Cite

Nigella sativa (N. sativa, Ranunculaceae family), commonly known as “black seed” or “black cumin,” is a flowering plant that grows in countries bordering the Mediterranean Sea, and in Pakistan, India, and Iran [1]. The people of the Middle East and Southeast Asian countries have used N. sativa seeds to treat disorders, such as bronchitis, asthma, and inflammatory, infectious, and gastrointestinal diseases, and applied its oil to treat skin diseases such as boils and eczema [2]. N. sativa seeds play an important role in the traditional treatment of various diseases, especially fever, chronic headache, migraine, hypertension, and paralysis [3]. Additionally, the extracts of N. sativa are traditionally used as a laxative, intestinal antiprotozoal agent, and carminative [4].

In the past 2 decades, various pharmacological or medicinal aspects of N. sativa including its antibacterial [5], anticancer [6, 7], anti-inflammatory [8], antioxidant [9, 10], immunomodulatory [11], analgesic [12, 13, 14], diuretic [15, 16], antihypertensive [17], antidiabetic [18, 19, 20], neuroprotective [16], gastroprotective [21, 22], and hepatoprotective properties [23], have been reported. N. sativa has been used in clinical research for neurological disorders [24, 25, 26], hypertension [27, 28], hyperlipidemia [29, 30], obesity [31, 32], rheumatoid arthritis [33, 34, 35], lung disease [36], thyroid dysfunction [37], hepatitis [38], and male infertility [39].

The herbaceous plant contains fixed oil (FO, 36%–38%), carbohydrates, proteins, fiber, minerals, volatile oil (0.2%), essential oil (0.4%–2.5%), alkaloids, coumarins, and saponins [40, 41, 42]. The main bioactive components of N. sativa seeds are thymoquinone, carvacrol, 4-cymene, pentacyclic triterpenoid saponins (α-hederin), and alkaloids (nigellicine, nigellicimine, nigellicimine-N-oxide, and nigellidine) [43, 44]. Thymoquinone is the main and most abundant (27.8%–57.0%) compound of N. sativa seeds essential oil, and the other components, such as carvacrol (5.8%–11.6%), 4-cymene (7.1%–15.5%), 4-terpineol (2.0%–6.6%), t-anethole (0.25%–2.3%), and longifolene (1.0%–8.0%) exist at lower amounts [45, 46]. Thymoquinone is also the major volatile component (0.72%–21.03%) of N. sativa volatile oil and has shown several pharmacological activities related to oxidative stress [7, 20]. Figure 1 presents the main bioactive components of N. sativa [43, 44].

Figure 1

Main bioactive components of N. sativa: (A) carvacrol (5-isopropyl-2-methylphenol; National Center for Biotechnology Information. PubChem Database compound identification number [CID] 10364), (B) 4-cymene (4-isopropyltoluene; CID 7463), (C) thymoquinone (4-cymene-2,5-dione; CID 10281), (D) nigellidine (CID 136828302), (E) nigellicine (CID 11402337), and (F) α-hederin (CID 73296).

N. sativa seed extracts and its bioactive components are generally regarded as chemicals with low toxicity [43, 47] that have a wide margin of safety [48, 49]. Nevertheless, the common structure of thymoquinone may cause oxidative stress and damage cellular macromolecules (DNA, lipids, and proteins) and signaling pathways, such as extracellular signal-regulated kinase (ERK), protein kinase C (PKC) and Ras; however, it is postulated that coexistence of other components of N. sativa reduces thymoquinone toxicity [45, 50, 51, 52]. Figure 2 presents various toxicities observed following exposure to N. sativa [49, 53, 54, 55, 56, 57, 58, 59, 60, 61].

Figure 2

Various toxicities reported for N. sativa. Abbreviations: γ-GT, gamma-glutamyl transferase; ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate aminotransferase; PT, prolonged prothrombin time; APTT, activated partial thromboplastin time; TT, thrombin time; ATIII, antithrombin III; RBCs, red blood cells; Hb, hemoglobin; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; PCV, packed cell volume; MCV, mean corpuscular volume; Plt, platelet; Hct, hematocrit; MGV, mean globular volume; PARP, poly(ADP-ribose) polymerase.

The present narrative review discusses the toxicity and adverse effects of different extracts and oils obtained from N. sativa reported in animals, cell lines, and humans.

Methods

We conducted a literature search of scientific databases including Web of Science, PubMed, Scopus, and Google Scholar. In this search, the following string of keywords was used: “Nigella sativa” or “sativa” or “Nigella” or “black seed” or “black cumin” or “black cumins” or “thymoquinone” or “carvacrol” or “4-cymene” and “safety” or “toxicity” or “cytotoxicity” or “genotoxicity” and “acute” or “subacute” or “subchronic” or “chronic”. The wild-card asterisk (*) was used to increase the scope of the search. The reference lists of discovered articles were also reviewed to identify reports that evaluated N. sativa toxicity published until March 2020. All studies that assessed the toxicity or reported adverse reactions of N. sativa following topical, parenteral, and oral treatment of experimental animals and humans and data from experiments done on cell lines, were included. All included studies were written in English. Review articles were not included.

Discussion
Acute toxicity of N. sativa in animal studies

The median lethal dose (50%) (LD50) values of N. sativa seed volatile oil, fixed oil (prepared by hexane extraction), and aqueous extract in male Swiss albino (SWR) mice were calculated using a Litchfield and Wilcoxon method. Intraperitoneal administration of volatile oil, aqueous extract, and fixed oil of N. sativa has LD50 values of 1,853, 3,020, and 3,371 mg/kg, respectively. Based on these data, authors attributed N. sativa toxicity to its volatile oil rather than aqueous extract and fixed oil [51].

Oral (10, 15, 20, 25, 30, 40, and 50 mL/kg) or intraperitoneal (0.25, 0.5, 1, 2, 3, 4, and 6 mL/kg) doses of N. sativa seeds fixed oil (prepared by hexane extraction) made in gum acacia (5%), were given to male and female mice. Importantly, using thin-layer chromatography (TLC), the fixed oil was characterized and it contained myristic, palmitic, stearic, oleic, linoleic, linolenic, and arachidic acids; triterpenes, and saponosides. For all doses, oral or intraperitoneal administration of N. sativa led to behavioral disorders and agitation followed by sedation. Furthermore, 12 h after administration of N. sativa (50 mL/kg oral or 4 mL/kg intraperitoneal), all animals died. In surviving mice, activity and growth were rapidly retrieved within 4–8 days after oil administration. This study indicated LD50 values of 28.8 mL/kg body weight (bw) and 2.06 mL/kg bw for oral and intraperitoneal FO, respectively, and also indicated that N. sativa fixed oil is of low toxicity and possesses a wide margin of safety [49].

LD50 values for aqueous, methanol, and chloroform extracts of N. sativa seeds following a single oral administration of 4 different doses (6, 9, 14, and 21 g/kg) of the extracts to mice, was evaluated, but zero mortality was observed. The preliminary analysis found neither mortality nor significant morbidity following treatment with the extracts. Therefore, aqueous, methanol, and chloroform extracts were found to be safe and exerted a wide margin of safety following acute exposure [4].

A more recent study reported zero mortality (LD50 could not be calculated) following administration of N. sativa essential oil at the doses of 0.2, 0.4, 0.4, 0.8, 1 mg/kg to either sex of white Wistar rats and albino mice (NMRI); however, this study lacked a full characterization of the essential oil and only total flavonoid content in terms of quercetin was reported [62].

A summary of studies [4, 49, 51, 62] that examined N. sativa acute toxicity is presented in Table 1.

Acute toxicity of Nigella sativa in animal studies

Substance/doseAnimals usedObservation periodLD50Reference
N. sativa seed VO, FO, and AE, i.p.SWR mice24 hAE: 3,020 mg/kgVO: 1,853 mg/kgFO: 3,371 mg/kg[51]
N. sativa seed FO 0.25, 0.5, 1, 2, 3, 4, and 6 mL/kg, i.p.Both sexes of mice15 days2.06 mL/kg[49]
N. sativa seed FO 10, 15, 20, 25, 30, 40, and 50 mL/kg, p.o28.8 mL/kg
N. sativa seeds AE, ME and CE 6, 9, 14 and 21 g/kg, p.o.Both sexes of young virgin mice7 daysNo mortality[4]
N. sativa EO 0.2, 0.4, 0.4, 0.8, 1 mg/kg, p.o.Both sexes of white Wistar rats and NMRINot specifiedNo mortality[62]

LD50, lethal dose 50%; VO, volatile oil; FO, fixed oil; EO, essential oil; AE, aqueous extract; ME, methanol extract; CE, chloroform extract; SWR, male Swiss albino; NMRI, albino mice; i.p., intraperitoneal, p.o., per oral.

Subacute toxicity of N. sativa in animal studies

To study subacute toxicity of cumin seeds, 10 mL/kg aqueous extract of N. sativa seeds was administered orally to male Sprague Dawley rats for 14 days. In this study, the aqueous extract was not characterized. The results demonstrated a notable increase in gamma-glutamyl transferase (γ-GT) amounts, though serum levels of alkaline phosphatase (ALP) remained unchanged and histopathological examinations did not show any damage; possibly, the findings were affected by an ether anesthesia effect on the release of ALP [63]. Oral administration of 10 mL/kg N. sativa seed oil to rats and mice for 48 h caused neither death nor obvious toxicity [53].

Oral administration of 6 g/kg/day of aqueous extract, and methanol and chloroform extracts of N. sativa seeds to male mice, for 14 consecutive days, did not affect plasma concentrations of ALP, alanine transaminase (ALT), or aspartate aminotransferase (AST). The pathological findings outlined only minor alterations in mice livers following treatment with these extracts. This study showed that even the 14-day administration of N. sativa seeds extracts has a wide margin of safety in mice [4].

Furthermore, 90, 180, 360, and 540 mg/kg of N. sativa seed mixed in a powder dough, was given orally for 1, 2, and 4 weeks to normal adult male albino rats. In this study, the authors did not present any information on the chemical composition of the mixture. N. sativa at the tested doses transiently altered both anticoagulant and coagulant profiles of rats. In this context, N. sativa markedly prolonged prothrombin time caused hyperfibrinogenemia and reduced activated partial thromboplastin time and thrombin time. Nevertheless, antithrombin III (ATIII) and AST levels remained unchanged while ALT and albumin levels significantly increased [54].

Powdered N. sativa seeds (0.01, 0.1, and 1 g/kg/day) administered for 28 days to male Sprague Dawley rats, did not affect the bodyweight of the rats, or serum AST and ALT levels compared with a control group. Histological examinations highlighted that 28-days treatment with these doses of N. sativa had no harmful impacts on liver tissue in the rats. However, no information on the composition of the seed powder was provided and the doses administered to rats were chosen based on human N. sativa consumption (viz., 2 g/d) [64].

Daily administration of N. sativa seeds aqueous extract (2, 6.4, 21, 33, and 60 g/kg, orally) to mice for 6 weeks produced hepatotoxic effects (based on histopathological examinations) at doses ≥21 g/kg, but did not influence kidney tissue (in terms of urea and albumin levels). A high mortality rate was found following the administration of 60 g/kg of the extract. The findings highlighted the safety of N. sativa at doses lower than 21 g/kg; however, the aqueous extract of the seeds was not characterized [65].

Although for centuries, a black seed and honey mixture (BSH) has used in traditional folk medicine, especially in Islamic countries because of its mention in the Hadith, its toxic effects are unclear. For this reason, a study was conducted to evaluate the effect of 14-day administration of 100, 500, 1,000, and 2,000 mg/kg doses of BSH to male Sprague Dawley rats and found an LD50 >2,000 mg/kg. The findings showed no notable alteration in body weight, and differential leukocyte count, or abnormalities in liver and kidney histopathology; however, limitations of this study included a lack of mixture characterization and histopathological assessment of only 2 organs [66].

Table 2 presents investigations [4, 53, 63, 64, 65, 66] conducted to evaluate the subacute toxicity of N. sativa in animals.

Subacute toxicity of Nigella sativa in animal studies

Substance/doseAnimals usedExposure periodObservation periodMain resultsReference
N. sativa seeds AE 10 mL/kg, p.o.Male Sprague Dawley rats14 days30 days↑ Serum γ-GT and ALT levels. Unchanged serum ALP levels and histopathological examinations[63]
N. sativa seed oil 10 mL/kg, p.o.Rats48 hNot specifiedNo toxicity[53]
Mice
N. sativa seeds AE, ME, and CE 6 g/kg, p.oBoth sexes of young virgin mice14 daysSame 14 daysNo toxicity wide margin of safety[4]
N. sativa powder 90, 180, 360, and 540 mg/kg, locallyNormal adult male albino rats1, 2, and 4 weeksSame 4 weeksTransient alterations in both anticoagulant and coagulant functions[54]
N. sativa powder 0.01, 0.1, and 1 g/kg/day, p.oMale Sprague Dawley rats28 daysSame 28 daysNo toxicity[64]
N. sativa AE 2, 6.4, 21, 33, and 60 g/kg, orally), p.oMus musculus6 weeksSame 6 weeks21 g/kg: hepatotoxic 60 g/kg: high mortality[65]
mice
BSH 100, 500, 1,000, and 2,000 mg/kg, p.oMale Sprague Dawley rats14 days28 daysNo toxicity[66]

AE, aqueous extract; ME, methanol extract; CE, chloroform extract; γ-GT, gamma-glutamyl transferase; ALP, alkaline phosphatase; ALT, alanine transaminase; BSH, black seed and honey mixture; i.p., intraperitoneal; p.o., per oral.

Subchronic toxicity of N. sativa in animal studies

Powdered N. sativa seeds (20 and 100 g/kg) were added to the diet of 7-day-old Hibro broiler chicks for 7 weeks. Administration of these doses of N. sativa seeds damaged the liver as reflected by increased AST and ALT levels and decreased albumin concentration and cholesterol levels in serum. Furthermore, 100 g/kg of N. sativa decreased red blood cells (RBCs), hemoglobin level, mean corpuscular hemoglobin concentration, and packed cell volume despite increases in mean corpuscular volume levels. Together, the results suggested that a 7-week treatment with N. sativa seeds did not have a negative influence on growth, pathological features of the main organs, or biochemical/hematological profile of the animals [55].

N. sativa oil obtained from Cairo Chemical Industries Co. (15 and 25 mg/kg) was administered to adult male albino rats for 1 month. However, no information on the chemical composition of the oil was noted. At the end of the experiment, histological changes were found in the cortex of the kidney and to a lesser extent, in hepatocytes in a dose-dependent manner. This study indicated that N. sativa oil (oil type not specified) must be used at appropriate doses [48].

Experiments [48, 55] that examined the subchronic toxicity of N. sativa are summarized in Table 3.

Subchronic toxicity of Nigella sativa in animal studies

Substance/doseAnimals usedExposure periodObservation periodMain resultsReference
N. sativa seeds 20 and 100 g/kg, p.o.7-day-old Hibro broiler chicks7 weeksSame 7 weeksNo toxicity[55]

p.o., per oral.

Chronic toxicity of N. sativa in animal studies

N. sativa fixed oil (prepared by hexane extraction, 2 mL/kg bw chosen based on the LD50 value obtained in an acute study) was orally given to Wistar-Kyoto rats for 12 weeks. Hematological examinations showed significant decreases in leukocyte and platelet counts despite significant increases in hematocrit, hemoglobin, mean globular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. No significant alterations were found in AST, ALT, ALP, and GGT levels and no histopathological damages were observed in the heart, kidneys, liver, and pancreas. The researchers suggested that N. sativa fixed oil has a wide margin of safety at therapeutic doses, but hematological impacts should be studied further [49].

Oral daily administration of 1 mL/kg bw N. sativa seed fixed oil (prepared by hexane extraction) for 12 weeks to Wistar-Kyoto rats led to notable decreases in leukocyte and platelet counts. By contrast, hemoglobin and hematocrit levels were raised significantly. Nevertheless, serum levels of key hepatic enzymes (namely, AST, ALT, ALP, and GGT) did not change significantly relative to controls. Together, these results indicated mild toxicity for N. sativa seed FO. In this report, the authors did not specify the sex of the rats or the chemical composition of the fixed oil [56].

Studies [49, 56] that evaluated the chronic toxicity of N. sativa in animal models are presented in Table 4.

Chronic toxicity of Nigella sativa in animal studies

Substance/doseAnimals usedExposure periodObservation periodMain resultsReference
N. sativa FO 2 mL/kg, p.o.Wistar-Kyoto rats12 weeksSame 12 weeks↓ Leukocyte and Plt↑ HCT, Hb, MGV, MCH, and MCHCNo alteration in AST, ALT, ALP, and GGT levels or histopathological featuresSlight toxicity[49]
N. sativa FO 1 mL/kg, p.o.Wistar-Kyoto rats12 weeksSame 12 weeks↓ Leukocyte and Plt↑ HCT, HbNo alteration in AST, ALT, ALP, and GGT levelsSlight toxicity[56]

FO, fixed oil; AST, aspartate aminotransferase; Plt, platelet; Hct, hematocrit; Hb, hemoglobin; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; MGV, mean globular volume; p.o. per oral.

Cytotoxic and genotoxic properties of N. sativa

Various concentrations (0.25, 0.5, and 1 μg/mL) of N. sativa oil were tested for possible cytotoxicity in cultures of gingival fibroblasts, but no cytotoxicity of the oil against the fibroblasts was found [67]. This study was limited because it did not indicate which type of oil was examined.

Effects of ethanolic extract of N. sativa seeds on rat L6 muscle (L6myc) and human hepatocellular carcinoma (HepG2) cell lines were assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays. The effect of the extract on glucose transporter-4 (GLUT4) translocation to the plasma membrane of L6-GLUT4 myc cells was examined using an enzyme-linked immunosorbent assay (ELISA) method. The MTT and LDH assays results revealed cytotoxic effects of the extract at doses >500 μg/mL. The median effective concentration (EC50) values for this extract were >2,000 μg/mL against L6myc and >1,470 μg/mL HepG2 cell lines [68].

The influences of various doses of N. sativa ethanolic extract (100, 500, and 1,000 μg/mL) on viability and proliferation of nonstimulated and concanavalin A or phytohemagglutinin-stimulated isolated rat splenocytes were examined. Based on the results, 1,000 μg/mL of the ethanolic extract resulted in a marked decrease in cell viability and proliferation in both nonstimulated and stimulated cells [57].

Cytotoxic properties of the essential oil and different extracts (methanol, ether, petroleum ether, chloroform, and water) of N. sativa seeds were tested using a brine shrimp lethality assay; results revealed that chloroform and petroleum ether extracts were more toxic than the other extracts [69].

Cytotoxic effects of various concentrations (500, 250, 125, and 62.5 μg/mL) of N. sativa seeds volatile oil were tested against 5 human cancer cell lines namely, SCL, SCL-6, SCL-37′6, NUGC-4, and Kato-3, and 3T6 fibroblast line [70].

Cytotoxicity of petroleum ether and aqueous extracts of N. sativa for the human acute myeloid leukemia cell line (HL60) was tested, and it was found that petroleum ether extract is more toxic towards these cells having a lower half-maximal inhibitory concentration (IC50) [71]. Treatment of Huh7 human cells with N. sativa essential oil (100 mg/mL) did not affect cell viability [72].

N. sativa seed oil and its active component thymoquinone caused a decrease in the size and volume of glioblastoma multiforme (GBM) tumors in a xenograft mouse model. In cell lines including U-1242, U251, U-87, U-373, A172, and SNB19, N. sativa seed oil (50–500 μg/mL) and thymoquinone (1–20 μM) inhibited, in a dose-dependent manner cell growth and colony formation in soft agar with an IC50 of 260 μg/mL and 6 μM, respectively, activated the caspase-9/3 pathway and induced the cleavage of the death substrate poly(ADP-ribose) polymerase (PARP) [58].

Cytotoxicity, genotoxicity, and antigenotoxicity properties of aqueous extract of N. sativa seeds (0.5, 1, 4, 8, 9, and 18 mg/mL) from 3 diverse regions in Morocco were assessed in human C3A cells; the location where the herbs were collected, test system used, and other experimental parameters were important factors influencing the outcomes [73].

Apoptogenic effects of methanolic, n-hexane, and chloroform extracts of N. sativa seed were examined in HeLa cancer cells. The findings suggested that all of these extracts can induce apoptosis in cells as confirmed by western blotting, DNA fragmentation tests, and terminal transferase-mediated dUTP-digoxigenin-end labeling (TUNEL) assay [74].

Potential antigenotoxic properties of aqueous extract of N. sativa 79.5 μg/mL were tested in F344 hepatocytes treated with N-methyl-N-nitro-N-nitrosoguanidine (MNNG); results showed that N. sativa could not protect hepatocytes from the clastogenic effect of MNNG and produced a remarkable increase of chromosomal aberrations when used as a pretreatment. The findings revealed that this extract displayed a small, but significant, genotoxic potential [59].

Based on the cytotoxic studies, we concluded that the ethanolic extract and aqueous extract of N. sativa are safer than other extracts in different cell lines. Essential oil and volatile oil of N. sativa are relatively safe.

Table 5 summarizes studies in vitro [57, 58, 59, 67, 68, 69, 70, 72, 71, 72, 73, 74] that evaluated cytotoxicity and genotoxicity of N. sativa.

Cytotoxic and genotoxic properties of Nigella sativa in vitro

SubstanceConcentration periodPeriodCell typeMain resultsReference
N. sativa oil0.25, 0.5, and 1 μg/mL95 hGingival fibroblastsNo cytotoxicity[67]
N. sativa EE0–2 mg/mL24 hRat L6 muscle cell lineHepG2 cell lineEC50 >2,000 μg/mL against L6myc cell linesEC50 >1,470 μg/mL against HepG2 cell lines[68]
N. sativa EE100, 500, and 1,000 μg/mL48 hIsolated rat splenocytesCytotoxic effects at 500 and 1,000 μg/mL[57]
N. sativa EO and ME, PE, CE, AE, and ether extract10, 100, and 1,000 μg/mL24 hBSLHigher toxicity by chloroform and petroleum ether extracts.LC50 petroleum ether: 7 μg/mLLC50 chloroform: 21 μg/mL[69]
N. sativa seed VO500, 250, 125, and 62.5 μg/mLNot specifiedSCL, SCL-6, SCL-37′6, NUGC-4, Kato-3, 3T6LC50 SCL 155.02 μg/mLLC50 SCL-6 185.77 μg/mLLC50 SCL-37′6 120.40 μg/mLLC50 NUGC-4 384.53 μg/mLLC50 3T6 286.83 μg/mL[70]
N. sativa PE and AE670 μg/mL24 hHL60IC50 PE 654 μg/mLIC50 AE >1,000 μg/ml[71]
N. sativa EO100 mg/mL24 hHuh7 human cellsNo cytotoxicity[72]
N. sativa seed oil50–500 μg/mLU-1242, U251, U-87, U-373, A172 and SNB19IC50 260 μg/mL[58]
AE of N. sativa0.5, 1, 4, 8, 9, and 18 mg/mLHuman C3A cellsPositive micronucleus test extract from Setta[73]
N. sativa seed ME, NE, and CE2, 2.25, 2.5, 2.75, and 3 μg/mL of methanolic, n-hexane.0.25, 0.5, 0.75, and 1 ng/mL of chloroform24 hHeLa cellsIC50 methanolic: 2.28 μg/mLIC50 n-hexane 2.20 μg/mLIC50 chloroform 0.41 ng/mL[74]
N. sativa AE79.5 μg/mL48 hF 344 hepatocytes treated with MNNG↑ Chromosomal aberrations[59]

VO, volatile oil; FO, fixed oil; AE, aqueous extract; ME, methanol extract; CE, chloroform extract; NE, n-hexane extract; EO, essential oil; EE, ethanol extract; PE, petroleum ether extract; EC50, effective concentration; BSL, brine shrimp lethality assay; LC50, concentration that kills 50% of the cells, IC50, half-maximal inhibitory concentration inhibits 50% cell maximal growth; HL60, human myeloid leukemia cell line; MNNG, N-methyl-N-nitro-N-c.

N. sativa toxicity in humans

Administration of N. sativa oil to human volunteers at 5 mL/day for 26 days produced no significant hepatic, renal, or gastrointestinal adverse effects [75, 76]. N. sativa seeds (3 g/day for 3 months) consumed by 39 centrally obese subjects did not lead to marked side effects [77]. Similarly, diabetic patients who took N. sativa seeds (1, 2, and 3 g/day for 3 months) showed no significant alterations in renal or hepatic function [18]. However, epigastric pain and hypoglycemia were observed in hepatitis C virus patients treated with N. sativa seed oil capsules [38]. The use of total oil was associated with a marked increase of blood levels of AST and ALT and both the oil and the crushed seeds resulted in significantly increased γ-GT and the ALP activities [78]. N. sativa seeds (5 g/day) had an inhibitory effect on CYP2D6 and CYP3A4 in human liver microsomes and healthy human volunteers [79].

A 28-year-old man who had used pure oil of black cumin topically on his neck for 3 months as a treatment of sore throat, presented with a 2-day history of maculopapular eczema, first on the neck and spreading to his arms and back. To our knowledge, this was the first documented case of allergic contact dermatitis caused by topical black cumin oil [60].

A 31-year-old woman with an 8-month history of eczema on both hands and exacerbation of the skin lesions repeatedly applied an ointment containing essential oil extracted from the seeds of black cumin to her palms as a skin-care product. A biopsy from the left hypothenar showed signs of subacute dermatitis. Patch tests showed reactions to the ointment of black cumin in the form of allergic contact dermatitis [61].

A 56-year-old woman presented a 2-day history of severe bullous target-like lesions, compatible with erythema multiform. Histopathology of the lesions indicated lymphocytic infiltration at the dermal–epidermal junction, dermal edema, basal vacuolization, and keratinocyte necrosis. During the last 15 days before the eruption, she had been taking 2 capsules of black cumin essential oil, containing 500 mg of organic N. sativa oil (and 7.5 mg of vitamin E) per day. These reactions (presented in Table 6), based on previous reports [60, 61, 80], should alert physicians to be informed of potentially intense adverse effects of N. sativa essential oils [80].

Nigella sativa toxicity in humans

SubstanceConcentrationExposure route/periodCase historyMain resultsReference
Pure oil of black cuminNot specifiedUsed on the neck for 3 months28-year-old man for treatment of sore throatAllergic contact dermatitis[60]
EO of the seeds of black cuminNot specifiedRepeatedly applied as an ointment31-year-old woman with an 8-month history of eczema on both handsAllergic contact dermatitis[61]
Capsules of BCEOContaining 500 mg of organic N. sativa oil and 7.5 mg of vitamin EDaily 15 days56-year-old womanSevere bullous target-like lesions, compatible with erythema multiforme[80]

EO, essential oil.

Clinical trials that examined N. sativa and its active constituent, thymoquinone, found these agents safe, but notably several adverse effects such as bloating, nausea, and burning sensation were observed in functionally dyspeptic patients treated with N. sativa oil. Moreover, after using N. sativa oil and crushed seeds, a slight increase in kidney and liver enzymes was observed [81].

Our literature review to retrieve studies conducted on the short- and long-term toxic effects of N. sativa oils and extracts showed that a considerable number of studies were conducted without characterizing the plant material or its extracts; moreover, studies simultaneously in both sexes, in animals other than rats or mice, or performed to provide a full toxicological screening of all parameters of importance, are lacking. Dose ranges vary among studies making it difficult to draw conclusions.

Conclusions

The essential oil obtained from N. sativa was found to be safer than the volatile oil against different cell lines. Human case reports indicated allergic contact dermatitis following the use of some preparations containing N. sativa. However, clinical trials did not report any severe adverse effects following consumption N. sativa. Studies that assessed N. sativa safety generally introduced this plant as a safe medicinal herb. Nevertheless, more detailed investigations are still required to have a clearer insight into the toxicological profile of N. sativa.

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