Drugs A - Z
Gymnema (Gymnema sylvestre R. Br.)
Generic Name: Gymnema sylvestre
CategoryHerbs & Supplements
Asclepiadaceae (family), Asclepias geminata roxb., Gemnema melicida, GS4 (water soluble extract of the leaves), gur-mar, gurmar, gurmarbooti, Gymnema inodum, Gymnema montanum, Gymnema sylvestre, kogilam, madhunashini, mangala gymnema, merasingi, meshashringi, meshavalli, miracle plant, periploca of the woods, Periploca sylvestris, podapatri, Proβeta®, ram's horn, small Indian ipecac, sarkaraikolli, shardunika, sirukurinja, vishani.
Preliminary human evidence suggests that gymnema may be effective in the management of blood sugar levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. Gymnema appears to lower serum glucose and glycosylated hemoglobin (HbA1c) levels following chronic use, but may not have significant acute effects. High-quality human trials are lacking in this area. Some of the available research has been conducted by authors affiliated with manufacturers of gymnema products.
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.
Preliminary human research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes when it is added to diabetes drugs being taken by mouth or to insulin. Further studies of dosing, safety, and effectiveness are needed before a strong recommendation can be made.
Gymnema sylvestre extract (GSE) has been shown to be effective for weight loss when used in combination with other products. The effects of gymnema are difficult to determine, and additional high-quality trials using gymnema alone are needed to confirm these results.
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.
Allergy, antimicrobial, antioxidant, aphrodisiac, cancer, cardiovascular disease, constipation, cough, dental caries, digestive stimulant, diuresis, gout, high blood pressure, laxative, liver disease, liver protection, malaria, metabolic disorders, rheumatoid arthritis, snake venom antidote, stomach ailments, uterine stimulant, viral infection.
Adults (18 years and older)
200 milligrams of extract GS4 taken by mouth twice daily or 2 milliliters of an aqueous decoction (10 grams of shade-dried powdered leaves per 100 milliliters) three times daily have been studied.
The manufacturer PharmaTerra recommends the dose for their product Proβeta® (GS4) to be two 250 milligram capsules taken twice daily at mealtimes (for adults weighing more than 100 pounds) or one 250 milligram capsule taken twice daily at mealtimes (for adults weighing less than 100 pounds).
Children (younger than 18 years)
There is not enough scientific evidence to safely recommend gymnema for use in children.
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.
Allergy to gymnema may occur. In theory, allergic cross-reactivity may exist with members of the Asclepiadaceae (milkweed) family.
Side Effects and Warnings
Aside from lowered blood sugar and increased effects of anti-diabetic drugs following chronic use of gymnema, no significant adverse effects were reported with the herb in multiple studies up to 20 months long. Caution is advised in patients with diabetes or low blood sugar and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, and medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels.
Gymnema is reported to suppress the ability to detect sweet tastes due to the component gurmarin. This phenomenon prompted the Hindi name gurmar or "sugar destroyer."
Pregnancy and Breastfeeding
Interactions with Drugs
Gymnema 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. Medication adjustments may be necessary.
Gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with drugs that lower cholesterol such as "statins" (HMGCoA reductase inhibitors) like lovastatin (Mevacor®) or atorvastatin (Lipitor®).
Gymnema may have additive effects with weight loss drugs.
Interactions with Herbs and Dietary Supplements
Gymnema 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.
Gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with herbs or supplements that lower cholesterol, such as fish oil, garlic, guggul, or niacin.
Absorption of oleic acid (a fatty acid) may be decreased by gymnema.
Gymnema may have additive effects with herbs and supplements that help with weight loss. It may interact with chromium, fat-soluble vitamins, and garcinia.
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); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Theresa Davies-Heerema, PhD (Boston School of Medicine); Ivo Foppa, MD, ScD (University of South Carolina); Paul Hammerness, MD (Harvard Medical School); Erica Seamon, PharmD (Natural Standard Research Collaboration); Sarah Taylor, PharmD (University of Pittsburgh); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD, MBA[c] (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (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.
Ananthan R, Baskar C, NarmathaBai V, et al. Antidiabetic effect of Gymnema montanum leaves: effect on lipid peroxidation induced oxidative stress in experimental diabetes. Pharmacol Res 2003;48(6):551-556.
Cicero AF, Derosa G, Gaddi A. What do herbalists suggest to diabetic patients in order to improve glycemic control? Evaluation of scientific evidence and potential risks. Acta Diabetol 2004;41(3):91-98.
Gholap S, Kar A. Effects of Inula racemosa root and Gymnema sylvestre leaf extracts in the regulation of corticosteroid induced diabetes mellitus: involvement of thyroid hormones. Pharmazie 2003;58(6):413-415.
Khare AK, Tondon RN, Tewari JP. Hypoglycaemic activity of an indigenous drug (Gymnema sylvestre, "Gurmar") in normal and diabetic persons. Indian J Physiol Pharm 1983;27:257-258.
Kothe A, Uppal R. Antidiabetic effects of Gymnema sylvestre in NIDDM - a short study. Indian J Homeopath Med 1997;32(1-2):61-62, 66.
Meiselman HL, Halpern BP. Effects of Gymnema sylvestre on complex tastes elicited by amino acids and sucrose. Physiol Behav 1970;5(12):1379-1384.
Porchezhian E, Dobriyal RM. An overview on the advances of Gymnema sylvestre: chemistry, pharmacology and patents. Pharmazie 2003;58(1):5-12.
Preuss HG, Bagchi D, Bagchi M, et al. Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss. Diabetes Obes Metab 2004;6(3):171-180.
Satdive RK, Abhilash P, Fulzele DP. Antimicrobial activity of Gymnema sylvestre leaf extract. Fitoterapia 2003;74(7-8):699-701.
Shanmugasundaram ERB, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharm 1990;30(3):281-294.
Shapiro K, Gong WC. Natural products used for diabetes. J Am Pharm Assoc (Wash) 2002 Mar-Apr;42(2):217-26.
Simons CT, O'Mahony M, Carstens E. Taste suppression following lingual capsaicin pre-treatment in humans. Chem Senses. 2002 May;27(4):353-65.
Xie JT, Wang A, Mehendale S, et al. Anti-diabetic effects of Gymnema yunnanense extract. Pharmacol Res 2003;47(4):323-329.
Ye W, Liu X, Zhang Q, et al. Antisweet saponins from Gymnema sylvestre. J Nat Prod 2001 Feb;64(2):232-5.
Yeh GY, Eisenberg DM, Kaptchuk TJ, et al. Systematic review of herbs and dietary supplements for glycemic control in diabetes. Diabetes Care 2003;26(4):1277-1294.
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.