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Viscum album
Toxic🐾Mistel · (Viscum album)
Sandalwood family (Santalaceae)
Description
An evergreen, ball-shaped hemiparasite, mistletoe perches high in the crowns of apple trees, poplars or pines and is traditionally harvested in winter between October and December. It contains cytotoxic mistletoe lectins (ML I–III) and viscotoxins, along with lignans, flavonoids and triterpenes. In folk medicine, herb preparations were traditionally used for mild hypertension and circulatory complaints; in clinical research, standardised mistletoe extracts are studied as complementary oncology therapy, for instance regarding tumour-associated fatigue and quality of life — always as prescription-only, parenterally administered products, never as self-medication with tea or tincture. The plant is considered toxic: berries and herb can cause nausea, vomiting, diarrhoea, pupil dilation and circulatory disturbances if ingested, with more severe poisoning possible in children. Mistletoe is also toxic to pets; contact a poison-control centre immediately if poisoning is suspected.
CONTRAINDICATED during pregnancy
Contraindicated in pregnancy. Mistletoe lectins are highly active proteins; uterus-contracting effects have been described. Parenteral mistletoe products are also contraindicated in pregnancy.
CONTRAINDICATED during breastfeeding
Contraindicated during lactation. No sufficient safety data for mother and child; potential transfer of active proteins.
CONTRAINDICATED for children
Contraindicated in children. Even a few berries can cause poisoning. Keep plants out of reach of children; safely dispose of berries from Advent wreaths or Christmas decorations.
Critical drug interactions with:
Immunsuppressiva / Immunosuppressants
Folk-medicinal use: cold compress of mistletoe-herb decoction on weeping skin rashes and eczema. Evidence weak, traditional household use — seek medical advice for extensive or unclear skin lesions.
Preparation & dosage
Folk-medicinal bath additive of mistletoe herb for relaxation and nervous tension. Tradition mainly in Swiss and southern German household medicine (e.g. Künzle); clinical evidence is lacking.
Preparation & dosage
Historical documentation only — do NOT use
These internal applications are historically documented. This plant is highly toxic — self-treatment can cause severe poisoning or death. For documentation only, explicitly NOT a recommendation.
Historical cold infusion of mistletoe herb (stems and leaves) for mild hypertension and circulatory complaints. Important: cold maceration only (8-12 h) — the cytotoxic lectins are heat-labile and a hot infusion inactivates them, but folk-medicinal constituents are also lost. Today this is of documentary interest only; therapeutic self-use is not recommended due to toxicological risks.
Preparation & dosage
Macerate 2.5-3.5 g of dried mistletoe herb in 150 ml of cold water for 8-12 hours, then strain. Use only under medical supervision — self-medication not recommended.
- Dry amount
- 2.5–3.5 g
- Doses per day
- 2×
- Max duration
- 4 weeks
Historical low-dose ethanolic tincture of mistletoe herb for circulatory weakness. Because of the cytotoxic lectins and viscotoxins, home preparation and self-use are no longer recommended today — the therapeutic margin is narrow and only suitable for prescription by a physician.
Preparation & dosage
1:5 in 40-50% ethanol, 1-2 ml per dose, maximum 2 times daily. Only under medical supervision — home preparation not recommended.
- Liquid amount
- 1–2 ml
- Doses per day
- 2×
- Max duration
- 4 weeks
Note: this use is NOT a home-made tincture but a standardised parenteral (subcutaneously injected) finished medicinal product — Iscador®, Helixor®, abnobaVISCUM®. Used in anthroposophic and integrative oncology as complementary therapy to conventional cancer treatments (surgery, chemotherapy, radiotherapy). Studies show improvements in quality of life, sleep and tumour-associated fatigue; a confirmed life-prolonging effect is contested. The ESMO complementary-oncology guideline lists mistletoe as an option for improving quality of life. To be administered only by experienced physicians.
TOXIC. Mistletoe berries and herb contain cytotoxic lectins (ML I-III) and viscotoxins. Ingestion of berries can cause nausea, vomiting, diarrhoea, abdominal pain, pupil dilation and circulatory disturbances; larger amounts can cause severe poisoning, especially in children. No self-medication with tea or tincture. Therapeutic mistletoe products (Iscador®, Helixor®, abnobaVISCUM®) are prescription-only and administered parenterally. In case of suspected poisoning, contact a poison-control centre immediately.
⏱ Max continuous use: 4 weeks
Contraindicated in pregnancy. Mistletoe lectins are highly active proteins; uterus-contracting effects have been described. Parenteral mistletoe products are also contraindicated in pregnancy.
Contraindicated during lactation. No sufficient safety data for mother and child; potential transfer of active proteins.
Contraindicated in children. Even a few berries can cause poisoning. Keep plants out of reach of children; safely dispose of berries from Advent wreaths or Christmas decorations.
Drug interactions
Antikoagulanzien / Anticoagulants
Mistletoe constituents may affect blood clotting; combined with vitamin K antagonists, DOACs or antiplatelet drugs an increased bleeding risk is possible.
Immunsuppressiva / Immunosuppressants
Mistletoe lectins are immunomodulatory (T-cell and cytokine stimulation) and can counteract the effect of immunosuppressants (e.g. ciclosporin, tacrolimus, biologicals).
MAO-Hemmer / MAO inhibitors
Traces of tyramine and biogenic amines have been reported in mistletoe; theoretical risk of hypertensive crises with concurrent MAO inhibitor therapy.
Antihypertensiva / Antihypertensives
Mistletoe preparations can lower blood pressure; combined with antihypertensives a synergistic hypotensive effect is possible — monitor blood pressure closely.
Contraindications
- Pregnancy and lactation
- Children and adolescents under 18 years of age
- Known hypersensitivity to mistletoe proteins
- Acute febrile and inflammatory diseases (for parenteral mistletoe preparations)
- Highly active autoimmune diseases under immunosuppression
- Primary and secondary hyperthyroidism with tachycardia (for parenteral use)
Harvested part: herb (harvested in winter)
- Time of day:
- During the day in dry weather; traditionally in the winter months, when the semi-parasitic mistletoe remains green and is easily visible against the bare host tree.
- Drying:
- Cut stems and leaves into small pieces, spread loosely on cloths or drying racks and dry in a shaded, airy place at a maximum of 35 °C. Avoid heat above 40 °C to limit further changes in lectins and aromatic compounds.
- Storage:
- 12 months — Store in well-sealed glass or tin containers, in a dark, cool and dry place; separate from foodstuffs and out of reach of children.
- Time of day:
- During the day in dry weather. Berries NOT for tea or consumption — for propagation only: the sticky seed is smeared on the bark of young host-tree branches in late winter.
- Drying:
- Berries are used fresh for propagation and are not dried.
- Storage:
- Do not store berries. Dispose of leftovers safely and immediately — toxic to humans and pets.
- Mistellektine (ML I, ML II, ML III)OtherContent: 0.05-0.1%Aerial parts
Ribosome-inactivating proteins (type II RIPs), key active substances of parenteral oncology therapy; cytotoxic and immunomodulatory, heat-labile.
- Viscotoxine (A1, A2, A3, B, 1-PS)OtherContent: 0.05-0.1%Aerial parts
Small basic cytotoxic polypeptides (~5 kDa, thionin family); membrane-damaging, contribute together with the lectins to toxicity and activity.
- Lignane (Eleutherosid E, Syringaresinol)OtherAerial parts
Phenolic lignans with antioxidant and mild vasoactive properties.
- Flavonoide (Quercetin- und Kämpferol-Glykoside)FlavonoidAerial parts
Antioxidant polyphenols contributing to the vasoprotective action of mistletoe herb.
- Triterpene (Oleanolsäure, Ursolsäure, Betulinsäure)OtherAerial parts
Pentacyclic triterpene acids with anti-inflammatory and in-vitro cytotoxic properties.
- Phenylpropanoide und PhenolcarbonsäurenPhenolic acidAerial parts
Minor accompanying constituents (e.g. caffeic-acid derivatives) with antioxidant activity.
- Freie Aminosäuren und biogene AmineOtherAerial parts
Contains γ-aminobutyric acid (GABA), choline, acetylcholine, histamine and tyramine in small amounts — relevant for theoretical drug interactions.
- [1]MonographKommission E Monographie: Visci albi herba (Mistelkraut), Bundesanzeiger Nr. 228 vom 05.12.1984(accessed: 2026-05-19)
- [2]MonographWHO Monographs on Selected Medicinal Plants, Vol. 4: Herba Visci(accessed: 2026-05-19)
- [3]MonographFachinformationen Iscador®, Helixor®, abnobaVISCUM® (Mistelextrakt-Fertigarzneimittel)(accessed: 2026-05-19)
- [4]MonographESMO Clinical Practice Guideline: Use of Complementary Medicine in Cancer Care (mistletoe section)(accessed: 2026-05-19)
- [6]MonographHeilkräuter-Lexikon: Mistel (Viscum album)(accessed: 2026-05-19)
- [7]MonographCliniTox Giftpflanzen — Viscum album L.s.l.: schwach giftig (+) (Institut für Veterinärpharmakologie und -toxikologie, Universität Zürich)(accessed: 2026-08-10)
- [5]BookGerhard Madaus, Lehrbuch der biologischen Heilmittel, Bd. III, Viscum album, Leipzig 1938 (PD)(accessed: 2026-05-19)