The dried leaf or extract of the Artemisia annua plant or its natural derivative artemisinin are available as supplements with anticancer, anti-inflammatory, and antimicrobial properties.

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This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.

Mode of action: interaction with iron

Artemisinin’s anticancer activity is believed to occur when it comes in contact with iron. Cancer cells concentrate iron for use in cellular division (the malaria parasite also collects high concentrations of iron). Artemisinin’s contact with iron triggers the release of free radicals between cells that destroy cancer cells. Because of this “ferroptosis” effect, iron is often administered several hours before artemisinin to enhance targeting the cancer cells while sparing normal cells.1Hu Y, Guo N et al. The potential mechanisms by which artemisinin and its derivatives induce ferroptosis in the treatment of cancer. Oxidative Medicine and Cellular Longevity. 2022 Jan 4;2022:1458143; Crespo-Ortiz MP, Wei MQ. Antitumor activity of artemisinin and its derivatives: from a well-known antimalarial agent to a potential anticancer drug. Journal of Biomedicine and Biotechnology. 2012;2012:247597. Some research shows that the effectiveness of artemisinin against colorectal cancer cells is enhanced by the addition of aminolevulinic acid, a clinically used heme synthesis precursor, to increase heme levels.2Wang J, Zhang J et al. Mechanistic investigation of the specific anticancer property of artemisinin and its combination with aminolevulinic acid for enhanced anticolorectal cancer activity. ACS Central Science. 2017;3(7):743–750.

Further evidence: preclinical studies

Improving treatment outcomes

Veterinary evidence of better survival than expected among pets with sarcoma treated with Artemisia annua

  • Survival of 40 and 37 months without tumor relapse by a cat and a dog with fibrosarcoma, and a further dog with complete remission of fibrosarcoma and another with remission of hemangioendothelial sarcoma treated after surgical tumor removal with powder of Herba Artemisiae annuae3Breuer E, Efferth T. Treatment of iron-loaded veterinary sarcoma by Artemisia annua. Natural Products and Bioprospecting. 2014 Apr;4(2):113-8.

Preclinical evidence of less tumor growth and lower cancer cell viability, adhesion, and invasion in cancer cells treated with Artemisia annua extracts or artemisinin

Cancer as a whole

  • Less tumor growth in 1321N1 astrocytoma, MCF-7 breast cancer, THP-1 leukemia, and LNCaP, Du-145, and PC-3 prostate cancer cells treated with alcohol extracts of Artemisia annua4Worku N, Mossie A et al. Evaluation of the in vitro efficacy of Artemisia annua, Rumex abyssinicus, and Catha edulis Forsk extracts in cancer and Trypanosoma brucei cells. ISRN Biochemistry. 2013 Sep 22;2013:910308.
  • Substantially less development of solid tumors (mastocytoma) in mice treated with artemisinin5Tilaoui M, Mouse HA, Jaafari A, Zyad A. Differential effect of artemisinin against cancer cell lines. Natural Products and Bioprospecting. 2014 Jun;4(3):189-96.

Bladder cancer

  • Artemisinin enhanced cytotoxic activity of miconazole against bladder cancer cells in preclinical studies6Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.
  • Artemisinin enhanced anticancer activity of butyric acid against bladder cancer cells in preclinical studies7Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Brain cancer

  • Artemisinin enhanced anticancer activity of curcumin against brain tumor cells in preclinical studies8Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Breast cancer

  • Anticancer activity against MDA-MB-231 breast cancer cells treated with polyphenols from Korean Artemisia annua L9Ko YS, Lee WS et al. Polyphenols from Artemisia annua L inhibit adhesion and EMT of highly metastatic breast cancer cells MDA-MB-231. Phytotherapy Research. 2016 Jul;30(7):1180-8.
  • Anticancer activity against human breast cancer cells treated with artemisinin in preclinical studies10Tin AS, Sundar SN et al. Antiproliferative effects of artemisinin on human breast cancer cells requires the downregulated expression of the E2F1 transcription factor and loss of E2F1-target cell cycle genes. Anticancer Drugs. 2012 Apr;23(4):370-9.
  • Artemisinin enhanced cytotoxic activity of miconazole against breast cancer cells in preclinical studies11Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.
  • Artemisinin enhanced anticancer activity of butyric acid against breast cancer cells in preclinical studies12Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.
  • Artemisinin enhanced the anticancer activity of halofuginone against breast cancer cells in preclinical studies13Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Cervical cancer

  • Artemisinin enhanced anticancer activity of resveratrol against cervical cancer cells in preclinical studies14Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Colorectal cancer

  • Artemisinin is able to target colorectal cancer cells rather than normal colon epithelial cells, an effect enhanced by the addition of aminolevulinic acid (ALA).15Wang J, Zhang J et al. Mechanistic investigation of the specific anticancer property of artemisinin and its combination with aminolevulinic acid for enhanced anticolorectal cancer activity. ACS Central Science. 2017;3(7):743–750.
  • Artemisinin enhanced the anticancer activity of halofuginone against colon cancer cells in preclinical studies16Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Kidney cancer

  • Less development of kidney adenocarcinoma in mice treated with artemisinin17Tilaoui M, Mouse HA, Jaafari A, Zyad A. Differential effect of artemisinin against cancer cell lines. Natural Products and Bioprospecting. 2014 Jun;4(3):189-96.

Liver cancer

  • Anticancer activity against human hepatoma cells treated with artemisinin18Hou J, Wang D, Zhang R, Wang H. Experimental therapy of hepatoma with artemisinin and its derivatives: in vitro and in vivo activity, chemosensitization, and mechanisms of action. Clinical Cancer Research. 2008 Sep 1;14(17):5519-30.
  • Artemisinin enhanced anticancer activity of resveratrol against liver cancer cells in preclinical studies19Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Lung cancer

  • Artemisinin inhibited lymph node and lung metastasis and prolonged survival without retarding tumor growth in mouse Lewis lung carcinoma (LLC) models.20Wang J, Zhang B et al. Artemisinin inhibits tumor lymphangiogenesis by suppression of vascular endothelial growth factor C. Pharmacology. 2008;82(2):148-55. 
  • Artemisinin enhanced cytotoxic activity of chloroquine against lung cancer cells in preclinical studies21Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.
  • Artemisia dried leaf extract led to lower colony formation and less tumor growth in preclinical studies.22Cheong DHJ, Tan DWS, Wong FWS, Tran T. Anti-malarial drug, artemisinin and its derivatives for the treatment of respiratory diseases. Pharmacological Research. 2020 Aug;158:104901. 
  • Artemisinin led to lower colony formation, less metastasis, less microvessel formation, lower VEGF, greater apoptosis, and other anticancer activity in preclinical studies.23Cheong DHJ, Tan DWS, Wong FWS, Tran T. Anti-malarial drug, artemisinin and its derivatives for the treatment of respiratory diseases. Pharmacological Research. 2020 Aug;158:104901. 

Nasopharyngeal cancer

  • Artemisinin enhanced the anticancer activity of BMI siRNA against nasopharyngeal cancer cells in preclinical studies24Efferth T. Cancer combination therapies with artemisinin-type drugs. Biochemical Pharmacology. 2017 Sep 1;139:56-70.

Optimizing body terrain

Blood sugar imbalance and insulin resistance: preclinical evidence of lower levels of blood glucose, insulin, and insulin resistance in animals treated with Artemisia annua L. extract

Body weight: preclinical evidence of lower markers of body fat and obesity in cells and animals treated with Artemisia annua L.

  • Lower body weight gain, adipose tissue mass, and adipocyte cell size in high-fat diet-induced obese rats treated with Artemisia annua L. leaves28Song Y, Lee SJ et al. Annual wormwood leaf inhibits the adipogenesis of 3T3-L1 and obesity in high-fat diet-induced obese rats. Nutrients. 2017 May 28;9(6):554.
  • Lower accumulation of lipid droplets and lower expressions of obesity-related proteins in 3T3-LI cells treated with Artemisia annua L. essential oil29Hwang DI, Won KJ et al. Anti-adipocyte differentiation activity and chemical composition of essential oil from Artemisia annua. Natural Product Communications. 2016 Apr;11(4):539-42.
  • Lower adipogenic differentiation of human adipose tissue-derived mesenchymal stem cells treated with artemisinic acid isolated from Artemisia annua L.30Lee J, Kim MH, Lee JH, Jung E, Yoo ES, Park D. Artemisinic acid is a regulator of adipocyte differentiation and C/EBP δ expression. Journal of Cellular Biochemistry. 2012 Jul;113(7):2488-99.

Hormone imbalance: preclinical evidence of lower levels of leptina hormone that helps regulate energy balance by inhibiting hunger and higher levels of adiponectina hormone and signaling protein involved in regulating glucose levels and fatty acid breakdown in diabetic animals treated with Artemisia annua L. extracts

  • Lower levels of leptin and higher levels of adiponectin in diabetic mice treated with various doses of Artemisia annua L. extracts, with stronger effects from hot water extracts compared to cold water or alcohol extracts; the effects with hot water extracts were comparable to treatment with metformin31Ghanbari M, Lamuki MS, Habibi E, Sadeghimahalli F. Artemisia annua L. extracts improved insulin resistance via changing adiponectin, leptin and resistin production in HFD/STZ diabetic mice. Journal of Pharmacopuncture. 2022 Jun 30;25(2):130-137.

Immune function: preclinical evidence of immune function activation with treatment with Artemisia annua or artemisinin

Inflammation: preclinical evidence of less inflammation in animals treated with Artemisia annua L. extracts, dried leaves, or artemisinin

Oxidation: preclinical evidence of less oxidative stress-mediated damage in liver cancer cells treated with a water extract of Artemisia annua

Your microbiome: preclinical evidence of antimicrobial activity against necrotic enteritis in birds fed n-hexane extract from fresh Artemisia annua leaves

Managing side effects and promoting wellness

Preclinical evidence of less fatty liver disease in mice fed a high-fat diet and treated with an Artemisia annua L. extract

Resource

Journal article

Bora KS, Sharma A. The genus Artemisia: a comprehensive review. Pharmaceutical Biology. 2011 Jan;49(1):101-9.

Keep reading about Artemisia annua and artemisinin

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Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Last update: December 15, 2022

Last full literature review: October 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

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