Fig (Ficus carica L.)

Category

Herbs & Supplements

Synonyms

Caricae fructus, feigen, Ficus benjamina (weeping fig), Ficus carica, Ficus elastica (rubber plant).

Background

Figs are thought to have been first cultivated in Egypt. They spread to ancient Crete and subsequently, to ancient Greece where they became a staple in the traditional diet. Figs were regarded with such esteem that laws were created forbidding the export of the best quality figs. Figs were respected in ancient Rome and thought of as a sacred fruit. According to Roman myth, the twin founders of Rome, Romulus and Remus, rested under a fig tree.

Traditionally, figs have been used to treat constipation, bronchitis, hyperlipidemia (high cholesterol), eczema, psoriasis (chronic skin disease), vitiligo (white skin patches), and diabetes (high blood sugar). Topically, its latex has been used to remove warts and treat skin tumors.

At this time, there are no high quality human trials supporting the effectiveness of fig for any indication. However, the antioxidant activity and cytotoxicity against various cancer cell lines reported in fig are potentially promising in its future therapeutic uses.

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.

Diabetes (Type 1): Preliminary evidence suggests that fig has antioxidant properties and may be beneficial in type 1 diabetes. Additional study is warranted in this area.
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.
Antioxidant, cancer, hemostatic potency (stops bleeding), photosensitization (abnormal sensitivity to sunlight).

Dosing

Adults (over 18 years old)

There is no proven safe or effective dose for fig. However, as a tea decoction, 1 cup daily of 13 grams of Ficus carica leaf has been used.

Children (under 18 years old)

There is no proven safe or effective dose for fig in children, and use is not recommended.

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 fig or herbs in the Moraceae family. Some oral allergy syndromes have been attributed to the cross-sensitivity in people to grass and birch pollens. Food allergy to fig has also been reported due to cross sensitization to weeping fig (Ficus benjamina), or mulberry. Sensitization to fig with cross-sensitization to weeping fig and natural rubber latex has also been reported.

Allergic reactions to fresh or dried figs can present as a consequence of primary sensitization to airborne Ficus benjamina allergens independent of sensitization to rubber latex allergens. Kiwi fruit, papaya, and avocado as well as pineapple and banana may be other fruits associated with sensitization to Ficus allergens.

Side Effects and Warnings

There are few reports of adverse effects associated with fig. At least one report has indicated no adverse effects in subjects who were treated with an oral (by mouth) fig leaf decoction for one month. However, because fig leaf contains psoralens, it may cause photodermatitis when applied on the skin. Excessive sunlight or ultraviolet light exposure should be avoided while using products that contain fig leaf.

Many cases of occupational allergy to weeping fig in plant keepers have been reported and side effects may include conjunctivitis, rhinitis, anaphylactic shock or asthma.

Although rare, obstructive ileus (intestinal/bowel obstruction), hemolytic anemia (deficiency of red blood cells), and retinal hemorrhages (bleeding of the retina) have been reported. Use cautiously in patients with bleeding disorders.

Pregnancy & Breastfeeding

Fig, taken as a medicinal agent, is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. However, fresh or dried fruit is likely safe when taken by mouth in amounts commonly found in foods.

Interactions

Interactions with Drugs

Theoretically, because fig leaf contains furocoumarins, it may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Theoretically, fig leaf 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, including a pharmacist. Medication adjustments may be necessary.

Interactions with Herbs & Dietary Supplements

Theoretically, because fig leaf contains furocoumarins, it may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Theoretically, fig leaf 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.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Abrams, PharmD (University of Rhode Island); Heather Boon, BScPhm, PhD (University of Toronto); Nina Crowley, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Catherine Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Adrianne Rogers, MD (Harvard Medical School); Erica Seamon, PharmD (Nova Southeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); 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.

Anahory T, Darbas H, Ongaro O, et al. Serratia ficaria: a misidentified or unidentified rare cause of human infections in fig tree culture zones. J Clin Microbiol 1998;36(11):3266-3272.

Antico A, Zoccatelli G, Marcotulli C, et al. Oral allergy syndrome to fig. Int Arch Allergy Immunol 2003;131(2):138-142.

Bollero D, Stella M, Rivolin A, et al. Fig leaf tanning lotion and sun-related burns: case reports. Burns 2001;27(7):777-779.

Brehler R, Abrams E, Sedlmayr S. Cross-reactivity between Ficus benjamina (weeping fig) and natural rubber latex. Allergy 1998;53(4):402-406.

Caiaffa MF, Cataldo VM, Tursi A, et al. Fig and mulberry cross-allergy. Ann Allergy Asthma Immunol 2003;91(5):493-495.

Diez-Gomez ML, Quirce S, Aragoneses E, et al. Asthma caused by Ficus benjamina latex: evidence of cross-reactivity with fig fruit and papain. Ann Allergy Asthma Immunol 1998;80(1):24-30.

Erdmann SM, Hipler UC, Merk HF, et al. Sensitization to fig with cross-sensitization to weeping fig and natural rubber latex. Int Arch Allergy Immunol 2004;133(3):316.

Focke M, Hemmer W, Wohrl S, et al. Cross-reactivity between Ficus benjamina latex and fig fruit in patients with clinical fig allergy. Clin Exp Allergy 2003;33(7):971-977.

Kanerva L, Estlander T, Petman L, et al. Occupational allergic contact urticaria to yucca (Yucca aloifolia), weeping fig (Ficus benjamina), and spathe flower (Spathiphyllum wallisii). Allergy 2001;56(10):1008-1011.

Ozdamar E, Ozbek S, Akin S. An unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology. J Burn Care Rehabil 2003;24(4):229-233.

Perez C, Canal JR, Torres MD. Experimental diabetes treated with ficus carica extract: effect on oxidative stress parameters. Acta Diabetol 2003;40(1):3-8.

Richter G, Schwarz HP, Dorner F, et al. Activation and inactivation of human factor X by proteases derived from Ficus carica. Br J Haematol 2002;119(4):1042-1051.

Rubnov S, Kashman Y, Rabinowitz R, et al. Suppressors of cancer cell proliferation from fig (Ficus carica) resin: isolation and structure elucidation. J Nat Prod 2001;64(7):993-996.

Serraclara A, Hawkins F, Perez C, et al. Hypoglycemic action of an oral fig-leaf decoction in type-I diabetic patients. Diabetes Res Clin Pract 1998;39(1):19-22.

Werfel S, Rueff F, Przybilla B. [Anaphylactic reaction to Ficus benjamina (weeping fig)]. Hautarzt 2001;52(10 Pt 2):935-937.

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.