Tulsi Moringa by Organic India

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. Preliminary clinical research shows that applying a gel formulation consisting of basil essential oil 5% and sweet orange essential oil 3% daily for 8 weeks can clear lesions in patients with acne (76896). The effect of basil essential oil alone on acne is unclear.
• Mental alertness. Preliminary clinical research shows that inhalation of aromatherapy consisting of basil, peppermint, and sandy everlasting essential oils improves attention, mental alertness, and mental focus when compared with placebo in patients reporting mental exhaustion with moderate burnout. After one week, patients in the aromatherapy group improved by about 21%, while patients in the control group improved by only 11% (68534). The effect of basil essential oil aromatherapy alone on mental alertness is unclear.
• Migraine headache. Preliminary clinical research in adults with migraine headaches shows that applying 2%, 4%, or 6% basil essential oil every 8 hours to the forehead and temples for 12 weeks reduces the intensity of migraine headache pain and the frequency of attacks in a dose- and time-dependent manner when compared with placebo (103622). More evidence is needed to rate basil for these uses.

(Read more about BASIL)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there has been interest in using oral holy basil for aging, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Asthma. Although there has been interest in using oral holy basil for asthma, there is insufficient reliable information about the clinical effects of holy basil for this condition.
• Dental plaque. Small clinical studies suggest that topical use of holy basil mouthwash, gel, or toothpaste may modestly reduce the severity of dental plaque. Details: Small clinical studies in patients with mild to moderate dental plaque or gingivitis shows that using 10 mL of a mouthwash containing holy basil leaf extract 4% twice daily for 30 days reduces plaque severity by about 17% to 28% when compared with baseline (91570,103621). In one study, this effect was significant when compared with a placebo mouthwash and similar to a mouthwash containing chlorhexidine 0.12% (91570), whereas the other study did not conduct comparisons between study groups (103621). A small clinical study in patients with chronic gingivitis shows that applying holy basil extract 2% gel as a gingival massage twice daily for 30 days reduces plaque severity when compared with baseline (110030). The validity of this finding is limited by the lack of statistical comparison to the other study groups. Also, a small clinical trial in children 14-15 years of age shows that brushing with toothpaste containing holy basil leaf extract 4% twice daily for 3 weeks reduces plaque severity when compared with placebo, with similar improvements when compared with a fluorinated toothpaste (104183). Holy basil has also been evaluated in combination with other ingredients. A small study shows that rinsing with 10 mL of a solution containing tea tree oil, clove, and holy basil (0.2% to 0.3% of each), for 30 seconds twice daily for 21 days, reduces plaque formation by 64%. This reduction is similar to a 72% reduction seen in the active control group using a mouth rinse containing thymol, eucalyptol, menthol, and methyl salicylate (91446).
• Diabetes. Small clinical studies suggest that oral holy basil may modestly improve glycemic control in patients with diabetes. Details: One small clinical trial in adults with type 2 diabetes shows that taking holy basil dried leaf powder 2.5 grams daily for 4 weeks decreases fasting and postprandial blood glucose by 18%, compared with a 7% reduction in those taking placebo (12242). Another small clinical study in patients with type 2 diabetes shows that taking holy basil 250 mg twice daily in combination with glyburide 5 mg daily for 3 months reduces fasting blood glucose by 16%, postprandial blood glucose by 13%, and glycated hemoglobin (HbA1c) levels by 18% when compared with glyburide alone (91571).
• Dyspepsia. Although there has been interest in using oral holy basil for dyspepsia, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Generalized anxiety disorder (GAD). It is unclear if oral holy basil is beneficial in patients with GAD. Details: One small, uncontrolled clinical study in patients with GAD shows that taking holy basil leaf extract 500 mg twice daily following meals for 60 days reduces anxiety and associated symptoms of stress and depression when compared to baseline (19575). The validity of these findings is limited by a lack of control group.
• Gingivitis. Small clinical studies suggest that topical use of holy basil mouthwash or toothpaste may modestly improve gingivitis. Details: Small clinical studies in patients with mild to moderate dental plaque or gingivitis shows that using 10 mL of a mouthwash containing holy basil leaf extract 4% twice daily for 30 days reduces gingivitis by about 23% to 40% when compared with baseline (91570,103621). In one study, these effects were significant when compared with placebo mouthwash and similar to those of a mouthwash containing chlorhexidine 0.12% (91570), whereas the other study did not conduct statistical comparisons between study groups (103621). A small clinical trial in children 14-15 years of age shows that brushing with toothpaste containing holy basil leaf extract 4% twice daily for 3 weeks reduces the severity of gingivitis when compared with placebo, with similar improvements when compared with a fluorinated toothpaste (104183). However, a small clinical study in patients with chronic gingivitis shows that applying holy basil leaf extract 2% gel as a gingival massage twice daily for 30 days does not reduce gingivitis severity when compared with baseline (110030). Holy basil has also been evaluated in combination with other ingredients. A small clinical study shows that rinsing with 10 mL of a solution containing tea tree oil, clove, and holy basil (0.2% to 0.3% of each), for 30 seconds twice daily for 21 days, reduces gum inflammation by 76%. This reduction is similar to a 70% reduction seen in the active control group using a mouth rinse containing thymol, eucalyptol, menthol, and methyl salicylate (91446).
• Headache. Although there has been interest in using oral holy basil for headache, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Hepatitis. Although there has been interest in using oral holy basil for hepatitis, there is insufficient reliable information about the clinical effects of holy basil for this condition.
• Hypercholesterolemia. Although there has been interest in using oral holy basil for hypercholesterolemia, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Hypertension. Although there has been interest in using oral holy basil for hypertension, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Insect repellent. Although there has been interest in using topical holy basil as an insect repellent, there is insufficient reliable information about the clinical effects of holy basil for this purpose.
• Insomnia. It is unclear if oral holy basil is beneficial for sleep problems. Details: A moderate-sized clinical study in adults with stress and sleep problems (i.e., unrefreshing sleep or difficulty falling or staying asleep) shows that taking holy basil 125 mg twice daily for 8 weeks does not improve patient-reported or wearable tracker scores related to sleep when compared with placebo (112416). However, the interpretation of these results is limited by self-reported outcomes and use of a non-validated measurement tool for sleep (i.e., Fitbit device).
• Obesity. It is unclear if oral holy basil is beneficial in overweight or obese patients. Details: One small clinical study in individuals with overweight or obesity shows that taking holy basil extract 250 mg twice daily for 8 weeks slightly reduces body weight and improves levels of triglycerides or low-density lipoprotein (LDL) cholesterol and certain glycemic indices when compared to baseline, but not when compared with no treatment. Holy basil extract also did not improve liver enzymes when compared to baseline or with no treatment (96944).
• Oral submucous fibrosis. It is unclear if topical holy basil paste is beneficial for oral submucous fibrosis. Details: A moderate-sized clinical study in adults with oral submucous fibrosis conducted in India shows that applying a paste containing holy basil extract 250 mg intraorally twice daily for 1 month modestly improves mouth opening scores and patient-reported burning sensation at the 3 month follow up when compared to baseline (112424). However, the validity of these findings is limited by poor methodology and lack of a comparator group.
• Respiratory tract infections. Although there has been interest in using oral holy basil for respiratory tract infections, including bronchitis, common cold, influenza, and tuberculosis, there is insufficient reliable information about the clinical effects of holy basil for these conditions.
• Stress. It is unclear if oral holy basil is beneficial in patients with stress. Details: One small clinical trial in patients experiencing various symptoms of stress shows that taking a specific holy basil extract (OciBest, Natural Remedies Pvt. Ltd.) 400 mg in the morning and 800 mg at night for 6 weeks decreases self-reported symptoms of stress, including forgetfulness, sexual problems and sleep problems of recent origin, and frequency of exhaustion, when compared with placebo (18107). A moderate-sized clinical study in adults with stress and sleep problems shows that taking holy basil 125 mg twice daily for 8 weeks modestly improves stress scores but does not improve individual symptoms related to stress including anxiety, mood disturbance, physical function, depression, fatigue, or sleep disturbance when compared with placebo (112416). However, the interpretation of these findings is limited by self-reported outcome measures and unclear clinical significance.
• Tinea corporis. Although there has been interest in using topical holy basil for tinea corporis, there is insufficient reliable information about the clinical effects of holy basil for this purpose. More evidence is needed to rate holy basil for these uses.

(Read more about HOLY BASIL)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Abdominal pain. Although there has been interest in using oral or topical lemongrass for abdominal pain, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Common cold. Although there has been interest in using oral lemongrass or lemongrass essential oil inhalation for the common cold, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Cough. Although there has been interest in using oral lemongrass for cough, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Dandruff. It is unclear if topical lemongrass is beneficial in patients with dandruff. Details: Preliminary clinical research in adults with dandruff shows that twice daily topical application of a hair tonic containing 5% to 15% lemongrass essential oil reduces dandruff when compared with placebo. Applying a 10% lemongrass formulation twice daily for 14 days reduced dandruff by around 81% compared with baseline. However, the level of benefit of lemongrass essential oil is difficult to assess from this evidence, as the base formulation also decreased dandruff by up to 58% (93950).
• Diabetes. Although there has been interest in using oral lemongrass for diabetes, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Epilepsy. Although there has been interest in using oral lemongrass for epilepsy, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Fatigue. Although there has been interest in using oral lemongrass for fatigue, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Gingivitis. It is unclear if lemongrass mouthwash is beneficial in patients with gingivitis. Details: Preliminary clinical research in children aged 9-12 years with mild gingivitis shows that using lemongrass oil 0.25% mouthwash, 10 mL twice daily, for 3 weeks moderately improves plaque and gingivitis scores when compared with no mouthwash (110622). Similarly, a small clinical trial in orthodontic patients aged 13 years and older with mild to moderate gingivitis shows that using a lemongrass 0.25% mouthwash for 1 minute daily for 3 weeks improves plaque and gingivitis scores when compared with no mouthwash (112153). Additionally, the lemongrass mouthwash was slightly better than chlorhexidine on some, but not all, tooth surfaces.
• Headache. Although there has been interest in using topical lemongrass for headache, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Hypercholesterolemia. It is unclear if oral lemongrass is beneficial in patients with hypercholesterolemia. Details: Preliminary clinical research shows that taking lemongrass essential oil 140 mg daily orally for 90 days does not reduce cholesterol levels when compared with baseline in patients with hypercholesterolemia (59670).
• Hypertension. Although there has been interest in using oral lemongrass for hypertension, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Influenza. Although there has been interest in using lemongrass essential oil inhalation for influenza, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Nausea and vomiting. Although there has been interest in using oral lemongrass for nausea and vomiting, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Neuropathic pain. Although there has been interest in using oral lemongrass for neuropathic pain, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Pain (acute). Although there has been interest in using oral or topical lemongrass, or lemongrass essential oil inhalation for acute pain, there is insufficient reliable information about the clinical effects of lemongrass for this purpose.
• Rheumatoid arthritis (RA). It is unclear if topical lemongrass is beneficial in patients with RA. Details: Preliminary clinical research shows that applying pure lemongrass essential oil to the skin daily for 30 days can lead to a modest, gradual reduction in pain scores when compared with baseline in adults with mild, moderate, or severe RA (97052). The validity of these results is limited by the lack of a control group.
• Thrush. It is unclear if oral lemongrass is beneficial in patients with thrush. Details: Preliminary clinical research shows that consuming a lemongrass infusion 250 mL twice daily for 10 days decreases thrush symptoms in patients with HIV/AIDS more effectively than applying a topical solution of gentian violet 0.5%. The lemongrass infusion used in this study was prepared by adding dried lemongrass 12.5 mL to 500 mL of boiling water and boiling for 10 minutes (59630). More evidence is needed to rate lemongrass for these uses.

(Read more about LEMONGRASS)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Asthma. It is unclear if oral moringa seed is beneficial in patients with asthma. Details: A small clinical study in patients with mild to moderate asthma shows that taking powdered dried moringa seed kernels 3 grams twice daily for 3 weeks reduces the severity of asthma symptoms, including dyspnea, wheezing, chest tightness, and cough, and improves lung function when compared to baseline (19278). The validity of this finding is limited by the lack of a control group.
• Child growth. It is unclear if oral moringa, taken during the second or third trimester or while breastfeeding, can improve infant growth. Details: An observational follow-up of a large randomized clinical trial conducted in Indonesia during the second trimester or 1 month after giving birth shows that taking 500 mg moringa leaf powder or extract daily for 4 months does not reduce stunting in infants followed for up to 11 months when compared with an unspecified dose of iron and folate (105471,105472). Other observational data, also from a large randomized clinical trial conducted in Indonesia, suggests the rate of stunted growth in children aged 36 to 42 months is 25% after taking 500 mg moringa leaf extract daily for 3 months during the third trimester, compared to 42% with 500 mg moringa leaf flour, or 33% with iron 60 mg and 0.2 mcg folic acid (110645). Researchers propose that differences in the nutritional content between moringa leaf extract and flour may account for the variation in results among forms.
• Diabetes. It is unclear if oral moringa leaf is beneficial in patients with diabetes; research is conflicting. Details: A small clinical study in therapy-naïve patients with type 2 diabetes shows that taking 4 grams of moringa leaf powder twice daily for 4 weeks does not affect fasting blood glucose (FBG) or postprandial glucose (PPG) when compared with placebo (105470). These findings are limited by the small size and short duration of the study. A non-randomized clinical study in patients with type 2 diabetes who are taking a sulfonylurea shows that taking 2 tablets containing an unspecified amount of powdered moringa leaf in addition to following a calorie-restricted diet for 90 days does not reduce glycated hemoglobin (HbA1c) when compared with standard treatment, although it modestly reduces PPG when compared with baseline (90572). Another small non-randomized clinical study in patients with type 2 diabetes who are taking hypoglycemic agents shows that taking powdered moringa leaf 8 grams daily for 40 days in addition to following a calorie-restricted diet reduces FBG, PPG, and lipid levels when compared with baseline (97208). It is unclear if any benefit identified in these studies is due to moringa or calorie restriction. Additionally, the validity of these findings is limited by the lack of a statistical comparison to the control group.
• HIV/AIDS. It is unclear if oral moringa leaf is beneficial in patients with HIV; research is conflicting. Details: Preliminary clinical research in normal weight Congolese patients with HIV who are on antiretroviral therapy shows that taking dried moringa leaf powder 10 grams three times daily with meals for 6 months increases body mass index (BMI) by 2 kg/m2 when compared with a nutritional counseling only group. However, there was no difference in immune function as measured by CD4 counts (97210). Results of other research are in conflict. A large clinical study in Nigerian adults treated with standard antivirals for HIV shows that taking moringa leaf powder 5 grams three times daily with meals for 6 months modestly increases CD4 counts but does not impact viral load or anthropometric parameters (i.e., weight, BMI) when compared with placebo. However, most patients were normal or overweight, and over half had an undetectable viral load at baseline (110648). Secondary analysis of this data suggests taking moringa may also improve quality of life (110649). However, the validity of this finding is limited by the inability to mask the taste of moringa leaf powder; patients may have been biased by knowing their study group assignment. Similarly, a small open label clinical study also in Nigerian adults treated with antiviral therapy for HIV shows that taking a moringa 200 mg capsule daily (Formula 10 Herbal Products, Nigeria) for 3 months modestly increases CD4 counts, lymphocyte and platelet counts, and hemoglobin when compared with antiviral therapy alone (110650).
• Hyperlipidemia. It is unclear if oral moringa leaf is beneficial in patients with hyperlipidemia. Details: One small clinical study in patients with hyperlipidemia shows that taking atorvastatin 10 mg daily with powder of an unspecified part of the moringa plant 1 gram twice daily for 45 days modestly reduces levels of total cholesterol and triglycerides when compared with taking atorvastatin alone (112639). Another small clinical study in patients with type 2 diabetes shows that taking powdered moringa leaf 8 grams daily in addition to following a calorie restricted diet for 40 days modestly reduces low-density lipoprotein (LDL) cholesterol, total cholesterol, and triglyceride levels when compared with baseline (97208). The validity of these findings is limited by the lack of a statistical comparison to the control group, as well as small study size and short duration. In contrast, one small clinical study in patients of Indian descent with hyperlipidemia shows that taking 8 tablets of standardized dehydrated moringa drumstick leaf (DDL) 4.6 grams daily for 50 days has no effect on lipid levels when compared with baseline (97212).
• Iron deficiency anemia. It is unclear if oral moringa leaf flour is beneficial for anemia during pregnancy. Details: A small clinical study in pregnant patients with anemia in Indonesia shows that consuming biscuits enriched with 5.6 grams of moringa leaf flour, in addition to iron 500 mg, daily for 60 days increases hemoglobin by 1 g/dL, compared to 0.66 mg/dL with iron 500 mg daily alone. (110647). The validity of this study is limited by poor methodology, including lack of randomization and blinding.
• Impaired glucose tolerance (prediabetes). It is unclear if oral moringa leaf powder is beneficial for patients with prediabetes. Details: A small clinical study in treatment-naïve adults with prediabetes shows that taking moringa leaf powder 2400 mg daily for 12 weeks modestly improves fasting blood glucose and glycated hemoglobin (HbA1c) but does not improve markers of insulin resistance or anthropometric measures (i.e. weight, BMI, waist circumference) when compared with placebo (110646).
• Lactation. Small clinical studies suggest that oral moringa leaf may modestly increase breastmilk volume during the first week of lactation. Details: A meta-analysis of 3 small clinical trials in breastfeeding patients shows that when started on postpartum day 3, moringa leaf increases breastmilk volume by about 120 mL per expression by day 7 when compared to control (90573). Studies included in the analysis used specific capsules containing moringa leaf (Natalac, Gruppo Medica Inc.) 250 mg twice daily on postpartum days 3-5 (20578), and specific capsules containing moringa leaf (Pro-Lacta, Pascual Laboratories, Inc.) 350 mg twice daily starting on postpartum day 3 and continuing for one week (90571). However, due to methodological limitations and the short duration of the included trials, the clinical significance of this finding is uncertain.
• Malnutrition. It is unclear if oral moringa leaf is beneficial for children with malnutrition. Details: One small clinical study in children with mild-to-moderate malnutrition shows that supplementing food with powdered dried moringa leaf 15 grams twice daily for 2 months results in 23 of 30 children having a 20% or greater improvement in weight, compared with only 2 of 30 children receiving no additional intervention (90576). It is unclear if maternal consumption of moringa leaves prevents malnutrition in infants. An observational follow-up of a large randomized clinical trial in Indonesian patients in their second trimester or one month postpartum shows that consuming four capsules, each containing 500 mg moringa leaf powder or extract, daily for 4 months might protect the infant against being underweight, but does not reduce stunting in infants followed for up to 11 months, when compared with an unspecified dose of iron and folate (105471,105472).
• Menopausal symptoms. It is unclear if oral moringa leaf improves menopausal symptoms. Details: A small clinical study in healthy postmenopausal patients shows that taking powdered moringa leaves 7 grams with food daily for 3 months modestly improves menopausal symptoms such as hot flashes and sleeping problems when compared with no dietary additives (90575).
• Obesity. Oral moringa leaf has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: One small clinical study shows that taking a combination product containing moringa leaf extract 200 mg, green coffee bean extract 300 mg, banaba leaf extract 100 mg, and vitamin D3 500 IU (CraveCheck, Advocare International) daily for 2 months does not reduce body weight when compared with placebo. In fact, patients in the placebo group showed slightly greater weight loss than patients in the treatment group. However, taking the combination product appears to reduce fat mass and increase fat-free or lean mass as measured by dual energy X-ray absorptiometry, suggesting that the combination product might improve body composition (97211). It is not clear if this effect is due to moringa, the other ingredients, or the combination.
• Oral leukoplakia. It is unclear if topical moringa leaf improves oral leukoplakia. Details: Preliminary clinical research in patients with oral leukoplakia shows that topical application 3 times daily for 3 months with a gel providing moringa leaf extract 2% reduces lesion size by about 77% compared to baseline. Moringa gel is modestly more effective for reducing lesion size than a specific cream (Retino-A) (112640). The validity of these findings is limited by the lack of a placebo group.
• Vitamin A deficiency. It is unclear if oral moringa leaf is beneficial in infants deficient in vitamin A. Details: Preliminary clinical research conducted in rural Ghana shows that vitamin A-deficient infants aged 8-12 months who receive cereal supplemented with moringa leaf powder for 6 weeks do not have a significant improvement in vitamin A status when compared with those given cereal without moringa (98455). More evidence is needed to rate moringa for these uses.

(Read more about MORINGA)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Basil has Generally Recognized as Safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when used topically in medicinal amounts. Solutions containing up to 6% basil essential oil have been used with apparent safety for up to 12 weeks (103622). There is insufficient reliable information available about the safety of basil when inhaled as aromatherapy.

POSSIBLY UNSAFE ...when used orally in medicinal amounts. Both the above ground parts and the oil of basil contain estragole, which might be hepatocarcinogenic and mutagenic (2,8,12).

CHILDREN: LIKELY SAFE
when the above ground parts are used in amounts commonly found in foods.

CHILDREN: POSSIBLY UNSAFE
when used orally in medicinal amounts due to the estragole constituent (2,8).

PREGNANCY AND LACTATION: LIKELY SAFE
when the above ground parts are used in amounts commonly found in foods.

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used in larger amounts due to the estragole constituent of the essential oil. Estragole might have mutagenic effects (2,12).

(Read more about BASIL)

POSSIBLY SAFE ...when used orally, short-term. Holy basil leaf extract has been used with apparent safety at a dose of 500 mg daily for 60-90 days (12242,18107,19575,91571,96944). ...when used topically in the mouth, short-term. Holy basil has been used with apparent safety as a 4% mouthwash solution for up to 30 days (91570,103621).

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used in high doses during pregnancy or when trying to conceive. Animal research suggests that relatively high doses of holy basil extract (200 mg/kg) may reduce implantation rate when used for one week, while long-term use of higher doses (2-4 grams/kg) may decrease the number of full-term pregnancies (55040,91569). There is insufficient reliable information available regarding the safety of holy basil during lactation; avoid using.

(Read more about HOLY BASIL)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Lemongrass has Generally Recognized as Safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when used orally or topically, short-term for medicinal purposes. Dried leaves of lemongrass or lemongrass essential oil have been safely used in studies lasting up to 2 weeks (6,12,2612,93950). ...when the essential oil of lemongrass is used by inhalation as a component of aromatherapy (2612).

PREGNANCY: LIKELY UNSAFE
when used orally. Lemongrass seems to have uterine and menstrual flow stimulating effects (12); avoid using.

LACTATION:
Insufficient reliable information available; avoid using.

(Read more about LEMONGRASS)

LIKELY SAFE ...when used orally in food amounts. The leaves, fruit, and seeds are commonly used in foods (16341,16344,90573).

POSSIBLY SAFE ...when moringa leaf or seed is used orally and appropriately in medicinal amounts, short-term. Tablets and capsules containing up to 30 grams of moringa leaf powder have been used daily with apparent safety in clinical studies lasting up to 6 months (20578,90572,90572,97209,97210). A dried moringa seed kernel powder has also been used with apparent safety in doses of 3 grams twice daily for 3 weeks (19278). ...when moringa leaf extract is used topically and appropriately. Moringa leaf extract 2% has been used 3 times daily with apparent safety in a clinical trial lasting 3 months (112640).

POSSIBLY UNSAFE ...when moringa root or root bark are used orally. Moringa root contains spirochin, a potentially toxic alkaloid, while moringa root bark contains stimulant alkaloids similar to ephedrine. Although spirochin has not been studied in humans, animal data shows that it can cause nerve paralysis (63764).

CHILDREN: POSSIBLY SAFE
when moringa leaf is used orally and appropriately, short-term. Powdered dried moringa leaf has been used with apparent safety in doses of 15 grams twice daily for up to 2 months (90576).

PREGNANCY: POSSIBLY SAFE
when the leaf is used orally during the second or third trimesters, short-term. Moringa leaf powder or extract 500 mg daily for up to 4 months has been used with apparent safety during the second and third trimesters (105469,105471,105472,110645). There is insufficient reliable information available about the safety of using moringa leaf by mouth during the first trimester.

PREGNANCY: POSSIBLY UNSAFE
when the root, bark, or flower are used orally. Traditionally, moringa root bark and gum from moringa trunk bark have been used to induce abortion. When taken orally along with black peppercorns to induce abortion, moringa root bark may cause fatality (63764). Animal research shows that moringa flower can cause uterine contractions (94634); however, this has not been assessed in humans. There is insufficient reliable information about the safety of using moringa seed during pregnancy; avoid using.

LACTATION: POSSIBLY SAFE
when moringa leaf is used orally, short-term. Moringa leaf powder or extract 2 grams daily has been used during lactation with apparent safety for up to 4 months (20578,90571,90573,105471,105472). There is insufficient reliable information available about the safety of using other parts of moringa during lactation; avoid using.

(Read more about MORINGA)

(Read more about BASIL)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, holy basil seed oil might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.  Details Animal research shows that holy basil seed oil can prolong bleeding time, possibly due to inhibition of platelet aggregation (13251). However, it is not known if this occurs in humans.

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, holy basil might increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details Small clinical studies show that taking holy basil can decrease fasting blood glucose and other measures of glycemic control in patients with type 2 diabetes (12242,91571).

PENTOBARBITAL (Nembutal) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, holy basil seed oil might increase the sedative effects of pentobarbital.  Details Animal research shows that holy basil seed oil increases pentobarbitone-induced sleeping time (13056,13251). However, it is not known if this occurs in humans or if this applies to other barbiturates or sedatives.

(Read more about HOLY BASIL)

CYTOCHROME P450 1A1 (CYP1A1) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, lemongrass might decrease the metabolism of CYP1A1 substrates.  Details Animal research shows that lemongrass and its constituent citral inhibit CYP1A1 (97051).

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, lemongrass might decrease the metabolism of CYP3A4 substrates.  Details Animal research shows that lemongrass and its constituent citral inhibit CYP3A4 (97051).

GLUCURONIDATED DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, lemongrass might increase the clearance and decrease the levels of glucuronidated drugs.  Details Animal research shows that lemongrass and its constituent citral induce uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation (97051).

PENTOBARBITAL (Nembutal) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, lemongrass might increase the effects and adverse effects of pentobarbital.  Details Animal research shows that high doses of lemongrass essential oil increases sleep time and decreases time to fall asleep in animals administered pentobarbital.

(Read more about LEMONGRASS)

ANTIDIABETES DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = B Theoretically, moringa might have additive effects when used with antidiabetes drugs; however, research is conflicting.  Details Animal research shows that moringa can lower blood glucose levels (12249,20571,20573,20574). However, research in humans has not shown consistent blood glucose lowering effects (97207,105470).

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, moringa might decrease the levels and clinical effects of CYP1A2 substrates.  Details In vitro research shows that moringa extract induces CYP1A2 enzymes (111404).

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.  Details Some in vitro research suggests that moringa inhibits cytochrome P450 3A4 (CYP3A4) (20576). However, other in vitro research suggests that moringa extract induces CYP3A4 enzymes (111404). A pharmacokinetic study in patients with HIV shows no change in the pharmacokinetics of nevirapine, which is partially metabolized by CYP3A4, when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days (97209).

LEVOTHYROXINE (Synthroid, others) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, moringa leaf can antagonize the effects of levothyroxine.  Details Animal research suggests that moringa aqueous leaf extract might reduce serum triiodothyronine (T3) concentrations by inhibiting the peripheral conversion of thyroxine (T4) to T3 (16348).

NEVIRAPINE (Viramune) Interaction Rating = Minor Be watchful with this combination. Severity = Insignificant •  Occurrence = Unlikely •  Level of Evidence = B Moringa leaf is unlikely to have a clinically significant interaction with nevirapine.  Details Nevirapine is partially metabolized by cytochrome P450 3A4 (CYP3A4). In vitro evidence suggests that moringa inhibits CYP3A4 (20576). However, a pharmacokinetic study in patients with HIV shows no change in nevirapine pharmacokinetics when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days (97209).

P-GLYCOPROTEIN SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, moringa leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.  Details In vitro research shows that moringa leaf extract inhibits renal P-glycoprotein transport activity (107850). So far, this reaction has not been reported in humans.

(Read more about MORINGA)

General ...Topically, occupational exposure to basil has resulted in contact dermatitis (95140).

Immunologic ...Allergic contact dermatitis has been reported in a 45-year old woman with occupational exposure to basil (95140).

(Read more about BASIL)

General ...Orally and topically, holy basil extract seems to be well tolerated.
Most Common Adverse Effects:
Orally: Loose stools and nausea.
Topically: Bitter taste with oral application.

Gastrointestinal ...Orally, two out of 24 participants taking capsules containing holy basil extract in one clinical study experienced nausea or loose stools (55037).
Topically, holy basil mouthwash has been reported to cause a bitter taste in clinical trials (55038).

(Read more about HOLY BASIL)

General ...Lemongrass is generally well tolerated when taken orally, applied topically, or inhaled as aromatherapy.
Most Common Adverse Effects:
Topically: Allergic reactions, irritation, rash.
Serious Adverse Effects (Rare):
Inhalation: Toxic alveolitis.

Dermatologic ...Topical use of lemongrass essential oil has caused a rash or irritation, possibly due to an allergic reaction (59513,59517,59567,59500). However, allergic reactions to topical use of lemongrass essential oil are rare (2,18).

Pulmonary/Respiratory ...There have been two cases of toxic alveolitis associated with inhalation of an unknown quantity of lemongrass essential oil (2).

(Read more about LEMONGRASS)

General ...Orally and topically, moringa leaf and seed seem to be well tolerated. Orally, moringa root and root bark might be unsafe. However, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Transient diarrhea.
Serious Adverse Effects (Rare):
Orally: Allergic reactions, including anaphylaxis, have been reported.

Cardiovascular ...Orally, a case of bilateral pulmonary embolism after a 5-month history of taking moringa leaf extract is reported in a 63-year-old female without other risks for venous thromboembolism. The patient recovered with standard anticoagulant treatment. Researchers speculate that possible procoagulant effects of moringa may have played a role in this event (110644).

Dermatologic ...Orally, Stevens-Johnson syndrome has been linked to the consumption of moringa leaves. A 53-year-old male presented with fever and generalized maculopapular rash 14 hours after eating food containing moringa leaves. Painful oral ulcers developed by the next day. The patient also reported a similar episode of oral ulcers after eating food containing moringa leaves three months earlier. The patient was treated with oral prednisolone and omeprazole and recovered within two weeks. Researchers speculate that the immunomodulatory effects of moringa may have played a role in this reaction (99876). There are also cases of fixed food eruption to moringa. In one case, suspected fixed food eruption occurred on the trunk and face of a 60-year-old female, reoccurring 8 hours after self reintroduction (112641).

Gastrointestinal ...Orally, moringa leaf powder can cause diarrhea. In a clinical trial, taking moringa leaf powder 8 grams daily resulted in transient diarrhea in 4 of 16 patients (25%) (105470).

Immunologic ...Orally, cases of anaphylaxis are reported after ingestion of young moringa leaves and seedpods. In these cases, positive skin-prick testing confirmed moringa as the causative allergen. The patients recovered after standard treatment (110597,110643). There are also cases of fixed food eruption to moringa. In one case, suspected fixed food eruption occurred on the trunk and face of a 60-year-old female, reoccurring 8 hours after self reintroduction (112641).

(Read more about MORINGA)