Uses

Asthma: Children and teenagers who took Pycnogenol (1 mg per pound of body weight) for 3 months had greater improvements in lung function and fewer asthma symptoms than others who took a placebo. Those who took Pycnogenol were also more likely to have reduced need for inhalers.¹ In another small study, adults with allergic asthma took 50 mg of Pycnogenol twice a day for six months in addition to their prescribed corticosteroid inhaler. Compared to those who only used the corticosteroid, those taking Pycnogenol were able to use a lower dose of the corticosteroid inhaler and had better control of symptoms, such as cough, severity of chest symptoms, wheezing, shortness of breath, and daytime symptoms.²

Osteoarthritis: Subjects with osteoarthritis who took 100 mg of Pycnogenol per day for 3 months improved their scores on an arthritis questionnaire by 56% compared to 10% for those who took a placebo. Walking distance increased from 68 to 198 meters for those in the Pycnogenol group but only 65 to 88 meters in the placebo group. The use of drugs decreased by 58% in the Pycnogenol group and 1% in the placebo group. Edema decreased 79% with Pycnogenol and 1% with placebo.³ Beneficial effects were also seen in a 3 month study of patients with knee osteoarthritis and a 4 week study of patients with hand osteoarthritis; both studies used 150 mg of Pycnogenol daily.^{4 5}

Menstrual pain: Pycnogenol relieved pain and lowered the need for analgesic medication among women experiencing menstrual pain in a study comparing 60 mg of Pycnogenol per day and a placebo. The supplements were taken daily for two months; after discontinuation of Pycnogenol supplementation, the required analgesic medication remained significantly lower than before supplementation.⁶

Male sexual function: For men, a combination of Pycnogenol and the amino acid L-arginine may help reverse erectile dysfunction. In one study, researchers found that 1.7 grams of L-arginine daily benefited only two of 40 male subjects. But with the addition of 80 mg or 120 mg of Pycnogenol daily, 32 and 37 of the men had improvements in erectile function, respectively.⁷ In a separate year-long study of 50 men with erectile dysfunction, 80 percent benefited from the combination of L-arginine and Pycnogenol. During the study, the partners of almost half the men became pregnant.⁸ Yet another study, this time in men with or without type 2 diabetes, three months of Pycnogenol supplementation improved erectile function significantly compared to placebo, but the effect was most pronounced in those with type II diabetes. This is significant because erectile dysfunction is an early complication of type 2 diabetes.⁹

Menopausal symptoms: Symptoms of perimenopause, such as fatigue, sleep issues, hot flashes, mood issues, and menstrual problems improved for women taking 200 mg of Pycnogenol daily in a double-blind, placebo-controlled trial. In addition, the ratio of LDL-cholesterol to HDL-cholesterol was favorably altered.¹⁰

Diabetes and its complications: Pycnogenol can reduce some of the signs and complications of diabetes. In one study, 77 people with type 2 diabetes took either 100 mg of Pycnogenol or a placebo for 12 weeks. Patients taking Pycnogenol showed significant reductions in blood sugar and a modest decline in hemoglobin A1c (HbA1c), a marker of diabetic control. They also had improvements in blood vessel tone that could lower their risk of heart disease.¹¹

A different group of researchers analyzed five clinical trials involving almost 1,300 patients and found that Pycnogenol supplements slowed the progression of diabetic retinopathy. Pycnogenol reduced blood leakage into the retina—a hallmark of the eye disease—and it also improved visual acuity. The dosages ranged from 60 to 150 mg daily.¹²

In a 2019 meta-analysis that included 24 randomized controlled trials with nearly 1,600 participants, Pycnogenol was found to significantly reduce fasting blood glucose and HbA1c in diabetic and hyperglycemic patients. Blood pressure, body mass index, and LDL cholesterol were also reduced, while HDL cholesterol increased. Stronger effects were seen when Pycnogenol was supplemented in doses of  ≥100mg per day and for eight weeks or longer.¹³

High blood pressure: The flavonoids in Pycnogenol play a key role in maintaining normal blood vessel tone and integrity. Researchers asked 58 patients with high blood pressure to take 100 mg of Pycnogenol daily for 12 weeks. The supplements improved blood vessel flexibility, and many of the patients were able to safely reduce their dosage of calcium antagonists, a type of medication used to treat hypertension.¹⁴

Chronic venous insufficiency (CVI): CVI is a condition in which the veins of the legs lose the ability to pump blood back to the heart. Symptoms of CVI include varicose veins, swelling or edema of the legs and ankles, and legs that feel tired, heavy, achy or restless. Patients with CVI who were treated with 150 mg of Pycnogenol per day showed improvement at 4 weeks and 8 weeks, with decreased edema and significant improvement in symptoms. There were no visible effects in untreated patients.¹⁵

How Much to Take

• Asthma: Children, 1 mg per pound body weight daily. Adults, 50 mg twice daily. 
• Erectile dysfunction: 80 mg of Pycnogenol and 1,500–2,000 mg of L-arginine daily.
• Most other conditions: 100 to 200 mg daily.

Cautions

Pycnogenol is safe and well-tolerated. Those with pre-existing medical conditions should check with their doctor before starting new supplements.

References

1. Lau BHS et al. Pycnogenol® as an adjunct in the management of childhood asthma. J Asthma 2004; 41:825-832.
2. Belcaro, G., Luzzi, R., Cesinaro Di Rocco, P., Cesarone, M. R., Dugall, M., Feragalli, B., Errichi, B. M., Ippolito, E., Grossi, M. G., Hosoi, M., Errichi, S., Cornelli, U., Ledda, A., & Gizzi, G. (2011). Pycnogenol® improvements in asthma management. Panminerva medica, 53(3 Suppl 1), 57–64. 
3. Belcaro G et al. Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteoarthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytother Res 2008; 22(4):518-523.
4. Cisar P et al. Effect of pine bark extract (Pycnogenol®) on symptoms of knee osteoarthritis.
5. Cesarone, M. R., Belcaro, G., Cox, D., Scipione, V., Scipione, C., Dugall, M., Hosoi, M., Feragalli, B., Hu, S., Coppazuccari, F., & Cotellese, R. (2024). Supplementary management of symptomatic hand osteoarthritis with Pycnogenol®. Minerva surgery, 79(5), 539–544. https://doi.org/10.23736/S2724-5691.24.10403-0 
6. Suzuki N et al. French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study. J Reprod Med 2008; 53(5):338-346.
7. Stanislavov, R. & Nikolova, V. (2010). Treatment of erectile dysfunction with Pycnogenol and L-arginine. Journal of Sex & Marital Therapy, 29(3), 207-213. https://doi.org/10.1080/00926230390155104
8. Lamm S et al. Prelox for improvement of erectile function: a review: Euro Bull Drug Res 2003; 11:29-37.
9. Trebaticky, B., Muchova, J., Ziaran, S., Bujdak, P., Breza, J., & Durackova, Z. (2019). Natural polyphenols improve erectile function and lipid profile in patients suffering from erectile dysfunction. Bratislavske lekarske listy, 120(12), 941–944. https://doi.org/10.4149/BLL_2019_158 
10. Yang HM et al. A randomized, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopauseal women. Acta Obstet Gynecol Scand 2007; 86(8):978-985.
11. Liu X et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sciences 2004; 74:855-862.
12. Schonlau F et al. Pycnogenol® for diabetic retinopathy. Int Ophthamol 2002; 24:161-171.
13. Malekahmadi, M., Moradi Moghaddam, O., Firouzi, S., Daryabeygi-Khotbehsara, R., Shariful Islam, S. M., Norouzy, A., & Soltani, S. (2019). Effects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Pharmacological research, 150, 104472. https://doi.org/10.1016/j.phrs.2019.104472 
14. Liu X et al. Pycnogenol®, French maritime pine bark extract, improves endothelial functionof hypertensive patients. Life Sciences 2004; 74:855-862.
15. Cesarone MR et al. Rapid relief of signs/symptoms I chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology 2006; 57(5):569-576.