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Most authorities on this side of the Atlantic scoff at Dr. Weiss’s suggestion that mistletoe is “gentle, nontoxic, and well tolerated.” The Food and Drug Administration calls it unsafe and has not approved any mistletoe preparation for treatment of any disease. In Natural Product Medicine, pharrnacognosists Ara Der Marderosian, ph.D., and Lawrence Liberti speak for most American experts when they write:
“Mistletoe’s use should be discouraged because of the documented toxicity associated with ingestion of all parts of the plant.”
How toxic is it? The Eclectics reported coma, convulsions, and deaths from ingestion of large doses of mistletoe leaves and berries. J. M. Kingsbury’s classic book, Poisonous Plants of the United States, reported one fatality from an overdose of berries. And Dr. Der Marderosian and Liberti report two mistletoe deaths, one from mistletoe tea intended as a tonic and another from high doses of the herb used to induce abortion.
On the other hand, a recent review of more than 300 cases of mistletoe ingestion in Annals of Emergency Medicine showed no deaths, and a majority of those who ingested the planttypically its berries-developed no symptoms of poisoning. The investigators concluded that while mistletoe is potentially toxic, adult ingestion of up to three berries or two leaves is unlikely to produce serious poisoning.
Keep It Away from Children
Child fatalities, however, have been reported from as few as two berries. Keep mistletoe out of the reach of children. If you hang it at Christmas, secure it carefully and explain to children that its berries should never be eaten-or remove the berries.
Caution for Women
Mistletoe contains a chemical (tyramine) that may stimulate uterine contractions. Pregnant women should not use it, except possibly at term and only under the supervision of a physician to induce labor.
Mistletoe’s abortion-inducing dose is close to its fatal dose. This herb should never be used to terminate pregnancy.
Those taking any MAO inhibitor antidepressant (Marplan, Nardil, Parnate) also should not use mistletoe, because the interaction of these drugs and the herb might cause a serious elevation in blood pressure, resulting in loss of consciousness.
Mistletoe may slow heart rate. People with heart disease or a history of stroke should not use it.
Other Cautions
Mistletoe may be used cautiously in low doses but only under the supervision of a medical professional. For otherwise healthy non-pregnant, non-nursing adults who are not taking MAO inhibitors or other blood pressure medications, mistletoe is thought to be relatively safe when used cautiously in small amounts for brief periods.
Mistletoe should be used in medicinal amounts only in consultation with your doctor. If mistletoe causes minor discomforts, such as stomach upset or diarrhea, use less or stop using it. Let your doctor know if you experience unpleasant effects or if the symptoms for which the herb is being used do not improve significantly in two weeks.
If any symptoms of toxicity develop-nausea, vomiting, diarrhea, headache, decreased heart rate, hallucinations, muscle spasms, or convulsions-seek emergency treatment immediately. At high doses, fatalities typically occur within ten hours of ingestion.
The Christmas Parasite
Both European and American mistletoe are parasitic, branching, woody, evergreen shrubs that live on a large number of trees. The European herb has thin, leathery, tonguelike, 2inch leaves. The American variety also has leathery leaves, but they are broader and up to 3 inches long. Both plants produce small, sticky white berries, which contain single seeds.
Mistletoe is well adapted to its aerial existence. Its sticky white berries attract birds, which carry them to perches in other trees. The birds eat some but drop others, which stick to the tree bark. Within a few days, the seeds inside newly “planted” mistletoe berries produce tiny roots, which bore their way into the host tree and establish new plants.
Mistletoe is gathered from the wild, not cultivated, but some crafters of mistletoe Christmas products reportedly “plant” the sticky seeds by inserting them into the bark of host trees.