Note: Bitter almond should not be confused with "sweet almond." Sweet almond seeds do not contain amygdalin and can be eaten, whereas bitter almonds can be toxic.
Background
The almond is closely related to the peach, apricot, and cherry (all classified as drupes). The most commonly used portion of the almond is the nut. A compound called amygdalin differentiates the bitter almond from the sweet almond. In the presence of water (hydrolysis), amygdalin yields glucose and the chemicals benzaldehyde and hydrocyanic acid (HCN). HCN, the salts of which are known as cyanide, is poisonous. To be used in food or as a flavoring agent, the HCN must be removed from the bitter almond oil. Once it is removed, the oil is called volatile almond oil and is considered to be almost pure benzaldehyde. Volatile almond oil can still be toxic in large amounts.
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.
Cancer (Laetrile):
"Laetrile" is an alternative cancer drug marketed in Mexico and other countries outside of the United States. Laetrile is derived from amygdalin, found in the pits of fruits and nuts such as the bitter almond. Early evidence suggests that laetrile is not beneficial in the treatment of cancer. In 1982, the U.S. National Cancer Institute concluded that laetrile was not effective for cancer therapy. Nonetheless, many people still travel to use this therapy outside the United States. Multiple cases of cyanide poisoning, including deaths, have been associated with laetrile therapy.
Grade: D
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. Antibacterial, anti-inflammatory, anti-itch, antispasmodic, cough suppressant, expectorant, hyperoxia (lack of oxygen), local anesthetic, mental health (neuropsychometric symptoms in AIDS patients), muscle relaxant, pain suppressant, psoriasis, sedative.
Dosing
Adults (18 years and older)
Due to potential toxicity, there is no widely accepted standard dose for bitter almond.
Children (younger than 18 years)
Due to potential toxicity, bitter almond products should be avoided 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
Allergies to almonds are common and have lead to severe reactions, including throat swelling that interferes with breathing. If allergic to other nuts, it is probably best to avoid almonds.
Side Effects and Warnings
Laetrile, derived from the amygdalin found in the pits of fruits and nuts such as the bitter almond, is considered unsafe in any form due to its potential for causing cyanide toxicity. Reactions are more severe when laetrile is taken by mouth than when injected into a vein or muscle. Some of the side effects have included dilated pupils, dizziness, drooping eyelids, drowsiness, headache, increased breathing, muscle weakness, nausea, stomach pain, and vomiting. High doses of bitter almond or laetrile may lead to a slowing of brain functions or breathing. Several cases of cyanide poisoning (some fatal) have been reported.
Drowsiness or sedation may occur with bitter almond. Use cautiously if driving or operating heavy machinery.
Pregnancy and Breastfeeding
Bitter almonds are not recommended in pregnant or breastfeeding women due to insufficient available data and potential risk for birth defects.
Interactions
Interactions with Drugs
In theory, bitter almond may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery. Avoid the use of alcohol as almond oil was shown in mice to cause a toxic reaction (nausea, vomiting, increased breathing, sweating) when taken with alcohol.
Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.
Interactions with Herbs and Dietary Supplements
Bitter almond may increase the amount of drowsiness caused by some herbs or supplements. Caution is advised while driving or operating machinery.
Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.
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): Winnie Abrahamson, ND; Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cathy Dennehy, PharmD (University of California, San Francisco); Nicole Giese, MS (Natural Standard Research Collaboration); Michael Goble, BS, PharmD (Massachusetts College of Pharmacy); David Kroll, PhD (Duke University); Richard Liebowitz, MD (Duke University); Michael Smith, M.R.PharmS, ND (Canadian College of Naturopathic Medicine); David Sollars MAc, HMC (New England School of Acupuncture); Philippe Szapary, MD (University of Pennsylvania); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (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.
Araya E, Rodriguez A, Rubio J, et al. Synthesis and evaluation of diverse analogs of amygdalin as potential peptidomimetics of peptide T. Bioorg Med Chem Lett 2005 Mar 1;15(5):1493-6.
Beamer WC, Shealy RM, Prough DS. Acute cyanide poisoning from laetrile ingestion. Ann Emerg Med 1983;12(7):449-451.
Chan TY. A probable case of amygdalin-induced peripheral neuropathy in a vegetarian with vitamin B12 deficiency. Ther Drug Monit 2006;28(1):140-141.
Chang LW, Zhu HP, Li WB, et al. [Protective effects of amygdalin on hyperoxia-exposed type II alveolar epithelial cells isolated from premature rat lungs in vitro]. Zhonghua Er Ke Za Zhi 2005 Feb;43(2):118-23.
Gill JR, Marker E, Stajic M. Suicide by cyanide: 17 deaths. Journal of Forensic Sciences. 2004 Jul;49(4):826-8.
Hamada A, Yoshioka S, Takuma D, et al. The effect of Eriobotrya japonica seed extract on oxidative stress in adriamycin-induced nephropathy in rats. Biol Pharm Bull 2004 Dec;27(12):1961-4.
Liegner KB, Beck EM, Rosenberg A. Laetrile-induced agranulocytosis. JAMA 1981 Dec 18;246(24):2841-2842.
Milazzo S, Ernst E, Lejeune S, et al. Laetrile treatment for cancer. Cochrane Database Syst Rev 2006;(2):CD005476.
Moertel CG, Fleming TR, Rubin J, et al. A clinical trial of amygdalin (Laetrile) in the treatment of human cancer. N.Engl.J.Med. 1982 Jan 28;306(4):201-206.
Moss RW. Patient perspectives: Tijuana cancer clinics in the post-NAFTA era. Integr Cancer Ther 2005 Mar;4(1):65-86.
Shragg TA, Albertson TE, Fisher CJ, Jr. Cyanide poisoning after bitter almond ingestion. West J Med 1982;136(1):65-69.
Vickers A. Alternative cancer cures: "unproven" or "disproven"? CA Cancer J Clin 2004 Mar-Apr;54(2):110-8.
Vickers AJ, Kuo J, Cassileth BR. Unconventional anticancer agents: a systematic review of clinical trials. J Clin Oncol 1-1-2006;24(1):136-140.
Willhite CC. Congenital malformations induced by laetrile. Science 1982 March 19;215(4539):1513-1515.
Zhu H, Chang L, Li W, et al. Effect of amygdalin on the proliferation of hyperoxia-exposed type II alveolar epithelial cells isolated from premature rat. J Huazhong Univ Sci Technolog Med Sci. 2004;24(3):223-5.
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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