White Willow Bark

Commonly used for

InflammationJoint Health

What is it? / Overview

White willow bark's salicin is metabolized by gut bacteria and the liver into salicylic acid, the same active compound aspirin produces, giving a milder, slower-onset anti-inflammatory and analgesic effect.

How is it used? / Administration

Form: Standardized extract (15% salicin) capsules, tablets, or tea

Typical dose studied: 120–240 mg salicin/day

Timing: With food to reduce GI irritation

Onset is slower than synthetic aspirin since salicin must first be converted to salicylic acid in the body. Not a substitute for aspirin's cardioprotective antiplatelet effect at typical pain-relief doses.

How well does it work? / Evidence

~ Moderate evidence

Who should avoid it?

Avoid with: Bleeding disorder / Coagulopathy; Peptic ulcer disease

Interacts with: Anticoagulants/antiplatelets (warfarin, aspirin) -- additive bleeding risk; NSAIDs -- overlapping mechanism, no reason to combine

Already taking it? Contains salicin, metabolized to the same active compound as aspirin -- avoid if aspirin-sensitive/allergic, and never give to children or teenagers with a viral illness (theoretical Reye's syndrome risk, same as aspirin). Use caution with a history of GI ulcers or GI bleeding, given the same salicylate-related irritation risk as aspirin.

Research & references

Chrubasik S et al. (2000). Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. American Journal of Medicine. Vlachojannis JE et al. (2009). A systematic review on the effectiveness of willow bark for musculoskeletal pain. Phytotherapy Research.