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What is it?

Maritime pine trees (Pinus pinaster) grow in countries on the Mediterranean Sea. Its bark may be helpful for asthma and improved leg circulation.

Maritime pine contains chemicals that might improve blood flow, stimulate the immune system, reduce swelling, prevent infections, and have antioxidant effects. Maritime pine trees that grow in southwest France are used to make Pycnogenol, the trademarked name for a specific maritime pine bark extract.

Maritime pine bark extract is used for asthma, high cholesterol, decline in memory, ADHD, and many other conditions, but there is no good scientific evidence to support many of these uses.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for MARITIME PINE are as follows:

Possibly effective for…

  • Asthma. Taking a specific maritime pine bark extract (Pycnogenol) by mouth daily, along with asthma medications, seems to decrease asthma symptoms and the need for rescue inhalers in children and adults with asthma. Keep in mind that maritime pine bark extract shouldn’t be used in place of asthma medicine.
  • Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI). Taking a specific maritime pine bark extract (Pycnogenol) by mouth seems to reduce leg pain and heaviness, as well as swelling, in people with circulation problems.
  • Osteoarthritis. Taking a specific maritime pine bark extract (Pycnogenol) by mouth might improve some symptoms of knee osteoarthritis. It also might reduce the need for pain medications in some people.

Possibly ineffective for…

  • High cholesterol. Taking a specific maritime pine bark extract (Pycnogenol) doesn’t lower low-density lipoprotein (LDL or “bad”) cholesterol in people with high cholesterol.

There is interest in using maritime pine bark for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Is it safe?

When taken by mouth: A specific maritime pine bark extract (Pycnogenol) is possibly safe when taken in doses of 50-450 mg daily for up to one year. It might cause dizziness and stomach problems in some people.

When applied to the skin: A specific maritime pine bark extract (Pycnogenol) is possibly safe when used as a cream for up to 7 days or as a powder for up to 6 weeks.

Special precautions & warnings:

Pregnancy: Taking a specific maritime pine bark extract (Pycnogenol) is possibly safe when used in late pregnancy. But until more is known, it should be used cautiously or avoided during pregnancy.

Breast-feeding: There isn’t enough reliable information to know if maritime pine is safe to use when breast-feeding. Stay on the safe side and avoid use.

Children: A specific maritime pine bark extract (Pycnogenol) is possibly safe to take by mouth for up to 3 months in children 6-18 years of age.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Maritime pine might cause the immune system to become more active, and this could increase the symptoms of auto-immune diseases. If you have one of these conditions, it’s best to avoid using maritime pine.

Bleeding conditions: Taking high doses of maritime pine might increase the risk of bleeding in people with bleeding conditions.

Surgery: Maritime pine might slow blood clotting and reduce blood sugar. There is some concern that it might cause blood sugar to go too low and increase the chance of bleeding during and after surgery. Stop using maritime pine at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Medications for diabetes (Antidiabetes drugs)
Maritime pine might lower blood sugar levels. Taking maritime pine along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Medications that decrease the immune system (Immunosuppressants)
Maritime pine can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking maritime pine along with these medications might decrease the effects of these medications.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Maritime pine might slow blood clotting. Taking maritime pine along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Are there interactions with herbs and supplements?

Herbs and supplements that might lower blood sugar
Maritime pine might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.
Herbs and supplements that might slow blood clotting
Maritime pine might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

Are there interactions with foods?

There are no known interactions with foods.

How is it typically used?

Maritime pine bark extract has most often been used by adults at a dose of 50 mg, taken 2-3 times daily, for up to one year. It’s also used in various products, including creams and topical powders. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

Other names

Condensed Tannins, Écorce de Pin, Écorce de Pin Maritime, Extrait d’Écorce de Pin, French Marine Pine Bark Extract, French Maritime Pine Bark Extract, Leucoanthocyanidins, Maritime Bark Extract, Oligomères de Procyanidine, Oligomères Procyanidoliques, Oligomeric Proanthocyanidins, OPC, OPCs, PCO, PCOs, Pine Bark, Pine Bark Extract, Pinus pinaster, Pinus maritima, Proanthocyanidines Oligomériques, Procyanidin Oligomers, Procyanodolic Oligomers, Pycnogenol, Pycnogénol, Pygenol, Tannins Condensés.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

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  2. Cesarone MR, Hu S, Belcaro G, et al. Pycnogenol®-Centellicum® supplementation improves lung fibrosis and post-COVID-19 lung healing. Minerva Med 2022;113:135-140. View abstract.
  3. Malekahmadi M, Shadnoush M, Islam SMS, et al. The effect of French maritime pine bark extract supplementation on inflammation, nutritional and clinical status in critically ill patients with traumatic brain injury: A randomized controlled trial. Phytother Res 2021;35:5178-5188. View abstract.
  4. Cotellese R, Hu S, Cesarone MR, et al. Pycnogenol® supplementation prevents inflammation and symptoms in recurrent, non-severe urinary infections. Panminerva Med 2021;63:343-348. View abstract.
  5. Ledda A, Hu S, Cesarone MR, et al. Pycnogenol® Supplementation Prevents Recurrent Urinary Tract Infections/Inflammation and Interstitial Cystitis. Evid Based Complement Alternat Med 2021;2021:9976299. View abstract.
  6. Zhao H, Wu J, Wang N, Grether-Beck S, Krutmann J, Wei L. Oral pycnogenol intake benefits the skin in urban Chinese outdoor workers: a randomized, placebo-controlled, double-blind, and crossover intervention study. Skin Pharmacol Physiol 2021;34:135-45. View abstract.
  7. Majidi Z, Ansari M, Maghbooli Z, et al. Oligopin supplementation mitigates oxidative stress in postmenopausal women with osteopenia: a randomized, double-blind, placebo-controlled trial. Phytomedicine 2021;81:153417. View abstract.
  8. Lima PB, Dias JAF, Esposito ACC, Miot LDB, Miot HA. French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double-blind, randomized, placebo-controlled trial. J Eur Acad Dermatol Venereol 2021;35:502-8. View abstract.
  9. Navval-Esfahlan E, Rafraf M, Asghari S, Imani H, Asghari-Jafarabadi M, Karimi-Avval S. Effect of French maritime pine bark extract supplementation on metabolic status and serum vascular cell adhesion molecule-1 levels in patients with type 2 diabetes and microalbuminuria. Complement Ther Med 2021;58:102689. View abstract.
  10. Manabe K, Kaidzu S, Tsutsui A, et al. Effects of French maritime pine bark/bilberry fruit extracts on intraocular pressure for primary open-angle glaucoma. J Clin Biochem Nutr 2021;68:67-72. View abstract.
  11. Aldret RL, Bellar D. A Double-Blind, Cross-Over Study to Examine the Effects of Maritime Pine Extract on Exercise Performance and Postexercise Inflammation, Oxidative Stress, Muscle Soreness, and Damage. J Diet Suppl. 2020;17:309-20. View abstract.
  12. Cesarone MR, Belcaro G, Agus GB, et al. Chronic venous insufficiency and venous microangiopathy: management with compression and Pycnogenol®. Minerva Cardioangiol. 2019;67:280-7. View abstract.
  13. Hu S, Hosoi M, Belcaro G, et al. Management of mild, primary Raynaud Syndrome: supplementation with Pycnogenol®. Minerva Cardioangiol. 2019;67:392-8. View abstract.
  14. Cesarone MR, Belcaro G, Hosoi M, et al. Supplementary management with Pycnogenol® in Parkinson’s disease to prevent cognitive impairment. J Neurosurg Sci. 2020;64:258-62. View abstract.
  15. Vinciguerra G, Belcaro G, Feragalli B, et al. PycnoRacer®, a fitness drink including Pycnogenol®, improves recovery and training in the Cooper test. Panminerva Med 2019;61:457-63. View abstract.
  16. Belcaro G, Cesarone MR, Cornelli U, et al. Xerostomia: prevention with Pycnogenol® supplementation: a pilot study. Minerva Stomatol. 2019;68:303-7. View abstract.
  17. Cesarone MR, Belcaro G, Scipione C, et al. Prevention of vaginal dryness in perimenopausal women. Supplementation with Lady Prelox®. Minerva Ginecol. 2019;71:434-41. View abstract.
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  20. Smetanka A, Stara V, Farsky I, Tonhajzerova I, Ondrejka I. Pycnogenol supplementation as an adjunct treatment for antidepressant-induced sexual dysfunction. Physiol Int. 2019;106:59-69. View abstract.
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  22. Ledda A, Belcaro G, Feragalli B, et al. Benign prostatic hypertrophy: Pycnogenol supplementation improves prostate symptoms and residual bladder volume. Minerva Med. 2018;109:280-284. View abstract.
  23. Hu S, Belcaro G, Ledda A, et al. Behçet syndrome: effects of Pycnogenol supplementation during regression phases. Minerva Cardioangiol. 2018;66:386-390. View abstract.
  24. Hadi A, Pourmasoumi M, Mohammadi H, Javaheri A, Rouhani MH. The impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials. Phytother Res. 2019;33:276-287. View abstract.
  25. Feragalli B, Dugall M, Luzzi R, et al. Pycnogenol: supplementary management of symptomatic osteoarthritis with a patch. An observational registry study. Minerva Endocrinol. 2019;44:97-101. View abstract.
  26. Belcaro G, Dugall M, Hu S, et al. Prevention of recurrent venous thrombosis and post-thrombotic syndrome. Minerva Cardioangiol. 2018;66:238-245. View abstract.
  27. Belcaro G, Cornelli U, Dugall, M, Hosoi M, Cotllese R, Feragalli B. Long-haul flights, edema, and thrombotic events: prevention with stockings and Pycnogenol supplementation (LONFLIT Registry Study). Minverva Cardioangiologica. 2018 Apr;66:152-9. View abstract.
  28. Ezzikouri S, Nishimura T, Kohara M, et al. Inhibitor effects of Pycnogenol on hepatitis C virus replication. Antiviral Res. 2015 Jan;113:93-102. View abstract.
  29. Belcaro G, Luzzi R, Hu S, et al. Improvement in signs and symptoms in psoriasis patients with Pycnogenol supplementation. Panminerva Med. 2014 Mar;56:41-8. View abstract.
  30. Belcaro G, Gizzi G, Pellegrini L, et al. Pycnogenol in postpartum symptomatic hemorrhoids. Minerva Ginecol. 2014 Feb;66:77-84. View abstract.
  31. Belcaro G, Dugall M, Hosol M, et al. Pycnogenol and centella asiatica for asymptomatic atherosclerosis progression. Int Angiol. 2014 Feb;33:20-6. View abstract.
  32. Ikuyama S, Fan B, Gu J, Mukae K, Watanabe H. Molecular mechanism of intracellular lipid accumulation: suppressive effect of Pycnogenol in liver cells. Functional Foods in Health & Disease 203;3:353-364.
  33. Luzzi R, Belcaro G, Hu S, et al. Improvement in symptoms and cochlear flow with Pycnogenol in patients with Meniere’s disease and tinnitus. Minerva Med. 2014 Jun;105:245-54. View abstract.
  34. Belcaro G, Cesarone R, Steigerwalt J, et al. Jet-lag: prevention with Pycnogenol. Preliminary report: evaluation in healthy individuals and in hypertensive patients. Minerva Cardioangiol. 2008 Oct;56(5 Suppl):3-9. View abstract.
  35. Matsumori A, Higuchi H, Shimada M. French maritime pine bark extract inhibits viral replication and prevents development of viral myocarditis. J Card Fail. 2007 Nov;13:785-91. View abstract.
  36. Belcaro G, Luzzi R, Dugall M, Ippolito E, Saggino A. Pycnogenol improves cognitive function, attention, mental performance and specific professional skills in healthy professionals aged 35-55. J Neurosurg Sci. 2014 Dec;58:239-48. View abstract.
  37. Sarikaki V, Rallis M, Tanojo H, et al. In vitro percutaneous absorption of pine bark extract (Pycnogenol) in human skin. J Toxicol 2004;23:149-158.
  38. Luzzi R, Belcaro G, Hosoi M, et al. Normalization of cardiovascular risk factors in pre-menopausal women with Pycnogenol. Minerva Ginecol. 2017 Feb;69:29-34. View abstract.
  39. Valls RM, Llaurado E, Fernandez-Castillo S, et al. Effects of low molecular weight procyanidin rich extract from French maritime bark on cardiovascular disease risk factors in stage-1 hypertensive subjects: randomized, double-blind, crossover, placebo-controlled intervention trial. Phytomedicine. 2016 Nov 15;23:1451-61. View abstract.
  40. Hosoi M, Belcaro G, Saggino A, Luzzi R, Dugall M, Feragalli B. Pycnogenol supplementation in minimal cognitive dysfunction. J Nuerosurg Sci. 2018 Jun;62:279-284. View abstract.
  41. Belcaro G, Dugall M, Ippolito E, Hus S, Saggino A, Feragalli B. The COFU3 Study. Improvement in cognitive function, attention, mental performance with Pycnogenol in healthy subjects (55-70) with high oxidative stress. J Neurosurg Sci 2015 Dec;59:437-46.
  42. Belcaro G, Dugall M. Preservation of muscular mass and strength in aged subjects with Pycnogenol supplementation. Minerva Ortopedica e Traumatologica 2016 Sept;67:124-30.
  43. Belcaro G, Dugall M, Luzzi R, Ippolito E, Cesarone MR. Postpartum varicose veins: supplementation with pycnogenol or elastic compression-A 12-month follow-up. Int J Angiol. 2017 Mar;26:12-19. View abstract.
  44. Belcaro G, Gizzi G, Pellegrini L, et al. Pycnogenol supplementation improves the control of irritable bowel syndrome symptoms. Panminerva Med. 2018 Jun;60:65-89. View abstract.
  45. Belcaro G. A clinical comparison of pycnogenol, antistax, and stocking in chronic venous insufficiency. Int J Angiol. 2015 Dec;24:268-74. Epub 2015 Jul 15. View abstract.
  46. Luzzi R, Belcaro G, Ippolito E. Carotid plaque stabilization induced by the supplement association Pycnogenol and centella asiatica (Centellicum). Minerva Cardioangiol. 2016 Dec;64:603-9.
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