Gymnema

by MedlinePlus

Preliminary human evidence suggests that gymnema may be effective in the management of blood sugar levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. Gymnema appears to lower serum glucose and glycosylated hemoglobin (HbA1c) levels following chronic use, but may not have significant acute effects. High-quality human trials are lacking in this area. Some of the available research has been conducted by authors affiliated with manufacturers of gymnema products.

Synonyms

Asclepiadaceae , Asclepias geminata roxb., Gemnema melicida , GS4 (water soluble extract of the leaves), gur-mar, gurmar, gurmarbooti, Gymnema inodum , kogilam, mangala gymnema, merasingi, meshashringi, meshavalli, periploca of the woods, periploca sylvestris, podapatri, Proβeta®, ram's horn, small Indian ipecac, sarkaraikolli, sirukurinja.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence

Diabetes

Animal studies report that gymnema can lower blood sugar levels. Preliminary human research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes when it is added to diabetes drugs being taken by mouth or to insulin. Further studies of dosing, safety, and effectiveness are needed before a strong recommendation can be made.

High cholesterol

Reductions in levels of serum triglycerides, total cholesterol, and low-density lipoprotein ("bad cholesterol") have been observed in animal studies. Preliminary research in people with type 2 diabetes reports decreased cholesterol and triglyceride levels. Better evidence is needed before a clear conclusion can be drawn.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Antimicrobial, aphrodisiac, cancer, cardiovascular disease, constipation, cough, digestive stimulant, diuresis, gout, high blood pressure, laxative, liver disease, liver protection, malaria, obesity, rheumatoid arthritis, snake venom antidote, stomach ailments, uterine stimulant, weight loss.

Dosing

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. At least one manufacturer offers an extract of gymnema standardized to 25% gymnemic acid, but this extract has not been thoroughly studied.

An extract from gymnema, labeled GS4, has been used in human research. GS4 has since been patented as the product Proβeta®. According to the makers of Proβeta®, the preparation is standardized to a specific biological result, as measured by a test developed by the company, which evaluates "pancreotropic®" effects.

Adults (18 years and older)

Type 1 diabetes: 200 milligrams of extract GS4 taken by mouth, twice daily, under careful continuation of insulin has been studied.

Type 2 diabetes: 200 milligrams of extract GS4 taken by mouth, twice daily, or 2 milliliters of an aqueous decoction (10 grams of shade-dried powdered leaves per 100 milliliters), three times daily has been studied.

Note: The manufacturer PharmaTerra recommends the dose for their product Proβeta® (GS4) to be two 250 milligram capsules taken twice daily at mealtimes (for adults weighing more than 100 pounds), or one 250 milligram capsule taken twice daily at mealtimes (for adults weighing less than 100 pounds).

Children (younger than 18 years)

There is not enough scientific evidence to safely recommend gymnema for use in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Allergy to gymnema may occur. In theory, allergic cross-reactivity may exist with members of the Asclepiadaceae (milkweed) family.

Side Effects and Warnings

Aside from lowered blood sugar and increased effects of anti-diabetic drugs following chronic use of gymnema, no significant adverse effects have been reported with the herb, in several studies up to 20 months long. Caution is advised in patients with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, and medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels.

Gymnema is reported to suppress the ability to detect sweet tastes, due to the component gurmarin. This phenomenon prompted the Hindi name gurmar or "sugar destroyer."

Pregnancy and Breastfeeding

Gymnema should not be used during pregnancy or breastfeeding due to lack of reliable safety information.

Interactions

Interactions with Drugs

Based on human and animal studies, gymnema may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with drugs that lower cholesterol such as "statins" (HMGCoA reductase inhibitors) like lovastatin (Mevacor") or atorvastatin (Lipitor").

Interactions with Herbs and Dietary Supplements

Based on human and animal studies, gymnema may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment. Possible examples include: Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, horse chestnut seed extract (HCSE), marshmallow, milk thistle, Panax ginseng, rosemary, Siberian ginseng, stinging nettle and white horehound. Based on human and animal studies, gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with herbs or supplements that lower cholesterol such as fish oil, garlic, guggul, or niacin.

Interactions with Foods

Based on animal study, absorption of oleic acid (a fatty acid) may be decreased by gymnema. It is unknown whether gymnema has these effects in humans, or affects the absorption of other nutritionally important lipids or fat-soluble vitamins (A, D, E, K).

About the Author

medlineplus.gov
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.