Related Terms

• Alpha-monoglucosylrebaudioside A, alpha-monoglucosylstevioside, amaha sutebia (Japanese), Asteraceae (family), azucacaa, brazzein, caáché (Spanish), Ca-A-E, caá-eé (Portuguese - Brazil), caffeoyl-feruloylquinic acids, caffeoylshikimic acids, Canderel Green®, candyleaf, capim doce (Portuguese), Compositae (family), Crystal Light Pure Fitness, curculin, Cweet, dicaffeoylquinic acids, dihydroisosteviol (DHISV), dihydropsuedoivalin, dihydrosteviol A, diterpenoid glycosides, édesfu (Hungarian), ent-kaurenoic acid, epidihydropseudoivalin, erva doce (Portuguese), estevia (Spanish), estévia (Portuguese), estévia-doce (Portuguese), Ex Slim Energy™, feruloylquinic acid, folhas da stévia (Portuguese), glucopyranosyl ester, glucosilsteviol, glycosides, gurmaar (Punjabi), heuningblaar (Afrikaans), hierba dulce (Spanish), Honest Tea®, honey leaf, Honigkraut (German), honingkruid (Dutch), hydroxycinnamate, isosteviol, jázmin pakóca (Hungarian), ka'a he'e (Guaraní), kaa he-he (Guaraní), kaa jhee (Guaraní), luteolin, luteolin-7-O-beta-D-glucoside, mabinlin, madhu parani (Marathi), madhu patra (Sanskrit), madhu patri (Telugu), miraculin, monellin, monocaffeoylquinic acids, NPI-028, NSF-02, octa-acetylombuoside, ombuine, ombuoside, Paraguai suhkruleht (Estonian), Paraguayan sweet herb, p-coumaroylquinic acid, pentadin, piccolo arbusto con foglia dolce (Italian), Pure Via™, quercetin, quercitrin, rebaudioside, Rebiana, retusine, roninowa, ronion, RP44, rubusoside, S6793, sacharol, satiwia (Thai), SE, seeni tulsi (Tamil), SoBe Lifewater drinks, sød stevia (Danish), sötflockel (Swedish), sötstevia (Swedish), Steviacane, Stevia connata, stevia del norte de Paraguay (Spanish), Stevia eupatoria, stevia glycosides, Stevia lita, Stevia pilosa, Stevia PureCircle®, Stevia rebaudiana, Stevia rebaudiana standardized extracts (SSEs), Stevia salicifolia, Stevia subpubescens, Stevia tomentosa, Stevia triflora DC., Stevia viscida, steviol (SV), steviolbioside, stevioside (SVS), stevisalioside A, Stevita, stīviyyāh (Hebrew), sugar leaf, Sun Crystals All-Natural Sweetener, Süssblatt (German), Süsskraut (German), sweet herb, sweet honey leaf, sweet leaf, sweet leaf of Paraguay, sweet proteins, talin, thaumatin, tian jü (Chinese), tian jü ye (Chinese), tricaffeoylquinic acids, Truvia, UltraMeal® PLUS 360° Stevia, ya wan (Thai), yerba dulce (Spanish).

• Note: Stevia rebaudiana should not be confused with Stevia salicifolia, also called ronion or roninowa. Stevia salicifolia contains the bitter glycoside stevisalioside.

Background

• Stevia (Stevia rebaudiana) leaf extracts have been used for many years in traditional treatment of diabetes in South America. Paraguay's rural and indigenous populations have used stevia for birth control.

• Rebaudioside A and stevioside are steviol glycoside compounds extracted from stevia that are used as natural sweeteners or dietary supplements. These compounds reportedly possess up to 250 times the sweetness intensity of sucrose.

• Available research is promising for use of stevia in high blood pressure and type 2 diabetes, although more well-designed clinical trials are needed.

Scientific Evidence

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.

• Alcohol abuse, antibacterial, anti-inflammatory, antimicrobial, antimutagenic (prevents gene mutations), antineoplastic (antitumor), antioxidant, antiviral (human rotavirus activity), birth control, diarrhea, digestive aid, diuretic (increased urine flow), energy, food additive, immune system regulation, obesity.

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)

• For high blood pressure, the following doses have been taken by mouth: stevioside (250 milligrams) capsules three times daily for three months; capsules containing 500 milligrams of stevioside powder taken three times daily for two years.

• For high blood sugar, the following doses have been taken by mouth: one gram of stevioside with meals; water-based extracts of five grams of stevia leaves taken at regular six-hour intervals for three days.

Children (under 18 years old)

• There is no proven safe or effective dose for stevia 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 in people with a known allergy or hypersensitivity to stevia or to members of the daisy family (Asteraceae/Compositae). Other members of the daisy family include ragweed, chrysanthemums, marigolds, and many other herbs.

Side Effects and Warnings

• Stevia may cause abdominal fullness, dizziness, altered kidney function, changes in sodium excretion, changes in urine flow, muscle weakness, muscle pain, and nausea.

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

• Stevia may lower blood sugar levels. Caution is advised in people 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.

• Use cautiously in people with low blood calcium, impaired kidney function, kidney diseases, in people using agents that widen blood vessels (specifically calcium channel blockers), children, pregnant women, breastfeeding women, or for periods longer than two years.

• Avoid in people with a known allergy or hypersensitivity to stevia or to members of the daisy family (Asteraceae/Compositae). Other members of the daisy family include ragweed, chrysanthemums, marigolds, and many other herbs.

Pregnancy and Breastfeeding

• Use cautiously in pregnant or breastfeeding women, due to insufficient available data.

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

• Stevia may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

• Stevia may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People 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.

• Stevia may also interact with agents that affect blood vessel width, agents used for the heart, antifungals, anti-inflammatories, antimicrobials, anticancer drugs, antivirals, appetite suppressants, calcium channel blockers, cholesterol-lowering drugs, drugs that increase urination, fertility agents, hormonal agents, memory-enhancing agents, and sodium monoketocholate (MKC).

Interactions with Herbs and Dietary Supplements

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

• Stevia 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.

• Stevia may also interact with antifungals, anti-inflammatories, antimicrobials, antioxidants, anticancer herbs and supplements, antivirals, appetite suppressants, cholesterol-lowering herbs and supplements, herbs and supplements that increase urination, herbs and supplements used for the heart, herbs and supplements that affect blood vessel width, fertility agents, hormonal agents, memory-enhancing agents, sugar, and sugar alcohols.

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. Ahmad, N., Fazal, H., Abbasi, B. H., et al. In vitro larvicidal potential against Anopheles stephensi and antioxidative enzyme activities of Ginkgo biloba, Stevia rebaudiana and Parthenium hysterophorous. Asian Pac.J Trop Med 2011;4(3):169-175. View Abstract

2. Anton, S. D., Martin, C. K., Han, H., et al. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite 2010;55(1):37-43. View Abstract

3. Barriocanal, L. A., Palacios, M., Benitez, G., et al. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul.Toxicol.Pharmacol. 2008;51(1):37-41. View Abstract

4. Chan, P., Tomlinson, B., Chen, Y. J., et al. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol 2000;50(3):215-220. View Abstract

5. Curi, R., Alvarez, M., Bazotte, R. B., et al. Effect of Stevia rebaudiana on glucose tolerance in normal adult humans. Braz.J.Med.Biol.Res. 1986;19(6):771-774. View Abstract

6. Ferri, L. A., Alves-Do-Prado, W., Yamada, S. S., et al. Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension. Phytother Res 2006;20(9):732-736. View Abstract

7. Geuns, J. M., Buyse, J., Vankeirsbilck, A., et al. Metabolism of stevioside by healthy subjects. Exp Biol Med (Maywood.) 2007;232(1):164-173. View Abstract

8. Gregersen, S., Jeppesen, P. B., Holst, J. J., et al. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism 2004;53(1):73-76. View Abstract

9. Hsieh, M. H., Chan, P., Sue, Y. M., et al. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clin Ther 2003;25(11):2797-2808. View Abstract

10. Koyama, E., Kitazawa, K., Ohori, Y., et al. In vitro metabolism of the glycosidic sweeteners, stevia mixture and enzymatically modified stevia in human intestinal microflora. Food Chem.Toxicol. 2003;41(3):359-374. View Abstract

11. Koyama, E., Sakai, N., Ohori, Y., et al. Absorption and metabolism of glycosidic sweeteners of stevia mixture and their aglycone, steviol, in rats and humans. Food Chem.Toxicol. 2003;41(6):875-883. View Abstract

12. Maki, K. C., Curry, L. L., Carakostas, M. C., et al. The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure. Food Chem.Toxicol. 2008;46 Suppl 7:S40-S46. View Abstract

13. Puri, M., Sharma, D., and Tiwari, A. K. Downstream processing of stevioside and its potential applications. Biotechnol.Adv 2011;29(6):781-791. View Abstract

14. Roberts, A. and Munro, I. Stevioside and related compounds: therapeutic benefits beyond sweetness. Pharmacol Ther 2009;122(3):e1-e2. View Abstract

15. Taware, A. S., Mukadam, D. S., and Chavan, A. M. Antimicrobial Activity of Different Extracts of Callus and Tissue Cultured Plantlets of Stevia Rebaudiana (Bertoni). Journal of Applied Science Research 2010;6(7):883-887.