What is Stone Root?

Stone root is a herbal remedy made from the root of Collinsonia canadensis, a woodland plant of eastern North America. It is also sold as knob root, horse balm or richweed. The root is hard and knobby, which is how it got its name.

It was used most by American Eclectic doctors in the 1800s. They gave it for piles (haemorrhoids), varicose veins and a hoarse, worn-out voice. Today you will find it as dried root, tincture, tea and capsules.

Here is the honest verdict. There are almost no human studies of stone root for any use. Long use in a tradition is not proof that something works, and it is not proof that it is safe.

How does Stone Root work?

Nobody has shown how stone root works in people, because the human research has not been done.

The old idea was that it acts as a vein tonic. Eclectic doctors believed it tightened slack, swollen veins and eased pressure in the back passage and throat. That belief came from bedside reports, not from testing.

The root does hold tannins, which bind and tighten protein in test-tube work. That is the basis of the astringent (tightening) claim. Whether enough reaches a swollen vein or an irritated throat after you swallow it has not been shown.

The root also holds rosmarinic acid. In cell and animal studies, rosmarinic acid appears to damp down inflammation. Those results do not tell you what a dose of stone root does in a person.

Treat any claim that stone root shrinks piles, clears varicose veins or passes a stone as unproven.

What forms does Stone Root come in?

Stone root is sold mainly as a dried root preparation.

Common forms include:

Dried, cut root for making a decoction (a simmered tea).

Liquid extracts and tinctures, usually alcohol-based.

Capsules of powdered root.

Combination products for piles or veins, often with horse chestnut, witch hazel or butcher's broom.

The fresh root and fresh leaves have a reputation for upsetting the stomach more than the dried root. Combination products make side effects hard to trace, because you cannot tell which plant caused what.

Where it comes from:

Stone root belongs to American folk medicine and to the Eclectic doctors of the 19th and early 20th centuries.

Settlers in eastern North America learned of the plant from local use and took it up for bruises, sprains and swollen veins. Eclectic writers such as John King and Finley Ellingwood later listed it in their manuals.

Their main uses were piles, varicose veins and a tired or hoarse voice in singers and public speakers. Some also gave it as a mild diuretic (a medicine that makes you pass more urine). It appeared in the National Formulary in the United States for part of that period.

The Eclectic school faded after the 1930s, and stone root faded with it. None of this old standing tells you whether the remedy helps or whether it is safe.

What does Stone Root help with?

• Piles (haemorrhoids): This was the main Eclectic use. Doctors gave stone root to ease swollen, painful veins in the back passage. There are no controlled human trials of stone root for piles. The claim rests on old case notes alone. Bleeding from the back passage can have serious causes. Get it checked by a doctor before you treat yourself for piles.
• Varicose veins and heavy, aching legs: Tradition treated stone root as a vein tonic for slack, swollen leg veins. No human trial supports this. Herbs with better human evidence for leg vein symptoms exist, such as horse chestnut seed extract. Sudden swelling, heat or pain in one leg needs urgent medical care, not a herb.
• Hoarseness and throat strain: Eclectic doctors called stone root a remedy for the tired voice of singers and preachers. It was given before heavy voice use. This use has not been tested in people. Any benefit may simply come from the warm drink and the rest. Hoarseness lasting more than three weeks should be seen by a doctor.
• Mild fluid retention: Stone root was used as a mild diuretic, meaning it was thought to make you pass more urine. This has not been measured in people. Swelling in the legs or belly can signal heart, liver or kidney trouble. See a doctor about new or worsening swelling rather than treating it yourself.
• Indigestion and stomach upset: Bitter, astringent roots were widely used for a sour or sluggish stomach, and stone root was one of them. There is no human evidence for this. In larger amounts, the root can cause the very symptoms it was meant to settle.
• Urinary stones (folk use only): Some folk sources linked the name to passing urinary stones. The name more likely came from the stone-hard root. There is no evidence that stone root dissolves or passes stones. Stones can block the urinary tract, which is a medical emergency. Do not rely on a herb for this.

What are the side effects of Stone Root?

• Nausea
• Vomiting, mostly with large amounts or the fresh plant
• Stomach pain or cramping
• Diarrhoea
• Passing more urine than usual
• Dizziness
• Headache
• Skin rash or itching in people allergic to the plant

Good to know:

Most reported effects are stomach-related and settle when you stop.

The safety record is thin, because stone root has not been studied in modern trials. Rare or long-term harms would not have been picked up.

Large amounts and fresh plant material are the main triggers for vomiting. Stop taking it if you feel sick, dizzy or crampy, and tell your doctor.

How much Stone Root should you take?

• Recommended daily: Labels and old herbal texts differ widely, and no safe or effective dose has been set in human studies. Traditional manuals listed roughly 1 to 4 grams of dried root as a decoction, or a few millilitres of tincture. Capsule products often sit in a similar range. That is background, not advice for you. Follow the label on the product you hold, and ask a pharmacist or doctor before you start, especially if you take other medicines.
• Best time of day: Time of day does not appear to matter, as no timing has been tested. Some people split the amount across the day to lower the chance of stomach upset. If it makes you pass more urine, you may prefer not to take it late at night.
• With or without food: Taking it with food is the usual advice, and it is the sensible one here. The root can irritate the stomach, and food may soften that. If it still causes nausea, stop taking it.
• Time to effect: There is no reliable answer, because the effect itself is unproven. Old reports describe easing over days of use. Stone root may well do nothing at all for your symptom. A throat tea can feel soothing straight away. That is the warm drink as much as the herb.
• How long to take it: No study has tested how long stone root can be taken safely. Traditional use was short, in bursts of days or a few weeks, around a flare-up. There is no safety record for daily use over months or years. If a symptom is not clearly better within a couple of weeks, stop and get it looked at.