Eden Apothecary · Herb Profile
Salix alba
Pronounced White Willow = WYT WIL-oh; Salix alba = SAY-liks AL-buh
Cold, dry, and bitter-astringent: a cooling anti-inflammatory anodyne and febrifuge that draws down fever and quiets the hot, throbbing, inflamed pain of joints, back, and head.
No pre-1900 source found for this exact plant and part. The old books either speak of willows as a group, describe the leaves rather than the bark, or describe the weeping willow.
Avoid. Willow bark's salicin yields salicylic acid, and salicylates cross the placenta and are cleared slowly by the newborn; as with aspirin, third-trimester use carries risks of premature closure of the fetal ductus arteriosus, prolonged gestation and labor, and maternal or neonatal bleeding. No studies have evaluated willow bark in pregnant women, and unlike low-dose aspirin, supplements carry no mandated pregnancy warning. Source: United States Pharmacopeia Safety Review of Willow Bark (Planta Medica, 2019; PMID 31604354); NCCIH; LactMed (NBK501904).
Best avoided. Milk levels have not been measured after willow bark or salicin specifically, but salicylic acid is known to pass into breast milk after aspirin or salicylate ingestion, with excretion rising disproportionately at higher maternal doses; high-dose maternal aspirin has been linked to metabolic acidosis in a breastfed infant, and salicylate carries a theoretical Reye's-syndrome concern. Safer analgesics and antipyretics are available. Source: LactMed / Drugs and Lactation Database, Willow Bark (NBK501904); Drugs.com breastfeeding summary.
Do not give to children or adolescents under 18, particularly during fever, influenza, chickenpox, or any viral illness. Salicylates are causally linked to Reye's syndrome, a rare but frequently fatal swelling of the liver and brain; in 2009 several children in China died of Reye's syndrome after being given willow bark tea for fever, prompting a mandated salicylate warning. Acetaminophen is the preferred pediatric antipyretic. Source: Memorial Sloan Kettering About Herbs, Willow Bark; StatPearls, Reye Syndrome (NBK526101); LactMed (NBK501904); NCCIH.
Willow bark is a salicylate-bearing botanical: its salicin is metabolized to salicylic acid, so the cautions of aspirin broadly apply, though the effect is gentler, slower, and with less direct antiplatelet and gastric action because salicin is a prodrug and lacks the acetyl group. Avoid in known aspirin or salicylate hypersensitivity (anaphylaxis has been reported) and in aspirin-sensitive asthma, where salicylates can trigger bronchospasm. Use caution with peptic ulcer or a history of GI bleeding, bleeding or clotting disorders, gout, diabetes, and kidney or liver disease. May cause stomach upset. Discontinue about 2 weeks before surgery. Salicin content of products varies widely, so potency and effect are inconsistent.
Contraindicated in salicylate or aspirin allergy; in children and teenagers, especially during any fever or viral illness (Reye's syndrome risk); in pregnancy and breastfeeding; in active peptic ulcer or GI bleeding; and in bleeding disorders or with anticoagulant therapy. Use cautiously in asthma, gout, diabetes, and kidney or liver disease. Not a substitute for medical evaluation of high or persistent fever or severe pain.
Salix alba is a fast-growing, abundant, widely cultivated and naturalized tree of no conservation concern; it is not on the United Plant Savers at-risk or to-watch lists. Willows coppice and pollard vigorously, so bark can be taken sustainably from prunings and managed stands. Harvest from young branches of cultivated or plentiful trees rather than stripping and girdling wild trunks.
Willows are named repeatedly in Scripture as riverside trees: the willows of the brook gathered for the Feast of Tabernacles (Leviticus 23:40), the harps hung upon the willows of Babylon (Psalm 137:2), and willows by flowing water (Job 40:22; Isaiah 44:4). These refer to the willow tree and its branches, not explicitly to medicinal bark. The specific use of willow bark and leaf as a remedy for fever, pain, and inflammation is Greco-Roman: Hippocrates and later Dioscorides (De Materia Medica) and Pliny recorded willow for pain, gout, and fever, the tradition that eventually yielded aspirin.
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