Mistletoe therapy is a complementary cancer therapy. The Integrated and Holistic Healthcare clinic offers mistletoe therapy consultations in London. However, If you do not live in London, you can still benefit from the therapy as online consultations are available for patients living in other parts of the UK, Europe and Worldwide.
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 which is mostly associated Christmas and Santa, was used by healthcare professionals and doctors for menstrual complaints, epilepsy, ulcers, cardiac insufficiency, high blood pressure and oedemas 1,2.
The white-berried mistletoe (Viscum album L) only entered cancer setting as alternative and complementary cancer medicine 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 therapy acts on many levels: On the one hand, it boosts the immune system by multiplying and activating the immune cells. On the other, mistletoe therapy can induce apoptosis (the process of natural cell death) in tumour cells, which results in the inhibition of tumour growth.
Healthy tissue is not adversely affected by this. On the contrary, immune cells and other healthy cells are protected against further injury, e.g. damage caused by cytostatic drugs.
Patients report that mistletoe therapy significantly improves their quality of life.
For example:
- Improvement of general condition and quality of life through
◦ Increased performance and vigour, less fatigue
◦ Normalised body rhythms including body temperature, sleep and digestion
◦ Increased appetite
◦ Reduced nausea and vomiting
◦ Greater emotional well-being
◦ Reduced depression and anxiety
- Reduction of adverse reactions to conventional therapies (e.g. chemo- or radiotherapy), in particular, cancer-related fatigue
- Alleviation of tumour-related pain
This mode of action makes mistletoe therapy a key supplement to standard oncological therapy.
The mistletoe extract can be taken orally, however, the most researched route of administration is via subcutaneous injections two or three times per week.
Oral drops are only provided by Iscador®. Other administration routes, such as intratumoral and intrapleural have been described. The mistletoe extract can also be administered intravenously as an off-label application.
If you are interested in having the Mistletoe extract in an IV infusion, please, do not hesitate to contact us.
Basic research results indicate that medicinal mistletoe may stimulate the immune system to fight cancer cells. Cytotoxic effects on tumour cells have been observed in animal models 4,5. One study data showed that mistletoe injections can attenuate airway inflammation and eosinophil infiltration in different types of cancers.6
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 pancreatic 7,8, lung 9, colorectal10, and breast cancers.11 A few studies indicate a possible positive effect on survival 7,12-14, although no significant survival effects were found for patients with metastatic colorectal cancer15, melanoma16, or head and neck cancer 17, 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, to possible interaction with chemotherapy, in two studies with 5-year follow-ups of breast cancer patients, mistletoe therapy did not appear to have a negative impact on chemotherapy efficacy11 and appeared to contribute to reducing disease/therapy-related signs and symptoms (e.g. mucositis, fatigue, pain, headache)20. The addition of mistletoe extracts in patients with advanced solid tumours allowed for higher gemcitabine doses to be used without apparent pharmacokinetic interactions21.
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 leukaemia 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 was 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 immune-stimulating 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.
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 patients, but the majority of reactions were mild to moderate and dose-related 46.
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.
These brands are manufactured in Germany. Although each brand does have its own way of production, all 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.
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®.."
Based on my experience, there is also individuality to be taken into consideration. Some patients have shown to respond particularly well to one specific brand (which again is different in each case).
The clinical response can be assessed easily by monitoring the cutaneous reaction around the injection site, and measuring the temperature on a daily basis may be indicated in some cases.
You can read more about each brand by clicking on their logo above.
IMPORTANT NOTE: The mistletoe extract does need a medical prescription and the therapy does require medical supervision. Do not trust any product available online without a medical prescription.
Initial call free of charge.
The cost of the actual mistletoe therapy depends on the dose that triggers the optimum response of your immune system. This, we cannot forecast and Dr Kloppenburg will provide close supervision until the optimum dose has been reached. Thereafter, a maintenance dose will be prescribed and a 4-months supply can be sent. At this stage, the cost will reduce significantly.
In a nutshell:
Supervision and prescription fee: £60.00
The cost of the Mistletoe ampoules depends on the dose, ranging from £80.00 to £138.00 per box* (2.5 weeks supply)
Packing and Postage (next day guaranteed delivery) £12.00
Needles and syringes £5.00 per box
All together means a cost of £274.00 every 5 weeks for the first 20 weeks. Thereafter, the cost of the ampoules will increase gradually according to the dose (see priceless below).
Usually, we send a 5-weeks supply after every dose adjustment until the optimum reaction is obtained. This can take between one and nine months, however, most patients experience optimum response within three to four months, some even during the first month.
Price list of each box (8 ampoules):
1mg = £80.00
5mg = £80.00
10mg = £80.00
20mg = £80.00
30mg = £88.00
50mg= £95.00
100mg= £138.00
*Import charges due to BREXIT regulation apply (20%)
** Prices shown refer to Helixor®.
Unfortunately, since April 2018 Mistletoe Therapy is no longer funded by the NHS. At the Royal London Hospital for Integrated Medicine (RLHIM), patients can get a prescription free of charge during their appointment, however, they have to pay for the mistletoe therapy themselves. Iscador® is the only brand available at the RLHIM and the pharmacy does sell needles and syringes.
Mistletoe Therapy is available Worldwide
Mistletoe Therapy is available no matter where you are*.
Technology nowadays allows us to stay connected almost worldwide and via telephone or video calls, you can get your individualised holistic care plan directly into your home.
Consultations can be held in English, Spanish or German.
*Limitations may apply due to international export/import licences. Please, contact us for more information
Our aim is to make it as easy, quick and cost-efficient as possible. Therefore, we have created the following system:
The most frequent “side effect” is actually a reaction on your skin around the injection site. This local inflammatory reaction correlates to your immune response and allows me to adjust the dose you need.
Other side effects, such as dizziness, flu-like sensation, itch, fatigue or even slightly increased temperature or enlarged lymph nodes may also occur, however, these are less frequent. In any case, patients under my care can always contact me (I want my patients to feel supported and well-looked after).
Extremely rare side effects are diarrhoea, weakness, allergic reaction including anaphylactic shock
All three brands are manufactured in Germany. Although each brand does have their own way of production, all 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.
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®..."
Iscador® Oral drops and injections are distributed by Customised 4U Pharmacy: tel: 0800 035 3078, fax 0800 035 3079. Email: enquiries@customised4upharmacy.co.uk. Address: Unit 2 Regents Drive, Low Prudhoe, Industrial Estate, Northumberland, NE42 6PX
AbnobaViscum® injections are distributed by
The Pharmacy at Mayfair and Clinic
6 Shepherd Market
Mayfair
London
W1J 7QD
Helixor® is the only brand which is available worldwide and has different contact details depending on the country. Check out www.helixor.com for more information.
Customised 4U Pharmacy (Iscador®) does charge £7 for postage.
The Pharmacy at Mayfair and Clinic (AbnobaViscum®) does charge £15 for postage.
Helixor® shipping prices depend on where you live.
The Pharmacy at Mayfair and Clinic (AbnobaViscum®) does send needles and syringes together with the AbnobaViscum® ampoules.
Customised 4U Pharmacy (Iscador®) and Helixor® do not send needles and syringes per post. You can go to your GP and request a prescription for subcutaneous needles (0,5x16mm, 25G 5/8", or insulin needles) and 1ml or 2ml syringes, or get them at boots or online.
Please, avoid insulin syringes (1ml syringe with a fixed needle). If needed, I will give you a prescription for needles and syringes for only £5.
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 and literature review, appears unlikely.
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).
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.
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 your 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 to 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.
Before opening, Iscador® Oral Drops should be stored at room temperature (15 - 25 °C).
Once opened, Iscador® Oral Drops should be stored in the fridge (2 - 8 °C).
The expiry of Iscador® Oral Drops is 3 weeks from opening.
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 ampoules 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.
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.
Yes! The skin provides us with reliable information about how your body reacts to the mistletoe extract.
If you have any other questions, please, contact us.
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
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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.