Home Ingredients European Mistletoe Herb (Viscum album), Oral Tea

European Mistletoe Herb (Viscum album), Oral Tea

Viscum album
Evidence Level
Preliminary
4 Clinical Trials
5 Documented Benefits
1/5 Evidence Score

European mistletoe (Viscum album) is a semi-parasitic evergreen shrub that grows on trees such as apple, oak and pine. Its dried leafy twigs are sold as a herbal tea, tincture or tablet, and in parts of Europe the tea is traditionally taken to support normal blood pressure. This page covers only oral use; injected prescription extracts such as Iscador and Helixor are separate products. Human evidence for the oral herb is thin: one uncontrolled pilot of a mother tincture in India, and one placebo-controlled trial of the related Korean variety on muscle in older adults. The European Medicines Agency reviewed the herb, found no evidence of clinical efficacy for its blood pressure use, and adopted no EU monograph. The plant contains toxic proteins (lectins and viscotoxins), so the berries and homemade preparations should be kept away from children.

Studied Dose Mother tincture 10 drops three times daily for 12 weeks in one uncontrolled pilot; Korean mistletoe extract 1 or 2 g/day for 12 weeks in one placebo trial. German tea products listed by the EMA: one 2 g tea bag per cup, 2 to 3 cups daily.
Active Compound No single active compound is established. The plant contains mistletoe lectins (ML I, ML II, ML III), viscotoxins (small proteins of 46 amino acids), phenylpropanes and lignans (such as syringin), flavonoids (mainly quercetin derivatives), triterpenes (oleanolic and betulinic acid), polysaccharides and biogenic amines; levels vary with host tree, plant part and harvest season.

Benefits

Traditional European tea for circulation and blood pressure

Mistletoe tea has long been used in Europe to support normal blood pressure, and Austria registered it as a traditional tea for mild cardiovascular complaints. Reviewing the herb, the European Medicines Agency judged the human data scarce and conflicting, found no evidence of clinical efficacy, and adopted no EU monograph.

Supported by Trial 1, Trial 3

Blood pressure readings with an oral mother tincture

In an Indian pilot study in people with primary hypertension, a mother tincture was taken at 10 drops three times daily for 12 weeks. Blood pressure and blood triglycerides were lower at the end than at the start, but there was no control group, so the change cannot be separated from time, placebo or other care.

Supported by Trial 1

Muscle mass and leg strength alongside exercise (Korean variety)

In a 12-week placebo-controlled trial in 67 adults aged 55 to 75 combined with resistance exercise, Korean mistletoe (Viscum album var. coloratum) extract improved knee peak torque versus placebo. Muscle mass, body fat and balance test times improved within the 2 g/day group over the trial. This is a different variety from European mistletoe, and a single trial.

Supported by Trial 2

Heart function in a rat model (animal study)

In rats given a drug that damages heart muscle, European mistletoe extract by mouth (250 mg/kg/day by stomach tube) kept ejection fraction higher than in untreated damaged rats (65.2% vs 56.7%) and lowered a heart strain marker. This is an animal result and has not been tested in people.

Supported by Trial 4

Insulin release from pancreatic cells (lab study)

In cultured insulin-producing pancreatic cells, a water extract of European mistletoe raised insulin release 1.1- to 12.2-fold over 20 minutes, and the effect did not depend on the lectins or on heating. This is a test-tube finding; no human study has tested oral mistletoe for blood sugar.

Supported by Trial 4, Trial 3

Mechanism of action

1

Toxic lectins and viscotoxins, and what reaches a cup of tea

Mistletoe lectin I is a ricin-like protein that blocked protein synthesis in lab cell systems and caused lesions in poisoned rats. In a lab analysis of mistletoe tea, viscotoxins did not dissolve with either hot or cold water, while 43% of lectins dissolved in a cold soak and hot infusion inactivated them by heat.

2

Blood vessel effects in lab tissue

In blood vessels from hypertensive rats, one winter pine-host mother tincture relaxed small arteries through nitric oxide and potassium channels. In rat aorta rings, however, several isolated mistletoe compounds tightened the vessel and only one relaxed it slightly, so lab results point in different directions.

3

Proposed nerve and amine pathways

Older literature summarized by the European Medicines Agency attributes the traditional blood pressure effect to choline esters, histamine, GABA, tyramine and flavones acting on the parasympathetic nervous system. The agency stated that the exact mode of action is still unknown, and no data exist on how oral preparations are absorbed.

Clinical trials

1
Viscum album Mother Tincture and Blood Pressure: Indian Single-Group Pilot (no control group)
PubMed

Single-group pretest and posttest pilot study at a homeopathic medical college in India of an oral Viscum album mother tincture, 10 drops three times daily for 12 weeks. (Poruthukaren et al. 2014, J Evid Based Complementary Altern Med)

People with primary hypertension; the abstract does not give the number of participants or their other treatments.

By paired t test, blood pressure and serum triglycerides fell significantly from baseline (P < .0001). The abstract gives no effect sizes, and with no placebo or control group the drop cannot be attributed to mistletoe rather than time, regression to the mean or other care.

2
Korean Mistletoe Extract with Resistance Exercise in Older Adults: 12-Week Placebo RCT
PubMed

Randomized placebo-controlled trial of Korean mistletoe (Viscum album var. coloratum) extract at 1 g/day or 2 g/day, or placebo, for 12 weeks combined with resistance exercise. (Lim et al. 2017, Exp Gerontol)

67 adults aged 55 to 75, assigned to placebo, 1 g/day or 2 g/day.

In the 2 g/day group, skeletal muscle mass, fat-free mass and percent body fat changed significantly during the trial; the abstract does not report these as differences versus placebo. Knee peak torque improved in the extract groups versus placebo (P = 0.026); set total work did not reach significance (P = 0.057) until adjusted for age, sex, protein and energy intake. Timed Up and Go improved in the high-dose group. This is the Korean variety, not European mistletoe.

3
Lab Study: What Hot Infusion and Cold Soaking Extract from Mistletoe Tea
PubMed

Laboratory analysis comparing mistletoe tea made as a hot infusion or by maceration at room temperature, measuring marker substances in the herb and in each tea. (Jäger et al. 2011, Sci Pharm)

No human or animal participants; dried mistletoe herb and tea preparations.

Neither method dissolved viscotoxins. A cold soak extracted 43% of mistletoe lectins, while hot infusion inactivated them by heat. Phenylpropane derivatives were fully extracted by both methods, flavonoid-like substances more by infusion (43% vs 31%), and triterpenes less than 2%. The authors note the relevance for efficacy is untested.

4
Animal Study: Oral European Mistletoe Extract in Rats with Drug-Induced Heart Damage
PubMed

Randomized rat study of Viscum album ssp. album given by stomach tube at 250 mg/kg/day in isoproterenol-induced heart failure, compared with untreated damaged and healthy control rats. (Karagöz et al. 2016, Anatol J Cardiol)

30 male Wistar rats, 10 per group.

Ejection fraction was 65.2% with the extract, 56.7% in untreated damaged rats and 73.3% in healthy controls (p < 0.05), with lower NT-proBNP, hs-CRP, nitric oxide and iNOS levels. An animal model at a high dose; no human data.

Side effects and drug interactions

Common Potential side effects

Berries and plant parts: the US National Cancer Institute notes that mistletoe plants and berries are considered poisonous. The European Medicines Agency describes the herb as non-toxic by mouth in usual use but reports rare nausea, vomiting, diarrhea, and raised blood pressure followed by shock, mostly after eating the berries. Keep decorations away from children and pets.
Most poison center data come from American mistletoe (Phoradendron), a different plant: of 1,754 US exposures in 1985 to 1992, 92.1% were in children, 99.2% had no ill effects and none were fatal. For European mistletoe, a toxicology review notes that reported deaths were mainly linked to excessive use in herbal teas, and that the only two mistletoe deaths reported over 25 years followed brewed teas.
Liver: two case reports linked oral mistletoe products to liver inflammation, one a multi-herb tablet that also contained skullcap and one a mistletoe extract taken with kudzu. LiverTox rates mistletoe as unlikely to cause clinically apparent liver injury. Stop and see a doctor for dark urine, yellow skin or right upper belly pain.
Pregnancy and breastfeeding: the European Medicines Agency notes use is not recommended because of the lectins and viscotoxins.
The European Medicines Agency found that the safety of oral mistletoe preparations has not been studied in dedicated human trials, and that oral pharmacokinetic data are lacking.

Important Drug interactions

Blood pressure medicines: no interaction studies exist; because mistletoe tea is traditionally taken to lower blood pressure, check with your doctor and monitor readings if you combine them.
Drugs cleared by CYP3A4: mistletoe weakly inhibited CYP3A4 in a lab study only at high concentrations, and the authors judged a clinically relevant interaction unlikely. The European Medicines Agency likewise judged drug interactions rather unlikely.
Prescribed injected mistletoe extracts: oral mistletoe products are not a substitute for, or a home version of, prescription injectables; tell your care team about any mistletoe product you take.

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Frequently asked questions about European Mistletoe Herb (Viscum album), Oral Tea

Is mistletoe tea the same thing as injected mistletoe extracts like Iscador?

No. Iscador, Helixor and similar products are prescription injections used in some European clinics, are not available commercially in the United States, and were studied by injection. A tea or capsule taken by mouth is a different preparation, and injection research does not tell you what the tea does.

Are mistletoe berries poisonous?

Treat them as poisonous and keep them away from children and pets. Most poison center data are for American mistletoe (Phoradendron), where nearly all accidental swallowing caused no ill effects. For European mistletoe, the EU regulator lists rare nausea, vomiting, diarrhea and shock, mostly after berries, while one toxicology review calls the berries harmless except in very large amounts. Call a poison center if a child eats any.

Does it matter whether mistletoe tea is made with hot or cold water?

It changes what ends up in the cup. In a lab analysis, neither method dissolved the viscotoxins; a 12-hour room-temperature soak extracted about 43% of the lectins, while hot water inactivated them, and hot water drew out more flavonoid-like compounds. Whether either version does anything in the body has not been tested.

Is American mistletoe the same plant as European mistletoe?

No. American mistletoe (Phoradendron) and European mistletoe (Viscum album) are different plants with different toxins. Most poison center data come from American mistletoe, and products sold as herbal mistletoe usually mean Viscum album, so check the Latin name on the label.

Does research on Korean mistletoe apply to European mistletoe?

Not directly. Korean mistletoe (Viscum album var. coloratum) is a related variety with its own extracts, and the one muscle trial in older adults used it together with resistance exercise. Results from it should not be assumed for European mistletoe tea.

What is European Mistletoe Herb (Viscum album), Oral Tea?

European mistletoe (Viscum album) is a semi-parasitic evergreen shrub that grows on trees such as apple, oak and pine. Its dried leafy twigs are sold as a herbal tea, tincture or tablet, and in parts of Europe the tea is traditionally taken to support normal blood pressure.

What is European Mistletoe Herb (Viscum album), Oral Tea used for?

NutraSmarts does not list European Mistletoe Herb (Viscum album), Oral Tea under a health category. What the research covers: Mistletoe tea has long been used in Europe to support normal blood pressure, and Austria registered it as a traditional tea for mild cardiovascular complaints.

What is the recommended dosage of European Mistletoe Herb (Viscum album), Oral Tea?

The clinically studied dose is Mother tincture 10 drops three times daily for 12 weeks in one uncontrolled pilot; Korean mistletoe extract 1 or 2 g/day for 12 weeks in one placebo trial. German tea products listed by the EMA: one 2 g tea bag per cup, 2 to 3 cups daily. Always follow the product label and check with a healthcare provider for personal advice.

Is European Mistletoe Herb (Viscum album), Oral Tea safe, and does it have side effects?

Side effects and cautions reported for European Mistletoe Herb (Viscum album), Oral Tea include: Berries and plant parts: the US National Cancer Institute notes that mistletoe plants and berries are considered poisonous. The European Medicines Agency describes the herb as non-toxic by mouth in usual use but reports rare nausea, vomiting, diarrhea, and raised blood pressure f… It may also interact with some medications. European Mistletoe Herb (Viscum album), Oral Tea is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does European Mistletoe Herb (Viscum album), Oral Tea interact with any medications?

Possible interactions include: Blood pressure medicines: no interaction studies exist; because mistletoe tea is traditionally taken to lower blood pressure, check with your doctor and monitor readings if you combine them. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for European Mistletoe Herb (Viscum album), Oral Tea?

NutraSmarts rates the evidence for European Mistletoe Herb (Viscum album), Oral Tea as Preliminary (1 out of 5). It is backed by 4 study summaries and 16 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(16 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Assessment report on Viscum album L., herba (EMA/HMPC/246778/2009). Final. European Medicines Agency. 2012;EMA/HMPC/246778/2009, 20 November 2012..SourceUsed to support: Not PubMed-indexed; official EU regulatory assessment. Austria registered comminuted mistletoe herb as a traditional herbal tea for mild cardiovascular problems; German tea products listed in the report use one 2 g tea bag per cup, 2 to 3 cups daily. The agency found little evidence for a blood pressure lowering effect (few patients, poorly defined inclusion criteria, scarce and conflicting results), no evidence of clinical efficacy, no oral pharmacokinetic data and no dedicated human safety studies. It describes oral ingestion as non-toxic in usual use but notes rare nausea, vomiting, diarrhea and hypertension followed by shock, mostly after berries; advises against use in pregnancy and breastfeeding; and judged drug interactions rather unlikely.
  2. PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, National Cancer Institute. Mistletoe Extracts (PDQ): Health Professional Version. National Cancer Institute. 2024;Updated November 6, 2024; accessed 2026..SourceUsed to support: Not PubMed-indexed; US government summary. Mistletoe extracts used in cancer care in Europe (such as Iscador and Helixor) are injectable prescription drugs that are not available commercially in the United States and are not approved as a treatment for people with cancer. Mistletoe plants and berries are considered poisonous to humans. Cited here only to separate injected products from the oral herb; no efficacy claims are drawn from it.
  3. LiverTox, National Institute of Diabetes and Digestive and Kidney Diseases. Mistletoe. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2022;Bethesda (MD): NIDDK; 2012-. Updated 2022 Jul 25. Bookshelf ID: NBK583200..PubMedUsed to support: NIH liver-injury database entry: European mistletoe has been taken by mouth as extracts, tablets or capsules; in the rare liver-injury cases attributed to it, patients also took other potentially liver-toxic herbs (skullcap, kudzu), so mistletoe has not been shown convincingly to cause clinically apparent liver injury (likelihood score E). It notes mistletoe can cause cardiac and neurologic toxicity in high doses.
  4. Poruthukaren KJ, Palatty PL, Baliga MS, Suresh S. Clinical evaluation of Viscum album mother tincture as an antihypertensive: a pilot study. J Evid Based Complementary Altern Med. 2014;19(1):31-5. doi: 10.1177/2156587213507726.PubMedUsed to support: Single-group pretest and posttest pilot in India in adults with primary hypertension: a Viscum album mother tincture taken at 10 drops three times daily for 12 weeks was followed by significant falls in blood pressure and serum triglycerides from baseline (paired t test, P < .0001). No control group; the abstract gives no participant number or effect sizes.
  5. Lim NJ, Shin JH, Kim HJ, Lim Y, Kim JY, Lee WJ, Han SJ, Kwon O. A combination of Korean mistletoe extract and resistance exercise retarded the decline in muscle mass and strength in the elderly: A randomized controlled trial. Exp Gerontol. 2017;87(Pt A):48-56. doi: 10.1016/j.exger.2016.11.003.PubMedUsed to support: Randomized placebo-controlled trial in 67 adults aged 55 to 75: Korean mistletoe (Viscum album var. coloratum) extract at 1 or 2 g/day for 12 weeks with resistance exercise. The 2 g/day group showed significant changes in skeletal muscle mass, fat-free mass and percent body fat; knee peak torque improved versus placebo (P = 0.026), and Timed Up and Go improved in the high-dose group. A different variety from European mistletoe.
  6. Jäger S, Beffert M, Hoppe K, Nadberezny D, Frank B, Scheffler A. Preparation of herbal tea as infusion or by maceration at room temperature using mistletoe tea as an example. Sci Pharm. 2011;79(1):145-55. doi: 10.3797/scipharm.1006-06.PubMedUsed to support: Lab analysis of mistletoe tea: neither hot infusion nor room-temperature maceration dissolved viscotoxins; maceration extracted 43% of mistletoe lectins, while infusion inactivated them by heat; infusion extracted 43% of flavonoid-like substances versus 31% by maceration; triterpenes were under 2%. The authors note that no active substances are known and efficacy relevance is untested.
  7. Karagöz A, Kesici S, Vural A, Usta M, Tezcan B, Semerci T, Teker E. Cardioprotective effects of Viscum album L. ssp. album (Loranthaceae) on isoproterenol-induced heart failure via regulation of the nitric oxide pathway in rats. Anatol J Cardiol. 2016;16(12):923-930. doi: 10.14744/AnatolJCardiol.2016.6780.PubMedUsed to support: Animal study in 30 rats: Viscum album ssp. album given by stomach tube at 250 mg/kg/day improved left ventricular measures after isoproterenol-induced heart damage (ejection fraction 65.2% vs 56.7% untreated, 73.3% healthy controls) and lowered NT-proBNP, hs-CRP, nitric oxide and iNOS. Not tested in people.
  8. Stirpe F, Legg RF, Onyon LJ, Ziska P, Franz H. Inhibition of protein synthesis by a toxic lectin from Viscum album L. (mistletoe). Biochem J. 1980;190(3):843-5. doi: 10.1042/bj1900843.PubMedUsed to support: Lab study: the toxic mistletoe lectin inhibited protein synthesis in a rabbit reticulocyte lysate (ID50 2.6 micrograms/ml) and in cultured cells (ID50 7 ng/ml); with lesions seen in rats poisoned with the lectin, the authors describe it as a toxin very similar to ricin.
  9. Gray AM, Flatt PR. Insulin-secreting activity of the traditional antidiabetic plant Viscum album (mistletoe). J Endocrinol. 1999;160(3):409-14. doi: 10.1677/joe.0.1600409.PubMedUsed to support: Lab study in clonal pancreatic B-cells: 1 to 10 mg/ml aqueous mistletoe extract raised insulin secretion 1.1- to 12.2-fold over 20 minutes; the effect did not depend on heat during preparation and was not mediated by lectins. No human data.
  10. Duarte RDSP, Melo MNO, Batista JVC, Martins GG, Oliveira AP, Taveira-da-Silva R, da Silva MLF, Valverde RHF, Einicker-Lamas M, Gasparotto Junior A, Baumgartner S, Holandino C. Viscum album L. mother tinctures modulate Na(+)/K(+) ATPase activity and expression, and promote endothelium-dependent vasodilation via SK channel and nitric oxide signalling. Front Physiol. 2025;16:1736143. doi: 10.3389/fphys.2025.1736143.PubMedUsed to support: Lab and isolated-tissue study of ten Viscum album mother tinctures: effects differed by host tree and harvest season; the winter pine-host tincture relaxed resistance arteries from spontaneously hypertensive rats through nitric oxide signaling and small-conductance calcium-activated potassium channels. One tincture (oak host) was cytotoxic in vitro.
  11. Deliorman D, Caliş I, Ergun F, Doğan BS, Buharalioğlu CK, Kanzik I. Studies on the vascular effects of the fractions and phenolic compounds isolated from Viscum album ssp. album. J Ethnopharmacol. 2000;72(1-2):323-9. doi: 10.1016/s0378-8741(00)00251-8.PubMedUsed to support: Lab study in noradrenaline-contracted rat aortic rings: isolated mistletoe phenolic compounds (syringin, coniferin and a flavanone glycoside) caused concentration-dependent contractions, only kalopanaxin D relaxed the vessel very slightly, and less polar subfractions had weak relaxant effects.
  12. Krenzelok EP, Jacobsen TD, Aronis J. American mistletoe exposures. Am J Emerg Med. 1997;15(5):516-20. doi: 10.1016/s0735-6757(97)90199-6.PubMedUsed to support: Poison center case series of 1,754 exposures to American mistletoe (Phoradendron, a different plant from Viscum album) reported to US poison centers in 1985 to 1992: 92.1% were in children, 94.7% were accidental, 99.2% had an outcome with no morbidity and there were no deaths; gut decontamination did not change outcomes.
  13. Evens ZN, Stellpflug SJ. Holiday plants with toxic misconceptions. West J Emerg Med. 2012;13(6):538-42. doi: 10.5811/westjem.2012.8.12572.PubMedUsed to support: Toxicology review: distinguishes American (Phoradendron serotinum) and European (Viscum album) mistletoe; states that Viscum berries are harmless except in very large amounts, that viscotoxins can cause delayed gastrointestinal upset, that reported European mistletoe fatalities were mainly linked to excessive use in herbal teas, and that the only two mistletoe deaths reported over 25 years followed brewed teas; notes steeping the plant in hot water may deliver large amounts of toxin, while most accidental exposures are symptom-free.
  14. Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed). 1981;282(6259):186-7. doi: 10.1136/bmj.282.6259.186.PubMedUsed to support: Case report: a 49-year-old woman had two episodes of hepatitis after taking herbal tablets containing kelp, motherwort, skullcap and mistletoe, confirmed by a challenge test; the authors blamed the mistletoe, but later commentary (LiverTox) notes skullcap is a known liver toxin, so attribution is uncertain.
  15. Kim HJ, Kim H, Ahn JH, Suk HJ. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med. 2015;21(3):180-5. doi: 10.1089/acm.2014.0228.PubMedUsed to support: Case report: a previously healthy 55-year-old man in Korea developed hepatocellular liver injury (ALT up to 1528 IU/L) after taking a mistletoe extract for 1 month and kudzu root extract for 10 days; a causality score rated mistletoe a probable cause, and liver tests fell after both were stopped.
  16. Engdal S, Nilsen OG. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients. Phytother Res. 2009;23(7):906-12. doi: 10.1002/ptr.2750.PubMedUsed to support: Lab enzyme study: a mistletoe remedy inhibited CYP3A4 only weakly (IC50 3594 micrograms/mL), and the authors judged clinically relevant systemic or intestinal CYP3A4 interactions unlikely for it.