Fenugreek- Medicinal Uses, Interactions, Side Effects, Dosage

Fenugreek-- Uses and Benefits, Preparations and Dosage

<p><strong>Fenugreek</strong></p> <p>Fenugreek bears hard, irregularly shaped seeds, which are used both as a spice and as an herbal medicine. The seeds have a characteristic odor and a somewhat bitter taste. Fenugreek is native to Asia and southeastern Europe. </p> <p><strong>Uses and Benefits: </strong></p> <p>Fenugreek came from the herbal medicine traditions of the Middle East, India, and Egypt, and later in China and Europe, and was favored as a digestive aid for dyspepsia, intestinal gas, ,anorexia, and diarrhea. It was also used to treat chronic cough, bronchitis, fever, sore throat, and mouth ulcers. Poultices and other external formulations have been used for wounds and skin irritations. Fenugreek's most common modern indications include diabetes and hyperlipidemia. </p> <p><strong>Pharmacology:</strong></p> <p>Fenugreek seeds contain 45-60% carbohy­drates (mainly mucilaginous fiber), proteins high in lysine and Iryptophan, 5-10% fixed oils, flavonoids, alkaloids such as Irigonelline, saponins such as fenugreekine, and coumarins. </p> <p>Similarly, various hypotheses about the mechanism of the hypo­glycemic activity of fenugreek have been postulated, including delayed gastric emptying and an agonist effect on insulin receptors.Both the coumarins and the fenugreek alkaloid, trigonelline, caused hypoglycemia or inhibited experimentally-induced hype­glycemia in different animal models.</p> <p><strong>Clinical Trials:</strong></p> <p>The hypoglycemic and lipid-lowering effects of fenugreek seed have been studied in many clinical trials, almost all from India. Although all of these studies reported positive effects, most of the trials were small, and study methodology and reporting of data were generally of poor quality. Most of the trials were uncontrolled, and none of the controlled studies were blinded. </p> <p>In a placebo-controlled trial of 2.5 g b.Ld. of encapsulated fenu­greek seed, no effect was seen on cholesterol in healthy subjects, and platelet aggregation, fibrinolytic activity, and fibrinogen levels also were not affected. However, in a subgroup of 30 patients with type diabetes and coronary artery disease, reductions in total cholesterol (about 6%) and triglycerides (about 16%) were reported by the end of 3 months. However, this trial was not ran­domized; there was no mention of blinding; and the data were poorly reported-thus casting doubts on the reported beneficial results. In a recent RCT with 18 type diabetics, 25- and 50-g doses of defatted fenugreek were compared to placebo for 20 days. There were significant decreases in total cholesterol, triglyc­erides, and VLDL. Characteristics of blinding were not mentioned in the study. </p> <p><strong>Adverse Effects:</strong></p> <p>No significant adverse effects were reported in any of the clinical trials, apart from occasional flatulence and diarrhea. Rare allergic symptoms, including numbness, swelling, and wheezing, have been reported with fenugreek applied topically. An interesting side effect is the peculiar odor of maple syrup that fenugreek has been reported to impart to urine when ingested in large amounts. </p> <p><strong>Side Effects and Interactions</strong></p> <p>The absorption of drugs taken concomitantly with fenugreek may be delayed or impaired because of the herb's high mucilaginous fiber conten. This effect has not been studied. In a patient previously stabilized on warfarin, oral consumption of one fenugreek capsule and 10 drops of a boldo <em>(Peumus boldus) </em>extract, both with meals, was associated with an elevation of the INR (from 2.3 to 3.4). The effect was confirmed with rechallenge, but the cause and effect relationship with fenugreek is not known. </p> <p><strong>Cautions:</strong></p> <p>Occupational exposure to fenugreek has been reported to cause asthma, and inhalation of seed powder may cause allergic symptoms such as rhinorrhea and wheezing. Because of reported oxytocic and isolated uterine stimulant activity in animals, fenugreek in doses larger than those encountered in foods is not recommended during pregnancy.</p> <p><strong>Preparations </strong><strong>& </strong><strong>Doses:</strong></p> <p>Common oral preparations include pulverized seeds, capsules with seed powder, and teas. Purverized seeds have been mixed with water to make a paste and used as a poultice. Typically, the recommended dose for oral use is 1-6 g three times a day. Doses as high as 50-100 g/day have been used in clinical trials. </p> <p><strong>Summary Evaluation </strong></p> <p>Animal studies and inadequately controlled clinical trials suggest that fenugreek lowers serum cholesterol and glucose levels. However, high-quality controlled trials are lacking, and thus efficacy has not been adequately demonstrated. Because the herb appears safe and well tolerated, and may be a good source of fiber, it is not unreasonable for diabetic or hypercholesterolemic patients to try fenugreek supplements, as long as clinical effects are monitored. None of the other claimed uses or indications for fenugreek have been evaluated clinically.</p>

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