Asclepiadaceae (family), Asclepias geminata roxb., Gemnema melicida, GS4 (water soluble extract of the leaves), gur-mar, gurmar, gurmarbooti, Gymnema inodum, Gymnema montanum, Gymnema sylvestre, kogilam, madhunashini, mangala gymnema, merasingi, meshashringi, meshavalli, miracle plant, periploca of the woods, Periploca sylvestris, podapatri, Proβeta®, ram's horn, small Indian ipecac, sarkaraikolli, shardunika, sirukurinja, vishani.
Preliminary human evidence suggests that gymnema may be effective in the management of blood sugar levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. Gymnema appears to lower serum glucose and glycosylated hemoglobin (HbA1c) levels following chronic use, but may not have significant acute effects. High-quality human trials are lacking in this area. Some of the available research has been conducted by authors affiliated with manufacturers of gymnema products.
Preliminary human research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes when it is added to diabetes drugs being taken by mouth or to insulin. Further studies of dosing, safety, and effectiveness are needed before a strong recommendation can be made.
Gymnema sylvestre extract (GSE) has been shown to be effective for weight loss when used in combination with other products. The effects of gymnema are difficult to determine, and additional high-quality trials using gymnema alone are needed to confirm these results.
200 milligrams of extract GS4 taken by mouth twice daily or 2 milliliters of an aqueous decoction (10 grams of shade-dried powdered leaves per 100 milliliters) three times daily have been studied.
The manufacturer PharmaTerra recommends the dose for their product Proβeta® (GS4) to be two 250 milligram capsules taken twice daily at mealtimes (for adults weighing more than 100 pounds) or one 250 milligram capsule taken twice daily at mealtimes (for adults weighing less than 100 pounds).
There is not enough scientific evidence to safely recommend gymnema for use in children.
Allergy to gymnema may occur. In theory, allergic cross-reactivity may exist with members of the Asclepiadaceae (milkweed) family.
Aside from lowered blood sugar and increased effects of anti-diabetic drugs following chronic use of gymnema, no significant adverse effects were reported with the herb in multiple studies up to 20 months long. Caution is advised in patients with diabetes or 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 qualified healthcare professional, and medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels.
Gymnema is reported to suppress the ability to detect sweet tastes due to the component gurmarin. This phenomenon prompted the Hindi name gurmar or "sugar destroyer."
Gymnema should not be used during pregnancy or breastfeeding due to a lack of reliable safety information.
Gymnema may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.
Gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with drugs that lower cholesterol such as "statins" (HMGCoA reductase inhibitors) like lovastatin (Mevacor®) or atorvastatin (Lipitor®).
Gymnema may have additive effects with weight loss drugs.
Gymnema 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.
Gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with herbs or supplements that lower cholesterol, such as fish oil, garlic, guggul, or niacin.
Absorption of oleic acid (a fatty acid) may be decreased by gymnema.
Gymnema may have additive effects with herbs and supplements that help with weight loss. It may interact with chromium, fat-soluble vitamins, and garcinia.
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Theresa Davies-Heerema, PhD (Boston School of Medicine); Ivo Foppa, MD, ScD (University of South Carolina); Paul Hammerness, MD (Harvard Medical School); Erica Seamon, PharmD (Natural Standard Research Collaboration); Sarah Taylor, PharmD (University of Pittsburgh); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD, MBA[c] (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).
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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.