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Bitter melon (Momordica charantia L. Curcurbitaceae) has traditionally been used as a remedy for lowering blood sugar in patients with diabetes. Preliminary data exists on bitter melon use in HIV and cancer. Extracts and powdered formulations of the fruit are most frequently used, although teas made from the stems and leaves are sometimes recommended.
Bitter melon is also consumed as a foodstuff and is found as an ingredient in some south Asian curries. The raw fruit is available in specialty Asian markets where it is known as karela.
MAP30, a protein isolated from bitter melon extract, has been reported to possess anti-cancer activity, although potential anti-cancer effects have not been studied in humans. Additional study is needed before a strong recommendation can be made.
Diabetes mellitus (hypoglycemic agent):
Preliminary study has indicated that bitter melon may decrease serum glucose levels; however, reports are mixed. Because safety and efficacy have not been established, bitter melon should be avoided by diabetics except under the strict supervision of a qualified healthcare professional, including a pharmacist, with careful monitoring of blood sugars.
Human immunodeficiency virus (HIV):
Early studies have shown that a protein in bitter melon called MAP30 may have antiviral activity, but this has not been studied in humans. Further research is needed before a strong recommendation can be made.
Due to the wide variations in preparation techniques of bitter melon, the proper dosing cannot be determined at the present time. Bitter melon has sometimes been administered as a fruit juice in doses of 50 milliliters or 100 milliliters in diabetic patients. Juice formulations have been reported to have more potent effects on blood sugar and lab values than the powder of the sun-dried fruit. However, safety and efficacy have not been established for any specific dose(s) of bitter melon.
Subcutaneous administration of bitter melon has been studied in humans, although safety, efficacy, and dosing have not been clearly established.
There is not enough scientific data to recommend bitter melon for use in children. Caution is advised, based on two case reports of hypoglycemic coma in children following the ingestion of bitter melon tea.
Individuals with allergies to plants related to the bitter melon or members of the Curcurbitaceae (gourd or melon) family, including Persian melon, honeydew, casaba, muskmelon, and cantaloupe, may have allergic reactions to bitter melon.
Headaches have been reported after the ingestion of bitter melon seeds. However, details regarding severity and duration of headaches are limited. Considerable rises in liver enzymes have been observed in animals after drinking bitter melon fruit juice and seed extract. These rises, however, have not been associated with significant damage or changes in the liver. The clinical relevance in humans has not been studied, so caution is advised, particularly in patients with underlying liver disease. The seeds and outer-rind of bitter melon contain a toxic chemical (lectin), which inhibits protein synthesis in the intestinal wall. Although this has not been correlated with signs or symptoms in humans, ingestion of bitter melon seeds or outer rind should be avoided due to potential adverse effects.
Bitter melon may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar) 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. Two case reports have documented hypoglycemic coma and convulsions in children after the administration of a bitter melon tea.
Ingestion of bitter melon (or bitter melon seeds) should be avoided in patients with glucose-6-phosphate dehydrogenase (G6PDH) deficiency, due to the risk of hemolytic reaction and "favism." Favism is the onset of hemolytic anemia with symptoms including headache, fever, stomach pain, and coma. G6PDH deficiency and favism are most common in people from the Mediterranean and the Middle East.
The fertility rate of mice that were fed with daily bitter melon juice dropped from 90% to 20% in one study. Sperm production was inhibited in dogs that were fed a bitter melon fruit extract for 60 days. However, studies of a protein isolated from bitter melon seeds, called MAP30, have found that they do not affect sperm motility in laboratory studies.
Bitter melon is not recommended during pregnancy; two proteins isolated from the raw fruit possess properties that may cause an abortion in animals. Lowered fertility rates are also possible.