{"id":96053,"date":"2025-05-23T08:25:28","date_gmt":"2025-05-23T07:25:28","guid":{"rendered":"https:\/\/www.herbalreality.com\/?post_type=herb&p=96053"},"modified":"2025-06-03T12:55:17","modified_gmt":"2025-06-03T11:55:17","slug":"lily-of-the-valley","status":"publish","type":"herb","link":"https:\/\/www.herbalreality.com\/herb\/lily-of-the-valley\/","title":{"rendered":"Lily of the valley"},"content":{"rendered":"","protected":false},"featured_media":96079,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"footnotes":"","beyondwords_generate_audio":"1","beyondwords_project_id":"47224","beyondwords_content_id":"ba236b04-83b6-4ec4-81e9-6d3015f19190","beyondwords_preview_token":"435dc619-41e8-4b00-8d79-4060bce86d03","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":[1961,1633,1839],"conditions":[694,685,699,698,700,697],"sustainability":[1576],"sense":[17,31,30,1821,27],"western_action":[1825,1008,1024],"chinese_action":[],"ayurvedic_action":[],"energetics_action":[1908,1499,1496,1494,1492,1380],"region":[1893],"class_list":["post-96053","herb","type-herb","status-publish","has-post-thumbnail","hentry","tag-anti-arrhythmic","tag-cardiotonic","tag-hypertensive","conditions-cardiovascular-system","conditions-digestive-system","conditions-musculoskeletal-system","conditions-reproductive-system","conditions-skin","conditions-urinary-system","sustainability-green-sustainability-status","sense-aromatic","sense-astringent-taste","sense-sharp","sense-sour","sense-sweet","western_action-circulatory-stimulant","western_action-diuretic","western_action-vasodilator","energetics_action-aromatic","energetics_action-astringent","energetics_action-sour","energetics_action-sweet","energetics_action-toning","energetics_action-warm","region-western-herbs"],"acf":{"last_reviewed":"20250502","herb_author":1910,"banner_text":"Lily of the valley is a practitioner-only herb for cardiovascular health","latin_name":"Convallaria majalis<\/span><\/i>","pseudonym_name":"","family_name":"Asparagaceae","herb_summary":"Lily of the valley is a Schedule 20 restricted herb, used to treat heart failure and cardiac insufficiency.","key_benefits":"Cardiotonic\r\nCoronary vasodilator\r\nHypertensive\r\nHeart failure\r\nMyocardial insufficiency\r\nCardiac arrhythmias\r\nOedema of cardiac origin","how_does_it_feel":"Lily of the valley tincture has a sweet, floral and slightly spicy aroma, which is charming and inviting. The tincture is pleasant tasting, sweet with a mildly sharp and astringent aftertaste. It feels gently warming and has a calming quality if you sit quietly and feel it moving through the body. After a few days of taking small (drop) doses you may notice a slight shift in any anxiety, low mood or restlessness and a slight elevation in vitality.\u00a0 <\/span>","hdif_image_1":96079,"hdif_image_2":96080,"hdif_image_3":96074,"hdif_video":"","sense":[17,31,30,1821,27],"what_can_i_use_it_for":"[caption id=\"attachment_96079\" align=\"alignright\" width=\"519\"]\"Lily Lily of the valley (Convallaria majalis<\/em>)[\/caption]\r\n\r\nLily of the valley is included on a list of the Schedule 20 Part 2 herbs in the European Human Medicines Regulation 2012 (1). These herbs may only be used by a qualified medical herbalist in their prescriptions, following a one-to-one consultation, and are not permitted for general sale (1).\u00a0Lily o<\/span>f the valley is not suitable for home remedies and is not recommended for use without the guidance of a qualified medical herbalist.<\/span>\r\n\r\nLily of the valley is a cardiotonic, coronary vasodilator and hypertensive. It is primarily used in cases of congestive heart failure due to a weakened heart muscle, or mechanical defects with the heart valves, and peripheral oedema of cardiac origin. Lily of the valley strengthens and tones the cardiac muscle, allowing for a more efficient pumping action, regulating the heart rate without putting extra demand on the coronary vessels (2,3). This improvement in the rhythm and power of the heartbeat increases the blood pressure and improves tonicity throughout the entire circulation (2). Lily of the valley also has a diuretic action on the kidneys, and is primarily indicated in cases of congestive heart failure where there is fluid build-up in the heart and oedema in the periphery.<\/span>","into_the_heart_of":"[caption id=\"attachment_96075\" align=\"alignright\" width=\"501\"]\"Lily Lily of the valley (Convallaria majalis<\/em>)[\/caption]\r\n\r\nThe cardiac glycosides are the main active constituents in lily of the valley. These exert their action by having a positive inotropic effect (intrinsic increase in the strength of the myocardial contraction) on the cardiac muscle cell (myocyte) membrane. Cardiac glycosides act directly on the extracellular (external) cardiac myocyte membranes to inhibit the sodium\/potassium ATPase (Na<\/span>+<\/span>\/K<\/span>+<\/span> ATPase) enzyme (4). This enzyme maintains the normal negative resting membrane potential of the myocytes by continuously pumping sodium (Na<\/span>+<\/span>) out of the cell in exchange for potassium (K<\/span>+<\/span>) being pumped back into the cell. This maintains the normal excitability of the cell membrane with Na<\/span>+<\/span> on the outside and K<\/span>+<\/span> on the inside of the cell.\u00a0 <\/span>\r\n\r\nAs part of this normal process, Na<\/span>+<\/span> is also exchanged with calcium (Na<\/span>+<\/span>\/Ca<\/span>++<\/span> exchanger), reducing the Ca<\/span>++<\/span> inside the cell after each muscle contraction (4). Inhibition of the Na<\/span>+<\/span>\/K<\/span>+<\/span> ATPase by the cardiac glycosides leaves less Na+ available to be exchanged with Ca<\/span>++<\/span> and, therefore, more Ca<\/span>++ <\/span>remains inside the myocyte (4). This increased intracellular level of Ca<\/span>++ <\/span>enhances muscle contractility and the force of the muscle contraction (positive inotropy) without the need for more energy or oxygen (5,6). Effectively, the heart beats more blood, more efficiently, without needing to speed up or use more oxygen (7). This increased cardiac output leads to a decrease in heart rate (negative chronotropic action), increased blood pressure (hypertensive action) and increased blood flow. Cardiac glycosides also act directly on the Na<\/span>+<\/span>\/K<\/span>+<\/span> ATPase in the central nervous system, activating the parasympathetic nervous system to decrease heart rate (4).<\/span>\r\n\r\nThe cardiac glycosides also decrease the conduction speed of the atrio-ventricular junction (negative dromotropic effect), which slows the heart rate and has an anti-arrhythmic effect on atrial arrhythmias, including atrial fibrillation (6,8). However, the therapeutic ratio of cardiac glycosides is low, meaning the dose needed to exert an effect is close to the toxic dose. In excess, cardiac glycosides can inhibit too much Na<\/span>+<\/span>\/K<\/span>+<\/span> ATPase, which can lead to atrial and ventricular myocardial excitability. This indicates that arrythmias and bradycardia (low heart rate) are possible side effects, and indications of toxicity (7). Also, low blood K<\/span>+<\/span> levels cause the cardiac glycosides to bind increasingly to the cell membrane, and the Na<\/span>+<\/span>\/K<\/span>+<\/span> ATPase pump is excessively inhibited, causing the same indications of toxicity (4).<\/span>\r\n\r\nThe diuretic action of lily of the valley occurs via two mechanisms. Firstly, the increased blood flow helps to transfer fluid from the tissues to the kidneys to be excreted, and the increased blood pressure through the kidney has a beneficial effect on diuresis. Secondly, the cardiac glycosides act directly on the kidney to limit the reabsorption of Na<\/span>+ <\/span>from the kidney tubules, which increases the excretion of fluid in the urine (4).<\/span>\r\n\r\nRegarding energetics and the essence of the plant, Culpeper stated that the spirit of the flowers restores lost speech, helps with palsy, and is exceedingly good for apoplexy (cerebrovascular accidents) to comfort the heart and the vital spirits (9). In traditional medicine, the vital spirits reside in the heart, which pumps these energies around the body, explaining the link between lily of the valley and vitality (10). Christopher Hedley describes lily of the valley as \u201ca herb for the heart and spirits\u201d (10). He stated that it works well in drop doses and can be used for supporting the emotional heart and disturbances in the vital spirits, such as anxiety, confusion, absent-mindedness, weak memory, and depression (10).<\/span>","tradtional_uses":"[caption id=\"attachment_96082\" align=\"alignright\" width=\"513\"]\"Lily Lily of the valley (Convallaria majalis<\/em>)[\/caption]\r\n\r\nIn the 1600s, Culpeper thought it a helpful herb to strengthen the brain and improve weak memory (9). Lily of the valley distilled water was dropped into the eyes to reduce inflammation, and an external application of the flowers was applied for gout (9).<\/span>\r\n\r\nConcurrent with its modern use, the main indication for lily of the valley was as a remedy for the heart. In 1898, King\u2019s American Dispensatory included lily of the valley as a herb indicated for \u201cheart irregularities due to mechanical impediments; mitral insufficiency; dropsy of cardiac origin; palpitation and vehement heart action, with arrhythmical movements, dyspnoea, and diminished arterial pressure; and quickened pulse with capillary obstruction\u201d (11).\u00a0<\/span>\r\n\r\nLily of the valley was used as a tonic for the heart, strengthening and increasing the action of the heart (11). This favourable action on the heart and vessels was known to slow the heartbeat, establish normal rhythm, increase heart power, improve arterial pressure, and deepen respiration (11). Mitral insufficiency, with the associated dyspnoea and palpitations, were considered the primary conditions indicated for lily of the valley, as well as being recommended in the early stages of\u00a0carditis\u00a0(inflammation of the heart) (11). It was not recommended for heart irregularities due to organic degeneration, such as insufficiency\u00a0or\u00a0stenotic conditions<\/span> of the aorta (11).<\/span>\r\n\r\nOwing to the actions upon the heart muscle and the diuretic action on the kidneys, it was also used in cases of dropsy (oedema) which were of cardiac origin (11,12). In these cases, cardiac debility\u00a0causes cardiac inefficiency, poor circulation through the heart, feeble circulation, diminished blood pressure, dyspnoea, diminished renal action with an increase of solids in the urine as well as hepatic fullness and engorgement (11). <\/span>\r\n\r\nLily of the valley was also used in cases of cardiac debility\u00a0following severe and exhaustive diseases such as\u00a0typhoid fever<\/span>, <\/span><\/i>to promote normal circulation, and relieve faintness upon standing (11). Ellingwood reported the use of lily of the valley for a case of heart failure with cardiac oedema, stating, \u201cin the left and right ventricles there was found an extravasation of blood under the endocardium. Under its influence the quantity of urine is much increased, and dropsical exudates are promptly absorbed and the weight of the patient lessened. The pulse grows fuller, more regular, and slower\u201d (2).<\/span>\r\n\r\nOwing to the diuretic action, lily of the valley was recommended in the form of a\u00a0 decoction of the flowers for removing obstructions in the urinary canal (13). It was also used as a tonic for the digestive tract, increasing the appetite and digestive power, and eliciting a slightly purgative effect (11). The powdered flowers were used in fomentations (compresses) for the removal of\u00a0ecchymosed spots\u00a0caused by\u00a0bruises, epilepsy and worms.\u00a0Miasmatic fevers\u00a0were treated with the root (11). A tea made from the flowers was considered an excellent treatment against all nervous complaints, and a cure for nervous headaches, and trembling limbs (14).<\/span>\r\n\r\nWhile it was stated that lily of the valley is never contraindicated in proper doses, it was known to be \u201cdecidedly toxic, death having promptly occurred from suspension of the heart action when introduced directly into the veins of the rabbit\u201d (11). Lethal doses were known to cause irregular cardiac action, with rapid and feeble pulsations; extreme slowing of respiration, significantly lowered blood-pressure, and finally arrest of the heart in systole, by direct stimulation of its inhibitory apparatus (12).\u00a0<\/span>","what_practioners_say":"[caption id=\"attachment_6363\" align=\"alignright\" width=\"323\"]\"Cardiovascular<\/a> Cardiovascular system[\/caption]\r\n

Cardiovascular system<\/h3>\r\nLily of the valley is a cardiotonic and coronary vasodilator, hypertensive, and anti-arrhythmic. It has a long history of use to support cases of congestive heart failure which are due to a myocardial insufficiency (weakened heart muscle), cardiomyopathies, and mechanical defects in the heart, such as valve disorders. These cardiac disorders result in dilation of the left ventricle without any compensatory hypertrophy as the heart muscle progressively weakens and becomes increasingly ineffective at pumping blood (15). Lily of the valley induces a positive inotropic action on the heart to restore strength and function, and efficient ejection of blood. This action increases the cardiac output without increasing the demand for oxygen by the heart muscle (5). This enables the heart to pump adequate amounts of blood around the body, preventing fluid from building up in the heart, lungs and periphery (16). <\/span>\r\n\r\nIf there is fluid in the pericardium or lungs, the effect of lily of the valley will be quickly observed (2). Combined with the diuretic action on the kidneys, lily of the valley is ideally suited to congestive heart failure where there is oedema, <\/span>low blood pressure<\/span><\/a> and a weak or slow pulse. However, it is also indicated in cases of tachycardia due to a weak heart inefficiently ejecting blood and needing to beat more rapidly to compensate for the stroke volume. Lily of the valley is particularly effective when used in early congestive heart failure, combining well with <\/span>hawthorn<\/span><\/a> (<\/span>Crataegus monogyna<\/span><\/i>) and <\/span>motherwort<\/span><\/a> (<\/span>Leonurus cardiaca<\/span><\/i>) to mitigate the onset of full-blown heart failure (4,5,17).\u00a0<\/span>\r\n\r\nOther indications for use include cardiac arrhythmias or bradycardia linked to mechanical heart defects (5). The cardiac glycosides in lily of the valley have a negative dromotropic action by decreasing the conductivity of the atrio-ventricular junction, which has an anti-arrhythmic effect on atrial arrhythmias (7). Great caution is warranted with this use since the therapeutic window is narrow, and toxicity can exacerbate arrhythmias. Lily of the valley can be used effectively to normalise the action of the heart, increase the rate and strength of the pulse in cases of bradycardia, and increase blood pressure in cases of hypotension (5,18). Bradycardia is common in the elderly, when the heart is weakened but is performing well when at rest. In these cases of mild bradycardic heart failure, lily of the valley is valuable to strengthen the heart. Lily of the valley can also be used for symptoms of cerebrovascular disorders in the elderly, including <\/span>memory loss<\/span><\/a>, confusion and fearfulness, and help with recovery from strokes (10).<\/span>\r\n\r\nLily of the valley affects the circulatory system in a similar way to foxglove (<\/span>Digitalis<\/span><\/i>). Digoxin (the active constituent derived from foxglove) is a licensed medication used to treat certain heart conditions, including heart failure and irregular heartbeats such as atrial fibrillation (19). It works by strengthening the heart's contractions and slowing the heart rate, helping the heart pump blood more efficiently. Digoxin requires careful dosing and has a narrow range of toxicity, causing symptoms like nausea, dizziness, and vision changes (20). Compared with foxglove, lily of the valley is generally as efficient as a heart tonic and diuretic, and in many cases may be a more suitable alternative (11). Lily of the valley is less toxic than other cardiac glycosides as it is poorly absorbed, has a short half-life, is rapidly excreted, and has no cumulative effects (4,15). <\/span>\r\n\r\nThis results in less risk of toxicity and side effects than digitalis, which has an accumulative effect which can result in vomiting, anorexia, disordered digestion, cerebral excitation, and pupillary dilatation (11,12). Lily of the valley can be used by an experienced practitioner to wean off digoxin, though the process is nuanced and requires an individually tailored approach (4). When working with lily of the valley it is important to consider that many factors will influence individual toxicity limits, and dosing needs to begin conservatively and be monitored closely (4).\u00a0<\/span>\r\n\r\n[caption id=\"attachment_6372\" align=\"alignleft\" width=\"317\"]\"Respiratory<\/a> Respiratory system[\/caption]\r\n

Respiratory system<\/h3>\r\nMitral valve defects and insufficiency often result in pulmonary congestion as the blood backs up into the pulmonary vessels. This results in pulmonary oedema and dyspnoea, which lily of the valley will resolve by improving the mechanical pumping action of the heart muscle. Therefore, lily of the valley will aid the body when there is difficulty breathing due to congestive conditions of the heart (16). Lily of the valley adds tone, power, vigour and regularity of action to the heart, and it supports the elimination of fluid from the respiratory tracts.<\/span>\r\n\r\nIn addition to recommending the use of lily of the valley for mild cardiac insufficiency and heart insufficiency due to old age, the German Commission E recommended use for chronic cor pulmonale (21). Chronic cor pulmonale is a condition where the right side of the heart becomes enlarged and weakened due to long-term lung diseases such as COPD, pulmonary fibrosis, pulmonary embolism or pulmonary hypertension. The lungs create high pressure in the pulmonary arteries, forcing the right ventricle to work harder, leading to right-sided heart failure. Lily of the valley can strengthen the heart contraction and offer support throughout these respiratory disease processes, and once the heart begins to fail.\u00a0<\/span>\r\n\r\nRespiratory illnesses such as viral infections, bacterial infections, tuberculosis, and prolonged fever, can result in congestion in the lungs, pulmonary effusion and an increased risk of developing endocarditis. In cases of endocarditis, lily of the valley combines well with <\/span>echinacea<\/span><\/a> (<\/span>Echinacea angustifolia<\/span><\/i>) and <\/span>poke root<\/span><\/a> (<\/span>Phytolacca decandra<\/span><\/i>) (5). In terms of providing holistic support to recovery from such illnesses, lily of the valley helps to overcome breathing distress, supports rest and sleep, and induces a general sense of improved wellbeing (2).\u00a0<\/span>\r\n

Musculoskeletal system\u00a0<\/i><\/h3>\r\nLily of the valley has a secondary effect in supporting rheumatic conditions, especially when the heart is involved such as\u00a0in rheumatic carditis\u00a0or\u00a0pericarditis\u00a0(2). It serves a double purpose by strengthening and improving the tone of the heart, and supporting the elimination of metabolic waste and inflammatory mediators, which cause and worsen the inflammation.<\/span>","research":"[caption id=\"attachment_96076\" align=\"alignright\" width=\"512\"]\"Lily Lily of the valley (Convallaria majalis<\/em>)[\/caption]\r\n\r\nThere is a lack of clinical evidence to support the use of lily of the valley, and the indications for use are based on traditional use, <\/span>in vitro<\/span><\/i> research to determine the plant constituents, and the known actions of the constituents. Contemporary research has confirmed a positive inotropic effect of lily of the valley extracts in animal models (8).<\/span>\r\n

Cytotoxic effects of the cardenolide convallatoxin and its Na, K-ATPase regulation<\/h3>\r\nThis study conducted <\/span>in vitro<\/span><\/i> research using animal cells to explore the cytotoxic effects of the cardenolide convallatoxin, and the mechanistic effects on Na,K-ATPase. The study demonstrated an inhibitory action of convallatoxin on Na,K-ATPase, supporting the mechanistic effect that lily of the valley has on regulating cardiovascular alterations seen in congestive heart failure and atrial arrhythmias. The study also found that convallatoxin induced cytostatic and cytotoxic effects and apoptotic cell death in\u00a0non-small cell lung cancer (A549 cells). The study confirmed the mechanism of convallatoxin as an Na,K-ATPase inhibitor, and also suggests that it might work as an antitumour agent to help prevent and treat lung cancer (22).<\/span>","did_you_know":"Since the Middle Ages, the flowers have been traditionally used as part of a bride's bouquet both for the floral scent, and their association with modesty and purity (3).<\/span>","additional_information_right":{"illustration":96090},"additional_information_left":{"botany":"Lily of the valley is a perennial,\u00a0deciduous, rhizomatous plant which forms mats of extensive colonies (25,26). It grows to between 10\u201325 cm in height, each plant spreading to 50 cm wide (25).\u00a0<\/span>\r\n\r\nLeaves appear in spring and remain in growth from April to September (25,29). The leaves are in pairs, which are broadly elliptic to narrowly ovate (25,27).<\/span>\r\n\r\nThe erect flower stems appear between the pairs of leaves in May and June, and develop into arching racemes of small, nodding, bell-shaped, highly fragrant, creamy-white flowers (25,27).<\/span>\r\n\r\nFruiting red berries develop in summer (25).<\/span>","common_names":"