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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 shows that taking pycnogenol before allergy season begins might reduce allergy symptoms in people with birch allergies.
  • Asthma. Taking pycnogenol daily, along with asthma medications, seems to decrease asthma symptoms and the need for rescue inhalers in children and adults with asthma.
  • Athletic performance. Young people (age 20-35 years) seem to be able to exercise on a treadmill for a longer time after taking pycnogenol daily for about a month.
  • Circulation problems. Taking pycnogenol by mouth seems to 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 using pycnogenol alone appears to be more effective.
  • Mental function. Research suggests that taking pycnogenol improves mental function and memory in both young adults and the elderly.
  • Disease of the retina in the eye. Taking pycnogenol daily for 2 months seems to slow or prevent further worsening of retinal disease caused by diabetes, atherosclerosis, or other diseases. It also seems to improve eyesight.

Possibly ineffective for...

  • Attention deficit-hyperactivity disorder (ADHD).

Insufficient evidence to rate effectiveness for...

  • Attention deficit-hyperactivity disorder (ADHD). Taking pycnogenol by mouth does not seem to help ADHD symptoms in adults. However, taking pycnogenol daily for one mouth appears to improve symptoms in children.
  • Clogged arteries (coronary artery disease). There is some evidence that taking 150 mg of pynogenol three times daily for 4 weeks might help improve some complications associated with clogged arteries.
  • Blood clots in deep veins (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. Also, taking pycnogenol 100 mg before a flight, 6 hours after the flight, and the following day appears to reduce the risk of blood clots forming in the veins during long flights.
  • Dental plaque. Early research suggests that chewing at least 6 pieces of gum with added pycnogenol for 14 days reduces bleeding and prevents increased plaque.
  • Diabetes. Early evidence suggests that taking 50-200 mg of pycnogenol daily for 3-12 weeks slightly decreases blood sugar in people with diabetes.
  • Circulation problems in diabetes. Early research shows that taking 50 mg of pycnogenol three times daily for 4 weeks improves circulation and symptoms in people with diabetes.
  • Swelling (edema). Early research suggests that taking 100 mg of pycnogenol before a flight, 6 hours after the flight, and once the next day reduces swelling and ankle swelling.
  • Erectile dysfunction (ED). Limited research suggests that pycnogenol, used alone or in combination with L-arginine, might improve sexual function in men with ED. It seems to take up to 3 months of treatment for significant improvement.
  • Heart failure. Early research suggests that taking a specific combination of pycnogenol and coenzyme Q10 (PycnoQ10) for 12 weeks improves some symptoms of heart failure
  • .
  • Hemorrhoids. Early research suggests that taking pycnogenol by mouth, alone or in combination with a pycnogenol cream, improves quality of life and symptoms of hemorrhoids.
  • High cholesterol. Pycnogenol seems to lower “bad cholesterol” (low-density lipoprotein (LDL) cholesterol).
  • High blood pressure. Pycnogenol seems to lower systolic blood pressure (the top number in a blood pressure reading) but does not significantly lower diastolic blood pressure (the bottom number).
  • Leg cramps. There is some evidence that taking 200 mg of pycnogenol daily might decrease leg cramps.
  • Menopausal symptoms. Early research shows that taking pycnogenol by mouth decreases menopausal symptoms, including tiredness, headache, depression and anxiety, and hot flashes.
  • Migraine. Early research suggests that taking pine bark extract (Enzogenol) by mouth in combination with vitamins E and C, daily for 3 months reduces the severity and likelihood of developing a migraine headache.
  • Osteoarthritis. There is mixed evidence about the effectiveness of pycnogenol for osteoarthritis. Pycnogenol might reduce overall symptoms, but it does not seem to reduce pain or improve the ability to perform daily tasks
  • Pain in late pregnancy. Early 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 3 months of pregnancy.
  • Pelvic pain in women. There is early evidence that pycnogenol might help reduce pelvic pain in women with endometriosis or severe menstrual cramps.
  • Skin aging. Early research suggests that taking pycnogenol for 12 weeks improves symptoms of skin aging.
  • Ulcers due to diabetes. Early research suggests that taking pycnogenol by mouth daily and applying it to the skin heals ulcers related to diabetes.
  • Improving symptoms of lupus (SLE). Early research suggests that taking pycnogenol reduces symptoms of SLE in some patients.
  • Ringing in the ears (tinnitus). Early research suggests that taking 100-150 mg of pycnogenol daily for 34 days reduces tinnitus symptoms.
  • Stroke prevention.
  • Muscle soreness.
  • 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 by mouth in doses of 50 mg to 450 mg daily for up to one year, and when applied to the skin as a cream for up to 7 days or as a powder for up to 6 weeks. Pycnogenol can cause dizziness, gut problems, headache, and mouth ulcers.

Special precautions & warnings:

Pregnancy and breast-feeding: Early research suggests that pycnogenol is POSSIBLY SAFE when used in late pregnancy. However, until more is known, pycnogenol should be used cautiously or avoided by women who are pregnant.

There is not enough reliable information about the safety of taking pycnogenol if you are breast-feeding. Stay on the safe side and avoid use.

Children: Pycnogenol is POSSIBLY SAFE when taken by mouth, short-term.

“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.

Bleeding conditions: In theory, high doses of pycnogenol might increase the risk of bleeding in people with bleeding conditions.

Diabetes: In theory, high doses of pycnogenol might decrease blood sugar too much in people with diabetes.

Surgery: Pycnogenol might slow blood clotting. There is some concern that it might increase the chance of bleeding during and after surgery. Stop using pycnogenol at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Medications for diabetes (Antidiabetes drugs)
Pycnogenol might decrease blood sugar levels. Diabetes medications are also used to lower blood sugar. Taking pycnogenol along with diabetes medications might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others. The mechanism of action is unclear.

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.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Pycnogenol might slow blood clotting. Taking pycnogenol along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Are there interactions with herbs and supplements?

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Herbs and supplements that might lower blood sugar
Pycnogenol might lower blood glucose levels. Using it with other herbs or supplements that have the same effect might cause blood sugar levels to drop too low. Some herbs and supplements that can lower blood sugar include alpha-lipoic acid, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.

Herbs and supplements that might slow blood clotting
Using pycnogenol along with herbs that can slow blood clotting could increase the risk of bleeding in some people. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.

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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology 2006;57:569-576. View abstract.
  11. Belcaro, G., Cesarone, M. R., Errichi, B. M., Ledda, A., Di, Renzo A., Stuard, S., Dugall, M., Pellegrini, L., Gizzi, G., Rohdewald, P., Ippolito, E., Ricci, A., Cacchio, M., Cipollone, G., Ruffini, I., Fano, F., and Hosoi, M. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin.Appl.Thromb.Hemost. 2006;12:318-323. View abstract.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
  16. Cesarone, M. R., Belcaro, G., Rohdewald, P., Pellegrini, L., Ippolito, E., Scoccianti, M., Ricci, A., Dugall, M., Cacchio, M., Ruffini, I., Fano, F., Acerbi, G., Vinciguerra, M. G., Bavera, P., Di Renzo, A., Errichi, B. M., and Mucci, F. Prevention of edema in long flights with Pycnogenol. Clin Appl.Thromb.Hemost. 2005;11:289-294. View abstract.
  17. Belcaro, G., Cesarone, M. R., Rohdewald, P., Ricci, A., Ippolito, E., Dugall, M., Griffin, M., Ruffini, I., Acerbi, G., Vinciguerra, M. G., Bavera, P., Di Renzo, A., Errichi, B. M., and Cerritelli, F. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl.Thromb.Hemost. 2004;10:373-377. View abstract.
  18. Hosseini, S., Pishnamazi, S., Sadrzadeh, S. M., Farid, F., Farid, R., and Watson, R. R. Pycnogenol((R)) in the Management of Asthma. J Med Food 2001;4:201-209. View abstract.
  19. Kimbrough, C., Chun, M., dela, Roca G., and Lau, B. H. PYCNOGENOL chewing gum minimizes gingival bleeding and plaque formation. Phytomedicine 2002;9:410-413. View abstract.
  20. Stefanescu, M., Matache, C., Onu, A., Tanaseanu, S., Dragomir, C., Constantinescu, I., Schonlau, F., Rohdewald, P., and Szegli, G. Pycnogenol efficacy in the treatment of systemic lupus erythematosus patients. Phytother Res 2001;15:698-704. View abstract.
  21. Araghi-Niknam, M., Hosseini, S., Larson, D., Rohdewald, P., and Watson, R. R. Pine bark extract reduces platelet aggregation. Integr.Med. 3-21-2000;2:73-77. View abstract.
  22. Belcaro, G., Cesarone, M. R., Dugall, M., Hosoi, M., Ippolito, E., Bavera, P., and Grossi, M. G. Investigation of Pycnogenol(R) in combination with coenzymeQ10 in heart failure patients (NYHA II/III). Panminerva Med 2010;52(2 Suppl 1):21-25. View abstract.
  23. Ledda, A., Belcaro, G., Cesarone, M. R., Dugall, M., and Schonlau, F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU.Int. 2010;106:1030-1033. View abstract.
  24. Wilson D, Evans M, Guthrie N et al. A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms. Phytother Res 2010;24:1115-9. View abstract.
  25. Belcaro G, Cesarone MR, Ricci A, et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with pycnogenol. Clin Appl Thromb Hemost 2006;12:440-4. View abstract.
  26. Vinciguerra G, Belcaro G, Cesarone MR, et al. Cramps and muscular pain: prevention with Pyconogenol in normal subjects, venous patients, athletes, claudicants and in diabetic microangiopathy. Angiology 2006;57:331-9. View abstract.
  27. Cesarone MR, Belcaro G, Rohdewald P, et al. Improvement of diabetic microangiopathy with Pycnogenol: A prospective, controlled study. Angiology 2006;57:431-6. View abstract.
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  29. Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract pycnogenol dose-dependently lowers glucose in type 2 diabetic patients (letter). Diabetes Care 2004;27:839. View abstract.
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  31. Kohama T, Inoue M. Pycnogenol alleviates pain associated with pregnancy. Phytother Res 2006;20:232-4. View abstract.
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Page last updated: 10 December 2014