Integrated and holistic healthcare clinic London

Mistletoe Therapy UK

Mistletoe therapy is a complementary cancer therapy. The Integrated and Holistic Healthcare clinic offers mistletoe therapy consultations in London. However, If you do not live in London, you can still benefit from the therapy as online consultations are available for patients living in other parts of the UK, Europe and Worldwide.

Table of Contents show

What is Mistletoe Therapy? 

The use of the mistletoe plant as a drug has a long tradition which traces back to the fourth century BC. Throughout the centuries this evergreen half-parasite which is mostly associated Christmas and Santa, was used by healthcare professionals and doctors for menstrual complaints, epilepsy, ulcers, cardiac insufficiency, high blood pressure and oedemas 1,2.
The white-berried mistletoe (Viscum album L) only entered cancer setting as alternative and complementary cancer medicine at the beginning of the 20th century through Rudolf Steiner (1861 - 1925), the founder of Anthroposophic Medicine.3 In 1916, he first mentioned the therapeutic possibilities of mistletoe extracts in the cancer setting.

 

How does the Mistletoe Therapy help with cancer?

Mistletoe therapy acts on many levels: On the one hand, it boosts the immune system by multiplying and activating the immune cells. On the other, mistletoe therapy can induce apoptosis (the process of natural cell death) in tumour cells, which results in the inhibition of tumour growth.
Healthy tissue is not adversely affected by this. On the contrary, immune cells and other healthy cells are protected against further injury, e.g. damage caused by cytostatic drugs.
Patients report that mistletoe therapy significantly improves their quality of life.

For example:
- Improvement of general condition and quality of life through
◦ Increased performance and vigour, less fatigue
◦ Normalised body rhythms including body temperature, sleep and digestion
◦ Increased appetite
◦ Reduced nausea and vomiting
◦ Greater emotional well-being
◦ Reduced depression and anxiety
- Reduction of adverse reactions to conventional therapies (e.g. chemo- or radiotherapy), in particular, cancer-related fatigue
- Alleviation of tumour-related pain

This mode of action makes mistletoe therapy a key supplement to standard oncological therapy.

How to take it - routes of Mistletoe Therapy administration

The mistletoe extract can be taken orally, however, the most researched route of administration is via subcutaneous injections two or three times per week.
Oral drops are only provided by Iscador®. Other administration routes, such as intratumoral and intrapleural have been described. The mistletoe extract can also be administered intravenously as an off-label application.
If you are interested in having the Mistletoe extract in an IV infusion, please, do not hesitate to contact us.

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Mistletoe Extract - A brief Summary of The Facts

Facts

Basic research results indicate that medicinal mistletoe may stimulate the immune system to fight cancer cells. Cytotoxic effects on tumour cells have been observed in animal models 4,5. One study data showed that mistletoe injections can attenuate airway inflammation and eosinophil infiltration in  different types of cancers.6

Studies in human beings suggest that the use of mistletoe extract alongside appropriate chemotherapy and radiotherapy may improve their tolerability by reducing their side effects and increasing quality of life, including in pancreatic 7,8, lung 9, colorectal10, and breast cancers.11 A few studies indicate a possible positive effect on survival 7,12-14, although no significant survival effects were found for patients with metastatic colorectal cancer15, melanoma16, or head and neck cancer 17, and further studies are required to confirm these findings.

Other preliminary studies suggest that intravesical mistletoe extract is safe and well-tolerated in patients with nonmuscle invasive bladder cancer18, and that mistletoe extract injection may be efficacious as chemical pleurodesis in patients with malignant pleural effusion19.

With regards, to possible interaction with chemotherapy, in two studies with 5-year follow-ups of breast cancer patients, mistletoe therapy did not appear to have a negative impact on chemotherapy efficacy11 and appeared to contribute to reducing disease/therapy-related signs and symptoms (e.g. mucositis, fatigue, pain, headache)20. The addition of mistletoe extracts in patients with advanced solid tumours allowed for higher gemcitabine doses to be used without apparent pharmacokinetic interactions21.

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Mechanisms of mistletoe extract action (summary)


Mistletoe extracts contain biologically active substances such as glycoproteins, especially mistletoe lectines I, II and II (ML I, ML II, ML III)22, polypeptide (e.g. viscotoxins23-25), peptides, amino acids, oligo- and polysaccharids26-27. Other molecules have also shown to have possibly beneficial properties, such as enzymes, sulphurous compounds, fats, phytosterols, triterpenes28-31, flavonoids, phenylpropanes, lignans, alkaloids, minerals, micronutrients and other proteins32,33.

Mistletoe lectins are the most investigated component. Their cytotoxic effects are partially due to ribosome-inactivating properties and induction of apoptosis34(“cell suicide”). In-vitro studies have shown that mistletoe lectins increase TNFα, IL-1, IL-2, and IL-6 cytokine secretion, stimulate immune-cell phagocytosis, induce macrophage cytotoxicity, and enhance cytotoxicity on cancer cells35
In lymphoblastic leukaemia cells, mistletoe extracts stimulate dendritic cell maturation and activation36 and induce dose-dependent apoptosis through caspase-8 and -9 dependent pathways37
Studies performed in animal models have shown that apoptotic induction37 produced by mistletoe extracts rich in triterpenes was greater, and also that these extracts improved efficacy against malignant melanoma when compared with conventional extracts, which reduce tumour angiogenesis38. Another component called Viscotoxins may also have tumour-inhibiting and immune-stimulating properties39. However, the pro and anti-proliferative effects produced by mistletoe extracts produced depended on dose40. Mistletoe-induced immune stimulation may explain physical improvements that contribute to increased quality of life in cancer patients34.

 

Drug interactions and side effects of Mistletoe Therapy - in a nutshell

Mistletoe extracts inhibit CYP3A4 and may, therefore, affect intracellular concentrations of drugs metabolised by this enzyme. However, in vitro studies show this effect only happens in very high doses and is unlikely when used in clinically relevant concentrations41,42
Raw mistletoe contains toxic constituents. Possible adverse effects of mistletoe treatment for cancer include injection site reactions, chills, and fever19,21,43-45. Long-term use may also reduce T-cell function in cancer patients, but the majority of reactions were mild to moderate and dose-related 46.

Note: The mistletoe extract is not a replacement for conventional cancer treatment, and it can be considered to be used alongside appropriate conventional cancer treatments.

Which Brands provide the Medicinal Mistletoe Extract?

These brands are manufactured in Germany. Although each brand does have its own way of production, all do carry out manufacture and quality control procedures according to legal regulations and in strict adherence to international standards and rules of “good manufacturing practice”, i.e. the GMP guidelines. These regulations are applied and continually updated according to the most current knowledge and technology. 

From the references on my Mistletoe Therapy page, the papers which did investigate different brands of mistletoe extracts, none but one, stated them to be different. The one paper which made a difference quotes: "...ADR (adverse drug reactions) frequency differed with respect to preparation type, with Iscador® preparations showing a higher relative frequency, compared to Abnoba viscum®.."

Based on my experience, there is also individuality to be taken into consideration. Some patients have shown to respond particularly well to one specific brand (which again is different in each case).

The clinical response can be assessed easily by monitoring the cutaneous reaction around the injection site, and measuring the temperature on a daily basis may be indicated in some cases.

You can read more about each brand by clicking on their logo above.

IMPORTANT NOTE: The mistletoe extract does need a medical prescription and the therapy does require medical supervision. Do not trust any product available online without a medical prescription.

What is the Cost of Mistletoe Therapy 

Initial call free of charge. 

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The cost of the actual mistletoe therapy depends on the dose that triggers the optimum response of your immune system. This, we cannot forecast and Dr Kloppenburg will provide close supervision until the optimum dose has been reached. Thereafter, a maintenance dose will be prescribed and a 4-months supply can be sent. At this stage, the cost will reduce significantly.

In a nutshell:

Supervision and prescription fee: £60.00

The cost of the Mistletoe ampoules depends on the dose, ranging from £80.00 to £138.00 per box* (2.5 weeks supply)

Packing and Postage (next day guaranteed delivery) £12.00

Needles and syringes £5.00 per box

All together means a cost of £274.00 every 5 weeks for the first 20 weeks. Thereafter, the cost of the ampoules will increase gradually according to the dose (see priceless below).

Usually, we send a 5-weeks supply after every dose adjustment until the optimum reaction is obtained. This can take between one and nine months, however, most patients experience optimum response within three to four months, some even during the first month.

Price list of each box (8 ampoules):

1mg = £80.00

5mg = £80.00

10mg = £80.00

20mg = £80.00

30mg = £88.00

50mg= £95.00

100mg= £138.00

*Import charges due to BREXIT regulation apply (20%)

** Prices shown refer to Helixor®.

Is Mistletoe Therapy available on the NHS?

Unfortunately, since April 2018 Mistletoe Therapy is no longer funded by the NHS. At the Royal London Hospital for Integrated Medicine (RLHIM), patients can get a prescription free of charge during their appointment, however, they have to pay for the mistletoe therapy themselves. Iscador® is the only brand available at the RLHIM and the pharmacy does sell needles and syringes.

 

Where is Mistletoe Therapy available?

Mistletoe Therapy is available Worldwide 

Mistletoe Therapy is available no matter where you are*.

Technology nowadays allows us to stay connected almost worldwide and via telephone or video calls, you can get your individualised holistic care plan directly into your home.

Consultations can be held in English, Spanish or German.

*Limitations may apply due to international export/import licences. Please, contact us for more information

 

How easy is it to get this therapy?

Our aim is to make it as easy, quick and cost-efficient as possible. Therefore, we have created the following system:

  • Request your initial call with Dr Kloppenburg for FREE. She will explain everything and assess your current situation. You will be sent additional information via email, including a link to complete your medical history on our patient portal online. Thereafter, Dr Kloppenburg will choose the best subtype of mistletoe extract for you. After you have paid the invoice, we can send the 5-weeks supply. Within the UK, you can receive the mistletoe extract via Royal Mail Next Day Guaranteed Delivery.

What side effects could you experience?

The most frequent “side effect” is actually a reaction on your skin around the injection site. This local inflammatory reaction correlates to your immune response and allows me to adjust the dose you need.

Other side effects, such as dizziness, flu-like sensation, itch, fatigue or even slightly increased temperature or enlarged lymph nodes may also occur, however, these are less frequent. In any case, patients under my care can always contact me (I want my patients to feel supported and well-looked after).

Extremely rare side effects are diarrhoea, weakness, allergic reaction including anaphylactic shock

Frequently Asked Questions

 

What are the differences between AbnobaVISCUM®, Helixor and Iscador®?

 

Manufacturer: 

All three brands are manufactured in Germany. Although each brand does have their own way of production, all do carry out manufacture and quality control procedures according to legal regulations and in strict adherence to international standards and rules of “good manufacturing practice”, i.e. the GMP guidelines. These regulations are applied and continually updated according to the most current knowledge and technology. 

Evidence: 

From the references on my Mistletoe Therapy page, the papers which did investigate different brands of mistletoe extracts, none but one, stated them to be different. The one paper which made a difference quotes: "...ADR (adverse drug reactions) frequency differed with respect to preparation type, with Iscador® preparations showing a higher relative frequency, compared to Abnoba viscum®..."

Distributor: 

Iscador® Oral drops and injections are distributed by Customised 4U Pharmacy: tel: 0800 035 3078, fax 0800 035 3079. Email: enquiries@customised4upharmacy.co.uk. Address: Unit 2 Regents Drive, Low Prudhoe, Industrial Estate, Northumberland, NE42 6PX

AbnobaViscum® injections are distributed by

The Pharmacy at Mayfair and Clinic
6 Shepherd Market
Mayfair
London
W1J 7QD

Helixor® is the only brand which is available worldwide and has different contact details depending on the country. Check out www.helixor.com for more information.

Postage: 

Customised 4U Pharmacy (Iscador®) does charge £7 for postage. 

The Pharmacy at Mayfair and Clinic (AbnobaViscum®) does charge £15 for postage.

Helixor® shipping prices depend on where you live. 

Needles and syringes: 

The Pharmacy at Mayfair and Clinic (AbnobaViscum®) does send needles and syringes together with the AbnobaViscum® ampoules.

Customised 4U Pharmacy (Iscador®) and Helixor® do not send needles and syringes per post. You can go to your GP and request a prescription for subcutaneous needles (0,5x16mm, 25G 5/8", or insulin needles) and 1ml or 2ml syringes, or get them at boots or online.

Please, avoid insulin syringes (1ml syringe with a fixed needle). If needed, I will give you a prescription for needles and syringes for only £5.

I want to travel, should I take the mistletoe extract with me and do I need to keep it refrigerated?

  • If you are on Iscador® Oral drops, and you travel for less than 1 month, it will be fine to have a few weeks break from it. If you wanted to take it with you, or you are leaving for more then 1 month, I recommend that you take enough supply with you. If you are travelling with an already opened bottle and the journey takes less than 8-12 hours, don't worry, otherwise, I'd recommend you take a small refrigerating box with you to keep to cool.
  • If you are on mistletoe therapy injections, and you are travelling for less than 1 week, it should be fine. If you are leaving for a longer period, I'd recommend that you take enough supply with you. If the journey takes less than 4-6 hours, there shouldn't be any problem. Otherwise, I recommend you take a small refrigerating box with you to keep it cool.

Can the Mistletoe Therapy be used instead of chemotherapy?

The Mistletoe Therapy is not a replacement for conventional medicine, and it can be considered to be used alongside appropriate conventional cancer treatments.

Studies have shown that the Mistletoe Therapy can reduce side effects of conventional treatments such as chemotherapy, radiotherapy and hormone therapy. In addition, it seems to increase their tolerability, increasing the likelihood of continuity on recommending dosages.

Chemical interference on treatment outcome, according to research and literature review, appears unlikely. 

How long should I take the Mistletoe Therapy?

The overall duration of treatment is not restricted, but will be individualised in each case.

Generally, after two years of continuous treatment, the frequency of injection can be reduced to 2 ampoules (2 injections) per week.

From the 3rd year onwards, treatment-free intervals can be taken, always adapted specially to each case.

After 5-7 years in total (from the beginning of treatment) treatment can be discontinued, or switched to oral drops if the patient’s condition and prognosis are favourable.

Iscador® Oral Drops are generally recommended to be taken continuously for 2 years. From the 3rd year onwards, treatment-free intervals are recommended in a progressively increasing regime, always adapted to each case. Generally, the recommended overall duration is 5 years, however, in some cases, therapy can be extended up to ten years (from the 6th year up to the 10th year, treatment-free intervals will progressively exceed treatment intervals).

How should I take the Iscador® Oral Drops?

The standard recommendation is to take 6 drops in the morning and 9 drops in the evening, from Monday to Friday only, for 3 weeks and then to have one full week break before a new bottle is started. Variations may be recommended to adjust to each case.

I did forget to take the Iscador® Oral Drops, what should I do?

If you didn’t take the drops in the morning, you can take them in together with drops in the evening. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take your 6 drops in the morning, then take 15 drops in the evening and continue as usual the following day)

If you didn’t take the drops in the evening, you can take them in together with drops the next morning. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take you 9 drops in the evening, then take 15 drops the next morning and continue as usual having 9 drops in the evening)

If you missed a complete day of treatment, divide the number of drops in 2 to half and add each half on the following two treatment days. (Example: you usually take 6 drops in the morning and 9 in the evening, and you missed one day: 6+9=15, 15/2=8, 15+8=23, so for the next two days you have 23 drops in total, 10 drops in the morning and 13 drops in the evening)

If you didn’t take the drops on a Friday, take them on Saturday.

In order to gain the most benefits from the mistletoe therapy, make sure that you take them as prescribed and following the instructions.

How should I store the Iscador® Oral drops?

Before opening, Iscador® Oral Drops should be stored at room temperature (15 - 25 °C).

Once opened, Iscador® Oral Drops should be stored in the fridge (2 - 8 °C).

The expiry of Iscador® Oral Drops is 3 weeks from opening.

How should I store the ampoules containing mistletoe extract?

The mistletoe extract has been protected from oxidation under the strictest conditions during the entire manufacturing process. For this reason, injections must be given immediately after breaking open the ampoules; the contents of opened ampoules cannot be used at a later time.
Ampoules containing brown-coloured liquid may not be used, as this indicates that the preparation has been exposed to oxygen and spoiled.

AbnobaVISCUM® 20 mg to 0.02 mg strengths, and all Iscador® ampoules must be stored in the fridge (2 to 13 °C). The ampoules may not be frozen. If ampoules are transported, e.g. from the pharmacy to the patient’s home, continual cooling at the above-mentioned temperatures is not necessary. However, extreme temperatures such as frost or heat (over 25 °C) should be avoided.

There are no particular storage recommendations for abnobaVISCUM D6 to D30 strengths. These ampoules do not have to be kept in the fridge, although they should not be stored or transported at temperatures above 25 °C.

How should I take the mistletoe injections?

Standard regime recommends having 3 injections weekly, on Mondays, Wednesdays and Fridays, at any time of the day.

Adjustments can be recommended as part of an individualised treatment, considering each patient’s situation.

I do have a red patch around the injection site, is it normal?

Yes! The skin provides us with reliable information about how your body reacts to the mistletoe extract. 

If you have any other questions, please, contact us.

More Information:

 Cancer Research UK www.cancerhelp.org.uk Helpline: 0808 800 404 (free, only UK)

Macmillan Cancer Support www.macmillan.org.uk Helpline: 0808 808 0000 (free, only UK)

Camphill Wellbeing Trust http://www.mistletoetherapy.org.uk/ NHSinform.

Cancer Information Online at your fingerTIPS (Tailored information for the People of Scotland) www.nhsinform.co.uk/cancer/TIPS

 

 

 

References:

  • https://www.mskcc.org/cancer-care/integrative-medicine/herbs/mistletoe-european

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33. Urech et al.: Triterpenes of mistletoe (VIscum album) in the “bird-lime” Viscin and its antiprolifertive activity. In Scheer R et al (Ed): Fortschritte in Der Misteltherapie. KVC Verlag, Essen, 133-144 (2005)
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38. Struh CM, Jager S, Kersten A, et al. Triterpenoids amplify anti-tumoral effects of mistletoe extracts on murine B16.f10 melanoma in vivo. PLoS One. 2013;8(4):e62168. doi: 10.1371/journal.pone.0062168
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41. Weissenstein U, Kunz M, Urech K, et al. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complement Altern Med.2014;14:6. doi: 10.1186/1472-6882-14-6
42. Engdal S, Nilsen OG. In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients.Phytother Res. Jul 2009;23(7):906-912. doi: 10.1002/ptr.2750
43. Huber R, Eisenbraun J, Miletzki B, et al. Pharmacokinetics of natural mistletoe lectins after subcutaneous injection.Eur J Clin Pharmacol. Sep 2010;66(9):889-897. doi: 10.1007/s00228-010-0830-5
44. Schad F, Atxner J, Buchwald D, et al. Intratumoral Mistletoe (Viscum album L) Therapy in Patients WithUnresectable Pancreas Carcinoma: A Retrospective Analysis. Integr Cancer Ther. Jul 2014;13(4):332-340.
45. Steele ML, Axtner J, Happe A, et al. Use and safety of intratumoral application of European mistletoe (Viscumalbum L) preparations in Oncology. Integr Cancer Ther. Mar 2015;14(2):140-148.
46. Bussing A, Stumpf C, Troger W, et al. Course of mitogen-stimulated T lymphocytes in cancer patients treated withViscum album extracts. Anticancer Res. Jul-Aug 2007;27(4C):2903-2910.
47. Steele ML, Axtner J, Happe A, et al. Adverse Drug Reactions and Expected Effects to Therapy with SubcutaneousMistletoe Extracts (Viscum album L.) in Cancer Patients. Evid Based Complement Alternat Med.2014;2014:724258. doi: 10.1155/2014/724258
Related articles:
48. Huber R, Ludtke R, Klassen M, et al. Effects of a mistletoe preparation with defined lectin content on chronichepatitis C: an individually controlled cohort study. Eur J Med Res. Sep 28 2001;6(9):399-405.
49. Horneber MA, Bueschel G, Huber R, et al. Mistletoe therapy in oncology. Cochrane Database Syst Rev.2008(2):CD003297. doi: 10.1002/14651858.CD003297.pub2
50. Bar-Sela G. White-berry mistletoe (Viscum album L.) as complementary treatment in cancer: Does it help? Eur JIntegr Med. 2011;3:e55-e62.
51. de Giorgio A, Stebbing J. Mistletoe: for cancer or just for Christmas? Lancet Oncol. Dec 2013;14(13):1264-1265.doi: 10.1016/s1470-2045(13)70560-6
52. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. Mar 2002;109(3):227-235.
53. Evens ZN, Stellpflug SJ. Holiday plants with toxic misconceptions. West J Emerg Med. Dec 2012;13(6):538-542.doi: 10.5811/westjem.2012.8.12572
54. Rosell S, Samuelsson G. Effect of mistletoe viscotoxin and phoratoxin on blood circulation. Toxicon. Aug1966;4(2):107-110.
55. Finall AI, McIntosh SA, Thompson WD. Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract. BMJ. Dec 23 2006;333(7582):1293-1294. doi: 10.1136/bmj.39044.460023.BE
56. Hall AH, Spoerke DG, Rumack BH. Assessing mistletoe toxicity. Ann Emerg Med. Nov 1986;15(11):1320-1323.
57. Kim HJ, Kim H, Ahn JH, et al. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern
Complement Med. Mar 2015;21(3):180-185.

INTEGRATED MEDICINE AND HOLISTIC HEALTHCARE CLINIC

Private Complementary and Alternative Healthcare clinic.
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London,
SE1 2UF
United Kingdom
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