Queen of the meadow

Queen of the Meadow: A Comprehensive Encyclopedic Reference

1. Identity and Nomenclature

The common name queen of the meadow is applied to two botanically distinct plants with overlapping folk traditions, and correctly distinguishing them is essential to understanding the literature.

1.1 Filipendula ulmaria (Meadowsweet) — The European Plant

Filipendula ulmaria, commonly known as meadowsweet or mead wort, is a perennial herbaceous plant in the family Rosaceae that grows in damp meadows, native throughout most of Europe and Western Asia. It has been introduced and naturalised in North America. Meadowsweet has also been referred to as queen of the meadow, pride of the meadow, meadow-wort, meadow queen, lady of the meadow, dollof, meadsweet, and bridewort.

In Europe, it took its name "queen of the meadow" for the way it can dominate a low-lying, damp meadow. The stems, growing to 1–2 metres tall, are erect and furrowed, reddish to sometimes purple. The leaves are dark-green on the upper side and whitish and downy underneath, much divided, interruptedly pinnate, having a few large serrate leaflets and small intermediate ones. Meadowsweet has delicate, graceful, creamy-white flowers clustered close together in irregularly-branched cymes, having a very strong, sweet smell redolent of antiseptic.

Meadowsweet (Filipendula ulmaria, formerly Spiraea ulmaria) is an herbaceous perennial plant in the Rosaceae or rose family. The former genus name Spiraea is of particular pharmacological significance: an alternative name, Spiraea, inspired chemist Friedrich von Heyden in the 1830s to name a compound he isolated from the plant as "spirin" — this later became our modern-day drug, Aspirin.

Its flowering tops (Filipendulae ulmariae herba), included in the European Pharmacopoeia (monograph 04/2013:1868), are used as a herbal substance (whole or cut), due to its contents of essential oils and salicylates. Extracts of Filipendulae herba are on the market in the European Union as food supplements.

1.2 Eutrochium purpureum / Eupatorium purpureum (Gravel Root) — The North American Plant

Eutrochium purpureum — also known as Kidney-Root, Sweetscented Joe Pye Weed, Sweet Joe-Pye Weed, Queen of the Meadow, or Trumpet Weed — is a herbaceous perennial plant in the sunflower family. Its common names include Queen of the Meadow, Joe Pye Weed, Trumpet-weed, Gravel-weed, Gravel-root, Joe-pie, and Purple Boneset.

Many products and older labels still use the older botanical name Eupatorium purpureum, while newer sources may use Eutrochium purpureum — a distinction that means buyers need to read labels carefully. The botanical synonyms include E. falcatum, Eutrochium purpureum, Cunigunda purpurea, and Eupatoriadelphus purpureus; E. maculatum, E. fistulosum, and E. verticillatum are said to have similar properties.

Gravel root refers to the medicinal root and rhizome of this species. It belongs to the Asteraceae family and is native to eastern North America, where it grows in damp meadows, woodland edges, and streamside areas. The plant itself is tall and striking, with purple-green stems and soft mauve flower clusters, but the part used in traditional medicine is the underground portion rather than the flowers.

This plant, likewise known by the names of Gravel Root, Joe-pye, and Trumpet-weed, is herbaceous, with a perennial, horizontal, woody caudex, with many long, dark brown fibers, which send up one or more solid, glabrous, green, sometimes purplish stems, five or six feet in height, with a purple band at the joints about an inch broad.

1.3 Navigating the Naming Overlap

In retail and herbal commerce, the name "queen of the meadow" appears on products derived from either plant. In European tradition and official pharmacopeial contexts, the name most reliably identifies Filipendula ulmaria. In North American herbal tradition, the same name most frequently identifies Eutrochium purpureum (gravel root). Both plants are discussed throughout this article; where distinctions are critical to safety or pharmacology, they are specified.

2. Common Forms and Preparations

2.1 Filipendula ulmaria Preparations

Filipendula ulmaria grows in damp environments and marshy areas and on riverbanks. It features clustered white flowers that have a pleasant, sweet aroma and are used in medicinal preparations such as teas and extracts. The plant is harvested in July when it is in flower and can be dried for later use. The aerial parts — including leaves, flowering stems, and flower heads — are the portions primarily used. Its flowering tops are used as a herbal substance in whole or cut form.

Commercial preparations include dried herb for infusion (herbal tea), tinctures in ethanol, fluid extracts, and encapsulated powders. The EMA and ESCOP recommend it as a traditional herbal medicinal product for the supportive treatment of the common cold.

2.2 Eutrochium purpureum (Gravel Root) Preparations

The roots and rhizomes are harvested for medicinal use in the autumn after the plant has finished flowering. The leaves and flowering stems are harvested in the summer before the buds open and are dried for later use. The roots are harvested in the autumn and dried for later use. Current commercial forms include loose dried root for decoction, tinctures, and fluid extracts.

3. Traditional and Historical Use

3.1 Filipendula ulmaria — European and Celtic Traditions

Meadowsweet has a very long history of herbal use; it was one of the three most sacred herbs of the Druids. Meadowsweet has been used medicinally since ancient Celtic and Anglo-Saxon times. The Druids regarded it as one of their most sacred herbs, and it was commonly used in ceremonial and healing practices.

In Chaucer's The Knight's Tale it is known as meadwort and was one of the ingredients in a drink called "save." It was also known as bridewort, because it was strewn in churches for festivals and weddings, and often made into bridal garlands. It was popular as a strewing herb in the Middle Ages, when it was scattered on floors to repel pests and freshen the room with its sweet, pleasant aroma.

The aboveground plant — leaves, stems, flowers — contain salicylate, the compound from which aspirin was derived in the 1800s. Willow bark (genus Salix) also has salicylate, but the German chemists who first purified salicylate worked with meadowsweet. They named it aspirin based on Spirea, meadowsweet's Latin name at the time. Long before that, Europeans had been treating fevers, aches, and pains with formulas made from meadowsweet.

Filipendula ulmaria is traditionally used for fever, pain, inflammatory diseases (arthrosis, rheumatism, and arthritis), gastric disorders, liver dysfunction, and gout. It has traditionally been employed for the treatment of rheumatism, headaches, and pneumonia, based on ethnopharmacological surveys. Several medicinal properties of the plant have also been reported in Persian medicine.

In 1899, scientists at the firm Bayer used salicylic acid derived from meadowsweet to synthesise acetylsalicylic acid (aspirin), which was named after the plant's former botanical genus name. In the late 19th century the German company Bayer was looking for a medicine that could replicate the traditional benefits in arthritis of willow bark (Salix alba), without the stomach-harming properties of the chemical initially derived from it, salicylic acid.

3.2 Eutrochium purpureum (Gravel Root) — North American Traditions

The plant was widely used by Native Americans. The Cherokee used the roots as a remedy for the kidneys and for rheumatism. It was also used as a partus preparator (to prepare the womb for labour) and to tone the uterus. The Chippewa used it when with a cold, inhaling the vapours from an infusion of the plant. The Potawatomi people used a poultice of the leaves for burns, and the Navajo used the herb as an antidote for poison.

The Abenaki tribe used Gravel Root as a mild diaphoretic to induce perspiration and break a fever. It has also been used to dispel small stones and sludge from the bladder. The Cherokee nation used Gravel Root in the treatment of joint disorders and, due to its diuretic, soothing, and astringent effect, also in urinary tract problems.

Adopted by white settlers, it was also used for urinary infection, gravel, and stones, and as a diaphoretic to help break a fever. Gravel root was considered a valuable remedy for dropsy — a term once used for fluid retention/oedema — and stranguary, another old term used for painful spasm in the bladder and urethra with frequent need to urinate, often whilst only passing small amounts of urine.

In nineteenth-century American Eclectic medicine, gravel root was formally documented. Queen of the meadow was described as having diuretic, subastringent, stimulant, tonic, and antilithic properties. It was noted to have a specific action upon the renal tract, increasing both the fluid and solid constituents of the urine. As its influence upon the stomach was regarded as good, it was considered that it might be used for a great length of time without ill results. Specific indications cited in eclectic texts included irritation of the bladder in women from displacement and chronic inflammation of the uterus, and suppression of urine, partial or complete, during or after pregnancy. Eupatorium purpureum was described as a remedy for diseases of the uric acid diathesis, irritation of the urinary tract being the chief symptom.

The common name of Joe-pye weed comes from the name of Joe Pye, a New England medicine man who was said to have halted an epidemic of typhoid fever in colonial Massachusetts with use of the plant.

4. Key Constituents and Active Compounds

4.1 Filipendula ulmaria

Phytochemical studies indicate the presence of several active compounds, mainly phenolic acids, flavonoids, tannins, and terpenoids. Salicylic acid and its derivatives are the most important compounds found in essential oil and extracts of different parts of the plant.

Similar to Salix species, meadowsweet contains salicylates and their precursors (isosalicin and monotropitin), as well as other phenolic constituents. It has been shown to contain flavonoid aglycons (e.g., quercetin and kaempferol), glycosylated flavonoids (such as rutin, hyperoside, quercitrin, avicularin, and astragalin), and hydrolysable tannins (tellimagrandin I and II, rugosin A, B, D, and E).

Detailed constituent profiling has identified: flavonoids at between 3–5%, consisting of quercetin, avicularin, hyperoside, rutin, kaempferol, and spireoside; phenolic glycosides including gaultherin, spiraein, isolacilin, and salicylate-derived constituents; volatile oil up to 0.2% including salicylaldehyde (75%) and methyl salicylate; polyphenols/tannins including ellagitannins (10–15%) and rugosin-D; and phenolic acids including gallic, p-coumaric, and vanillic acids.

Salicylates are the main components of the volatile oil, mainly salicylaldehyde (up to 70%). A 2016 comprehensive phytochemical study using UHPLC found that a total of 119 compounds were tentatively identified, 69 of them new to F. ulmaria. A rich diversity of phenolic constituents was detected, and only a few non-phenolic phytochemicals were observed.

The main constituents have been identified as tellimagrandin I (TI), monotropitoside (Mt), rutin (R), miquelianin (Mq), and spiraeoside (Sp).

A 2024 HPLC analysis of a meadowsweet dry tincture found that salicylic acid (18.84 mg/g dry extract), rutin (9.97 mg/g), p-coumaric acid (6.80 mg/g), quercetin (4.47 mg/g), rosmarinic acid (4.01 mg/g), and vanillic acid (3.82 mg/g) were the major components.

It should be noted that the amount of salicylates, mostly present in the form of glycosides, is assumed to be less than 0.5% (ESCOP, 2003). The EMA assessment report further clarifies that according to Schulz et al. (1998), infusions contain only trace amounts of salicylates, so meadowsweet tea is considered as an aromatic remedy rather than a salicylate medication. There appears to be some doubt whether salicylates will play an important role in experimental or clinical effects.

4.2 Eutrochium purpureum (Gravel Root)

The root and rhizome contain: volatile oil (0.07%), flavonoids (euparin), resin (eupurpurin), iron phosphate, potassium chloride, silica, calcium, sodium, acid phosphate, and pyrrolizidine alkaloids.

The best-known reported constituents in gravel root include benzofuran-type compounds such as cistifolin, euparin, and euparone, along with resins and a small volatile oil fraction. Further phytochemical analysis of the crude extract led to the isolation of three known benzofurans — euparin, euparone, 6-hydroxy-3beta-methoxytrematone — and a new benzofuran, 5-acetyl-6-hydroxy-2-(1-oxo-2-acetoxy-ethyl)-benzofuran.

Reported constituents from the genus Eupatorium involve flavonoids, terpenoids, pyrrolizidine alkaloids, phenylpropanoids, quinonoids, essential oils, and some others, altogether more than 300 compounds.

5. Mechanisms of Action

5.1 Filipendula ulmaria — Mechanisms

Anti-inflammatory activity: Salicylates — salicin and salicylic acid — are analgesic and anti-inflammatory. However, the broader polyphenol fraction is now considered central. Meadowsweet is widely used in phytotherapy against inflammatory diseases, but its active constituents are not exactly known. It contains many constituents, such as flavonoid glycosides, which are not absorbed but are metabolised in the colon by gut microbiota, producing potentially active metabolites that can be absorbed.

In vitro work has identified cyclooxygenase inhibition as a likely pathway. In vitro anti-inflammatory activity was evaluated by testing the inhibition of NF-κB activation, COX-1, and COX-2 enzyme inhibition. From a phytochemical perspective, the anti-inflammatory activity can be attributed to the ubiquitous class of polyphenols present at high levels in F. ulmaria extracts, including salicylates, other phenolic acids, flavonoid glycosides, and tannins.

Gastroprotective activity: Unlike extracted aspirin, which can cause gastric ulceration at high doses, the combination of constituents in meadowsweet acts to protect the inner lining of the stomach and intestines whilst still providing anti-inflammatory benefits. A limited number of mechanistic in vitro experiments indicated that Filipendula extracts inhibited the classical pathway of the complement system, production of pro-inflammatory cytokines, and expression of adhesion molecules.

Xanthine oxidase inhibition (gout mechanism): A study focused on the use of F. ulmaria for the treatment of gout disease first studied the chemical composition of a methanolic extract of the aerial parts and demonstrated its xanthine oxidase (XO) inhibitory activity. The flavonoid spiraeoside was demonstrated to possess an activity around 25 times higher than allopurinol, used as a reference in the treatment of gout disease — though this was an in vitro finding only.

Antioxidant and DNA-protective activity: The tincture was found rich in phenolic compounds especially salicylic acid and flavonoids, and demonstrated strong in vitro antioxidant and DNA-protective effects at low concentrations.

Neuroinflammatory mechanisms (emerging research): Through analytical and phytochemical analyses, decreased α-synuclein accumulation in a model organism could be attributed to the presence of spiraeoside (Sp) and miquelianin (Mq), whereas the abundant phenol glycoside monotropitoside showed no activity in this model. This research is early-stage.

5.2 Eutrochium purpureum (Gravel Root) — Mechanisms

Anti-inflammatory (cistifolin): In vitro anti-inflammatory activity has been demonstrated from an isolated constituent of gravel root known as cistifolin, a benzofuran flavonoid which may contribute to the plant's reputation as an anti-rheumatic herb. Previous reports revealed that cistifolin from the rhizome of Eupatorium purpureum showed activity both in in vitro and in vivo models of inflammation. Data showed that, in addition to LFA-1 and other integrin-mediated leucocyte adhesions, cistifolin inhibits the Mac-1 (CD11b/CD18)-dependent monocyte adhesion to fibrinogen in a concentration-dependent manner.

Diuretic action: As a diuretic, gravel root is described as stimulating the flow of water and solutes. It is particularly noted as helpful in removing urinary gravel. The specific pharmacological mechanism by which this diuretic effect operates has not been established in rigorous clinical studies.

6. Scientific Evidence by Area of Use

6.1 Inflammation and Pain (Filipendula ulmaria)

Meadowsweet has been traditionally used in most European countries for the treatment of inflammatory diseases due to its antipyretic, analgesic, astringent, and anti-rheumatic properties. However, there is little scientific evidence on F. ulmaria anti-inflammatory effects regarding its impact on cyclooxygenases enzymatic activity and in vivo assessment of anti-inflammatory potential.

One study (Katanić et al., 2016, Journal of Ethnopharmacology) tested methanolic extracts of aerial parts and roots in COX-1 and COX-2 enzyme assays and a carrageenan-induced paw edema model in rats. The in vivo anti-inflammatory effect of F. ulmaria extracts was determined in two doses (100 and 200 mg/kg body weight) with a hot plate test and carrageenan-induced paw edema test in rats. The observed results of in vitro and, for the first time, in vivo anti-inflammatory activity of meadowsweet extracts provided support for the traditional use of this plant in the treatment of different inflammatory conditions. Further investigation of the anti-inflammatory compounds was recommended to reveal the mechanism. This research is animal/preclinical; no controlled human clinical trials of anti-inflammatory effect have been published.

The EMA recognizes meadowsweet as a traditional herbal medicinal product for the relief of minor joint pain, including lower back pain. This regulatory classification is based on traditional use evidence rather than controlled clinical trials.

6.2 Gastrointestinal Health (Filipendula ulmaria)

Meadowsweet is traditionally used to treat gastrointestinal disorders associated with hyperacidity, such as gastritis, acid dyspepsia, and gastroduodenal ulceration. It may promote the healing of chronic stomach ulcers caused by ethanol.

Preclinical evidence from animal studies supports gastroprotective effects. Preparations of Filipendulae ulmariae flos have been reported to cause lowering of motor activity and rectal temperature, myorelaxation, and potentiation of narcotic action; to prolong life expectancy of mice, lower vascular permeability, and prevent the development of stomach ulcers in rats and mice. Antiulcerative effects were also documented for other parts of the plant.

A 2018 study examined lyophilised flower infusions in a gastroprotection model in rats. Examination of lyophilised infusions (100–300 mg/kg, orally) demonstrated gastroprotective action in rats that revealed their capacity to preserve mucosal integrity. In addition, spiraeoside (50 mg/kg, orally) and tellimagrandin II (40 mg/kg, orally) showed ulceroprotective activity. These are animal studies. People use meadowsweet for respiratory tract infections, headache, heartburn, and many other conditions, but there is no good scientific evidence from clinical trials to support these uses.

6.3 Fever and Common Cold (Filipendula ulmaria)

Meadowsweet helps treat the symptoms of the common cold — fevers and headaches — thanks to its high salicylic acid content. The EMA and ESCOP recommend it as a traditional herbal medicinal product for the supportive treatment of the common cold. This recommendation rests on traditional use data and plausible pharmacological mechanisms (salicylate content), not on double-blind randomised controlled trials.

6.4 Gout (Filipendula ulmaria — In Vitro Only)

Filipendula ulmaria is a plant traditionally used for treatment of gout. A study focused on the use of F. ulmaria for gout disease first studied the chemical composition of a methanolic extract of the aerial parts and demonstrated its xanthine oxidase (XO) inhibitory activity in vitro. The glycosylated flavonoid spiraeoside was demonstrated to possess an activity around 25 times higher than allopurinol, used as a reference in the treatment of gout disease. This is an in vitro enzyme assay result only; no human studies have evaluated this effect. The clinical relevance of the in vitro XO inhibition remains unknown.

6.5 Antioxidant and Antiproliferative Activity (Filipendula ulmaria — In Vitro Only)

The high antioxidant potential of the species was confirmed by four methods, best expressed by the results of the CUPRAC assay (10,605.91 μM TE/g dry extract). The study reported for the first time highly protective activities of meadowsweet dry tincture against oxidative DNA damage and its antiproliferative effect against hepatocellular carcinoma (HepG2 cell line). Meadowsweet dry tincture was concluded to possess great potential to prevent diseases caused by oxidative stress. The study concluded that meadowsweet has potential in reducing oxidative stress-related diseases; however, further research is needed to explore its clinical application. All such findings are in vitro only.

6.6 Neurodegenerative Disease (Filipendula ulmaria — Preclinical)

Among Filipendula species, meadowsweet has long been valued for its anti-inflammatory effects, consistently demonstrated across in vitro and in vivo studies, yet has received little attention in the context of neurodegeneration. A 2025 Frontiers in Pharmacology study examined constituents miquelianin and spiraeoside in a C. elegans model of α-synuclein aggregation (relevant to Parkinson's disease) and in human microglial cell cultures. The decreased α-synuclein accumulation could be attributed to the presence of spiraeoside and miquelianin. This is very preliminary preclinical research with no established clinical relevance.

6.7 Urinary Tract and Kidney Stone Conditions (Eutrochium purpureum)

Gravel root has a long-standing history of use in traditional herbal medicine, particularly among Native American tribes and early American settlers. It was commonly employed as a remedy for urinary tract conditions, including infections, kidney stones ("gravel"), and other ailments of the urinary system. The herb was traditionally thought to help "flush out" the urinary tract and encourage urination, thereby assisting in the expulsion of pathogens or stones. Despite this traditional usage, there is a significant lack of modern scientific evidence to substantiate gravel root's efficacy for urinary tract infections.

What makes gravel root appealing is not one dramatic, proven effect, but a cluster of traditional actions: mild diuretic support, possible anti-inflammatory activity, and a long reputation in formulas aimed at urinary discomfort. Traditionally used for conditions of the genitourinary system, Eupatorium purpureum lacks substantiation in standard medical literature. No published controlled human trials of gravel root for urinary conditions have been identified in the current literature.

6.8 Anti-Inflammatory and Antirheumatic Use (Eutrochium purpureum)

The anti-inflammatory activity of the antirheumatic herb Eupatorium purpureum has been demonstrated in both in vitro and in vivo models of inflammation. The key compound identified is cistifolin. Previous reports revealed that cistifolin from the rhizome of Eupatorium purpureum showed activity both in in vitro and in vivo models of inflammation. Data showed that cistifolin inhibits the Mac-1 (CD11b/CD18)-dependent monocyte adhesion to fibrinogen in a concentration-dependent manner. Further phytochemical analysis also led to the isolation of three known benzofurans — euparin, euparone, and 6-hydroxy-3beta-methoxytrematone. None of these additional benzofuran compounds were active in suppressing integrin-mediated monocytic U937 cell adhesions in vitro. There are no clinical trials in humans evaluating gravel root for rheumatic conditions.

7. Body Systems and Health Areas Associated with Queen of the Meadow

7.1 Filipendula ulmaria

• Musculoskeletal system: Of great use in musculoskeletal conditions such as arthritis, gout, and all kinds of muscle and joint pains (traditional use; preclinical support; no RCTs).
• Gastrointestinal system: Has specific use for peptic ulcers both as prophylactic and as treatment. Regulates gastric acid levels and protects and soothes gastrointestinal mucous membranes.
• Immune and febrile states: The leaves and flowering stems are alterative, anti-inflammatory, antiseptic, aromatic, astringent, diaphoretic, diuretic, stomachic, and tonic.
• Urinary system: Meadowsweet has long been used to support urinary tract health, with diuretic properties documented in traditional sources.
• Cardiovascular/anticoagulant: Anti-coagulant activity is listed among its medicinal actions, attributed to its salicylate content; this has not been formally evaluated in clinical trials.

7.2 Eutrochium purpureum (Gravel Root)

• Urinary/renal system: It works particularly on the genito-urinary system and the uterus. Especially valuable as a diuretic and stimulant, as well as an astringent tonic; a tea made from the roots and leaves has been used to eliminate stones from the urinary tract, to treat urinary incontinence in children, cystitis, urethritis.
• Musculoskeletal system: It is also said to be helpful in treating rheumatism and gout by increasing the removal of waste from the kidneys.
• Febrile conditions: Gravel root was used by the native North American Indians as a diaphoretic to induce perspiration and break a fever. The plant was quickly adopted by the white settlers and still finds a use in modern herbalism.

8. Dosage Forms and Reported Dosages

8.1 Filipendula ulmaria — As Reported in Sources

The EMA and ESCOP have published assessment reports and monographs for Filipendula ulmaria herba and flos (flowering tops). The flowering tops, included in the European Pharmacopoeia (monograph 04/2013:1868), are used as a herbal substance in whole or cut form.

In animal studies cited above, extracts were administered at doses of 100 and 200 mg/kg body weight in rats for anti-inflammatory testing, and 100–300 mg/kg orally for gastroprotective effects. These are animal-study doses and do not translate directly to human dosing.

In the in vitro DNA-protective study, the dry tincture was prepared from 100 g of dried herb in one litre of 96% ethanol.

8.2 Eutrochium purpureum (Gravel Root) — As Reported in Sources

Reported herbal pharmacy references cite: tincture (fresh plant, 1:4 ratio; 35% ethanol) at 1–5 ml three times daily; dried root tincture (1:5 ratio; 25% ethanol) at 1–5 ml three times daily; decoction at 1 teaspoon per cup, 1 to 2 cups per day.

These dosages are drawn from traditional/naturopathic herbal references, not from clinical trials. Modern human research is thin, product quality can vary, and there are meaningful safety questions around possible pyrrolizidine alkaloid exposure and adulteration with related plants.

Eclectic medical texts cite dosage from five to thirty minims for the specific extract.

9. Safety Considerations and Interactions

9.1 Filipendula ulmaria — Safety

Salicylate content and drug interactions: No drug interactions are documented clinically. Theoretically, as preparations of Filipendula ulmaria may contain salicylates, there might be a potential for interactions with other salicylate-containing products or other NSAID medicines administered concurrently. However, the amount of salicylates, mostly present in the form of glycosides, is assumed to be less than 0.5% (ESCOP, 2003). Infusions contain only trace amounts of salicylates, so meadowsweet tea is considered an aromatic remedy rather than a salicylate medication. There appears to be some doubt whether salicylates will play an important role in experimental or clinical effects.

Aspirin sensitivity: Because the plant contains salicylate precursors, individuals with known hypersensitivity or intolerance to aspirin/salicylates should exercise caution, though the EMA assessment notes the salicylate burden from typical preparations is low.

Short-term use safety: Meadowsweet is possibly safe when used short-term. Taking meadowsweet in large amounts or for a long period of time is possibly unsafe. It contains chemicals called salicylates, which are similar to aspirin.

9.2 Eutrochium purpureum (Gravel Root) — Safety

Pyrrolizidine alkaloids (PAs) — the principal safety concern: Pyrrolizidine alkaloids (PAs) are naturally occurring phytochemicals found in certain plant families. They are produced by the plants as a defence mechanism against being eaten. Some PAs can be carcinogenic, hepatotoxic, and mutagenic.

It is possible, but certainly by no means definite, that Gravel root may contain hepatotoxic pyrrolizidine alkaloids. PA levels include specifically 1,2-unsaturated types (e.g., intermedine and lycopsamine families) that can cause liver toxicity after metabolic activation. PA levels vary by species, plant part, harvest, and extraction method. Alcoholic tinctures and hot-water preparations can co-extract PAs.

A PubMed-indexed 2018 study (Colegate et al., Phytochemical Analysis) specifically examined pro-toxic dehydropyrrolizidine alkaloids that are associated with liver disease in humans. The potential for long-term, low-level or intermittent exposures to cause or contribute to chronically-developing diseases is of international concern. The study analyzed Eutrochium purpureum and related species and concluded that concerns associated with dehydropyrrolizidine alkaloids provide a compelling reason for preclusive caution until further research can better define the toxicity and carcinogenicity of the dehydropyrrolizidine alkaloid content.

Hepatotoxicity contraindication: Because of the pyrrolizidine alkaloids, internal use, particularly long-term, may lead to hepatotoxicity and should be avoided in patients with liver disease. Its use is also contraindicated in pregnancy due to its abortifacient effect and during breastfeeding, again due to the pyrrolizidine alkaloids.

Adulteration and misidentification risk: Adulteration of Gravel root with other family members such as Boneset can be a risk, along with that of the common occurrence of interspecies hybridization, which has the potential to cause an alteration in the plant's phytochemical profile. Gravel root is a plant with some concern about adulteration, misidentification, and hybridization with related species. This matters because the chemistry and safety profile of a product can change when the wrong plant is harvested or mixed in.

Asteraceae allergy: It belongs to the Asteraceae (daisy) family — relevant because people with ragweed or other Asteraceae allergies may also react to it.

10. Regulatory and Pharmacopeial Status

Filipendula ulmaria flowering tops are included in the European Pharmacopoeia (monograph 04/2013:1868). The ESCOP published a formal monograph for Filipendulae ulmariae herba (Meadowsweet), published in 2015, which selects and summarises scientific studies and textbooks regarding efficacy, dosage, and safety supporting the therapeutic uses of meadowsweet. The EMA's Committee on Herbal Medicinal Products (HMPC) has produced both draft and final assessment reports for the herb and flower of F. ulmaria.

No equivalent official European pharmacopeial or EMA/ESCOP monograph has been established for Eutrochium purpureum (gravel root), reflecting the limited clinical evidence base and unresolved safety questions regarding pyrrolizidine alkaloid content for that species.

11. Summary of Evidence Strength

• Filipendula ulmaria — anti-inflammatory/antirheumatic: Traditional use well documented across cultures and centuries; preclinical (animal and in vitro) evidence supports plausibility; no published randomised controlled trials in humans.
• Filipendula ulmaria — gastric/gastroprotective: Strong preclinical (animal model) evidence; no human clinical trials; EMA recognition as traditional medicinal product.
• Filipendula ulmaria — fever/cold: Traditional use basis; salicylate mechanism is pharmacologically plausible; no clinical trials; EMA/ESCOP traditional use recognition.
• Filipendula ulmaria — gout (xanthine oxidase inhibition): In vitro only; striking enzymatic potency demonstrated for spiraeoside; no clinical data.
• Filipendula ulmaria — antioxidant/antiproliferative: In vitro only; no clinical application established.
• Eutrochium purpureum — urinary/renal: Extensive traditional use documentation; no controlled clinical trials; evidence base is traditional and preclinical only.
• Eutrochium purpureum — anti-inflammatory: In vitro and in vivo (animal) evidence for cistifolin; no human trials.

References

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• Herbal Reality. Meadowsweet (Filipendula ulmaria): Benefits, Uses, Safety.
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