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Mistletoe Therapy

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Mistletoe Therapy

 

Mistletoe Therapy - Introduction

The use of the mistletoe plant as a drug has a long tradition which traces back to the fourth century BC. Throughout the centuries this evergreen half-parasite was used for menstrual complains, epilepsy, ulcers, cardiac insufficiency, high blood pressure and oedemas 1,2.
The white-berried mistletoe (Viscum album L) only entered cancer setting at the beginning of the 20th century through Rudolf Steiner (1861 - 1925), the founder of Anthroposophic Medicine 3. In 1916 he first mentioned the therapeutic possibilities of mistletoe extracts in the cancer setting.

 

 

Mistletoe Extract - TheFacts

Basic research indicates that medicinal mistletoe may stimulate the immune system to fight cancer cells. Cytotoxic effects on tumour cells have been observed in animal models4,5. One study showed that mistletoe injections can attenuate airway inflammation and eosinophil infiltration6.

Studies in human beings suggest that the use of mistletoe extract alongside appropriate chemotherapy and radiotherapy may improve their tolerability by reducing their side effects and increasing quality of life, including in pancreatic7,8, lung9, colorectal10, and breast11cancers. A few studies indicate a possible positive effect on survival7,12-14, although no significant survival effects were found for patients with metastatic colorectal cancer15, melanoma16, or head and neck cancer17, and further studies are required to confirm these findings.

Other preliminary studies suggest that intravesical mistletoe extract is safe and well tolerated in patients with nonmuscle invasive bladder cancer18, and that mistletoe extract injection may be efficacious as chemical pleurodesis in patients with malignant pleural effusion19.

With regards, possible interaction with chemotherapy, two studies with 5-year follow-ups of breast cancer cancer patients, mistletoe therapy did not appear to have a negative impact on chemotherapy efficacy11 and appeared to contribute reducing disease/therapy-related sign and symptoms (e.g. mucositis, fatigue, pain, headache)20. The addition of mistletoe extract in patients with advanced solid tumours allowed for higher gemcitabine doses to be used without apparent pharmacokinetic interactions21.

 


Mechanisms of mistletoe extract action


Mistletoe extracts contain biologically active substances such as glycoproteins, especially mistletoe lectines I, II and II (ML I, ML II, ML III)22, polypeptide (e.g. viscotoxins23-25), peptides, amino acids, oligo- and polysaccharids26-27. Other molecules have also shown to have possibly beneficial properties, such as enzymes, sulphurous compounds, fats, phytosterols, triterpenes28-31, flavonoids, phenylpropanes, lignans, alkaloids, minerals, micronutrients and other proteins32,33.

Mistletoe lectins are the most investigated component. Their cytotoxic effects are partially due to ribosome-inactivating properties and induction of apoptosis34(“cell suicide”). In-vitro studies have shown that mistletoe lectins increase TNFα, IL-1, IL-2, and IL-6 cytokine secretion, stimulate immune-cell phagocytosis, induce macrophage cytotoxicity, and enhance cytotoxicity on cancer cells35
In lymphoblastic leukemia cells, mistletoe extracts stimulate dendritic cell maturation and activation36 and induce dose-dependent apoptosis through caspase-8 and -9 dependent pathways37
Studies performed in animal models have shown that apoptotic induction37 produced by mistletoe extracts rich in triterpenes were greater, and also that these extracts improved efficacy against malignant melanoma when compared with conventional extracts which reduce tumour angiogenesis38. Another component called Viscotoxins may also have tumour-inhibiting and immunestimulating properties39. However, the pro- and anti-proliferative effects produced by mistletoe extracts produced depended on dose40. Mistletoe-induced immune stimulation may explain physical improvements that contribute to increased quality of life in cancer patients34.

 

Drug interactions and side effects of Mistletoe Therapy 

Mistletoe extracts inhibit CYP3A4 and may, therefore, affect intracellular concentrations of drugs metabolised by this enzyme. However, in vitro studies show this effect only happens in very high doses and is unlikely when used in clinically relevant concentrations41,42
Raw mistletoe contains toxic constituents. Possible adverse effects of mistletoe treatment for cancer include injection site reactions, chills, and fever19,21,43-45. Long-term use may also reduce T-cell function in cancer patients46, but the majority of reactions were mild to moderate and dose-related46.

Note: The mistletoe extract is not a replacement for conventional cancer treatment and it can be considered to be used alongside appropriate conventional cancer treatments.

 

 

 

 

Mistletoe Therapy Faq's
What are the differences between AbnobaVISCUM® and Iscador®?

What are the differences between AbnobaVISCUM® and Iscador®?

  • Manufacturer: Both brands are manufactured in Germany. Although each brand does have their own way of production, both do carry out manufacture and quality control procedures according to legal regulations and in strict adherence to international standards and rules of “good manufacturing practice”, i.e. the GMP guidelines. These regulations are applied and continually updated according to the most current knowledge and technology. 
  • Evidence: From the references on my Mistletoe Therapy page, the papers which did investigate different brands of mistletoe extracts, none but one, stated them to be different. The one paper which made a difference quotes: "...ADR (adverse drug reactions) frequency differed with respect to preparation type, with Iscador® preparations showing a higher relative frequency, compared to Abnoba viscum®..."
  • Distributor: 
        • Iscador® Oral drops and injections are distributed by Customised 4U Pharmacy: tel: 0800 035 3078, fax 0800 035 3079. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.. Address: Unit 2 Regents Drive, Low Prudhoe, Industrial Estate, Northumberland, NE42 6PX
        • AbnobaViscum® injections are distributed by Village Pharmacy Charlton Ltd: tel 0208 858 0907, tel/fax 0208 265 5222. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.. Address: 9 The Village, Charlton, SE7 8UG
        • Feel free to contact them is case you do have any question.
      • Processing the prescription: Once we had our telephone consultation, I send the repeat prescription directly to the corresponding pharmacy and they will process it. For AbnobaViscum®, The Village Pharmacy usually do contact my patients within 1-2 working days to arrange payment and postage. For Iscador®, patients have to contact the Customised 4U Pharmacy (0800 035 3078) 24 hours after I did send the prescription.
      • Postage: 
        • Customised 4U Pharmacy (Iscador®) does charge £7 for postage. 
        • The Village Pharmacy (AbnobaViscum®) does charge £15 for postage.
      • Prices: you can check prices on my Mistletoe Therapy site.
      • Prescription: Both brands can be prescribed privately (£30 for prescription and telephone consultation), however, Iscador® can be prescribed on the NHS with no extra charge. For that you do need an appointment with me at The Royal London Hospital for Integrated Medicine.
      • Supply: 
        • Iscador® injections do come in boxes of 7 ampoules each and the price remains the same no matter how many boxes I do prescribe.
        • AbnobaViscum® injections do come in boxes of 8 ampoules each, and for a 4 months supply (48 ampoules) they offer a discount (check prices on my Mistletoe Therapy site). 
      • Needles and syringes: 
        • Customised 4U Pharmacy (Iscador®) does not send needles and syringes per post. For Iscador® injections you can go to your GP and request a prescription for subcutaneous needles (0,5x16mm, 25G 5/8", or insulin needles) and 1ml syringes or get them at boots or online.
        • The Village Pharmacy (AbnobaViscum®) does send needles and syringes together with the AbnobaViscum® ampoules.
I want to travel, should I take the mistletoe extract with me and do I need to keep it refrigerated?
  • If you are on Iscador® Oral drops, and you travel for less then 1 month, it will be fine to have a few weeks break from it. If you wanted to take it with you or you are leaving for more then 1 month, I recommend that you take enough supply with you. If you are traveling with an already opened bottle and the journey takes less then 8-12 hours, don't worry, otherwise, I'd recommend you take a small refrigerating box with you to keep to cool.
  • If you are on injections, and you are traveling for less then 1 week, it should be fine. If you are leaving for a longer period, I'd recommend that you take enough supply with you. If the journey takes less than 4-6 hours there shouldn't be any problem. Otherwise, I recommend you take a small refrigerating box with you to keep it cool.
Can the Mistletoe Therapy be used instead of chemotherapy?

The Mistletoe Therapy is not a replacement for conventional medicine and it can be considered to be used alongside appropriate conventional cancer treatments.

Studies have shown that the Mistletoe Therapy can reduce side effects of conventional treatments such as chemotherapy, radiotherapy and hormone therapy. In addition, it seems to increase their tolerability, increasing the likelihood of continuity on recommending dosages.

Chemical interference on treatment outcome, according to research, appears unlikely. Read more

For how long should I take the Mistletoe Therapy?

The overall duration of treatment is not restricted but will be individualised in each case.

Generally, after two years of continuous treatment, the frequency of injection can be reduced to 2 ampoules (2 injections) per week.

From the 3rd year onwards, treatment-free intervals can be taken, always adapted specially to each case.

After 5-7 years in total (from the beginning of treatment) treatment can be discontinued, or switched to oral drops if the patient’s condition and prognosis are favourable.

Iscador® Oral Drops are generally recommended to be taken continuously for 2 years. From the 3rd year onwards, treatment-free intervals are recommended in a progressively increasing regime, always adapted to each case. Generally, the recommended overall duration is 5 years, however, in some cases, therapy can be extended up to ten years (from the 6th year up to the 10th year, treatment-free intervals will progressively exceed treatment intervals).

How should I take the Iscador® Oral Drops?

The standard recommendation is to take 6 drops in the morning and 9 drops in the evening, from Monday to Friday only, for 3 weeks and then to have one full week break before a new bottle is started. Variations may be recommended to adjust to each case.

I did forget to take the Iscador® Oral Drops, what should I do?

If you didn’t take the drops in the morning, you can take them in together with drops in the evening. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take you 6 drops in the morning, then take 15 drops in the evening and continue as usual the following day)

If you didn’t take the drops in the evening, you can take them in together with drops the next morning. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take you 9 drops in the evening, then take 15 drops the next morning and continue as usual having 9 drops in the evening)

If you missed a complete day of treatment, divide the number of drops in 2 half and add each half on the following two treatment days. (Example: you usually take 6 drops in the morning and 9 in the evening, and you missed one day: 6+9=15, 15/2=8, 15+8=23, so for the next two days you have 23 drops in total, 10 drops in the morning and 13 drops in the evening)

If you didn’t take the drops on a Friday, take them on Saturday.

In order to gain the most benefits from the mistletoe therapy, make sure that you take them as prescribed and following the instructions.

How should I store the Iscador® Oral drops?

Before opening, Iscador® Oral Drops should be stored at room temperature (15 - 25 ºC).

Once opened, Iscador® Oral Drops should be stored in the fridge (2 - 8 ºC).

The expiry of Iscador® Oral Drops is 3 weeks from opening.

How should I store the ampoules containing mistletoe extract?

The mistletoe extract has been protected from oxidation under the strictest conditions during the entire manufacturing process. For this reason, injections must be given immediately after breaking open the ampoules; the contents of opened ampules cannot be used at a later time.
Ampoules containing brown-coloured liquid may not be used as this indicates that the preparation has been exposed to oxygen and spoiled.

AbnobaVISCUM® 20 mg to 0.02 mg strengths and all Iscador® ampoules must be stored in the fridge (2 to 13 °C). The ampoules may not be frozen. If ampoules are transported, e.g. from the pharmacy to the patient’s home, continual cooling at the above-mentioned temperatures is not necessary. However, extreme temperatures such as frost or heat (over 25 °C) should be avoided.

There are no particular storage recommendations for abnobaVISCUM D6 to D30 strengths. These ampoules do not have to be kept in the fridge, although they should not be stored or transported at temperatures above 25 °C.

How should I take the mistletoe injections?

Standard regime recommends having 3 injections weekly, on Mondays, Wednesdays and Fridays, at any time of the day.

Adjustments can be recommended as part of an individualised treatment considering each patient’s situation.

I do have a red patch around the injection site, is it normal?

Yes! The skin provides us with reliable information about how your body reacts to the mistletoe extract. Check Are there any side effects? for more information.

If you have any question, please, contact me.

 

 

What is the Cost of Mistletoe Therapy 

The cost of mistletoe treatment varies depending on the brands (Iscador, Abnoba )and forms (drops or injections).


Brand & Form

Iscador® Oral drops*

£36.40

(1 bottle)

£135.60

(4 bottles)

£188.40

(6 bottles)

Iscador® plain ampoules**

£78.00

(1 box, 7 amps)

£546.00

(7 boxes, 49 amps)

£780.00

(10 boxes, 70 amps)

Iscador® Series ampouls**

£128.00

(2 boxes, 14 amps)

£512.00

(8 boxes, 56 amps)

£640.00

(10 boxes, 70 amps)

AbnobaViscum®*** 0.02 - 2 mg ampoules

£81.00

(1 box, 8 amps)

£407.00

(6 boxes, 48 amps)

-

 

AbnobaViscum®*** 20mg ampoules

£87.00 

(1 box, 8 amps)

£433.00

(6 boxes, 48 amps)

 

 

 

*Iscador® Oral drops +£10 for packaging and postage. Prescription fee is included.

**Iscador® ampoules: +£7 for packaging and postage. Prescription fee in not included (+£30).

***AbnobaViscum® ampoules: +£15 for packaging and postage. Prescription fee in not included (+£30).

Please note that prices are subject to any price increases from the manufacturer.

 

 

More Information:

 Cancer Research UK www.cancerhelp.org.uk Helpline: 0808 800 404 (free, only UK)

Macmillan Cancer Support www.macmillan.org.uk Helpline: 0808 808 0000 (free, only UK)

Camphill Wellbeing Trust http://www.mistletoetherapy.org.uk/ NHSinform.

Cancer Information Online at your fingerTIPS (Tailored information for the People of Scotland) www.nhsinform.co.uk/cancer/TIPS

 

 

 

References:

  • https://www.mskcc.org/cancer-care/integrative-medicine/herbs/mistletoe-european

1. Kienle G., Kiene H. (2003) Verträglichkeit, Nebenwirkungen, Überempfindlichkeitsreaktionen, Toxizität. In: Kienle G., Kiene H., Die Mistel in der Onkologie. Fakten und konzeptionelle Grundlagen. Stuttgart: Schattauer 2003, 591–607.
2. Büssing A: Biological and pharmacological properties of Viscum album L. In Büssing A (Ed): Mistletoe - The Genus Viscum. Harwood Academic Publishers, Amsterdam, 124-182 (2000).
3. Kienle GS, Kiene H, Albonico HU: Anthroposophic Medicine: Effectiveness, Utility, Costs, Safety. Stuttgart, New York: Schattauer Verlag; 2006.
4. Struh CM, Jager S, Schempp CM, et al. A novel triterpene extract from mistletoe induces rapid apoptosis in murine B16.F10 melanoma cells. Phytother Res. Oct 2012;26(10):1507-1512. doi: 10.1002/ptr.4604
5. Beuth J, Ko HL, Schneider H, et al. Intratumoral application of standardized mistletoe extracts down regulates tumor weight via decreased cell proliferation, increased apoptosis and necrosis in a murine model. Anticancer Res. Nov-Dec 2006;26(6B):4451-4456.
6. Shen JJ, Chiang MS, Kuo ML, et al. Partially purified extract and viscolin from Viscum coloratum attenuate airway inflammation and eosinophil infiltration in ovalbumin-sensitized mice. J Ethnopharmacol. Jun 1 2011;135(3): 646-653. doi: 10.1016/j.jep.2011.03.065
7. Troger W, Galun D, Reif M, et al. Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer. Dec 2013;49(18):3788-3797. doi: 10.1016/j.ejca.2013.06.043
8. Troger W, Galun D, Reif M, et al. Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int. Jul 21 2014;111(29-30):493-502, 433 p following 502.
9. Bar-Sela G, Wollner M, Hammer L, et al. Mistletoe as complementary treatment in patients with advanced non- small-cell lung cancer treated with carboplatin-based combinations: a randomised phase II study. Eur J Cancer. Mar 2013;49(5):1058-1064. doi: 10.1016/j.ejca.2012.11.007
10. Friedel WE, Matthes H, Bock PR, et al. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. J Soc Integr Oncol. Fall 2009;7(4): 137-145.
11. Troger W, Zdrale Z, Stankovic N, et al. Five-year follow-up of patients with early stage breast cancer after a randomized study comparing additional treatment with Viscum album (L.) extract to chemotherapy alone. Breast Cancer (Auckl). 2012;6:173-180. doi: 
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12. Ostermann T, Raak C, Bussing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009;9:451. doi: 10.1186/1471-2407-9-451
13. Grossarth-Maticek R, Kiene H, Baumgartner SM, et al. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health Med. May-Jun 2001;7(3):57-66, 68-72, 74-56 passim.
14. Grossarth-Maticek R, Ziegler R. Randomised and non-randomised prospective controlled cohort studies in matched-pair design for the long-term therapy of breast cancer patients with a mistletoe preparation (Iscador): a re-analysis. Eur J Med Res. Nov 30 2006;11(11):485-495.
15. Bar-Sela G, Haim N. Abnoba-viscum (mistletoe extract) in metastatic colorectal carcinoma resistant to 5- fluorouracil and leucovorin-based chemotherapy. Med Oncol. 2004;21(3):251-254. doi: 10.1385/MO:21:3:251
16. Kleeberg UR, Suciu S, Brocker EB, et al. Final results of the EORTC 18871/DKG 80-1 randomised phase III trial. rIFN-alpha2b versus rIFN-gamma versus ISCADOR M versus observation after surgery in melanoma patients with either high-risk primary (thickness >3 mm) or regional lymph node metastasis. Eur J Cancer. Feb 2004;40(3): 390-402.
17. Steuer-Vogt MK, Bonkowsky V, Ambrosch P, et al. The effect of an adjuvant mistletoe treatment programme in resected head and neck cancer patients: a randomised controlled clinical trial. Eur J Cancer. Jan 2001;37(1):23-31.
18. Rose A, El-Leithy T, vom Dorp F, et al. Mistletoe Plant Extract in Patients with Nonmuscle Invasive Bladder Cancer: Results of a Phase Ib/IIa Single Group Dose Escalation Study. J Urol. Oct 2015;194(4):939-943.
19. Cho JS, Na KJ, Lee Y, et al. Chemical Pleurodesis Using Mistletoe Extraction (ABNOVAviscum((R)) Injection) for Ann Thorac Cardiovasc Surg. 2016;22(1):20-26.
20. Beuth J, Schneider B, Schierholz JM. Impact of complementary treatment of breast cancer patients with standardized mistletoe extract during aftercare: a controlled multicenter comparative epidemiological cohort study. Anticancer Res. Jan-Feb 2008;28(1b):523-527.
21. Mansky PJ, Wallerstedt DB, Sannes TS, et al. NCCAM/NCI Phase 1 Study of Mistletoe Extract and Gemcitabine in Patients with Advanced Solid Tumors. Evid Based Complement Alternat Med. 2013;2013:964592. doi: 10.1155/2013/964592
22. Franz H, Ziska P, Kindt A: Isolation and properties of three lectins from mistletoe ( Viscum album L.). Biochemical Journal 1981, 195:481-484.
23. Winterfeld K, Bijnen AB: Viscotoxin, ein neuer Inhaltsstoff der Mistel ( Viscum album L.). Liebigs Ann Chem 1948, 561:107- 115.
24. Urech K, Scher JM, Hostanska K, Becker H: Apoptosis inducing activity of viscin, a lipophilic extract from Viscum album L. Journal of Pharmacy and Pharmacology 2005, 57 101-109.
25. Winterfeld K, Kronenthaler A: Zur Chemie des blutdrucksenkenden Bestandteils der Mistel. (Viscum album). Arch Pharm 1942, 280:103-115.
26. Mueller EA, Anderer FA: A Viscum album oligosaccharide activating human natural cytotoxicity is an interferon gamma inducer. Cancer Immunol Immunother 1990, 32:221-227.
27. Klett CY, Anderer FA: Activation of natural killer cell cytotoxicity of human blood monocytes by a low molecular weight component from Viscum album extract. Arzneimittel-Forschung/Drug Research 1989, 39 (II)(12):1580-1585.
28. Struh CM, Jager S, Kersten A, Schempp CM, Scheffler A, Martin SF: Triterpenoids amplify antitumoural effects of mistletoe extracts on murine B16.f10 melanoma in vivo. PLoS One 2013, 8(4):e62168.
29. Delebinski CI, Jaeger S, Kemnitz-Hassanin K, Henze G, Lode HN, Seifert GJ: A new development of triterpene acid- containing extracts from Viscum album L. displays synergistic induction of apoptosis in acute lymphoblastic leukaemia. Cell Prolif 2012, 45(2):176-187.
30. Kleinsimon S, Kauczor G, Jaeger S, Eggert A, Seifert G, Delebinski C: ViscumTT induces apoptosis and alters IAP expression in osteosarcoma in vitro and has synergistic action when combined with different chemotherapeutic drugs. BMC Complement Altern Med 2017, 17(1):26.
31. Twardziok M, Kleinsimon S, Rolff J, Jager S, Eggert A, Seifert G, Delebinski CI: Multiple Active Compounds from Viscum album L. Synergistically Converge to Promote Apoptosis in Ewing Sarcoma. PLoS One 2016, 11(9):e0159749.
32. Saller R., Kramer S., Iten F., Melzer J. (2005) Unerwünschte Wirkungen der Misteltherapie bei Tumourpatien- ten – Eine systematische Übersicht. In: Scheer R., Bauer R., Becker H., Fintelmann V., Kemper F. H., Schil- cher H. (Hrsg.), Fortschritte in der Misteltherapie: Aktueller Stand der Forschung und klinische Anwendung. Essen: KVC Verlag 2005, 367–403.
33. Urech et al.: Triterpenes of mistletoe (VIscum album) in the “bird-lime” Viscin and its antiprolifertive activity. In Scheer R et al (Ed): Fortschritte in Der Misteltherapie. KVC Verlag, Essen, 133-144 (2005)
34. Melzer J, Iten F, Hostanska K, et al. Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forsch Komplementmed. Aug 2009;16(4):217-226. doi: 10.1159/000226249
35. Goebell PJ, Otto T, Suhr J, et al. Evaluation of an unconventional treatment modality with mistletoe lectin to prevent recurrence of superficial bladder cancer: a randomized phase II trial. J Urol. Jul 2002;168(1):72-75.
36. Elluru SR, Duong van Huyen JP, Delignat S, et al. Induction of maturation and activation of human dendritic cells: a mechanism underlying the beneficial effect of Viscum album as complimentary therapy in cancer. BMC Cancer. 2008;8:161. doi: 10.1186/1471-2407-8-161
37. Delebinski CI, Jaeger S, Kemnitz-Hassanin K, et al. A new development of triterpene acid-containing extracts from Viscum album L. displays synergistic induction of apoptosis in acute lymphoblastic leukaemia. Cell Prolif. Apr 2012;45(2):176-187. doi: 10.1111/j.1365-2184.2011.00801.
38. Struh CM, Jager S, Kersten A, et al. Triterpenoids amplify anti-tumoral effects of mistletoe extracts on murine B16.f10 melanoma in vivo. PLoS One. 2013;8(4):e62168. doi: 10.1371/journal.pone.0062168
39. Kleijnen J, Knipschild P. Mistletoe treatment for cancer review of controlled trials in humans. Phytomedicine. Dec 1994;1(3):255-260. doi: 10.1016/S0944-7113(11)80073-5
40. Lyu SY, Park WB. Effects of Korean mistletoe lectin (Viscum album coloratum) on proliferation and cytokine expression in human peripheral blood mononuclear cells and T-lymphocytes. Arch Pharm Res. Oct 2007;30(10): 1252-1264.
41. Weissenstein U, Kunz M, Urech K, et al. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complement Altern Med.2014;14:6. doi: 10.1186/1472-6882-14-6
42. Engdal S, Nilsen OG. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients.Phytother Res. Jul 2009;23(7):906-912. doi: 10.1002/ptr.2750
43. Huber R, Eisenbraun J, Miletzki B, et al. Pharmacokinetics of natural mistletoe lectins after subcutaneous injection.Eur J Clin Pharmacol. Sep 2010;66(9):889-897. doi: 10.1007/s00228-010-0830-5
44. Schad F, Atxner J, Buchwald D, et al. Intratumoral Mistletoe (Viscum album L) Therapy in Patients WithUnresectable Pancreas Carcinoma: A Retrospective Analysis. Integr Cancer Ther. Jul 2014;13(4):332-340.
45. Steele ML, Axtner J, Happe A, et al. Use and safety of intratumoral application of European mistletoe (Viscumalbum L) preparations in Oncology. Integr Cancer Ther. Mar 2015;14(2):140-148.
46. Bussing A, Stumpf C, Troger W, et al. Course of mitogen-stimulated T lymphocytes in cancer patients treated withViscum album extracts. Anticancer Res. Jul-Aug 2007;27(4C):2903-2910.
47. Steele ML, Axtner J, Happe A, et al. Adverse Drug Reactions and Expected Effects to Therapy with SubcutaneousMistletoe Extracts (Viscum album L.) in Cancer Patients. Evid Based Complement Alternat Med.2014;2014:724258. doi: 10.1155/2014/724258
Related articles:
48. Huber R, Ludtke R, Klassen M, et al. Effects of a mistletoe preparation with defined lectin content on chronichepatitis C: an individually controlled cohort study. Eur J Med Res. Sep 28 2001;6(9):399-405.
49. Horneber MA, Bueschel G, Huber R, et al. Mistletoe therapy in oncology. Cochrane Database Syst Rev.2008(2):CD003297. doi: 10.1002/14651858.CD003297.pub2
50. Bar-Sela G. White-berry mistletoe (Viscum album L.) as complementary treatment in cancer: Does it help? Eur JIntegr Med. 2011;3:e55-e62.
51. de Giorgio A, Stebbing J. Mistletoe: for cancer or just for Christmas? Lancet Oncol. Dec 2013;14(13):1264-1265.doi: 10.1016/s1470-2045(13)70560-6
52. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. Mar 2002;109(3):227-235.
53. Evens ZN, Stellpflug SJ. Holiday plants with toxic misconceptions. West J Emerg Med. Dec 2012;13(6):538-542.doi: 10.5811/westjem.2012.8.12572
54. Rosell S, Samuelsson G. Effect of mistletoe viscotoxin and phoratoxin on blood circulation. Toxicon. Aug1966;4(2):107-110.
55. Finall AI, McIntosh SA, Thompson WD. Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract. BMJ. Dec 23 2006;333(7582):1293-1294. doi: 10.1136/bmj.39044.460023.BE
56. Hall AH, Spoerke DG, Rumack BH. Assessing mistletoe toxicity. Ann Emerg Med. Nov 1986;15(11):1320-1323.
57. Kim HJ, Kim H, Ahn JH, et al. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern
Complement Med. Mar 2015;21(3):180-185.

 

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Last modified on 10 May 2019
Dr Saskia H. Kloppenburg Vieth

Consultant in General Internal Medicine and Specialist in Complementary Cancer Care
MBBS, MRCIM (Spain), MSc Homeopathy, MFHom, Master practitioner in Ericksonian Hypnotherapy and Neurolinguistic Programming, MSc in Nutrition
(GMC reg. number: 7541548)
Integrative medicine Doctor and Holistic Medicine Practitioner