Lime (Citrus aurantifolia)
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.
AA, acid lime, Adam's apple, agua de limón (Spanish), ascorbic acid, β-pinene, baladi (Egypt, Sudan), bara nimbu, bijapura, bisabolene, citral, Citrus acida, Citrusaurantiifolia, Citrus lima, Citrus limetta, Citrus limetta var. aromatica, Citrus limmerttioides, Citrus medica var. acida, common lime, dayap (Tagalog), dayalap (Tagalog), dehydrofelodipine (primary metabolite of felodipine), doc (Morocco), felodipine, fenchone, furocoumarins, jeruk neepis (Malay), jeruk nipis (Indonesia), jeruk pecel (Indonesia), key lime, Krôôch chhmaa muul (Khmer), lamoentsji (Netherlands), lamunchi (Netherlands), large lime, lebu (India), lemmetje (Dutch), lime water, lima ácida (Portuguese, Spanish), lima boba (Spanish), lima chica (Spanish), limah (Arabic), limão galego (Portuguese), limau asam (Malaysia), limau neepis (Malay), limau nipis (Malay), limbu (India), lime (Danish), limeade, lime essential oil, lime flower (Tilia cordata Mill.), lime juice, lime mexicaine (French), lime oil, limetta (Italian), Limettae fructus, Limette, limette acide (French), Limettenbaum (German), Limettenzitrone (German), limettier (French), limey, limoen (Flemish), limón agria (Spanish), limón agrio (Spanish), limón chiquito (Spanish), limón corriente (Spanish), limón criollo (Spanish), limón sutil (Spanish), limonene, Limonia aurantiifolia, limun (India), limûn baladi (Egypt, Sudan), manao (Thai), Mexican lime, naaw (Laotian), ndimu (East African), nebu (India), nimbu (India), Opuntia vulgaris pads, oxypeucedanin, polyphenolic, Rutaceae (family), saure Limette (German), som manao (Thai), sour lime, suwa (Visayan), sweet limes, terpineol, turanj, West Indian lime.
"Lime" refers to a number of citruses with typically round, green to yellow fruits, which are frequently associated with the lemon. Lime fruit, particularly its juice and zest, is used in food and beverages for its flavor and floral aroma. Due to its acidity, it is also used for pickling. Dried limes are typically used as flavoring in Persian cuisine. According to the U.S. Food and Drug Administration (FDA), lime has generally recognized as safe (GRAS) status for use in food in the United States when it is taken by mouth in amounts commonly found in foods.
Lime is believed to be native to the tropical regions of Asia and the Malay Archipelago. It may have been brought to Persia, Palestine, Egypt, and Europe by Arabs from India at about the same time as sour orange and lemon. It is thought that lime was introduced to Florida in the United States during the establishment of St. Augustine in 1565. Today, south Florida is the source of more than 85% of North American limes.
In the 1700s, British sailors consumed limes and other citrus fruits on board ships to prevent rickets, which occurs from a lack of vitamin C. Hence, the sailors derived the nickname "limey."
Evidence of limeade's use in iron-deficient women is conflicting. Preliminary studies have observed a protective effect of lime against cholera, but there are no well-designed clinical trials at this time evaluating the use of lime in the treatment of other conditions.
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.
One study found that lime juice used in sauces might aid in the prevention of cholera. Another preliminary study suggested that using limes in the main meal may also have a protective effect; both studies were investigated by the same primary author. Additional study is needed before a firm recommendation can be made.
There is conflicting evidence regarding the effectiveness of lime's ability to increase iron absorption. Additional study is needed before a firm conclusion can be drawn.
*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).
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.
Acne, antimicrobial, antioxidant, antiseptic, arthritis, asthma, astringent, bad breath, cancer, chilblains (inflammation caused by the cold), colds, contraceptive (birth control), cough, detoxification, diarrhea (oral rehydration), diuretic (increases urine), dysentery (severe diarrhea), dyspepsia (upset stomach), fever, flu, genitourinary tract disorders, hair loss, headache, heart palpitations, hemorrhage (intestinal bleeding), hemorrhoids, HIV, immunomodulator, indigestion, insect bites, jaundice, liver disorders, nausea, neuralgia (nerve pain), rheumatism, sexually transmitted disease (prevention), scurvy (vitamin C deficiency), stimulant, stomach ailments, tonic, ulcers, varicose veins.
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 (over 18 years old)
There is no proven effective dose for lime. A limeade drink containing 25 milligrams ascorbic acid (vitamin C) has been studied, but showed no clear benefit.
Children (under 18 years old)
There is no proven effective dose for lime in children.
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.
Avoid in individuals with a known allergy or hypersensitivity to lime. When applied on the skin, lime oil may cause hypersensitivity. Distilled lime oil may be non-irritating, non-sensitizing and non-phototoxic to human skin, but expressed lime oil and lime peel may cause phototoxic skin reactions.
Side Effects and Warnings
Lime juice, peel and oil are generally considered safe to consume in food amounts, and few reported side effects, including photosensitivity, headaches, diarrhea and dental effects, have been noted in case reports and clinical studies. Lime has GRAS (generally recognized as safe) status for use in foods in the United States.
Lime is possibly safe for use when used orally in medicinal amounts, or when lime oil is applied on the skin in cosmetics.
Lime is possibly unsafe when applied on the skin in large amounts. Lime oil contains oxypeucedanin, which may cause photosensitization.
Lemon and lime juice are widely used for douches among women at high risk of HIV transmission. However, there is no evidence that lime douche is effective for this use and caution is advised.
Theoretically, distilled lime oils may promote tumors in the presence of carcinogenic chemicals.
Pregnancy and Breastfeeding
Lime is not recommended for pregnant or breastfeeding women if using in amounts greater than those typically found in foods because of insufficient available evidence.
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
Based on laboratory studies, lime may interfere with the way the body processes certain drugs using the liver's cytochrome P450 (CYP450) enzyme system. As a result, the levels of drugs metabolized via CYP450 may be affected in the blood, and may cause potentially serious adverse reactions. Some drugs that may be affected are benzodiazepines, calcium channel blockers, some HIV antivirals, some HMG CoA reductase inhibitors and some macrolide antibiotics.
Based on laboratory study, fresh lime juice in concentrations above 5% may increase the transport of digoxin across cell membranes. As a result, the levels of digoxin may be affected in the blood, and may cause altered effects or potentially serious adverse reactions, including overdose.
Concentrations of lime juice may enhance the absorption of [(14)C]-mannitol; this could result in excessive diuresis and lead to electrolyte abnormalities or kidney failure. Caution is advised.
Theoretically, use of lime oil with photosensitizing agents may increase the risk of phototoxicity.
Interactions with Herbs and Dietary Supplements
Based on laboratory study, lime may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 (CYP450) enzyme system. As a result, use may cause the levels of other herbs or supplements to be too high or too low in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
Based on laboratory and human study, there is conflicting evidence as to whether ascorbic acid (vitamin C) in limeade affects iron absorption. Preliminary study shows that limeade may increase iron absorption, but human study did not show any therapeutic effect in iron deficient women.
Based on laboratory study, a 30% concentration of lime juice may enhance the absorption of [(14)C]-mannitol; this could result in excessive diuresis, and lead to electrolyte abnormalities or renal failure.
Theoretically, use of lime oil with photosensitizing agents may increase the risk of phototoxicity.
Theoretically, concomitant use of herbs and supplements containing psoralens might potentiate effects and adverse reactions. Caution is advised.
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).
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.
Arias BA, Ramon-Laca L. Pharmacological properties of citrus and their ancient and medieval uses in the Mediterranean region. J Ethnopharmacol. 2-10-2005;97(1):89-95. View Abstract
Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin.Pharmacol.Ther. 2003;73(6):529-537. View Abstract
Kawaii S, Tomono Y, Katase E, et al. Antiproliferative effects of the readily extractable fractions prepared from various citrus juices on several cancer cell lines. J Agric.Food Chem 1999;47(7):2509-2512. View Abstract
Garcia OP, Diaz M, Rosado JL, et al. Ascorbic acid from lime juice does not improve the iron status of iron-deficient women in rural Mexico. Am.J.Clin.Nutr. 2003;78(2):267-273. View Abstract
Gharagozloo M, Ghaderi A. Immunomodulatory effect of concentrated lime juice extract on activated human mononuclear cells. J.Ethnopharmacol. 2001;77(1):85-90. View Abstract
Gharagozloo M, Doroudchi M, Ghaderi A. Effects of Citrus aurantifolia concentrated extract on the spontaneous proliferation of MDA-MB-453 and RPMI-8866 tumor cell lines. Phytomedicine. 2002;9(5):475-477. View Abstract
Gill JS, Bhagat CI. Acute copper poisoning from drinking lime cordial prepared and left overnight in an old urn. Med.J.Aust. 5-17-1999;170(10):510. View Abstract
Imade GE, Sagay AS, Onwuliri VA, et al. Use of lemon or lime juice douches in women in Jos, Nigeria. Sex Health. 2005;2(4):237-9. View Abstract
Lim SL, Lim LY. Effects of citrus fruit juices on cytotoxicity and drug transport pathways of Caco-2 cell monolayers. Int.J Pharm. 1-3-2006;307(1):42-50. View Abstract
Lissera RG, Luna Maldonado ER, Battellino LJ. In vitro erosive capacity of some fruit juices and soft or low alcoholic strength beverages on human teeth. Acta Odontol.Latinoam. 1998;11(1):55-71. View Abstract
Murcia MA, Jimenez AM, Martinez-Tome M. Evaluation of the antioxidant properties of Mediterranean and tropical fruits compared with common food additives. J Food Prot. 2001;64(12):2037-2046. View Abstract
Paine MF, Criss AB, Watkins PB. Two major grapefruit juice components differ in time to onset of intestinal CYP3A4 inhibition. J Pharmacol Exp.Ther. 2005;312(3):1151-1160. View Abstract
Rodrigues A, Sandstrom A, Ca T, et al. Protection from cholera by adding lime juice to food - results from community and laboratory studies in Guinea-Bissau, West Africa. Trop.Med.Int.Health 2000;5(6):418-422. View Abstract
Rodrigues A, Brun H, Sandstrom A. Risk factors for cholera infection in the initial phase of an epidemic in Guinea-Bissau: protection by lime juice. Am.J.Trop.Med.Hyg. 1997;57(5):601-604. View Abstract
Weber IC, Davis CP, and Greeson DM. Phytophotodermatitis: the other "lime" disease. J Emerg.Med. 1999;17(2):235-237. 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.
March 22, 2017