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Betel Nut (generic name)

treats Schizophrenia, Dental cavities, Stimulant, Ulcerative colitis, Anemia, Stroke recovery, and Saliva stimulant
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Alternate Title

Areca catechu L., Arecoline

Category

Herbs & Supplements

Synonyms

Amaska, Areca catechu, areca quid, areca nut, arecoline, arequier, betal, betel quid, betelnusspalme, chavica etal, gutkha, hmarg, maag, marg, mava, mawa, paan, Palmaceae (family), pan, pan masala, pan parag, pinang, pinlang, Piper betel Linn. (leaf of vine used to wrap betel nuts), pugua, ripe areca nut without husk, quid, Sting® (Tantric Corporation), supai, ugam.

Background

Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. Anecdotal reports have indicated that small doses generally lead to euphoria and increased flow of energy while large doses often result in sedation. Although all three ingredients may contribute to these effects, most experts attribute the psychoactive effects to the alkaloids found in betel nuts.

Betel nut is reportedly used by a substantial portion of the world's population as a recreational drug due to its stimulant activity. Found originally in tropical southern Asia, betel nut has been introduced to the communities of east Africa, Madagascar, and the West Indies. There is little evidence to support the clinical use of betel nut, but the constituents have demonstrated pharmacological actions. The main active component, the alkaloid arecoline, has potent cholinergic activity.

Constituents of betel nut are potentially carcinogenic. Long-term use has been associated with oral submucous fibrosis (OSF), pre-cancerous oral lesions (mouth wounds), and squamous cell carcinoma (cancer). Acute effects of betel chewing include worsening of asthma, low blood pressure, and rapid heart beat.

Evidence

DISCLAIMER: 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.

Anemia: Early poor-quality research reports that betel nut chewing may lessen anemia in pregnant women. Reasons for this finding are not clear, and betel nut chewing may be unsafe during pregnancy.
Grade: C

Dental cavities: Due to the known toxicities of betel nut use and the availability of other proven products for dental hygiene, the risks of betel nut may outweigh potential benefits.
Grade: C

Saliva stimulant: Betel nut chewing may increase salivation. However, it is not clear if this is helpful for any specific health condition. Due to known toxicities from betel nut use, the risks may outweigh any potential benefits.
Grade: C

Schizophrenia: Preliminary poor-quality studies in humans suggest improvements in symptoms of schizophrenia with betel nut chewing. However, side effects such as tremors and stiffness have been reported. More research is necessary before a firm conclusion can be drawn.
Grade: C

Stimulant: Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. It is believed that small doses can lead to stimulant and euphoric effects, and betel nut chewing is popular due to these effects. Chronic use of betel nuts may increase the risk of some cancers, and immediate effects can include worsening of asthma, high or low blood pressure, and abnormal heart rate. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.
Grade: C

Stroke recovery: Several poor-quality studies report the use of betel nut taken by mouth in patients recovering from stroke. In light of the potential toxicities of betel nut, additional evidence is needed in this area before a recommendation can be made.
Grade: C

Ulcerative colitis: Currently, there is a lack of satisfactory evidence to recommend the use of betel nut for ulcerative colitis. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. 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 healthcare provider. There may be other proposed uses that are not listed below.
Alcoholism, aphrodisiac, appetite stimulant, appetite suppressant, asthma, blindness from methanol poisoning, cough, dermatitis (used on the skin), digestive aid, diphtheria, diuretic, ear infection, excessive menstrual flow, excessive thirst, fainting, gas, glaucoma, impotence, intestinal worms, joint pain/swelling, leprosy, respiratory stimulant, toothache, veterinary uses (intestinal worms).

Dosing

Adults (18 years and older)

Betel nut can be chewed alone, but it is often chewed in combination with other ingredients (called a "quid") including calcium hydroxide, water, catechu gum, cardamom, cloves, anise seeds, cinnamon, tobacco, nutmeg, and gold or silver metal. These ingredients may be wrapped in a betel leaf, followed by sucking the combination in the side of the mouth. It is reported that ingestion of 8-30 grams of areca nut may be deadly.

Children (younger than 18 years)

Betel is not recommended in children due to risks of toxicity, including worsening symptoms of asthma, effects on the heart, and cancer.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Breathing problems with betel nut use have been reported, although no allergic reactions are noted in the available scientific literature. Caution is warranted in people with allergies to other members of the Palmaceae family.

Side Effects and Warnings

Betel nut cannot be considered safe for human use by mouth. This is due to toxic effects associated with short or long-term chewing or eating of betel nut.

Betel nut and chemicals in betel leaves may cause skin color changes, dilated pupils, blurred vision, wheezing/difficulty breathing, and increased breathing rate. Tremors, slow movements, and stiffness have been reported in people also taking anti-psychotic medications. Worsening of spasmodic movements has occurred in patients with Huntington's disease. Seizure has been reported with high doses.

"Cholinergic" toxicity symptoms from betel use may include salivation, increased tearing, lack of urinary control (incontinence), sweating, diarrhea, and fever. Other problems may include confusion, problems with eye movement, psychosis, amnesia, stimulant effects, and a feeling of euphoria. Long-term users may form a dependence on the effects of betel, and discontinuing use may cause signs of withdrawal, such as anxiety or memory lapse.

Chewing betel nuts can also cause nausea, vomiting, diarrhea, stomach cramps, chest pain, high or low blood pressure, and irregular heart beats. A heart attack occurred in a man immediately after chewing betel nut. It is not clear if betel was the cause.

Betel chewing has been shown to have a harmful effect on the gums. The nut may cause the teeth, mouth, lips, and stool to become red stained. Burning and dryness of mouth may occur.

Studies of Asian populations have linked pre-cancer conditions of the mouth and esophagus to betel use ("oral submucous fibrosis"). There may be a higher risk of cancers of the liver, mouth, stomach, prostate, cervix, and lung with regular betel use.

In animals, a chemical in betel nut alters blood sugar levels. Although human study is lacking in this area, caution is advised in people with diabetes or glucose intolerance, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. Betel nut chewers may have a higher risk of developing type 2 diabetes. Animal studies show mixed effects on thyroid function and increased skin temperature. Other problems can include increased blood calcium levels and kidney disease ("milk alkali syndrome"), possibly due to calcium carbonate paste sometimes used for preparing betel nuts for chewing.

Some betel nuts may be contaminated with harmful substances, including aflatoxin (a toxin produced by mold) or lead. Betel nut may cause metabolic syndrome, immunosuppression, and liver toxicity.

Pregnancy and Breastfeeding

Betel nut is not recommended during pregnancy and breastfeeding due to the risk of birth defects or spontaneous abortion.

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