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Herb library · Herb · Lessertia frutescens (syn. Sutherlandia frutescens)

Sutherlandia (cancer bush)

A southern African shrub sold as a tonic and promoted for HIV, cancer and wasting. In a trial in adults with HIV it did not change viral load or CD4 counts, and two people taking the TB medicine isoniazid developed tuberculosis. There is no good evidence for cancer.

Traditional use

Indigenous to the drier regions of southern Africa, with a long history of traditional use. It has been used for cancer (hence "cancer bush"), tuberculosis, diabetes, influenza, arthritis, stomach ulcers, anxiety and depression, and in the 2000s South Africa's health ministry supported it for people with HIV. It is widely sold over the counter. Pappe (1857) noted it growing wild across the Cape and, after Thunberg, its dried root and leaf used for eye complaints; Andrew Smith (1895), writing from the Eastern Cape, recorded a leaf preparation taken as a tonic.

What studies show

  • Limited

    HIV: a 24-week randomized, placebo-controlled trial in 107 adults with HIV found no change in viral load, and CD4 counts were similar to placebo. The Sutherlandia group had more days of infection, attributed to two tuberculosis cases in people taking isoniazid.

  • Insufficient

    Cancer: a 2025 review found mostly poorly designed lab studies at unrealistic doses and no rigorous animal or clinical studies, and concluded it should not currently be recommended for cancer.

  • Insufficient

    Safety in healthy adults: a small 3-month trial (25 people) of leaf-powder capsules found it was tolerated, with no difference in side effects from placebo; people taking it reported a better appetite.

Be careful of

Cautions

  • InteractionIsoniazid and other TB medicines: a trial found a possible interaction, with tuberculosis developing in two people who took Sutherlandia alongside isoniazid, and researchers advise people on isoniazid not to use antioxidant botanicals at the same time.
  • InteractionHIV medicines: in lab tests it almost completely blocked CYP3A4, a liver enzyme that processes many antiretrovirals, and affected a drug pump. Whether this matters in people has not been studied.
  • NoteReported side effects include occasional mild diarrhea, dry mouth, increased urination, and dizziness in very underweight people. Its compound L-canavanine has been linked to a lupus-like autoimmune syndrome after long-term exposure.
  • PregnancyRare reports of harm to the unborn baby and of miscarriage exist. Ask a clinician before using it in pregnancy.
  • Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines (especially HIV or TB medicines), are pregnant or breastfeeding, or are giving it to a child. Do not use it in place of prescribed care for HIV, TB or cancer.

From the old books

What herbals and dispensaries of the past printed. History, in their words.

“A preparation from the leaves of this plant, made in any of the ordinary ways, is employed as a tonic. Its probable function may be presumed from the more pronounced effects of the plant, referred to elsewhere, though its suitability in any case can be found out only by experiment.”
Andrew Smith, A Contribution to South African Materia Medica (1895), p. 62. See the page of A Contribution to South African Materia Medica, p. 62 (opens in a new tab) · Read the full passage from A Contribution to South African Materia Medica, p. 62
“It grows wild in hilly parts all over the colony. According to Thunberg (Travels, vol. I., pag. 160), the roots and leaves of this plant, when dried and pulverised, are of use in diseases of the eye.”
L. Pappe, Floræ Capensis Medicæ Prodromus (1857), p. 11. See the page of Floræ Capensis Medicæ Prodromus, p. 11 (opens in a new tab) · Read the full passage from Floræ Capensis Medicæ Prodromus, p. 11

Sources

  1. Consumption of Sutherlandia frutescens by HIV-Seropositive South African Adults: An Adaptive Double-Blind Randomized Placebo Controlled Trial (PLoS One, 2015) (opens in a new tab) · NIH · read September 25, 2026
  2. Does Concurrent Use of Some Botanicals Interfere with Treatment of Tuberculosis? (Neuromolecular Med, 2016) (opens in a new tab) · NIH · read September 25, 2026
  3. The "Cancer Bush" Sutherlandia (syn. Lessertia) frutescens. An Example of Promotional Research, or Is There Scientific Merit? (Planta Med, 2025) (opens in a new tab) · NIH · read September 25, 2026
  4. A randomized, double-blind, placebo-controlled trial of Lessertia frutescens in healthy adults (PLoS Clin Trials, 2007) (opens in a new tab) · NIH · read September 25, 2026
  5. African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology (Nutr J, 2005) (opens in a new tab) · NIH · read September 25, 2026

Reviewed September 25, 2026.