{"id":14897,"date":"2024-11-17T11:55:33","date_gmt":"2024-11-17T11:55:33","guid":{"rendered":"https:\/\/www.herbalreality.com\/?post_type=herb&p=14897"},"modified":"2025-11-06T12:13:30","modified_gmt":"2025-11-06T12:13:30","slug":"comfrey","status":"publish","type":"herb","link":"https:\/\/www.herbalreality.com\/herb\/comfrey\/","title":{"rendered":"Comfrey"},"content":{"rendered":"\n

<\/p>\n","protected":false},"featured_media":14906,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"footnotes":"","beyondwords_generate_audio":"1","beyondwords_project_id":"47224","beyondwords_content_id":"17fe8a98-e8be-494e-8137-d85f2b937462","beyondwords_preview_token":"4d5ac511-74b7-4d49-b95e-03b601500074","beyondwords_player_content":"","beyondwords_player_style":"","beyondwords_language_code":"","beyondwords_language_id":"","beyondwords_title_voice_id":"","beyondwords_body_voice_id":"","beyondwords_summary_voice_id":"","beyondwords_error_message":"","beyondwords_disabled":"","beyondwords_delete_content":"","beyondwords_podcast_id":"","beyondwords_hash":"","publish_post_to_speechkit":"","speechkit_hash":"","speechkit_generate_audio":"","speechkit_project_id":"","speechkit_podcast_id":"","speechkit_error_message":"","speechkit_disabled":"","speechkit_access_key":"","speechkit_error":"","speechkit_info":"","speechkit_response":"","speechkit_retries":"","speechkit_status":"","speechkit_updated_at":"","_speechkit_link":"","_speechkit_text":""},"tags":[],"conditions":[685,699,695,700],"sustainability":[1576],"sense":[31,18,786,28,527,27],"western_action":[990,992,994,996,1000,1005,1010,1025],"chinese_action":[],"ayurvedic_action":[],"energetics_action":[1499,1498,1382,1488,1381,1494,1492],"region":[1893],"class_list":["post-14897","herb","type-herb","status-publish","has-post-thumbnail","hentry","conditions-digestive-system","conditions-musculoskeletal-system","conditions-respiratory-system","conditions-skin","sustainability-green-sustainability-status","sense-astringent-taste","sense-bitter","sense-cooling","sense-mucilaginous","sense-salty","sense-sweet","western_action-analgesic","western_action-anti-inflammatory","western_action-antioxidant","western_action-antirheumatic","western_action-astringent","western_action-demulcent","western_action-expectorant","western_action-vulnerary","energetics_action-astringent","energetics_action-bitter","energetics_action-cool","energetics_action-moist","energetics_action-neutral","energetics_action-sweet","energetics_action-toning","region-western-herbs"],"acf":{"last_reviewed":"20241117","herb_author":1910,"banner_text":"Comfrey is applied externally to heal skin, connective tissue and bone","latin_name":"Symphytum officinale<\/em>","pseudonym_name":"","family_name":"Boraginaceae","herb_summary":"Comfrey promotes wound healing, supports skin regeneration, heals bone and reduces inflammation. Because of safety concerns it is now recommended to be used externally only. It is commonly used in topical treatments for bruises, sprains, bones injuries, aches and pains.","key_benefits":"Tissue healer\r\nSkin abrasions\r\nMuscular-skeletal issues\r\nSprains and strains\r\nJoint pain\r\nOsteoarthritis\r\nAnti-inflammatory","how_does_it_feel":"Comfrey is a highly mucilaginous herb, and simply breaking open a fleshy leaf will reveal slimy mucilage seeping out. Experientially, we can get to know a lot about comfrey herb just by observing, touching and smelling it.\r\n\r\nVisually, comfrey has big, green, plump, luscious leaves which look nutritious and are filled with fluid. The smell of the leaf is fresh, slightly salty, cucumber-like and mildly sweet, indicating the mineral and polysaccharide content. As you break up a leaf and roll it in your hands it becomes moist and mucilaginous, revealing the high content of polysaccharides. It feels cooling and soothing, reflecting the energetics and anti-inflammatory properties which draw heat from inflammations (1). As the plant\u2019s mucus dries on the skin it feels tacky and tightened, due to the high tannin content, which is astringent and toning for surfaces and mucous membranes.\r\n\r\nMade into a leaf infusion the smell is strong, salty, seaweed-like and slightly sweet, linking to the nourishing minerals and polysaccharides. The taste is much blander than the smell; slightly salty, sweet, bitter and astringent. The sweetness is from the abundant polysaccharides, the bitterness from the alkaloids and the astringency from the tannins (1).","hdif_image_1":14906,"hdif_image_2":14908,"hdif_image_3":14904,"hdif_video":"https:\/\/youtu.be\/9_rYTGKEylA","sense":[31,18,786,28,527,27],"what_can_i_use_it_for":"Comfrey is a potent tissue healer of the skin, connective tissues and bone (2). It is now recommended for external use only, as it contains potentially toxic constituents called pyrrolizidine alkaloids (PAs) (3). See the section on safety (below).\r\n\r\nComfrey is a primary first aid remedy for wounds, cuts, abrasions, burns, scalds, sunburn, skin irritations and rashes (4,5). It has a soothing and cooling effect. The cell-healing action of some of the constituents, notably allantoin which rapidly moves through the tissues, speeds up wound healing and reduces the production of scar tissue (6).\r\n\r\nThere is a wealth of clinical research demonstrating the efficacy and safety of comfrey preparations for topical treatment of painful muscle and joint complaints including pain, inflammation and swelling of muscles and joints in degenerative arthritis; acute myalgia (muscle pain); sprains, contusions and strains after sports injuries and accidents (7,8).","into_the_heart_of":"Comfrey is cooling, moistening, and slightly constricting (9,10,11). Energetically and emotionally, comfrey relates to the base chakra; where energy is stored (12). Comfrey is for those who lack structure and form in their lives, who need to develop a solid base, to give a sense of order where chaos is felt (12). Comfrey is a powerful healer of raw and sensitive emotional wounds and trauma, providing a soothing and grounding protective layer while the person heals (12).\u00a0 Comfrey also confers determination, cohesiveness, and the ability to fuse back together what has come apart, while encouraging growth and change (2,13).","tradtional_uses":"[caption id=\"attachment_14907\" align=\"alignright\" width=\"600\"]\"Comfrey Comfrey blossoms (Symphytum officinale<\/em>)[\/caption]\r\n\r\nComfrey has a long history of use in healing wounds, injured tissues, and broken bones; and many of the common names allude to these virtues (14). Parkinson recommended that the fresh roots were \u201cbruised, beaten small and laid on leather\u201d to be applied externally to broken bones, fresh wounds, gout, painful joints, ulcers, and gangrene (11). A decoction of the root was used externally for mastitis and bleeding haemorrhoids, while the internal applications were for ailments of the lungs to help expectorate mucus and heal ulcers in those who are coughing up blood (11).\r\n\r\nThe earlier traditions of internal use largely stemmed from the effect of the mucilaginous agents on mucous tissues of the lungs and digestive tract (15). A strong decoction of the root, drunk ad <\/em>libitum<\/em>, was used for pneumonia, quinsy, whooping cough, to relieve breathing difficulty and to aid expectoration, especially in cases of bleeding in the lungs (14,16). Comfrey root, boiled in water, or made into a wine or syrup was used for diarrhoea, dysentery, bronchial irritation, coughs, haemoptysis, leucorrhoea, female debility, and passive haemorrhages from the bowels, kidneys, or womb (15). These were taken in doses of 1 to 4 fluid ounces (30\u2013100ml), 2\u20133 times a day. (15).\r\n\r\nThe young leaves were eaten as a green vegetable and used to flavour cakes, while the roots were used together with chicory and dandelion root as a coffee alternative (14).\r\n\r\nIt should be noted that since the discovery of pyrrolizidine alkaloids, constituents with known toxicity risks, that can cause veno-occlusive liver disease in susceptible individuals, many of the traditional herbal uses of the comfrey have come into question (11) The delayed nature of this potential toxicity means that it is unlikely to have been spotted in earlier practice and now we cannot exclude the possibility that this happened. See the section on safety below.","what_practioners_say":"[caption id=\"attachment_14906\" align=\"alignright\" width=\"600\"]\"Comfrey Comfrey (Symphytum officinale<\/em>)[\/caption]\r\n

Skin<\/h3>\r\nThe therapeutic properties of comfrey are based on its tissue healing, astringent, anti-inflammatory, and analgesic effects when applied directly to the skin (7). Due to the PA content of comfrey and the associated potential hepatotoxicity, the safest means of taking this herb is via external application. The skin absorption of PAs is low, while the other therapeutic constituents are freely absorbed (3).\r\n\r\nComfrey stimulates granulation and tissue regeneration and prevents scar tissue formation, making it an excellent remedy for any type of skin damage (7). Allantoin and rosmarinic acid are implicated in the pharmacodynamic effects of comfrey (7). Allantoin is a potent cell-proliferator, which stimulates the growth of healthy tissue, speeds wound-healing and reduces scar formation (6,17). Rosmarinic acid has anti-inflammatory, anti-viral and anti-bacterial activity (3,17). In addition to the action of allantoin and the phenols, the mucilaginous polysaccharides have a local anti-inflammatory and soothing action (18). There are also high levels of astringent tannins that will help heal surface damage. This makes comfrey ideal for topical applications to the skin for bruises, swellings, irritable skin lesions, wounds, ulcers, insect bites, eczema and psoriasis<\/a> (10,18,19). Allantoin is highly soluble in hot water, somewhat soluble in oil, and only slightly soluble in alcohol extracts (17). For this reason, comfrey works well as a poultice, compress, soak or wash for wounds, external ulcers, burns, eczema, acne, psoriasis and chronic varicose ulcers (2,6). Human clinical and observational studies have identified the efficacy of external comfrey preparation for acne, psoriasis, atopic dermatitis and venous leg ulcers (21).\r\n

Musculoskeletal<\/h3>\r\n

Bone<\/h4>\r\nComfrey is one of the best herbs to support bone healing from fractures and breaks, due to the combination of the minerals, the healing properties of allantoin, and the anti-inflammatory action. Allantoin is a remarkable cell proliferator that stimulates the production of collagen, connective tissue, cartilage and bone (4).\r\n

Soft-tissue<\/h4>\r\nThe anti-inflammatory, analgesic and healing properties of comfrey can be applied to heal soft-tissue injuries such as sprains, bruises, pulled muscles, ligament strains; and myalgia (muscle pain) (19,33,34). The topical application of comfrey has been shown to have an anti-inflammatory and analgesic action which improves pain and functional movement in acute myalgia (22). In acute ankle sprains, comfrey ointment has been shown to reduce pain and ankle oedema, and improve ankle mobility (23), with a superior analgesic effect to diclofenac (24,25).\r\n

Joints<\/h4>\r\nComfrey reduces inflammation and pain in joint conditions such as osteoarthritis, degenerative arthritis and gout (19,33,34). In addition to the actions of allantoin, phenols and mucilage, the silica in comfrey affects both soft and firm structures in the human body, having a firming effect on soft connective tissue and strengthening and stabilising joints and ligaments (13). Comfrey root extract ointment has been clinically demonstrated to reduce pain, improve mobility and increase quality of life in knee osteoarthritis (26). Additionally, two observational studies identified that two weeks of topical treatment with comfrey root preparations reduced joint pain by 50% and completely eliminated morning stiffness in osteoarthritis (26). In addition to working well as an ointment for musculoskeletal conditions, comfrey works well as a warm compress, as the mucilage retains the heat and allows the heat to penetrate the tissues more progressively (18).\r\n

Gastrointestinal<\/h3>\r\nDue to concerns about hepatotoxicity the internal use of comfrey is no longer recommended. However before these potential long-term risks were identified it was used in the gastrointestinal tract for its wound-healing, analgesic, astringent and soothing effects and some practitioners still reserve it for the short term only (3). The mucilaginous polysaccharides produce a mucous coating which soothes and protects exposed or irritated surfaces of the gastrointestinal tract (18). The astringent tannins can stop bleeding and protect the surface membranes against inflammation and infection (4). Comfrey has therefore been used in the treatment of gastric and duodenal ulcers, gastric reflux, oesophagitis, ulcerative colitis and hiatus hernia (6,18).\r\n\r\nHerbal alternatives to comfrey to support mucous membrane healing and treat gastric ulcers, gastritis and gastrointestinal inflammations include slippery elm bark<\/a> (Ulmus fulva<\/em>), marshmallow roo<\/a>t (Alth<\/em>a<\/em>ea officinalis)<\/em>, liquorice<\/a> (Glycyrrhiza glabra<\/em>), plantain<\/a> (Plantago lanceolata<\/em>) and meadowsweet<\/a> (Filipendula ulmaria<\/em>) (4,6).","research":"[caption id=\"attachment_14902\" align=\"alignright\" width=\"600\"]\"Comfrey Comfrey root ointment (Symphytum officinale<\/em>)[\/caption]\r\n\r\nA critical scoping review in 2013 evaluated the clinical evidence to support the external uses of comfrey (21). The authors concluded that there is robust evidence of benefit for ankle distortions (sprains), back pain, abrasion wounds and osteoarthritis (21).\r\n

Wound-healing<\/h3>\r\nBarna carried out a randomised-controlled, double-blind clinical study on 278 patients with fresh skin abrasions. Topical application of a comfrey ointment (10% extract) was compared to a lower dose, reference preparation (1% extract). After 2\u20133 days there was a significantly faster reduction in the wound area with the 10% extract, and a complete healing time that was three days faster than the 1% extract. The authors concluded that comfrey ointment extract can contribute to significant wound-healing effects (20).\r\n

Muscle pain\/myalgia<\/span><\/h3>\r\nKucera et al. assessed the effectiveness of two strengths of topical comfrey cream (10% vs 1%) in 215 patients with myalgia. Participants in both groups applied 2\u20133 g of cream three times per day, for 8\u201310 days to their affected pain area. Pain in motion, pain at rest, and pain on palpation all decreased in both groups, and this effect was significantly greater for the 10% cream. The authors concluded that the study confirms the anti-inflammatory and analgesic effects of topical comfrey application for muscle pain (22).\r\n

Osteoarthritis<\/h3>\r\nGrube et al. carried out a randomis ed, double\u2010blind, placebo-controlled trial of 220 patients with painful osteoarthritic knee. Three times a day for 21\u2009days the patients applied 2\u2009g comfrey root cream (35% of a 1:2 extract, equivalent to 17.5 g comfrey root per 100 g) or placebo cream. Pain at rest and during movement decreased significantly more in the comfrey group (54.7%) compared to the placebo (10.7%). Pain, stiffness and function symptoms were reduced by 58.0% in the comfrey group, which was significantly greater than the placebo (14.1%). Knee mobility and quality of life significantly increased in the comfrey group. The authors concluded that comfrey root extract ointment is well suited for the treatment of knee osteoarthritis by reducing pain, improving mobility and increasing quality of life (26).\r\n

Sprains<\/h3>\r\n142 patients with a unilateral acute ankle sprain took part in a double-blind, randomised, placebo-controlled study (23). A comfrey extract ointment (35% of a 1:2 extract, equivalent to 17.5 g comfrey root per 100 g) or placebo, was applied at 2 g, four times per day, for 7\u20149 days. The comfrey treatment significantly reduced pain and ankle oedema, and significantly improved ankle mobility compared to the placebo (23).\r\n\r\nA randomised, parallel-group study enrolled 164 patients with an acute, unilateral ankle sprain (24). Four times per day, for 7 days they applied 2 g of either comfrey ointment (35% 1:2 extract, equivalent to 17.5 g comfrey root per 100 g), or diclofenac gel. The improvement in tenderness to pressure was superior in the comfrey group. Pain at rest decreased by 92% and 85% in the comfrey and diclofenac groups, respectively, and pain during movement decreased by 83% and 72% for the comfrey and diclofenac groups, respectively. There was a slightly greater, but not significantly different reduction in pain in the comfrey group, meaning the comfrey had a comparable analgesic effect to the diclofenac (24). A later study re-evaluated the data and concluded that comfrey ointment was statistically superior to diclofenac (25).","did_you_know":"Comfrey is used as an organic fertiliser by soaking the leaves in water to make a liquid feed for nourishing poor-quality soil\u00a0 \u00a0(27,28). The fresh leaves also speed up composting and can be used as mulch around other plants in the growing season (27). However, using comfrey in such a way can increase the PA content of plants in the vicinity via horizontal transfer (29). The use of comfrey in composting and as a fertiliser is, therefore, only appropriate for ornamental gardening.","additional_information_right":{"illustration":105132},"additional_information_left":{"botany":"There are several hybrids of the native common comfrey, which are all perennial with rough, hairy leaves and stem, broad lanceolate leaves along a long stalk (27,39). The bell-shaped flowers are in spikes which are coiled in a spiral at first (27,39).\r\n\r\nCommon comfrey (Symphytum officinale<\/em>) is a tall, deciduous, perennial herb growing to about 1.5 m tall (28). It forms a clump of erect stems bearing coarse, hairy dark green leaves up to 25 cm in length, from April to October (28,39). The upper stem leaves run down the stem to the next leaf junction, creating the winged stem (39). The tubular flowers with long sepal teeth form in clusters, they are creamy-yellow\/pink\/ pale purple, 2 cm in length, appearing in late spring and summer, from May to July (28,39,40).\r\n\r\nThe most common hybrid in the UK is Russian comfrey (Symphytum<\/em>\u00a0\u00d7\u200a\u2060uplandicum<\/em>) which is a hybrid of S. asperum<\/em>\u00a0and S.<\/em> officinale <\/em>(27,39,40). Russian comfrey can be differentiated from common comfrey by the bright blue\/violet flowers, narrower leaves, and shorter winged sections which end between the leaves (39,40). Russian comfrey is much higher (up to five times) in the hepatotoxic PAs than common comfrey, which is important to consider when growing, harvesting and using comfrey as herbal medicine (11).","common_names":"