Generic Name: Avocado

Category

Herbs & Supplements

Synonyms

Abokado, aguacate, ahuacate, ahuacatl, alligator pear, avocado pear, avocato, Persea americana, Persea americana var. drymifolia Blake, Persea gratissima, Persea leiogyna, Persea nubigena var. guatamalensis L., Persea persea, Laurus persea.

Background

Avocados are fruits that contain 60% more potassium than bananas; they are also sodium and cholesterol-free. An avocado has a higher fat content (5 grams per serving) than other fruit, but the fat is monounsaturated fat, which is considered healthy when consumed in moderation. Diets rich in monounsaturated fatty acids can reduce total cholesterol levels in the blood and increase the ratio of high-density lipoprotein (HDL, "good" cholesterol) to low-density lipoprotein (LDL, "bad" cholesterol).

In addition to high cholesterol, avocado has been taken by mouth to treat osteoarthritis. Its oils have been used topically to treat wounds, infections, arthritis, and to stimulate hair growth. The seeds, leaves, and bark have been used for dysentery and diarrhea. It is also used in topical creams for regular skincare. Historically, the Amazonian natives used avocado to treat gout (inflamed foot), and the Mayan people believed it could keep joints and muscles in good condition, avoiding arthritis and rheumatism.

The most promising use for avocado is in a combination product, avocado/soybean unsaponifiables (ASU), which is a combination of avocado oil and soybean oil.

Caution is advised when taking Mexican avocado due to the constituents, estragole and anethole, which may be liver damaging and cancer causing.

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.

High cholesterol: Avocados added to the diet may lower total cholesterol, LDL ("bad" cholesterol), HDL ("good" cholesterol) and triglycerides. Additional study is needed before a strong recommendation can be made.
Grade: B

Osteoarthritis (knee and hip): A combination of avocado/soybean unsaponifiables (ASU) has been found beneficial in osteoarthritis of the knee and hip. Additional study using avocado alone is needed before a firm recommendation can be made.
Grade: B

Psoriasis: Early scientific study showed promising effects using avocado in a cream for psoriasis. Additional studies are needed in this area before a firm recommendation can be made.
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.
Aphrodisiac, arthritis, atherosclerosis (hardening of the arteries), cancer, chemoprotectant, connective tissue disorders, dermatitis, diarrhea, dysentery (severe diarrhea), eczema, gingivitis, gout (inflamed foot), hair growth, inflammation (oral), menstrual flow stimulant, neuralgia (nerve pain), periodontitis / gingivitis, scleroderma (a skin disease), sexual arousal, skin care, toothache, wound healing.

Dosing

Adults (18 years and older)

The avocado fruit is typically used for medicinal purposes, although the oil has also been studied. To reduce high cholesterol, ½ -1 ½ avocado, or 300 grams, consumed daily for two to four weeks has been used. Avocado-enriched diets, with 75% of the fat coming from the avocado, have also been studied for two to four weeks.

Children (younger than 18 years)

Safety, efficacy, and dosing have not been systematically studied. Use in children should be supervised by a qualified healthcare professional.

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

Avoid in individuals with a known allergy or hypersensitivity to avocado. An association between allergy to latex, chestnut, banana and/or avocado has been reported. Symptoms of allergy may include anaphylaxis, hives, vomiting, intestinal spasms, or bronchial asthma.

Side Effects and Warnings

In general, it appears that avocado is well tolerated and is likely safe when consumed in amounts commonly found in foods. Caution should be taken when used in people with hypersensitivity to latex.

Most skin adverse effects are due to allergy, and symptoms may include reddening of the skin, itching, hives, or eczema.

Adverse effects due to ASU (avocado/soybean unsaponifiables) include flu-like symptoms, paralysis, gastrointestinal disorders, nausea, gastralgia (stomach pain), vomiting, inflammation of the intestine, migraine headache with fever, headache, drowsiness, bronchial asthma, or vomiting.

Certain types of avocado oil may cause liver damage. Caution is advised when taking Mexican avocado due to the constituents, estragole and anethole, which may be liver damaging and cancer causing. Caution is advised in patients with compromised liver function.

Pregnancy and Breastfeeding

Taking avocado in medicinal amounts is not recommended during pregnancy or breastfeeding.

Some varieties of avocado may be unsafe during breastfeeding. The Guatemalan variety of avocado may cause mammary gland damage and reduce milk production.

Interactions

Interactions with Drugs

Avocado may decrease the effect of "blood thinning" or anti-inflammatory medications. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). Avocado may also interact with other types of anti-inflammatories.

Avocado may add to the effects of cholesterol-lowering medications. Patients taking these medications should consult with a qualified healthcare professional, including a pharmacist.

Avocado contains moderate amounts of tyramine and may increase the risk of high blood pressure when taken with monoamine oxidase inhibitors (MAOIs). Examples of MAOI drugs include isocarboxazid (Marplan®), phenelzine (Nardil®), and tranylcypromine (Parnate®). Caution is advised.

Interactions with Herbs and Dietary Supplements

Avocado may reduce the "blood thinning" effect of certain herbs and supplements, such as garlic or Ginkgo biloba. It may also interact with herbs and supplements that have anti-inflammatory effects. Caution is advised.

Avocado may add to the effects of cholesterol-lowering agents such as fish oil, garlic, guggul, red yeast and niacin.

Avocado contains moderate amounts of tyramine and may increase the risk of high blood pressure when taken with herbs and supplements that have monoamine oxidase inhibitor (MAOI) activity. Caution is advised.

Avocado is rich in beta-sitosterol. Consuming avocado concurrently with other supplements, including beta-sitosterol, could potentially lead to increased side effects.

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): Tracee Rae Abrams, PharmD (University of Rhode Island); Heather Boon, B.Sc.Phm, PhD (University of Toronto); Mary Giles, PharmD (University of Rhode Island); Cathy DeFranco Kirkwood, MPH (MD Anderson Cancer Center); Hope J. Lafferty, AM (Memorial Sloan-Kettering Cancer Center); Adrianne Rogers, MD (Boston University School of Medicine); Anneli Savinainen, MS (MPI); Lisa Scully, PharmD (University of Rhode Island); Erica Rusie, PharmD (Nova Southeastern University); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University); Jen Woods, BS (Northeastern University).

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.

Appelboom T, Schuermans J, Verbruggen G, et al. Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. A double blind, prospective, placebo-controlled study. Scand.J.Rheumatol. 2001;30(4):242-247.

Blickstein D, Shaklai M, Inbal A. Warfarin antagonism by avocado. Lancet 4-13-1991;337(8746):914-915.

Blotman F, Maheu E, Wulwik A, et al. Efficacy and safety of avocado/soybean unsaponifiables in the treatment of symptomatic osteoarthritis of the knee and hip. A prospective, multicenter, three-month, randomized, double-blind, placebo-controlled trial. Rev.Rhum.Engl.Ed 1997;64(12):825-834.

Diaz-Perales A, Blanco C, Sanchez-Monge R, et al. Analysis of avocado allergen (Prs a 1) IgE-binding peptides generated by simulated gastric fluid digestion. J.Allergy Clin.Immunol. 2003;112(5):1002-1007.

Duester, K. C. Avocado fruit is a rich source of beta-sitosterol. J.Am.Diet.Assoc. 2001;101(4):404-405.

Ernst E. Avocado-soybean unsaponifiables (ASU) for osteoarthritis - a systematic review. Clin.Rheumatol. 2003;22(4-5):285-288.

Henrotin YE, Sanchez C, Deberg MA, et al. Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes. J.Rheumatol. 2003;30(8):1825-1834.

Kim, O. K., Murakami, A., Nakamura, Y., Takeda, N., Yoshizumi, H., and Ohigashi, H. Novel nitric oxide and superoxide generation inhibitors, persenone A and B, from avocado fruit. J.Agric.Food Chem. 2000;48(5):1557-1563.

Kut-Lasserre, C., Miller, C. C., Ejeil, A. L., Gogly, B., Dridi, M., Piccardi, N., Guillou, B., Pellat, B., and Godeau, G. Effect of avocado and soybean unsaponifiables on gelatinase A (MMP-2), stromelysin 1 (MMP-3), and tissue inhibitors of matrix metalloproteinase (. J.Periodontol. 2001;72(12):1685-1694.

Lequesne M, Maheu E, Cadet C, et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis Rheum. 2002;47(1):50-58.

Levy, D. A., Mounedji, N., Noirot, C., and Leynadier, F. Allergic sensitization and clinical reactions to latex, food and pollen in adult patients. Clin.Exp.Allergy 2000;30(2):270-275.

Lopez Ledesma R, Frati Munari AC, Hernandez Dominguez BC, et al. Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia. Arch.Med.Res. 1996;27(4):519-523.

Maheu E, Mazieres B, Valat JP, et al. Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial with a six-month treatment period and a two-month followup demonstrating a persistent effect. Arthritis Rheum. 1998;41(1):81-91.

Perkin, J. E. The latex and food allergy connection. J.Am.Diet.Assoc. 2000;100(11):1381-1384.

Stucker M, Memmel U, Hoffmann M, et al. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis. Dermatology 2001;203(2):141-147.

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.