Is Comfrey Safe to Eat?
Tuberous comfrey (left) with cream flowers, Russian comfrey (right) with purple flowers.
Common comfrey is a wild-growing herb that has a long tradition as both an edible and a medicinal species. It is a nutritious plant, being very high in Vitamin A, riboflavin, potassium, manganese and dietary fibre, and also a source of other vitamins and minerals such as magnesium and selenium needed by our bodies. It isn’t eaten a lot, as it has a slightly hairy, rough texture as the leaves age, but the young leaves and buds are very tender and delicious in recipes such as Comfrey Leaf Lemonade Fritters. The leaves are used a lot as a herbal tea. In other countries it has been grown as a vegetable and prepared as a ratatouille – and very tasty it is too!
In herbal medicine, comfrey is traditionally used to repair damaged joints, broken bones and torn tendons. This is because comfrey is very high in both vitamin K and vitamin K2 which promote fracture healing (Hodges, 1995). Incidentally, comfrey is one of the few plants that takes up vitamin B12 from the soil, the vitamin that vegans need to supplement with to avoid pernicious anaemia. The name comfrey comes from the Latin ‘confera’ which means to knit together, hence the old country name for comfrey of Knitbone. (It’s botanical name comes from the Greek word symphyo meaning to unite.) Comfrey root ointment is used to treat painful osteoarthritis of the knee. A clinical trial showed that the ointment works significantly better than a placebo ointment, with five times the effect in pain reduction and four times improvement in quality of life (Grube, Grünwald, Krug & Staiger, 2007).
Comfrey is often used in ointments such as this Napiers Organic Comfrey and Hypericum Soothing SalveIt is also used in cosmetics because comfrey contains substances that help skin regrow, including allantoin, rosmarinic acid and tannins.
Although herbal medicines are widely considered by the scientific community to be of lower risk than synthetic drugs, they can still sometimes cause toxicity or side effects (De Smet, 2004).
What are pyrrolizidine alkaloids (PAs)?
You may have found warnings or restrictions on the internal use of comfrey on the internet. This is because comfrey contains pyrrolizidine alkaloids (PAs). Pyrrolizidine alkaloids are a group of 660 phytochemicals found in over 6,000 plants. PAs can also found in honey, grains, milk, offal and eggs. In the case of some species of comfrey, a particular PA called echimidine has caused special concern as it is toxic to the liver in animals. Due to this, medicinal or food products for internal use containing comfrey root, are restricted in many countries, with a few also restricting comfrey leaf, although it contains far fewer alkaloids.
The species really matters!
My homemade Comfrey Leaf Fritters made from tuberous comfrey (Symphytum tuberosum).
There are several species of comfrey plant. I only eat common comfrey, Symphytum officinale (leaf not root) which rarely contains echimidine and tuberous comfrey (Symphytum tuberosum) which has less than 0.02% PAs. The difficulty nowadays is that common comfrey hybridises to Russian comfrey and some modern analysis shows echimidine appearing in common comfrey too.
Up until now (2018), Common comfrey leaf Symphytum officinale has been allowed in over-the-counter preparations in the USA, UK, Canada, Germany. Canada’s Food and Drug Regulations prohibits the sale, for medicinal purposes, of any products containing echimidine (Canada Gazette, 30 March 1988). Canada’s Cosmetic Regulations ban Symphytum species EXCEPT for Symphytum officinale which is allowed. Echimidine, considered to be the most toxic of the PAs found in comfrey (Brauchli-Theotokis 1987), is rarely found in most samples of common comfrey (Symphytum officinale L.) (Couet et al. 1996; Roitman 1981) but seems to appear more often in later studies. This may be due to the ability of common comfrey to hybridise with prickly comfrey creating a hybrid called Russian comfrey (Symphytum x uplandicum).
Look at the photo at the top of this post – it shows the difference between tuberous comfrey and Russian comfrey. Here in Scotland, tuberous comfrey always has cream flowers.
Common comfrey has flowers that range from white to purple. This make identification a little more difficult. Common comfrey in England mainly has strong coloured pink-purple flowers and lance shaped leaves, while Russian comfrey, which tends to be a bigger plant with broader pointed leaves, has paler violet or blue-purple flowers. Russian comfrey is widely sold to gardeners as the Bocking 14 hybrid for fertiliser. Due to the concerns about PAs, it is important to be able to identify the different comfrey species and it is not easy to tell them apart – except for the tuberous comfrey.
Common comfrey
Common comfrey with white flowers
Common comfrey with pink flowers.jpg?ssl=1)
Common comfrey with purple flowersBritish herbalists use, common comfrey Symphytum officinale. Please see the following excerpt from American Botanical Council research in 1994 when the first concerns were raised.
“The first Canadian action was taken in 1982, when the Health Protection Branch of Health and Welfare Canada introduced an amendment to Canada’s Food and Drug Regulations which prohibits the sale, for medicinal purposes, of any products containing echimidine (Canada Gazette, 30 March 1988).
Echimidine, considered to be the most toxic of comfrey PAs (Brauchli-Theotokis 1987), is not found in common comfrey (Symphytum officinale L.). However, it is present in prickly comfrey (S. asperum Lepechin) and its hybrids with S. officinale (Huizing, Gadella, and Kliphuis 1982), including Russian comfrey (S. x uplandicum Nyman), which is the most commonly encountered commercial comfrey in Britain (Clapham, Tutin and Warburg 1962) due to its popularity as a garden fertiliser especially the strain called Bocking.
Russian comfrey Bocking 14
Russian comfrey flowers
The intent of the Canadian legislation is to have more careful attention paid to identification of botanical species by the herbal industry, and to alert the Canadian public to the potential danger of PA consumption. There was no intent to underestimate the relative potential danger of echimidine-free S. officinale. Both root and leaf of Symphytum officinale have been shown to be carcinogenic in rats (Hirono et al. 1978), though again in this paper there is species confusion because the authors equate common comfrey and Russian comfrey!”
Animal testing – is it like for like?
Apart from the species mix up, these theoretical dangers quoted above in Hirono et al. 1978 are not without controversy. Dangerous actions are sometimes attributed to herbs because of in vitro or animal studies. And yet many papers that demonstrate actions in vitro or in animals cannot always be replicated in vivo – i.e. in humans. Animals and humans are not the same. In the Hirono study, the researchers found that forcing rats to eat huge quantities of ground comfrey leaves and roots did them no good at all – especially the 2 week old baby rats. Of note, out of 28 rats fed 8% of diet as dry weight comfrey, one showed a liver tumour at 600 days (a long life for a rat!). The average adult human would probably need to ingest 20,000 comfrey leaves to produce a comparative dose. Assuming 3 dried leaves of comfrey per cup of leaf tea, this equates to drinking 6,666 cups of tea. If you drank a cup of comfrey leaf tea every single day, it would take you over 18 years to reach this level of consumption!
A respected research herbalist, Margaret Whitelegg MNIMH wrote a paper in January 1993 called “In Defence of Comfrey” that was submitted to the Department of Health and Ministry of Agriculture, Fisheries and Food by the National Institute of Medical Herbalists – when these issues first surfaced. If you use her reference below of 5,607 leaves in a man-sized rat being equivalent to the injections of isolated PAs in another animal study, you’d need 1,867 cups of tea, so 5 years if drunk at a cup a day to match the study dose.
There are actually very few cases of comfrey toxicity in humans and they are all more complex than occasional consumption of comfrey as a vegetable. One of the 4 actual human cases known at the time, was a woman who took comfrey in excess – a.k.a. overdosing. She was a forty-seven year old non-alcoholic woman who began to feel unwell in 1978 with vague abdominal pain, fatigue and allergies (Bach, Swan et al (37)). She drank as many as ten cups of comfrey tea per day in addition to taking handfuls of comfrey pills, for over a year. Four years later, her serum aminotransferase levels were twice normal range. Eight years later she had further signs of liver disease. Despite the obvious abuse of comfrey and its use in a very unusual way, nevertheless this case is used to condemn the plant when taken in normal, moderate doses. I wonder what the effects of 10 cans of Red Bull or Coke drunk every day for four years would be on your liver? However, that doesn’t result in a ban of soft drinks.
In her paper, Margaret Whitelegg made the following points that I find significant:
“While evidence on pyrrolizidine alkaloid (PA) toxicity is mounting and the case against any PA-containing plant appears increasingly clear, the controversy over comfrey deserves closer inspection. It appears to be damned by its association with the effects of other PA containing plants, by the effects of its alkaloids on laboratory animals and by certain cases of hepatotoxicity through ingestion of the plant by humans. Yet I would argue that the case against comfrey is by no means proven in the scientific literature.”
She goes on to say:
“Effects on Animals.
Papers on the harmful effects of PAs on laboratory animals are legion, both those in other plant species (1-7) and in comfrey itself (8-11). One of the most often cited papers to this effect is that of Culvenor et al, “The structure and toxicity of the alkaloids of Russian Comfrey, a medicinal herb and item of human diet (12)”. He reported on an experiment in which alkaloids of comfrey were administered intraperitoneally to two-week old rats, either as a single dose or as multiple doses beginning at two weeks old over intervals of nine weeks. Evidence of hepatotoxicity was found. Bone (13) and Pembery (14) criticise this paper. Their criticisms reflect certain problems that occur repeatedly throughout the literature, whether proposing hepatotoxic, genotoxic or carcinogenic effects. Both authors suggest that two-week old rats are more vulnerable to the effects of PAs and, according to Jago, (15) are particularly susceptible to the induction of megalocytosis. Pembery, for the Doubleday Institute, looks more closely at the numerical data and extrapolates equivalent quantities of PAs for humans, suggesting that exposure in humans at such levels is unlikely : “…it can be seen that the dose required to produce the least effect in the rats, reduced liver function, detectable by a change in the proportion of the plasma proteins, is equivalent to the alkaloid from 5,607 leaves if administered to a “man-sized rat” That is, if we assume that the effect of the alkaloid in man (sic) is going to be the same as in a young rat, apparently the most susceptible of any so far tested. If an average comfrey leaf is taken as 100g (and older leaves are much more than this), this dose level represents about eight times the body weight of the man-sized rat. Deaths occurred at levels equivalent to the alkaloid from 19,880 leaves or equivalent to 28 times the bodyweight of the man-sized rat.” [My bold emphasis.]
“More importantly, however – and this applies to all experiments with isolated alkaloids – both authors argue that to give alkaloids in isolation and injected intraperitoneally into animals, cannot reflect the effects in humans of the entire plant taken orally. This reflects one of the central tenets of herbal medicine, that an isolated chemical of a plant, while useful for certain indications, cannot define the action of the whole herb, where the herb is more than the sum of the individual parts, its constituents working synergistically to create its healing effects. A press release by the National Institute of Medical Herbalists (16), written by F. Fletcher Hyde, FNIMH, speaks of “…two insupportable assumptions. First, that the naturally occurring complex in the plant … can be regarded as a mere physical dilution of alkaloids that the human metabolism is identical with that of the rat which is susceptible to these alkaloids, and not with the sheep which is resistant to them.”
“…Tea, almonds, apples, pears, mustard, radishes and hops, to list only a few items, all contain substances which, if extracted, can be shown to be poisonous when tested under conditions similar to those used in the comfrey experiments. Must we then ignore our experience of the usefulness and wholesomeness of these foods because controlled trials and scientific evidence have not been published to establish their safety?”
Personally, I would have also added honey to that list as it often contains the highest levels of PAs in your local supermarket. I also think that there is an extremely valid point to be made that extrapolating results to determine the safety of humans eating comfrey, from results of animals being injected with high concentrations of the alkaloids extracted from comfrey, is not sound.
The plant part matters: leaf not root
“Health and Welfare Canada has for many years refused to register comfrey root products for any medicinal application, in recognition of the much greater risk presented by root material as compared to leaf. Comfrey root has been consistently observed to contain roughly ten times the concentration of PA found in leaves (Mattocks 1986, Roitman 1981). Manufacturers have been advised that the inclusion of comfrey root in herbal preparations is no longer acceptable.” Again, this refers to the root not the leaf.
Research can be contradictory
Comfrey was banned in Australia because of a paper called, The structure and toxicity of the alkaloids of Russian comfrey (S. x uplandicum) a medicinal herb and item of human diet by Dr. C. Culvenor, et al, Australia, 1980. Although Culvenor and his associates identified eight alkaloids in comfrey, four being new to science; there does seem to be inaccuracy, when he quoted the results of Pederson (1975 ). Quotes indicated that he found a 9% concentration of alkaloids in leaves, when Pederson’s actual figures were 0.9 parts per thousand when estimated by titration, and 1.9 parts per thousand when estimated gravimetrically.
Theoretical dangers are often attributed to herbs because of the singular action of one constituent, although herbs are a complex blend of hundreds of phytochemicals whose combined beneficial and protective action often negate the harmful action of one compund. For example, meadowsweet contains salicylic acid (naturally) which is what aspirin is made of (chemically). Aspirin can upset stomachs yet meadowsweet is used by medical herbalists to treat stomach ulcers. Meadowsweet, unlike aspirin, contains many other phytochemicals which have a soothing effect. Read more here about the use of comfrey in creams and ointments.
Reported side effects
There have been some side effects reported from:
• taking comfrey medication (species not recorded) – a woman (1985) taking two comfrey medicines, one for four months and one for six months, and 2 women (1987) who took comfrey-pepsin tablets for 6 months.
• drinking comfrey tea (species not recorded) – a boy with Crohn’s disease (1987) who regularly drank comfrey tea and a woman (1989) who drank 10 cups of comfrey tea daily for 4 years
• eating comfrey (species not recorded) – one single case of a man (1990) who ate 4-5 cooked comfrey leaves a day for 2 weeks where comfrey may have contributed to his death by liver failure (he also had some other very bizarre dietary habits).
These few case studies do support that underlying illness, poor nutrition and the concurrent use of hepatotoxic drugs, increase the likelihood that veno-occlusive (liver) disease may develop when using PA-containing drugs or eating PA-containing plants (Rode, 2002). In particular, they point out that you should avoid taking comfrey in excess – the feature that unites this handful of reports.
To put this in perspective, according to the Office for National Statistics, between 1993 and 2011 around 23,630 people have died in the UK from drug-related poisoning not including drug misuse! (The total deaths if you include drug misuse being 52,732.) Where the cause of death is mentioned on the death certificate, this includes:
• 8606 deaths due to paracetamol poisoning
• 8324 deaths due to antidepressants
• 4611 deaths due to benzodiazepines (Diazepam (Valium), Temazepam and Nitrazepam
• 3079 deaths due to Tramadol
• 872 deaths due to aspirin
• 0 deaths due to comfrey
Note for people taking medication
An obvious recommendation with comfrey is not to eat or drink it excessively. I would add that you should definitely not eat it if you already take a drug that is known to harm the liver. This includes: acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others. If you are on other medication, especially carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, or rifabutin (Mycobutin), speak to your doctor or medical herbalist before using comfrey, as like other herbs, it may compete with the drug in your liver, the combination of which can cause side-effects.
Using comfrey in pregnancy
Warnings about use in pregnancy, breast-feeding and children found on medicinal/drug advice websites will always caution against use in these conditions without the advice of a doctor unless specific clinical trials have been done on children or pregnant women – which they rarely are! So this is a default warning. To be quite honest very few doctors would even know the answer as without specific genotox/clinical trials this information does not exist. To be on the safe side, pregnant or breastfeeding women should not eat or drink comfrey. Externally, the tiny amount used in a cosmetic cream would be negligible. If you are pregnant or planning to conceive, and wish to use herbal medicines, please err on the side of caution and seek the advice of a qualified medical herbalist.
Why I eat comfrey
There are many issues with the way that research is reported on the internet and many people scare themselves by reading badly referenced and poorly interpreted reports. I eat comfrey personally because I cannot find a single published case history of a healthy human actually experiencing (as opposed to theoretically being at risk from) liver damage from eating identified common comfrey. Nor do I intend to ever consume 20,000 leaves nor drink a cup a day for 18 years.
I also have a huge amount of cream-flowered tuberous comfrey growing here in Scotland (less than 0.02% PAs). So this is mainly the species I eat, in season.
I’m not saying that comfrey is totally safe or denying the presence of PAs. That would be to discredit science and just be ignorant! However, it is all a question of perspective. I believe that I will be doing less harm to my body by occasionally eating or using comfrey than I would from, for example, drinking caffeinated drinks daily, eating processed foods full of chemicals, eating non-organic food sprayed with pesticides, breathing in fragrance chemicals from electric “air fresheners”, traffic fumes, pharmaceutical drug side-effects… the list goes on.
One point that I also find particularly relevant is that not only does the comfrey species matter but the animal species that are studied matters too. Rats are not like humans. Especially 2 week old baby rats. Rode, 2002 points out that as not all animals are susceptible to PA toxicity, comparing humans to rats is not comparing like for like. Using ragwort (Senecio) as an example, as it contains high levels of PAs, she says “The response of different animal species to PAs varies tremendously. Pigs, chickens and rats are highly sensitive to poisoning by Senecio, whereas mice and sheep are resistant. Moreover, the response of a species to Senecio might not reflect its susceptibility to other PAs. For example, guinea-pigs are susceptible to Senecio, but resistant to monocrotaline. Additionally, the route of administration can dramatically affect the toxic response. For example, rabbits are relatively resistant to chronic feeding of Senecio, but are killed by a single injection of the purified alkaloids. Despite their sensitivity to PAs, pigs readily accept comfrey and show no adverse effects, even when comfrey represents 40% of their diet. Chickens, another sensitive species, also show no ill effects when fed comfrey. By contrast, rats appear to be sensitive to the PAs in comfrey. Indeed, when rats consume high levels of comfrey or are injected with purified comfrey PAs, they develop liver tumours and hepatic lesions indicative of PA poisoning. However, rats might not be an appropriate human model because their hepatic response to PAs seems to differ from the human response.”
Significantly, a trial by Dr. Clare Anderson, from the Laboratory of Pharmakinetics and Toxicology, School of Medicine, University College, London, tested forty long-term comfrey consumers, who then submitted for liver function tests (Anderson, 1981). This was a small group for a clinical trial but with prolonged consumption of comfrey leaf (0.5–25 g day for 1–30 years).
This is the only study that I can find that has actually tested humans! The abstract from the subsequent paper (Anderson & McLean, 1989) states that: There was no evidence of liver damage in a group of 29 people who had regularly consumed comfrey. Twenty-nine volunteers responded to mailed questionnaires regarding duration, amount, and form of comfrey used. At the same time, liver function tests (bilirubin, transaminase, and GGT) were performed on the volunteers. Most volunteers (21/29) had used comfrey for 1-10 years (mean intake 3.0 g dry leaf/day); 5/29 used it for 11-20 years (mean intake 2.6 g dry leaf/day); and 3/29 used it for 21-30 years (mean intake 11 g dry leaf/day).
All were found to have perfectly fit livers!
Update: Later in 2019 there is a NIMH seminar on comfrey with an update on modern evidence. So we shall see what new thinking comes to light on the question “is comfrey toxic?”.
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Author
Monica Wilde works at Napiers the Herbalists. She is a Research Herbalist with a Masters Degree from UCLAN and an advocate for quality, safety and research in herbal medicine. Her special interest is researching drug-herb interactions. At weekends, Monica runs foraging courses and events specialising in wild food and wild medicine.
Podcast
Robin Harford of Eatweeds.co.uk has recorded a Podcast interview with Monica speaking about comfrey. Click here to listen. It is the second interview on the Podcast.
References
Anderson, C. (1981) Comfrey in Perspective. The Lancet, 1(8235): 1424
Anderson, P.C. & McLean, A.E.M. (1989). Comfrey and liver damage. Hum Toxicol
Couet, C., Crews, C. & Hanley, A. (1996) Analysis, separation, and bioassay of pyrrolizidine alkaloids from comfrey (Symphytum officinale). Nat Toxins. 4(4):163-7. PubMed PMID: 8887946.
De Smet, P. (2004) Health risks of herbal remedies: an update. Clin. Pharmacol. Ther., 76: 1–17
Grube, J., Grünwald, L., Krug, C. & Staiger. (2007) Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: Results of a double-blind, randomised, bicenter, placebo-controlled trial. Phytomedicine, 14: 2-10
Hodges, S., (1995) Comfrey root & bone healing.Bone, 16(3): 405
Pedersen (1975) Arch. Pharm. Chem. Sc. Ed. 3: 55-64
Rode, D. (2002). Comfrey toxicity revisited. Trends in Pharmacological Sciences, 23(11): 497-499
Roitman JN. (1981) Comfrey and liver damage. Lancet. 1(8226):944. PubMed PMID: 6112346.
Really apt, as I decided just today I needed to learn more about Comfrey. So thank you!
You are very welcome. I get asked about comfrey a lot!
I have a comfrey question I’ve not been able to find the answer to: My bees love comfrey nectar, but is it making their honey unsafe for me to eat?
Honey already contains PAs but we’ve been eating it for hundreds of thousands of years so I wouldn’t worry. According to Wikipedia: “It has been estimated that 3% of the world’s flowering plants [circa 6,000] contain pyrrolizidine alkaloids. Honey can contain pyrrolizidine alkaloids, as can grains, milk, offal and eggs.” Reductionist science doesn’t always work with plant effects as they contain numerous protective biochemicals as well.
A well written and sensible approach to the consumption of comfrey.
A well researched and thought through piece.
I’ve been eating comfrey leaf frittatas since I was a tiny kid and I’ve made it to 50+ with a proven healthy liver (due to a brush with viral hep I’ve had plenty of liver function tests and biopsies and my liver is fine!!!). As you say, it’s crucial to recognise common comfrey (Russian comfrey is rare outside gardens in the UK) and also – I would add – to know about preparation and possible s/e’s.
Thanks Lesley, and cheers for letting me know about your liver 🙂 Russian comfrey is starting to make more of an appearance, and it does hybridise so needs to be kept an eye out for. Actually I think that there is more trouble with people mistaking foxglove for comfrey and getting ill from foxglove poisoning, than there are reports of comfrey side effects on the liver!
Any hybridisation I see is usually very close to gardens………but I’d agree that – certainly in the UK – there are more poisonings reported due to consumption of foxglove (accidental or otherwise) than there are reports of even mild hepotoxicity from comfrey consumption. In my limited experience it’s often the case with actual reports of such that the linking of Comfrey consumption and concurrent toxic hepatitis is a paper exercise with comfrey being assumed to be the cause since little else can be found……….locally there was a rash of reports of milk thistle affecting liver function tests in the mid 90s, but it later transpired that the consumption of milk thistle was DUE to folk seeking relief from liver-based symptoms (hep c) rather than the causal agent. I sometimes wonder how many links are erroneously formed between many medications – herbal or otherwise – and clinical symptoms simply because the consumption of one is present during the experiencing of the other…..
Having said that I’d like to see more scientific and fact based evidence on comfrey.
Is the flower colour an absolute in telling the two apart. Also the common comfrey leaf shape seems rounder the russian more spear shaped, is this a reliable trait to use when the flowers aren’t out (if this is so I think the russian is also spreading along river banks – i guess an accelerated vector from back gardens. Finally is the relative pricklyness useful in IDing? Many thanks for the article
Yes the flower colour is an absolute in telling the two apart… except in hybrids! Look up the Symphytums here http://www.ukwildflowers.com/Web_pages_intros_indexes/latin_index.htm#S though because there are also a few other comfreys (caucasian comfrey – blue flowers) (tuberous comfrey = creamflowers/brown tip) that you need to be aware of it only using flowers as ID. The common comfrey leaf shape is rounder, also paler, livelier green with cream decurrent veins while the Russian is more spear shaped, darker, more blue-green with dark veins. Common is shorter and a friendlier looking plant, Russian is bigger, bullish and bristlier (your ‘relative prickleyness’). Luckily even if you have a few meals out of the ‘wrong’ comfrey, you will be fine!
Interesting: trying to figure out based on this info why this site
https://www.horizonherbs.com/product.asp?specific=1922
is listing this plant as officinalis, and specifically “low in pyrrolizidine alkaloids” when the plant appears by most of your described identifiers to be russian comfrey and not common or true comfrey at all….
any thoughts before I abandon the site as an unreliable source?
Here in Scotland the majority of common comfrey has cream flowers so is a really easy way of making sure you don’t have Russian comfrey. However, it’s not the same everywhere. I know down in Dorset they are mainly pink-purple flowered. I would guess this is the same in the USA. It makes positive ID much trickier especially as russian comfrey, being a hybrid between officinalis and asperum, is variable. Rough comfrey (S. asperum) is also blue-pink flowered.
Thanks for the information, I have a 34 year old ‘relative’ of an original Bocking 14 , it has pale mauve flowers. i have just decided to make tea ( for my consumption)with the young leaves. I’m guessing if i do this in moderation all will be well. As you say the leaves contain less PA’s than the root. Are there any synergistic herbs that help the benefits of comfrey ? Instinctively I thought dandelion, mint and rosemary. I really appreciated this link. Brilliant . Many thanks.
For consumption (of the lungs) I’d recommend herbs like plantain for expelling mucus, antimicrobial thyme, elecampane for the lungs, and you may be best seeing a trained Herbalisy. However if you mean to do with digestion then dandelion for the liver and mint to reduce indigestion are perfect. Fennel helps with gas. Meadowsweet balances stomach acids. Each plant has many gifts for us.
So is the medicinal value of both comfreys of equal value? Externally or internally of taken in moderation?
Yes they are equivalent. The difference in strength varies because of growing season, area, conditions and the root is stronger than the leaf, more so taken internally. In a licensed medicine produced under GMP the plant strength is monitored and products produced consistently. In unlicensed products, cosmetics and home made products there will be fluctuation.
Very interesting article, thank you. The American herbalist Susun Weed – who is an advocate of comfrey leaf use internally and externally – suggests that the Russian comfrey is actually the safe variety, because it has been hybridised and has had the PA levels lowered through selective breeding. She feels that the real issue is that most commercially-available dried comfrey is mislabelled (as officinale when it’s actually uplandicum).
http://www.susunweed.com/herbal_ezine/June08/wisewoman.htm
Can you clarify?
Hi. I read Susun’s article http://www.susunweed.com/herbal_ezine/June08/wisewoman.htm and have to disagree with her comments about common comfrey (S. officinale) which British herbalists use, based on the research I have had access to. She specifically talks about her experience with Russian comfrey (Symphytum uplandicum) – in the USA “Symphytum uplandica x” – used by American herbalists, which is both a hybrid between S. officinale and Rough Comfrey (Symphytum asperum) and to confuse matters further, also commonly hybridises itself. Echimidine is more likely passed on by S. asperum as this has also tested positive in the past.
But the point Susun is making is very valid. When tested, the leaves she had were not found to contain any significant levels of PAs.
However, we’re splitting hairs as even where comfrey leaves do contain PAs, biochemist Bruce Ames gives one cup of comfrey tea the same HERP carcinogenic risk factor (0.03%) as a peanut butter sandwich! Still lower than 1 bottle (354ml) beer at HERP 2.8% or 1 glass (250ml) of wine at HERP 4.7% (Science, 1987).
The moral of the tale is that it is probably not wise to make comfrey, peanut butter sandwiches, beer or wine a “significant part” of your regular diet for an extended period of time.
References
Ames., BN., Magaw, R., & Gold, LS. (1987) Ranking possible carcinogenic hazards. Science, 17(236), 4799, 271-280. DOI: 10.1126/science.3563506
http://toxnet.nlm.nih.gov/cpdb/pdfs/Science-Ranking.pdf
Thanks for the fast reply, Monica!
Another example of the US and UK being divided by a common language, I guess – and made even more complicated where botanical terms are concerned. Reassuring information, however. I follow Susun’s recommendation of drinking herbal infusions daily and I probably have about 2 pints of comfrey infusion a week which means most days are comfrey-free, so I’ll relax and continue (especially since I don’t drink beer or eat peanut butter!).
Thanks for the great site – I’m from Scotland originally, living in England now, but I’ll keep an eye on your course dates for the next time I’m up visiting the family…
I consumed Comfrey tea to treat my Crohns, it was quite helpful and I didn’t get any side effects from drinking it.
hi what was your protocol? quantity, timing, frequency, type of herb(dried root or leaf or fresh)?
Love your point on perspective
Hi Monica,
Amazing article, thanks a lot for sharing your knowledge.
I hope you don’t mind me asking questions about comfrey. I am planning to plant some in my garden, since I don’t want it spreading all over the place, I would like to use bocking 14, which I believe is seedless and therefore easier to control.
I have been researching and it seems that bocking 14 is a hybrid between common and Russian comfrey. Would that be this hybrid low in alkaloids, and therefore safe for human consumption?
Thanks a lot for your time, and regards from North Edinburgh!
Hi Olmo, Bocking 14 will probably contain similar PAs to Russian comfrey so limit it to occasional use only. Best, Monica
Thanks a lot for your answer.
Awesome article thanks Monica. It has been burning a hole in conscience as I put comfrey leaf (and a little root) in some of my powders, only using officinale, I researched the 1968 (?) Hirono study and realised that the repeated cautions from foraging books were based on this unscientific report getting re-repeated to a point where it is now a ‘cultural’ fact that comfrey is dangerous and of course the rise in liver cancer incidence has to be from everyone eating comfrey!! I will not be using the root in the future just to be on the safe side and shall replace with nettle and dandelion root (unless you know of any dangers from these two beauties). This article covers more ground than any other I’ve read, thank you. Positive Harmonious Vibrations . .. Karl . .
Hi Karl. Glad the article was useful. It is highly unlikely that even a short course of the root will do harm – unless someone has a pre-existing liver condition. It is not a poison like monkshood or digitalis with a narrow therapeutic index. Even in the case of a broken bone, no one is likely to take it for more than a few weeks. I know people who had bad breaks and took it for 6 to 8 weeks with no problems at all. But I would advise against long-term use which is unnecessary anyway. Nature teaches us moderation. Any substitution would depend on what you were using it for. Yarrow for healing, boneset, many options.
Thank you for your reply – I make and sell powders, although I always advise customers not to take the powder with comfrey in for more than a fortnight at a time. Although my instinct tells me comfrey is harmonious for humans I have to appreciate the science (which is still very limited when looking at the whole plant and its holistic biological use) and use caution – as dandelion grows with us as well I shall swap the comfrey root for this in the 2 powders it is in (and then only to the tune of 2% of total powder mix, so 6 grams at most per 260g, with 5 grams/day means only about 0.1g per serving of comfrey root). My worry has been eased, thank you again . . . Karl . .
Hi Monica, I found your article and all the comments very useful. My family and I have been eating comfrey for more than 25 years, about every two weeks when the leaves are good over the summer months. I got to know it 25 years ago when still living in South Africa were I grew up. (I live in the UK now.) My parents had a large patch in their vegetable garden. My mom cooked it like spinach and mixed it with potatoes and onions. This mix goes on a piece of toast with some tomato sauce (not catchup) and cheese on top and in the oven for a few minutes like a thick pizza. We’ve had it like that ever since. In SA we had to plant it like vegetables and great was my surprise when I came to the UK in 2001 to see it grows wild and the property that we rented had plenty of it! At just over 70, my mom’s fingers were becoming crooked because of the onset of rheumatism. (The main reason why they planted the comfrey.) She used the roots to make a pulp, put it in a plastic bag and had her hands in it every evening for about an hour. She kept it in the fridge and re-used it until it was not slippery and more. After about 3 months her fingers were nearly back to normal and she could get her wedding ring off and on again. It seemed that this treatment had a permanent effect because her hands/fingers did not get any worse later. (She passed away when she was 83.) I have comfrey in my allotment here in the UK and we are still enjoying it about every two weeks with no negative effects.
Thanks Ivan. That’s really interesting.
Also if you have any comfrey recipes you’d like to share. Thanks.
Today at 10am on an empty stomach I ate a small (3 peas size) chunk of Russian comfrey root (fresh). At 11am I had a turkey sub and by 1130 I had food poisoning symptoms. Horrible.
Not sure if it was the sub or root but my current theory is that the root caused a parasitic die off resulting in a Herxheimer Reaction. Again, could be the sub, but wanted to share the anecdote.
Thanks for sharing that John and sorry you’ve had that experience. It sounds as if it was probably the turkey. Classic food poisoning symptoms are associated with bacteria in poultry and shellfish. Herb side effects tend to be specific to the species.
Comfrey is not poisonous, and in healthy soil most soil bacteria are good for us, so I’d be very surprised if it was the comfrey that caused those symptoms. Re herxing, when Teasel root is used, as in the treatment of Lyme disease, it can cause a Herxheimer reaction but I’ve not heard of this happening with comfrey root. In fact, in the past, comfrey was used to treat stomach problems not cause them.
Comfrey is in flower at the moment so I don’t doubt your identification. As a side note though, before flowering some people confuse comfrey with the foxglove. Symptoms of foxglove poisoning include: Blurred vision. Confusion. Depression. Disorientation or hallucinations. Fainting. Halos around objects (yellow, green, white) Headache. Irregular or slow heartbeat. Death. Comfrey root does not manifest immediate symptoms. It’s the possible toxic effect of a lot of it over time to the liver, that has some medics concerned. Hope you’re feeling better now.
Excellent article and comments . . was just reading about American and Australian farmers who feed their cows and horses up to 30lbs of comfrey leaf/day! There was not one mention of this causing any problems and it was a generational thing, so has been going on for ages, this is why I keep finding huge patches of comfrey on some farms as this practice has died out here in the UK. Keep on informing Monica, great work . . . x
Thanks for you information. For five years I’ve been drinking the tea on and off or using it for external wounds. I’m not sure what liver damage would be like? All I know is time and again I have used it after strenuous work outs and never I am sore the next day. I’m also glad to know it has such great nutrients. I’ve settled my mind a long time ago that the way certain groups use science for making money and establishing power of people. The way they treat comfrey is typical of the abuse of science.
Hi, Brendon Rundell, how do you use(in what ways) comfrey after your workouts to prevent soreness ?
love this!,i grow it in my garden , being using it for face masks , mixed with wheat germ ,so much bad press against this plant,.of course the drug companies dont want you to use ,as they would go out a business
Hi Monica! I wanted to order an herbal collagen and this was the only one I found.. anima Mundi collagen.. it doesn’t state what type of comfrey is in it? I was wondering if this is something I could safely take daily and continue to take throughout my life?
https://animamundiherbals.com/collections/superfoods/products/new-plant-based-collagen
I can’t tell you the answer to that. Personally I wouldn’t use anything daily for life. I follow the seasons which allows my body a break from things when they’re out of season.
Great blog; I bought comfrey from Coe and after a month planted they are about 4 inches tall (it’s dec 1 ). I’m in Jacksonville, Florida and thank you for the info. If you want to purchase comfrey, go to coescomfrey.com, thanx
Please note that Coe’s Comfrey sells the Bocking #4 strain of Russian comfrey, Symphytum peregrinum, which is mot the same as common comfrey, Symphytum officinale.
Such a wonderful article. Thank you! I am a Brazilian Jiujitsu athlete, and I partially torned ACL, MPFL, and MCL ligaments on my knee. I am super depresed. I am taking a conservative way of recovering and I have included comfrey leaves in tea, comfrey supplement pills, and comfrey oil for massage.
Any suggestion will be more than welcome. Al the best, Viviana
Don’t overdo the comfrey. If you’re doing a lot of it take milk thistle to to protect your liver. Remember there are also other excellent healing herbs such as yarrow, Calendula, to add to the mix.
That is a well-read masterpiece. Just as I was getting ready to make me comfrey infusion I came across this and had to read. People can abused plants, food, pills medication vitamins, so we are the ones who do damage to our body and can kill ourselves if we’re not vigilant. Educate yourself on every plant, just as we have to be careful on what we eat and how much we eat. Moderation in everything
What an informative article. Thank you so much. I love Comfrey! It’s healing properties are amazing. It’s our go to for external wounds in my home. My kids will often tell people when they have cuts or scrapes to put comfrey on it 🙂
I would like to try comfrey tea for a short time for some teeth and gum issues. I’m not sure where to find it in the U.S. though. It seems like all of the comfrey I have found here is the Russian type.
Make a strong decoction and use it as a gargle/mouth wash without swallowing.
Hi Monica,
What a powerful and informative article. I grew up in Kenya with Comfrey as a vegetable and my parents and grandparents have over the years used it and as a skin rash treatment. No recorded liver condition have we ever experienced.
Thank you
Benson
Thanks for your comment. I also grew up in Kenya, in Tigoni.
Monica, Wow! wow! am so excited to hear that. The world is a small village. I know Tigoni very well and it’s a beautiful green place to grow up in. Comfrey has been like our staple food in Central Kenya where we used it in almost every meal as greens.
I am now using it with my entire family and going further to research on making infusion,salve and body creams.
Looking forward to more conversations on this subject.
Keep the good news going.
Benson
I love the way you think and compare things! Great article! 🙂 I’m very familiar with comfrey (my mother — who was very knowledgeable of plants and herbs — used to have it in the garden and we used it when needed), so I grew up knowing it, respecting it, and integrating with it. All what you said makes total sense to me. Thank you for sharing valuable thoughts and experiences.
Thanks. I’m glad you found the post interesting.
Monica, Can you recommend a site or several to purchase comfrey seeds or plants to put in my garden. I would like to make tea occasionally and use the leaves to enrich my soil. But I do want to make sure I am purchasing the correct strain. Thanks for such a great article.
Just look for a seed supplier that states the botanical name of the species they are selling. E.g. https://www.nickys-nursery.co.uk/product_info.php/comfrey-common-100-seeds-h167-p-781
Hi Monica,
I was hoping you could help.I am in the USA and have the Blocking 14 Comfrey growing.( The bumblebees love it) I don’t have a source yet for common comfrey, but really appreciate your info identifying the different types. So my question is ; one of our horses has a torn tendon, the vet said will take about a year to heal. Would blocking 14 comfrey be helpful if he ate a leaf or two every couple of days? Also is the Blocking 14 version safe for chickens? thanks very much
Horses will choose to eat comfrey when injured (see Juliette de Bairacli Levy‘s book The Complete Herbal Handbook for Farm and Stable) but shouldn’t overgraze on it long-term. A handful of leaves a day should be fine. Even better, pulp the leaves or roots in a blender, and apply the paste as a poultice under a dressing, over the tendon (if possible).
Thank you very much!
I am located in the US. Is using comfrey topically beneficial for vitiligo or tinea versicolor? I plan to plant and grow common comfrey soon, but right now I only have access to dried (cut and sifted) leaves (organic symphytum official) from a company called Frontier Coop. I also have some dried comfrey root on order. I was going to make a poultice in a blender and use it as a mask on affected areas. How long or how often would be advisable?
I’ve never used it on patients for vitiligo as I tend to see it more of an autoimmune condition that needs to be treated internally as well. Do let me know how you get on with it.
Thank you for your prompt reply. My daughter is being treated internally by a naturopath. I thought maybe comfrey would help topically at the same time. I’ll keep you updated.
It certainly wouldn’t do her any harm and comfrey is anti-inflammatory and supports the whole substructure of the skin’s collagen matrix. Glad to hear she is also being treated internally as well.
I am under the care of a naturopath and I am supposed to drink comfrey tea to help with stomach ulcers. I am in America and have only been able to find comfrey online. I am concerned the type I bought might not be true to the name. It says comfrey leaf c/s organic symphytum officinale on the package but also states that it’s sourced from Croatia. After reading your article I’m concerned it’s not the true plant. Do you recommend a resource. Covid is making Everything difficult to find in my area. Thank you for Any help.
Herbs from Croatia are generally excellent quality. Eastern Europe has a strong herbal medicine tradition and a lot of herbs come from that region because the climate is favourable. It’s unlikely that it’s not what it says it is if they have an ongoing trading relationship with the USA. You didn’t say where in America you are but you could try emailing the Klein’s via their website https://www.reverencebotanicals.com as they have a great organic herb farm in North Carolina.
Thank you Very much for the info! 🙂
I am from Pennsylvania. I will Absolutely check out the Klein’s website!
Also, thank you Very much for the information regarding the source of the brand I bought. It’s Extremely difficult to get accurate info on herbal medicine where I’m located. I subscribed to your site as soon as I stumbled across this article. You are thorough and easy to understand. I am looking forward to reading through the rest of your work. 😀
Blessings and thank you so much again!
Croatia is a major supplier of quality herbs and medicinal plant material. I can’t see any problem with the supply you’ve mentioned.
I came to your article after reading Wikipedia. i find Wikipedia very useful as a guide to know when some plant is useful. The harder Wiki knock it the better for me to know that the herb is powerful medicine.
Well Wiki is not an entity really, just a group of editors and I don’t know if any of them are herbalists.
Super helpfull Thanks! I needed to know if comfrey bocking 14 is edible or not…
Just want to send sincere appreciation for this thorough and well-written article! We have comfrey on our homestead, and have used it for years. This gave me great confidence in answer yes when my 6 year old daughter asked if she could eat comfrey blossoms.
Hi thanks for this really informative article. I’m not sure which type of Comfrey I consumed for two weeks and I’m concerned about mild liver pain. I’m hoping for a blood test and have asked the seller about the Comfrey variety.
I would hope that 2 weeks of comfrey would not have been excessive enough for liver problems. Hope you feel better soon.
Thanks for this very informative article. We have had either Russian or Bocking #14 Comfrey since about 1970. I’ve used it most of that time with chickens and ducks, who love it. Also llamas and goats for much of that time. (I understand that Comfrey has more protein than Alfalfa.) My husband and I and our three daughters used it in a green drink for many years (pineapple juice, comfrey leaves, almonds, and dates). No animals, birds, or people here have ever had any problem with Comfrey! What I recall of the studies done the end of the 1900s to discredit Comfrey refined it and refined it and refined it to get to a point where there were enough PAs to be poisonous. I haven’t looked at those articles for years, but given that one would have to drink 6,666 cups of tea or eat almost 20,000 leaves to have a problem, that sounds like that’s what happened. (Plant the seeds of poisonous effect — or sexual abuse…– and one can’t NOT remember it.)
Comfrey has so many health benefits so why do the medical ‘experts’ say it deadly!!
I think Big Pharma and the ( chemical) medical board ban it’s use because it cure so much naturally. I had a tear in my Achilles’ tendon, a poultice of comfrey root and a little olive oil mended it, no more pain!
Well done, Monica, I suspected as much… you are a brave woman indeed!
I have saved a PDF for posterity and reference, many thanks!
Great article Monica, and I had also read Susuns prior to this one about Comfrey….I recently fractured my ankle and had surgery 2 weeks ago today and after researching nutrition and any herbal holistic aspects I can incorporate into my lifestyle from here on I’ve discovered Comfrey in the mix. Any recommendations on purchasing ingestible Comfrey and if not what would recommend for external use on a recovering ankle. Thank you so much for your knowledge and time.