Devil's Claw and Pelargonium (Umckaloabo): From Traditional Use to Clinical Trials

From traditional plant to modern product

Devil's claw (Harpagophytum procumbens) and pelargonium (Pelargonium sidoides, sold as the extract Umckaloabo) are both southern African plants that became widely sold herbal medicines, especially in Europe. They are a useful pair because both have been tested in randomized trials, which many traditional plants have not. They also show a limit of that testing: the trials are often small, short and of uneven quality. This page covers each plant's traditional background, the trial evidence for specific uses, and safety. It does not give doses or preparation instructions.

Devil's claw: traditional use and trade

A 2012 review describes devil's claw as an important traditional medicine of the Kalahari region of southern Africa, used as a general health tonic and for arthritis, pain, fever, ulcers and boils. The review included a focus group with communities in Botswana, and lists other uses such as indigestion, urinary infections and postpartum pain. [1] Namibia is the main exporter, and high demand has led to over-harvesting, because the whole plant is often destroyed when the secondary tubers are dug up. [1] An earlier review notes that harvesting has raised income in marginalized communities, while also raising sustainability questions. A 2000 proposal to list the plant under CITES, the international wildlife trade treaty, was withdrawn in 2004 after the countries where it grows worked on sustainability. [2] See sustainability and commercialization of traditional medicine.

Devil's claw: what the research shows

In the European Union, the herbal medicines committee assessed devil's claw root on a "traditional use" basis. It concluded the root can be used for minor joint pain, mild digestive upset and temporary loss of appetite in adults, that this rests on at least 30 years of use rather than strong trials, and that people should see a doctor if joint pain lasts more than 4 weeks. [4] See how traditional-use registration works in the EU.

Devil's claw: safety and quality

A systematic review of 28 trials found that, in the double-blind studies, side effects were not more common than with placebo. Minor events occurred in about 3 percent of patients, mostly digestive. A few reports of acute toxicity were found but none of chronic toxicity, and the authors said more long-term safety data were urgently needed. [5] The European committee lists diarrhea, nausea, vomiting, abdominal pain, headache, vertigo and allergic reactions such as rash, hives and face swelling. [4] Proper evidence not found in the sources we read on interactions with specific prescribed medicines or on use in pregnancy, so ask a pharmacist. The plant raw material is sometimes intentionally adulterated with a close relative, Harpagophytum zeyheri, which may affect how well a product works. [1] A 2021 review said it has not been shown beyond reasonable doubt that both species are equally safe and effective. [6]

Pelargonium (Umckaloabo): traditional use

A 2026 systematic review says Pelargonium sidoides has a long history of traditional use among indigenous peoples of southern Africa for respiratory and gastrointestinal disorders, and that its root extract became the pharmaceutical product Umckaloabo (extract EPs 7630). [7] The sources we read do not name the specific peoples, so we do not either.

Pelargonium: what the research shows

The Cochrane review also suspected publication bias, and reported that side effects were more common with pelargonium than comparators, though none were serious. [8] The NHS says bronchitis is usually caused by an infection and often gets better without treatment in around 3 weeks. [10] For general cough care see cough and sore throat remedies.

In the EU, the herbal medicines committee concluded that pelargonium root can be used, on a traditional-use basis, for the symptoms of the common cold in patients from age 6. The committee said that although a possible effect on bronchitis cough was seen in three studies, weaknesses in design meant firm conclusions could not be drawn. [11]

Pelargonium: safety and the liver question

The EU committee lists very rare side effects (fewer than 1 in 10,000 patients): mild gut complaints, mild nose and gum bleeding and allergic reactions. It also notes that liver problems have been reported, with unknown frequency. [11] Two reviews of the suspected cases (13 and 15 reports) found that a role for pelargonium could not be established in any of them, because other causes, other medicines and poor data got in the way. [12][13] The honest summary is that a liver signal was reported, has not been confirmed, and has not been fully ruled out. Yellow skin or eyes can be a sign of serious liver disease and need urgent medical help, according to the NHS, so stop the product and seek care if that happens. [14] See liver safety.

Who should get conventional care first

The NHS advises urgent medical advice for bronchitis symptoms if you cough up blood, have chest pain, feel short of breath, have had a cough for more than 3 weeks, are pregnant, are over 65 or have a long-term condition, and emergency help if you are struggling to breathe. [10] The EU committee advises seeing a doctor if cold symptoms last longer than 1 week and says pelargonium root medicines should only be used from age 6. [11] Devil's claw medicines should only be used in adults. [4] People with liver disease, those on prescribed medicines, and pregnant or breastfeeding women should ask a pharmacist first. See talking with a health professional.

Related pages

African traditional medicine overview, historical use vs clinical evidence and Sutherlandia and kanna.