Lovage

Levisticum officinale W.D.J.Koch belongs to Apiaceae (Umbelliferae), the family of carrot, celery, parsley, fennel, and angelica. Maud Grieve’s A Modern Herbal (1931) lists the older Linnaean name Ligusticum levisticum and the English names Old English lovage, Italian lovage, and Cornish lovage. Kew’s Plants of the World Online records it as a perennial of the temperate biome, native from southern Iran to Afghanistan. That is not where most readers will meet it. The Botanical Society of Britain and Ireland (BSBI) describes it as native to Iran and Afghanistan but widely naturalized in Europe, North America, and elsewhere through its use as a herb; in Britain and Ireland it is a neophyte, a plant introduced by people, that was being grown in gardens by medieval times and was first recorded in the wild in 1836, at Kells in County Meath. Older books placed its origin closer to home: Grieve believed it was native to the mountains of southern France, northern Greece, and the Balkans, a view modern checklists no longer support.

Lovage is a stout, clump-forming plant. Grieve describes a thick, fleshy, carrot-shaped root 5 or 6 inches long, greyish brown outside and whitish within, with a strong aromatic smell and taste. Hollow, channelled stems rise 3 or 4 feet or more, and the large, dark green, shining leaves are divided into narrow wedge-shaped segments, not unlike those of a coarse celery, giving off a scent reminiscent of both angelica and celery when bruised. In June and July the branched stem tips carry flat umbels of yellow flowers like those of fennel or parsnip, followed by small, very aromatic, yellowish-brown fruits, elliptical and curved, with three prominent winged ribs. It is easy to grow from seed or by dividing the roots in rich, moist, well-drained soil and sun (Grieve), and BSBI finds it naturalized on rough ground and by walls, paths, and roadsides. Several unrelated or distant plants have also been called lovage, including Scotch or sea lovage (Ligusticum scoticum), black lovage or Alexanders (Smyrnium olusatrum), and water lovage (a species of Oenanthe), so the Latin name matters on a label.

The root’s chemistry explains its smell. EMA’s assessment report puts the volatile oil at 0.6% to 1% of the root, of which up to 70% is alkylphthalides, mainly responsible for the characteristic odor; about 20 phthalides have been isolated, making up 64% to 80% of the oil, with (Z)-ligustilide described as the lead compound and 3-butylidenephthalide another major one. The oil also contains monoterpenes such as β-phellandrene and pinene, and the root holds sotolone, a flavor compound with a smell likened to hydrolyzed vegetable protein or curry. Coumarins include umbelliferone, coumarin itself, and the furanocoumarins bergapten and psoralen, with total coumarins estimated at 3.2%, along with the polyacetylene falcarindiol (0.14% to 0.2%) and phenolic acids. Olennikov (Metabolites 2022) identified 25 compounds in fresh roots, chiefly coumarins such as apterin, xanthotoxin, isopimpinellin, and pimpinellin, at 1.7 to 2.9 mg/g in fresh roots and 15 to 24 mg/g in dried commercial root. Medicinal root must meet European Pharmacopoeia monograph 1233, updated in 2021 (EMA). Oil content depends on husbandry: leaving the leaves on the plant until autumn raised it from 0.52% to 0.85% in one study (EMA).

Lovage carries a place name. EMA’s assessment report notes that Dioscorides described it as ligusticon in Greek, ligusticum in Latin, a plant of the Alpine region of Liguria in Italy, and Merriam-Webster traces the English word through Middle English lovache and Anglo-French luvasche to Late Latin levisticum, an alteration of Latin ligusticum, “Ligurian”; its first known use in English dates to the fourteenth century. In the ninth century the Capitulare de villis, a decree on the running of the Carolingian imperial estates, listed it among the plants every estate garden should grow (EMA). Its famous seventieth chapter names levisticum alongside rosemary, fennel, celery, and parsley, though a modern botanical index of the list notes that the word could also have meant alpine lovage, Ligusticum mutellina (biozac). Medieval and Renaissance writers, including Lonicerus in 1564 and Matthiolus, used lovage mainly to bring on menstruation, to relieve wind, as a diuretic, and for skin ailments, and an eleventh-century treatise attributed to Trotula of the Salerno medical school recommended garden lovage for lightening the skin (EMA).

Its folk reputation was broad but never grand. Grieve wrote that lovage was much used as a drug plant in the fourteenth century, probably more for its pleasant smell than anything else, that it was never an official remedy, and that no extravagant claims were made for it. Old writers recommended an infusion of the root for gravel, jaundice, and urinary troubles, and Culpeper prized the seeds, recommending a decoction for agues and pleurisy and a distilled water as a gargle for quinsy. In the kitchen, the leafstalks were once blanched like celery and the young stems candied like angelica. Grieve also punctured one popular association: the old public-house cordial called “Lovage” was brewed mainly from tansy and a yarrow, Achillea ligustica, and probably owed what virtue it had to them rather than to lovage. A modern myth follows the same pattern. German gardeners call lovage Maggikraut, but Nestlé’s ingredient list for Maggi seasoning names biologically processed wheat protein, water, flavoring, the flavor enhancers monosodium glutamate and disodium inosinate, salt, and sugar, with no lovage.

Formal medical recognition centered on the urinary tract. EMA’s assessment report cites a German source from 1900 recording its use for inflammatory urinary conditions and kidney stones, and in 1990 Germany’s Commission E endorsed it for irrigation, or flushing, therapy in inflammation of the lower urinary tract and to prevent kidney gravel, at 4 to 8 g a day. The British Herbal Pharmacopoeia of 1983 listed flatulent colic, indigestion, fluid retention, painful or delayed periods, and cystitis. Lovage root teas have been sold in Poland since at least 1967. EMA’s herbal committee adopted a European monograph on 20 November 2012, accepting traditional use only, and a periodic review in 2021 found no new data that justified changing it, noting that no new single-herb lovage products had been authorized in the EU since 2012. Lovage lives on mainly in combinations: EMA records a UK traditional registration for a tablet of lovage root, centaury, and rosemary for minor urinary complaints associated with cystitis in women, and the 2018 trial report states that Canephron N is approved in 28 countries, including Germany and Ukraine. In the United States, lovage is listed among natural flavoring substances permitted in food.

How lovage might increase urine is barely studied. EMA found no data at all on its pharmacology or pharmacokinetics in people. The animal evidence is old and thin: experiments in rabbits and mice in 1937 with an infusion of the root showed a slight increase in urine volume and chloride, while other tests at 0.25 to 1 g of root per animal produced no diuresis (EMA, citing the British Herbal Compendium). Some authors attributed any diuretic effect of the oil to its terpenes. The idea behind “flushing” therapy is to raise the volume of urine passing through the bladder, and the handbooks are explicit that it requires plenty of fluid: Wichtl’s reference text calls abundant fluid intake necessary, and one German compendium asks for at least 2 liters a day (EMA). Since the tea is itself water and is taken with extra drinks, it is hard to separate any effect of the root from the effect of drinking more. EMA concluded that the laboratory data support the traditional use, but added that the therapeutic importance of the plant can be overestimated.

Most laboratory work concerns the phthalides, especially ligustilide and butylidenephthalide, many of them studied as pure compounds or from related plants. EMA summarizes studies in which ligustilide relaxed isolated rat artery rings by blocking calcium entry, butylidenephthalide inhibited contractions of guinea pig intestine, though less potently than the antispasmodic drug papaverine, and ligustilide inhibited spontaneous contractions of isolated rat uterus. Given by stomach tube to mice, ligustilide reduced pain responses, and in monocytes, immune cells, ligustilide and a related phthalide suppressed production of the inflammatory messenger TNF-α. The polyacetylene falcarindiol blocks 5-lipoxygenase, an enzyme in another inflammatory pathway. Whether any of this happens in people drinking the tea is unknown: in rats only about 2.6% of an oral dose of ligustilide was absorbed (EMA). Lovage oil also showed antibacterial activity in test tubes, ranking among the ten most active of 25 essential oils in one screen, and a root extract strengthened the antibiotic ciprofloxacin against drug-resistant Salmonella strains, although the isolated fractions did not (Garvey and colleagues 2011, cited by EMA). None of these effects has been tested in a person with a urinary infection.

Two other findings shape the safety advice. In a 1958 experiment, an extract injected under the skin of rats whose ovaries had been removed produced weak estrogen-like effects, with 1 g of root roughly equal to 8 international units of estradiol, compared with 200 to 300 units for hops (EMA); EMA cites this weak estrogenic activity as a reason for concern in pregnancy. And the root’s furanocoumarins become reactive under ultraviolet light: bergapten and a lovage extract caused mutations in green algae exposed to long-wave ultraviolet light, and EMA notes that furanocoumarins as a class are linked to gene mutations and cancer when activated by light, so it considers sun exposure a concern, while judging that this is not borne out by clinical or pharmacovigilance data for the tea at monograph doses. For Canephron N, the trial report cites laboratory and animal studies of the whole combination suggesting anti-inflammatory, antispasmodic, anti-adhesive, pain-relieving, and diuretic activity, but these were studies of the three-herb mixture, and the contribution of lovage within it is not known.

Flushing the urinary tract is lovage root’s one officially recognized medical use, and it rests on tradition rather than proof. EMA’s 2012 monograph accepts the cut root as a herbal tea “to increase the amount of urine to achieve flushing of the urinary tract as an adjuvant in minor urinary complaints,” on the basis that it has been used medicinally for at least 30 years, 15 of them in the European Union. Adjuvant means alongside other measures, not instead of treatment. The assessors found no clinical studies of single-herb lovage preparations, no dose-response studies, and no data in children or older people, so the plant could not qualify for well-established use. The 2021 periodic review identified 24 new publications, none of them clinical trials of lovage, and none justified a revision. Older references cast the net wider: Commission E listed flushing therapy for lower urinary tract inflammation and prevention of kidney gravel, and the British Herbal Compendium added menstrual and digestive complaints. None of these uses has been tested in a trial, and lovage is not a treatment for kidney stones or for an established infection.

The clinical evidence that does exist comes from Canephron N, and it should be read as evidence for that product. Wagenlehner and colleagues (Urologia Internationalis 2018) randomized 659 women aged 18 to 70 with typical symptoms of a new, uncomplicated lower urinary tract infection, in 51 centers in Germany, Ukraine, and Poland, to two Canephron N tablets three times a day for seven days or a single 3 g dose of fosfomycin, with matching placebos so that neither patients nor doctors knew who had which. The main outcome was whether women needed additional antibiotics by about day 38. In the per-protocol analysis, 83.5% on Canephron N and 89.8% on fosfomycin needed none, a difference of 6.3 percentage points (95% confidence interval 0.5 to 12.0 points in favor of fosfomycin); in the broader analysis that kept women with protocol deviations, the gap was 8.3 points. The authors chose a 15% non-inferiority margin, arguing that the two treatments worked in different ways, instead of the 10% usually applied; the result would not have passed the stricter test. Symptom scores fell faster with fosfomycin by day 4, about a quarter of the women had negative urine cultures, and the trial was sponsored by Bionorica, whose employees helped design it and analyze the data.

Safety in that trial deserves attention. Five women on Canephron N (1.5%) developed pyelonephritis, a kidney infection, compared with one (0.3%) on fosfomycin. The difference was not statistically significant, and three of the five cases began on the day of enrollment or the day after, so the authors suggested some infections were already developing; they also called for further study of the risk. Gastrointestinal side effects were less common with the herbal tablets (4.0% versus 6.6%), and no one died or stopped treatment because of a treatment-related adverse event. The same pattern, fewer antibiotics at the cost of more symptoms and more kidney infections, was seen when uva ursi was compared with fosfomycin. For prevention, Germany’s Institute for Quality and Efficiency in Health Care (IQWiG), in a 2022 assessment of herbal remedies for recurrent bladder infections, found only a hint of added benefit from a single study of the lovage, rosemary, and centaury preparation taken with antibiotics compared with antibiotics alone. A 2026 meta-analysis by Ak and colleagues (Neurourology and Urodynamics) pooled 12 studies of Canephron N with 3,821 patients and concluded that it was an effective and safe alternative to antibiotics, but only eight of the studies were randomized and heterogeneity was substantial.

None of the Canephron N research shows that lovage works on its own. The product contains equal amounts of three herbs, and at six tablets a day it supplies about 108 mg of lovage root, roughly 2% to 3% of the 4 to 6 g a day that EMA’s monograph allows as tea. Lovage’s other uses are culinary. The leaves are used as a potherb and celery substitute in soups and stews, the young stems can be candied, and the seeds are used for flavoring (Grieve; Merriam-Webster). US regulations list lovage among natural flavoring substances that may be added to food, and EMA notes that lovage extract has also been used at low levels to flavor some cigarettes. EMA’s assessment report lists Czech combination teas containing lovage root, with herbs such as wormwood, yarrow, and peppermint, for temporary loss of appetite and mild bloating, and older herbals used the root and seeds for colic and wind, but these digestive uses have not been studied. The antibacterial and anti-inflammatory activity seen in test tubes remains a laboratory finding.

EMA’s monograph covers a single preparation: the cut, dried root as a herbal tea. For adults and older people, 2 to 3 g of root is steeped in 150 ml of boiling water as an infusion and drunk twice a day, for a total of 4 to 6 g a day. It should not be used for more than two to four weeks, and a doctor should be consulted if symptoms persist. Older references give similar or higher amounts. Commission E allowed 4 to 8 g a day; Hager’s handbook steeped 1.5 g in 150 ml of hot water for 10 to 15 minutes and recommended drinking it between meals; and Polish teas were made as a decoction of 4 to 5 g in a 200 ml cup of hot water for 15 minutes (EMA). Because the aim is to increase the flow of urine, the handbooks stress drinking plenty of fluid alongside the tea, at least 2 liters a day in one German compendium. EMA does not recommend lovage root for anyone under 18. The leaves used in cooking are a different part of the plant and are not covered by the monograph.

Combination tablets are the form most people encounter. In the Wagenlehner trial, each coated Canephron N tablet contained 18 mg each of powdered centaury herb, lovage root, and rosemary leaf, and women took two tablets three times a day before or after meals for seven days. The UK traditional registration recorded by EMA is for a similar tablet of lovage root, centaury, and rosemary, for women only. Bionorica’s products and their licensed uses differ from country to country, so the label and patient leaflet are the guide to what a particular pack contains and who it is for. Other combination teas and tablets may include lovage alongside herbs such as wormwood, yarrow, peppermint, licorice, or fennel (EMA), each with its own cautions. The trial’s results apply only to the product and dose tested, and they do not tell you what a homemade tea or a different blend will do.

Practical points: buy lovage root from a pharmacy or reputable supplier that names Levisticum officinale root, because several other plants are called lovage. Do not forage for lovage or any similar-looking herb unless you are certain of its identity. In 2021, Michel and colleagues (Der Anaesthesist) described a couple aged 69 and 71 who mistook leaves of monkshood (Aconitum napellus), growing near the herbs in their garden, for lovage; both developed aconitine poisoning with tingling, low blood pressure, slow heart rate, and irregular heartbeats and needed intensive care, though both recovered. If you grow lovage, wear gloves and long sleeves when cutting large amounts in strong sun, since handling the plant has caused blistering rashes. During prolonged use of the root, older handbooks advise avoiding intense sunbathing and ultraviolet light, such as tanning beds (EMA). Stop and see a doctor if symptoms are not clearly better within a few days, or at once if fever, back pain, painful urination, cramps, or blood in the urine appear.