Bloodroot: Benefits, Side Effects and Dosage

Bloodroot (Sanguinaria canadensis) is a North American perennial herb with a storied history in traditional medicine. Celebrated by Native Americans for its purported healing abilities, bloodroot has found its way into modern herbal remedies, oral care products, and even controversial cancer salves. Yet, as with many botanicals, the line between benefit and risk is fine and often blurred by folklore, preliminary scientific findings, and reports of severe side effects. This article dives deep into the current evidence on bloodroot’s benefits, side effects, and dosage to help you make informed decisions about its use.

Benefits of Bloodroot

Bloodroot has been used for centuries in herbal medicine, but what does science actually say about its effects? Let’s explore the potential health benefits of this intriguing plant, as supported by research.

Potential Benefit	Mechanism/Outcome	Evidence Strength	Source(s)
Immunomodulation	Alters immune cell cytokine production and proliferation	Moderate	3, 5
Selective Anticancer Activity	Inhibits proliferation of some cancer cell lines	Preliminary	3, 1
Anti-inflammatory	Reduces certain inflammatory markers in vitro	Preliminary	1, 5
Antimicrobial	Shown in some oral care products and preclinical studies	Conflicting	4, 1

Table 1: Key Benefits of Bloodroot

Traditional and Historical Uses

Bloodroot was historically used by Native Americans for a wide range of conditions, including wound healing, pain relief, fever reduction, respiratory issues, and blood purification. The plant’s vivid red sap and myriad of bioactive alkaloids made it a staple in traditional medicine 1 8. While these uses are well-documented, modern science has only partially validated them.

Immunomodulatory Effects

Recent studies suggest that bloodroot extracts can modulate the immune system. In vitro models have shown that extracts from bloodroot flowers, roots, and rhizomes can alter cytokine production by human peripheral blood mononuclear cells. For example:

• Water infusions and alcohol tinctures of bloodroot increased proliferation of immune cells and selectively inhibited the proliferation of certain leukemia cell lines, suggesting both immune-boosting and anti-cancer potential 3.
• Rhizome extracts demonstrated immunosuppressive effects on specific cytokines like interleukin-2 (IL-2) and IL-8, which could be relevant for inflammatory conditions 5.

It’s important to note these effects were observed in laboratory models, not in living humans, so their clinical relevance is still uncertain.

Anticancer and Anti-inflammatory Properties

Bloodroot contains several benzophenanthridine alkaloids (notably sanguinarine and chelerythrine) that have demonstrated selective activity against cancer cell lines in vitro 1 3. Some extracts diminished the growth of leukemia cells while sparing healthy immune cells, hinting at possible anticancer benefits 3. Additionally, anti-inflammatory properties have been suggested due to the suppression of certain cytokines, but again, these findings stem from cell studies, not human trials 1 5.

Oral Health and Antimicrobial Activity

Bloodroot extracts were once common in mouthwashes and toothpastes, thanks to their purported antibacterial and anti-inflammatory effects. However, clinical studies on their effectiveness against dental plaque and gingivitis have yielded mixed results 4. While initial studies suggested some benefit when bloodroot toothpaste and mouthwash were used together, later studies found conflicting outcomes. The antimicrobial properties appear promising in preclinical settings, but robust evidence in humans is lacking or inconsistent 4.

Limitations of Current Evidence

• Most research is preclinical (lab-based, not human trials).
• Effects vary depending on the plant part used (flower, rhizome, root) and extraction method (infusion, tincture).
• No large, high-quality clinical trials confirm the benefits in humans.

Side Effects of Bloodroot

While bloodroot’s allure as a natural remedy is strong, its side effects can be severe and even life-threatening. Let’s take a closer look at the adverse effects associated with its use.

Side Effect	Description / Presentation	Severity	Source(s)
Tissue Necrosis	Localized tissue death, ulceration	High	1, 6, 7, 8
Eschar Formation	Black scab-like lesions (eschar)	High	6, 8
Keloid Scarring	Raised, thickened scar tissue	Moderate	8
Oral Leukoplakia	Pre-cancerous white patches in mouth	Moderate-High	1, 4
Severe Inflammation	Swelling, redness, pain	Moderate	7
Wound Complications	Poor healing, secondary infection	Moderate	7, 6

Table 2: Notable Side Effects of Bloodroot

Topical Use Risks: Escharotics and Tissue Damage

Bloodroot is a powerful escharotic—meaning it destroys living tissue. When used topically, especially as so-called "black salves" promoted online for skin lesions or cancers, bloodroot can cause severe tissue necrosis, ulceration, and the formation of black eschars (scabs). Case reports in both humans and animals document:

• Painful ulcerated wounds
• Excessive tissue loss
• Delayed healing
• Secondary infections
• Permanent scarring and keloid formation 6 7 8

In some cases, topical application has led to misdiagnosis or delayed treatment of underlying skin cancers, with devastating consequences 6.

Oral and Systemic Side Effects

Bloodroot-containing oral products (toothpastes, mouthwashes) have been associated with the development of leukoplakia—a white, pre-cancerous lesion of the oral mucosa that can progress to cancer 1 4. While early safety studies downplayed these risks, subsequent evidence led to the removal of bloodroot from many commercial oral care products 4.

Systemic absorption after ingestion or inappropriate use may result in:

• Nausea, vomiting, and diarrhea
• Abdominal pain
• Potential toxicity to internal organs (although data here are limited)

Veterinary and Animal Risks

Reports in veterinary medicine echo similar concerns. Dogs injected with bloodroot extract for tumor treatment experienced severe local necrosis and wound complications, sometimes requiring surgical intervention and prolonged recovery 7.

Why Are These Risks So Serious?

The active compounds in bloodroot—primarily sanguinarine and related alkaloids—are cytotoxic. While this underpins any potential anti-cancer effect, it also means indiscriminate tissue destruction can occur wherever the extract is applied or absorbed 1 8. This duality makes unsupervised or home use especially dangerous.

Dosage of Bloodroot

Determining a safe and effective dosage for bloodroot is fraught with uncertainty. Here’s what the evidence and expert consensus reveal.

Form / Route	Typical Dosage / Use	Safety Status	Source(s)
Oral (herbal)	Not standardized; rarely recommended	Unsafe/Not Recommended	1, 4, 8
Topical (black salve)	Variable, unregulated	Highly Unsafe	6, 8
Oral care (toothpaste/mouthwash)	Formerly used; now withdrawn	Withdrawn due to safety	4
Traditional (Native American)	Small amounts for specific ailments	Historical use only	1, 8

Table 3: Bloodroot Dosage and Safety Overview

Lack of Standardized Dosage

There is no universally accepted safe or effective dose of bloodroot for any condition. Most modern herbalists and physicians advise against its use due to unpredictable potency, variable alkaloid content, and severe side effect risks 1 4 8.

Oral and Topical Preparations

• Oral Use: Bloodroot is sometimes still found in herbal supplements, but safe dosing guidelines are absent. The U.S. Food and Drug Administration does not recognize it as safe for any internal use 1 4.
• Topical Use: "Black salve" and other bloodroot-containing topical products are not regulated and have been linked to numerous cases of disfigurement and harm 6 7 8.

Historical Practices

Traditional Native American uses involved small, carefully prepared doses for specific conditions, often under the guidance of experienced healers 1 8. Modern preparations, especially those sold online, lack such safeguards.

Medical and Regulatory Consensus

• Most health authorities strongly discourage the use of bloodroot for self-treatment, especially for cancers or skin lesions.
• Products containing bloodroot have been withdrawn from the oral care market due to safety concerns 4.
• Self-experimentation or use without medical supervision is considered dangerous and can result in permanent harm 6 7 8.

Conclusion

Bloodroot is a striking example of a medicinal plant that bridges the gap between ancient tradition and modern controversy. While laboratory studies hint at immunomodulatory and anticancer activity, the risks—especially of severe tissue destruction—are substantial. There is no established safe dosage, and self-medication with bloodroot, especially in the form of black salves or unregulated supplements, can be extremely dangerous.

Key Takeaways:

• Potential Benefits: Bloodroot shows some immunomodulatory, anti-inflammatory, and anticancer activity in lab studies, but these have not been confirmed in robust human trials 1 3 5.
• Major Risks: Severe side effects—including tissue necrosis, scarring, and oral leukoplakia—are well documented, particularly with topical and oral use 1 4 6 7 8.
• Dosage: No safe or effective dose is established; most authorities recommend against its use outside supervised research or traditional settings 1 4 6 8.
• Regulatory Status: Many bloodroot products, especially for oral care, have been withdrawn due to safety concerns 4.
• Recommendation: Approach bloodroot with extreme caution; consult a knowledgeable healthcare provider before considering any use.

Bloodroot’s story is a cautionary tale—reminding us that not all natural remedies are safe or effective, and that evidence, not folklore, should guide our health choices.