Educational information, not medical advice — ask your doctor or midwife.
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Sangre de grado is the red sap of an Amazon tree, Croton lechleri. The name means "dragon's blood" in Spanish. People paint it on the skin, and less often take it by mouth.
The sap is tapped from cuts in the bark. It is thick, dark red and dries to a film on skin. Folk use in Peru, Ecuador, Bolivia and Colombia covers cuts, bites, mouth sores and loose stools.
Here is the honest verdict. One purified part of the sap became a prescription drug, crofelemer, which helps some adults with watery stools. The raw sap sold in shops has had very little testing in people.
Long traditional use is not proof that a remedy works. It is also not proof that it is safe. That caution applies to every section below.
Most of the proposed actions come from lab and animal work, not from people.
In test tubes, the sap's tannin-like compounds bind to protein. They form a sticky seal over raw tissue. That may explain why the dried sap acts like a thin scab.
Crofelemer, the drug made from the sap, blocks two chloride channels in the gut wall. Chloride channels are tiny gates that let salt and water into the bowel. Less salt and water means firmer stools.
Taspine, one of the sap's compounds, speeds the closing of wounds in cell and animal studies. Whether this happens on human skin is not settled.
In animal studies, the sap calmed pain signals from skin nerves. Lab tests also show it slows some bacteria and viruses. None of this has been confirmed in good human trials.
The most common form is the raw red sap, sold in small dropper bottles.
Creams, gels and balms carry it for skin use. Many are blended with other plants, so the sap content is unclear.
Capsules and tinctures of dried sap are sold for gut complaints. Strength is rarely stated in a way you can check.
Mouth rinses, throat sprays and soaps also exist. These are cosmetic or food-supplement products in most countries.
Crofelemer is different from all of these. It is a prescription tablet made from the sap, sold under names such as Mytesi.
Quality of raw sap varies a lot. Some bottles are watered down, and some come from other Croton species.
Amazon peoples used the red sap long before European contact. Spanish accounts from the 1600s already described it as a wound remedy.
Healers in Peru, Ecuador and Colombia brushed it onto cuts, bites, boils and mouth sores. It dried into a protective coat.
It was also swallowed, diluted in water, for loose stools and stomach pain. Market stalls across the region still sell it this way.
Drug companies began to study the sap in the 1980s. That research led to the purified drug crofelemer.
Stop and see a doctor if a wound turns red, hot, swollen or oozes pus, or if you get a fever.
Get medical help for loose stools that last more than two days.
Get help right away for signs of dehydration: very dark urine, little or no urine, dizziness on standing, or a dry mouth with no tears.
Call emergency services for swelling of the lips, tongue or throat, a spreading rash, or trouble breathing. These can be signs of a severe allergic reaction.
In the United States, raw sangre de grado is sold as a dietary supplement or cosmetic, and is not approved as a medicine. Crofelemer, made from the sap, is an approved prescription drug there. In the UK and EU it is sold as a supplement or cosmetic and holds no medicine licence.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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