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fenugreek (generic name)

an herbal product - treats Galactagogue, Diabetes mellitus type 2, Diabetes mellitus type 1, and Hyperlipidemia
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Alternate Title

Trigonella foenum-graecum

Category

Herbs & Supplements

Synonyms

Abish, alholva, bird's foot, bockhornsklover, bockshornklee, bockshornsamen, cemen, chilbe, diosgenin, fenegriek, fenogreco, fenogrego, fenigreko, fenugree, fenugreek seed, fenu-thyme, foenugraeci semen, gorogszena, graine de fenugrec, gray hay, Greek hay seed, griechische Heusamen, fieno greco, halba, hilbeh, hulba, hu lu ba, kasoori methi, kozieradka pospolita, kreeka lambalaats, mente, mentikura, mentula, methi, methika, methini, methri, methro, mithiguti, pazhitnik grecheskiy, penantazi, sag methi, sambala, sarviapila, shabaliidag, shambelile, trigonella, trigonelline, trogonella semen, uluhaal, uwatu, vendayam, venthiam.

Background

Fenugreek has a long history of medical uses in Indian and Chinese medicine, and has been used for numerous indications, including labor induction, aiding digestion, and as a general tonic to improve metabolism and health.

Preliminary study has suggested possible hypoglycemic (blood sugar lowering) and anti-hyperlipidemic properties of fenugreek seed powder when taken by mouth. However, at this time, the evidence is not sufficient to recommend either for or against fenugreek for diabetes or hyperlipidemia. Nonetheless, caution is warranted in patients taking blood sugar-lowering agents, in whom blood glucose levels should be monitored. Hypokalemia (lowered potassium levels in the blood) has also been reported, and potassium levels should be followed in patients taking concomitant hypokalemic agents, or with underlying cardiac disease.

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.

Diabetes mellitus type 1: Review of the literature suggests a possible efficacy of fenugreek in type 1 diabetics. Although promising, these data cannot be considered definitive. At this time there is insufficient evidence to recommend either for or against the use of fenugreek for type 2 diabetes.
Grade: C

Diabetes mellitus type 2: Fenugreek has been found to lower serum glucose levels both acutely and chronically. Although promising, these data cannot be considered definitive, and at this time there is insufficient evidence to recommend either for or against fenugreek for type 2 diabetes. Additional study is warranted in this area.
Grade: C

Galactagogue (breast milk stimulant): Traditionally in India, fenugreek has been used to increase milk flow. Additional study is needed to confirm this finding.
Grade: C

Hyperlipidemia: There is insufficient evidence to support the use of fenugreek as a hyperlipidemic agent.
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.
Abortifacient (induces abortion), abscesses, antioxidant, aphthous ulcers, appetite stimulant, asthenia, atherosclerosis (hardening of the arteries), baldness, beriberi (vitamin B1 deficiency), boils, breast enhancement, bronchitis, burns, cancer, cellulitis, chapped lips, colic, colon cancer, constipation, convalescence (gradual healing), cough (chronic), dermatitis, diarrhea, digestion, dropsy, dysentery, dyspepsia (upset stomach), eczema, energy enhancement, food uses, furunculosis (acute skin disease), gas, gastritis, gastric ulcers, gout (foot inflammation), heart conditions, Helicobacter pylori infection, hepatic disease, hepatomegaly, hernia, high blood pressure, immunomodulator, impotence, indigestion, infections, inflammation, inflammatory bowel disease, insecticide, labor induction (uterine stimulant), leg edema, leg ulcers, leukemia, lice, liver damage, low energy, lymphadenitis (inflammation of the lymph nodes), menopausal symptoms, myalgia (muscle pain), postmenopausal vaginal dryness, protection against alcohol toxicity, rickets, splenomegaly (enlarged spleen), stomach upset, thyroxine induced hyperglycemia, tuberculosis, vitamin deficiencies, wound healing.

Dosing

Adults (18 years and older):

Products rich in fenugreek fiber may interfere with the absorption of oral medications due to its mucilaginous fiber content and high viscosity in the gut. Medications should be taken separately from such products. However, it should be noted that fenugreek is rarely used for its fiber content.

There is no proven effective dose of fenugreek in adults. For type 1 diabetes, 100 grams of debitterized powdered fenugreek seeds divided in two equal doses has been used. For type 2 diabetes, 2.5 grams of fenugreek seed powder in capsule form, twice daily for three months, or 25 grams seed powder, divided in two equal doses has been used. For hyperlipidemia, 2.5 grams of fenugreek seed powder in capsule form, twice daily for three months, or 100 grams debitterized powdered seeds divided in two equal doses has been used.

Children (younger than 18 years):

There is no proven effective dose of fenugreek in children.

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

Caution is warranted in patients with known fenugreek allergy, or with allergy to chickpeas due to possible cross-reactivity. Inhaling fenugreek seed powder may cause allergic or asthmatic reactions, including bronchospasm

Side Effects and Warnings

Fenugreek has traditionally been considered safe and well tolerated. There are rare reports of dizziness, diarrhea, gas, facial swelling, numbness, difficulty breathing (after inhalation from occupational exposure), fainting, increased risk of bleeding, reduction of blood sugars, reduction of serum potassium levels, and alteration of thyroid hormone levels.

Blood sugars should be followed in patients with diabetes. Patients should be monitored if taking anticoagulants or drugs that affect potassium levels.

Pregnancy and Breastfeeding

Literature review reveals no reliable human data or systematic study of fenugreek during pregnancy or lactation. Caution is warranted during pregnancy due to potential hypoglycemic effects. In addition, both water and alcoholic extracts of fenugreek exert a stimulating effect on isolated guinea pig uterus, especially during late pregnancy. As a result, fenugreek may possess abortifacient effects, and is usually not recommended for use in doses higher than found in foods during pregnancy.

Interactions

Interactions with Drugs

Products rich in fenugreek fiber may interfere with the absorption of oral medications due to its mucilaginous fiber content and high viscosity in the gut. Medications should be taken separately from such products.

Fenugreek is thought to possess both acute and chronic hypoglycemic properties. Concomitant use with other hypoglycemic agents may lower serum glucose more than expected, and levels should be monitored closely

Fenugreek should be used cautiously with medications that decrease blood potassium levels, diuretics, laxatives, mineralocorticoids, hormone replacement therapy (HRT), birth control pills, thyroid medications, corticosteroids, anticoagulants, cardiac glycosides, and monoamine oxidase inhibitors. Use cautiously when taking with drugs used for cancer or high cholesterol, or when taking with alcohol.

Interactions with Herbs and Dietary Supplements

Fenugreek 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.

Fenugreek 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.

Fenugreek should also be used cautiously with agents that decrease blood potassium levels, diuretic agents, laxatives, phytoestrogens, and herbs with monoamine oxidase inhibitor properties. Use cautiously when taking with drugs used for cancer, pain, heart conditions, thyroid conditions or high cholesterol. Fenugreek may interact with antioxidants.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MPhil (Memorial Sloan-Kettering Cancer Center); J. Kathryn Bryan, BA (Natural Standard Research Collaboration); Dilys Burke, BA (Natural Standard Research Collaboration); Lisa Cheung, PharmD (University of Rhode Island); Edzard Ernst, MD (University of Exeter); Nicole Giese, MS (Natural Standard Research Collaboration); Ivo Foppa, MD, ScD (University of South Carolina); Paul Hammerness, MD (Harvard Medical School); Sadaf Hashmi, MD, MPH (Natural Standard Research Collaboration); Grace Kuo, PharmD (Baylor College of Medicine); Michelle Miranda, PharmD (University of Rhode Island); Siddhartha Mukherjee, MD (Harvard Medical School); Michael Smith, M.R.PharmS., ND (Canadian College of Naturopathic Medicine); David Sollars, M.Ac, HMC (New England School of Acupuncture); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Nazhiyath Vijayan, MD (University of California, Davis); Minney Varghese, BS (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: 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.

Abdel-Barry JA, Abdel-Hassan IA, Jawad AM, et al. Hypoglycaemic effect of aqueous extract of the leaves of Trigonella foenum-graecum in healthy volunteers. East Mediterr Health J 2000;6(1):83-88.

Abdo MS, al Kafawi AA. Experimental studies on the effect of Trigonella foenum-graecum. Planta Med 1969;17(1):14-18.

Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 1997;56(5):379-384.

Damanik R, Wahlqvist ML, Wattanapenpaiboon N. Lactagogue effects of Torbangun, a Bataknese traditional cuisine. Asia Pac J Clin Nutr 2006;15(2):267-74.

Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. J Assoc Physicians India 2001;49:1057-1061.

Izzo AA, Di Carlo G, Borrelli F, et al. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol 2005 Jan;98(1):1-14.

Lambert JP, Cormier A. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21(4):509-512.

Madar Z, Abel R, Samish S, et al. Glucose-lowering effect of fenugreek in non-insulin dependent diabetics. Eur J Clin Nutr 1988;42(1):51-54.

Neeraja A, Pajyalakshmi P. Hypoglycemic effect of processed fenugreek seeds in humans. J Food Sci Technol 1996;33(5):427-430.

Panda S, Tahiliani P, Kar A. Inhibition of triiodothyronine production by fenugreek seed extract in mice and rats. Pharmacol Res 1999;40(5):405-409.

Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenumgraecum). Ann Allergy Asthma Immunol 1997;78(3):297-300.

Rao PU, Sesikeran B, Rao PS, et al. Short term nutritional and safety evaluation of fenugreek. Nutr Res 1996;16(9):1495-1505.

Shekelle PG, Hardy M, Morton SC, et al. Are Ayurvedic herbs for diabetes effective? J Fam Pract 2005 Oct;54(10):876-86.

Sowmya P, Rajyalakshmi P. Hypocholesterolemic effect of germinated fenugreek seeds in human subjects. Plant Foods Hum Nutr 1999;53(4):359-365.

Topaloglu AK, Zeller WP, Andersen BD, et al. Maternal fenugreek ingestion simulating maple syrup urine odor in the infant. Ann Med Sci 1996;5(1):41-42.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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