There is perhaps no other herb that is more effective at promoting the speedy healing of wounds, ranging from bruises to broken bones, than comfrey.

Comfrey has been known by many names over the centuries. Most commonly called knitbone or bruisewort by herbalists, comfrey has also been hailed as “the arthritic herb” by people who sought it for it’s profound healing powers (de Baïracli Levy, J., 1986: 152).

Throughout history, comfrey has been used in the treatment of ulcers, colic, internal hemorrhages, bone fractures, ruptures, pulmonary ailments, sprains, muscle swelling, myalgia, bruisings, burns, hip dysplasia, rheumatism, arthritis, tooth decay, and to ease aches and pains (de Bairacli Levy, 1991; Freeman, 1991; Self, 1996).

Author Sally Freeman (1991: 129) wrote, “the sturdy root and broad, hairy leaves of comfrey have been used since antiquity for lung and skin problems, including bleeding, and for setting broken bones.” However, as herbalist Hilary Page Self (1996: 34) noted, “Depending on the bias of the writer, comfrey has been hailed as a ‘cure-all’ by some and ‘dangerously toxic’ by others. The truth would appear to be somewhere between these two extremes.”

Symphytum Officinale

Common comfrey (Symphytum officinale) is a perennial herb with an extensive root system when it becomes well-established. It’s name is derived from the Greek word ‘symphyo’ meaning ‘to grow together’ or ‘unite’.

It was once widely fed to livestock. In Eastern Europe and Russia it was cultivated as a fodder plant for horses and cattle (Self, 1996). Common comfrey proliferates wildly from seed, however it is most potent medicinally before flowering. It’s the only known plant that extracts vitamin b12 from the soil, and it regenerates quickly because of the rich store of minerals in its roots (Bareeba et al., 1992). Therefore, you can cut the leaves back or harvest four to five times per year without harming the plant.

Juliette de Bairacli Levy (1991: 54) wrote that “English gypsies say that a handful of comfrey roots, cleaned and fed daily to horses and cows in the spring, will rid them of all winter torpor and put them into fine bloom in one week.” The use of comfrey roots has steadily decreased to this day, though, as science has warned of the dangers of alkaloid compounds found within comfrey since the 1960’s (Self, 1996).

Safe or Toxic?

If you’ve heard about comfrey, you have likely heard about the dangers of using it internally. The fears about comfrey’s toxicity and it’s effect on the liver is due to the pyrrolizidine alkaloids (henceforth PA’s) it contains. What are PA’s? They are plant made compounds which are found most frequently in the Compositae, Leguminosae, and Boraginaceae families, and can cause liver damage to humans and animals if ingested (Smith and Culvenor, 1981; Hartmann, 1999).

The active compounds of comfrey have not fully been found yet, however the hepatotoxicity (damage to the liver) has been confirmed following its intake. The highest concentration of PA’s are found in the root of the plant, and in the young, or first bloom leaves (Self, 1996; Green, 2011). Due to it’s PA content, the use of the root is restricted or limited in many countries (Jedlinszki et al., 2017).

Lycopsamine is a main PA contained in comfrey. A study looking at the diffusion and penetration of lycopsamine through topical application of comfrey ointment concluded that caution should be taken by consumers as well as regulatory agencies when using comfrey, regulating it, and interpreting the results of studies on its toxicity levels. The researches noted, “the ratio of toxic PAs is certainly lower than the maximal reported total PA value in the roots” (Jedlinszki et al., 2017: 3). The study also cited previous research demonstrating that comfrey was superior over placebo in treating sprain, osteoarthritis, and low back pain (Staiger et al., 2009; Grube et al., 2007; Koll et al., 2004) as well as superior to the drug diclofenac (D'Anchise et al., 2007; Predel et al., 2005).

Many herbalists are quick to rein in the fear that may be spread by data correlating comfrey to toxic, potentially carcinogenic compounds as well, preaching it is overall beneficial in spite of the PA’s present (de Bairacli Levy, 1991; Freeman, 1991). Allantoin, the most important therapeutic compound present in comfrey, stimulates new cell growth. Comfrey also contains tannin, which is an astringent that acts to form a protective film over wounds. These two compounds make comfrey an unparalleled wound healing herb, as it quickly seals wounds and gets to work creating new cells to mend damaged tissues, hence the name ‘knitbone’. In fact, care must be taken to thoroughly flush and disinfect wounds prior to applying comfrey, as it is so effective at sealing wounds that it can seal harmful bacteria inside before the wound is healed.

Overall, it appears even scientific literature embraces comfrey as a powerful remedy which cannot be overlooked. One particularly thorough study promotes comfrey as a “valuable therapy option for the treatment of painful muscle and joint complaints” (Staiger, 2012: np).

Contraindications

If you are pregnant, nursing, or suffer from liver disease, comfrey is inadvisable to work with. There are a number of herbs that work wonders similar to comfrey, and it isn’t worth risking your health when many others can provide help you’re seeking without any complications.

How To Use Comfrey

Now that you’ve been presented with all the perspectives surrounding comfrey, ranging from scientific data to folklore accounts, you can find your own truth, which as herbalist Hilary Self notes, may be “somewhere between these two extremes”. My philosophy is moderation in all things, and so even if comfrey may be a good remedy for you, I would not recommend long-term use (for example, using internally for five days a week for no more than two weeks at a time).

A Case Study with Comfrey

The first time I called on comfrey to help heal wounds was when my mom was in a car crash and suffered twenty-two broken bones. The blunt trauma she suffered was so severe in fact that in the first week or so following her accident, her doctors didn’t know how many bones had been broken. She kept complaining to them about her profound pain level so they ordered more x-rays to be done, and each subsequent x-ray revealed more broken bones that were previously undiagnosed.

Each day I brewed a quart of comfrey tea for my mom to drink and twice daily applied comfrey poultices to all her known broken bones and other areas which were in pain. Within two weeks, she was decreasing her pain medicine. Within three weeks, she was out walking dogs around the block. Within three months, she was back at work and steadily getting back to her regular routine. She credits the comfrey tea and poultices for her rapid recovery, as do I.

Comfrey has it’s place in the medicine cabinet, that’s for certain. Know when to work with comfrey, and what method to use to prepare it.

Comfrey Infusion

Boil water and prepare one tablespoon for comfrey leaf, fresh or dried. Pour 8 ounces of water over herb, and if possible, cover the infusion for 20 minutes, allowing to steep. Strain comfrey, and sip slowly when hot. Or cover and refrigerate for up to 24 hours and sip later.

Comfrey Oil Infusion

A simple oil infusion can be made by filling a jar up half way with dried comfrey leaf and covering the herb with your choice of oil (my favorite is sunflower, though it’s said that sunflower spoils more easily than others, such as extra virgin olive oil), making sure there is at least a half inch of oil on top.

Label and seal this jar tightly, placing in an area where it can be bathed in sunlight each day for 3 to 6 weeks.

Shake at least once a day to disperse the oil and prevent the mixture from going rancid. After infusing for the desired amount of time, (you will notice the oil has turned a lovely, vivid green color) strain herb from oil through cheesecloth. Press and squeeze cloth firmly to save every drop of oil.

Store in firmly capped jar in cool, dark place for 6 months to 1 year.

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Resources

Bareeba, F.B., Odwongo, W.O. and Mugerwa, J.S., 1992. The potential of Russian comfrey (Symphytum officinale) as an animal feedstuff in Uganda. THE COMPLEMENTARITY OF FEED RESOURCES FOR ANIMAL PRODUCTION IN AFRICA, p.249.

D’Anchise, R., Bulitta, M. and Giannetti, B., 2007. Comfrey extract ointment in comparison to diclofenac gel in the treatment of acute unilateral ankle sprains (distortions). Arzneimittelforschung, 57(11), pp.712-716.

de Baïracli Levy, J., 1986. The complete herbal handbook for the dog and cat. Faber and Faber Limited.

de Baïracli Levy, J., 1991. The complete herbal handbook for farm and stable. Faber and Faber Limited.

Freeman, S., 1991. Herbs for all seasons: growing and gathering herbs for flavor, health, and beauty. Plume.

Grube, B., Grünwald, J., Krug, L. and Staiger, C., 2007. Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial. Phytomedicine, 14(1), pp.2-10.

Hartmann, T., 1999. Chemical ecology of pyrrolizidine alkaloids. Planta, 207(4), pp.483-495.

Jedlinszki, N., Balázs, B., Csányi, E. and Csupor, D., 2017. Penetration of lycopsamine from a comfrey ointment through human epidermis. Regulatory Toxicology and Pharmacology, 83, pp.1-4.

Koll, R., Buhr, M., Dieter, R., Pabst, H., Predel, H.G., Petrowicz, O., Giannetti, B., Klingenburg, S. and Staiger, C., 2004. Efficacy and tolerance of a comfrey root extract (Extr. Rad. Symphyti) in the treatment of ankle distorsions: results of a multicenter, randomized, placebo-controlled, double-blind study. Phytomedicine, 11(6), pp.470-477.

Predel, H.G., Giannetti, B., Koll, R., Bulitta, M. and Staiger, C., 2005. Efficacy of a Comfrey root extract ointment in comparison to a Diclo-fenac gel in the treatment of ankle distortions: Results of an observer-blind, randomized, multicenter study. Phytomedicine, 12(10), pp.707-714.

Self, H.P., 1996. A modern horse herbal. Kenilworth Press, Addington.

Smith, L.W. and Culvenor, C.C.J., 1981. Plant sources of hepatotoxic pyrrolizidine alkaloids. Journal of Natural Products, 44(2), pp.129-152.

Staiger, C., Giannetti, B.M. and Tschaikin, M., 2009. Comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo-controlled, multicenter trial. Planta Medica, 75(09), p.SL49.

Staiger, C., 2012. Comfrey: a clinical overview. Phytotherapy Research, 26(10), pp.1441-1448.

Taylor, A. and Taylor, N.C., 1963. Protective Effect of Symphytum officiale on Mice Bearing Spontaneous and Transplant Tumors. Proceedings of the Society for Experimental Biology and Medicine, 114(3), pp.772-774.