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Smilax

Health Conditions18
Table of contents

Other Names

AlambrillaAniketonBa QiaBlack CreeperCarrion flowerCarrionflowerCat greenbrierCatbrierCatbriersChin-lao-shuChina rootChinarootChinese SmilaxChob cheeniCocolmecaCommon greenbrierCoprosmanthusDilaxDudhilataDwipautraEcuadorian sarsaparillaGlabrous greenbrierGray sarsaparillaGreenbriarGreenbriarsGreenbrierGreenbriersHeterosmilaxHonduran sarsaparillaJackson BrierJamaican sarsaparillaJapicangaJin Gang TengJingangtengJupicangaKalisarKhao yenKuang-yen-pa-hsiehMexican sarsaparillaNative sarsaparillaNemexiaOligosmilaxPaalvalliParillaxPleiosmilaxPrickly-ivyPrickly-ivysPseudosmilaxRad. Sarzae Jam.Rhizoma Smilacis GlabraeSalsaparrilhaSalsepareilleSaparnaSarivaSarsaSarsaparillaSarsparillaShan Gui LaiShan Ku'ei-laiShiny Leaf SmilaxSiamalataSmilaceSmilacis Chinae RhizomaSmilacis Glabrae RhizomaSmilax aristolochiaefoliaSmilax barbillanaSmilax medicaSmooth herbaceous greenbrierSugandhiSweet sarsaparillaTi-hu-lingTu Fu LingTu fulingTufulingZarzaparillaZarzaparrilla

Synopsis

Smilax (Sarsaparilla): A Comprehensive Reference

1. Identity and Botanical Classification

Genus and Species

Smilax, commonly known as sarsaparilla, belongs to the monocot family Smilacaceae Vent. The genus comprises over 267 species, predominantly native to tropical, subtropical, and temperate habitats of the Old and New World. The genus is widely distributed across all continents except Antarctica, with its rhizomes being the primary source of commercial and therapeutic value.

Medicinally and commercially significant species include a range of American, European, and Asian taxa. Smilax medica, S. officinalis, S. regelii, and S. febrifuga are among those used to produce sarsaparilla. These are distinct from S. glabra (also known as chinaroot), which contains different chemicals. Sarsaparilla is also different from "Indian sarsaparilla," which comes from an unrelated plant called Hemidesmus indicus.

Key species in international trade and research include:

  • Smilax officinalis Kunth — Honduran sarsaparilla; family Smilacaceae (formerly placed in Liliaceae); one of the most cited medicinal species.
  • Smilax ornata Lem. — A perennial trailing vine with prickly stems native to Mexico and Central America; common names include sarsaparilla, Honduran sarsaparilla, and Jamaican sarsaparilla.
  • Smilax glabra Roxb. — Known in Chinese medicine as Tu fuling or "Tufuling." Geographically distributed in China, Nepal, Pakistan, Mexico, Vietnam, India, Cambodia, Thailand, Bangladesh, Belgium, Laos, Brazil, Myanmar, Australia, Malaysia, Japan, and the United States.
  • Smilax china L. — Known in TCM as Baqia; native to East Asia.
  • Smilax aspera L. — European sarsaparilla, found in Mediterranean regions.
  • Smilax aristolochiifolia Mill. — A perennial woody climber native to Mexico and Central America.

Common Names and Etymology

The Spanish name "zarzaparrilla" is derived from words meaning "bramble" (from Basque sartzia, "bramble") and "little grape vine." Other common names include smilax, smilace, sarsa, and khao yen.

Plant Description and Parts Used

All species of Smilax are climbing or trailing plants with prickly, thorned stems — a characteristic reflected in the plant's name. Various species are found in Mexico, South America, and the Caribbean. The root is used in herbal medicine. The root has a pleasant fragrance and spicy sweet taste, and has been used as a natural flavoring agent in medicines, foods, and non-alcoholic beverages.

Common Preparations and Forms

Sarsaparilla is available as a tea and dietary supplement, and is also commonly used as a natural flavoring in foods and drinks. In Asian countries, S. glabra is commonly used in foods, teas, and herbs, while in the West it is an ingredient in draft beer and other beverages due to its foaming properties. In supplement commerce, it is sold as dried root powder, standardized extracts in capsule or tablet form, tinctures, and decoctions. Smilax ornata is used as the basis for a soft drink frequently called sarsaparilla; it is also a primary ingredient in old-fashioned-style root beer, historically used in conjunction with sassafras.

2. Traditional and Historical Use

Indigenous American Traditions

Smilax ornata was considered by Native Americans to have medicinal properties and was a popular European treatment for syphilis when it was introduced from the New World. For centuries, indigenous people around the world used the root of the sarsaparilla plant for treating joint problems like arthritis, and for healing skin problems like psoriasis, eczema, and dermatitis. The root was also thought to cure Hansen's disease (leprosy) due to its "blood-purifying" properties.

In Mexico, the Totonac culture used specific species for food and medicine: Smilax aristolochiifolia, known as "kgentsililh," forms part of traditional Totonac recipes, in which the tender stems are used in local medicine to treat menstrual pain, dysentery, and to prevent hair loss.

Introduction to European Medicine

According to Monardes, the Spanish botanist, Mexican sarsaparilla was introduced into European medicine about 1536 at Seville. A Smilax root from Mexico was introduced into European medicine in 1536, where it developed a strong following as a cure for syphilis and rheumatism. Gerard, in his Great Herbal, mentions that the Honduran and Peruvian sarsaparilla "are a remedy against long continual pain of the joints and head, and against the cold."

From 1820 to 1910, it was registered in the U.S. Pharmacopoeia as a treatment for syphilis. Sarsaparilla was later introduced into European medicine and eventually registered as an herb in the United States Pharmacopoeia to treat syphilis. By the nineteenth century, a leading London physician described sarsaparilla as "the great restorer of appetite, flesh, colour, strength and vigour."

Traditional Chinese Medicine (TCM)

Smilax glabra was first recorded in the Ben Cao Jing Ji Zhu of the Southern and Northern Dynasties (420–589 AD), written by Tao Hongjing. In the Tang Dynasty (618–907 AD), the Ben Cao Shi Yi records that it could be used as food. The Ben Cao Tu Jing, written by Su Song in the Song Dynasty (960–1279 AD), first recorded that it was sweet, calm in nature, non-toxic, and had recorded efficacy.

Smilax china, locally known as Baqia, has been extensively used in traditional Chinese medicine to treat conditions such as acute bacillary dysentery, gout, tumors, pelvic inflammation, and syphilis. Smilax glabra (Tu fuling) is another prominent species in TCM, frequently used to treat syphilis, rheumatism, and scabies. S. glabra was widely used in traditional Chinese medicine for the treatment of syphilis, hypertonia, nephritis, heavy metal poisoning and other diseases in China.

The modern 2020 edition of the Chinese Pharmacopoeia describes S. glabra as the dry rhizome of the Liliaceae family Smilax glabra, indicated for treating syphilis, turbidity, carbuncle, scrofula, and scabies.

South and Southeast Asian Traditions

The rhizome has been used in traditional Chinese medicine for infections and inflammatory conditions. In India, fresh roots are made into an extract to treat sores and venereal diseases. In Thailand, traditional practitioners have widely used it to treat cancer, AIDS, and other conditions.

Syphilis Treatment History

A Smilax root from Mexico was introduced into European medicine in 1536, where it developed a strong following as a cure for syphilis and rheumatism. Since this time, Smilax roots have had a long history of use for syphilis and other sexually transmitted diseases throughout the world. Clinical tests in China demonstrated that the Chinese species Tu fu ling rhizome (Smilax glabra) is effective for treating syphilis in about 90% of acute cases and 50% of chronic cases (Bensky and Gamble, 1986). This finding, while historically cited, pre-dates modern randomized controlled trial methodology.

3. Phytochemistry: Key Constituents and Active Compounds

Overall Chemical Diversity

To date, at least 1,058 compounds have been identified from Smilax species, including flavonoids, phenolic acids, steroidal saponins, polysaccharides, and stilbenoids. For S. glabra specifically, more than 200 chemical components have been discovered, including flavonoids, phenolics, phenolic acids, stilbenes, organic acids, phenylpropanoids, and others.

Steroidal Saponins

Steroidal saponins are among the most characteristic and historically significant constituents of the genus. Key compounds include sarsasapogenin, sarsaparilloside, parillin, sarsaponin, smilagenin, smilasaponin, smilax saponins A–C, smiglaside A–E, and titogenin, among others. Early chemical analysis identified three related saponin compounds — smilacin/sarsaparill-saponin, sarsa-saponin, and parillin — that all split up into sarsasapogenin (parigenin) and one or more molecules of glucose on boiling with dilute acids.

Sarsaparilla contains steroidal saponins such as sarsasapogenin, which may mimic the action of some human hormones. This property remains undocumented, however. Sapogenins present in sarsaparilla include smilagenin and sarsasapogenin; these compounds have the potential to serve as raw material for the synthesis of medicinally useful steroids in a laboratory setting — but this synthetic transformation does not occur spontaneously in the human body.

Flavonoids

Flavonoids are the main active components in S. glabra. Six major flavonoids isolated from a standardized S. glabra extract include astilbin (18.10%), neoastilbin (11.04%), isoastilbin (5.03%), neoisoastilbin (4.09%), engeletin (2.58%), and (−)-epicatechin (1.77%). Astilbin is considered the principal bioactive flavonoid and has received the most pharmacological attention. Astilbin has been noted for its antitumor, antidiabetic, antihypertensive, anti-hyperuricemic, and hepatoprotective potential.

Stilbenes

Stilbenes, commonly located in plant xylem, demonstrate a broad spectrum of biological functions: antioxidative, antiviral, antineoplastic, anti-inflammatory, and hypoglycemic actions, as well as modulation of insulin sensitivity and lipid metabolism. Resveratrol, a naturally occurring stilbene present in Smilax, exhibits antioxidative, anti-aging, and glucose-lowering effects, and has been associated with reduced cardiovascular disease risk.

Phytosterols and Other Compounds

Sarsaparilla contains phytosterols such as beta-sitosterol, which may contribute to the anti-inflammatory effect of the herb. Other documented constituents include stigmasterol, diosgenin, quercetin, shikimic acid, oxalic acid, fatty acids, and various phenylpropanoids. Some species contain alkaloids such as smilaxin; terpenes like steroidal saponins and volatile oils; and a variety of phenolic compounds, including pyrocatechol tannins, lignin, quinones, and flavonoids.

4. Mechanisms of Action

Anti-Inflammatory Pathways

Research on S. china extract (ES) suggests it can selectively inhibit the activity of COX-2, and its anti-inflammatory effect is associated with the inhibition of IL-1β, IL-6, and TNF-α via negative regulation of MAPK and NF-κB signaling pathways in LPS-induced THP-1 cells.

For astilbin specifically, the mechanisms of astilbin-mediated anti-inflammation and immunosuppression involve downregulating the activities of macrophages, dendritic cells, and effector T cells, and inducing regulatory B cells and T cells. Astilbin suppresses inflammatory cell function by inhibiting the PI3K/AKT, TLR4/MyD88/NF-κB, and MAPK signaling pathways and promoting the expression of SOCS3, leading to less production of IL-1β, IL-6, TNF-α, IFN-γ, and MMPs.

In an in vitro study with six isolated S. glabra flavonoids, all six flavonoids could significantly inhibit the secretion of IL-1β, IL-6, NO (p < 0.01) and the protein expression of NF-κB p-p65 (p < 0.01) in LPS-stimulated RAW264.7 cells.

Anticancer Mechanisms

Anticancer effects may be due to apoptotic induction via Bax upregulation, Bcl-2 downregulation, or cell cycle arrest and decreased mRNA expression of cyclin B1 and Cdk1 in carcinoma cells. These findings are, to date, limited to laboratory studies.

Anti-Inflammatory Effect on T-Lymphocytes

Anti-inflammatory effects may also be due to inhibition of T-lymphocyte adhesion, causing a decrease in T-cell ability to express CD44 and produce TNF-α.

Endotoxin Binding

The mechanism of action of sarsaparilla is largely unknown, although the plant does contain several saponins and has been shown to be clinically effective in the treatment of psoriasis. This evidence points to a possible effect on binding of cholesterol and bacterial toxins in the intestines. Evidence supports sarsaparilla as an endotoxin binder. Endotoxins are cell wall constituents of bacteria that are absorbed from the gut; normally, the liver filters out these and other gut-derived compounds before they reach the general circulation.

Uric Acid–Lowering Mechanisms

URAT1, a uric acid reabsorption protein, is responsible for about 90% of uric acid reabsorption in the kidneys, making it a key therapeutic target for hyperuricemia treatment. Molecular docking and metabolic studies have examined whether flavonoids from S. glabra can inhibit xanthine oxidase (XOD) and interact with URAT1 and other transporters involved in uric acid metabolism. Previous experimental studies identified flavonoids in S. glabra rhizome as potential quality markers for its uric acid-lowering pharmacodynamic effects, although the pathways through which these flavonoids exert their effects in vivo remain under investigation.

Saponins and Bioavailability Enhancement

The saponins have been shown to facilitate the body's absorption of other drugs and phytochemicals, which accounts for sarsaparilla's history of use in herbal formulas as an agent for bioavailability enhancement and to potentiate the effect of other herbs.

5. Scientific Evidence by Area of Use

5.1 Skin Conditions (Psoriasis)

The most historically cited clinical evidence for sarsaparilla relates to psoriasis. In 1942, the New England Journal of Medicine published a controlled study (Thurman, 1942, reported in Murray and Pizzorno, 1989) showing that an endotoxin-binding saponin extract of sarsaparilla was effective in reducing psoriasis symptoms. The results of a clinical study with 92 patients reported that it improved psoriasis lesions in 62% of cases and completely cleared lesions in 18% of cases.

Additionally, a 2001 U.S. patent was filed on sarsaparilla (Smilax china) for psoriasis, citing clinical observations with dosages of 3–6 g daily. It reported marked clinical improvements in patients with psoriasis vulgaris, pustular psoriasis, and erythroderma psoriaticum, and noted that upon discontinuation after two months, there was further gradual remission with no side effects.

Regarding mechanism, astilbin — the key S. glabra flavonoid — has been studied in mouse models for psoriasis-like skin lesions. Astilbin inhibits Th17 cell differentiation and ameliorates imiquimod-induced psoriasis-like skin lesions in BALB/c mice via the Jak3/Stat3 signaling pathway. This is a preclinical finding.

Evidence strength: The 1942 human study is the primary clinical reference but predates modern RCT methodology (no placebo control, no blinding reported by secondary accounts). More recent evidence is limited to in vitro and animal models. Overall, the clinical evidence for psoriasis must be considered weak by contemporary standards and in need of replication with modern trial design.

5.2 Rheumatoid Arthritis and Joint Inflammation

Anti-inflammatory activity has been observed in rat models of arthritis, but studies in humans are lacking. In a preclinical study of astilbin in a complete Freund's adjuvant (CFA)-induced arthritis rat model, daily oral administration of astilbin at 5.3 mg/kg reduced joint damage in the hind paw of adjuvant arthritis (AA) rats. Astilbin exhibited remarkable inhibitory effects on TNF-α, IL-1β, and IL-6 mRNA expression, with significant decreases in serum cytokine levels. The reduced cytokine expression was associated with protein activity suppression of key molecular targets IKKβ, NF-κB p65 subunit, and TLR adaptor MyD88. The therapeutic effects of astilbin on inhibition of cytokine production were close to those of a commonly used antirheumatic drug, leflunomide.

Evidence strength: Preliminary (animal model only). No human clinical trials have been conducted.

5.3 Hyperuricemia and Gout

Smilax has been traditionally used for centuries to treat gout, among other ailments. Modern pharmacological studies have shown that S. glabra has hypouricemic and anti-gout biological activities. Preclinical studies examined the anti-hyperuricemic effect of S. china and S. glabra in mouse models. Anti-hyperuricemic and nephroprotective effects of Smilax china L. were demonstrated in a published study in the Journal of Ethnopharmacology.

From 2000 to 2024, clustering analysis of Chinese research literature indicates that fundamental research on the pharmacodynamic substances of S. glabra and its application in treating gout and psoriasis has been a prominent research focus.

Evidence strength: Preliminary. Evidence is derived from in vitro studies and animal (mouse) models. No controlled human clinical trials have been published on hyperuricemia or gout as of the current literature search.

5.4 Anti-Infective / Syphilis and Venereal Disease

Sarsaparilla has been traditionally used for treating syphilis, leprosy, and psoriasis; however, clinical evidence to support these uses is lacking. Historical clinical observations from China, cited in Bensky and Gamble (1986), reported effectiveness in treating syphilis, but these pre-date modern trial standards.

Evidence strength: Absent by contemporary clinical standards. Only historical and ethnopharmacological reports exist.

5.5 Anticancer Activity

Smilax glabra has not been shown to treat or prevent cancer. Lab studies suggest this plant has anti-inflammatory and anticancer properties; however, clinical studies have not been conducted and it is not known if the same effects would occur in humans.

In vitro, sarsaparilla extract has been shown to inhibit cancer cell growth. Studies published in Cancer Prevention Research examined the inhibition of cancer cell growth by S. glabra rhizome extract through S-phase arrest, apoptosis, and autophagy via the redox-dependent ERK1/2 pathway (PMC-cited reference, 2015). Another study found that S. glabra extract inhibits migration and invasion of cancer cells by suppressing the TGF-β1 pathway.

Evidence strength: Preclinical only (cell line and animal studies). No human clinical evidence.

5.6 Antidiabetic / Blood Glucose Effects

Mexican people use Smilax dominguensis as a traditional medicine for diabetes control. Flavonoids isolated from this species have been studied for their antihyperglycemic and hypolipidemic activity mediated by peroxisome proliferator-activated receptors (PPARs). Regarding stilbenes, while stilbenes present a promising foundation for antihyperglycemic pharmacotherapy, current research does not substantiate a marked hypoglycemic effect from S. glabra rhizome, suggesting that these compounds may contribute to other therapeutic benefits or that their efficacy is not pronounced.

Evidence strength: Preliminary (in vitro and animal studies). Insufficient human clinical data.

5.7 Hepatoprotective Effects

Reports have shown anti-inflammatory and liver-protecting effects for sarsaparilla. Animal studies have examined the protective effects of the flavonoid-rich fraction from S. glabra rhizome against carbon tetrachloride-induced hepatotoxicity in rats. Smilax spp. contains resveratrol and oxyresveratrol, which have been shown to reduce oxidative damage in the liver caused by mitochondrial dysfunction due to nicotine. It has also been found to enhance the rate of nicotine turnover within the body by enhancing CYP2A6-mediated metabolism. This evidence suggests sarsaparilla's use as a hepatoprotective agent.

Evidence strength: Preclinical. No controlled human hepatoprotection trials.

5.8 Antioxidant Activity

Results of in vitro studies showed that (−)-epicatechin, astilbin, neoastilbin, isoastilbin, and neoisoastilbin from S. glabra had strong antioxidant activities in both DPPH and ABTS+ radical-scavenging capacities and in the FRAP (ferric reducing antioxidant power) system. These are in vitro findings with no direct translation to clinical human outcomes established.

5.9 Bodybuilding and Anabolic Claims

A review of smilax compounds present in bodybuilding supplements said to "enhance performance" examined more than 600 commercially available supplements and determined that there was no research to validate these claims. Sarsaparilla has been marketed fraudulently as containing testosterone and/or other anabolic steroids. While it is a rich source of natural plant steroids and saponins, it has never been proven to have any anabolic effects, nor has testosterone been found in sarsaparilla or any other plant source. Sarsaparilla does contain plant sterols, which can be synthesized into testosterone and estrogen in a laboratory setting; however, this process simply does not occur inside the human body.

Evidence strength: No evidence. Claims of anabolic or testosterone-boosting effects are unsupported by any published human data.

6. Body Systems and Health Areas

Isolated constituents from Smilax species exhibit a broad spectrum of pharmacological activities, including anticancer, antidiabetic, anti-inflammatory, antimicrobial, antioxidant, antiviral, immunomodulatory, and hepatoprotective effects. The body systems most historically and pharmacologically associated with Smilax include:

  • Integumentary system (skin): Psoriasis, eczema, leprosy, dermatitis — historically prominent; limited modern clinical evidence.
  • Musculoskeletal system: Rheumatism, gout, arthritis — both traditional use and preclinical pharmacological investigation.
  • Immune system: Pharmacological studies have demonstrated anti-infective, anti-cancer, anti-inflammatory, antioxidant, and cardiovascular protection effects.
  • Hepatic system: Liver protection (hepatoprotection) against chemical toxins studied in animal models.
  • Renal system: Uric acid excretion, anti-hyperuricemia studied in animal models; diuretic effects attributed to saponin content.
  • Endocrine/Metabolic system: Antidiabetic properties under investigation, primarily at preclinical level.
  • Infectious disease (historical): Syphilis, gonorrhea, leprosy — historically prominent; no modern clinical trials.

7. Dosage Forms and Reported Dosages

Typical doses of sarsaparilla for a variety of uses range from 0.3 to 2 g/day of the powdered root. Clinical trials are lacking to provide guidance on therapeutic dosages.

In the 2001 U.S. patent on Smilax china cited for psoriasis, dosages of 3–6 g daily were associated with reported clinical improvements in psoriasis patients. In preclinical arthritis research, daily oral administration of astilbin at 5.3 mg/kg in rat models reduced joint damage.

Forms available commercially include:

  • Dried root powder (encapsulated or for decoction)
  • Standardized extracts in capsule or tablet form
  • Hydroalcoholic tinctures
  • Herbal teas (decoctions)
  • Flavoring ingredient in beverages

The FDA considers sarsaparilla to be a natural flavoring substance for use in foods and drinks. The FDA has not reviewed sarsaparilla supplements for safety and effectiveness.

8. Safety Considerations and Known Interactions

General Safety Profile

No major contraindications, warnings, or side effects have been formally documented. GI irritation and increased diuresis have been reported. In unusually high doses, the plant may be harmful, including GI irritation.

Limitations of Toxicological Data

Many studies on the biological activity of S. glabra were mainly based on crude extracts and active ingredients, and there is a lack of clinical studies and toxicity studies to support the development of drug design, development, and therapy. Most current findings are derived from preliminary in vitro and in vivo studies.

Drug Interactions

Sarsaparilla may increase the absorption of digitalis and bismuth, increasing the chance of toxicity. This interaction is based on the known bioavailability-enhancing properties of saponins. Estrogenic and antiestrogenic activities have been described for extracts of at least one of the species. Drug interactions are none well documented.

Occupational Asthma

A clinically documented safety concern is occupational respiratory sensitization. A case of occupational asthma resulting from exposure to sarsaparilla (Smilax) in an herbal tea worker was described in the Journal of Allergy and Clinical Immunology (1996). A 36-year-old man first experienced rhinitis and asthma 6 months after starting employment in a factory where various herbal teas were manufactured. Occupational asthma caused by sarsaparilla root dust has been reported.

Pregnancy and Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Safety in pregnancy and lactation has not been established.

Kidney Disease

Caution has been raised in persons with pre-existing renal impairment, though the evidence base for this recommendation is not robust. Due to limited clinical study data, use of sarsaparilla cannot be recommended for any indication.

Species Confusion and Quality Issues

Many Smilax species are very similar in appearance regardless of origin, creating significant potential for misidentification and variable potency in commercial preparations. Sarsaparilla products may be made from many species of smilax including S. medica, S. officinalis, S. regelii, and S. febrifuga, but these are not the same as S. glabra, which contains different chemicals that have different effects on the body.

9. Overall Evidence Assessment

Traditional knowledge, increasingly supported by pharmacological evidence, highlights the substantial therapeutic potential of Smilax species. However, most current findings are derived from preliminary in vitro and in vivo studies. Future research should focus on clinically relevant, mechanistic, and integrative approaches to fully elucidate therapeutic potential and facilitate the development of evidence-based applications.

Although sarsaparilla products may be used for various health purposes, their benefits for any use are not well defined. The gap between preclinical pharmacology and confirmed human clinical benefit remains wide. Historical association with treating conditions such as cancer, psoriasis, eczema, and joint pain stems from an outdated belief in blood purification. While these uses are well-documented, the scientific evidence supporting them remains limited. Some studies suggest potential antifungal, anti-inflammatory, and anticancer properties, yet further research is necessary to validate these claims.

References

Health Conditions

Health conditions that Smilax may help support.

  • In vitro studies confirm strong antioxidant activity of Smilax glabra flavonoids (astilbin, neoastilbin, epicatechin) via DPPH, ABTS radical scavenging, and FRAP assays. S. china extracts show free radical scavenging and antioxidant enzyme fortification. The antioxidant activity is well characterised at the molecular level across multiple species.

  • Astilbin from Smilax glabra has been specifically studied as an immunomodulatory agent in autoimmune conditions including collagen-induced arthritis and psoriasis-like models. A 2003 US patent was awarded for smilax flavonoids in treating autoimmune diseases and inflammatory reactions. The mechanism involves selective T-cell modulation rather than broad immune suppression.

  • Multiple Smilax species (S. glabra, S. china, S. canellifolia, S. perfoliata) have demonstrated blood-glucose-lowering effects in alloxan- and streptozotocin-induced diabetic rodent models. Smilax glabra ethyl acetate extract reduced blood glucose to physiological levels in diabetic mice after two weeks. The mechanism appears insulin-dependent, suggesting an insulin-sensitising rather than secretagogue action.

  • CholesterolScientific

    Smilax saponins bind cholesterol in the intestinal tract, potentially reducing absorption, and this mechanism has been proposed since the 1980s. Early clinical observations described steroidal saponins reducing blood cholesterol. Pre-clinical data on S. china show lipid accumulation inhibition. Evidence remains largely mechanistic and animal-based.

  • Multiple in vitro and animal studies demonstrate anti-inflammatory activity for Smilax extracts and their isolated flavonoids. Key constituents astilbin and related stereoisomers suppress NF-κB signalling, inhibit IL-1β, IL-6, and TNF-α production, and reduce nitric oxide in LPS-stimulated macrophage models. Evidence remains at pre-clinical (animal/cell) level without confirmed human RCTs.

  • Rhizoma Smilacis Glabrae (S. glabra) has been used in TCM for gout for centuries and multiple pre-clinical studies demonstrate xanthine oxidase inhibition and uricosuric effects. Astilbin stereoisomers reduce serum uric acid in hyperuricemic mouse models. A combination study with etoricoxib in acute gouty arthritis showed increased efficacy, providing some clinical-context evidence.

  • Kidney HealthScientific

    Smilax glabra has been used in TCM for nephritis and kidney conditions for centuries. Animal studies demonstrate that its flavonoid-rich fractions reduce uric acid nephropathy by lowering uric acid, reducing renal oxidative stress and inflammation, and modulating renal urate transporters. A historical report showed that sarsaparilla increased urinary excretion of uric acid in chronic nephritis patients.

  • Liver DetoxScientific

    Hepatoprotective effects of Smilax extracts have been demonstrated in animal models of liver damage, and a study of S. regelii ethanol extract showed protection against CCl4-induced hepatocellular damage in rats. S. china polysaccharide activated Nrf2-ARE antioxidant pathways protecting against APAP-induced acute liver injury. The genus has a long traditional use across multiple systems for liver disease.

  • PsoriasisScientific

    Smilax (sarsaparilla) has one of its strongest documented links with psoriasis. A 1942 New England Journal of Medicine report and a later 92-patient clinical study both reported significant improvement in psoriatic lesions. The key constituent astilbin from Smilax glabra inhibits Th17 cell differentiation via the Jak3/Stat3 pathway in murine psoriasis-like models, with effects comparable to calcipotriol at lower doses.

  • Astilbin from Smilax glabra has been studied specifically in CFA-induced arthritis rat models and collagen-induced arthritis, showing suppression of Th17-mediated and NF-κB-driven joint inflammation. One case report in humans found benefit from a Smilax-containing Ayurvedic formula. Pre-clinical evidence is consistent but human RCTs have not been conducted.

  • AcneTraditional

    Sarsaparilla has documented traditional and some early experimental use for acne, attributed to its putative endotoxin-binding and anti-androgenic properties. Clinical research has validated traditional use for skin conditions including acne, though formal RCT evidence is lacking.

  • ArthritisTraditional

    Sarsaparilla has been used for centuries across indigenous Central/South American, Asian, and European herbal traditions to treat joint pain and rheumatism. Animal model studies support anti-inflammatory and anti-arthritic mechanisms, but no controlled human clinical trials confirm efficacy for arthritis specifically.

  • DermatitisTraditional

    Smilax roots have been used by Amazon shamans and indigenous practitioners for dermatitis and inflammatory skin conditions, documented in multiple ethnobotanical records. Anti-inflammatory flavonoids and saponins in the root provide a mechanistic basis, though no clinical trials in dermatitis have been conducted.

  • EczemaTraditional

    Sarsaparilla root has traditional use for eczema across indigenous American, European, and Asian herbal systems, attributed to blood-purifying and anti-inflammatory properties. The endotoxin-binding hypothesis provides a plausible modern mechanistic rationale, and the anti-inflammatory flavonoids of Smilax species are pharmacologically relevant to eczematous conditions.

  • FeverTraditional

    Sarsaparilla has a documented traditional use as a diaphoretic (sweat-promoting) and febrifuge across European, Asian, and Latin American herbal traditions. The species Smilax febrifuga is named for this use. No modern clinical evidence exists for this application.

  • Sarsaparilla has been used for centuries across Central/South American, Asian, and European traditions as an aphrodisiac and treatment for sexual impotence. Its steroidal saponins are hypothesised to mimic or modulate reproductive hormones, though testosterone has never been detected in the plant and no human RCTs confirm efficacy for libido.

  • MenopauseTraditional

    Sarsaparilla has traditional use as a hormone-balancing tonic for menopausal symptoms, attributed to its steroidal saponins which are described in some sources as phytoestrogenic. No human clinical trials have been conducted, and direct estrogenic activity in humans has not been confirmed.

  • Sarsaparilla is traditionally used as a diuretic across European, Asian, and Latin American herbal systems, and it appears in historical pharmacopoeias as a diuretic tonic. German Commission E has noted that sarsaparilla may cause increased urination. No controlled clinical trials confirm diuretic efficacy.

Body Systems

Body systems that Smilax may help support.

  • No body systems available.
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