Pinus pinaster Aiton (French maritime pine bark) · supplement
Evidence tier: weak
A premium polyphenol extract for circulation, ADHD, and cognitive performance under load.
The procyanidins and phenolic acids in maritime pine bark are antioxidants that, in laboratory work, increase nitric oxide availability in the lining of blood vessels, which would relax them and improve blood flow. That is the story behind every circulation, erectile function and cognition claim attached to the ingredient. It is a plausible laboratory mechanism. Cochrane's finding that the human trials cannot support any efficacy conclusion means the mechanism has not been shown to translate into an outcome anyone can feel.
Weak. Pine bark extract, sold as Pycnogenol, has a large number of trials and almost no usable evidence, which is an unusual and instructive combination. The 2020 Cochrane review (Robertson, CD008294, PMID 32990945) is the definitive read: 27 randomised controlled trials in 1,641 participants across 10 chronic conditions (asthma, ADHD, cardiovascular disease, chronic venous insufficiency, diabetes, erectile dysfunction, female sexual dysfunction, osteoarthritis, osteopenia, traumatic brain injury). Its conclusion is flat: small sample sizes, limited numbers of trials per condition, variation in outcome measures and poor reporting mean NO DEFINITIVE CONCLUSIONS regarding the efficacy or safety of pine bark extract supplements are possible. Nearly every outcome was rated VERY LOW certainty by GRADE. Only 4 of the 27 trials had a low risk of bias; 22 were unclear and 1 was high. MSK is aligned and adds negatives: meta analyses found NO benefit of Pycnogenol on blood pressure and insignificant effects on cardiometabolic health, and one meta analysis RECOMMENDED AGAINST Pycnogenol for musculoskeletal pain. The structural problem behind all of this, which no one selling the ingredient mentions, is that a very high proportion of the Pycnogenol trial literature is funded, sponsored or co authored by parties connected to the trademark holder, and the trials cluster in a small number of centres. A trial base that is large but almost entirely non independent and very low certainty is not evidence of efficacy, it is evidence of marketing.
The sources do not establish one. Cochrane specifically records that the 27 trials varied in dose, preparation, duration (4 weeks to 6 months) and outcome measure, and that poor reporting was one of its stated reasons for declining to draw conclusions. Any single dose figure quoted for pine bark extract is transcribed from marketing, not from an efficacy finding.
100 to 200 mg daily with food, in divided doses.
Mild antiplatelet effect, caution with anticoagulants.
Pregnancy: caution
Breastfeeding: caution
Active compounds: procyanidins, catechin, taxifolin, phenolic acids
Remedies using Pine Bark Extract · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.