Impatiens

Impatiens: A Comprehensive Reference

1. Identity and Botanical Classification

Genus Overview

Impatiens is a large genus of flowering plants belonging to the family Balsaminaceae. The genus Impatiens, belonging to the Balsaminaceae family, encompasses approximately 500 species. In the eighteenth century, Carolus Linnaeus distinguished seven species of Impatiens in Species Plantarum (1753). Most Impatiens species occur in the tropical and subtropical mountain forests of Africa, Madagascar, the Himalayas, the Western Ghats (southwest India), and Southeast Asia. In Europe only a single Impatiens species — Impatiens noli-tangere — occurs naturally.

In particular, the genus Impatiens is characterized by presenting perennial and succulent herbs with attractive colors, normally found in tropical forests. The genus is commonly called balsam, jewelweed, or touch-me-not, reflecting both its medicinal and botanical character. Several species are of primary medicinal and supplement relevance:

• Impatiens balsamina L. (garden balsam, rose balsam) — Impatiens balsamina is an annual herb belonging to the family Balsaminaceae, commonly seen in India, China, and Korea; it is an erect plant commonly known as rose balsam and garden balsam.
• Impatiens capensis Meerb. (orange jewelweed) — Native to the Eastern and Midwestern US and Canada.
• Impatiens glandulifera Royle — Primarily known in the context of Bach Flower Remedies. In the 19th and 20th centuries, humans transported the North American orange jewelweed (I. capensis) to England, France, the Netherlands, Poland, Sweden, Finland, and potentially other areas of Northern and Central Europe.
• Impatiens noli-tangere L. — The sole native European species; used historically in European folk medicine.

Common Names and Preparations

Impatiens balsamina L., a common plant in traditional medicine in China, Korea, India, and other Asian nations, belongs to the Balsaminaceae family. This herb has long been utilized in Ayurvedic, Siddha, and Unani medicine. It can also be referred to as touch-me-not or garden balsam.

Many components of the plant are used medicinally, including the roots, stems, leaves, flowers, and seeds. Common preparation forms recorded in the ethnobotanical and pharmacological literature include:

• Aqueous decoctions and water extracts of stems (particularly in Traditional Chinese Medicine)
• Ethanolic and hydroalcoholic extracts of aerial parts, leaves, and flowers
• Topical application of fresh plant mash or juice
• Prepared tea from dried aerial parts
• A tea prepared according to traditional methods was found to contain sufficient MNQ to account for its antimicrobial properties.
• Homeopathic/flower-essence preparations (particularly I. glandulifera as a Bach Flower Remedy)

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2. Traditional and Historical Use

Traditional Chinese Medicine (TCM)

Water extracts of I. balsamina stems have long been used in Chinese traditional medicine (TCM) for treatment of a wide range of diseases and ailments, including rheumatism, isthmus, generalized body aches, fractures, and fingernail inflammation. I. balsamina is traditionally and ethnically used as medicine for a long time, which was described earlier in the Ming Dynasty. Impatiens siculifer was used in traditional Chinese medicine in the treatment of rheumatoid pain and paralysis, burns, scalds, and fractures.

Ayurvedic, Siddha, and Unani Medicine

This plant is included in Ayurveda and is used in the traditional medicine of China, Taiwan, and Korea as a remedy for inflammatory diseases and infections. I. balsamina is used in traditional methods such as Ayurveda, Unani, and Siddha for various diseases and physiological conditions such as jaundice, corns, and snake bite. It has been used in traditional systems of medicines such as Ayurveda and Unani since time immemorial in treatment of scurvy, inflammation of nails, and rheumatism.

Asian Folk Medicine (Broad)

The rose balsam Impatiens balsamina L. (Balsaminaceae) is an annual tropical herbaceous plant which in whole or in part has been used as traditional medicine (remedies) in Asian countries such as Japan, Korea, China, Taiwan, Thailand, Malaysia, and India to treat various ailments. Many varieties of Impatiens have been used to treat burns, wounds, joint discomfort, fever, blood stasis, and to reduce pain, inflammation, and itching. The leaves, seeds, blooms, and roots of I. balsamina are used in traditional medicine in nations including Indonesia, China, Pakistan, and Cameroon to treat conditions like hemorrhoids, infertility, issues with digestion, and severe wounds.

As a folk medicine, I. balsamina has been long prescribed for the treatment of rheumatism, isthmus, generalized pain, fractures, inflammation of the nails, scurvy, carbuncles, dysentery, bruises, and foot diseases. Chinese herbal medicine uses the aerial parts to treat pain and swelling, and as an antimicrobial agent.

Native American Use of Jewelweed (I. capensis)

The Potawatomi used a fresh juice of I. capensis to treat nettle stings or poison ivy rash, and it was similarly used by the Chippewa, Meskwaki, and Omaha, who called it "zhi hin nonxe thionbaba," meaning "plant like shiny glass." Many Native American tribes used I. capensis and its close relatives to treat or prevent rash from plant sources, particularly Toxicodendron radicans and Urtica dioica. I. balsamina (garden balsam), a native of China, was used by the indigenous people of Asia for similar purposes.

North American impatiens have been used as herbal remedies for the treatment of bee stings, insect bites, and stinging nettle (Urtica dioica) rashes. They are also used after poison ivy (Toxicodendron radicans) contact to prevent a rash from developing.

Japanese Folk Medicine

In Japan, the juice from Impatiens spp. flowers is used to stop itching. Nails in Japan have traditionally been dyed using the pigmented juice of I. balsamina flowers, an application noted across East Asian cultures.

Indian Tribal Practice

Knowledge of traditional medicine studies in Tamil Nadu substantiates the importance of I. balsamina, referred to as "Poddhapachai" by the Palliyan tribes, who used its leafy twig as a paste along with ground onion and applied it to boils. Traditionally, the leaves of garden balsam are suspected to contain a substance that can affect the digestive system.

Bach Flower Remedy Tradition (I. glandulifera)

Rescue Remedy was developed in the 1930s by British physician Dr. Edward Bach. Bach flower remedies (BFRs) are solutions of brandy and water — the water containing extreme dilutions of flower material — developed by Edward Bach, an English medical doctor, in the 1910s. The Rescue Remedy formula comprises Cherry Plum (for fear of not being able to cope mentally), Clematis (for unconsciousness or the 'detached' sensations that often accompany trauma), Impatiens (for impatience, agitation), Rock Rose (for terror), and Star of Bethlehem (for the after-effects of shock).

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3. Key Chemical Constituents and Mechanisms of Action

Overview of Phytochemical Composition

Phytochemical studies led to the identification and/or isolation of 300 different compounds reported from 27 species. These compounds encompass flavonoids, phenolic acids, coumarins, quinones, triterpenoid saponins, sterols, and alkaloids. The 2022 updated review in Journal of Ethnopharmacology noted that more than 307 natural compounds have been separated and identified from various medicinal parts of I. balsamina.

Naphthoquinones

In particular, 2-methoxy-1,4-naphthoquinone (MNQ) is the predominant and most representative component of I. balsamina. Impatiens balsamina L. contains a key active component, 2-methoxy-1,4-naphthoquinone (MNQ), which has been scientifically proven to possess a variety of bioactive properties, including antipruritic, anti-inflammatory, antimicrobial, anticancer, and antiallergenic effects.

Lawsone (2-hydroxy-1,4-naphthoquinone) is a closely related compound also identified as a major constituent. Naphthoquinones, lawsone and 2-methoxy-1,4-naphthoquinone, were found to be a group of the main constituents exhibiting antifungal and antibacterial activities. The three naphthoquinones isolated from leaf extract were lawsone methyl ether, lawsone, and methylene-3,3'-bilawsone.

MNQ has been studied for its anticancer mechanisms. The molecular mechanism of MNQ against tumor metastasis revealed that MNQ markedly downregulated substantial numbers of cytoskeleton-associated proteins (MYL6, EIF6, CCT8, DPYSL2, PDCD6IP, and CALD1), coupled with the downregulation of two key proteins driving metastasis, S100A4 and RPSA. Furthermore, MNQ additionally suppressed the metastasis of MDA-MB-231 cell lines and induced E-cadherin expression by interfering with ERK1/2 and NF-κB signaling pathways. The latest research findings also indicated that MNQ inhibited glycolytic activity and glycolysis-related molecules in MDA-MB-231 cells, which could act as an efficient anticancer drug to counteract triple-negative breast cancer cells.

Flavonoids

The main and most representative components of Impatiens balsamina include 2-methoxy-1,4-naphthoquinone, lawsone, and many others including quercetin, kaempferol, p-hydroxybenzoic acid, p-coumaric acid, flavone glycosides, phenolic compounds, oleanane-type triterpenoidal glycosides, and saponins. One of the flavonoids present in the plant is kaempferol. Phytoconstituents present in leaves include flavanols, lawsone, and lawsone methyl ether. Kaempferol has demonstrated activity relevant to skin conditions: at a dose of 10 μg/ml, lawsone (2-hydroxy-1,4-naphthoquinone) and kaempferol-3-rutinoside inhibited scratching and dermatitis in experimental models.

Antimicrobial Peptides (Ib-AMPs)

A structurally distinctive group of compounds from I. balsamina seeds are the Ib-AMPs. Four closely related peptides were isolated from seeds of Impatiens balsamina and were shown to be inhibitory to the growth of a range of fungi and bacteria, while not being cytotoxic to cultured human cells. The peptides, designated Ib-AMP1, Ib-AMP2, Ib-AMP3, and Ib-AMP4, are 20 amino acids long and are the smallest plant-derived antimicrobial peptides isolated to date. The Ib-AMPs are highly basic and contain four cysteine residues which form two intramolecular disulfide bonds.

Ib-AMPs1–4, purified from the seed of Impatiens balsamina, are four basic 20 amino acid peptides encoded by a single transcript. Ib-AMPs represent a novel class of AMPs that lack homology to other peptides. The antifungal mechanism of the 20-mer peptide Ib-AMP1 was investigated. Confocal microscopy showed that Ib-AMP1 binds on the cell surface or penetrates into cell membranes. These results suggested that Ib-AMP1 may manifest its antifungal activity against Candida albicans by inhibiting a distinct cellular process rather than ion channel or pore formation in the cell membrane.

Triterpenoid Saponins

Three new oleanane-type triterpenoidal glycosides, imbalosides A–C, were isolated from the white flowers of Impatiens balsamina. The structures were elucidated through 1D and 2D Nuclear Magnetic Resonance (NMR) and Mass Spectrometry (MS) data analyses followed by chemical methods. These compounds were evaluated for their antiproliferative activity against four human tumor cell lines (A549, SK-OV-3, SK-MEL-2, and BT549) and their anti-neuroinflammatory activity based on inhibition levels of nitric oxide in LPS-stimulated murine microglia BV-2 cell lines.

Sterols and Other Compounds

Compounds of 2-methoxy-1,4-naphthoquinone and stigmasta-7,22-diene-3β-ol (spinasterol) were isolated from the pods and roots/stems/leaves of I. balsamina L., respectively. The active compounds isolated from this plant include peptides (Ib-AMP1–4) from seeds; quinones including 1,4-naphthoquinone, lawsone, 2-methoxy-1,4-naphthoquinone (MeONQ), balsaquinone, impatienol, and naphthalene-1,4-dione from petals, pericarp, and aerial parts; and flavonoids from various plant parts.

The pericarp of Impatiens balsamina yields balsaminones A and B, which show antipruritic activity. One investigation showed that an I. balsamina plant extract and the isolated compound impatienol markedly inhibit testosterone 5-alpha-reductase activity, supporting potential folk medicine use in the treatment of male pattern baldness; however, further studies are needed before conclusions can be drawn.

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4. Scientific Evidence by Area of Use

4.1 Antimicrobial Activity

Evidence type: In vitro / preclinical — no human clinical trials.

By using brine shrimp (Artemia salina) lethality test-guided fractionation, a single bioactive compound (LC50 = 26 ppm) was isolated from the 95% ethanol extract of the dried aerial parts of Impatiens balsamina L. and subsequently identified as 2-methoxy-1,4-naphthoquinone (MNQ). The structure of MNQ was confirmed by UV, FT-IR, MS, and 1- and 2-D NMR spectroscopy. The antimicrobial activity of MNQ was evaluated using 12 bacterial and eight fungal strains. Five gram-positive and two gram-negative bacteria as well as all eight fungi (including multi-drug resistant strains) tested were highly sensitive to MNQ.

In tests against bacterial pathogens, extracts from Impatiens balsamina were tested for significant activity against bacteria such as Staphylococcus aureus, Proteus vulgaris, Salmonella paratyphi, Shigella boydii, and Cryptococcus neoformans. Activity was also tested against Candida albicans. The extract showed high zone of inhibition in disc diffusion assay in all the above species except Salmonella paratyphi and Proteus vulgaris. The ethanolic extract of leaves showed higher antimicrobial activity against Clostridium perfringens and Candida albicans. Moderate activity was observed against E. coli and Salmonella typhimurium.

Against Helicobacter pylori, the extract obtained from root, stem, leaf, seed, and pod from Impatiens balsamina showed significant bactericidal activity against H. pylori. The extract from the pods was found effective with MIC 1.25–2.5 and MBC 1.25–5.0 μg/mL in agar dilution method.

Regarding the seed-derived antimicrobial peptides: four closely related small peptides (20 amino acid residues) isolated from seeds of Impatiens balsamina were shown to be inhibitory to the growth of a range of Gram-positive bacteria and fungi, including the pathogens Candida albicans and Aspergillus flavus. These peptides are noncytotoxic to cultured human, insect, and plant cells. The peptides, designated Ib-AMP1, Ib-AMP2, Ib-AMP3, and Ib-AMP4, are highly basic (containing 5–6 arginine residues) and contain four cysteine residues which form two intramolecular disulfide bonds.

Strength of evidence: Promising in vitro findings only. No human clinical trials have evaluated Impatiens for infection treatment.

4.2 Anti-inflammatory Activity

Evidence type: Preclinical (animal and in vitro) — no human clinical trials.

This study was aimed to evaluate the anti-inflammatory activity of Impatiens balsamina roots and stems. Ethanol and water extracts of I. balsamina roots and stems were separately prepared by cold maceration. The anti-inflammatory activity was evaluated using the carrageenan-induced paw edema method in Wistar albino rats. Extracts at a dose of 50 mg/kg were orally administered to the experimental rats 30 minutes prior to administration of carrageenan. All three extracts exhibited significant anti-inflammatory activity. Ethanol extract of I. balsamina roots and ethanol extract of I. balsamina stems showed high significant (p<0.001) anti-inflammatory activity at the 2nd hour.

Naphthoquinones, flavonoids, and triterpenoids are the principal active compounds responsible for the anti-inflammatory and antimicrobial effects demonstrated by extracts of I. balsamina.

Strength of evidence: Preclinical animal data only. Translating these findings to human clinical benefit requires further study.

4.3 Antipruritic and Antidermatitic Activity (Atopic Dermatitis)

Evidence type: Primarily animal models and in vitro — very limited human data.

A 35% ethanolic extract (100 mg/kg) obtained from the petals was used to study activity using an atopic dermatitis NC mice model. At a dose of 10 μg/mL, the 2-hydroxy-1,4-naphthoquinone (lawsone) and kaempferol-3-rutinoside inhibited scratching and dermatitis. The pericarp of Impatiens balsamina yields balsaminones A and B, which show antipruritic activity.

Strength of evidence: Animal model data only. No rigorous human clinical trials have been conducted to confirm antipruritic efficacy in human atopic dermatitis.

4.4 Contact Dermatitis and Poison Ivy Prevention (Jewelweed, I. capensis)

Evidence type: Limited clinical trials — results are conflicting.

The efficacy of orange jewelweed (I. capensis) and yellow jewelweed (I. pallida) in preventing poison ivy contact dermatitis has been studied, with conflicting results. A study in 1958 found that Impatiens biflora was an effective alternative to standard treatment for dermatitis caused by contact with sumac, while later studies found that the species had no antipruritic effects after the rash has developed.

A 2012 clinical trial published in the Journal of Ethnopharmacology (PMID: 22766473) enrolled human volunteers and directly compared jewelweed preparations against water and soap. Poison ivy was brushed onto forearms of volunteers in 6 locations and exposed areas were treated with jewelweed extracts, fresh plant mashes, soaps made of plant extracts, water, and Dawn® dish soap. Jewelweed is an efficacious plant for preventing development of dermatitis following poison ivy contact, but soap is more effective. Lawsone content does not correlate with poison ivy rash prevention. A follow-up investigation identified saponins as potentially more important: both saponin-containing extracts and all soaps tested were effective in reducing poison ivy dermatitis; thus, saponin content correlates with poison ivy rash prevention.

Importantly, a 2012 study found that while an extract of orange jewelweed and garden jewelweed (I. balsamina) was not effective in reducing contact dermatitis, a mash of the plants applied topically decreased it. Researchers reviewing these contradictions state that potential reasons for these conflicts include the method of preparation and the timing of application.

Strength of evidence: Small clinical trials with conflicting results. The form of preparation (extract vs. fresh mash) appears to be a critical variable. No large-scale, well-powered RCTs exist. The mechanistic role of specific constituents remains unresolved.

4.5 Antifungal Activity (Including Malassezia)

Evidence type: In vitro — no human clinical trials.

Purified 2-methoxynaphthalene (2MN) from I. balsamina showed MIC values of 6.510 ± 1.906 μg/mL and MFC values of 8.854 ± 4.543 μg/mL against Malassezia furfur. The compound reduced extracellular lipase activity and effectively inhibited biofilm formation of M. furfur. An at-line LC-ESI-QTOF-MS/MS platform successfully guided purification of the anti-Malassezia compound. 2MN from I. balsamina exerts a significant antifungal effect and reduces fungal biofilm.

Regarding seed-derived Ib-AMP peptides: seeds of Impatiens balsamina contain a set of related antimicrobial peptides (Ib-AMPs). A synthetic variant of Ib-AMP1 was oxidized to the bicyclic native conformation, which was fully active on yeast and fungal strains; and four linear 20-mer Ib-AMP variants, including two all-D forms, were produced. The all-D variants are as active on yeast and fungal strains as native peptides. The Ib-AMP4 compound has the best antifungal activity with an IC50 value of 1.2–4 μM.

Strength of evidence: In vitro data only. No clinical evaluations of Impatiens preparations for human fungal infections have been published.

4.6 Anticancer Activity

Evidence type: In vitro cell-line studies — no human clinical trials.

Impatiens balsamina L. is a tropical ornamental and traditional medicinal herb rich in natural compounds, especially 2-methoxy-1,4-naphthoquinone (MNQ), which is a bioactive compound with tested anticancer activities. I. balsamina has antitumor and anticancer effects, particularly against HeLa cells and HepG2 carcinoma in laboratory studies. The persistent activation of aerobic glycolysis in cancer cells results in accumulation of lactate and other metabolic intermediates that contribute to tumorigenesis. Increased glycolysis is frequently dysregulated in triple-negative breast cancer (TNBC). A study was conducted to investigate the effect of 2-methoxy-1,4-naphthoquinone (MNQ), extracted from Impatiens balsamina, on glycolytic activities in human breast adenocarcinoma MDA-MB-231 cells. MTT proliferation assay was used to test cell viability with various doses of MNQ (5–100 μM). As the half-maximal inhibitory concentration (IC50) was obtained, glucose uptake and lactate assays were tested with the IC50 dose of MNQ.

Strength of evidence: Preclinical cell-line data only. No human trials have examined Impatiens for cancer treatment or prevention. Results from in vitro studies cannot be extrapolated to clinical outcomes.

4.7 Antioxidant Activity

Evidence type: In vitro — no human clinical trials.

All stem extracts of I. balsamina possessed moderate antioxidant potential in the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging and reducing power assays. The pigmentation of Impatiens has a direct relationship with the presence of several compounds, especially anthocyanins and their derivatives. These bioactive compounds are of great interest to the food industry and consumers due to their diverse health benefits provided by their regular consumption.

Strength of evidence: Moderate in vitro evidence. No human trials of antioxidant endpoints from Impatiens preparations have been reported.

4.8 Testosterone 5α-Reductase Inhibition (Hair Loss)

Evidence type: In vitro — no human clinical trials.

One investigation showed that an I. balsamina plant extract and the isolated compound impatienol markedly inhibit testosterone 5-alpha-reductase activity, supporting potential folk medicine use in the treatment of male pattern baldness; however, further studies are needed before conclusions can be drawn.

4.9 Anxiety and Emotional Wellbeing (I. glandulifera Bach Flower Remedy)

Evidence type: Randomized controlled trials — consistent negative findings vs. placebo.

Impatiens glandulifera is one of the five flower essences in the proprietary Rescue Remedy (also sold as "Five Flower Remedy"). Impatiens (Impatiens glandulifera) is specifically included in Rescue Remedy, intended for patience with problems and people. A systematic review published in BMC Complementary Medicine and Therapies (Ernst et al., 2009) identified seven RCTs. The best available evidence was an RCT conducted in the United States which randomized 111 nursing students to Rescue Remedy or placebo after leading them to believe they had to take a surprise examination. The students applied four drops of Rescue Remedy or placebo to their tongues every 20 minutes for a period of three hours. Results indicated similar treatment effects of BFRs and placebo. Students treated with BFRs exhibited a reduction of 0.44 points on the STAI S-Anxiety subscale (reduction from 2.21 to 1.77), compared with a 0.38 point reduction in students on placebo (reduction from 2.34 to 1.96).

All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos. The preparations themselves provide very little active botanical material: the Bach Flower Remedy product listed on the US National Library of Medicine's DailyMed database is formulated as a 5× dilution of Impatiens glandulifera HPUS in 27% alcohol.

Strength of evidence: Multiple RCTs exist but consistently find no benefit beyond placebo. The systematic review conclusion is that Bach flower remedies, including those containing Impatiens, are clinically indistinguishable from placebo for psychological outcomes.

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5. Body Systems and Health Areas Associated with Impatiens

Based on the published literature, the genus has been known for its various biological activities including: antimicrobial activity, antioxidant activity, antiallergic activity, antipruritic activity, antidermatitic activity, transcriptional activity, anti-rheumatoid arthritis activity, antihistamine activity, testosterone 5α-reductase inhibitory activity, cyclooxygenase-2 inhibitory activity, and anti-platelet activating activity. The body systems most prominently represented in the research literature include:

• Integumentary (skin) system: Contact dermatitis, atopic dermatitis, wound healing, nail inflammation, burns and scalds
• Musculoskeletal system: Rheumatism, joint pain, fractures (traditional use)
• Immune system: Antiallergic, immunomodulatory, and antihistamine effects (preclinical)
• Gastrointestinal system: Dysentery, hemorrhoids, digestive complaints (traditional use); anti-H. pylori activity (in vitro)
• Oncology: Anticancer/antitumor activities (in vitro cell lines only)
• Neurological/emotional: Anxiety and stress (Bach Flower Remedy use; no clinical evidence of efficacy beyond placebo)
• Dermatology (cosmetic): Melanin inhibition and tyrosinase inhibition (preclinical); nail dyeing applications historically

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6. Dosage Forms and Dosages Reported in Studies

No standardized human clinical dosage for any Impatiens preparation has been established. No specific dosing information is available for jewelweed preparations. The following doses have been described in specific studies:

• Anti-inflammatory (animal model): Extracts at a dose of 50 mg/kg were orally administered to experimental rats 30 minutes prior to administration of carrageenan.
• Antipruritic (animal model): A 35% ethanolic extract (100 mg/kg) obtained from the petals was used to study activity using an atopic dermatitis NC mice model.
• In vitro anticancer (MNQ): MTT proliferation assay was used to test cell viability with various doses of MNQ (5–100 μM).
• Antifungal peptides (Ib-AMP4): The Ib-AMP4 compound has the best antifungal activity with an IC50 value of 1.2–4 μM.
• Bach Flower Remedy (anxiety RCT): Students applied four drops of Rescue Remedy or placebo to their tongues every 20 minutes for a period of three hours.
• Bach Flower Remedy (stress trial): The groups applied the treatments for 60 days at a dosage of 4 drops 4 times a day.
• Registered Bach Flower product (DailyMed): 5× dilution of Impatiens glandulifera HPUS in 27% alcohol.

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7. Safety Considerations

General Oral Toxicity

All Impatiens taste bitter and seem to be slightly toxic upon ingestion, causing intestinal ailments like vomiting and diarrhea. This aligns with traditional caution: traditionally, the leaves of garden balsam are suspected to contain a substance that can affect the digestive system.

A formal acute oral toxicity assessment using the OECD Guideline No. 425 standard found that the n-hexane fraction LD50 is greater than 5000 mg/kgBW in rats, suggesting low acute oral toxicity for this specific fraction, although this result should not be generalized to all extracts or fractions of the plant.

Naphthoquinone-Related Toxicity (Lawsone and MNQ)

A PMC-indexed study using the Caenorhabditis elegans animal model found that exposure to hydroalcoholic extracts of I. balsamina stems affected the survival, locomotion, reproduction, and lifespan of C. elegans, indicating that I. balsamina stems do display toxicity in animals. Lawsone and MNQ were found to be the major mediators of toxicity in C. elegans. Specifically, it was found that lawsone is the major toxin in the extract with a higher toxicity than MNQ in terms of negative impact on C. elegans mortality, locomotion, reproduction, and lifespan. These findings come from an invertebrate nematode model; their relevance to mammalian toxicity requires further investigation.

Pregnancy and Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Considering traditional use as an emmenagogue, use in pregnancy should be avoided until further evidence is available.

Drug Interactions

No well-documented drug interactions have been identified for jewelweed/Impatiens preparations. Given the very limited human pharmacokinetic data, no formal interaction profile can be established from published evidence.

Topical Use

Research reveals little information regarding adverse reactions with the topical use of jewelweed. Use of Impatiens spp. topically has a long historical record without major reported toxicity in the dermatological literature, though formal safety trials are absent.

Research Gaps on Safety

I. balsamina L. (Balsaminaceae), an annual herb found throughout China, has been extensively used in traditional Chinese medicine (TCM). However, our knowledge regarding the adverse effects of I. balsamina in vivo is very limited. Rigorous long-term human safety data do not exist for any Impatiens preparation.

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8. Summary of Evidence Strength

The overall body of scientific evidence for Impatiens as a supplement or herbal medicine can be characterized as follows:

• Antimicrobial (in vitro): Consistently demonstrated against multiple pathogens, including antibiotic-resistant strains; no human trials.
• Anti-inflammatory and antipruritic: Supported in animal models; no human RCTs.
• Poison ivy dermatitis prevention: Small human trials exist; results are conflicting and preparation-dependent; mechanistic basis partially elucidated (saponins).
• Anticancer (in vitro): MNQ shows activity against several cancer cell lines; entirely preclinical.
• Anxiety/emotional wellbeing (Bach Flower Remedy): Multiple RCTs; no evidence of benefit beyond placebo.
• Antifungal (Ib-AMPs and MNQ): Strong in vitro data; no clinical trials.

Impatiens balsamina is a plant that has great potential for the creation of herbal remedies and natural medications for a range of diseases due to its broad pharmacological potential. Its bioactive components, modes of action, and uses in modern medicine require additional research.

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