DRUGS AND SUPPLEMENTS

Avocado (Persea americana)

March 22, 2017

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Avocado (Persea americana)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Abokado, aguacate, ahuacate, ahuacatl, alligator pear, avocado pear, avocato, Persea americana, Persea americana var. drymifolia Blake, Persea gratissima, Persea leiogyna, Persea nubigena var. guatamalensis L., Persea persea, Laurus persea.

Background

  • Avocados are fruits that contain 60% more potassium than bananas; they are also sodium and cholesterol-free. An avocado has a higher fat content (5 grams per serving) than other fruit, but the fat is monounsaturated fat, which is considered healthy when consumed in moderation. Diets rich in monounsaturated fatty acids can reduce total cholesterol levels in the blood and increase the ratio of high-density lipoprotein (HDL, "good" cholesterol) to low-density lipoprotein (LDL, "bad" cholesterol).

  • In addition to high cholesterol, avocado has been taken by mouth to treat osteoarthritis. Its oils have been used topically to treat wounds, infections, arthritis, and to stimulate hair growth. The seeds, leaves, and bark have been used for dysentery and diarrhea. It is also used in topical creams for regular skincare. Historically, the Amazonian natives used avocado to treat gout (inflamed foot), and the Mayan people believed it could keep joints and muscles in good condition, avoiding arthritis and rheumatism.

  • The most promising use for avocado is in a combination product, avocado/soybean unsaponifiables (ASU), which is a combination of avocado oil and soybean oil.

  • Caution is advised when taking Mexican avocado due to the constituents, estragole and anethole, which may be liver damaging and cancer causing.

Scientific Evidence

Uses

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.

Grade*

High cholesterol

Avocados added to the diet may lower total cholesterol, LDL ("bad" cholesterol), HDL ("good" cholesterol) and triglycerides. Additional study is needed before a strong recommendation can be made.

B

Osteoarthritis (knee and hip)

A combination of avocado/soybean unsaponifiables (ASU) has been found beneficial in osteoarthritis of the knee and hip. Additional study using avocado alone is needed before a firm recommendation can be made.

B

Psoriasis

Early scientific study showed promising effects using avocado in a cream for psoriasis. Additional studies are needed in this area before a firm recommendation can be made.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/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 health care professional.

  • Aphrodisiac, arthritis, atherosclerosis (hardening of the arteries), cancer, chemoprotectant, connective tissue disorders, dermatitis, diarrhea, dysentery (severe diarrhea), eczema, gingivitis, gout (inflamed foot), hair growth, inflammation (oral), menstrual flow stimulant, neuralgia (nerve pain), periodontitis / gingivitis, scleroderma (a skin disease), sexual arousal, skin care, toothache, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • The avocado fruit is typically used for medicinal purposes, although the oil has also been studied. To reduce high cholesterol, ½ -1 ½ avocado, or 300 grams, consumed daily for two to four weeks has been used. Avocado-enriched diets, with 75% of the fat coming from the avocado, have also been studied for two to four weeks.

Children (younger than 18 years)

  • Safety, efficacy, and dosing have not been systematically studied. Use in children should be supervised by a qualified healthcare professional.

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

  • Avoid in individuals with a known allergy or hypersensitivity to avocado. An association between allergy to latex, chestnut, banana and/or avocado has been reported. Symptoms of allergy may include anaphylaxis, hives, vomiting, intestinal spasms, or bronchial asthma.

Side Effects and Warnings

  • In general, it appears that avocado is well tolerated and is likely safe when consumed in amounts commonly found in foods. Caution should be taken when used in people with hypersensitivity to latex.

  • Most skin adverse effects are due to allergy, and symptoms may include reddening of the skin, itching, hives, or eczema.

  • Adverse effects due to ASU (avocado/soybean unsaponifiables) include flu-like symptoms, paralysis, gastrointestinal disorders, nausea, gastralgia (stomach pain), vomiting, inflammation of the intestine, migraine headache with fever, headache, drowsiness, bronchial asthma, or vomiting.

  • Certain types of avocado oil may cause liver damage. Caution is advised when taking Mexican avocado due to the constituents, estragole and anethole, which may be liver damaging and cancer causing. Caution is advised in patients with compromised liver function.

Pregnancy and Breastfeeding

  • Taking avocado in medicinal amounts is not recommended during pregnancy or breastfeeding.

  • Some varieties of avocado may be unsafe during breastfeeding. The Guatemalan variety of avocado may cause mammary gland damage and reduce milk production.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. 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.

Interactions with Drugs

  • Avocado may decrease the effect of "blood thinning" or anti-inflammatory medications. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). Avocado may also interact with other types of anti-inflammatories.

  • Avocado may add to the effects of cholesterol-lowering medications. Patients taking these medications should consult with a qualified healthcare professional, including a pharmacist.

  • Avocado contains moderate amounts of tyramine and may increase the risk of high blood pressure when taken with monoamine oxidase inhibitors (MAOIs). Examples of MAOI drugs include isocarboxazid (Marplan®), phenelzine (Nardil®), and tranylcypromine (Parnate®). Caution is advised.

Interactions with Herbs and Dietary Supplements

  • Avocado may reduce the "blood thinning" effect of certain herbs and supplements, such as garlic or Ginkgo biloba. It may also interact with herbs and supplements that have anti-inflammatory effects. Caution is advised.

  • Avocado may add to the effects of cholesterol-lowering agents such as fish oil, garlic, guggul, red yeast and niacin.

  • Avocado contains moderate amounts of tyramine and may increase the risk of high blood pressure when taken with herbs and supplements that have monoamine oxidase inhibitor (MAOI) activity. Caution is advised.

  • Avocado is rich in beta-sitosterol. Consuming avocado concurrently with other supplements, including beta-sitosterol, could potentially lead to increased side effects.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Appelboom T, Schuermans J, Verbruggen G, et al. Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. A double blind, prospective, placebo-controlled study. Scand.J.Rheumatol. 2001;30(4):242-247. View Abstract

  2. Blickstein D, Shaklai M, Inbal A. Warfarin antagonism by avocado. Lancet 4-13-1991;337(8746):914-915. View Abstract

  3. Blotman F, Maheu E, Wulwik A, et al. Efficacy and safety of avocado/soybean unsaponifiables in the treatment of symptomatic osteoarthritis of the knee and hip. A prospective, multicenter, three-month, randomized, double-blind, placebo-controlled trial. Rev.Rhum.Engl.Ed 1997;64(12):825-834. View Abstract

  4. Diaz-Perales A, Blanco C, Sanchez-Monge R, et al. Analysis of avocado allergen (Prs a 1) IgE-binding peptides generated by simulated gastric fluid digestion. J.Allergy Clin.Immunol. 2003;112(5):1002-1007. View Abstract

  5. Duester, K. C. Avocado fruit is a rich source of beta-sitosterol. J.Am.Diet.Assoc. 2001;101(4):404-405. View Abstract

  6. Ernst E. Avocado-soybean unsaponifiables (ASU) for osteoarthritis - a systematic review. Clin.Rheumatol. 2003;22(4-5):285-288. View Abstract

  7. Henrotin YE, Sanchez C, Deberg MA, et al. Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes. J.Rheumatol. 2003;30(8):1825-1834. View Abstract

  8. Kim, O. K., Murakami, A., Nakamura, Y., Takeda, N., Yoshizumi, H., and Ohigashi, H. Novel nitric oxide and superoxide generation inhibitors, persenone A and B, from avocado fruit. J.Agric.Food Chem. 2000;48(5):1557-1563. View Abstract

  9. Kut-Lasserre, C., Miller, C. C., Ejeil, A. L., Gogly, B., Dridi, M., Piccardi, N., Guillou, B., Pellat, B., and Godeau, G. Effect of avocado and soybean unsaponifiables on gelatinase A (MMP-2), stromelysin 1 (MMP-3), and tissue inhibitors of matrix metalloproteinase (. J.Periodontol. 2001;72(12):1685-1694. View Abstract

  10. Lequesne M, Maheu E, Cadet C, et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis Rheum. 2002;47(1):50-58. View Abstract

  11. Levy, D. A., Mounedji, N., Noirot, C., and Leynadier, F. Allergic sensitization and clinical reactions to latex, food and pollen in adult patients. Clin.Exp.Allergy 2000;30(2):270-275. View Abstract

  12. Lopez Ledesma R, Frati Munari AC, Hernandez Dominguez BC, et al. Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia. Arch.Med.Res. 1996;27(4):519-523. View Abstract

  13. Maheu E, Mazieres B, Valat JP, et al. Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial with a six-month treatment period and a two-month followup demonstrating a persistent effect. Arthritis Rheum. 1998;41(1):81-91. View Abstract

  14. Perkin, J. E. The latex and food allergy connection. J.Am.Diet.Assoc. 2000;100(11):1381-1384. View Abstract

  15. Stucker M, Memmel U, Hoffmann M, et al. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis. Dermatology 2001;203(2):141-147. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017