Stella Lucia Volpe, Ph.D., R.D., L.D.N., FACSM, is professor and chair of the Department of Nutrition Science at Drexel University, Philadelphia, PA. Her degrees are in both Nutrition and Exercise Physiology; she also is ACSM Certified Clinical Exercise SpecialistSM and a registered dietitian. Dr. Volpe’s research focuses on obesity and diabetes prevention using traditional interventions and mineral supplementation and, more recently, by altering the environment to result in greater physical activity and healthy eating. Dr. Volpe is an associate editor of ACSM’s Health & Fitness Journal®.
Disclosure: The author declares no conflicts of interest and does not have any financial disclosures.
Pycnogenol® is the U.S. registered trademark term for a product that is made from the pine bark of the French maritime pine tree, Pinus pinaster. Peanut skin, grape seed, and witch hazel bark all have the same active ingredients as does Pycnogenol (5).
No caption available...Image Tools
There have been many suggested uses for Pycnogenol, including treatment for circulation problems, high blood pressure, muscle soreness, generalized pain, allergies, asthma, ringing in the ears, osteoarthritis, diabetes mellitus, attention deficit hyperactivity disorder, heart disease, stroke, menopausal symptoms, painful menstrual cycles, erectile dysfunction, and retinopathy (5). It seems that Pycnogenol can solve all problems! Of course, we know, this is not true!
Pycnogenol seems to be safe when taken in doses of 50 mg to 450 mg daily for up to 6 months, although most research studies have not been conducted for long periods to assess these doses. Some adverse side effects of Pycnogenol include dizziness, gastrointestinal upset, headaches, and ulcers in the mouth. Furthermore, although Pycnogenol is likely safe during late pregnancy, it is recommended that women who are pregnant or breast feeding avoid consuming this nutriceutical. In addition, individuals with autoimmune diseases, such as lupus, rheumatoid arthritis, or multiple sclerosis, should avoid the use of Pycnogenol (5).
Pycnogenol has been evaluated for its effect on many of the previously mentioned conditions and found to be of none to limited benefit, but it also has been studied for its effects on varicose veins, blood lipid levels, cognitive function, and exercise performance (5). It is these latter four topics that will be discussed in this Nutritionist’s View column.
PYCNOGENOL AND VARICOSE VEINS
There are many people who suffer from varicose veins, perhaps including some of your clients, and many may undergo a procedure to correct the problem. Varicose veins are visible on the surface of the skin and appear as large and bulging vessels usually in the legs (6). Pycnogenol has been studied to determine if it can improve the venous tone of varicose veins. Belcaro et al. (2) assessed the stretching and dilatation of vein segments ex vivo (meaning “outside of the body”) in participants who had primary varicose veins compared with those who also had primary varicose veins but also took 150 mg/day of Pycnogenol for 3 months before surgery to remove them. The researchers compared 30 venous segments from the participants who used Pycnogenol for 3 months with those of 10 participants who did not take Pycnogenol. They compared venous segments from both of these groups with normal healthy venous segments. They found that the participants who supplemented with Pycnogenol had venous segments that significantly were more elastic and significantly had better tone than both those with varicose veins who did not take Pycnogenol and normal vein segments. Thus, in this study, where the researchers used ex vivo segments, Pycnogenol seemed to improve venous tone and elasticity. How this would carry over to improving venous tone of those with varicose veins within the body is still not known. So, at this time, it does not seem prudent to suggest to someone with varicose veins to take Pycnogenol.
PYCNOGENOL AND BLOOD LIPID CONCENTRATIONS
Heart disease is one of the leading causes of death in the United States, and although regular exercise and healthy eating are two of the main factors that can prevent heart disease, research is conducted on other methods as well. Sahebkar (3) conducted a meta-analysis (a statistical analysis incorporating many like studies conducted in this area) on the effects of Pycnogenol on blood lipid levels. Sahebkar (3) included controlled clinical trials that examined the effects of Pycnogenol supplementation on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations.
The researcher included a total of 7 clinical trials with a total of 442 participants (226 who supplemented with Pycnogenol; 216 in the control group). Based on this meta-analysis, there were no differences in any of the lipid concentrations between those who supplemented with Pycnogenol and those who were given a placebo.
Thus, at this time, there is no evidence that Pycnogenol supplementation will affect blood lipid levels positively. More research needs to be conducted to assess if dose and duration need to be better controlled.
PYCNOGENOL AND COGNITIVE FUNCTION
Some research has shown that Pycnogenol improves cognitive function in individuals.
Belcaro et al. (1) conducted a 12-week product evaluation registry study to evaluate Pycnogenol supplementation on cognitive function, attention, and mental performance in healthy professionals with “increased oxidative stress in a professional context.” Thirty healthy professionals were assigned to take 150 mg/day of Pycnogenol or act as controls for the study period. At baseline, cognitive function, attention, and oxidative stress values were similar between groups. After 12 weeks, those taking Pycnogenol significantly had greater improvements in cognitive function, memory, and oxidative stress (lower free radical production). Although some of the changes were small, they significantly were different compared with the controls. Based on this small study, it seems that Pycnogenol might improve cognitive function, but results from randomized, double-blind, placebo-controlled trials are needed before making any recommendations about Pycnogenol and cognitive function.
PYCNOGENOL AND EXERCISE PERFORMANCE
No caption available...Image Tools
So, now that we have discussed Pycnogenol with respect to health and disease, does it work as an ergogenic aid? Vinciguerra et al. (4) conducted another registry study to assess the effects of Pycnogenol on physical fitness using the Army Physical Fitness Test (APFT). They conducted this study to examine the efficacy of Pycnogenol use as a supplement and its efficacy for improved exercise performance, recovery, and oxidative stress.
Vinciguerra et al. (4) conducted the study in two parts. First, 100 mg/day of Pycnogenol was supplemented in healthy individuals during an 8-week preparation and training program to evaluate its effects on physical fitness. In Part 2 of their study, they examined the effects of 150 mg/day of Pycnogenol supplementation in triathletes.
Results from Part 1 revealed significant improvement in the 2-mile run time of healthy men and women in both groups; however, the 74 participants who supplemented with 100 mg/day of Pycnogenol significantly ran faster than the 73 control participants. The Pycnogenol group also performed a greater number of push-ups and sit-ups (as part of the APFT), and its oxidative stress significantly was lower than that of the control group.
With respect to the triathletes, in 32 men who supplemented with Pycnogenol, a faster triathlon time was observed compared with that in the 22 control triathletes (89 minutes 44 seconds vs. 96 minutes 5 seconds, respectively). In addition, those who supplemented with Pycnogenol significantly had less cramps and lower oxidative stress than those in the control group. Thus, from this two-part study, it seems that Pycnogenol supplementation might be an effective ergogenic aid, but caution must be taken. This is just one study, and thus, more studies are needed to evaluate Pycnogenol further as an ergogenic aid. Specifically, randomized, double-blind, placebo-controlled trials need to be conducted on various types of athletes before any definitive conclusions.
Pycnogenol is a fairly new supplement that is being studied among various types of populations. It is advanced as an antioxidant and, thus, may have beneficial effects on oxidative stress and perhaps be beneficial in some disease states. It also may be effective as an ergogenic aid. Nonetheless, many more studies need to be conducted before the use of Pycnogenol as a supplement for any of the conditions discussed. In addition, Pycnogenol-medication interactions have not been identified, which are always important to assess to prevent serious adverse events from occurring. The main goal of this Nutritionist’s View article was to bring this supplement to your attention and to ensure that you learn more about it as more research is conducted.
1. Belcaro G, Dugall M, Luzzi R, Hosoi M, Corsi M. Improvements of venous tone with pycnogenol in chronic venous insufficiency: an ex vivo
study on venous segments. Int J Angiol. 2014; 23 (1): 47–52.
2. Belcaro G, Luzzi R, Dugall M, Ippolito E, Saggino A. Pycnogenol® improves cognitive function, attention, mental performance and specific professional skills in healthy professionals age 35–55. J Neurosurg Sci. 2014 Mar 28. [Epub ahead of print].
3. Sahebkar A. A systematic review and meta-analysis of the effects of Pycnogenol on plasma lipids. J Cardiovasc Pharmacol Ther. 2014; 19 (3): 244–55.
4. Vinciguerra G, Belcaro G, Bonanni E, et al. Evaluation of the effects of supplementation with Pycnogenol® on fitness in normal subjects with the Army Physical Fitness Test and in performances of athletes in the 100-minute triathlon. J Sports Med Phys Fitness. 2013; 53 (6): 644–54.
Rohdewald P. A review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology. Int J Clin Pharmacol Ther. 2002; 40 (4): 158–68.
Lui X, Wei J, Tan F, Zhou S, Wurthwein G, Rohdewald P. Pycnogenol®, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004; 74 (7): 855–62.
© 2014 American College of Sports Medicine.