Drugs A - Z
Carob (Ceratonia siliqua)
Generic Name: locust bean gum
CategoryHerbs & Supplements
Alanine, algaroba, arobon, Caesalpinioideae (subfamily), carob bean gum, carob flour, carob gum, carobel, caruba, cellulose, ceratonia gum, Ceratonia siliqua, cheshire gum, China-Eisenwein, cinnamic acid, Fabaceae (family), flavonoids, free gallic acid, fructose, galactomannan, gallic acid, gallotannins, glucose, glycine, goma de garrofín, gomme de caroube, gumilk, hemicellulose, Leguminosae (family), leucine, locust bean, locust bean gum, maltose, methyl gallate, Pomana A, phenolic antioxidants, phenylalanine, praline, St. John's bread, sucrose, tannins, Thiacyl au Caroube, tyrosine, valine.
Carob (Ceratonia siliqua) is a leguminous evergreen tree of the family Leguminosae (pulse family). Although it was originally native to Mediterranean regions, it is now cultivated in many warm climates, including Florida and California. The pods may be ground into a flour, which is often used as a cocoa substitute because it has a somewhat similar taste to chocolate and one-third the calories.
There is conflicting data on the effect of carob bean gum as a formula thickener and its effect on regurgitation frequency. The use of soluble dietary fibers, such as carob bean gum, has been shown to alter food structure, texture and viscosity, the rate of starch degradation during digestion, and the regulation of postprandial blood sugar and insulin levels.
EvidenceDISCLAIMER: 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.
Hypercholesterolemia (high cholesterol):
Fiber, such as oat fiber, has been shown to reduce serum cholesterol levels. Carob pod fiber or carob bean gum may also have this ability, although additional research is needed to confirm these findings.
Diarrhea in children:
Traditionally, carob has been used for the treatment of gastrointestinal conditions, especially diarrhea. Preliminary study used different types of carob products as an adjunct to oral rehydrating solution and showed promising results. Additional study is needed in this area.
Gastroesophageal reflux disease (in infants):
Locust bean gum is a common food thickener and may prove helpful in infantile gastroesophageal reflux. However, additional study is needed in this area.
TraditionWARNING: 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.
Anthelmintic (expels worms), antioxidant, antiviral, cancer, celiac disease, cough (retching, in infants), demulcent (soothing agent), diabetes, diarrhea (in adults), digestive disorders, dyspepsia (upset stomach), eye infections, flavoring agent, food uses, improve eyesight, laxative, nausea and vomiting during pregnancy, nutritional deficiencies, obesity, stomach pain, vomiting (in infants).
Adults (18 years and older)
There is no proven safe or effective dose for carob. Traditionally, 20 grams carob daily with plenty of water has been used. As a powder, 20-30 grams added to water, tea, or milk taken once daily has also been used.
Children (younger than 18 years)
There is no proven safe or effective dose for carob in children, and use is not recommended.
SafetyDISCLAIMER: 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.
Avoid in individuals with a known allergy or hypersensitivity to carob (Ceratonia siliqua), its constituents, or any plants in the Fabaceae family, including tamarind. Pollen from the carob tree has been reported as an important inhalant allergen. Asthma and rhinitis to carob bean flour have been reported. Explosive vomiting, urticaria (hives), and a rash have also been reported following allergy to an anti-regurgitation milk formula containing carob bean gum in an infant. Individuals allergic to peanuts may also have cross-sensitivity to raw carob pulp.
Side Effects and Warnings
There are no reports of serious adverse effects related to the consumption of carob. The consumption in designated therapeutic doses can be generally considered as safe, although side effects may include a feeling of fullness. Carob is likely safe when consumed in amounts usually found in foods; in the United States carob has generally recognized as safe (GRAS) status.
Carob is possibly unsafe when used uncontrolled and unreflected in infants with gastroesophageal reflux, in pregnant women, or in patients with anemia, diabetes, hyperlipidemia (high cholesterol), hypouricemia (low uric acid), known allergies to members of the Fabaceae family, peanuts, or other nuts, or who have experienced previous complications with powdered, bulk forming laxative drinks. Carobis is also possibly safe when used by patients taking herbs or drugs by mouth, as carob bean gum may decrease bowel transit time. Use cautiously in patients with diabetes as locust bean gum may decrease glucose response and glycemic index.
In patients with renal (kidney) failure, ingestion of locust bean gum showed laxative effects, decreased high blood pressure, and caused a fall in serum urea, creatinine, and phosphorus.
A five month-old child who was allergic to an anti-regurgitation milk formula containing carob bean gum experienced urticaria (hives) and a rash within 30 minutes of administration of the formula. Thickening milk feeds (Carobel®) may cause necrotizing enterocolitis (a serious intestinal illness in babies that may cause tissue damage to the intestines) in low birth-weight infants.
Avoid in patients with a chromium, cobalt, copper, iron, or zinc disorder or deficiency as carob bean gum may reduce absorption of these minerals. Use cautiously in patients with anemia (red blood cell deficiency) as carob bean gum may reduce the absorption of iron. Avoid in patients with metabolic disorders, with acute diarrhea or in underweight infants.
Pregnancy and Breastfeeding
Interactions with Drugs
Carob may alter blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.
Carob bean gum may reduce hyperlipidemia (high cholesterol) in adults and LDL ("bad") cholesterol levels in children and adolescents with elevated plasma LDL cholesterol levels. Caution is advised in patients taking cholesterol-lowering agents due to additive effects.
Although not well studied in humans, carob bean gum polysaccharides may block a step in rubella virus replication subsequent to virus attachment, and may interact with antiviral agents. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.
Carob leaf extracts may act as chemopreventive agents. Caution is advised when taking with other drugs with similar effects.
Carob bean gum may decrease bowel transit time or increase fecal weight. It may also reduce the adherence of Escherichia coli on intestinal epithelial. Thus, it may interact with laxatives or other agents taken by mouth, and caution is advised.
In children and infants with acute diarrhea, carob bean juice or carob pod powder may reduce the symptoms of infectious diarrhea. Caution is advised when taking carob with other agents that have similar effects.
Interactions with Herbs and Dietary Supplements
Based on a laboratory study, carob may reduce the adherence of Escherichia coli on intestinal epithelial.
Carob bean gum may reduce hyperlipidemia (high cholesterol) in adults and LDL ("bad") cholesterol levels in children and adolescents with elevated plasma LDL cholesterol levels. Caution is advised in patients taking cholesterol-lowering herbs, such as red yeast rice, due to additive effects.
Carob bean gum polysaccharides may block a step in rubella virus replication subsequent to virus attachment. Caution is advised in patients taking herbs with antiviral effects, due to possible additive effects.
Carob leaf extracts may act as chemopreventive agents. Caution is advised when taking with other herbs with similar effects.
Although not well studied in humans, carob bean gum may reduce the absorption of zinc, iron, copper, chromium and cobalt. Carob bean gum may decrease bowel transit time or increase fecal weight, and caution is advised when using with laxative herbs, such as psyllium.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Thomas Brendler (PlantaPhile); Nicole Giese, MS (Natural Standard Research Collaboration); Joerg Gruenwald, PhD (Phytopharm Research); David Lee, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: 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.
Aggett PJ, Agostoni C, Goulet O, et al. Antireflux or antiregurgitation milk products for infants and young children: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol. Nutr 2002;34(5):496-498.
Borrelli O, Salvia G, Campanozzi A, et al. Use of a new thickened formula for treatment of symptomatic gastrooesophageal reflux in infants. Ital J Gastroenterol.Hepatol. 1997;29(3):237-242.
Carroll AE, Garrison MM, Christakis DA. A systematic review of nonpharmacological and nonsurgical therapies for gastroesophageal reflux in infants. Arch Pediatr Adolesc.Med 2002;156(2):109-113.
Gruendel S, Garcia AL, Otto B, et al. Carob pulp preparation rich in insoluble dietary fiber and polyphenols enhances lipid oxidation and lowers postprandial acylated ghrelin in humans. J Nutr 2006;136(6):1533-1538.
Guggenbichler JP. Adherence of enterobacteria in infantile diarrhea and its prevention. Infection 1983;11(4):239-242.
Kwiterovich PO Jr. The role of fiber in the treatment of hypercholesterolemia in children and adolescents. Pediatrics 1995;96(5 Pt 2):1005-1009.
Loeb H, Vandenplas Y, Wursch P, et al. Tannin-rich carob pod for the treatment of acute-onset diarrhea. J.Pediatr.Gastroenterol.Nutr. 1989;8(4):480-485.
McPherson V, Wright ST, Bell AD. Clinical inquiries. What is the best treatment for gastroesophageal reflux and vomiting in infants? J Fam.Pract. 2005;54(4):372-375.
Miyazawa R, Tomomasa T, Kaneko H, et al. Effect of locust bean gum in anti-regurgitant milk on the regurgitation in uncomplicated gastroesophageal reflux. J.Pediatr.Gastroenterol.Nutr. 2004;38(5):479-483.
Puntis JW. Re: Effect of locust bean gum in anti-regurgitant milk on the regurgitation in uncomplicated gastroesophageal reflux. J Pediatr Gastroenterol.Nutr 2005;40(1):101-102.
Savino F, Muratore MC, Silvestro L, et al. Allergy to carob gum in an infant. J.Pediatr.Gastroenterol.Nutr. 1999;29(4):475-476.
Trommer H, Neubert RH. The examination of polysaccharides as potential antioxidative compounds for topical administration using a lipid model system. Int J Pharm 7-14-2005;298(1):153-163.
Turnbull LA, Santamaria S, Martorell T, et al. Seed size variability: from carob to carats. Biology Letters 2006;2:397-400.
Wenzl TG, Schneider S, Scheele F, et al. Effects of thickened feeding on gastroesophageal reflux in infants: a placebo-controlled crossover study using intraluminal impedance. Pediatrics 2003;111(4 Pt 1):e355-e359.
Zunft HJ, Luder W, Harde A, et al. Carob pulp preparation for treatment of hypercholesterolemia. Adv.Ther. 2001;18(5):230-236.
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.