Benefits
Traditional use to increase urine flow and flush the urinary tract
Europe's herbal committee accepts dandelion leaf tea, liquid extract and fresh juice as a traditional herbal medicine to increase urine output and flush the urinary tract in minor urinary complaints, with adequate fluid intake. That acceptance rests only on long-standing use: its assessors found no clinical studies and said a well-established use could not be supported.
Urination frequency over one day in a small volunteer study
In 17 volunteers who took 8 mL of a fresh leaf ethanol extract three times in one day, urination frequency rose in the 5 hours after the first dose and the ratio of urine volume to fluid intake rose after the second dose. The third dose changed nothing, and total daily urine volume did not change significantly. There was no control group or blinding, and volunteers recorded their own intake and output.
Urine and salt excretion in rats
In an older rat study summarized by Europe's assessors, water extracts of dandelion leaf given by stomach tube increased urine output more than root extracts did, with the strongest urine and salt excretion at a very high dose equal to 8 g of dried leaf per kg of body weight. Potassium excretion was especially high, which the assessors said may be due to the leaf's own potassium content.
Potassium supplied by the leaf and its tea
Dried dandelion leaf held about 30 to 48 mg of potassium per gram in one field study, and an infusion of 5 g of leaf in 200 mL of water contained 519 mg of potassium per liter. Europe's assessors calculated that the top traditional tea dose could supply up to about 3,100 mg of potassium a day, roughly two thirds of the US adult recommended intake at the time.
Liver fat and liver enzyme markers in mice
In mice fed a high-fat diet, adding a dandelion leaf extract to the feed reduced fat build-up in the liver, body and liver weight, blood triglycerides, cholesterol, insulin and fasting glucose compared with the high-fat diet alone. In mice on a liver-damaging diet, the extract lowered ALT and markers of oxidative stress and inflammation. No study has tested these outcomes in people.
Mechanism of action
Potassium load and salt excretion (proposed)
Europe's assessors suggest that any diuretic action of the leaf may be linked to its high potassium content, which is largely extracted into the tea. In rats, leaf extracts raised potassium excretion strongly. Whether ordinary tea amounts change urine output in people has not been shown in a controlled study.
Bitter sesquiterpene lactones
The leaf's bitter taste is linked mainly to taraxinic acid glucosyl ester and a related lactone. In lab work, the leaf extract and this compound activated Nrf2, a cell antioxidant switch, in human liver cells more strongly than a root extract did. Europe's assessors tie dandelion's allergy risk to the same class of compounds.
Bile flow in animals
Older animal studies summarized by Europe's assessors found that a leaf decoction raised bile output by up to 40% in rats when given into the small intestine, and doubled it for 30 minutes in dogs when injected. These were not oral studies in people. Europe lists blocked bile ducts and gallstones among the reasons not to use the leaf.
Drug-metabolizing liver enzymes in rats
Rats that drank a 2% dandelion tea for four weeks had lower activity of the liver enzymes CYP1A2 (15% of control) and CYP2E, and higher activity of the detoxifying enzyme UDP-glucuronosyl transferase (244% of control), while CYP2D and CYP3A were unchanged. Whether tea drinking does this in people is unknown.
Clinical trials
Single-group pilot study: volunteers recorded fluid intake and urine output for 2 baseline days, a dosing day with 8 mL of a fresh leaf hydroethanolic extract three times, and 24 hours after dosing; the extract was supplied at no cost by its maker. (Clare et al. 2009, J Altern Complement Med)
17 volunteers analyzed. The full text describes healthy women aged 18 to 65; 28 people enrolled and 11 did not finish, citing difficulty measuring fluid intake and output.
Urination frequency rose significantly (p < 0.05) in the 5 hours after the first dose, and the excretion ratio (urine volume to fluid intake) rose (p < 0.001) in the 5 hours after the second dose. The third dose failed to change any measure, and neither total daily fluid intake nor total daily urine volume differed significantly from the baseline day; the authors could not rule out a bladder-irritant effect. There was no placebo or control group and no blinding, and Europe's 2019 review noted self-monitoring and no correction for water in food. No adverse events were recorded.
Patch-test study in which patients with a known contact allergy to sesquiterpene lactones were recalled and tested with water extracts of 8 Asteraceae herbal teas, parthenolide and other sesquiterpene lactones. (Lundh et al. 2006, Contact Dermatitis)
20 patients with a known contact allergy to sesquiterpene lactones, from a Swedish dermatology research group.
18 of the 20 patients had positive reactions to the Asteraceae teas, mainly to those based on German chamomile, dandelion and wormwood. This was a skin test, not a study of drinking the tea, but it shows that people with this allergy often react to dandelion tea extracts.
Mouse feeding study: C57BL/6 mice received normal chow, a high-fat diet, or the high-fat diet with dandelion leaf extract at 2 or 5 g per kg of feed. (Davaatseren et al. 2013, Food Chem Toxicol)
C57BL/6 mice; no human participants.
Compared with the high-fat diet alone, the extract reduced liver fat accumulation, body and liver weight, serum triglycerides, total cholesterol, insulin, fasting glucose and HOMA-IR, and increased AMPK activation in liver and muscle. Not tested in people.
Rat study: female Wistar rats (5 per group) drank 2% dandelion, peppermint or chamomile tea, green tea extract, caffeine solution or water for four weeks before liver enzyme activity was measured. (Maliakal et al. 2001, J Pharm Pharmacol)
Female Wistar rats; no human participants.
Dandelion tea lowered CYP1A2 activity to 15% of control and CYP2E activity to 48% of control, and raised UDP-glucuronosyl transferase activity to 244% of control. CYP2D, CYP3A and glutathione S-transferase did not change. The relevance to people drinking dandelion tea is unknown.
Laboratory-animal study of dandelion extracts on urine output and body weight; PubMed has no abstract, so the details here come from the EMA assessment report. (Rácz-Kotilla et al. 1974, Planta Med)
Male rats given extracts by stomach tube (50 mL per kg of body weight); no human participants.
Water extracts of the leaf raised urine output more than root extracts. The highest diuretic and salt-excretion indices came at a dose equal to 8 g of dried herb per kg of body weight, far above human traditional amounts. Potassium excretion was very high, which the EMA report links to the leaf's potassium content of about 4.25%.