Does garcinia cambogia have drug interactions

Does garcinia cambogia have drug interactions
Se ven más poco clara para algunas soluciones sorprendentes que les dan resultados dentro del marco de tiempo breve .

Garcinia Cambogia

GENERIC NAME(S): Chromium-Brindal Berry

OTHER NAME(S): Garcinia Cambogia Tablet

How to use Garcinia Cambogia

Consult your pharmacist.

Side Effects

Consult your pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Consult your pharmacist.

Related Links

Interactions

Consult your pharmacist.

Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Missed Dose

Consult your pharmacist.

Consult your pharmacist.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised July 2016. Copyright(c) 2016 First Databank, Inc.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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Garcinia (hydroxycitric acid)

Scientific Name(s): Garcinia cambogia (Gaertn.) Desr. Family: Clusiaceae (Guttiferae)

Common Name(s): Malabar tamarind , hydroxycitric acid ( HCA )

The medical literature primarily documents weight loss and lipid-lowering activity for the plant. However, trials supporting its use are limited.

The dosages of G. cambogia extract in clinical trials ranged from 1,500 to 4,667 mg/day (25 to 78 mg/kg/day). The equivalent hydroxycitric acid (HCA) dose in the trials ranged from 900 to 2,800 mg/day (15 to 47 mg/kg/day). G. cambogia is available in capsule or tablet form with a maximum dose of 1,500 mg/day.

Contraindications

Avoid use if there is a known allergy or hypersensitivity to any components of G. cambogia .

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

The herb has documented drug interactions.

Adverse Reactions

At least 15 clinical studies involving approximately 900 patients document very mild adverse reactions. Most adverse reactions included headache, dizziness, dry mouth, and GI complaints such as nausea and diarrhea.

Toxicology

Toxicology studies resulted in no toxicity or deaths in animals at dosages of HCA 5,000 mg/kg, equivalent to 350 g or 233 times the maximum dosage of 1.5 g/day of HCA. In patients taking certain combination weight-loss supplements containing G. cambogia , severe or even fatal hepatotoxicity may occur.

The genus Garcinia is mainly distributed in tropical regions and includes approximately 200 species. G. cambogia belongs to the family Guttiferae and is found in India, Malaysia, and Africa. G. cambogia is commonly found in evergreen or semievergreen forests of southwest India, where 36 other species have been documented. 1 , 2 The plant species has variability in its branching pattern, fruit color, shape, and size. 1 The tree is small-to-medium in size with drooping branches. The leaves are dark green and glossy, oval-shaped with a narrow end, 5 to 12 cm in length, and 2 to 7 cm around. The tree is tolerant to drought and flowers during the hot season. The yellow, orange, or red fruit ripens during the rainy season and contains HCA. It is ovoid in shape, 5 centimeters around, has 6 to 8 seeds, and is listed in the US Department of Agriculture inventory of perennial edible fruits. 2

Dried fruit rinds have been used extensively for centuries throughout Southeast Asia for culinary purposes as a condiment and flavoring agent in place of tamarind or lemon. Additional culinary uses include the flavoring of curries, meat, and seafood. The fruit extract has been used as a flavoring agent for beverages and gourmet spices, as well as a carminative, thereby helping to prevent the formation of gas in the GI tract after a meal. HCA and other organic acids from the dried rind combined with salt help lower pH and provide a bacteriostatic effect used in curing fish. The herb is considered beneficial for overall health in the traditional Ayurvedic medical system. Rheumatism and bowel complaints are treated with a decoction of the fruit rind. A rinse is used from the herbal extract in veterinary medicine for some diseases of the mouth in cattle. HCA has also become popular as an ingredient for weight loss. 2 , 3 , 4

HCA is the primary medicinal component contained in the fruit rinds of G. cambogia . 5 HCA is present as up to 30% by weight in the pericarp of G. cambogia fruit. 6 Xanthones, xanthone derivatives, and polyisoprenylated benzophenones have been isolated.

If you don’t have sapling then you can use the seeds.

6 , 7 Some salts used in commercial products are water soluble and bioavailable, and are a good source of calcium (495 mg) and potassium (720 mg). 8 Studies also document interest in production of HCA by using microorganisms. 9 , 10

Uses and Pharmacology

The medical literature primarily documents research on the weight loss and lipid-lowering activity of the plant.

In vitro and animal data

In 2 experiments using the human hepatoma cell line HepG2, overnight exposure to G. cambogia extract caused an upregulation of low-density lipoprotein (LDL) receptor activity and an upregulation of the level of HMG-CoA reductase resulting in decreased cholesterol synthesis. 11 Flavonoids from the plant reduced lipid levels in normal and hypercholesterolemic rats. 7 Reductions were also documented in triglycerides, phospholipids, and free fatty acids. The mechanism of action for the flavonoids may involve: (1) reducing the rate of lipogenesis by reducing the activities of lipogenic enzymes, glucose-6-phosphate dehydrogenase, and isocitrate dehydrogenase; and (2) increasing the rate of degradation of cholesterol leading to higher levels of hepatic and fecal bile acids, as well as neutral sterols in rats treated with the herb. While dexamethasone typically elevates lipid profiles, G. cambogia extract maintained normal lipid levels in rats administered dexamethasone. 12

In a 4-week randomized, double-blind, placebo-controlled trial, 150 obese patients were treated with a dietary supplement ( G. cambogia extract 55 mg, chitosan 240 mg, and chrome 19 mg) together with a weight reduction regimen. Treatment groups administered the dietary supplement showed statistically significant dose-related reductions in weight, total and LDL cholesterol, and triglycerides, and improvement in high density lipoprotein cholesterol. 13

The suggested mechanism of action involves HCA-inhibiting lipogenesis, increasing lipid oxidation, and reducing food intake. 3 , 14

A study in obese rats found high doses of HCA-containing G. cambogia (154 mmol HCA/kg diet) effective in suppressing epididymal adipose tissue. This same study also found testicular atrophy and toxicity at dosages of 778 mg HCA/kg body weight/day (102 mmol HCA/kg diet) and higher. 4 Another study in rats administered a high-fat diet and a mixture of G. cambogia extract, soypeptide, and L-carnitine, led to a reduction in body weight and accumulation of visceral fat mass. 15 The mixture also improved blood and hepatic lipid concentrations or the induced dyslipidemia in the rats. Other combination products with G. cambogia are also effective in reducing weight gain and improving dyslipidemia, hyperinsulinemia, hyperleptinemia, and fatty liver in mice. 16 The antiobesity effect involves modulation of several genes associated with visceral adipogenesis. One study in adult, nonobese cats found no effect on fat-free mass or energy expenditure. 17

In an 8-week randomized clinical trial, 40 patients were given either placebo or G. cambogia extract (500 mg/capsule) by mouth before each meal. Patients administered the extract exhibited weight loss and improvement in cholesterol and triglycerides when compared with the placebo group. 2

In a 12-week, randomized, double-blind, placebo-controlled study, 40 obese patients were treated with a combination supplement containing G. cambogia 50 mg as well as a 1,200 calorie diet per day. Two tablets of the supplement were taken by mouth 3 times a day after meals. The treatment group attained a 3.5 kg weight loss versus 1.2 kg on placebo, and a more than 85% reduction in fat loss in body composition measurements. The majority of the active group participants did not follow the diet regimen. 18

In a 12-week, double-blind, placebo-controlled, parallel group trial, 89 mildly overweight women were treated with a 1,200 kcal diet along with 2 caplets of G. cambogia 400 mg or matched placebo 3 times a day before each meal. At the end of the trial, both groups lost weight, but the treatment group achieved greater reduction in body weight. G. cambogia had no effect on appetitive variables. 14

Numerous studies document the safety profile of the calcium-potassium double salt of 60% HCA preparation (HCA-SX), as well as its bioavailability and efficacy in helping patients attain a healthy body weight. 3 , 19 , 20 , 21 , 22 , 23

An 8-week, randomized, placebo-controlled, double-blind study examined the efficacy of HCA-SX in 54 overweight patients. The treatment group was administered a combination supplement containing G. cambogia 500 mg 3 times a day while the control group received the placebo. All patients were asked to maintain a low-fat diet and drink 64 oz of water per day. The treatment group lost an average weight of 11.14 lb/person as compared with the control group, which lost an average of 4.2 lb/person. 19

Another 8-week, randomized, placebo-controlled, double-blind study examined the efficacy of HCA in 60 obese patients. The dosage regimen for HCA was 400 mg 3 times a day before each meal. All patients were on a low-fat diet and also instructed to exercise 3 times a week. Results indicated weight loss for the experimental group compared with the placebo group and that 87% of the weight loss in the HCA group was because of fat loss. Appetite scores were also reduced in the HCA-treated group. 19

Visceral, subcutaneous, and total fat accumulation were reduced in 39 patients over 16 weeks in a double-blind, randomized, placebo-controlled trial. The dosage regimen included HCA 1,000 mg/day versus placebo. At the end of the treatment, both groups were administered placebo for 4 weeks and no rebound effect was documented. 24

Another clinical study documented that treatment with HCA failed to produce weight change and fat mass change in patients. 25 However, the design of the clinical trial, the lack of bioavailability, and dosage of HCA used have been criticized.

Perfect Nutra Garcinia Cambogia Results When I actually started to take Perfect Nutra Garcinia Cambogia.

But if you maintain a healthy diet and take the recommended dose of Garcinia cambogia per day, you may be able to lose more weight than someone who is eating the same diet and maintains the same exercise routine as you – at least according to current clinical studies.

2

Other pharmacologic activity

Some studies found that supplementation with G. cambogia can reduce oxidative damage. 26

The fruit contains xanthones, which inhibit pre-neoplastic lesions in mammary and colon cancer. The xanthones may also induce apoptosis in mouth, leukemia, breast, gastric, and lung cancer cell lines in vitro. 27

Glucose metabolism may be improved by lowering serum insulin levels in mice treated with G. cambogia . Leptin is a hormone associated with appetite control. G. cambogia may have leptin-like activity as mice treated with G. cambogia had decreased serum leptin levels and a reduced leptin/white adipose tissue ratio. 28 HCA treatment delayed and reduced intestinal glucose absorption in rats; the treatment causes delayed intestinal absorption of glucose rather than delayed gastric emptying. 29

HCA promoted lipid oxidation and reduced carbohydrate use in mice at rest and during running. 30 The utilization of respiratory gases was reduced for mice treated with HCA at rest and during exercise. Some studies on herbal coffee supplements with HCA showed an increase in resting energy expenditure to enhance metabolic rates and promote weight and fat loss. 31 , 32

Antiulcer activity was observed against induced gastric mucosal injury in rats with pretreatment of G. cambogia extract that decreased volume and acidity of gastric juice. 33 A similar study in rats found activity against indomethacin-induced gastric ulcers. 34 The anti-inflammatory activity of G. cambogia protected against induced colitis in rats. 35

Red blood cell count

A G. cambogia extract caused an increase in the red blood cell (RBC) count in rat tissue. The activity may be (1) associated with the iron in G. cambogia , as iron is an erythropoietic agent; (2) antioxidant activity and may decrease the rate of oxidant-induced hemolysis, which increases the life span of the RBC; or (3) the content of bioflavonoids in the plant, which may increase the level of peripheral testosterone, which can stimulate erythropoiesis in humans. 36

The dosages of G. cambogia extract in clinical trials ranged from 1,500 to 4,667 mg/day (25 to 78 mg/kg/day). The equivalent HCA dose in the trials ranged from 900 to 2,800 mg/day (15 to 47 mg/kg/day). 2 , 14 , 18 , 19 , 23 , 24 , 25 G. cambogia is available in capsule or tablet form with a maximum dose of 1,500 mg/day.

Pregnancy/Lactation

Due to lack of clinical and scientific information, use should be avoided during pregnancy and lactation. One animal study in rats documented decreased maternal body weight gain during gestation. 37

Interactions

In patients taking medications for diabetes by mouth or insulin, G. cambogia may lower blood sugar levels. 28 , 29

G. cambogia contains iron and thus may have additive adverse reactions for patients taking medications for anemia. 36

Potassium and calcium supplements

Some commercial G. cambogia products contain adequate amounts of potassium and calcium. 8 Caution is advised for patients taking medications for heart disease, high blood pressure, or arrhythmia while supplementing with any product containing this herb.

A mouse study using a commercial polyherbal product containing G. cambogia found a potential serotonergic effect on food intake. Caution is advised for patients being treated for pain or taking medications for any psychiatric condition. 38

Singulair (or leukotriene receptor antagonists)

One case report documented fatal liver failure in a patient taking Singulair and 2 dietary supplements, one of which included G. cambogia and citrus derivatives. 39

A case report of rhabdomyolysisis is documented in a patient taking a combination herbal medicine containing G. cambogia . 40

In one case report, the international normalized ratio of a patient returned to normal after he stopped taking a combination herbal product containing G. cambogia . 41

Adverse Reactions

A total of 15 clinical studies involving approximately 900 patients documented very mild adverse reactions. Most adverse reactions included headache, dizziness, dry mouth, and GI complaints such as nausea and diarrhea. 2 , 42

Toxicology

Toxicology studies resulted in no toxicity or deaths in animals at HCA dosages of 5,000 mg/kg, equivalent to 350 g or 233 times the maximum dose of 1.5 g/day of HCA. 5 In patients taking certain combination weight-loss supplements containing G. cambogia , severe or even fatal hepatotoxicity may occur. 43 , 44 Some animal studies document testicular toxicity, 4 , 45 while other studies do not. 46 , 47

No unusual electrocardiographic effects (QTc interval or other electrocardiograph variables) were seen over 5 hours in patients taking half the recommended dose of a multicomponent weight loss supplement containing G. cambogia . 48 Patients receiving G. cambogia extract (1,667.3 mg/kg equivalent to 1,000 mg HCA/day) for 12 weeks exhibited no reproductive toxicity on serum testosterone, estrone, and estradiol levels. 49

Bibliography

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3. Ohia SE, Opere CA, LeDay AM, Bagchi M, Bagchi D, Stohs SJ. Safety and mechanism of appetite suppression by a novel hydroxycitric acid extract (HCA-SX). Mol Cell Biochem . 2002;238(1-2):89-103.

4. Saito M, Ueno M, Ogino S, Kubo K, Nagata J, Takeuchi M. High dose of Garcinia cambogia is effective in suppressing fat accumulation in developing male Zucker obese rats, but highly toxic to the testis. Food Chem Toxicol . 2005;43(3):411-419.

5. Jena BS, Jayaprakasha GK, Singh RP, Sakariah KK. Chemistry and biochemistry of (-)-hydroxycitric acid from Garcinia .

This takes a lot of effort and strong willpower, but you shouldn’t get discouraged because it is far from being impossible.

J Agric Food Chem . 2002;50(1):10-22.

6. Masullo M, Bassarello C, Suzuki H, Pizza C, Piacente S. Polyisoprenylated benzophenones and an unusual polyisoprenylated tetracyclic xanthone from the fruits of Garcinia cambogia . J Agric Food Chem . 2008;56(13):5205-5210.

7. Koshy AS, Anila L, Vijayalakshmi NR. Flavonoids from Garcinia cambogia lower lipid levels in hypercholesterolemic rats. Food Chem . 2001;72(3):289-294.

8. Downs BW, Bagchi M, Subbaraju GV, Shara MA, Preuss HG, Bagchi D. Bioefficacy of a novel calcium-potassium salt of (-)-hydroxycitric acid. Mutat Res . 2005;579(1-2):149-162.

9. Hida H, Yamada T, Yamada Y. Production of hydroxycitric acid by microorganisms. Biosci Biotechnol Biochem . 2005;69(8):1555-1561.

10. Yamada T, Hida H, Yamada Y. Chemistry, physiological properties, and microbial production of hydroxycitric acid. Appl Microbiol Biotechnol . 2007;75(5):977-982.

11. Berkhout TA, Havekes LM, Pearce NJ, Groot PH. The effect of (-)-hydroxycitrate on the activity of the low-density-lipoprotein receptor and 3-hydroxy-3-methylglutaryl-CoA reductase levels in the human hepatoma cell line Hep G2. Biochem J . 1990;272(1):181-186.

12. Mahendran P, Devi CS. Effect of Garcinia cambogia extract on lipids and lipoprotein composition in dexamethasone administered rats. Indian J Physiol Pharmacol . 2001;45(3):345-350.

13. Girola M, De Bernardi M, Contos S, et al. Dose effect in lipid-lowering activity of a new dietary integrator (chitosan), Garcinia combogia extract and chrome. Acta Toxicol Ther . 1996;17(1):25-40.

14. Mattes RD, Bormann L. Effects of (-)-hydroxycitric acid on appetitive variables. Physiol Behav . 2000;71(1-2):87-94.

15. Kim YJ, Kim KY, Kim MS, Lee JH, Lee KP, Park T. A mixture of the aqueous extract of Garcinia cambogia , soy peptide and L: -carnitine reduces the accumulation of visceral fat mass in rats rendered obese by a high fat diet. Genes Nutr . 2008;2(4):353-358.

16. Kim KY, Lee HN, Kim YJ, Park T. Garcinia cambogia extract ameliorates visceral adiposity in C57BL/6J mice fed on a high-fat diet. Biosci Biotechnol Biochem . 2008;72(7):1772-1780.

17. Leray V, Dumon H, Martin L, et al. No effect of conjugated linoleic acid or Garcinia cambogia on fat-free mass, and energy expenditure in normal cats. J Nutr . 2006;136(suppl 7):1982S-1984S.

18. Thom E. A randomized, double-blind, placebo-controlled trial of a new weight-reducing agent of natural origin. J Int Med Res . 2000;28(5):229-233.

19. Lau FC, Bagchi M, Sen C, Roy S, Bagchi D. Nutrigenomic analysis of diet-gene interactions on functional supplements for weight management. Curr Genomics . 2008;9(4):239-251.

20. Talpur N, Echard BW, Yasmin T, Bagchi D, Preuss HG. Effects of niacin-bound chromium, Maitake mushroom fraction SX and (-)-hydroxycitric acid on the metabolic syndrome in aged diabetic Zucker fatty rats. Mol Cell Biochem . 2003;252(1-2):369-377.

21. Bagchi D, Deshmukh NS, Soni MG, Bagchi M. Safety of a novel calcium/potassium salt of (-)-hydroxycitric acid: I. Two generation reproduction toxicity study. Toxicol Lett . 2007;172(suppl 1):S190.

22. Asghar M, Monjok E, Kouamou G, Ohia SE, Bagchi D, Lokhandwala MF. Super CitriMax (HCA-SX) attenuates increases in oxidative stress, inflammation, insulin resistance, and body weight in developing obese Zucker rats. Mol Cell Biochem . 2007;304(1-2):93-99.

23. Preuss HG, Rao CV, Garis R, et al. An overview of the safety and efficacy of a novel, natural(-)-hydroxycitric acid extract (HCA-SX) for weight management. J Med . 2004;35(1-6):33-48.

24. Hayamizu K, Ishii Y, Kaneko I, et al. Effects of Garcinia cambogia (hydroxycitric acid) on visceral fat accumulation: A double-blind, randomized, placebo-controlled trial. CurrTher Res Clin Exp . 2003;64(8):551-567.

25. Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA . 1998;280(18):1596-1600.

26. Yonei Y, Takahashi Y, Hibino S, Watanabe M, Yoshioka T. Effects on the human body of a dietary supplement containing L-carnitine and Garcinia cambogia extract: a study using double-blind tests. J Clin Biochem Nutr . 2008;42(2):89-103.

27. Mazzio EA, Soliman KF. In vitro screening for the tumoricidal properties of international medicinal herbs. Phytother Res . 2009;23(3):385-398.

28. Hayamizu K, Hirakawa H, Oikawa D, et al. Effect of Garcinia cambogia extract on serum leptin and insulin in mice. Fitoterapia . 2003;74(3):267-273.

29. Wielinga PY, Wachters-Hagedoorn RE, Bouter B, et al. Hydroxycitric acid delays intestinal glucose absorption in rats. Am J Physiol Gastrointest Liver Physiol . 2005;288(6):G1144-G1149.

30. Ishihara K, Oyaizu S, Onuki K, Lim K, Fushiki T. Chronic (-)-hydroxycitrate administration spares carbohydrate utilization and promotes lipid oxidation during exercise in mice. J Nutr . 2000;130(12):2990-2995.

31. Hoffman JR, Kang J, Ratamess NA, Jennings PF, Mangine G, Faigenbaum AD. Thermogenic effect from nutritionally enriched coffee consumption. J Int Soc Sports Nutr . 2006;3:35-41.

32. Taylor LW, Wilborn CD, Harvey T, Wismann J, Willoughby DS. Acute effects of ingesting Java Fittrade mark energy extreme functional coffee on resting energy expenditure and hemodynamic responses in male and female coffee drinkers. J Int Soc Sports Nutr . 2007;4:10.

33. Mahendran P, Sabitha KE, Devi CS. Prevention of HCl-ethanol induced gastric mucosal injury in rats by Garcinia cambogia extract and its possible mechanism of action. Indian J Exp Biol . 2002;40(1):58-62.

34. Mahendran P, Vanisree AJ, Shyamala Devi CS. The antiulcer activity of Garcinia cambogia extract against indomethacin-induced gastric ulcer in rats. Phytother Res . 2002;16(1):80-83.

35. dos Reis SB, de Oliveira CC, Acedo SC, et al.

Basically, HCA accelerates the burning of excess stored fat.

Attenuation of colitis injury in rats using Garcinia cambogia extract. Phytother Res . 2009;23(3):324-329.

36. Oluyemi KA, Omotuyi IO, Jimoh OR, Adesanya OA, Saalu CL, Josiah SJ. Erythropoietic and anti-obesity effects of Garcinia cambogia (bitter kola) in Wistar rats. Biotechnol Appl Biochem . 2007;46(pt 1):69-72.

37. Deshmukh NS, Bagchi M, Yasmin T, Bagchi D. Safety of a novel calcium/potassium salt of (-) hydroxycitric acid (HCA-SX): II. Developmental toxicity study in rats. Toxicol Mech Methods . 2008;18(5):443-451.

38. Kaur G, Kulkarni SK. Investigations on possible serotonergic involvement in effects of OB-200G (polyherbal preparation) on food intake in female mice. Eur J Nutr . 2001;40(3):127-133.

39. Actis GC, Bugianesi E, Ottobrelli A, Rizzetto M. Fatal liver failure following food supplements during chronic treatment with montelukast. Dig Liver Dis . 2007;39(10):953-955.

40. Mansi IA, Huang J. Rhabdomyolysis in response to weight-loss herbal medicine. [Published correction appears in: Am J Med Sci . 2004;328(2):129.] Am J Med Sci . 2004;327(6):356-357.

41. Ferris DJ. Interaction between warfarin and Garcinia cambogia (Fat Burner); a case report. ASHP Midyear Clinical Meeting . 38(DEC): p P-404(D). 2003.

42. Pittler MH, Schmidt K, Ernst E. Adverse events of herbal food supplements for body weight reduction: systematic review. Obes Rev . 2005;6(2):93-111.

43. Shim M, Saab S. Severe hepatotoxicity due to Hydroxycut: a case report. Dig Dis Sci . 2009;54(2):406-408.

44. Lobb A. Hepatoxicity associated with weight-loss supplements: a case for better post-marketing surveillance. World J Gastroenterol . 2009;15(14):1786-1787.

45. Anno T, Oono H, Tamura K. Improvement of testicular toxicity in F/344DuCrj male rats fed Ca-type Garcinia cambogia extract by zinc supplemented diets. Nippon Shokuhin Kagaku Gakkaishi . 2005;12(3):121-127.

46. Shara M, Ohia SE, Yasmin T, et al. Dose- and time-dependent effects of a novel (-)-hydroxycitric acid extract on body weight, hepatic and testicular lipid peroxidation, DNA fragmentation and histopathological data over a period of 90 days. Mol Cell Biochem . 2003;254(1-2):339-346.

47. Burdock G, Soni M, Bagchi M, Bagchi D. Garcinia cambogia toxicity is misleading. [Published correction appears in: Food Chem Toxicol . 2007;45(3):515.] Food Chem Toxicol . 2005;43(11):1683-1684; author reply 1685-1686.

48. Min B, McBride BF, Kardas MJ, et al. Electrocardiographic effects of an ephedra-free, multicomponent weight-loss supplement in healthy volunteers. Pharmacotherapy . 2005;25(5):654-659.

49. Hayamizu K, Tomi H, Kaneko I, Shen M, Soni MG, Yoshino G. Effects of Garcinia cambogia extract on serum sex hormones in overweight subjects. Fitoterapia . 2008;79(4):255-261.

Copyright © 2009 Wolters Kluwer Health

Garcinia Cambogia

What is Garcinia cambogia?

Garcinia cambogia is an extract obtained from the dried fruit of the Garcinia cambogia (GC) tree, a native plant species of South India and South Asia. 1,2 The fruit looks like a small green pumpkin, and is used extensively in Asian-style cooking for its sour flavor.

What is the active ingredient and how does it work?

The skin, or rind of Garcinia cambogia fruit contains large amounts of hydroxycitric acid (HCA). HCA is a derivative of citric acid, and is marketed as a weight loss supplement, either alone or in combination with other supplements. 1,2

How HCA works to promote weight loss is not precisely known, but several theories exist. Some experts believe it works by inhibiting an enzyme called citrate lyase, interfering with the conversion of unused carbohydrates into fat. Although HCA does have this effect on carbohydrates in a laboratory petri dish, it is unproven whether it does this once inside the body. 1,2

Other experts suggest HCA affects other enzymes involved in carbohydrate metabolism, such as pancreatic alpha amylase and intestinal alpha glucosidase. A few postulate that it increases the release or availability of serotonin in the brain, promoting appetite suppression. 1,2 Nobody knows for sure just how HCA works… or if it really does work.

Is there any evidence to support Garcinia cambogia as a weight loss supplement?

Several trials have investigated use of Garcinia cambogia for weight loss in humans. Some of these trials are of better quality than others, and reviews that group trials together to look for an overall effect give us a better “bigger picture” than just looking at the results of a single trial.

An analysis in 2011 by Onakpoya et al 1 found 12 trials that investigated the effect of Garcinia cambogia for weight loss that matched their strict quality criteria. Although they found evidence that Garcinia cambogia did promote weight loss in the short term, the effect was small and barely significant. The same conclusion was reached in another review by Fassina et al 2 in 2015 of 17 trials, both in humans and animals. Interestingly, in one of the largest individual trials of 135 people, both the active group (the group taking GC) and the control group (the group taking a placebo – or an inactive supplement) lost a significant amount of weight over a 12-week treatment period. 3 As many other previous trials have suggested, it is often the support and encouragement people receive to lose weight that makes more of a difference than any diet or supplement.

In summary, evidence so far does not suggest Garcinia cambogia is effective as a weight loss supplement; although larger scale trails conducted over a longer period of time may shed more light on the subject.

For now, increasing physical activity levels, avoiding alcohol, and eating a healthier diet with more vegetables, whole grains, and less red meat is more likely to make you shed weight long-term than Garcinia cambogia supplements.

Is there any harm in taking Garcinia cambogia supplements?

It is important to remember that ANY product labeled as “natural” or “herbal” is not unquestionably safe.

Hey, I even heard stories about people taking Garcinia 1 hour after their meal, because it helps them to stop snacking between meals, stops their emotional eating, and that is a good thing!

Herbal remedies classified as dietary supplements in the United States are regulated as food products. This means they have not been subjected to the same requirements for safety or efficacy as medicines.

Garcinia cambogia has been implicated in causing liver damage, both when used in combination with other ingredients (for example, in the original formulation of the product Hydroxycut) and when used by itself. Two severe cases are documented. The first was a 52-year-old female who developed severe liver failure requiring a liver transplant after taking 1000 mg of Garcinia cambogia for 15 days, and the other was a 42-year-old female who developed abnormally high liver function tests and coagulopathy (an impaired ability of the blood to clot) after one week of taking GC. 4 The second lady recovered without incident several days after Garcinia cambogia was discontinued. Interestingly, the manufacturer of Hydroxycut temporarily withdrew the product, but it has since returned a reformulated version that lacks Garcinia cambogia to the market. 5

Other reported adverse effects are generally mild when Garcinia cambogia is taken at the recommended dosage and include stomach upset, dry mouth, headaches, dizziness, and diarrhea. 2,6 Herbal remedies should not be taken by women who are pregnant or breastfeeding and anybody with heart disease or other medical conditions should consult their doctor before use. Some studies have suggested that Garcinia cambogia can lower blood sugar or interfere with diabetes control, so it is particularly important if you have diabetes that you talk with your doctor.

On the positive side, unlike stimulants such as phentermine, Garcinia cambogia does not act on the central nervous system, so does not cause sleeplessness, anxiety, affect the heart or blood pressure, and its efficiency does not decrease with time. 5,6,7

Does Garcinia cambogia have any effect on blood sugars?

There have been several contradictory claims about the effects Garcinia cambogia has on blood glucose control with some celebrity endorsements even suggesting it may be beneficial for people with diabetes. While studies in rats have shown a reduction in the amount of glucose absorbed and less of a spike in blood glucose levels following a meal, rats are not humans so studies were needed to determine if this also applied to humans.

Thazhath et al 8 took 12 healthy participants and 8 people with diabetes and compared the effects of hydroxycitric acid (the active ingredient of Garcinia cambogia) plus glucose to water plus glucose in a cross-over type trial. Although some reduction in blood sugar levels were seen in healthy people, there was no reduction in the blood sugar levels in people with diabetes. Other markers, such as insulin response, were not affected.

Other human studies have also failed to support use of Garcinia cambogia for blood sugar control. Yonei et al 9 tested the effects of daily supplementation with Garcinia cambogia extract (500 mg/day as hydroxycitric acid) and L-carnitine (600 mg/day) on 35 healthy individuals aged 40-60 with a BMI of 24 or higher. After 8 weeks’ supplementation, the group receiving Garcinia cambogia had an increase of 4.5% in their total cholesterol, 4.1% in their fasting blood sugar levels, and 3.4% in their HbA1c (provides a reflection of long-term glucose control).

Conversely, a 2008 10 study reported a significant reduction in total cholesterol and LDL-cholesterol when Garcinia cambogia extract was combined with Amorphophallus konjac (also known for its weight loss properties). However, no effect was seen on triglyceride or glucose levels.

Generally speaking, most trials 11 have not shown Garcinia cambogia to have an effect on blood sugars or insulin control; one trial reported a lowering in healthy non-diabetic subjects while another reported an increase in fasting blood sugar levels in overweight individuals. Even though laboratory studies on human cells and animal studies suggested Garcinia cambogia reduced cell synthesis of lipids and increased degradation of cholesterol, human trials have been contradictory. No effects on triglycerides have been reported. Based on the evidence available, Garcinia cambogia is unlikely to have an effect on blood glucose or cholesterol levels, and does not appear beneficial for people with diabetes.

Does Garcinia cambogia interact with any medications?

Garcinia cambogia may interact with the following:

  • Diabetes medications, including insulin – variable effects reported, always consult a doctor before use if you have diabetes. 12,13,14,15

Other possible, but unsubstantiated, interactions include:

  • Iron supplements – several informative sites state Garcinia cambogia contains iron 12 ; however, most supplements use an extract of Garcinia cambogia, which is unlikely to contain high amounts of iron. Several other fruits (such as prunes, persimmons, and passion fruit) also contain iron but are not reported as interacting with iron supplements
  • Serotonin-stimulating antidepressants (such as Celexa, Paxil, Zoloft) or pain medications (such as tramadol) – one mouse study 16 suggested Garcinia cambogia had a serotonin-enhancing effect; however, this has not been verified in humans
  • Asthma medications (including montelukast) – one documented case study 17 of a woman who developed fatal liver failure after taking two dietary supplements (one of which was Garcinia cambogia) for two weeks on top of her usual asthma medications, including montelukast
  • Statins – this is based on the fact that statins can cause rhabdomyolysis (a destruction of muscle cells). One case study 18 reported rhabdomyolosis in a women taking a combination weight loss supplement (of which one of the ingredients was garcinia cambogia); so some experts are concerned about a theorectical additive effect with statins (she was not taking a statin at the time)
  • Warfarin – A man taking warfarin together with a combination herbal product that included Garcinia cambogia, reported a change in his INR (a measure of the clotting ability of the blood) that returned to normal after discontinuation of the supplement.