DRUGS AND SUPPLEMENTS

Nutmeg (Myristica fragrans, Myristica officinalis)

March 22, 2017

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Nutmeg (Myristica fragrans, Myristica officinalis)

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

  • Alpha-pinene, alpha-terpineol, basbas (Arabic), basbasah, (Arabic), basbaz (Persian), beta-phellandrene, beta-pinene, bicuiba (Portuguese), borneol, buah pala (Malay), bunga pala (Malay), chan thet (Thai), chant heed (Laotian), cineole, dâu khâu (Vietnamese), dehydrodiisoeugenol (DDIE), diarylpropanoids, dihydroguaiaretic acid (DHGA), dok chand (Thai), elemicin, erythro-austrobailignan-6 (EA6), estragole, eugenol, fatty lipids, fleur de muscade (French), flor de noz moscada (Brazilian Portuguese), foelie (Dutch), gamma-terpinene, gerinol, guaiacin, industan djevisi (Turkish), isoeugenol, isolicarin, jaaiipatrii (Nepali), jaayphala (Hindi), jadikkai (Tamil), jaephal (Hindi), jaiphal (Bengali), jaiphul (Hindi), jaitri (Hindi), jajikaia (Telugu), jajipatri (Sanskrit), jajiphalam (Sanskrit), japatri (Telugu), jathi seed (Malayalam), jathikkai (Thai), jati pattiri (Tamil), jatikka (Tamil), javitri (Hindi), jayaphal (Nepali), josat al teeb (Arabic), jousbuva (Arabic), jouzboyah (Persian), jouzuttib (Arabic), kambang pala (Malay, Java), kembang pala (Malay), licarin, lignans, lignan-ketone, ligroin, look jun (Thai), macelignan, machilin, macia (Spanish), macis (French, Spanish), malabaricone, meso-dihydroguaiaretic acid (DGA), methoxybenzene, methoxyeugenol, methyleugenol, moscada (Spanish), moscadeira (Portuguese), moscadero (Spanish), moschokarydo (Greek), muscadier (French), Muskatbaum (German), Muskatblüte (German), muskatnii orekh (Russian), muskatnød (Danish), muskatnogo orekha (Russian), muskatnoi drechi (Russian), Muskatnuβ (German), Muskatnuβbaum (German), muskott (Swedish), myristic acid, myristica, Myristica cagayanensis, Myristica fragrans, Myristica officinalis, Myristicae aril, Myristicaceae (family), Myristicae semen, myristicin, myrisisolignan, nectandrin-B (NB), neolignans, nhuc dâu khau (Vietnamese), nikuzuku (Japanese), noce moscata (Italian), nogal moscado (Spanish), noix de banda (French), noix muscade (French), nootmuskaat (Dutch), nootmuskaatboom (Dutch), noz moscada (Brazilian Portuguese), nuez moscada (Spanish), nutmeg, nux moschata, nuz moscada (Portuguese), otobanone, otobaphenol, pala (Indonesian), pala banda (Malay), pattiri (Tamil), pied de muscade (French), resorcinols, rou dou kou (Chinese), rou dou kou yi (Chinese), rou guo (Chinese), rou kou (Chinese), sadikka (Sinhalese), safrole, sekar pala (Malay), semen Myristicae, sushonaya shelukha (Russian), taiphal (Hindi), taipmal (Hindi), taukau (Chinese), terpene, terpinen-4-ol, terpineol, trimyristin, vicuiba (Telugu), volatile oil, yu guo (Chinese), yu guo hua (Chinese), zadeikpo (Burmese).

  • Note: Jamaican nutmeg (Monodora myristica) is a plant that has an aroma similar to nutmeg and has been sold as a substitute for nutmeg. However, it is in a different family (Annonaceae) and is not covered in this monograph.

Background

  • Nutmeg and mace are two commonly used spices that come from the same tree, Myristica fragrans. Nutmeg is made from the seed of the tree and mace from the seed covering. Papuan nutmeg (Myristica argentea), Bombay nutmeg (Myristica malabarica), and Jamaican nutmeg (Monodora myristica) are not true nutmeg.

  • Nutmeg is best known for its use in food. It is used in cooking around the world. Other traditional uses of nutmeg include treatment of diarrhea, mouth sores, and insomnia.

  • Nutmeg also has a history of abuse as a recreational drug. Severe nutmeg poisoning and, in some cases, death have been reported with consumption of very large amounts of nutmeg.

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.

  • Abortion inducing, antibacterial, antifungal, antihistamine, antioxidant, antispasmodic, antiviral, anxiety, aromatherapy, arthritis, bad breath, blood thinner, cancer, childbirth (topical), depression, diabetes, diarrhea, dyspepsia (upset stomach), expectorant (induces cough), fever, flavoring, food preservation, gas, gastritis (inflammation of the stomach), hallucinogenic, hemorrhoids, heart disease, high blood pressure, high cholesterol, hypnotic, inflammation, insecticide, kidney disease, leukemia, lice, liver protection, measles, memory, menstrual flow stimulant, mental illness, mood enhancement, mouth sores, narcotic, nausea, nerve damage, pain, preservative, radiation protection, sedative, sexual dysfunction, sleep disorders, stomach disorders, ulcers, vomiting, weight loss.

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)

  • Nutmeg has been taken by mouth as a powder or essential oil for stomach disorders. For toothache, nutmeg essential oil has been applied to the gum.

Children (under 18 years old)

  • Insufficient available evidence.

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 with known allergy or sensitivity to nutmeg, its constituents, or members of the Myristicaceae family.

Side Effects and Warnings

  • Nutmeg 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 glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Nutmeg may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Nutmeg may cause low blood pressure. Caution is advised in patients with low blood pressure and in those taking drugs, herbs, or supplements that lower blood pressure.

  • Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

  • Use caution in patients with epilepsy or in those who are taking antiseizure medication.

  • Avoid large amounts of nutmeg, especially in women who are pregnant.

  • Avoid with known allergy or sensitivity to nutmeg, its constituents, or members of the Myristicaceae family.

Pregnancy and Breastfeeding

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

  • Nutmeg may induce uterine contractions. Large amounts of nutmeg may cause miscarriage.

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

  • Nutmeg may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Nutmeg may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Nutmeg may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.

  • Nutmeg may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • Nutmeg may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Nutmeg may also interact with anesthetics, antiaging agents, antibiotics, anticancer agents, antidepressants, antifungal agents, anti-inflammatory agents, antipsychotics, antiseizure agents, antiulcer agents, antivirals, cholesterol-lowering agents, drugs that affect the nervous system, drugs that may damage the liver, drugs that protect against the harmful effects of radiation, fertility agents, heart drugs, laxatives, painkillers, prostaglandins, sedatives/hypnotics/anxiolytics, stimulants, and weight loss agents.

Interactions with Herbs and Dietary Supplements

  • Nutmeg 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.

  • Nutmeg may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Nutmeg may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.

  • Nutmeg may increase the amount of drowsiness caused by some herbs or supplements.

  • Nutmeg may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may change in the blood. It may also alter the effects that other herbs or supplements potentially may have on the P450 system.

  • Nutmeg may also interact with anesthetics, antiaging herbs and supplements, antibacterials, anticancer herbs and supplements, antidepressants, antifungals, anti-inflammatory herbs and supplements, antioxidants, antipsychotics, antiseizure herbs and supplements, antiulcer herbs and supplements, antivirals, cholesterol-lowering herbs and supplements, fertility herbs and supplements, herbs and supplements that may damage the liver, herbs and supplements used for the heart, herbs and supplements that affect the nervous system, herbs and supplements that protect against the harmful effects of radiation, laxatives, painkillers, sedatives, stimulants, and weight loss 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. Chirathaworn C, Kongcharoensuntorn W, Dechdoungchan T, et al. Myristica fragrans Houtt. methanolic extract induces apoptosis in a human leukemia cell line through SIRT1 mRNA downregulation. J Med Assoc Thai 2007;90(11):2422-8.View Abstract

  2. Demetriades AK, Wallman PD, McGuiness A, et al. Low cost, high risk: accidental nutmeg intoxication. Emerg Med J 2005;22(3):223-5.View Abstract

  3. Dorman HJ, Deans SG. Antimicrobial agents from plants: antibacterial activity of plant volatile oils. J Appl Microbiol 2000;88(2):308-16.View Abstract

  4. Duan L, Tao HW, Hao XJ, et al. Cytotoxic and antioxidative phenolic compounds from the traditional Chinese medicinal plant, Myristica fragrans. Planta Med 2009;75(11):1241-5.View Abstract

  5. Firouzi R, Shekarforoush SS, Nazer AH, et al. Effects of essential oils of oregano and nutmeg on growth and survival of Yersinia enterocolitica and Listeria monocytogenes in barbecued chicken. J Food Prot 2007;70(11):2626-30.View Abstract

  6. Forrester MB. Nutmeg intoxication in Texas, 1998-2004. Hum Exp Toxicol 2005;24(11):563-6.View Abstract

  7. Gonçalves JL, Lopes RC, Oliveira DB, et al. In vitro anti-rotavirus activity of some medicinal plants used in Brazil against diarrhea. J Ethnopharmacol 2005;99(3):403-7.View Abstract

  8. Hallström H, Thuvander A. Toxicological evaluation of myristicin. Nat Toxins 1997;5(5):186-92.View Abstract

  9. Kwon HS, Kim MJ, Jeong HJ, et al. Low-density lipoprotein (LDL)-antioxidant lignans from Myristica fragrans seeds. Bioorg Med Chem Lett 2008;18(1):194-8.View Abstract

  10. Misharina TA, Terenina MB, Krikunova NI. [Antioxidant properties of essential oils]. Prikl Biokhim Mikrobiol 2009;45(6):710-6.View Abstract

  11. Noiles K, Pratt M. Contact dermatitis to Vicks VapoRub. Dermatitis 2010;21(3):167-9.View Abstract

  12. Nguyen PH, Le TV, Kang HW, et al. AMP-activated protein kinase (AMPK) activators from Myristica fragrans (nutmeg) and their anti-obesity effect. Bioorg Med Chem Lett 2010;20(14):4128-31.View Abstract

  13. Rani P, Khullar N. Antimicrobial evaluation of some medicinal plants for their anti-enteric potential against multi-drug resistant Salmonella typhi. Phytother Res 2004;18(8):670-3.View Abstract

  14. Van Gils C, Cox PA. Ethnobotany of nutmeg in the Spice Islands. J Ethnopharmacol 1994;42(2):117-24.View Abstract

  15. Yang XW, Huang X, Ahmat M.[New neolignan from seed of Myristica fragrans]. Zhongguo Zhong Yao Za Zhi 2008;33(4):397-402.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