Orally, fenugreek
is used for
diabetes, loss of
appetite, dyspepsia,
gastroesophageal
reflux disease (GERD), gastritis, constipation, atherosclerosis, hyperlipidemia,
and for stimulating lactation. Fenugreek is used orally for kidney diseases,
beriberi, hernia, and impotence and other male problems. Fenugreek is also used
orally for fever, mouth ulcers, boils, bronchitis, cellulitis, tuberculosis, chronic coughs, chapped lips,
baldness, and cancer.
Topically, fenugreek
is used as a poultice
for local inflammation,
myalgia, lymphadenitis,
gout, wounds, leg
ulcers, and eczema.
In foods,
fenugreek is included as an ingredient in spice blends. It is also used as a flavouring
agent in imitation
maple syrup, foods,
beverages, and tobacco.
In
manufacturing, fenugreek extracts are used in soaps and cosmetics.
Safety:
LIKELY SAFE
...when used orally
in amounts commonly
found in foods.
Fenugreek
has Generally Recognized as Safe (GRAS) status in the US (5).
POSSIBLY
SAFE ...when used orally in medicinal amounts (
8, 13,
16, 17, 12).
CHILDREN:
POSSIBLY UNSAFE ...when used orally; avoid using. Fenugreek tea has
caused loss of consciousness and unusual body odour in children. The body odour
may be confused
with maple syrup
disease (12).
PREGNANCY:
LIKELY UNSAFE ...when used orally in amounts greater than those
found in foods
because of its
potential oxytocic and
uterine stimulant activity (18).
Consumption of fenugreek just
before delivery may
cause the neonate to have an
unusual body odour, which could be confused with maple syrup disease.
It does not appear
to cause long-term
sequelae (11).
LACTATION: Insufficient
reliable information available;
avoid using. Although fenugreek is used to promote
lactation, there are no clinical studies testing its safety in mother or infant
(22).
Effectiveness:
INSUFFICIENT
RELIABLE EVIDENCE to RATE
Diabetes. Consuming
fenugreek, mixed with
food during a meal,
seems to reduce postprandial
blood glucose levels
in patients with type
1 or type 2
diabetes. It may be given in combination with guar gum or by
itself (15, 16, 21). Muffins made from
a batter consisting
of foxtail and barnyard millet,
in combination with legumes and fenugreek, do not produce a substantial
increase in postprandial blood
glucose in diabetic
patients (14).
Gastroesophageal
reflux disease (GERD). Clinical research shows that taking a specific fenugreek
product (FenuLife, Frutarom Belgium), 2 grams twice daily 30 minutes before
the two biggest
meals of the
day, significantly improves symptoms of heartburn after one week
of treatment and continuing
through the 2-week study period. Fenugreek was as effective as taking ranitidine
75 mg twice daily (23).
Hypercholesterolemia.
There is conflicting evidence about the use of fenugreek for lowering serum
cholesterol (8, 13,
16).
Hypertriglyceridemia. Preliminary
clinical research suggests fenugreek might lower
triglycerides in people
with type 2
diabetes (21).
More
evidence is needed to rate fenugreek for these uses.
Mechanism of Action:
The
applicable part of fenugreek is the seed. The active constituents include trigonelline,
4-hydroxyisoleucine, and sotolon (7, 20).Fenugreek seeds have a distinctive
bitter taste and odour. Sotolon is frequently used as a flavoring for artificial maple syrup (20). Soaking fenugreek
seeds overnight and washing the seeds
in water can
decrease some of
the taste and
odor (13).
Fenugreek
seeds contain about 50% dietary fiber and pectin and may affect gastrointestinal transit,
slowing glucose absorption. About 80% of
the total content of free amino
acids in the seeds is present as 4-hydroxyisoleucine, which appears to
directly stimulate insulin
(10, 19, 20,
21). This effect is
glucose dependent and only
occurs in the
presence of moderate
to high glucose concentrations. Some
evidence suggests the seed consumption might decrease calcium oxalate deposition in the kidneys (4).
Fenugreek
contains coumarins and other constituents that might affect platelet aggregation, but
this might not be significant clinically (7).
Preliminary
research suggests fenugreek has stimulating effects on the uterus, intestine,
and heart (18).
Adverse
Reactions:
Orally,
fenugreek can cause
diarrhoea, dyspepsia, abdominal
distention, and flatulence (2, 21). With large doses, hypoglycemia is possible
(1). Fenugreek can cause allergic reactions
including nasal congestion,
hoarseness, persistent coughing,
wheezing, facial angioedema, and shock (3). The paste of fenugreek applied to
the scalp can cause allergic symptoms, including head numbness, facial
swelling, and wheezing (3). Consumption of fenugreek by pregnant women just
before delivery may cause the neonate to have an unusual body odor, which may
be confused with maple syrup disease. It does not appear to cause long-term sequelae
(11). This unusual
body odor may
occur in children
drinking fenugreek tea. Loss of consciousness may also occur in children
drinking tea made from fenugreek (12).
Interactions with Herbs &
Supplements:
ANTICOAGULANT/ANTIPLATELET HERBS
AND SUPPLEMENTS:
Concomitant use
of herbs that
have constituents that might affect
platelet aggregation could theoretically increase the risk of bleeding
in some people (6, 7, 8). These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, red clover, turmeric, and others.
HERBS AND
SUPPLEMENTS WITH HYPOGLYCEMIC
POTENTIAL:
Theoretically,
fenugreek might have additive effects with herbs that decrease blood glucose
levels (15, 16). Herbs with hypoglycemic potential include devil's claw,
fenugreek, guar gum, Panax ginseng, and Siberian ginseng.
Interaction
Rating = Moderate Be cautious with this combination.
Severity
= High • Occurrence = Possible • Level of Evidence = B
There is
some concern that fenugreek might have additive effects when used with
anticoagulant or antiplatelet drugs, resulting in increased risk of bruising
and bleeding. Some of
the constituents in
fenugreek have antiplatelet
effects, although these might
not be present
in concentrations that
are clinically significant (6, 7,
8). Some drugs with anticoagulant or antiplatelet effects include aspirin,
clopidogrel (Plavix), nonsteroidal anti-infl
ammatory
drugs (NSAIDs) such as diclofenac (Voltaren,
Cataflam, others), ibuprofen (Advil, Motrin,
others), naproxen (Anaprox, Naprosyn,
others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, and others.
ANTIDIABETES
DRUGS <<interacts with>> FENUGREEK
Interaction
Rating = Moderate Be cautious with this combination.
Severity
= Moderate • Occurrence = Probable • Level of
Evidence
= B
Fenugreek
may reduce blood glucose levels (15, 16) and might have additive
effects on
glucose levels when
used with antidiabetes
drugs.
Monitor
blood glucose levels closely. Medication dose adjustments may be necessary.
Some antidiabetes drugs include glimepiride
(Amaryl), glyburide (DiaBeta,
Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone
(Avandia), and others.
WARFARIN
(Coumadin) <<interacts with>> FENUGREEK
Interaction
Rating = Moderate Be cautious with this combination.
Severity
= High • Occurrence = Possible • Level of Evidence = D
Fenugreek might
have additive effects
with warfarin and increase
the international normalized ratio
(INR). Some fenugreek constituents
have antiplatelet effects, although these might not be present in
concentrations that are clinically significant (7, 8). Fenugreek in combination
with boldo has been associated with increased INR in a patient taking warfarin
(6).
Interactions with Foods:
ALLERGY
TO FABACEAE: Chickpea, also a member of the Fabaceae family, has shown
cross-reactivity in patients
allergic to fenugreek. Theoretically, patients who are allergic to
other Fabaceae plants including soybeans, peanuts, and green peas might also be
allergic to fenugreek (3).
Interactions
with Lab Tests:
BLOOD
GLUCOSE: Fenugreek can lower blood glucose and test results (15, 16).
URINE ODOUR:
Fenugreek can cause
a maple syrup
odour in urine.
Avoid confusion with "maple syrup urine" disease (9).
Interactions
with Diseases or Conditions:
DIABETES:
Fenugreek can alter blood sugar control in people with diabetes (15, 16). Blood
glucose levels should
be monitored closely.
KIDNEY STONES
(Nephrolithiasis): Theoretically, fenugreek
can decrease calcium oxalate deposition and stone formation (4)
Dosage/Administration:
ORAL: For
diabetes, fenugreek 10 to 15 grams per day, as a single dose or in divided doses, with meals has been used (15, 16). A
hydroalcoholic extract of fenugreek
seeds 1 gram
per day has
also been used
(21).
For
hyperlipidemia, 0.6 to 2.5 grams of fenugreek 2 times daily with meals has been
used. It may be used alone or in combination with guar gum and other plant fibres (8, 16).
For gastroesophageal reflux
disease (GERD), a
specific fenugreek product (FenuLife, Frutarom Belgium) 2 grams
twice daily, 30 minutes before the two biggest meals of the day, has been used (23).
Editor's Comments:
The taste
and odor of fenugreek resembles maple syrup, and it has been used to mask the
taste of medicines
(9). Fenugreek leaves are
eaten in India as a vegetable (3)
2. Sharma RD, Raghuram TC, Rao NS. Effect of
fenugreek seeds on blood
glucose
and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6.
3. Patil SP, Niphadkar PV, Bapat MM. Allergy to
fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997;78:297-300.
4. Ahsan SK, Tariq M, Ageel AM, et al. Effect of
Trigonella foenum-graecum and Ammi
majus on calcium
oxalate urolithiasis in
rats. J Ethnopharmacol 1989;26:249-54.
5. Electronic Code of Federal Regulations. Title
21. Part 182 -- Substances
