What Is Pycnogenol?
Pycnogenol is a patented extract of the French maritime pine bark (Pinus pinaster).
It is standardized to contain 65-75% procyanidins, a class of polyphenols and flavonoids like those found in blueberries, wine, grape skin, citrus, and cocoa. Some research suggests that procyanidins may have antioxidant and anti-inflammatory activity. The remaining compounds are phenolic acids, which may also have antioxidant activity [1, 2].
Research into Pycnogenol has revealed some promising results in over 30 health conditions. However, it’s unclear how clinically effective Pycnogenol is for most of these conditions due to the low quality of evidence. That said, there are some instances where this extract may possibly be effective.
In this article, we’ll summarize all the potential benefits and the scientific research surrounding pine bark extract and Pycnogenol.
Pine Bark Extract vs. Pycnogenol
Pycnogenol is officially extracted from the French maritime pine (Pinus pinaster), which grows in the southwest coast of France. Its quality is specified in the United States Pharmacopeia .
Extracts can also be made from other pine barks, such as Pinus radiata, Pinus densiflora, Pinus thunbergii, and Pinus massoniana. Most have similar amounts of active substances and are often sold under the brand name Pycnogenol .
However, some of these other pine bark extracts can have different active compounds, which may affect their biological activity.
For example, Enzogenol is an extract from a pine that grows in California and Mexico (Pinus radiata) that may have cognitive-enhancing effects. Trees of this pine have been naturalized in Australia and New Zealand, where most Enzogenol is now made .
How Does Pycnogenol Act in the Body?
There’s some evidence that Pycnogenol acts similar to a sustained-release formulation. According to some researchers, when you take Pycnogenol :
- Small molecule antioxidants (phenolic acids, catechin, and taxifolin) are quickly absorbed and begin to act in the body within 30 min
- The remaining more complex antioxidants (long chains of procyanidins) reach the gut, where your gut microbiome breaks them down into active metabolites
- The microbiome-produced active compounds appear in blood 6 h later and remain for at least 14 h
Research suggests that Pycnogenol may protect cells in the body against oxidative stress. It also may help regenerate and maintain vitamin C and E levels while also potentially increasing nitric oxide levels, which may relax and protect blood vessels .
Health Benefits of Pycnogenol
Possibly Effective For:
1) Exercise Performance & Recovery
Clinical research suggests that Pycnogenol is possibly effective for improving athletic performance. According to researchers, it may help prevent the rise in free radicals typically seen after exercise, which could cause muscle fatigue and damage .
A study of 147 people found that pycnogenol (100 mg/day) may improve running, push-ups, and sit-ups endurance in recreational athletes over an 8-week training program. It also may enhance swimming, biking, and running scores in professional athletes preparing for a triathlon (at 150 mg/day). Finally, research suggests that Pycnogenol may improve triathlon time while possibly reducing cramps and post-running pain .
Pycnogenol (200 mg/day) may reduce muscle cramps and pain according to a study of 66 healthy people, athletes, and those with venous problems after 4 weeks. The researchers of the study propose that pycnogenol may reduce pain and cramps during retraining and rehabilitation in people with blood vessel problems .
Based on another study of 6 trained and 7 untrained people, an antioxidant combination product containing Pycnogenol (Lactaway) may increase endurance. This supplement may also increase muscle endurance and performance after a single pre-exercise dose according to a study of 9 cyclists [12, 13].
2) Asthma Symptoms
Pycnogenol (up to 200 mg/day) may improve asthma and reduce inflammatory asthma markers in the blood, leukotrienes, after 4 weeks, according to a randomized placebo-controlled trial of 26 asthma patients .
A randomized placebo-controlled trial of 60 children with mild-to-moderate asthma found that those who took Pycnogenol may be able to reduce or discontinue their use of rescue inhalers more often than the placebo group .
In a study of 76 people with allergic asthma, Pycnogenol (100 mg/day) added to conventional corticosteroid inhalers for 6 months helped 55% of them reduce inhaler use frequency and dosage. In contrast, almost 20% of the participants on inhalers alone had to increase their dosage. Researchers suggest that Pycnogenol may reduce cough, night-awakenings, improve airway flow, and the need for additional asthma medication .
A trial of 39 people with hay fever found that Pycnogenol may reduce nose and eye symptoms. In the study, the placebo group had higher IgE antibodies to the birch allergen than those who took Pycnogenol during the allergy season .
Pycnogenol (100 mg/day) may reduce hay fever symptoms, according to a clinical trial of 39 people. Another clinical trial of 76 people with allergic asthma also suggests that Pycnogenol may reduce IgE antibodies and asthma symptoms [18, 16].
Importantly, all studies found that Pycnogenol has to be taken at least 5 weeks before the allergy season in order to see potential benefits, with the best results in those who take it 7-8 weeks ahead. One study suggests that Pycnogenol has no effect when given just 3 weeks beforehand, as it possibly requires a lag time to stabilize the immune response .
4) Cognitive Function and Brain Fog
There’s evidence that Pycnogenol may be a promising nootropic for various groups of people, including middle-aged professionals, students, and people with mild cognitive decline like brain fog.
A clinical trial of 60 health professionals found that Pycnogenol (150 mg/day) may improve cognitive function, attention, mental performance and specific professional skills after 12 weeks. Researchers suggest it may boost sustained attention, memory, executive functions, mood, and reduce oxidative stress .
A trial of 53 students found that pycnogenol may improve cognitive function, memory, attention, mood, and mental performance after 8 weeks .
Pycnogenol (100 mg/day) given to 44 older healthy people with high oxidative stress improved cognitive function, attention, mental performance, and reduced oxidative stress after 12 months .
Pycnogenol also potentially improved cognitive function in 78 people with mild cognitive impairment. All included participants had “subclinical” cognitive impairment, which looks like typical brain fog .
Enzogenol, a slightly different pine bark extract, improved cognitive function in a clinical trial of 42 older men after 5 weeks of supplementation .
5) Vein Diseases and Swelling
Pycnogenol (100 mg/day) may reduce leg swelling, spider veins, and cramps according to a study of 133 women with varicose veins who recently gave birth. Researchers suggest that it may have stronger benefits than elastic compression stockings. In the study, women taking Pycnogenol were more satisfied and compliant to the regimen .
A randomized clinical trial of 30 people found that Pycnogenol (150 mg/day) may help heal vein ulcers from surgery and reduce swelling after 3 months of treatment .
When pycnogenol cream was added to oral supplements in a small study of 18 people with vein ulcers, it helped ulcers heal more quickly .
One study of 211 found that Pycnogenol may help prevent edema and ankle swelling from long flights .
Pycnogenol improved symptoms, circulation, and reduced complications in 156 people with deep vein thrombosis (blot clots in deep leg veins) in a 12-month study. It had the best results when combined with compression stockings, but worked just as well alone .
Insufficient Evidence For:
The following purported benefits of Pycnogenol are only supported by limited, low-quality clinical studies. There is insufficient evidence to support the use of Pycnogenol for any of the uses listed below. Remember to speak with a doctor before taking Pycnogenol. It should never be used as a replacement for approved medical therapies.
6) Metabolic Syndrome
A trial of 132 people found that Pycnogenol (150 mg/day) may improve risk factors of metabolic syndrome including lowering triglyceride levels, blood pressure, and fasting glucose, decreasing waist circumference, and increasing HDL cholesterol levels .
In a study of 50 overweight people, a combination product (Pycnogenol, Madeglucyl, and starches called Glucaffect) reduced weight, BMI, blood glucose, and HbA1C after 8 weeks .
A number of clinical trials suggest that Pycnogenol may lower blood glucose if taken daily for at least 12 weeks.
Pycnogenol (125 mg/day) had the same effects in another study of 48 people with diabetes and high blood pressure. It also may help those on blood pressure medications to reduce their dose .
In another trial, 30 people with type 2 diabetes received a range of pycnogenol doses. The most effective blood sugar-lowering dose was 200 mg/day – higher doses had no further benefit .
8) Diabetic Retinopathy
Diabetic retinopathy is a type of eye injury caused by complications from diabetes.
In 24 people with early eye damage from diabetes, Pycnogenol improved vision, reduced eye swelling, and improved circulation in the eye after 2 months. Used early on, it may prevent eye damage and blindness from diabetes .
A trial of 86 people with eye damage from diabetes found that antioxidant therapy (including pycnogenol, vitamin E, and Coenzyme Q10) may improve eye health and reduce reactive oxygen species levels .
9) Blood Pressure and Heart Health
According to some researchers, Pycnogenol may lower blood pressure by relaxing blood vessels, reducing free radicals, and lowering inflammation. According to a meta-analysis of 9 trials including 549 people, 150-200 mg/day for at least 12 weeks may reduce both diastolic and systolic blood pressure .
A study of 58 people with high blood pressure suggests that even lower doses (100 mg/day) may improve blood vessel health and reduce markers of high blood pressure (endothelin-1) after 12 weeks. In the study, many of the participants on Pycnogenol reduced their dosage of high-blood-pressure medication (nifedipine) .
Higher doses (200 mg/day) may improve blood vessel health and function after 8 weeks according to a study of 23 people with heart disease .
A Pycnogenol combination product (with l-arginine, alpha lipoic acid, B vitamins, and vitamin K2) may help protect the blood vessels and reduce high homocysteine levels, according to a trial of 25 people .
A study of 32 people with heart failure lasting 12 weeks suggests that a combination of Pycnogenol with CoQ10 (PycnoQ10) may improve blood pressure, heart function, edema, and capacity for physical activity .
10) Symptoms of ADHD
A clinical trial of 57 ADHD children found that daily Pycnogenol (1 mg/kg) for one month may reduce hyperactivity symptoms. Researchers suggest this effect may be due to reduced dopamine and adrenaline levels and increased glutathione levels.
In a study of 61 ADHD children, pycnogenol reduced hyperactivity, improved attention, and motorics after 1 month. But a month after pycnogenol was stopped, the symptoms came back, suggesting that it may need to be used regularly to achieve the benefits .
A trial of children with ADHD found that Pycnogenol may improve attention, possibly by increasing the total antioxidant status and reducing DNA damage. In another study, Pycnogenol increased glutathione levels and total antioxidants after a month in children with ADHD [42, 43].
However, a study of 24 adults with ADHD found that pycnogenol did not improve ADHD symptoms better than placebo. Researchers from the study suggest that low Pycnogenol dosage and short study duration may explain the lack of benefits .
11) Osteoarthritis Symptoms
In a study of 33 people with severe osteoarthritis, pycnogenol (200 mg/day) reduced inflammatory markers after 3 weeks. Researchers suggest that it may epigenetically turn off genes responsible for joint damage (ADAMTS) as well as reduce inflammation enzymes (MMP3) and cytokines (IL 1-beta) [47, 48].
In one clinical trial of 156 osteoarthritis patients, pycnogenol reduced pain, stiffness, swelling, and improved joint function after 3 months. In a smaller study of 58 people, pycnogenol reduced the inflammatory marker CRP [49, 50].
Pycnogenol (150 mg/day) reduced pain in a study of 100 people with osteoarthritis after 3 months. Subjects in the study that took Pycnogenol ended up taking fewer painkillers .
One study found that Pycnogenol may reduce the activity of the inflammatory enzymes COX1 and COX2, similar to how NSAID drugs work. According to the lab results of 10 volunteers, a higher Pycnogenol dose (300 mg) may impact these enzymes after just 30 minutes .
Systemic Lupus Erythematosus (SLE)
According to a study of 11 patients with lupus, pycnogenol may reduce symptoms, inflammation, and oxidative stress .
It also reduced LDL cholesterol at a slightly lower dose (125 mg/day) in those with type 2 diabetes in a clinical trial of 48 people after 12 weeks. High-dose Pycnogenol (360 mg/day) for 4 weeks had the same LDL-lowering benefits in another study of 40 people [32, 56].
14) Oral Health
Chewing gum with Pycnogenol (2.5 mg/piece) for 4 weeks reduced bad breath and mouth bacteria in a trial of 22 people .
15) Common Cold
Pycnogenol (100 mg/day) supplementation may decrease symptoms of the common cold and speed up recovery, according to a clinical trial of 146 people. In the study, it reduced cold symptoms and complications, the number of lost working days, and the use of over-the-counter medications compared to those who did not supplement with the extract .
A trial of 84 people found that both Pycnogenol oral supplements and creams (0.5%) may prevent hemorrhoids from bleeding during acute attacks after 7 days. In contrast, bleeding still occurred in the control group .
17) Melasma (or Chloasma)
Pycnogenol may help reduce symptoms of melasma, a form of hyperpigmentation, possibly because it protects against UV rays. A study of 30 women found that Pycnogenol (75 mg/day) may reduce the skin area affected by melasma as well as lower symptoms of fatigue, constipation, body pain, and anxiety .
18) Skin Health
Pycnogenol supplementation reduced skin redness from UV rays in a trial of 21 people over 8 weeks. With time, the participants were able to handle more UV radiation without experiencing skin damage .
In a study of 20 postmenopausal women, 12 weeks of pycnogenol supplementation improved hydration and elasticity of the skin. It also may increase the activity of genes that make collagen and hyaluronic acid in the body .
19) Erectile Dysfunction (ED)
The combination of L-arginine and Pycnogenol may help in erectile dysfunction by boosting nitric oxide, which potentially could improve blood flow in men .
In a clinical trial of 40 men with erectile dysfunction, 92.5% of the men on this combination regained normal erections after 3 months. Pycnogenol was gradually increased to 120 mg/day over this time period, while the l-arginine was maintained at 1.7 g/day throughout. Another group of men who took just l-arginine didn’t improve .
In another trial, a combination supplement (Pycnogenol 60 mg/day, L-arginine 690 mg/day and aspartic acid 552 mg/day) improved erectile dysfunction and sexual satisfaction in men after 8 weeks. It also slightly decreased blood pressure and increased testosterone .
20) Menopausal Symptoms
Pycnogenol (100 mg/day) improved menopausal symptoms and quality of life in a clinical trial of 35 women after 8 weeks .
A combination product with Pycnogenol (Lady Prelox) improved sexual function in a clinical trial of 83 healthy postmenopausal women after 8 weeks. The study suggests it may increase desire, arousal, lubrication, orgasm, satisfaction and reduce pain .
21) Pain In Pregnancy
Low-dose Pycnogenol (30 mg/day) may reduce pain in pregnant women, particularly hip, joint, lower back, groin, and calf cramps in the third trimester .
22) Menstrual Pain
In a clinical trial of 116 women, Pycnogenol (60 mg/day) reduced menstrual pain and the need for additional painkillers, taken over 2 cycles. These benefits appeared to persist for some time even after stopping supplementation .
Another study of 47 women found that supplementing with 30 mg Pycnogenol twice daily for over 1 month may reduce menstrual pain .
23) Sexual Function in Women
In a study of 100 healthy women mostly in their early 40s with mild sexual dysfunction, a combination product with Pycnogenol (Lady Prelox) improved sexual function over 8 weeks .
24) Male Reproductive Health
25) Crohn’s Disease in Children
A 10 week clinical trial with 30 children shows that Pycnogenol may improve symptoms of Crohn’s disease. Researchers suggest this benefit may be due to an increase in glutathione and SOD, two antioxidants that may reduce inflammation and oxidative stress in Crohn’s .
26) Irritable Bowel Syndrome (IBS)
27) Chemotherapy Side Effects
According to a study in 59 cancer patients, Pycnogenol (150 mg/day) may reduce side effects associated with radiation or chemotherapy, including mouth soreness and ulcers, mouth and eye dryness, nausea, vomiting, diarrhea and weight loss .
In a study of 72 children undergoing cancer chemotherapy, Pycnogenol reduced painful mouth ulcers, both alone and in combination with vitamin E .
In a clinical trial of 92 people with tinnitus, or ringing in the ears, Pycnogenol (100-150 mg/day) helped reduce symptoms and improve blood flow in the ears after 4 weeks .
In combination with Mirtoselect, Pycnogenol may improve blood flow to the eye and reduce eye blood pressure as shown in a trial of 38 people .
Enzogenol, a slightly different pine bark extract, may help improve brain function after mild concussions. It decreased concussion symptoms in 42 student-athletes with a history of sports-related concussions after 6 weeks. Enzogenol also may reduce mental fatigue and sleep problems .
31) Jet Lag
A study of 68 people found that Pycnogenol, started 2 days prior to flying, may reduce the duration of jet lag symptoms .
32) Leg Cramps
A study of 66 healthy adults found that Pycnogenol may reduce the number of leg cramps experienced .
Limitations and Caveats
Certain studies used combination products, so it’s unknown what the contribution of Pycnogenol itself was.
Also, it’s important to note that some of these studies were funded by Horphag Research, the original developers and exclusive marketers of Pycnogenol. However, these studies appear to be methodologically sound and reliable, with no blatant errors in the study design and data collection.
Pycnogenol Side Effects & Precautions
Pycnogenol is considered possibly safe when taken orally or when applied topically as a cream or ointment.
Reported effects include:
Pycnogenol acts as a sustained-release formulation. But the actual bioavailability of this complex mixture is still unknown. Since components of Pycnogenol can be modified during digestion and absorption as well as by the liver, diseases that affect the gut or liver may increase or decrease its effects .
Supplementing with Pycnogenol
In the following sections, we’ll discuss the common forms and dosages of Pycnogenol that are commercially available. Pycnogenol is not approved by the FDA for medical use. Regulations set manufacturing standards for supplements, but that does not guarantee that they are safe or effective. Speak with your doctor before supplementing.
There is currently insufficient evidence to determine what a safe and effective dose of lysine is for specific conditions.
The dosage in most clinical studies varied between 50-360 mg/day. The standard dose appears to be 100-200 mg/day.
Pycnogenol and Pine Bark Extract Supplements
Various brands of pycnogenol are available. Some pycnogenol supplements are mixed with other antioxidants, such as vitamin C.
- Pycnogenol is standardized to contain 70 ± 5% procyanidins, which should be on the label
- Pycnogenol standardization doesn’t determine other major active compounds, which can vary
Pine bark extracts other than pycnogenol are also sold. Although these may still be high quality, the active compounds are more likely to vary.