood-brain barrier, and regulate key pathophysiological processes such as inflammation, autophagy, and apoptosis.
Anticancer Mechanisms
Safflower can be used in multiple pathways during coronary heart disease treatment and can exert anti-apoptotic effects by regulating the expression of Bax, Bcl-2, and SIRT1/FoxO1 signaling pathway-related proteins. HSYA has been found to induce autophagy in hepatocellular carcinoma cells by promoting Beclin 1 expression and inhibiting ERK phosphorylation, indicating HSYA may be a potential therapeutic agent for hepatocellular carcinoma.
5. Scientific Evidence by Health Area
5.1 Cardiovascular Disease
In clinical settings, the safflor yellow injection, which mainly contains about 80% HSYA, was approved by the China State Food and Drug Administration and used to treat cardiac diseases such as angina pectoris. In basic pharmacology, HSYA has been proved to exhibit a broad spectrum of biological effects including cardiovascular effect, neuroprotection, liver and lung protection, antitumor activity, metabolism regulation, and endothelium cell protection.
HSYA has attracted much interest for its pharmacological actions in treating and/or managing cardio-cerebrovascular diseases (CCVDs), such as myocardial and cerebral ischemia, hypertension, atherosclerosis, vascular dementia, and traumatic brain injury, in massive preclinical studies. Safflower yellow injection, a purified yellow pigment extract from Carthami Flos containing no less than 70% of HSYA, is commercially available for stable exertional angina pectoris of coronary heart disease with a marked curative effect in Chinese clinical practice.
Regarding the seed oil: increasing dietary n-6 linoleic acid (LA) in place of saturated fatty acids lowers serum total cholesterol, primarily by reducing low-density lipoprotein with little or no effect on high-density lipoprotein. However, outcomes data for safflower oil specifically are mixed. In the Sydney Diet Heart Study, an increase of 5% of food energy from n-6 LA (from safflower oil) predicted 35% and 29% higher risk of cardiovascular death and all-cause mortality, respectively. The overall evidence for safflower oil and cardiovascular mortality is therefore conflicting, and cannot be summarized as uniformly beneficial.
A review of human intervention trials provided evidence that LA consumption decreases CVD lipid risk markers in healthy individuals, though this addresses the general class of linoleic-acid-rich oils rather than safflower oil in isolation, and translation to hard clinical endpoints remains uncertain.
Evidence strength: HSYA-based injectable preparations have human clinical use in China but broader randomized controlled trial data in non-Chinese populations is sparse. The seed oil's effect on lipid biomarkers has some human evidence, but mortality data are mixed.
5.2 Cerebrovascular Disease and Neuroprotection
GuHong injection, composed of safflower and the chemical drug N-acetyl-L-glutamine, has been reported to have great value in clinical settings for cerebrovascular diseases such as ischemic stroke and related diseases. In animal experiments, HSYA administration ameliorated infarct size, neurological deficit score, histopathological changes, carotid intima-media thickness, and blood lipid levels (total cholesterol and triglycerides).
A review of hydroxysafflor yellow A (HSYA) identified a total of 14 in vitro and 17 in vivo studies that provided evidence of clinical promise, indicating HSYA is safe for consumption and may be effective for the treatment of ischemia stroke and reperfusion injury.
Safflower has been used for hundreds of years as a food additive, coloring agent, and medicinal herb; there is an accumulating body of literature addressing the possible therapeutic roles of safflower, including antidepressant-like action, angiogenesis, wound healing, anti-thrombotic, anti-inflammatory, anti-ischemic, and neuroprotective effects.
Evidence strength: Predominantly preclinical (animal and cell-based) for most neuroprotective applications; injectable safflower preparations have some clinical use data in China. Robust independent human RCTs are lacking.
5.3 Gynecological Conditions (Dysmenorrhea, Amenorrhea)
Safflower with a wide spectrum of pharmacological effects has been used to treat dysmenorrhea, amenorrhea, postpartum abdominal pain and mass, trauma, and pain of joints. The dried flower of C. tinctorius is clinically used to alleviate pain, increase circulation, and reduce blood-stasis syndrome with dysmenorrhea, amenorrhea, trauma, and joint pain. As medical research advances, the clinical applications of safflower in specialized fields such as gynecology and dermatology have become increasingly prevalent and demonstrate significant therapeutic effects.
Evidence strength: Historical and traditional use is well documented across multiple cultures. Mechanistic plausibility exists through anticoagulant and uterine stimulant properties. Formally designed human RCTs specifically evaluating safflower alone for these indications remain limited in the peer-reviewed English-language literature.
5.4 Bone Health and Osteoporosis
Safflower seeds are used as a folk medicine to enhance bone formation or to prevent osteoporosis in Korea; the methanolic extract of safflower seeds contains high mineral content, such as calcium, potassium, and phosphorous. In animal studies (3 to 11-week-old rats), oral treatment with the methanolic extract of safflower seeds resulted in a significant increase in osteoblast markers in serum, including osteocalcin content, bone-specific alkaline phosphatase activity, and insulin-like growth factor I levels, as well as increased femoral and tibial length.
Evidence strength: Evidence is primarily preclinical (animal/in vitro). Human clinical trials confirming anti-osteoporotic efficacy are not yet established.
5.5 Hepatoprotection and Metabolic Effects
Extracts and metabolites derived from safflower have demonstrated a range of bioactivities including antioxidant, hepatoprotective, anti-inflammatory, and anticancer effects. A rat model study examined the effects of methanolic safflower flower extract (SFFE) on hepatic injury and steatosis in type 2 diabetes mellitus induced by a high-fat diet and streptozotocin. Experimental groups included control, control + SFFE, T2DM, T2DM + SFFE, and T2DM + SFFE + brusatol; SFFE was administered at 300 mg/kg, and all experiments concluded after 8 weeks.
A safflower and peach kernel herb pair is widely used in TCM for the treatment of liver fibrosis.
Evidence strength: Hepatoprotective effects are supported by animal studies and in vitro data. Controlled human clinical evidence is currently very limited.
5.6 Anti-inflammatory Activity
Modern pharmacological studies have shown that safflower has many beneficial bioactivities, such as anti-inflammatory, antioxidant, and antitumor effects, as well as protective effects against cerebral ischemia injury and ameliorating myocardial ischemia. Pharmacological investigations have demonstrated that this plant possesses certain biological properties such as anti-inflammatory, cardioprotective, antitumor, anti-osteoporosis, and hepatoprotective effects.
Evidence strength: Anti-inflammatory effects are well documented at the preclinical level across multiple model systems. Human intervention trials evaluating anti-inflammatory outcomes specifically for safflower extracts remain scarce.
5.7 Antitumor Activity
Safflower polysaccharide (SPS) is one of the most important active components of safflower; accumulating evidence supports its immuno-regulatory function and antitumor effect. In breast cancer, SPS has been shown to inhibit MCF-7 cell proliferation and metastasis. SPS is also found to inhibit proliferation of human hepatic cancer SMMC-7721 cells through regulation of cell cycle-related gene expression.
In a mouse model, 50 mg/kg of SPS-1 (an active fraction isolated from safflower polysaccharide) significantly inhibited colorectal cancer induced by azoxymethane/dextran sodium sulfate and changed the polarization of macrophages to the M1 phenotype.
Evidence strength: All current antitumor evidence derives from in vitro cell studies and animal models. There are no published human clinical trials of safflower preparations as anticancer agents.
5.8 Mood, Cognition, and Neuropsychiatric Effects
Safflower (Carthamus tinctorius) has been used in food and traditional medicine due to its active compounds such as flavonoids, phenylethanoid glycosides, coumarins, fatty acids, and steroids to treat conditions such as dysmenorrhea, amenorrhea, and other diseases. Preclinical work has explored antidepressant-like and anxiolytic properties. The evidence for the efficacy of many complementary and alternative interventions used to treat anxiety and depression remains poor, and recent systematic reviews point to a significant lack of methodologically rigorous studies within the field; however, this lack of evidence does not diminish the popularity of such interventions within the general Western population.
Safflower (Carthamus tinctorius L.) has been shown in animal studies to attenuate memory loss and improve anxiety and depression.
Evidence strength: Preliminary; predominantly animal studies. Human clinical evidence for mood or cognitive effects of safflower is currently insufficient to draw conclusions.
5.9 Diabetes and Metabolic Syndrome
C. tinctorius has recently been shown to have antioxidant, analgesic, anti-inflammatory, and antidiabetic activities. Belury and colleagues compared the effects of safflower oil and conjugated linoleic acid on obese postmenopausal women with Type 2 diabetes, and safflower oil's association with reduced abdominal fat took the researchers by surprise. This result emerged from a secondary analysis of data collected from that clinical trial.
Evidence strength: Some human clinical data exist, specifically for safflower oil in obese postmenopausal diabetic women; these findings are from a secondary analysis and require confirmation in prospective, hypothesis-driven trials.
6. Dosage Forms and Reported Dosages
The following dosages are reported as they appear in the cited source literature and do not represent clinical recommendations.
- HSYA (injectable, preclinical): HSYA at 5 mg/kg, administered 30 minutes before ischemia intraperitoneally, was found to improve ischemia/reperfusion injury in animal models.
- Safflower yellow injection (clinical, China): Safflower yellow injection containing no less than 70% HSYA is commercially available in China for stable exertional angina pectoris of coronary heart disease.
- Safflower seed oil (human trial — abdominal fat/diabetes): The chief researcher suggested that a daily dose of safflower oil — about 1⅔ teaspoons — may be a safe way to help reduce cardiovascular disease risk based on clinical trial findings.
- Safflower seed oil (RCT — endothelial function): Eighty-five overweight men (aged 45–68 years, BMI 25–35 kg/m²) were randomized to receive 4.5 g/day of various oils including safflower oil in a 4-week double-blind study.
- Safflower flower extract (animal — hepatoprotection): Safflower flower extract (SFFE) was administered at 300 mg/kg in a rat model of type 2 diabetes mellitus for 8 weeks.
- Safflower polysaccharide (animal — colorectal cancer): 50 mg/kg of SPS-1 significantly inhibited colorectal cancer in a mouse model.
- Methanolic seed extract (animal — osteoporosis): The methanolic extract of safflower seeds (MESS) was administered orally to 3-week-old Sprague-Dawley rats for 8 weeks, resulting in significant increases in osteoblast markers.
7. Body Systems and Associated Health Areas
- Cardiovascular system: Anticoagulant, antiplatelet, antithrombotic, and vasodilatory activities; clinical injectable preparations used in China for angina pectoris; effects on blood lipids via seed oil.
- Cerebrovascular and neurological: Neuroprotective activity against ischemic stroke and reperfusion injury; HSYA shown to preserve the blood-brain barrier and modulate neuroinflammation.
- Female reproductive system: Long-standing traditional use for dysmenorrhea, amenorrhea, and postpartum pain across Chinese, Persian, and Ayurvedic traditions; mechanistic basis in uterine stimulant and blood-activating properties.
- Musculoskeletal system (bone): Traditional use in Korea for bone health; preclinical data on osteoblast stimulation; traditional use for joint pain and trauma.
- Hepatic and metabolic: Hepatoprotective and antifibrotic activity demonstrated preclinically; antidiabetic and hypolipidemic effects under investigation.
- Immune system and oncology: Polysaccharide fractions (SPS) show immunomodulatory and antitumor effects in cell and animal models.
- Neuropsychiatric: Preliminary preclinical evidence for antidepressant-like and anxiolytic effects; no established human clinical evidence.
- Skin and dermatology: Clinical applications in dermatology have become increasingly prevalent. Safflower oil is used topically for moisturization.
8. Safety Considerations and Drug Interactions
General Safety Status
Safflower seed oil is generally recognized as safe (GRAS) by the FDA. Safflower oil is generally safe when used as part of the diet, both orally and topically; however, when used intravenously or in the form of safflower flowers, caution should be exercised.
Pregnancy
Safflower flower has abortifacient, menstrual stimulant, and uterine stimulant effects, making it possibly unsafe during pregnancy. A study reported an association between maternal exposure to C. tinctorius extract at doses of 1.2 and 2 mg/kg and congenital malformations in offspring. There is limited information about the safety of safflower flower during lactation.
Anticoagulant and Antiplatelet Drug Interactions
Safflower can significantly inhibit platelet aggregation in vivo and in vitro and has a certain inhibitory effect on the activation of the endogenous coagulation system; it may produce a synergistic anticoagulant effect with warfarin. Studies in rats showed that the combined use of Carthamus tinctorius L. and warfarin significantly prolonged prothrombin time and bleeding time. Safflower oil, particularly at high doses, may interact with anticoagulant/antiplatelet drugs like warfarin, potentially increasing bleeding risk.
Allergenicity
Safflower belongs to the Asteraceae (Compositae) family, which includes known allergenic plants such as ragweed, chrysanthemums, and daisies. Cross-reactivity with other Asteraceae family members is a recognized safety concern for individuals with relevant allergies.
Standardization Challenges
Research on safflower remains limited, and many active metabolites have yet to be thoroughly investigated in terms of their phytochemical and pharmacological properties; only a handful of active metabolites have been isolated and assessed for their biological activity, and there is a notable deficiency in research regarding their mechanisms of action.
Evidence Gaps
There is insufficient reliable information available about the pharmacokinetics of safflower. Chemical instability and low bioavailability have severely hampered the clinical applications of HSYA during the treatment of cardiovascular and cerebrovascular disease. Many active metabolites of safflower have yet to be thoroughly investigated in terms of their phytochemical and pharmacological properties.
References
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- Chinese Journal of Integrative Medicine: Phytochemistry, pharmacology and medicinal properties of Carthamus tinctorius L. (2013)
- PubMed: Medical uses of Carthamus tinctorius L. (Safflower): a comprehensive review from Traditional Medicine to Modern Medicine (2018)
- PMC: Hydroxysafflor Yellow A: A Promising Therapeutic Agent for a Broad Spectrum of Diseases (2018)
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- PMC: Hydroxysafflor Yellow A: A Systematical Review on Botanical Resources, Physicochemical Properties, Drug Delivery System, Pharmacokinetics, and Pharmacological Effects (2021)
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- PMC: Safflower Improves Memory, Learning, and Behavior in Rats Subjected to Sleep Deprivation (2024)
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- PubMed: CLA does not impair endothelial function and decreases body weight as compared with safflower oil in overweight and obese male subjects (2011)
- PMC: The effects of Carthamus tinctorius L. on placental histomorphology and survival of the neonates in mice (2014)
- Royal Botanic Gardens, Kew: Safflower — Carthamus tinctorius