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Pycnogenol


What is it?

Pycnogenol is the US registered trademark name for a product derived from the pine bark of a tree known as Pinus pinaster. The active ingredients in pycnogenol can also be extracted from other sources, including peanut skin, grape seed, and witch hazel bark.

Pycnogenol is used for treating circulation problems, allergies, asthma, ringing in the ears, high blood pressure, muscle soreness, pain, osteoarthritis, diabetes, attention deficit-hyperactivity disorder (ADHD), a disease of the female reproductive system called endometriosis, menopausal symptoms, painful menstrual periods, erectile dysfunction (ED), and an eye disease called retinopathy.

It is also used for preventing disorders of the heart and blood vessels, including stroke, heart disease, and varicose veins.

Pycnogenol is used to slow the aging process, maintain healthy skin, improve athletic endurance, and improve male fertility.

Some people use skin creams that contain pycnogenol as “anti-aging” products.

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 PYCNOGENOL are as follows:

Possibly effective for...

  • Allergies. Some research in people with allergies to birch shows that taking pycnogenol starting before allergy season begins might reduce allergy symptoms.
  • Circulation problems. Taking pycnogenol by mouth seems to significantly reduce leg pain and heaviness, as well as fluid retention in people with circulation problems. Some people use horse chestnut seed extract to treat this condition, but pycnogenol alone appears to be more effective.
  • Disease of the retina in the eye. Taking pycnogenol daily for two months seems to slow or prevent further worsening of retinal disease caused by diabetes, atherosclerosis, or other diseases. It also seems to improve eyesight.
  • Improved endurance in athletes. Young people (age 20-35) seem to be able to exercise on a treadmill for a longer time after taking pycnogenol daily for about a month.
  • High blood pressure. Pycnogenol seems to lower systolic blood pressure (the first number in a blood pressure reading) but does not significantly lower diastolic blood pressure (the second number).
  • Asthma in children.
  • Varicose veins.

Possibly ineffective for...

  • Attention deficit-hyperactivity disorder (ADHD).

Insufficient evidence to rate effectiveness for...

  • Blood clots in the vein (deep vein thrombosis, DVT). There is some evidence that taking a specific combination product (Flite Tabs) might help to prevent DVT during long-haul plane flights. The product combines a blend of 150 mg of pycnogenol plus nattokinase. Two capsules are taken 2 hours before the flight and then again 6 hours later.
  • High cholesterol. Pycnogenol seems to lower “bad cholesterol” (low-density lipoprotein (LDL) cholesterol).
  • Pelvic pain in women. There is preliminary evidence that pycnogenol might help reduce pelvic pain in women with endometriosis or severe menstrual cramps.
  • Pain in late pregnancy. Preliminary research suggests that taking 30 mg of pycnogenol daily reduces lower back pain, hip joint pain, pelvic pain, and pain due to varicose veins or calf cramps in the last three months of pregnancy.
  • Erectile dysfunction (ED). Limited research suggests pycnogenol, used alone or in combination with L-arginine, might improve sexual function in men with ED. It seems to take up to three months of treatment for significant improvement.
  • Aging.
  • Heart disease.
  • Stroke prevention.
  • Muscle soreness.
  • Leg cramps.
  • Circulation problems in diabetes.
  • Osteoarthritis.
  • Menopausal symptoms.
  • Ringing in the ears (tinnitus).
  • Other conditions.
More evidence is needed to rate pycnogenol for these uses.

How does it work?

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Pycnogenol contains substances that might improve blood flow. It might also stimulate the immune system and have antioxidant effects.

Are there safety concerns?

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Pycnogenol is POSSIBLY SAFE when taken in doses of 50 mg to 450 mg daily for up to 6 months. Pycnogenol can cause dizziness, gut problems, headache, and mouth ulcers.

Special precautions & warnings:

Pregnancy and breast-feeding: Preliminary research suggests pycnogenol might be safe in late pregnancy. But until more is known, pycnogenol should be avoided by women who are pregnant or breast-feeding.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Pycnogenol 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 pycnogenol.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Medications that decrease the immune system (Immunosuppressants)
Pycnogenol seems to increase the immune system. By increasing the immune system, pycnogenol might decrease the effectiveness of medications that decrease the immune system.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Are there interactions with herbs and supplements?

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There are no known interactions with herbs and supplements.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For allergies: 50 mg twice daily.
  • For asthma in children: 1 mg per pound of body weight given in two divided doses.
  • For poor circulation: 45-360 mg daily, or 50-100 mg three times daily.
  • For diseases of the retina, including those related to diabetes: 50 mg three times daily.
  • For mild high blood pressure: 200 mg of pycnogenol daily.
  • For improving exercise capacity in athletes: 200 mg daily.

Other names

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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, Pycnogénol, Pygenol, Tannins Condensés.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Pycnogenol page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/1019.html.

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  3. Durackova, B. Trebatický V. Novotný I. Žit®anová J. Breza. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction - a pilot study. Nutrition Research 2003;23:1189-1198.
  4. Hosseini S, Pishnamazi S Sadrzadeh SMH Farid F Farid R Watson RR. Pycnogenol in the management of asthma. J Medicinal Food 2001;4:201-209.
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  7. Jialal I, Devaraj S Hirany S et al. The effect of pycnogenol supplementation on markers of inflammation. Alternative Therapies 2001;7:S17.
  8. Durackova, Z., Trebaticky, B., Novotny, V., Zitnanova, A., and Breza, J. Lipid metabolism and erectile dysfunction improvement by Pycnogenol(R), extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction -- a pilot study. Nutr.Res. 2003;23:1189-1198.
  9. Kohama T, Negami M. Effect of Low-dose French Maritime Pine Bark Extract on Climacteric Syndrome in 170 Perimenopausal Women: A Randomized, Double-blind, Placebo-controlled Trial. J Reproductive Med 2013;58:39-47.
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  1. Hosseini, S., Lee, J., Sepulveda, R. T., Fagan, T., Rohdewald, P., and Watson, R. R. A randomized, double blind, placebo controlled, prospective 16 week crossover study to determine the role of Pycnogenol(R) in modifying blood pressure in mildly hypertensive patients. Nutr.Res. 2001;21:67-76.
  2. Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.
  3. Wei, Z., Peng, Q., and Lau, B. Pycnogenol enhances endothelial cell antioxidant defenses. Redox Report 1997;3:219-224.
  4. Virgili, F., Kobuchi, H., and Packer, L. Procyanidins extracted from Pinus maritima (Pycnogenol): scavengers of free radical species and modulators of nitrogen monoxide metabolism in activated murine RAW 264.7 macrophages. Free Radic.Biol Med 1998;24(7-8):1120-1129. View abstract.
  5. Macrides, T. A., Shihata, A., Kalafatis, N., and Wright, P. F. A comparison of the hydroxyl radical scavenging properties of the shark bile steroid 5 beta-scymnol and plant pycnogenols. Biochem Mol Biol Int 1997;42:1249-1260. View abstract.
  6. Noda, Y., Anzai, K., Mori, A., Kohno, M., Shinmei, M., and Packer, L. Hydroxyl and superoxide anion radical scavenging activities of natural source antioxidants using the computerized JES-FR30 ESR spectrometer system. Biochem Mol Biol Int 1997;42:35-44. View abstract.
  7. van Jaarsveld, H., Kuyl, J. M., Schulenburg, D. H., and Wiid, N. M. Effect of flavonoids on the outcome of myocardial mitochondrial ischemia/reperfusion injury. Res Commun.Mol Pathol.Pharmacol 1996;91:65-75. View abstract.
  8. Rong, Y., Li, L., Shah, V., and Lau, B. H. Pycnogenol protects vascular endothelial cells from t-butyl hydroperoxide induced oxidant injury. Biotechnol Ther 1994;5(3-4):117-126. View abstract.
  9. Furumura, M., Sato, N., Kusaba, N., Takagaki, K., and Nakayama, J. Oral administration of French maritime pine bark extract (Flavangenol((R))) improves clinical symptoms in photoaged facial skin. Clin.Interv.Aging 2012;7:275-286. View abstract.
  10. Perera, N., Liolitsa, D., Iype, S., Croxford, A., Yassin, M., Lang, P., Ukaegbu, O., and van, Issum C. Phlebotonics for haemorrhoids. Cochrane.Database.Syst.Rev. 2012;8:CD004322. View abstract.
  11. Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol(R) (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;4:CD008294. View abstract.
  12. Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol((R)) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;2:CD008294. View abstract.
  13. Marini, A., Grether-Beck, S., Jaenicke, T., Weber, M., Burki, C., Formann, P., Brenden, H., Schonlau, F., and Krutmann, J. Pycnogenol(R) effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacol.Physiol 2012;25:86-92. View abstract.
  14. Mach, J., Midgley, A. W., Dank, S., Grant, R. S., and Bentley, D. J. The effect of antioxidant supplementation on fatigue during exercise: potential role for NAD+(H). Nutrients. 2010;2:319-329. View abstract.
  15. Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., Frohlich, G. M., Kaiser, P., Hirt, A., Haile, S. R., Krasniqi, N., Matter, C. M., Uhlenhut, K., Hogger, P., Neidhart, M., Luscher, T. F., Ruschitzka, F., and Noll, G. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. Eur.Heart J. 2012;33:1589-1597. View abstract.
  16. Luzzi, R., Belcaro, G., Zulli, C., Cesarone, M. R., Cornelli, U., Dugall, M., Hosoi, M., and Feragalli, B. Pycnogenol(R) supplementation improves cognitive function, attention and mental performance in students. Panminerva Med. 2011;53(3 Suppl 1):75-82. View abstract.
  17. Errichi, S., Bottari, A., Belcaro, G., Cesarone, M. R., Hosoi, M., Cornelli, U., Dugall, M., Ledda, A., and Feragalli, B. Supplementation with Pycnogenol(R) improves signs and symptoms of menopausal transition. Panminerva Med. 2011;53(3 Suppl 1):65-70. View abstract.
  18. Belcaro, G., Luzzi, R., Cesinaro Di, Rocco P., Cesarone, M. R., Dugall, M., Feragalli, B., Errichi, B. M., Ippolito, E., Grossi, M. G., Hosoi, M., Errichi, S., Cornelli, U., Ledda, A., and Gizzi, G. Pycnogenol(R) improvements in asthma management. Panminerva Med. 2011;53(3 Suppl 1):57-64. View abstract.
  19. Errichi, B. M., Belcaro, G., Hosoi, M., Cesarone, M. R., Dugall, M., Feragalli, B., Bavera, P., Hosoi, M., Zulli, C., Corsi, M., Ledda, A., Luzzi, R., and Ricci, A. Prevention of post thrombotic syndrome with Pycnogenol(R) in a twelve month study. Panminerva Med. 2011;53(3 Suppl 1):21-27. View abstract.
  20. Aoki, H., Nagao, J., Ueda, T., Strong, J. M., Schonlau, F., Yu-Jing, S., Lu, Y., and Horie, S. Clinical assessment of a supplement of Pycnogenol(R) and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother.Res. 2012;26:204-207. View abstract.
  21. Ohkita, M., Kiso, Y., and Matsumura, Y. Pharmacology in health foods: improvement of vascular endothelial function by French maritime pine bark extract (Flavangenol). J.Pharmacol.Sci. 2011;115:461-465. View abstract.
  22. Dvorakova, M., Paduchova, Z., Muchova, J., Durackova, Z., and Collins, A. R. How does pycnogenol(R) influence oxidative damage to DNA and its repair ability in elderly people? Prague.Med.Rep. 2010;111:263-271. View abstract.
  23. Henrotin, Y., Lambert, C., Couchourel, D., Ripoll, C., and Chiotelli, E. Nutraceuticals: do they represent a new era in the management of osteoarthritis? - a narrative review from the lessons taken with five products. Osteoarthritis.Cartilage. 2011;19:1-21. View abstract.
  24. Pavone, C., Abbadessa, D., Tarantino, M. L., Oxenius, I., Lagana, A., Lupo, A., and Rinella, M. [Associating Serenoa repens, Urtica dioica and Pinus pinaster. Safety and efficacy in the treatment of lower urinary tract symptoms. Prospective study on 320 patients]. Urologia. 2010;77:43-51. View abstract.
  25. Drieling, R. L., Gardner, C. D., Ma, J., Ahn, D. K., and Stafford, R. S. No beneficial effects of pine bark extract on cardiovascular disease risk factors. Arch.Intern.Med. 9-27-2010;170:1541-1547. View abstract.
  26. Reuter, J., Wolfle, U., Korting, H. C., and Schempp, C. Which plant for which skin disease? Part 2: Dermatophytes, chronic venous insufficiency, photoprotection, actinic keratoses, vitiligo, hair loss, cosmetic indications. J.Dtsch.Dermatol.Ges. 2010;8:866-873. View abstract.
  27. Grossi, M. G., Belcaro, G., Cesarone, M. R., Dugall, M., Hosoi, M., Cacchio, M., Ippolito, E., and Bavera, P. Improvement in cochlear flow with Pycnogenol(R) in patients with tinnitus: a pilot evaluation. Panminerva Med. 2010;52(2 Suppl 1):63-67. View abstract.
  28. Stuard, S., Belcaro, G., Cesarone, M. R., Ricci, A., Dugall, M., Cornelli, U., Gizzi, G., Pellegrini, L., and Rohdewald, P. J. Kidney function in metabolic syndrome may be improved with Pycnogenol(R). Panminerva Med. 2010;52(2 Suppl 1):27-32. View abstract.
  29. Cesarone, M. R., Belcaro, G., Rohdewald, P., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Ippolito, E., Fano, F., Dugall, M., Cacchio, M., Di, Renzo A., Hosoi, M., Stuard, S., and Corsi, M. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study. Phytomedicine. 2010;17:835-839. View abstract.
  30. Ferri, C. and Grassi, D. Antioxidants and beneficial microvascular effects: is this the remedy? Hypertension 2010;55:1310-1311. View abstract.
  31. Cesarone, M. R., Belcaro, G., Stuard, S., Schonlau, F., Di, Renzo A., Grossi, M. G., Dugall, M., Cornelli, U., Cacchio, M., Gizzi, G., and Pellegrini, L. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants--a controlled study. J.Cardiovasc.Pharmacol.Ther. 2010;15:41-46. View abstract.
  32. Belcaro, G., Cesarone, M. R., Errichi, B., Di, Renzo A., Grossi, M. G., Ricci, A., Dugall, M., Cornelli, U., Cacchio, M., and Rohdewald, P. Pycnogenol treatment of acute hemorrhoidal episodes. Phytother.Res. 2010;24:438-444. View abstract.
  33. Steigerwalt, R., Belcaro, G., Cesarone, M. R., Di, Renzo A., Grossi, M. G., Ricci, A., Dugall, M., Cacchio, M., and Schonlau, F. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J.Ocul.Pharmacol.Ther. 2009;25:537-540. View abstract.
  34. Belcaro, G., Cesarone, M., Silvia, E., Ledda, A., Stuard, S., G V, Dougall, M., Cornelli, U., Hastings, C., and Schonlau, F. Daily consumption of Reliv Glucaffect for 8 weeks significantly lowered blood glucose and body weight in 50 subjects. Phytother.Res. 4-29-2009; View abstract.
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  36. Zibadi, S., Rohdewald, P. J., Park, D., and Watson, R. R. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr.Res. 2008;28:315-320. View abstract.
  37. Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. M., Vinciguerra, G., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Gizzi, G., Ippolito, E., Ricci, A., Cacchio, M., Cipollone, G., Ruffini, I., Fano, F., Hosoi, M., and Rohdewald, P. Variations in C-reactive protein, plasma free radicals and fibrinogen values in patients with osteoarthritis treated with Pycnogenol. Redox.Rep. 2008;13:271-276. View abstract.
  38. Ryan, J., Croft, K., Mori, T., Wesnes, K., Spong, J., Downey, L., Kure, C., Lloyd, J., and Stough, C. An examination of the effects of the antioxidant Pycnogenol on cognitive performance, serum lipid profile, endocrinological and oxidative stress biomarkers in an elderly population. J Psychopharmacol. 2008;22:553-562. View abstract.
  39. Cisar, P., Jany, R., Waczulikova, I., Sumegova, K., Muchova, J., Vojtassak, J., Durackova, Z., Lisy, M., and Rohdewald, P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother.Res. 2008;22:1087-1092. View abstract.
  40. Suzuki, N., Uebaba, K., Kohama, T., Moniwa, N., Kanayama, N., and Koike, K. French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study. J Reprod.Med. 2008;53:338-346. View abstract.
  41. Belcaro, G., Cesarone, M. R., Errichi, S., Zulli, C., Errichi, B. M., Vinciguerra, G., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Errichi, S., Gizzi, G., Ippolito, E., Ricci, A., Cacchio, M., Cipollone, G., Ruffini, I., Fano, F., Hosoi, M., and Rohdewald, P. Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytother.Res. 2008;22:518-523. View abstract.
  42. Dvorakova, M., Jezova, D., Blazicek, P., Trebaticka, J., Skodacek, I., Suba, J., Iveta, W., Rohdewald, P., and Durackova, Z. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (pycnogenol). Nutr.Neurosci. 2007;10(3-4):151-157. View abstract.
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  45. Chovanova, Z., Muchova, J., Sivonova, M., Dvorakova, M., Zitnanova, I., Waczulikova, I., Trebaticka, J., Skodacek, I., and Durackova, Z. Effect of polyphenolic extract, Pycnogenol, on the level of 8-oxoguanine in children suffering from attention deficit/hyperactivity disorder. Free Radic.Res 2006;40:1003-1010. View abstract.
  46. Dvorakova, M., Sivonova, M., Trebaticka, J., Skodacek, I., Waczulikova, I., Muchova, J., and Durackova, Z. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox.Rep. 2006;11:163-172. View abstract.
  47. Voss, P., Horakova, L., Jakstadt, M., Kiekebusch, D., and Grune, T. Ferritin oxidation and proteasomal degradation: protection by antioxidants. Free Radic.Res 2006;40:673-683. View abstract.
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  50. Grimm, T., Skrabala, R., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Single and multiple dose pharmacokinetics of maritime pine bark extract (pycnogenol) after oral administration to healthy volunteers. BMC.Clin Pharmacol 2006;6:4. View abstract.
  51. Golanski, J., Muchova, J., Golanski, R., Durackova, Z., Markuszewski, L., and Watala, C. Does pycnogenol intensify the efficacy of acetylsalicylic acid in the inhibition of platelet function? In vitro experience. Postepy Hig.Med Dosw.(Online.) 2006;60:316-321. View abstract.
  52. Cesarone, M. R., Belcaro, G., Rohdewald, P., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Gizzi, G., Ippolito, E., Fano, F., Dugall, M., Acerbi, G., Cacchio, M., Di Renzo, A., Hosoi, M., Stuard, S., and Corsi, M. Comparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb.Hemost. 2006;12:205-212. View abstract.
  53. Trebaticka, J., Kopasova, S., Hradecna, Z., Cinovsky, K., Skodacek, I., Suba, J., Muchova, J., Zitnanova, I., Waczulikova, I., Rohdewald, P., and Durackova, Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur.Child Adolesc.Psychiatry 2006;15:329-335. View abstract.
  54. Chayasirisobhon, S. Use of a pine bark extract and antioxidant vitamin combination product as therapy for migraine in patients refractory to pharmacologic medication. Headache 2006;46:788-793. View abstract.
  55. Grimm, T., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Inhibition of NF-kappaB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol). J Inflamm.(Lond) 2006;3:1. View abstract.
  56. Schafer, A., Chovanova, Z., Muchova, J., Sumegova, K., Liptakova, A., Durackova, Z., and Hogger, P. Inhibition of COX-1 and COX-2 activity by plasma of human volunteers after ingestion of French maritime pine bark extract (Pycnogenol). Biomed.Pharmacother. 2006;60:5-9. View abstract.
  57. Belcaro, G., Cesarone, M. R., Errichi, B. M., Ledda, A., Di Renzo, A., Stuard, S., Dugall, M., Pellegrini, L., Rohdewald, P., Ippolito, E., Ricci, A., Cacchio, M., Ruffini, I., Fano, F., and Hosoi, M. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol. Angiology 2005;56:699-705. View abstract.
  58. Baumann, L. How to prevent photoaging? J Invest Dermatol. 2005;125:xii-xiii. View abstract.
  59. Torras, M. A., Faura, C. A., Schonlau, F., and Rohdewald, P. Antimicrobial activity of Pycnogenol. Phytother Res 2005;19:647-648. View abstract.
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