DRUGS AND SUPPLEMENTS

Haritaki (Terminalia chebula)

March 22, 2017

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Haritaki (Terminalia chebula)

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

  • Abhaya (Sanskrit), amrita, black myroblan, chebulagic acid, chebulic acid, chebulic myroblan, chebulinic acid, chetaki, Combretaceae (family), fatty acids, fructus Chebulae, gall nut, harad (Hindi), harada, haradae, harade, harar, harida, haritaki (Sanskrit), horitoki, jivanti, kadukkaya (Tamil), karkchettu (Telugu), kashi, myroblan, putana, rohini, Terminalia chebula, vijaya.

Background

  • Haritaki is a common herbaceous plant used widely in Ayurvedic medicine, a traditional holistic medicine with origins in India. People eat the haritaki fruit in pickled or candied form and in fruit preserves.

  • Haritaki is used as a medicine for many conditions, the most common being constipation, digestive conditions, and infection. Haritaki fruit contains chemicals that have laxative and astringent effects. It may have also antibacterial, anti-inflammatory, antimicrobial, antioxidant, anti-allergic, and diuretic properties. Well-designed human studies are needed to determine if haritaki is safe and effective for treating any medical condition.

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*

No available studies qualify for inclusion in the evidence table.

*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.

  • Adaptogen (agents that help the body adapt to stress or other challenges), allergic rhinitis, anaphylaxis (a life-threatening allergic reaction), anemia, anti-inflammatory, antimicrobial, antioxidant, asthma, cardiotonic (an agent having a beneficial action the heart), colic, constipation, cough, dental plaque (oral bacteria), diabetes (type 2), digestive disorders, diuresis (increased urine), fever, flatulence, flu, hemorrhoids, herpes simplex virus type 1, high cholesterol, homeostasis (maintenance of a stable environment in the body), human immunodeficiency virus (HIV), jaundice, kidney disorders, liver protection, mouth rinse, rheumatic pain, rheumatoid arthritis, skin diseases, stomatitis (inflammation in the mouth), ulcers, urinary disorders, vomiting, 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)

  • There is no proven safe or effective dose for haritaki in adults. Haritaki has been taken by mouth as a dried powder, concentrated powder extract, and tablets.

Children (under 18 years old)

  • There is no proven safe or effective dose for haritaki 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

  • Avoid if allergic or hypersensitive to haritaki, Terminalia chebula, its constituents, or members of the Combretaceae family.

Side Effects and Warnings

  • Haritaki may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

  • Avoid in patients with known allergy or sensitivity to haritaki or its constituents.

  • Avoid if pregnant or breastfeeding, due to a lack of sufficient data.

Pregnancy and Breastfeeding

  • Haritaki is not recommended in pregnant or breastfeeding women, due to a lack of available scientific evidence.

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

  • Haritaki 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, including a pharmacist. Medication adjustments may be necessary.

  • Haritaki may also interact with antibiotics, anticancer agents, antifungals, anti-inflammatory agents, cholesterol lowering agents, antivirals, cardiovascular drugs, gastrointestinal agents, liver damaging agents, and sertraline.

Interactions with Herbs and Dietary Supplements

  • Haritaki may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood sugar levels may require monitoring, and doses may need adjustment.

  • Haritaki may also interact with antibacterials, anticancer herbs and supplements, antifungals, anti-inflammatory herbs and supplements, antioxidants, antivirals, cardiovascular herbs and supplements, cholesterol lowering herbs and supplements, gastrointestinal herbs and supplements, and liver damaging herbs and supplements.

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. Ballabh, B, Chaurasia, OP, Ahmed, Z, et al. Traditional medicinal plants of cold desert Ladakh-used against kidney and urinary disorders. J Ethnopharmacol. 7-23-2008;118(2):331-339. View Abstract

  2. Carounanidy, U., Satyanarayanan, R., and Velmurugan, A. Use of an aqueous extract of Terminalia chebula as an anticaries agent: a clinical study. Indian J Dent.Res 2007;18(4):152-156. View Abstract

  3. Kim, HG, Cho, JH, Jeong, EY, et al. Growth-inhibiting activity of active component isolated from Terminalia chebula fruits against intestinal bacteria. J Food Prot. 2006;69(9):2205-2209. View Abstract

  4. Kumar, MS, Kirubanandan, S, Sripriya, R, et al. Triphala promotes healing of infected full-thickness dermal wound. J Surg.Res 2008;144(1):94-101. View Abstract

  5. Kurokawa, M, Nagasaka, K, Hirabayashi, T, et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27(1-2):19-37. View Abstract

  6. Meena, AK, Bansal, P, Kumar, S, et al. Estimation of heavy metals in commonly used medicinal plants: a market basket survey. Environ. Monit. Assess. 12-18-2009;View Abstract

  7. Murali, YK, Anand, P, Tandon, V, et al. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced diabetic rats. Exp.Clin Endocrinol.Diabetes 2007;115(10):641-646. View Abstract

  8. Patel, RK, Gondaliya, DP, and Subramanian, S. Evaluation of commercial "Haradae" (Terminalia chebula). Indian Journal of Natural Products (India) 2004;19:511-518

  9. Prasad, KP, Tharangani, PG, and Samaranayake, CN. Recurrent relapses of depression in a patient established on sertraline after taking herbal medicinal mixtures--a herb-drug interaction? J Psychopharmacol 2009;23(2):216-219. View Abstract

  10. Sabu, MC and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. View Abstract

  11. Saravanan, S, Srikumar, R, Manikandan, S, et al. Hypolipidemic effect of triphala in experimentally induced hypercholesteremic rats. Yakugaku Zasshi 2007;127(2):385-388. View Abstract

  12. Senthilkumar, GP and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518

  13. Srikumar, R, Parthasarathy, NJ, Shankar, EM, et al. Evaluation of the growth inhibitory activities of Triphala against common bacterial isolates from HIV infected patients. Phytother.Res 2007;21(5):476-480. View Abstract

  14. Vonshak, A, Barazani, O, Sathiyamoorthy, P, et al. Screening South Indian medicinal plants for antifungal activity against cutaneous pathogens. Phytother.Res 2003;17(9):1123-1125. View Abstract

  15. Yukawa, TA, Kurokawa, M, Sato, H, et al. Prophylactic treatment of cytomegalovirus infection with traditional herbs. Antiviral Res 1996;32(2):63-70. 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