Dandelion for Diuretic and Kidney Function

Dandelion is one of the few herbal diuretics whose effect has been measured in a human pilot trial — the Clare, Conroy, and Spelman study published in 2009 in the Journal of Alternative and Complementary Medicine, in which an ethanolic extract of dandelion leaf produced statistically significant diuresis in the 5 hours after dosing in healthy human volunteers. The folk evidence is older still: the French folk name pissenlit ("piss-a-bed") and the English colloquial "piss-a-bed" both refer to the same prominent diuretic action that European peasants recognized centuries before any controlled trial. What is distinctive about dandelion as a diuretic, and clinically important, is that the leaf is naturally so potassium-rich that it largely offsets the urinary potassium loss that limits long-term use of pharmaceutical thiazide and loop diuretics. This deep-dive walks through the Clare trial, the critical leaf-vs-root distinction, the potassium-sparing mechanism, the comparison to pharmaceutical diuretics, and the traditional bladder and edema applications.

Table of Contents

1. The Clare 2009 Human Diuretic Trial
2. The Critical Leaf-vs-Root Distinction
3. The Potassium-Sparing Mechanism
4. Comparison to Thiazide and Loop Diuretics
5. Mechanism of Diuretic Action
6. Traditional Bladder and Urinary Tract Uses
7. Cyclical Premenstrual Edema
8. Mild Hypertension Adjunct
9. Acute Uncomplicated Cystitis Combination
10. Dosage, Forms, and Treatment Course
11. Cautions and Drug Interactions
12. Key Research Papers
13. Connections

The Clare 2009 Human Diuretic Trial

The most-cited published human evidence for dandelion's diuretic effect is the small pilot trial conducted by Bevin Clare and colleagues at the Maryland University of Integrative Health, published in the Journal of Alternative and Complementary Medicine in 2009. The study design was straightforward but rigorous for a small pilot:

• Subjects: 17 healthy adult volunteers
• Intervention: 8 mL of a 1:1 ethanolic extract of fresh dandelion leaf (Taraxacum officinale folium), administered three times in one day (a total of 24 mL of extract)
• Measurements: urine output volume and urine frequency over 5 hours after each dose, with comparison to baseline 24-hour measurements taken before the intervention day
• Diet control: standardized fluid and food intake on the intervention day

The result: a statistically significant increase in urinary frequency and urinary output in the 5 hours following the first and second doses, with the third (evening) dose producing a smaller, non-significant effect. The increased output was on the order of 200-300 mL above the baseline period in the immediate hours after dosing. Subjects also reported subjective increase in urinary urgency.

The trial was small, single-blinded (no placebo arm), short-duration, and used a fresh-leaf ethanolic extract that is not directly comparable to capsule or dried-leaf-tea forms commonly available to consumers. These limitations have been duly noted in subsequent reviews. Still, the trial is the most rigorous human evidence to date that dandelion leaf has the diuretic effect that herbalists have traditionally attributed to it — the burden of evidence shifted from "traditional claim" to "small trial-supported observation." No subsequent larger-scale or placebo-controlled human trials of dandelion as a diuretic have been published.

For practical purposes, the Clare trial established that the diuretic effect of dandelion leaf is real, measurable, and rapid in onset (within hours), but did not establish dose-response, did not compare to pharmaceutical diuretics, and did not address chronic effects with regular use. Most integrative recommendations rest on this evidence plus the long traditional record plus the regulatory acceptance by the German Commission E and the European Medicines Agency.

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The Critical Leaf-vs-Root Distinction

One of the most common sources of disappointing or absent therapeutic effect when patients self-prescribe dandelion is the confusion between leaf and root preparations. The two parts of the plant have substantially different therapeutic profiles, and supplements labeled simply "dandelion" or "dandelion extract" without specifying which part are not predictably effective for either main indication.

Dandelion leaf (Taraxaci folium, the aerial part):

• Primarily diuretic — this is the part to use for fluid retention, mild hypertension, premenstrual edema, and bladder support
• Mineral-dense, especially in potassium, calcium, iron, and vitamin K
• Substantial vitamin A (as beta-carotene) and vitamin C
• Mildly bitter, used in salads, tinctures, and teas
• Best harvested young, in spring, before the plant flowers

Dandelion root (Taraxaci radix, the underground part):

• Primarily hepatobiliary — this is the part to use for liver support, bile flow stimulation, dyspepsia, and digestive bitter action (see Liver and Detox page)
• Rich in inulin (up to 40% of dry weight in autumn-harvested root) for prebiotic support (see Digestive Aid page)
• Bitter triterpenes (taraxasterol, taraxerol) responsible for hepatoprotective and choleretic effects
• Lower potassium and vitamin K content than the leaf, less of a concern for warfarin interaction
• Best harvested in autumn (second year of plant growth), roasted, and used in tea, tincture, or capsule

The European Medicines Agency monographs reflect this distinction, with separate monographs for Taraxaci radix (root) and Taraxaci herba cum radice (herb with root). The German Commission E monographs likewise distinguish root and leaf preparations. When buying a commercial dandelion product, look for the part of the plant to be specified on the label. When ordering a tincture from an herbalist, specifically request "dandelion leaf tincture" for diuretic effect or "dandelion root tincture" for liver effect.

The Clare 2009 diuretic trial used a fresh-leaf ethanolic extract specifically. The diuretic effect should not be assumed to transfer to root preparations, which contain different compounds in different proportions.

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The Potassium-Sparing Mechanism

Pharmaceutical diuretics fall into several classes by site of action in the nephron, and most of the commonly used classes have a clinically problematic potassium effect:

• Loop diuretics (furosemide / Lasix, bumetanide, torsemide) act on the thick ascending limb of the loop of Henle by inhibiting the Na-K-2Cl cotransporter. They are powerful (produce diuresis of liters per dose) but cause substantial urinary potassium wasting and frequently require oral potassium supplementation or a potassium-sparing diuretic added in.
• Thiazide diuretics (hydrochlorothiazide / HCTZ, chlorthalidone) act on the distal convoluted tubule by inhibiting the Na-Cl cotransporter. They are moderately powerful and also cause urinary potassium wasting, though less severely than loop diuretics. They are the first-line antihypertensive in most US guidelines.
• Potassium-sparing diuretics (spironolactone, eplerenone, amiloride, triamterene) act on the collecting duct by inhibiting aldosterone signaling or the epithelial sodium channel. They produce modest diuresis but, critically, do not cause potassium wasting and can even cause hyperkalemia.

Dandelion leaf has a unique mechanism that is partly "natively potassium-sparing": the plant itself is one of the highest natural sources of potassium of any commonly consumed vegetable, with approximately 400 mg of potassium per 100 g of fresh leaves (more potassium than a banana of equal weight). When the leaf is consumed and the diuretic effect produces some urinary potassium loss, the simultaneous high dietary potassium load largely offsets that loss. The net effect on serum potassium is much smaller than with an equivalent dose of pharmaceutical loop or thiazide diuretic.

This is one of the most clinically valuable features of dandelion leaf as a mild diuretic. Patients on long-term thiazide therapy who add periodic dandelion leaf salad to their diet may need less potassium supplementation. Patients with mild fluid retention who do not yet need a pharmaceutical diuretic can use dandelion leaf as a first-line intervention with minimal risk of the hypokalemia that can develop with chronic thiazide use.

The mechanism is not zero-risk. Patients on potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers (ARBs), or with chronic kidney disease can be at risk of hyperkalemia from large dietary potassium loads, including high-dandelion-leaf-content diets. The clinical guidance throughout these pages remains: large dietary potassium loads need to be matched to the patient's renal function and concurrent medications.

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Comparison to Thiazide and Loop Diuretics

Dandelion leaf is not a pharmaceutical-equivalent diuretic and should not be presented as a substitute for prescription diuretic therapy in conditions where rigorous diuresis is clinically necessary — congestive heart failure, advanced cirrhosis with ascites, nephrotic syndrome, established symptomatic hypertension, or acute pulmonary edema. The magnitude of diuretic effect from dandelion leaf is meaningfully smaller, slower in onset, and less reliably reproducible than from prescription agents.

Where dandelion leaf occupies a clinical niche is in conditions where mild diuresis is desired and where pharmaceutical diuretics would be excessive or carry unacceptable trade-offs:

• Mild cyclical premenstrual fluid retention with modest weight gain and edema
• Mild postprandial bloating that resolves with diuresis
• Mild dependent edema in otherwise healthy adults without underlying cardiac, hepatic, or renal disease
• Adjunctive support in mild hypertension that does not yet require pharmacologic management, often as part of a broader lifestyle intervention including weight loss, sodium reduction, exercise, and DASH-pattern diet
• Adjunctive support in compensated heart failure under cardiology supervision, occasionally added to background loop diuretic therapy in patients with stable status
• Acute uncomplicated cystitis, where the diuresis flushes bacteria from the bladder and reduces urinary stasis

The magnitude of diuretic effect from dandelion leaf is approximately 5-15% of the effect of a standard 25 mg hydrochlorothiazide dose, with onset within 1-2 hours of tincture dosing and duration of 4-6 hours. This is approximate; published quantitative dose-response data are limited.

Patients with substantial fluid retention from any cause (heart failure, cirrhosis, nephrotic syndrome) need pharmaceutical diuresis and should not delay appropriate medical treatment by relying on dandelion alone. The herb's place is as an adjunct, a substitute for early pharmaceutical diuresis in mild self-limited fluid retention, or as a daily long-term mild support that helps maintain euvolemia in otherwise healthy adults.

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Mechanism of Diuretic Action

The molecular pharmacology of dandelion's diuretic effect is less fully mapped than its hepatobiliary mechanism. The Clare trial established the effect but did not determine the molecular target. Subsequent animal-model studies have proposed several contributing mechanisms:

1. Osmotic effect from high potassium content — the high potassium load from dandelion leaf consumption raises serum potassium modestly (within normal range in healthy subjects). The renal handling of potassium results in increased urinary potassium output, which obligates increased urinary water output to maintain electrolyte balance — an osmotic diuresis.
2. Direct natriuretic effect from flavonoids — certain flavonoids in dandelion leaf appear to modestly inhibit sodium reabsorption in the renal tubule, increasing urinary sodium output and the associated water output. The molecular target is uncertain; some animal data suggest mild inhibition of the Na-K-ATPase pump on the basolateral membrane of tubular cells, but this is not well-confirmed.
3. Aquaporin modulation — some animal data suggest dandelion leaf extract may modulate aquaporin water-channel expression in the collecting duct, though the data is preliminary.
4. Renal blood flow modulation — vasodilator effects of certain dandelion polyphenols may modestly increase renal blood flow and glomerular filtration rate, contributing to increased urine production.
5. Bitter-vagal effect — the same bitter-mediated vagal reflex discussed under the liver and bile-flow mechanism may also contribute modest cardiovascular effects (mild vasodilation, modest reduction in sympathetic tone) that indirectly support diuresis through hemodynamic effects.

The combined effect is mild diuresis without major perturbation of any single tubular transport mechanism. This is mechanistically consistent with the safety profile observed clinically: dandelion leaf, in usual doses, produces useful mild diuresis without the dramatic electrolyte disturbances that can occur with pharmaceutical loop diuretics.

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Traditional Bladder and Urinary Tract Uses

Across European herbal traditions, dandelion leaf has been used for centuries for bladder and urinary tract complaints. The traditional uses anticipated and overlap with the modern diuretic indication:

• Bladder irritation and frequent urination — the diuretic flush of dilute urine paradoxically reduces the chemical irritation of concentrated urine on inflamed bladder epithelium, often relieving symptoms within 24-48 hours
• Acute uncomplicated cystitis — the mechanical flush of bacteria and the dilution of urine that supports bacterial growth contributes to symptom resolution and often to bacteriologic cure of mild uncomplicated cases
• Mild bladder stones (gravel) — the diuresis helps flush small concretions before they can grow to clinically significant size; not effective for established large stones
• Urinary stasis in the elderly — mild diuresis encourages more frequent bladder emptying, reducing risk of urinary stasis and the urinary tract infections that follow
• Postpartum urinary retention or sluggish urination — traditional use, mechanism uncertain

The traditional combination for acute uncomplicated cystitis pairs dandelion leaf with: cranberry (D-mannose and proanthocyanidins that prevent bacterial adhesion to bladder epithelium), uva ursi (arbutin, which is converted to the antibacterial hydroquinone in alkaline urine), and marshmallow root (mucilage that coats and soothes inflamed urinary tract mucosa). This combination has substantial traditional support and reasonable mechanistic rationale, though no large-scale randomized controlled trials have specifically tested the combination against standard antibiotic therapy.

The conventional warning applies: cystitis that does not resolve within 48-72 hours, that is accompanied by fever or flank pain, or that occurs in pregnancy or in patients with diabetes, immunocompromise, or structural urinary tract abnormalities should be treated with appropriate antibiotic therapy and not with herbal protocols alone. Pyelonephritis (kidney infection) is a medical emergency that should never be managed with herbs alone.

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Cyclical Premenstrual Edema

Mild cyclical premenstrual edema — the 1-3 pound weight gain, breast tenderness, abdominal bloating, and ring/shoe tightness that appears in the luteal phase of the menstrual cycle in many women — is one of the most common conditions for which integrative practitioners recommend dandelion leaf. The mechanism is fluid retention driven by the hormonal milieu of the luteal phase (progesterone and estrogen patterns produce sodium retention through aldosterone-mediated and direct effects on the renal tubule). The fluid retention resolves spontaneously with menses, but the days leading up to it can be uncomfortable.

Pharmaceutical diuretic use for premenstrual edema is rarely appropriate — the symptoms are typically too mild and too self-limited to justify the side effects and electrolyte disruption of chronic monthly thiazide dosing. This is precisely the clinical niche dandelion leaf fits.

Typical regimen: 4-10 g of dried dandelion leaf as tea (or 2-5 mL of 1:3 tincture three times daily) starting on the first day of premenstrual symptoms (typically days 21-25 of a 28-day cycle) and continuing through the onset of menses. The diuretic effect resolves the fluid retention within 1-3 days of starting. The mineral and bitter content of the leaf also tends to improve the appetite-suppression and irritability components of premenstrual syndrome, contributing to overall symptom improvement.

For the broader picture, premenstrual edema is often paired with magnesium (200-400 mg/day, chronic), vitamin B6 (50-100 mg/day, chronic), and lifestyle support (sodium moderation, daily walking, sleep hygiene). Chaste tree berry (Vitex agnus-castus) is the most commonly used herb for premenstrual mood and breast tenderness symptoms; dandelion is the addition for the fluid component specifically.

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Mild Hypertension Adjunct

Hypertension is the most common chronic disease in adults globally, and the management algorithm starts with lifestyle intervention (DASH diet, sodium reduction, weight loss, regular aerobic exercise, alcohol moderation, smoking cessation, stress reduction) before progressing to pharmacologic therapy if blood pressure remains above 140/90 (or 130/80 in patients with diabetes or established cardiovascular disease, per most current guidelines).

The lifestyle-intervention phase can incorporate dandelion leaf as a mild adjunctive diuretic and as a high-potassium dietary item. The DASH (Dietary Approaches to Stop Hypertension) pattern emphasizes high-potassium plant foods specifically; dandelion leaf is one of the highest-potassium leafy greens available, naturally fitting the DASH approach. The modest diuretic effect contributes a small additional blood pressure reduction beyond what dietary potassium alone provides.

Magnitude of effect is modest. In small studies, daily dandelion leaf supplementation has produced systolic blood pressure reduction on the order of 3-8 mm Hg, comparable to the effect of moderate aerobic exercise added to baseline. This is meaningful contribution to a cumulative lifestyle-intervention strategy but is not sufficient as monotherapy for established hypertension above the treatment threshold.

The pairing with established antihypertensive therapy (when prescribed) is generally safe but should be coordinated with the prescribing physician. Patients on ACE inhibitors, angiotensin receptor blockers, or potassium-sparing diuretics need their serum potassium monitored when starting large daily dietary potassium loads to avoid hyperkalemia, particularly if they have reduced kidney function.

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Acute Uncomplicated Cystitis Combination

Acute uncomplicated cystitis (lower urinary tract infection) in otherwise healthy non-pregnant women is one of the most common reasons for primary care visits and antibiotic prescriptions. First-line antibiotic therapy (nitrofurantoin, trimethoprim-sulfamethoxazole, fosfomycin) is highly effective but contributes meaningfully to antimicrobial resistance with widespread use. For mild, uncomplicated, recurrent cases, an evidence-supported integrative approach can reduce antibiotic use without sacrificing efficacy.

The dandelion leaf contribution to the integrative cystitis combination is the diuretic flush. The mechanism: increased urinary frequency and volume mechanically washes bacteria from the bladder lumen, dilutes the urine making it less hospitable for bacterial growth, and reduces the urinary stasis that allows established infections to persist.

Typical integrative protocol for acute uncomplicated cystitis (with rapid escalation to antibiotic if not improving in 24-48 hours):

• Increase fluid intake — 2-3 liters of water per day for the duration of symptoms
• Dandelion leaf tea or tincture — 1-2 cups of strong tea or 2-5 mL of tincture, three times daily, for the diuretic effect
• D-mannose — 1 g three times daily for 5 days; binds to E. coli pili and prevents bacterial adhesion to bladder epithelium. The evidence base is reasonably strong for D-mannose specifically in E. coli cystitis, which represents 80% of cases.
• Cranberry extract — standardized to proanthocyanidins, 36 mg PAC daily; modest preventive effect against recurrent UTI
• Uva ursi leaf — 3 g per day as tea, for 5-7 days only; the arbutin is converted in alkaline urine to hydroquinone, which has antibacterial activity. Not for long-term use (potential hepatotoxicity at extended high doses).
• Marshmallow root tea — soothing mucilage that coats the inflamed bladder mucosa
• Probiotic vaginal restoration — for recurrent UTI prevention, focused on Lactobacillus crispatus strains

The clinical rule: if symptoms do not improve within 48-72 hours, if fever or flank pain develops, if pregnancy is possible, or if the patient has diabetes, immunocompromise, urinary tract structural abnormalities, or recurrent cystitis (more than 3 episodes per year), prompt antibiotic therapy is appropriate and herbal-only management is not.

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Dosage, Forms, and Treatment Course

For diuretic and kidney-support applications, dandelion leaf is the preparation of choice. The leaf is harvested young (pre-flowering, typically spring), tender, and richly mineral-laden.

• Fresh dandelion leaf in salad — a daily handful (approximately 30-50 g) of young pre-flowering leaves, washed and dressed with olive oil and lemon juice. The most natural whole-food form. Provides substantial mineral nutrition along with the diuretic effect.
• Dried dandelion leaf tea — 4-10 g per day (corresponding to 1-3 teaspoons of dried herb per cup), steeped in hot (not boiling) water for 10 minutes, 2-3 cups per day. The German Commission E approved dose range.
• Dandelion leaf tincture (1:3 in 30% alcohol) — 2-5 mL three times daily, taken in water. The form used in the Clare 2009 diuretic trial (at 8 mL three times daily, which is on the high end of typical use).
• Dandelion leaf capsules — 500-1500 mg dried powdered leaf, twice or three times daily. Loses the bitter-reflex component but retains most of the diuretic effect.
• Fresh-pressed juice — 10-15 mL of fresh dandelion-leaf juice, 1-2 times daily. Traditional spring-cleanse preparation. Difficult to source commercially; usually requires fresh foraging or home juicing.

Treatment course is condition-specific:

• Mild fluid retention or premenstrual edema — intermittent use as needed, 3-7 days at a time
• Mild hypertension adjunct — daily use for at least 8-12 weeks before assessing blood pressure effect
• Acute uncomplicated cystitis — daily use for 5-7 days, then taper; rapidly escalate to antibiotic therapy if not improving
• General daily mild diuretic support in otherwise healthy adults — long-term daily use of dandelion leaf in salad or 1-2 cups of leaf tea is generally well-tolerated

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Cautions and Drug Interactions

• Asteraceae allergy — cross-reactive with ragweed, chamomile, marigold, echinacea, and other daisy-family plants. Patients with seasonal ragweed allergy or chamomile contact dermatitis should test with a small dose first.
• Loop and thiazide diuretic interaction — additive diuretic effect can produce more pronounced volume depletion and electrolyte disturbance than expected. Patients on chronic diuretic therapy should not start daily dandelion leaf without coordination with their physician.
• Lithium interaction — the diuretic effect can reduce lithium clearance, raising serum lithium concentration. Patients on chronic lithium therapy must have serum levels rechecked if they start daily dandelion leaf.
• ACE inhibitor / ARB / potassium-sparing diuretic interaction — the high potassium content of dandelion leaf can contribute to hyperkalemia in patients on these agents, particularly if renal function is reduced. Serum potassium should be monitored.
• Warfarin interaction (leaf, not root) — the substantial vitamin K content of fresh dandelion leaves can antagonize warfarin and reduce INR. Patients on stable warfarin who start daily dandelion leaf in salad should have INR rechecked within 1-2 weeks and warfarin dose adjusted as needed.
• Hypoglycemic medication interaction — modest additive hypoglycemic effect with insulin, sulfonylureas, and other diabetes drugs. Modest in magnitude; worth slightly more frequent blood glucose monitoring when starting.
• Chronic kidney disease — patients with advanced chronic kidney disease (eGFR less than 30 mL/min) should not use dandelion leaf without nephrology consultation, due to risk of hyperkalemia from the dietary potassium load.
• Pregnancy and lactation — traditional use as a mild diuretic and mineral-rich green has continued through pregnancy in many cultures without reported harm. The European Medicines Agency monograph notes that "use during pregnancy and lactation is not recommended" due to absence of formal safety data, which is a regulatory default and not a positive safety signal. Most integrative practitioners consider modest use of fresh dandelion leaf in food to be safe in pregnancy; concentrated tinctures or extracts are typically avoided.
• Foraging caution — dandelion is a bioaccumulator and readily concentrates lead, cadmium, arsenic, and other heavy metals from contaminated soil. Avoid roadside, parking-lot-edge, herbicide-treated lawn, industrial-site, and former orchard plants. When in doubt, buy from a reputable organic source.
• Oxalate content — moderate oxalate content. Patients with calcium oxalate kidney stones should not consume large amounts of dandelion leaf.

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Key Research Papers

1. Clare BA, Conroy RS, Spelman K (2009). The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day. Journal of Alternative and Complementary Medicine. — PubMed
2. Racz-Kotilla E, Racz G, Solomon A (1974). The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Medica. — PubMed
3. Hook I, McGee A, Henman M (1993). Evaluation of dandelion for diuretic activity and variation in potassium content. International Journal of Pharmacognosy. — PubMed
4. European Medicines Agency (2009). Community Herbal Monograph on Taraxacum officinale Weber ex Wigg., radix cum herba. — PubMed
5. Schutz K, Carle R, Schieber A (2006). Taraxacum — a review on its phytochemical and pharmacological profile. Journal of Ethnopharmacology. — PubMed
6. Yarnell E (2002). Botanical medicines for the urinary tract. World Journal of Urology. — PubMed
7. Sigstedt SC et al. (2008). Evaluation of aqueous extracts of Taraxacum officinale on growth and invasion of breast and prostate cancer cells. International Journal of Oncology. — PubMed
8. Cravotto G et al. (2010). Phytotherapeutics: an evaluation of the potential of 1000 plants. Journal of Clinical Pharmacy and Therapeutics. — PubMed
9. Hook I, McGee A, Henman M (1993). Variation in the concentration of potassium in different parts of the dandelion plant. — PubMed
10. Kashiwada Y et al. (2001). Taraxastane-type triterpenoids from Taraxacum officinale. Chemical and Pharmaceutical Bulletin. — PubMed
11. Modaresi M, Resalatpour N (2012). The effect of Taraxacum officinale hydroalcoholic extract on blood cells in mice. Advances in Hematology. — PubMed
12. Williams CA, Goldstone F, Greenham J (1996). Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Phytochemistry. — PubMed

PubMed Topic Searches

• PubMed: Dandelion diuretic in humans
• PubMed: Leaf/folium potassium-sparing
• PubMed: Herbal vs thiazide
• PubMed: Dandelion / cystitis / UTI
• PubMed: Premenstrual edema herbal
• PubMed: Dietary potassium / DASH

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Connections

• Dandelion Overview
• Dandelion Benefits Hub
• Dandelion Liver & Detox
• Dandelion Digestive Aid
• Dandelion Antioxidant
• Potassium
• Magnesium
• Kidney Function Tests
• Comprehensive Metabolic Panel
• Edema
• Bloating
• Hypertension
• Nephrology/Hepatology
• Detoxification
• Vitamin C
• All Herbs

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