Despite sounding like an anatomical structure, the term rose hips actually refers to the seed pods of roses. All rose species bear these, but because most rose bushes are trimmed and pruned we rarely see them today. Normally, species of the Rosa canina family will form these small, berry-sized, reddish seed balls after flower petals fall in late summer.1

The seed pods, harvested in the late fall, are prized for their medicinal properties and widely cultivated for their usefulness.1 According to ancient literature, the Chinese, Persians, Romans and Greeks all used the rose seed pod for a variety of purposes and sometimes called it a “hip” or a “haw.”1


Background


Rose hips are particularly high in vitamin C content, and are said to contain 10 to 50 times as much of this nutrient as in a normal orange.1 Historically, the rose was also referred to as the “dog rose” and was so named because ancient lore held that the extract derived from it could cure the bite of a rabid dog.1

The dog rose was extremely popular during World War II.2 The British people were encouraged to gather rose hips to make vitamin C syrup for children to prevent the development of scurvy.2,3 German submarines were sinking most commercial ships carrying imported citrus fruits from the tropics and children were developing nutritional deficiencies as a result.2,3

Science


Much of rose hips’ medicinal activity has been credited to its high concentration of vitamin C. Vitamin C is an essential nutrient with specific functions as an enzymatic cofactor and potent antioxidant. Unprocessed rose hips contain about 1,250 mg/100 g of pure vitamin C.2 In addition, rose hips contain large amounts of polyphenols, which are also known to possess antioxidative properties.2

Rose hips have been studied for their effect on autoimmune diseases such as rheumatoid arthritis. One double-
blinded, randomized controlled trial examined 89 patients with known rheumatoid arthritis. The subjects were given either capsules filled with rose hip powder totaling 5 g per day or placebo for six months.4 Outcomes were based on administration of a health-assessment questionnaire administered at baseline and at six months.4 These scores improved in the active-treatment group but declined in the 
placebo group.4

However, in a meta-analysis of studies on rose hip use, antioxidant and anti-inflammatory actions were verified, but the German Commission E did not recommend their use, largely due to a lack of sufficient data.5

In another meta-analysis of clinical trials examining the efficacy of rose hips in individuals with osteoarthritis, three studies were identified covering 287 patients for a mean duration of three months.6,7 These were randomized, controlled trials evaluating pain reduction from use of rose hip powder-filled capsules. Over the three trials, poststudy pain scores were improved in all active control patients by a 2:1 ratio over placebo.6,7 


Even though vitamin C seems to be the major reason for rose hips’ activity, basic research has shown that the polyphenolic compounds in rose hips extract also have therapeutic effects. One study tested the effect of rose hips on poly­morphonuclear white blood cells in the respira­tory tract. Knowing that reactive airway results in the stimulation of these cells and the subsequent production of oxidative by-products, researchers developed a rose hip extract without the vitamin C. This extract was then tested on the specific respiratory cell lines.8 The results still showed inhibition of oxidative pathways, confirming that 
vitamin C is not the only antioxidative component of rose hip products.8

Safety, interactions


Since rose hips are a botanical product, allergic reaction is always a possibility and should be monitored for — especially upon first use of the product. For similar reasons, pregnant or lactating women and infants should avoid these products.

Interactions and adverse reactions typically are centered on the vitamin C content. Excess vitamin C can cause gastrointestinal distress and fatigue.9 Rose hips and vitamin C enhance absorption of any iron-containing supplements and, in large doses, can potentiate warfarin.9

Dosage and cost


Rose hips may be found in powder-filled capsules, liquid extract or as a tea. Typical daily doses in tea form are 2.0-2.5 grams steeped in 
150 cc of water several times a day.2 For rheumatoid arthritis, a powder-filled capsule totaling 
2.5 g b.i.d. is recommended.2

Products made from rose hips are relatively inexpensive, ranging from $5 to $20 for a one-month supply, depending on the form. 


Summary


Rose hips are a mild, pleasant supplement that are safe for routine use. While efficacy data are not robust, there is evidence supporting the supplement’s use, and it builds in the long term. Providers may recommend this product as adjunctive therapy for a wide range of conditions or as a routine preventive regimen.

Sherril Sego, FNP-C, DNP, is a staff clinician at the VA Hospital in Kansas City, Mo., where she practices adult medicine and women’s health. She also teaches at the nursing schools of the University of Missouri and the University of Kansas.

References


1. Hanrahan C, Frey R. Rose hip. Gale Encyclopedia 
of Alternative Medicine. 2nd Edition. Farmington Hills, Michigan:Gale Cengage Learning;2005. Available at 
www.encyclopedia.com/doc/1G2-3435100673.html.


2. Fetrow C, Avila J. Complementary & Alternative Medicines. Springhouse, PA: Springhouse Corporation; 1999:351-352.


3. Barlow K. Vitamin C from rose-hips. BMJ. 1941;1:797-799.


4. Willich SN, Rossnagal K, Roll S, et al. Rose hip herbal remedy in patients with rheumatoid arthritis: A randomized controlled trial. Phytomedicine. 2010;17:87-93.


5. Chrubasik C, Roufogalis BD, Muller-Ladner U, et al. A systematic review on the Rosa canina effect and efficacy profiles. Phytother Res. 2008;22:725-733.


6. Rein E, Kharazmi A,Winther K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis—a double-blind, placebo-
controlled, randomised trial. Phytomedicine. 2004;11:383-391.


7. Christensen R, Bartels EM, Altman RD, et al. Does the powder of Rosa canina (rosehip) reduce pain in osteo­arthritis patients? A meta-analysis of randomized controlled trials. Osteoarthritis Cartilage. 2008;16:965-972.


8. Daels-Rakotoarison DA, Gressier B, Trotin F, et al. Effects of Rosa canina fruit extract on neutrophil respiratory burst. Phytother Res. 2002;16:157-161.


9. Therapeutic Research Faculty. Rose hip. Natural Medicines Comprehensive Database. 

All electronic documents accessed on December 5, 2011.