Chanca Piedra

1. Chanca Piedra - Stonebreaker Classification

Division: Magnoliophyta (Flowering plants)
Class: Magnoliopsida (Dicotyledons)
Subclass: Rosidae
Order: Euphorbiales
Family: Euphorbiaceae (Spurge family, Euphorbs)
Genus: Phyllanthus (L.) Murr.
Species: Phyllanthus niruri L.
Synonyms:

• Diasperus niruri (L.) Kuntze
• Nymphanthus niruri Lour.
• Phyllanthus carolinianus Blanco
• Phyllanthus debilis Willd.
• Phyllanthus humilis Salisb.
• Phyllanthus niruri Mueel Arg.
• Phyllanthus pentaphyllus Wright
• Phyllanthus urinaria Wall.
• Phyllanthus sellowianus
• Phyllanthus fraternus
• Phyllanthus lathyroides
• Phyllanthus lonphali
• Phyllanthus amarus Schum. et Torn.

Related Species:

• Phyllanthus amarus Schum. et Torn.
• Phyllanthus urinaria Wall.
• Phyllanthus liebmannianus
• Phyllanthus debilis Willd.
• Phyllanthus fraternus
• Phyllanthus sellowianus

Observation: The fact that several species appear in the synonyms list as well as in the related species list is due to the existing discrepancies among the experts according to denomination of the species within the genus Phyllanthus (L.) Murr. Whereas some researchers consider certain types as synonyms, others consider them as independent species. Sometimes, one name is indicated to be synonymous with another and, sometimes, both names are used interchangeably as if referring to one plant. Available information is so confusing that in the 1990s a major reorganization of the Phyllanthus (L.) Murr. genus was conducted. Nowadays, Phyllanthus amarus Schum. et Torn. and Phyllanthus sellowianus are often considered a variety of Phyllanthus niruri (L.) Murr.

Common Names: “stonebreaker”, “gale of the wind”, “child pick-a-back”, “gulf leafflower”, “common leaf-flower”, “necklace leaf-flower”, “black catnip”, “shatterstone”, “carry-me-seed”, “cane peas senna”, “creole senna”, “quinine weed”, “cane senna”, “creole senna”; Bahamas “hurricane weed”, “gale-wind grass”. Spanish/Castilian: “chancapiedra”, “viernes santo”, “yerba de san Pablo”; Peru “chancapiedra”. Portuguese: “quebra pedra”, "arranca-pedras", “erva pombinha”, “herva pombinha”, “malva-pedra”, “pombinha”. French: “graine en bas fievre”. Languages from South East Asia: “punarnava”, “amli”, “bhonya”, “bhoomi amalaki”, “bhui-amla”, “bhuianvalah”, “bhuimy-amali”, “bhuin-amla”, “bhumyamalaki”, “bahupatra”. Amazon Languages: “mapatan”, “para-parai mi”, “pei”, “shka-nin-du”,  “ya-taibai”, “yaa tai bai”, “yah-tai-bai”. Créole (Haiti): “dèyè do”. Sanscrit: “bhoomya”, “amalakee”. Hindi: “pitirishi”, “budhatri”. Others: “hsieh hsia chu”, “phyllanto”, “sacha foster”, “daun marisan”, “derriere-dos”, “elrageig”, “elrigeg”, “evatbimi”, “jar-amla”, “jar amla”, “kizha nelli”, “pitirishi”.

2. Chanca Piedra - Stonebraker Description

Habit: Small, erect, glabrous, annual herb that grows up no more than 50 cm in height. Its stems are simple, woody or slightly woody and yellowish. They are also stramineous or brownish at the base, and the branches are green from the middle to the upper part.

Leaves: Small, simple, distichous, and stipulate. The stipules are lanceolate or triangular. The petioles are of approximately 0.5 mm long. The blade is membranous or thin-papery, oblong or elliptic-oblong, green-colored, from 3 mm to 10 mm long, and from 2 mm to 5 mm wide. The blade base is rounded; the apex obtuse or rounded and often apiculate. When the plants are picked, the feathery leaves fold in, completely closing themselves.

Flowers: Small and yellow. They are monoecious (unisexual), yellowish-green, solitary or several in axillary fascicles, often one female flower and several male ones (sometimes absent) per fascicle.
Male flowers: the pedicels are approximately 0.5 mm to 1mm long. They possess five sepals, which are obovate to broadly ovate, 1.2 mm to 1.5 mm long and 1mm to 1.5 mm wide, with an obtuse or rounded apex. The sepals are also yellow-green at the middle part but reddish at the base; the margins are membranous. Five disc-glands are present. These glands are obovate, of 0.25 mm to 0.4 mm wide. The stamens are three; the filaments are completely connate into column, of 0.2 mm to 0.3 mm high. The anthers are nearly globose; the anther-cell is longitudinally dehiscent.
Female flowers: Their pedicels are 1.5 mm to 4 mm long. They possess five sepals, unequal, broadly elliptic or obovate, of 1.5 mm to 2.3 mm long, and 1.2 mm to 1.8 mm wide. The sepal apex is obtuse or rounded, green at the middle part, and its margins are membranous and yellow-white. Female flower disc is discoidal. The ovaries are globose, smooth, and 3-celled; the three styles are free, bifid at the apex and the lobes are revolute.

Fruit: Very small. They are oblate capsules, of near 3mm across. They are also brown-red, smooth, of 3 bivalved cocci when maturity, and persistent columella and sepals. The fruits are from 1 mm to 1.5 mm long, and from 0.8 mm to 1.2 mm wide, approximately, with granulose arrange into severally straight parallel longitudinal stripes on the back. They burst open and the seeds are hurled away.

3. Chanca Piedra - Stonebreaker Origin, Distribution and Ecology

Origin: It is indigenous to the rainforests of the Amazon and other tropical areas throughout the world, including the Bahamas, central and southern India, and China. Its botanical center of origin is unknown.

Distribution: Phyllanthus niruri L. grows as a seed worldwide. In Latin-American rainforests (the Amazon) this plant is known as ‘chanca piedra’ or ‘quebra pedra’. In India, this plant is called ‘niruri’ and ‘bhumy amalaki’. Phyllanthus niruri L. is quite prevalent in the Amazon and other wet rainforests, growing and spreading freely (much like a weed). Phyllanthus amarus and Phyllanthus sellowianus are closely related to Phyllanthus niruri L. in appearance, phytochemical structure, and history of use, but typically are found in the drier tropical climates of India, Brazil, and even Florida and Texas. Phyllanthus niruri L. distributes in South China, Taiwan, India, Indochina, the Philippines, Nigeria, Guam, Cuba, and Tropical America.

Ecology: Phyllanthus niruri L. is an annual weed that can be found both in farming lands and in abandoned terrains. It grows up suitably in areas between 50 m and 300 m a. s. l. and requires full sunlight or light shade and moist soil with a high level in calcium; pH of soil must be at about 8.0. It propagates by seeds.

Although Phyllanthus niruri L. possesses medicinal properties, it is not used to be cultured. Herbalists are used to sell it in fairs and marketplaces, because they are a natural medicine in which many people trusts. Phyllanthus niruri L. proliferates preferably on abandoned fields, roadsides, waste places, or forest edges.

Flowering and Fruiting: In the North Hemisphere, from January to October. In the South Hemisphere, from July to April.

4. Chanca Piedra - Stonebreaker History

Phyllanthus niruri L. is a field weed that proliferates throughout the tropical and subtropical regions of Asia and America. It has an amazing amount of related species, because its genus — Phyllanthus (L.) Murr. genus— is unusually broad, and comprises from 600 to 700 species of shrubs, trees, and annual or biennial herbs. Unfortunately, there exists an enormous confusion among scientists regarding plant identification. The differences among the identified species within the genus Phyllanthus (L.) Murr. are so small that many of them are considered by some botanists as a unique species or as varieties of the same species. Hence, in many cases, plant misidentification makes no distinction among several species in published clinical research, which makes evaluation of published medical information difficult.

Then, we can consider that different species within this genus have very similar properties; actually we could be dealing with the same species or a variety of the same species. Each country —and even each region where plants of this genus are used— has its preferred species. The most known and most employed species are Phyllanthus niruri L., Phyllanthus amarus, and Phyllanthus urinaria. Medicinal properties are attributed to the three species. They are believed to have benefic effects on kidney, liver and digestive system, in general, among other benefits. Many species within this genus have very similar chemical compounds. In Peru, we have Phyllanthus niruri L.

The specific epithet niruri was assigned to this plant by Swedish naturalist Charles von Linée, and comes from its Indian vernacular name. Effectively, this plant was already well known and used since more than 2,000 years in the ancient Hindi system of traditional medicine or ayurvedic medicine. Phyllanthus niruri L. grows not only in Peru but also in India, China and tropical America.

Phyllanthus niruri L. is also employed for numerous other conditions by the indigenous peoples. Many of the uses of this plant are relative to the digestive tract and for many types of biliary and urinary conditions besides kidney and gallbladder stones, but some other uses are not related to digestive tract at all. Some other uses not related to digestive tract are: diabetes, malaria, fever, flu, tumors, jaundice, vaginitis, bacterial infections in general, etc. Phyllanthus niruri L. is also considered analgesic, aperitif, carminative, tonic, etc. It is also widely employed as well as for its diuretic, analgesic, stomachic, antispasmodic, febrifugal, and cell protective properties in many other conditions. The Dusun and Kadazan use Phyllanthus niruri L. to treat malaria.

Herbalists are used to sell Phyllanthus niruri L. in fairs and marketplaces and, although it is a medicine that many people trust in, Phyllanthus niruri L. is not cultivated. The traditional way to obtain it is gathering directly from field.

Nowadays, Phyllanthus niruri L. can be found as a weed in rainforest worldwide and has a long history in herbal medicine systems in every tropical country where it grows. The way indigenous people employ Phyllanthus niruri L. is very similar worldwide. The natural remedy is usually just a standard infusion or weak decoction of the whole plant, including the roots, or only its aerial parts.

Phyllanthus niruri L. has been being used for so many purposes in herbal medicine systems that some skeptical people could consider it as a bluff more than a plant wonder. The real thing is that in clinical research over the years —Phyllanthus niruri L. has been the subject of phytochemical research since the mid-1960 and clinical research since earlier— this plant has demonstrated some of the multiple purposes that it is used for. The reason for its multiple uses is the interesting fact that Phyllanthus niruri L. is a phytochemically complicated plant. It means that its chemical composition is outstandingly complex. Nobody really knows the specific active compounds or the synergistic interactions among them which allow people to be healed. And this condition also makes searching, isolation, characterization, and administration of single Phyllanthus niruri L. chemicals too difficult. In spite of that, Phyllanthus niruri L. is widely used in folk medicine worldwide.

Many of the active constituents are attributed to biologically active lignans, glycosides, flavonoids, alkaloids, ellagitannins, and phenylpropanoids found in the leaf, stem, and root of the plant. Common lipids, sterols, and flavonols also occur in the plant.

In Brazil, a Phyllanthus niruri L., as well as Phyllanthus amarus tea made from the whole plant is a folk treatment for painful kidneys. Brazilian herbalists also use it in order to remove uric acid from the urine and to eliminate stones. It is also used in Brazil for hydropsy, urinary and bladder infections and blockages, liver ailments, painful joints, cystitis, prostate disorders, kidney disorders, hepatitis, diabetes and as an antispasmodic and muscle relaxant specific to the urinary tract system. Other uses in Brazil are: abortifacient, ache (joint), albuminuria, analgesic, antibacterial, anticancerous, antidiabetic, anti-inflammatory, antilithic, antispasmodic, antiviral, aperient, arthritis, biliary conditions, bladder problems, bladder stones, calculi, catarrh (liver and kidney), cholagogue, cystitis, deobstruent, diaphoretic, digestion stimulant, diuretic, fever, gallbladder, gallstones, gastritis, gastrointestinal problems, gout, hepatoprotective, hypertension, hypoglycemic, jaundice, kidney colic, kidney pain, kidney stones, liver, malaria, muscle relaxant, obesity, prostatitis, purgative, renal colic, renal problems, stomachic, sudorific, tonic, uric acid excess, urinary problems, uterine relaxant.

In the Bahamas, the locals boil Phyllanthus niruri L., as well as Phyllanthus amarus to make a tea to treat poor appetite, constipation, typhoid fever, and, provided the patient doesn't have an upset stomach, flu and colds. Also as antihepatotoxic, antispasmodic, appetite stimulant, antiviral, aperitif, bactericidal, cold, constipation, diuretic, fever, flu, hypoglycemic, laxative, stomachache, typhoid.

In the Caribbean, Phyllanthus niruri L., as well as Phyllanthus amarus uses are: Antihepatotoxic, antispasmodic, appetite stimulant, antiviral, aperitif, bactericidal, cold, constipation, diuretic, fever, flu, hypoglycemic, laxative, stomachache, typhoid.

In Haiti, Phyllanthus niruri L. is used as carminative, colic, digestive, diuretic, fever, indigestion, malaria, spasmolytic, stomachache, stomachic, and tenesmus.

In the Amazon, Phyllanthus niruri L., as well as Phyllanthus amarus uses are: anodyne, aperitif, blennorrhagia, carminative, colic, diabetes, digestive, diuretic, dropsy, dysentery, dyspepsia, emmenagogue, fever, flu, gallstones, gonorrhea, itch, jaundice, kidney aliments, kidney stones, laxative, malaria, proctitis, stomachache, stomachic, tenesmus, tonic, tumor, vaginitis, vermifuge.

In India, Phyllanthus niruri L. as well as Phyllanthus amarus is a common household remedy for asthma, bronchitis and to cure coughing, extreme thirst, anemia, jaundice and tuberculosis. Other uses in India are: anemia, asthma, astringent, bronchitis, conjunctivitis, cough, deobstruent, dropsy, diabetes, diarrhea, diuretic, dysentery, fevers, eye disorders, galactagogue, genitourinary disorders, gonorrhea, hepatitis, jaundice, leucorrhea, menorrhagia, oligogalactia, ringworm, scabies, stomachic, thirst, tuberculosis, tumor (abdomen), urogenital tract infections, warts.

In Malaya, Phyllanthus niruri L., as well as Phyllanthus amarus uses are: Caterpillar sting, dermatosis, diarrhea, diuretic, emmenagogue, itch, miscarriage, piscicide, purgative, renosis, syphilis, and vertigo.

In Peru, the most common name for Phyllanthus niruri L. is ‘chanca piedra’, meaning ‘stone breaker’ because it has been used for generations by the indigenous peoples of the Amazon as an effective remedy to eliminate gallstones and kidney stones and for other kidney problems.. More than one physician there has prescribed this feathery-leafed herb to cure kidney stones and gallstones, problems from which the plant takes its common name and for which the remedy is regarded infallible. Other uses in Peru are: diuretic, emmenagogue, gallstones, hepatitis, kidney pain, kidney problems, renal problems, urinary infections, vermifuge.

The plant does not lose its effectiveness when dried, so it can be shipped anywhere. This herb is now available in the United States as ‘quebra pedra’ or ‘chanca pedra’ ("stonebreaker"), the more common names in Brazil. In the United States, an extract with diuretic and analgesic properties is prepared with the dry plant; and also is used as analgesic, bronchitis, cholagogue, deobstruent, diabetes, fever, gallbladder problems, gallstones, gout, hepatitis, hypertension, kidney problems, kidney stones, liver disease, uric acid excess, urinary tract infections.

Some informal studies suggest that Phyllanthus niruri L. extract can completely eliminate the calculi within a week or two in  ninety-four percent of patients. According to this informal study, not only was the herb infallibly successful in healing, but also the only evidence of any side effect was an occasional case of cramps during the expulsion of stone. Some Peruvian herbalists claim that after prescribing it for years they had never known it to fail or to cause any unpleasant side effects.

Recent investigations consider Phyllanthus niruri L. good for hepatitis, cold, flu, tuberculosis, and other viral infections. Hence, Phyllanthus niruri L. could provide an abundantly available nontoxic alternative not only to treat the hepatitis B, but ideally to render carriers sero-negative for the virus so they won't pass it on to others. Combined with vaccines, Phyllanthus niruri L., or perhaps other herbs combined, might make a significant contribution to the eradication of viral hepatitis.

Liver diseases and disorders, including anemia, jaundice and liver cancer, have also been supported by investigations. Phyllanthus niruri L. is also believed to be useful in order to treat edemas and anorexia.

Another widespread employment of Phyllanthus niruri L. is for diabetes and cancer, although these uses might be further investigated. Some results obtained in clinic investigations suggest the utility of Phyllanthus niruri L. as an antihepatotoxic, antilithic, analgesic, hypotensive, antispasmodic, antiviral, antibacterial, diuretic, antimutagenic, and hypoglycemic.

Popular medicine also considers Phyllanthus niruri L. useful to treat problems proper of women, such as dysmenorrhea (painful menstruation). In that sense, Phyllanthus niruri L. is considered a plant with emmenagogue properties due to its capacity to stimulate, initiate and/or promote menstrual flow.

In Suriname’s traditional medicine, a bitter extract of Phyllanthus niruri L. or Phyllanthus amarus is used against kidney and bladder disorders, uterus complaints, constipation, anorexia, dyspepsia and jaundice.

Other closely related species also used as medicine are Phyllanthus urinaria, Phyllanthus debilis and Phyllanthus fraternus. There also exists confusion among Phyllanthus niruri L., Phyllanthus amarus and Phyllanthus sellowianus over the years (and all of them seem to contain activity against the endogenous DNAp of hepadnaviruses, the same way as Phyllanthus niruri, Phyllanthus amarus and Phyllanthus urinaria do).

5. Chanca Piedra - Stonebreaker Uses

Parts Used:

Entire plant (including roots) or only aerial parts.

Properties:

Phyllanthus niruri L. is used against:

• abdominal pain
• ache (joint)
• afflictions of the urinary system
• albuminuria
• anemia
• anorexia
• arthritis
• asthma
• biliary conditions
• bladder disorders
• bladder stones
• blennorrhagia
• bronchitis
• bruises
• calculi
• cancer
• catarrh (liver and kidney)
• caterpillar sting
• chromosome damage
• colds
• conjunctivitis
• constipation
• cough
• cuts
• cystitis (bacterial infection)
• dermatitis
• dermatosis
• diabetes
• diarrhea
• digestive
• digestive disorders
• dropsy (edema) abnormal collection of fluid in spaces between cells
• dysentery
• dysmenorrhea (painful menstruation)
• dyspepsia
• edemas
• endogenous DNAp of hepadnaviruses
• extreme thirst
• eye diseases
• fever
• flu
• frequent bloody stools and rectal spasms
• gallbladder problems
• gallstones
• gastritis
• gastrointestinal problems
• genitourinary disorders
• gonorrhea
• gout
• heartburn
• hepatitis B
• hypertension
• hypoglycemic
• ictericia
• inflammation of the appendix
• intestinal bacteria
• intestinal chemical irritants
• intestinal parasites
• intestinal protozoa
• itch
• jaundice
• kidney colic
• kidney disease
• kidney infections in general
• kidney pain
• kidney stones
• laxative
• leucorrhea
• liver cancer growing rate
• liver disease
• malaria
• menorrhagia
• menstrual problems
• miscarriage
• nausea
• obesity
• oligogalactia
• painful joints
• poor appetite
• proctitis
• proliferation of mutated and cancerous cells
• prostatitis
• rectitis
• renal colic
• renosis
• ringworm
• scabies
• skin ulcers
• stomachache
• syphilis
• tenesmus
• thirst
• tuberculosis
• tumor (abdomen)
• typhoid fever
• uric acid excess
• urinary problems
• urogenital tract infections
• urolithiasis
• uterus complaints
• vaginitis
• venereal diseases
• vertigo
• viral infections of reproductive system
• warts

Phyllanthus niruri L. is used as:

• abortifacient
• aldose reductase inhibitor
• analgesic
• anodyne
• antibacterial
• anticancerous
• antidiabetic
• antihepatotoxic
• anti-inflammatory
• antilithic
• antimalarial
• antimutagenic
• antinociceptive
• antipyretic
• antispasmodic
• antiviral
• aperitif
• astringent
• bactericidal
• carminative
• cell protector
• cholagogue
• choleretic
• colic
• deobstruent
• depurative (cleanse or purify the blood)
• detoxifier
• diaphoretic
• digestion stimulant
• dispels mucus
• disperses calcification
• disperses damp heat
• diuretic (increases urination)
• dyspeptic
• emmenagogue (stimulates, initiates and/or promotes menstrual flow)
• febrifuge
• for slimming
• fortifies liver and gallbladder
• galactagogue
• harmonizes middle burner
• hepatoprotective (liver-protecting activity)
• hepatotonic
• HIV-1 reverse transcriptase inhibitor
• hypertension
• hypoglycemic
• hypotensive
• immune system stimulator
• laxative
• liver protecting activity
• muscle relaxant
• piscicide
• poultice
• purgative
• reduce cholesterol levels
• reduce triglyceride levels
• smooth muscle relaxant
• soothes the liver
• stimulates bile production
• stimulates the elimination of uric acid
• stimulates the secretion of bile, and encourages efficient liver function
• stomachic
• sudorific
• tonic
• tonifies liver and gallbladder
• uterine relaxant
• vermifuge

The first medical effect on humans of Phyllanthus niruri L., a diuretic effect, was scientifically demonstrated in India in 1929. Since then, a tablet of Phyllanthus niruri L. is sold as a diuretic in that country under the name of Punarnava. During a 1952 study performed on dogs, a diuretic effect was observed, too. In several 1990 clinical studies on humans and rats performed at the Paulista School of Medicine in São Paulo, Brazil, the investigators reported a significant increase in diuresis and sodium and creatine excretion produced by a simple infusion (tea) of Phyllanthus niruri L. In a 1995 study designed to confirm the hypotensive effect of Phyllanthus niruri L., Indian investigators administered Phyllanthus niruri L. leaf powder in capsules to hypertensive individuals and, as a result, not only confirmed its hypotensive effect but also observed a significant increase in urine volume (diuretic effect), and in urine and serum sodium excretion. As a diuretic, Phyllanthus niruri L. also helps to combat edemas (dropsy).

The vernacular name of Phyllanthus niruri L. in the different languages of the places where it grows (“chancapiedra”, “stone breaker”, “quebra pedra”, etc.) refers to the effective use of it made through generations by indigenous peoples of the Amazonian, India, China, etc. Effectively, the most common traditional use of Phyllanthus niruri L. is in order to eliminate gallstones and kidney stones. Hence, in the Amazon Hispanic region, this plant is known as “chancapiedra”. In Brazil, the plant is known as “quebra-pedra” or “arranca-pedras” that also alludes to the same property. Based on its long documented history of use in the region, the plant is considered effective.

In one of the first studies conducted with Phyllanthus niruri L., researchers reported antispasmodic properties and smooth muscle relaxant properties (including a uterine relaxant effect). In a mid-1980s study, investigators confirmed the antispasmodic activity of Phyllanthus niruri L. This led the investigators to conclude that smooth muscle relaxation within the urinary or biliary tract probably facilitates the expulsion of kidney or bladder calculi.

The first directly validated longstanding traditional use of Phyllanthus niruri L. was for kidney stones. In 1990, Nicole Maxwell reported that Dr. Wolfram Wiemann (of Nuremburg, Germany) treated more than 100 kidney stone patients with Phyllanthus niruri L. imported from Peru and found that 94% of them successfully eliminated stones within a week or two. The same year, the Paulista School of Medicine in São Paulo, Brazil, conducted several clinical studies with humans and rats with kidney stones. A simple infusion (tea) of Phyllanthus niruri L. was administered to the patients and the rats for 1 to 3 months. The researchers reported that, as a result, the tea promoted the elimination of stones. They also reported a significant increase in diuresis and sodium and creatine excretion, as has already been said.

In another scientific study carried out in 1999 (Campos, A.H., et.al.) —an in vitro study— investigators demonstrated the potent and effective non-concentration-dependent inhibitory effect of Phyllanthus niruri L. on the formation of calcium oxalate crystals (calcium oxalate crystals are the building blocks of most kidney stones).

In a new clinical study conducted in 2002 —an in vivo study, this time— investigators inserted calcium oxalate crystals in the bladders of rats, treated them for 42 days with a water extract of Phyllanthus niruri L., and compared them with other group of rats which received only water. The results indicated that Phyllanthus niruri L. strongly inhibited the growth of the seeded calculus and reduced the number of stone satellites compared with the group receiving water. As a consequence, today Phyllanthus niruri L. is found in many pharmacies throughout Brazil.

Apart from being used in herbal medicine for kidney stones, Phyllanthus niruri L. has shown to be effective for gallstones, although no specific research has been done related to this use. In spite of that, a 1985 in vivo study performed on rats showed that an aqueous extract of Phyllanthus niruri L. could reduce cholesterol and triglyceride levels (cholesterol is related to gallstones). Besides, in a 2002 in vivo study performed on rats, Indian investigators reported that Phyllanthus niruri L. had choleretic activity —that is, increased bile secretion— and significantly lowered blood cholesterol levels, confirming the previous study. These effects on gallbladder processes suggest indirectly that Phyllanthus niruri L. could act against gallstones.

Another use traditionally associated to Phyllanthus niruri L. is as a hepatoprotective (liver-protecting activity). There exists some investigation with respect to this. The antihepatotoxic activity of Phyllanthus niruri L. has been attributed to at least two novel lignan phytochemicals named phyllanthin and hypophyllanthin. It has been demonstrated than Phyllanthus niruri L. protects rats from liver damage induced by alcohol, and normalizes a “fatty liver”. One in vitro study and four in vivo studies with rats and mice established that extracts of Phyllanthus niruri L. could effectively protect liver against damage caused by various chemical liver toxins. Similarly, two clinical studies concluded that Phyllanthus niruri L. shown an antihepatotoxic effect in children with hepatitis and jaundice.

In India, HP-1, a herbal formulation comprising of Phyllanthus niruri L. and extracts of Terminalia belerica, Terminalia chebula, Phyllanthus emblica and Tinospora cordifolia was evaluated for hepatoprotective activity against carbon tetrachloride (CCl4) induced toxicity. Results showed that HP-1 reversed the leakage of lactate dehydrogenase (LDH) and glutamate pyruvate transaminase (GPT) and prevented the depletion of glutathione (GSH) levels in a primary monolayer culture of rat hepatocytes (in vitro). HP-1 attenuated the serum toxicity as manifested in elevated levels of transaminases (glutamate oxaloacetate transaminase (GOT), and GPT). The antioxidative enzymes in liver (catalase and superoxide dismutase (SOD)) were restored to normal values after the oral administration of HP-1. HP-1 suppressed the formation of the superoxide anion radical and reduced CCl4 mediated lipid peroxidation (LPO). This study concluded that HP-1 is a potential hepatoprotective formulation with an additional attribute of being anti-peroxidative.

In the same way, an Indian investigation concluded that Phyllanthus niruri L. used as a single drug was effective in the treatment of jaundice in children, whereas British researchers reported that children treated with a Phyllanthus niruri L. extract for acute hepatitis had liver function return to normal within five days. Moreover, a Chinese clinical study shown that the administration of 900mg of powdered Phyllanthus niruri L., twice a day to adults with chronic hepatitis had antihepatotoxic actions.

In a 2000 liver cancer study performed on mice, scientists reported that a Phyllanthus niruri L. water extract administered orally increased the life span of mice with liver cancer in 19 weeks (the mice in the control group without treatment lived for 33 weeks and the mice in the treatment group lived for 52 weeks).

In a related investigation, another research group tried to induce liver cancer in mice that had been pre-treated with a water extract of Phyllanthus niruri L. As a result, the investigators conclude that Phyllanthus niruri L. extract has the capability to reduce tumor incidence as well as levels of carcinogen-metabolizing enzymes, levels of liver cancer markers, and liver injury markers. All of these beneficial properties are dose-dependent.

Other important traditional use of Phyllanthus niruri L. is for hypertension, and some investigation has been made in this sense. The first time a hypotensive effect —that is, the diminishing of blood pressure— was noted was in 1952, in a study performed on dogs. In a 1988 study, researchers attributed hypotensive effects of Phyllanthus niruri L. to a specific phytochemical called geraniin (an ellagitannin phytochemical). In 1995, Indian researchers administered Phyllanthus niruri L. leaf powder in capsules to hypertensive individuals and reported a significant reduction in systolic blood pressure (hypotensive effect), a significant increase in urine volume (diuretic effect), and in urine and serum sodium excretion, as well as hypoglycemic activity. In 1996, scientists of a Brazilian university isolated and tested the hypotensive phytochemical geraniin from Phyllanthus niruri L. and reported that it had also analgesic activity.

Traditionally, Phyllanthus niruri L. has also been used in order to treat diabetes. As Indian researchers discovered in 1995, Phyllanthus niruri L. leaf powder capsules have a significant hypoglycemic activity in humans. There exist two other studies with diabetic rabbits and rats supporting the traditional use of Phyllanthus niruri L. in diabetes. Moreover, another study showed that Phyllanthus niruri L. could inhibit aldose reductase activity. The aldose reductase inhibition is crucial in the treatment of human diabetes, because substances with the ability to inhibit aldose reductase act on nerve endings exposed to high blood sugar concentration to prevent some of the chemical imbalances that occur and thus protect the nerve. The aldose reductase inhibitory effect has been attributed in part to another ellagitannin phytochemical (ellagic acid) found in Phyllanthus niruri L. This well-studied phytochemical has been associated by more than 400 clinical studies with many other curative effects.

As it has been said previously, both human and animal hepatoprotective properties have been scientifically proved, even during hepatitis infection. This fact lead scientists to test Phyllanthus niruri L. extracts against the hepatitis B virus. Hepatitis B is known to be the major cause of hepatoma —that is, liver cancer— worldwide, and liver cancer is a 100% fatal disease. Moreover, people with the hepatitis B virus —known as HBV carriers or hepatitis V virus carriers—  are 200 times more likely to develop liver cancer than people who is not an HBV carrier, even decades after initial infection. This hepatitis is transmitted through sexual contact, from mother to child inside the uterus, through blood transfusions, and through needles, in a very similar way than HIV is done. As a matter of fact, HBV is reported to be 100 times more infectious than HIV. Furthermore, many people who contract HBV become chronic (and, often, asymptomatic) carriers of the disease while still being contagious to others. The Center for Disease Control (CDC) in the United States considers that there are one million HBV carriers in that country and 300 million worldwide, and that in the United States 3,000 to 4,000 people who die due to cirrhosis and 1,000 who die due hepatoma in any given year are HBV carriers.

As a result, more than 20 studies have been published to date about Phyllanthus niruri L. extract direct antiviral activity in human, animal, and in vitro cell culture against the hepatitis B virus. In 1988 Dr. Baruch Blumberg, 1963 Nobel Prize laureate for discovering the HBV antigen, reported that Phyllanthus niruri L. could shorten the chronic carrier stage of Hepatitis B. Dr. Blumberg and his Indian colleagues published the first study conducted in humans in which study they reported that a water extract of Phyllanthus amarus (for some investigators, a related species; for others, the same species than Phyllanthus niruri L.) cleared the HBV surface antigen from 22 of 37 chronic HBV patients in only 30 days (and they continued to test negative for 9 months). This same team has performed other several in vitro as well as animal studies with woodchucks (woodchucks respond to chronic HBV infection in much the same manner as humans do). In all these studies a similar and effective anti-HBV effect has been shown. They consider that the antiviral properties of Phyllanthus niruri L.  were achieved in part through a strong inhibition of reverse transcriptase (which made it possible to treat such retroviruses as HIV and sarcoma and leukemia viruses). As a result this work team patented a complicated extraction process in which the plant was first macerated in cold water, then filtered to extract the resulting fluid first in hexane, then in benzene, then in methanol, and back into water, although they did not characterized the chemical compound responsible for the antiviral properties.

Contrarily —and surprisingly— in 1994, a New Zealand research group performed a double-blind HBV human trial with a chemically-altered extract of Phyllanthus amarus which was standardized to the geraniin content (the chemical documented with analgesic and hypotensive properties) with no positive response. However, by the same time Chinese investigators published two studies with a Phyllanthus niruri L. water extract and/or powder in which patients with HBV shown good responses. A second study of this Chinese team, published in 1995, determined that Phyllanthus urinaria had the best results and that other related species of plants used shown different levels of antiviral activity against HBV. In an earlier publication (2001) this Chinese team compared 30 chronic HBV patients to whom an extract of Phyllanthus niruri L. was administered with 25 patients to whom interferon (IFN-alpha 1B) was administered for three months. Both treatments had the same effectiveness of 83%, but the group who received the Phyllanthus niruri L. extract rated significantly higher in the normalization of liver enzymes (ALT, AG, and SB) and recovery of liver function than the interferon-treated group.

According to Thyagarajan et al. (1988), Phyllanthus amarus L., a species closely related to Phyllanthus niruri L., could help to diminish the presence of hepatitis virus type B found in human blood; however, it does not removes 100% of the virus, so it should not be considered a cure (Leelarasamee et al., 1990). Apparently, Phyllanthus urinaria, other species closely related to Phyllanthus niruri L., is the most efficient for the treatment of this disease (Meixa et al., 1995).

The Cochrane Hepato-Biliary Research Group in Copenhagen reviewed all the HBV published research (22 randomized trials) and concluded that in spite of the fact that there is a lot of confusion related to taxonomic identification of different species within the Phyllanthus (L.) Murr. genus, extracts taken from the studied species of this genus have a positive effect on clearance of serum HBsAg (HBV surface antigen) comparable to interferon and are better than nonspecific treatment or other herbal medicines for HBV and liver enzyme normalization.

The good results obtained with Phyllanthus niruri L. respect to HBV led some Japanese investigators concerned about HIV to perform a specific study. Hence, in 1992 a Japanese workgroup reported the ability of a simple water extract of Phyllanthus niruri L. to inhibit HIV-1 reverse transcriptase. They attributed this effect to a phytochemical called repandusinic acid A which, when tested individually, demonstrated significant reverse transcriptase inhibition and cytotoxicity to HIV-1 at very small dosages (a 90% in vitro inhibition using only 2.5 mcg). Moreover, in a 1996 study, Bristol-Myers Squibb Pharmaceutical Research Institute isolated and described another chemical compound in Phyllanthus niruri L. with reverse transcriptase inhibition activity—a novel compound that they named niruriside.

A 2002 Indian in vitro study examined the anti-HIV effects of the alkaloid extract of Phyllanthus niruri L. in human cell lines. The inhibitory effect on HIV replication was monitored in terms of inhibition of virus induced cytopathogenecity in MT-4 cells. The alkaloid extract of Phyllanthus niruri L. showed suppressing activity on strains of HIV-1 cells cultured on MT-4 cell lines. The CC50 for the extract was found to be 279.85 micro gm/L whereas the EC50 was found to be 20.98 micro gm/L. Interestingly the Selectivity Index (SI) was found to be 13.34, which showed a clear selective toxicity of the extract for the viral cells. The alkaloid extract of Phyllanthus niruri was thus found to exhibit sensitive inhibitory response on cytopathic effects induced by both the strains of human immunodeficiency virus on human MT-4 cells in the tested concentrations.

In addition to these antiviral properties, the plant has also shown other antimicrobial effects. Phyllanthus niruri L. demonstrated in vitro antibacterial actions against Staphylococcus, Micrococcus, and Pasteurella bacteria as well as in vivo and in vitro antimalarial properties, which validates other traditional uses.

Six studies performed at a Brazilian university have shown that Phyllanthus niruri L. has some analgesic activity. Between 1994 and 1995, three different studies performed on animals concluded that the oral, intragastrical, and intraperitoneal administration of water and/or alcohol extracts of Phyllanthus niruri L. to mice produced a strong and dose-dependent analgesic effect. Even when mice were fed orally with a hydroalcohol extract at only 35 mg/kg these marked analgesic effects were recorded.

In a 1996 study, the same investigators isolated and tested the hypotensive phytochemical geraniin from Phyllanthus niruri L. and reported that it was seven times more potent as an analgesic than aspirin or acetaminophen. Unlike aspirin —which can harm the mucosal lining of the stomach and cause ulcers— geraniin has been reported to have antiulcerous and gastroprotective properties instead. This analgesic effect is probably why so many people taking Phyllanthus niruri L. for kidney stones —a very painful illness— report such quick relief and long before chanca piedra could actually break down and expel a stone.

Other two studies conducted by the same Brazilian team in 2000 not only confirmed the analgesic properties of Phyllanthus niruri L. on normal pain models but also reported its effectiveness on neurogenic pain models in mice. They also reported the ability of geraniin to inhibit several neurotransmitter processes that relay and receive pain signals in the brain.

Today we can say that Phyllanthus niruri L. also has an anticancerous activity. Its antimutagenic activity has been proved in animals. Hence, several in vivo studies —and one cell culture in vitro study as well— have shown that extracts of Phyllanthus niruri L. have the ability to stop or inhibit mutations in cells, including liver ones. These experiments have been conducted in the presence of chemical compounds that are known for their ability to induce cellular mutations and DNA strand breaks, situation that can lead to the raising of cancerous cells.

It seems that the hepatoprotective activity as well as the anticancerous activity of Phyllanthus niruri L. observed in several studies are mainly related to an antiproliferative effect against mutated and cancerous cells rather than an anti-tumoral effect or selective ability to kill cancer cells. An in vitro cancer study performed on sarcoma, carcinoma, and lymphoma cells confirmed this antiproliferative effect of the Phyllanthus niruri L. extract. In this study, investigators concluded that certain substances present in Phyllanthus niruri L. extract could inhibit several particular enzyme processes related to the replication and growth of cancer cells, situation that would stop or slow cancer cell growing and/or division before they can form a tumor, rather than killing them all when the tumor is already settled.

This antimutagenic —and hence, anticancerous— activity was proved again in other study that showed that Phyllanthus niruri L. extract protected mouse bone marrow cells against chromosome damage both under chemical induction and radiation induction of chromosome damage in mice. In order to protect mouse chromosomes against 4 gy of gamma radiation damage, only 25 mg of Phyllanthus niruri L. extract per kg of animal body weight were needed.

Phyllanthus niruri L. is a highly beneficial medicinal and phytochemically-rich plant whose many biological activities and benefits are attributed to many chemicals. The synergistic interactions among the many chemical compounds in Phyllanthus niruri L. still remain unclear, although it seems that most of the phytochemicals are completely water-soluble.

Phyllanthus niruri L. has also been satisfactorily used to treat acute or chronic inflammation of the skin (dermatosis/dermatitis). It is thought that helps to avoid the developing of blisters or other eruptions. It is also thought to act as detoxifier; it is, promotes removal of toxins from system/organ. It also acts as dyspeptic in cases of stomach discomfort, heartburn or nausea.

Popular medicine also considers Phyllanthus niruri L. useful to treat problems proper of women, such as dysmenorrhea (painful menstruation). In that sense, Phyllanthus niruri L. is considered a plant with emmenagogue properties due to its capacity to stimulate, initiate and/or promote menstrual flow.

Some modern herbalists are studying the uses of Phyllanthus niruri L. Phyllanthus amarus and Phyllanthus urinaria in dietetic regimes for people with excess of weight; it is, for slimming. Additionally, these three species have other applications such as against inflammation of the appendix, diabetes and for prostate problems.

Phyllanthus amarus, Phyllanthus niruri L. and Phyllanthus urinaria are all employed in the treatment against kidney - and gallstones as well as other kidney related problems.

Phyllanthus niruri L. is considered a plant with febrifuge properties; it means, with the ability to reduce high body temperatures.

The fruits of Phyllanthus acidus, a related species, are made into preserves. The leaves and bark of Phyllanthus ernblica, called amla or Indian gooseberry, contain tannin and are used in tanning and dyeing. In India people make its dried fruit into ink, hair dye, and detergent. They also use the fresh fruit, which is high in vitamin C, in drinks and candy.

Phytochemicals:

• lignans
• phyllanthine
• hypophyllanthine
• alkaloids
• bioflavonoids
• quercetin
• catechin
• astragalin
• brevifolin
• carboxylic acids
• corilagin
• cymene
• ellagic acid
• ellagitannins
• gallocatechins
• geraniin
• hypophyllanthin
• lignans
• lintetralins
• lupeols
• methyl salicylate
• niranthin
• nirtetralin
• niruretin
• nirurin
• nirurine
• niruriside
• norsecurinines
• phyllanthin
• phyllanthine
• phyllanthenol
• phyllochrysine
• phyltetralin
• repandusinic acids
• quercetin
• quercetol
• quercitrin
• rutin
• saponins
• triacontanal
• tricontanol

6. Chanca Piedra - Stonebreaker Dosage and Contraindications

Phyllanthus niruri L. is commonly used as a tea (herb infusion), weak decoction or capsule. Alcohol tinctures have not been traditionally used with Phyllanthus niruri L. (as the more fragile, water-soluble phytochemicals and sterols are thought to be damaged in alcohol).

Doses:

Depending on what it is employed for, 1–3 cups are taken daily. Use as follows:

• Prevention and health maintenance dosages are reported by practitioners to be 1–3 cups weekly.
• Some pharmacies in Brazil and South America sell concentrated fluid extracts or water/glycerin extracts. Depending on the concentration of the extracts, 2–6 ml are taken 2–3 times daily.

Contraindications:

Consider the following:

• Phyllanthus niruri L. has demonstrated hypotensive effects in animals and humans. People with a heart condition and/or taking prescription heart medications should consult their doctor before taking this plant. It may be contraindicated for some individuals depending on the condition and/or medications may need monitoring and adjusting.
• Phyllanthus niruri L. has been considered in herbal medicine to be abortive (at high dosages) as well as an emmenagogue. While not studied specifically in humans or animals, animal studies do indicate it has uterine relaxant effects. It is therefore contraindicated during pregnancy.
• Phyllanthus niruri L. has been documented with female antifertility effects in one mouse study (the effect was reversed 45 days after cessation of dosing). While this effect has not been documented in humans, the use of the plant is probably contraindicated in women seeking pregnancy or taking fertility drugs. This effect has not been substantiated sufficiently to be used as a contraceptive, however, and should not be relied on for such.
• Phyllanthus niruri L. has demonstrated hypoglycemic effects in animals and humans. It is contraindicated for people with hypoglycemia. Diabetics should consult their doctor before taking this plant as it may be contraindicated for some individuals and/or insulin medications may need monitoring and adjusting.
• Phyllanthus niruri L. has been documented in human and animal studies with diuretic effects. Chronic and acute use of this plant may be contraindicated in various other medical conditions where diuretics are not advised. Chronic long-term use of any diuretic can cause electrolyte and mineral imbalances; however, human studies on chanca piedra (for up to three months of chronic use) have not reported any side effects. Consult your doctor if you choose to use this plant chronically for longer than three months concerning possible side effects of long-term diuretic use.
• It's also important to note than in all the research published over the last 20 years, no signs of toxicity or side effects have been reported in any of the human or animal studies, even in acute or chronic use. Animal studies report no genotoxic, mutagenic or carcinogenic effects.
• It has been recommended the powdered form of Phyllanthus niruri L. in amounts ranging from 900-2,700 mg per day for three months.

Drug Interactions:

• May potentiate insulin and antidiabetic drugs.
• This plant contains a naturally-occurring phytochemical called geraniin. This chemical has been documented with negative chronotropic, negative inotropic, hypotensive and angiotensin-converting enzyme inhibitor effects in animal studies with frogs, mice and rats. As such, this plant may potentiate antihypertensive drugs, Beta-blocker drugs and other heart medications (including chronotropic and inotropic drugs).
• May potentiate prescription diuretic drugs.

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