Mullein is a wonderful, abundant herb used for a number of children’s conditions. In this article we will explore the clinical research, safety and efficacy of Mullein (Verbascum thapsus) for use in children.
Introduction
Mullein, scientifically known as Verbascum thapsus, is a versatile flowering plant belonging to the Scrophulariaceae family, widely recognized for its medicinal properties across various cultures throughout history. Native to Europe, Asia and North Africa, mullein has also naturalized in other regions, including North America, where it thrives in diverse habitats such as meadows, roadsides, and wastelands. From ancient civilizations to contemporary herbal medicine, mullein has been revered for its diverse pharmacological properties ranging from its soothing effects on respiratory ailments to its potential as an anti-inflammatory and anti-microbial agent. As scientific interest in herbal remedies continues to grow, mullein remains a subject of limited modern research despite its millennia-long history of clinical use. This extensive traditional usage provides valuable support for further research endeavors aimed at verifying and substantiating its clinical efficacy and safety profile in contemporary healthcare practices.
Identifying mullein (Verbascum thapsus)
Mullein is often found in areas of disturbed soil in full sun. It can be discovered along roadsides, fence posts, meadows, construction sites and other neglected areas. Mullein is characterized by its tall, erect stalk adorned with large, soft, and fuzzy leaves, and bright yellow flowers blooming in a spiral. The plant can reach a height of 5-10 feet tall if left undisturbed. The leaves are bluish gray-green and fuzzy, typically 5-10 inches long (up to 12 inches). Mullein leaves are known by experienced hikers to be a great alternative to toilet paper, given their size and softness.
Traditional Uses
Mullein, with its storied history, unfolds as a botanical tapestry woven with diverse threads of traditional uses across cultures and centuries. Mullein is indigenous to northern Africa, western and central Asia and Europe and has been used as a medicine since ancient times as exemplified by Pedanius Dioscorides, a Greek botanist, and physician, advocated for Mullein’s use in pulmonary diseases over two millennia ago.1–3
Mullein transcends the realms of utility, delving into superstitions and mysticism. Throughout the Middle Ages, Mullein was believed to possess the power to control demons. Greek legends attribute a stalk of Mullein to Ulysses, given by the gods for protection against enchantments. In Homer’s Odyssey, Odysseus is given a plant, widely thought by scholars to be verbascum, as a talisman of protection against Circe.4
As a medicine, Mullein species have played a significant role in Spanish folk medicine for treating diverse pathologies for centuries. Notably, it was commonly employed topically for circulatory system diseases including hemorrhoid treatment through sitz baths or direct application of plant decoction. Additionally, Mullein was utilized for digestive ailments, respiratory disease, musculoskeletal conditions, skin issues and sense-organ ailments such as conjunctivitis and otitis media.5
The arrival of Mullein in North America can be traced back to Puritans in the late 1630s, who introduced its seeds for medicinal gardens. It was also used by early settlers to poison fish so they were easier to collect and harvest.6
Despite being non-indigenous, Native Americans quickly embraced Mullein, using its naturally furry leaves to line moccasins and applying pigment from its crushed yellow flowers as war paint during times of conflict. They would also brew Mullein tea to soothe sore throats, and apply leaf poultices for ailments such as abscesses, bruises, and burns and crafting beads from its roots for teething babies.7
Early Naturopathic Use
The “Fathers of Naturopathic Medicine,” Benedict Lust and Sebastian Kneipe, left a significant legacy in the early 20th century with their insights into herbal remedies. Among the many plants they studied and wrote about, mullein stood out for its remarkable medicinal properties. Sebastian Kniepe, in his 1900 writing, highlighted mullein’s effectiveness in treating a range of upper respiratory complaints. He wrote: “ All sorts of throat complaints… from a simple catarrh in the throat to the worst obstructions of phlegm in the throat and chest… are removed by either tea of mullein, tea of sage leaves, tea of basil or tea of hyssop.”8
Similarly, Benedict Lust echoed Kneip’s sentiments in his 1920 publication in the Herald of Health and Naturopath, emphasizing mulleins efficacy for sore throats and mucus-related issues. Lust provided a vivid description of mullein’s habitat and cultivation, noting its popularity among older generations and immigrant communities. He lauded mullein as an excellent remedy, particularly during winter, for throat afflictions and respiratory issues such as catarrhs and chest congestion.8
“This plant grows on stony hillocks and in quarries, and it is also cultivated in many parts of the country. It is in bloom all summer. Old people and peasant immigrants from the old world hold it in great repute, and there’s a reason. It will be found to furnish an excellent remedy, especially in the winter, for the affections of the throat incident to that season, and also for catarrhs, mucus on the chest and scatiness of breath.” 8
Adding to the discourse, M.G. Young contributed to the discussion on mullein’s therapeutic potential in a 1916 issue of the Herald of Health and Naturopath. Young advocated for the use of ground mullein, combined with sassafras and hot water, as a superior application for various conditions characterized by swelling and congestion, including swollen face, chronic abscess, and localized “dropsies” (referred to as swelling under the skin and generally known today as “edema”). He emphasized mullein’s rapid pain-relieving and swelling reducing effects, making it a valuable remedy in such cases. 8
The plant’s journey through history showcases its resilience, adaptability, and the myriad ways it has intertwined with human cultures, ranging from ancient remedies to contemporary herbal practices. Mullein stands as a testament to the enduring relationship between humanity and the botanical world, offering lessons in resourcefulness, healing, and the rich tapestry of cultural interconnectedness.
Phytochemistry
In a noteworthy study conducted in 2021, researchers compared bibliographic evidence of Mullein used in folkloric traditional Spanish medicine with research on active constituents to better understand potential actions and applications. Their in silico findings not only corroborated experimental results from previous research but also highlighted the potential biological activities of these phytochemicals. Key constituents including flavonoids (such as luteolin, quercetin, apigenin, and kaempferol), terpenes (ursolic acid), and other compounds (e.g., acacetin, apigetrin, cynaroside) exhibit affinities with crucial inflammatory molecules. The study underscores flavones and flavonols’ affinity for arachidonic acid-lipoxygenase (LOX), indicating potential anti-inflammatory mechanisms. Certain compounds also show interactions with NADPH oxidase-4 (NOX4) and pro-inflammatory cytokines, supporting anti-inflammatory effects. Verbascum demonstrates diverse anti-inflammatory effects through compounds such as cynaroside, supporting traditional applications in digestive and respiratory contexts; for musculoskeletal conditions, it shows promise for pain and inflammation management, while its dermatologic applications, including otitis treatment, are rationalized by specific anti-inflammatory compounds like apigenin. In circulatory diseases, flavonoids demonstrate antioxidant and vasodilatory activities, explaining cardiovascular protective actions, while antihypertensive effects are linked to a-adrenergic antagonist activity. Verbascum’s potential infectious diseases, including COVID-19, is suggested emphasizing flavonoids’ interactions with viral targets. In essence, Verbascum’s traditional uses seem to align with its bioactive compounds, offering avenues for further investigation, especially given the compounds’ anti-inflammatory potential.5,9
| Terpenes | Catalposide, Specioside, Buddlindeterpene B, ursolic acid, Verbascoside, poliumoside |
| Flavonoids | Apigenin, apigenin-7-glucuronide, apigetrin, cynaroside, luteolin, luteolin-7-glucuronide, quercetin, 3’-methylquercetin, kaempferol, rutin, acacetin, acacetin-7-o-a-d-glucoside |
Is Mullein safe in children? Is Mullein safe in pregnancy or lactation?
Pregnancy, Lactation: According to Mills and Bone, mullein root, leaf and flower are deemed safe for use during pregnancy or lactation, with no known contraindications, warnings, adverse reactions, or drug interactions.10 However, Mosby’s Handbook of Drug-herb Interactions suggests a potential concern related to the high mucilage content in mullein, which could interfere with the absorption of certain oral medication.11 To mitigate this risk, it is advised to administer mullein at least 2 hours before or after taking medication. Additionally, it is important to consider the potential for irritation from the leaf hairs when preparing mullein-based remedies. Given the historical use as a fish poison, mullein seeds are not recommended for consumption.
Children and infants: The safety of mullein for infants has been a topic of debate. The concern is related to its potential effects on infants who spend much of their time in horizontal positions. The worry is that the thinning mucus could possibly worsen infections by facilitating their spread deeper into the lungs. While I have not personally observed this phenomenon, I do feel confident in recommending its use in children over 6 months of age who are able to sit independently.
Of course, dosing is a consideration for all medicines given to children (botanical or not!). For children, doses should be adjusted for body size. Mullein flower oil is considered “possibly safe” when applied to the external ear canal, short-term.12 It is important to ensure the eardrum is intact before administration and I would recommend parents consult their pediatrician before use.
Medicinal Use of Mullein (Verbascum thapsus)
Despite its extensive historical usage, conventional research on mullein as a medicinal aid is limited. Notably, there is an absence in current research supporting Mullein’s primary historical use for upper respiratory symptoms. The majority of available literature consists of in silico or in vitro studies, with very few published in vivo studies. These studies report on the potential anti-inflammatory and antimicrobial effects of Mullein. Henceforth, I will refer to Mullein by its scientific name to remain true to the published research.
Why in vitro studies matter:
In vitro studies play a crucial role in the initial assessment of a substance’s potential therapeutic effects. While they may not replicate the complex environment of the human body entirely, the provide valuable insights into a substance’s mechanisms of action and its effects on specific pathogens or conditions. These studies serve as a foundational step in the research process, guiding further investigation into the substance’s safety and efficacy before clinical trials are conducted. Therefore, while in vitro findings should be interpreted cautiously and validated through clinical studies, they provide essential preliminary data that inform subsequent research directions and potential therapeutic applications.
The information derived from these experimental studies showcase a plethora of biological and pharmacological attributes. These include antiviral, antioxidant, analgesic, sedative, anti-inflammatory, hypnotic, antibacterial, antifungal, and anticancer properties.1 Below details the current evidence supporting verbascum for a variety of pediatric applications including ear pain, STD prevention, and infection management. I would have liked to see more evidence on the use of Mullein for respiratory diseases to corroborate its historical use, yet no in vitro studies were accessible.
Herbal comfort: A Natural Solution for Ear Pain
A 2001 study aimed to evaluate the effectiveness and tolerance of Otikon Otic Solution, a naturopathic herbal extract, in comparison to Anaesthetic ear drops for alleviating ear pain associated with acute otitis media (AOM). Otikon contains Allium sativum, Verbascum thapsus, Calendula flores, and Hypericum perforatum in olive oil, while Anaesthetic drops include ametocaine and phenazone in glycerin. In a randomized trial involving 103 children aged 6 to 18 with AOM-related otalgia, both treatment groups demonstrated comparable outcomes in terms of age, sex, laterality of AOM, and effectiveness in symptom improvement. The study found a statistically significant improvement in ear pain scores throughout the 3-day assessment period, concluding that Otikon, of naturopathic origin, is as effective as Anaesthetic ear drops and is suitable for managing AOM-associated ear pain. This suggests a potential alternative treatment with naturopathic extracts for ear pain associated with acute otitis media.13
In 2003, a study assessed the effectiveness of Naturopathic Herbal Extract Ear Drops (NHED) compared to conventional treatments for ear pain in children with acute otitis media (AOM). Conducted as a double-blind trial with 171 participants, all treatment groups, including NHED alone, NHED with anesthetic, and oral amoxicillin, exhibited significant improvement in ear pain over 3 days. Notably, NHED outperformed controls, and patients using ear drops alone experienced a better response than those combining ear drops with amoxicillin. The findings suggest that naturopathic herbal extract solutions, especially NHED, may be advantageous for managing AOM-related ear pain in children, irrespective of concurrent antibiotic treatment, underscoring the potential of alternative approaches in addressing pediatric ear pain.14
Mullein’s Mighty Powers: Combatting Worms, Bacteria and Viruses
Children are particularly susceptible to infections due to their still-developing immune systems and frequent interactions with other children in school and daycare settings. In the face of these challenges, the exploration of natural remedies with potent antimicrobial and anthelmintic properties becomes increasingly relevant. Verbascum has emerged as a promising candidate in this regard. Recent research endeavors have unveiled its remarkable capabilities in combating various infectious agents, ranging from worms and bacterias to viruses. These findings shed light on verbascum’s potential as a therapeutic agent to address the health concerns commonly encountered in pediatric populations.
In 2012, researchers aimed to explore the antispasmodic and anthelmintic properties of crude aqueous methanolic extract of v. thaspus. Results demonstrated effectiveness against Ascardia galli (roundworms) and Raillietina spiralis (tapeworms), with paralysis occurring more rapidly at higher extract concentrations. Additionally, v. thaspus showed potent relaxation activity on rabbit’s jejunum sections and exhibited significant wormicidal effect compared to albendazole (conventional antihelmethic medicine), suggesting its therapeutic potential as a spasmodic and anthelmintic agent.15
A 2016 study published in the Journal of Medicinal Plants Studies investigated the antibacterial activity of methanolic and acetone leaf extracts of v. thaspus against various human pathogens. Results revealed significant antibacterial activity against E. coli, Yersinia pestis, Bacillus cerus, Pseudomonas aeruginosa, Listeria monocytogenes, and Staphylococcus aureus, with methanolic leaf extract showing greater efficacy compared to acetone leaf extract. Additionally, both extracts exhibited higher inhibition of gram-positive bacteria than gram-negative bacteria, suggesting their potential for further therapeutic exploration.16
Findings from a recent study on the antiviral activity of methanolic extract from verbascum may be effective against influenza A virus. Even at minimum concentrations (6.25 ug/ml), the extract exhibited 50% efficacy. The potency of the anti-influenza viral activity appears to be influenced by the quantity of these active compounds present in the plants, which can vary based on factors such as geographical distribution, seasonal collection and environmental conditions. Importantly, the research found no toxicity associated with higher doses, highlighting its safety profile.17 Additional anti-viral findings are noted below in research elucidating the efficacy of verbascum on herpes simplex virus.
Holistic Adolescent Health: Research on use of Mullein for Effective STD Management
In the realm of pediatric medicine, it is essential to address a spectrum of health concerns affecting adolescents, and one pressing issue is the risk of sexually transmitted diseases (STDs or STIs). While this topic may raise concerns for parents and clinicians alike, it’s crucial to approach it with sensitivity and awareness. In this section, we delve into the potential of Verbascum thapsus as a therapeutic avenue for Trichomonas vaginalis and Herpes Simplex Virus. By focusing on innovative and natural solutions, we aim to empower parents and clinicians to engage in open conversations about adolescent health, ensuring a comprehensive and proactive approach to addressing potential challenges.
Trichomoniasis is a sexually transmitted disease (STD) caused by a tiny parasite called Trichomonas vaginalis. Metronidazole is used as routine treatment of disease. Some reports have confirmed the potential carcinogenic and teratogenic effects of this drug on fetus and indication of drug resistance.
In 2015, verbascum thapsus extract’s effects on T. vaginalis were assessed across various concentrations. Evaluation included toxicity on mice macrophages using MMT ([3-(4,5-dimethyl thiazolyl-2)- 2,5-diphenyle tetrazolium bromide ]) assay and apoptosis induction via Flow Cytometry. Results indicated significant apoptosis induction and low toxicity, suggesting Verbascum thaspus as a promising candidate for further medical studies.18
A followup study in 2018 by the same researchers investigated the anti-trichomonal activity of alcoholic extracts from a combination of Verbascum thapsus and Zingiber officinale on Trichomonas vaginalis. Metronidazole, a standard treatment, served as a positive control. The results confirmed that alcoholic extract combination induces programmed cell death in T. vaginalis without harming macrophages.19
Traditionally, Herpes Simplex Virus type 1 (HSV-1) has been associated with oral lesions, commonly known as cold sores. However, there is growing clinical recognition of HSV-1 as a sexually transmitted infection, particularly contributing to geneital herpes cases. In light of this shift in transmission patterns, there’s an urgent need to identify effective agents to combat the spread of HSV-1. Way back in 1987, a preliminary phytochemical analysis of lyophilized infusion from Verbascum flowers (FVI) revealed the presence of flavonoids, iridoids, phenolic acids, saponins, amino acids, free sugars and mucilages. IN vitro studies assess the antiviral activity of FVI against Herpes simplex 1 virus (HSV-1). Results indicated a significant decrease in virus titer by approximately 2.5 log at non-toxic FVI concentrations. Additionally, the plaque reduction test conducted in Vero cells revealed 50% inhibition of virus plaques at 190 micrograms/ml of FVI. Furthermore, FVI exhibited a virucidal effect against HSV.20 Further research is needed to fully comprehend the potential of verbascum in treating HSV infections. However, understanding its antiviral properties is crucial as it presents a promising avenue for a natural and safe alternative to conventional medications in managing HSV-1 infections.
Conclusion
The exploration of mullein’s medicinal properties offers valuable insights into its diverse therapeutic applications, rooted in centuries of traditional use across various cultures. From its ancient origins in European medicine to its integration into contemporary herbal practices, mullein’s rich history underscores its versatility in addressing a myriad of health concerns. Despite its extensive traditional usage, modern research on mullein remains limited, highlighting the need for further investigation to substantiate its clinical efficacy and safety profile.
Through studies on phytochemical composition and therapeutic properties, mullein emerges as a promising candidate for combating infections, acting as an anti-inflammatory and analgesic agent. These findings not only reaffirm mullein’s historical significance, but also pave the way for its integration into holistic approaches to pediatric health, offering natural solutions for conditions such as ear pain, STIs, and respiratory infections. I can personally attest to mullein’s efficacy, particularly in addressing common pediatric ailments like otitis media and dry coughs and use this herb regularly with my patients.
As we continue to unravel mullein’s mighty powers, it becomes increasingly evident that this botanical gem holds immense potential for enhancing pediatric healthcare through its multifaceted healing properties.
References
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