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Horseradish Armoracia rusticana Cochlearia armoracia

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Background: 
  • Horseradish (Armoracia rusticana) is a hardy perennial plant of the Brassicaceae family, which includes mustard and cabbage. Large doses by mouth can cause gastrointestinal upset, bloody vomiting, diarrhea, and irritation of mucous membranes and the urinary tract. Horseradish may also provoke allergic reactions.
  • Although horseradish may be irritating, it is frequently used as a condiment or spice, especially for beef, sausages, and fish. The U.S. Food and Drug Administration (FDA) has approved horseradish (Armoracia lapathifolia Gilib.) as Generally Recognized as Safe (GRAS) as a seasoning, spice, and flavoring (the FDA currently accepts Armoracia lapathifolia as the binomial name for horseradish, although Armoracia rusticana is more commonly used and is the preferred name by the U.S. Department of Agriculture).
  • Traditionally, horseradish has been used for pain, rheumatism, and cancer. It has also been studied for bronchitis, sinusitis, and urinary tract infections, but additional study is needed before making firm recommendations.
Related Terms: 
  • Allyl isothiocyanate, allylisothiocyanate, Armoracia lapathifolia Gilib., Armoracia rusticana, Armoracia rusticana Gaertner, Armoracia sativa Heller, Amoraciae Rusticanae Radix, Bohemian horseradish, Brassicaceae (family), Cochlearia armoracia, Cochlearia rusticana Lamarck, common horseradish, glucobrassicin, gluconasturtiin, glucosinolates, great raifort, horseradish peroxidase, horseradish peroxidase/indole-3-acetic acid, isoenzymes, isothiocyanates, Meerrettich (German), mountain radish, myrosinase, neoglucobrassicin, pepperrot, phosphatidylcholines, red cole, seiyowasabi (Japanese), sinigrin, thioglucoside conjugates, Western wasabi.
  • Note: This monograph does not include wasabi (Wasabia japonica), for which horseradish is a common substitute.
  • Note: The U.S. Food and Drug Administration (FDA) defines horseradish as the root of Armoracia lapathifolia Gilib. This monograph uses the more common scientific name Armoracia rusticana, which is used by the U.S. Department of Agriculture (USDA).
Evidence Table: 
  • These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
    		• Grade*
    Bronchitis
    Horseradish may have antibiotic activity, and has been used in combination with other herbs to treat bronchitis. However, additional studies are needed that use horseradish as a single therapy before a strong recommendation can be made.
    C
    Sinusitis
    Horseradish may have antibiotic activity, and has been used in combination with other herbs to treat sinusitis. However, additional studies are needed that use horseradish as a single therapy before a strong recommendation can be made.
    C
    Urinary tract infection
    Horseradish may have antibiotic activity, and has been used in combination with other herbs to treat urinary tract infections. However, additional studies are needed that use horseradish as a single therapy before a strong recommendation can be made.
    C
    Dosing: 
    Adults (over 18 years old)
    • There is no proven safe or effective medicinal dose of horseradish in adults.
    Children (under 18 years old)
    • There is no proven safe or effective medicinal dose of horseradish in children.
    Safety: 
    Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
    Allergies
    • Avoid in individuals with a known allergy or hypersensitivity to horseradish (Armoracia rusticana), its constituents, or members of the Brassicaceae family. Large doses taken by mouth may provoke allergic reactions.
    Side Effects and Warnings
    • Horseradish is likely safe when the root is used in food amounts. The U.S. Food and Drug Administration (FDA) has approved horseradish as Generally Recognized as Safe (GRAS) as a seasoning, spice, and flavoring.
    • There are few reported adverse effects associated with horseradish. Possible side effects include: abortion, aggravated stomach ulcers, esophageal irritation or other stomach conditions, allergic reactions, blistering, bloody vomiting, burning pain at the epigastrium, depressed thyroid function, diarrhea, diuretic, gastrointestinal upset, irritated mouth, pharynx, esophagus and stomach, irritation of mucous membranes and the urinary tract, nausea, sinus and eye irritation, skin irritation, stimulated bladder, stimulation of the stomach and salivation, violent sneezing, vomiting, and worsened kidney conditions.
    • Use cautiously in patients with low blood pressure or taking antihypertensives, as horseradish in medicinal amounts may lower blood pressure.
    • Use cautiously in patients taking anti-inflammatory agents, as horseradish may inhibit COX-1 enzymes.
    • Use cautiously in patients undergoing treatment for cancer, as horseradish and horseradish combined with indole-3-acetic acid may have antineoplastic (anticancer) activity.
    • Use cautiously in patients with thyroid disorders or taking thyroid hormones, as medicinal amounts of horseradish may interact with thyroid medications.
    • Avoid medicinal amounts of horseradish in patients who are pregnant or breastfeeding, as glucosinolates from horseradish are considered a toxin that can be excreted through breast milk and may pose a toxicity hazard.
    • Use cautiously in patients with kidney disorders, kidney inflammation, gastrointestinal conditions, or ulcers, as horseradish may have strong diuretic (increased urination) effects.
    • Use cautiously in patients with stomach ulcers.
    Pregnancy and Breastfeeding
    • Avoid if pregnant or breastfeeding. Horseradish has been used to induce abortion. Certain chemicals, such as glucosinolates, from horseradish are considered toxins that can be excreted through breast milk and may pose a toxicity hazard.
    Interactions: 
    Interactions with Drugs
    • Horseradish may have antibiotic activity. Use cautiously with antibiotics, due to additive effects.
    • Horseradish may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
    • Horseradish in medicinal amounts may have hypotensive (blood pressure-lowering) activity. Use cautiously with blood pressure medications.
    • Horseradish may inhibit COX-1 enzymes. Use cautiously with anti-inflammatory agents, due to possible additive effects.
    • Horseradish may have antineoplastic activity. Use cautiously with anticancer medications, due to possible additive effects.
    • Horseradish root may have oxidative activity; use cautiously with other antioxidants, due to possible additive effects.
    • Medicinal amounts of horseradish may interact with thyroid medications.
    • Horseradish may have strong diuretic (increased urination) effects.
    • Medicinal amounts of horseradish may interact with thyroid medications; use cautiously.
    Interactions with Herbs and Dietary Supplements
    • Horseradish may have antibiotic activity. Use cautiously with antibacterial herbs and supplements, due to possible additive effects.
    • Horseradish may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto.
    • Horseradish may inhibit COX-1 enzymes. Use cautiously with anti-inflammatory herbs and supplements.
    • Horseradish may have antineoplastic activity. Use cautiously with anticancer herbs or supplements.
    • Horseradish root may have oxidative activity. Use cautiously with herbs or supplements with antioxidant activity.
    • Horseradish may have strong diuretic effects. Horseradish may also have beneficial effects when taken with the phytohormone, indole-3-acetic acid, although human evidence is lacking in this area.
    • Horseradish in medicinal amounts may have hypotensive (blood pressure-lowering) activity; use cautiously with blood pressure medications.
    • Horseradish contains tannins and vitamin C, which may have additive effects when taken with other tannin-containing herbs or vitamin C supplements.
    • Medicinal amounts of horseradish may interact with thyroid medications; use cautiously.
    Attribution: 
    • This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): J. Kathryn Bryan, BA (Natural Standard Research Collaboration); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Tera Stock, PharmD (Massachusetts College of Pharmacy and Health Sciences); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).
    References: 
    Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
    • Agabeili RA, Kasimova TE, Alekperov UK. [Antimutagenic activity of plant extracts from Armoracia rusticana, Ficus carica and Zea mays and peroxidase in eukaryotic cells]. Tsitol.Genet. 2004;38(2):40-45.
    • Agabeili RA, Kasimova TE. [Antimutagenic activity of Armoracia rusticana, Zea mays and Ficus carica plant extracts and their mixture]. Tsitol.Genet. 2005;39(3):75-79.
    • Conaway CC, Yang YM, Chung FL. Isothiocyanates as cancer chemopreventive agents: their biological activities and metabolism in rodents and humans. Curr Drug Metab 2002;3(3):233-255.
    • Goos KH, Albrecht U, Schneider B. [Efficacy and safety profile of a herbal drug containing nasturtium herb and horseradish root in acute sinusitis, acute bronchitis and acute urinary tract infection in comparison with other treatments in the daily practice/results of a prospective cohort study]. Arzneimittelforschung 2006;56(3):249-257.
    • Govere EM, Tonegawa M, Bruns MA, et al. Using minced horseradish roots and peroxides for the deodorization of swine manure: a pilot scale study. Bioresour.Technol 2007;98(6):1191-1198.
    • Kawaoka A, Matsunaga E, Endo S, et al. Ectopic expression of a horseradish peroxidase enhances growth rate and increases oxidative stress resistance in hybrid aspen. Plant Physiol 2003;132(3):1177-1185.
    • Li X, Kushad MM. Purification and characterization of myrosinase from horseradish (Armoracia rusticana) roots. Plant Physiol Biochem 2005;43(6):503-511.
    • Luczaj L, Szymanski WM. Wild vascular plants gathered for consumption in the Polish countryside: a review. J Ethnobiol.Ethnomedicine. 2007;3:17.
    • Park IK, Choi KS, Kim DH, et al. Fumigant activity of plant essential oils and components from horseradish (Armoracia rusticana), anise (Pimpinella anisum) and garlic (Allium sativum) oils against Lycoriella ingenua (Diptera: Sciaridae). Pest.Manag.Sci 2006;62(8):723-728.
    • Patterson AV, Saunders MP, Greco O. Prodrugs in genetic chemoradiotherapy. Curr Pharm Des 2003;9(26):2131-2154.
    • Sakuyama H, Endo Y, Fujimoto K, et al. Oxidative degradation of alkylphenols by horseradish peroxidase. J Biosci.Bioeng. 2003;96(3):227-231.
    • Tonegawa M, Dec J, Bollag JM. Use of additives to enhance the removal of phenols from water treated with horseradish and hydrogen peroxide. J Environ.Qual. 2003;32(4):1222-1227.
    • Veitch NC. Horseradish peroxidase: a modern view of a classic enzyme. Phytochemistry 2004;65(3):249-259.
    • Weil MJ, Zhang Y, Nair MG. Colon cancer proliferating desulfosinigrin in wasabi (Wasabia japonica). Nutr Cancer 2004;48(2):207-213.
    • Weil MJ, Zhang Y, Nair MG. Tumor cell proliferation and cyclooxygenase inhibitory constituents in horseradish (Armoracia rusticana) and Wasabi (Wasabia japonica). J Agric Food Chem 3-9-2005;53(5):1440-1444.
    Disclaimer : 
    The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
    Copyright: 
    Copyright © 2010 Natural Standard (www.naturalstandard.com)

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