ALOE VERA - BENEFIT, SIDE EFFECT, MEDICINAL USE - NEWSHA

Common Name: Aloe vera

Scientific Name: Aloe vera L.

History and Origin

The very first records of Aloe have been found in a collection of Sumerian clay tablets dated 2100 B.C.

The first discussion of Aloe as a laxative was also mentioned in the Papyrus Ebers in 1550 B.C.; not only Egyptians, but also Romans, Greeks, Arabs and Indians recognized the medicinal benefits of this plant.

Aloe Vera was first cultivated for pharmaceutical distribution in 1920. The commercial use of Aloe gel started in the 50s and in the 60s. Pharmacist, Dr Bill C. Coates, in Dallas (Texas, USA) succeeded in extracting Aloe Vera gel while preserving its main benefits.

Although the plant is native to Southern and Eastern Africa, it grows in a large variety of climates including temperate and subtropical areas.

Aloe Vera Plant Structure

Aloe vera is a perennial, drought-resisting plant (i.e., it is able to survive up to 7 years without any water!) with thick, tapered, green lance-shaped, juicy, basal, sharp pointed, jagged and edged leaves.

The leaves join at the stem forming a rosette. Each plant has normally 12 to 16 leaves (between 25 and 30 cm long, while 3-10 cm across the base) weighing up to 1.5 kg when mature.

The leaves of Aloe vera are constituted by the rind (or skin), which is a thick epidermis covered with cuticle surrounding the mesophyll.

Aloe leaves secrete two exudates: one is produced by the pericyclic cells under the cutinized epidermis of the leaves, and it is a reddish-yellow juice, called latex; the other one is produced by the thin-walled tubular cells in the inner central zone (parenchyma) of the leaf, and it is a transparent, slippery mucilage or gel, called aloe vera gel.

The leaves are covered by a thick cuticle and successive leaves have fewer whitish spots and are gray-greenish in color.

Its flowering stage starts from October to January, and the long inflorescence has a large number of small bright red or yellow flowers. Propagation is generally vegetative. Fruits develop from February to April and contain many seeds. ⁽¹⁾

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Fig. 1 The photo of Aloe vera L. Fig. 2 The photo of Aloe vera leaf

Aloe Vera Health Benefits

1. Promoting Weight Loss

According to the results of a research published in the Nutrition Journal, prediabetes patients have lost weight and body fat after taking Aloe Vera gel complex. ⁽²⁾ The Journal of Obesity Research and Clinical Practice also reported that plant phytosterols found in Aloe Vera could reduce visceral fat accumulation in diabetic fatty rats, and it would be useful for improvement of hyperlipidemia and hyperglycemia. ⁽³⁾

2. Preventing Skin Aging and Repairing Damaged Skin

Aloe Vera increases the type I procollagen gene expression (collagen protein which maintains tissue structure is made of procollagens) and significantly improves wrinkles and elasticity in human skin. ⁽⁴⁾

It has been reported that Aloe Vera gel protects the skin from radiation damage. The exact role is not determined; however, when monitoring the administration of Aloe Vera gel, it was observed that an antioxidant protein, metallothionein, is generated in the skin, which removes hydroxyl radicals and prevents suppression of superoxide dismutase and glutathione peroxidase in the skin. ⁽⁵⁾

Aloe Vera plant seems to be effective in healing wounds due to Mannose-6-phosphate (M6P). It also heals wounds by enhancing Hyaluronic acid and Dermatan sulfate levels, which stimulate collagen synthesis and fibroblast activity. ⁽⁴⁾

3. Regulating Blood Cholesterol Levels

In a study investigating the effects of Aloe Vera gel extract on lipid profiles in Wistar rats published in Nigerian Journal of Physiological Sciences in 2010, the rats that received Aloe Vera gel showed significant reduction in plasma total cholesterol, triglycerides, and LDL-cholesterol ratio. Moreover, these rats had significantly higher HDL-cholesterol ratio. ⁽⁴⁾

In another study published in Journal of Clinical and Experimental Pharmacology and Physiology, it was shown that oral administration of Aloe Vera gel extract at a dose of 300 mg/kg body weight per day to STZ-induced diabetic rats for a period of 21 days resulted in a significant reduction in fasting blood glucose, plasma and tissue (liver and kidney), cholesterol, triglycerides, free fatty acids and phospholipids. ⁽⁶⁾

4. Boosting Vitality and Energy

Aloe Vera refreshes people by improving blood circulation and oxygen transportation to their cells. It increases energy levels and makes everyone feel relaxed. ^{(7, 8)}

Aloe Vera extract is a strong antioxidant which reduces cell-damaging process in stressful situations and minimizes biochemical and physiological changes as much as possible. ⁽⁹⁾

5. Regulating Blood Glucose Levels

Aloe Vera has been used for diabetes mellitus (DM) treatment in many parts of the world including Latin America from way back. According to the reports, long-term use of Aloe Vera gel regulates blood sugar in people aged 35 to 65 years. ⁽¹⁰⁾ Although there have been several studies showing that Aloe Vera reduces blood sugar, this effect still needs to be proved by conducting more and more randomized double-blind trials. It is the presence of phytosterols and other components of Aloe Vera which results in reduction of blood sugar. Also, it has been shown that Aloe Vera reduces insulin resistance in animals. ⁽¹¹⁾

6. Improving Digestive System Function

Aloe Vera has been widely used in treatment of stomach and intestine disorders; however; such effect has not been proved and confirmed yet. A recent study has yielded promising yet indefinite results with regard to the effectiveness of Aloe Vera in ulcerative colitis treatment. Conducting more controlled tests is suggested in this regard. ⁽¹²⁾ Aloe Vera had the same effect of Omeprazole in treatment of peptic ulcer disease. Aloe Vera extract suppresses acid secretion as it contains lectins. It also increases mucus stability, helping peptic ulcer be treated more efficiently. ⁽¹¹⁾

7. Increasing Fertility

Investigation on the effect of hydro-alcoholic extract of Aloe Vera plant on rats’ sex hormones indicates that this extract increases serum concentration of estrogen. According to the results of this study, the extract produces estrogen as it contains phytoestrogen compounds like β-sitosterol.

As observed in another study, Aloe Vera extract increases primary spermatocytes, testis mean weight and testosterone in mice. ⁽¹³⁾

Researchers believe that anti-apoptosis factors in Aloe Vera extract increase the number of sperms. Furthermore, as flavonoids and vitamins A, C, and E in Aloe Vera decrease oxygen free radicals, sperms are protected from oxidative stress.

8. Anti-cancer

It has been observed that Aloe Vera reduces COX-2 and NMP-9 (proteins related to Cyclooxygenase system) in laboratory mice suffering from breast cancer. Increasing COX-2 and NMP-9 is considered to be an initial diagnosis sign in breast cancer. According to researchers, it is likely that Aloe Vera inhibits Cyclooxygenase-2 activity (inflammatory markers in body).

What Are Aloe Vera Side Effects?

1. Pregnancy or Breast-Feeding

There is a report that Aloe is associated with miscarriage. It could also be a risk for birth defects. So, do not take Aloe by mouth if you are pregnant or breast-feeding.

2. Children

Using Aloe gel topically might be safe if used correctly. However, oral use of Aloe latex and Aloe whole leaf extract by children is not recommended; Children younger than 12 years old might have diarrhea, stomach pain, and cramps.

3. Diabetes

Some researchers suggest that Aloe might lower blood sugar. Thus, diabetic patients should monitor their blood sugar levels closely if they take Aloe orally.

4. Intestinal Conditions such as Crohn's Disease, Obstruction or Ulcerative Colitis

Do not take Aloe latex if you have any of the above- mentioned conditions. Aloe latex is a bowel irritant. Remember, any product made from Aloe whole leaves contains some Aloe latex.

5. Hemorrhoids

Do not take Aloe latex if you have hemorrhoids. It could make the condition worse.

Remember, any product made from Aloe whole leaves contains some Aloe latex.

6. Kidney Problems

High doses of Aloe latex have been associated with kidney failure and other serious problems.

7. Surgery

Aloe might affect blood sugar levels. As a result, it could interfere with blood sugar control during and after surgery. So, stop using Aloe at least 2 weeks before a scheduled surgery. ⁽¹⁴⁾

8. Long-Term Use of Aloe:

- Prolonged use of Aloe may lead to pigmentation in the intestinal mucosa, a harmless side effect which usually reverses upon discontinuation of the drug. Long-term use can also lead to albuminuria and hematuria.

- Hypersensitivity (dermatitis) has been reported after long-term use of oral and topical Aloe preparation.

- Long-term use can cause loss of electrolytes, in particular potassium.

- Chronic use with high doses of Aloe reduces vasoactive intestinal peptide and somatostatin levels, which may damage enteric nervous tissue. ⁽¹⁵⁾

Nutritional Information

Many factors can affect the nutrients composition of Aloe vera, such as the species and edaphoclimatic conditions. Generally, Aloe vera contains water, total lipids, fatty acids, sterols, protein, soluble sugars, polysaccharides, dietary fibre, and vitamins. ⁽¹⁾

Aloe Vera Daily Dosage

The recommended single dosage is 0.05 gr Aloe powder in the evening. ⁽¹⁵⁾

The following oral doses have been studied in scientific research:

- For constipation: 100-200 mg of Aloe or 50 mg of Aloe extract taken in the evening.

- For diabetes: The most effective dose and form of Aloe are not clear. Multiple doses and forms of Aloe (including powder, extract, and juice) were studied for 4 to 14 weeks; they used 100-1000 mg of Aloe powder and 15-150 ml of Aloe juice per day.

- For oral submucous fibrosis: They used 30 ml of pure Aloe vera juice twice a day and applied pure Aloe vera gel to lesions three times a day for 3 months.

- For weight loss: They used a specific Aloe gel product containing 147 mg of Aloe twice a day. ⁽¹⁴⁾

Bioactive Compounds

The parenchymatous cells, in the fresh leaves of Aloe Vera, secrete a colorless mucilaginous gel that contains 98-99% water and 1-2% active compounds like Aloesin, Aloin, Aloe-emodin, Aloe-mannan, Flavonoids, Saponin, Sterols, Amino acids and Vitamins, Free Anthroquinones, and their derivatives like Isobarbaloin, Barbaloin-IO-Aloe emodin-9 anthrone, and chromones. Carbohydrates are the main component of Aloe gel; the main carbohydrates of Aloe vera are mannose, rhamnose, arabinose, glucose, galactose, acemannan, and xilose.

Best Time to Consume

For constipation: In the evening before

For weight loss: During the day.

Possible Drug Interactions

1. Cardiac Glycosides and Antiarrhythmic Drug

Chronic use of Aloe can lead to potassium loss, which can increase the actions of cardiac glycosides and antiarrhythmic drugs.

2. Thiazide diuretics, Loop Diuretics, Licorice and Corticosteroids

Using Aloe along with the above-mentioned agents increase the risk of potassium deficiency (hypokalemia). ⁽¹⁵⁾

3. Also, the following oral medications are known to interact with Aloe:

- Digoxin (Lanoxin)

- Antidiabetes drugs: glimepiride, glyburide, insulin, pioglitazone, rosiglitazone, chlorpropamide, glipizide, tolbutamide.

- Sevoflurane (Ultane)

- Stimulant laxatives: bisacodyl (Correctol, Dulcolax), cascara, castor oil (Purge), senna (Senokot).

- Warfarin (Coumadin)

- Diuretic drugs: chlorothiazide (Diuril), chlorthalidone, and hydrochlorothiazide. ⁽¹⁴⁾

Traditional Use

Chinese Medicine:

The most common use in Chinese medicine is for treatment of fungal diseases.

Indian Medicine:

Uses in Indian medicine include stomach tumors, constipation, colic, skin diseases, amenorrhea, worm infestation, and infections.

Unproven Uses: European folk medicine

In European folk medicine, the drug is employed for its ability to influence digestion.

Some Questions about Aloe Vera

Is it good to drink Aloe Vera juice every day?

It really depends on the user's conditions. Keep in mind that natural products are not always necessarily safe and dosages can be important. Aloe vera can be consumed daily but you must consult with a health care practitioner if you are in certain conditions. For instance, the juice acts as a laxative which is not recommended for pregnant women and for those with motion sickness.

For more information about recommended daily dosage of Aloe vera, see the “Aloe Vera Daily Dosage” section.

What are the side effects of drinking Aloe Vera juice?

- Anthraquinones such as aloin and barbaloin in Aloe vera may cause allergic reactions; such substances are also laxative; thus, if taken in large amounts, it may cause diarrhea. Severe diarrhea can cause pain, cramps and dehydration.

- Aloe vera juice may cause adverse reactions when consumed along with few medicines.

- Aloe vera juice reacts to herbs like jalap roots, rhubarb root, castor oil and bark root, which may result in dehydration and diarrhea.

- Use of Aloe vera gel may sometimes cause redness, burning, stinging sensation and rarely generalized dermatitis in sensitive individuals. Red urine, abdominal cramps, hepatitis, dependency or worsening of constipation are some other side effects associated with Aloe vera. Since it is a Laxative, its prolonged use may lead to low potassium levels and it has been reported to increase the risk of colorectal cancer.

- There are many health risks associated with Aloe vera juice; it can worsen health problems like colitis, Crohn’s disease, diverticulosis, appendicitis, intestinal obstruction, hemorrhoid, and stomach pains and ulcers. Due to its purgative and irritant qualities, Aloe vera should not be used by pregnant women; it may result in uterine contractions, leading to miscarriage and birth defects. Lactating women may experience diarrhea. It is also considered unsafe for children under the age of 12 years.

- Persons suffering from heart disease must not use Aloe vera because Consumption of Aloe Vera juice can lead the body to produce excessive amounts of adrenaline and can cause irregular heartbeats.

- There have been a few reports indicating liver problems in some people who have taken Aloe leaf extract, but this is not common, and it is thought to only occur in people who are extra sensitive to Aloe.

For more information about the side effects of using Aloe vera, see the “What Are Aloe Vera Side Effects?” section.

Is Aloe vera good for kidneys?

The nephroprotective effect of Aloe Vera leaf extract could be due to the inherent antioxidant and free-radical-scavenging principle(s) contained in the extract. Aloe vera can alleviate oxidative stress, and it is a nephroprotective agent against drug-induced nephrotoxicity.

Is Aloe vera good for diabetes?

According to the reports, long-term use of Aloe vera gel regulates blood sugar. Laboratory studies indicate that Aloe can stimulate insulin release from the pancreas and can reduce blood glucose levels.

For more information, see the “Aloe Vera Health Benefits” section, “Regulating Blood Glucose Levels” subsection.

Does Aloe Vera purify blood?

This plant not only shows a blood purifying property but also has some other properties like antiseptic, anti-inflammatory, anti-viral, antitumor, and immunomodulators.

Aloe vera extract can improve blood supply and purify it at the same time. Purified blood is a prerequisite for functional organs.

Although Aloe vera has been proved to cure many cardiovascular and circulatory problems, you should not take everything for granted.

What does Aloe Vera cure?

The plant leaves contain numerous vitamins, minerals, enzymes, amino acids, natural sugars, and other bioactive compounds with emollient, purgative, antimicrobial, anti-inflammatory, antioxidant, aphrodisiac, anti-helminthic, antifungal, antiseptic and cosmetic values for health care. This plant has the potential to treat sunburns, burns and minor cuts, and even skin cancer. In cosmetics, it mainly acts as a skin healer and prevents injury of epithelial tissues, cures acne and keeps the skin young and healthy. In addition, it is an extremely powerful laxative.

For more information, see the “Aloe Vera Health Benefits” section.

Is it safe to use Aloe Vera straight from the plant?

- It is safe for most people to use Aloe vera topically for minor skin care concerns. Although the plant is well tolerated, the skin irritations and allergic reactions are possible.

- Aloe gel is likely safe when taken appropriately and for only a limited period of time.

- Taking Aloe latex or Aloe whole leaf extract by mouth is possibly unsafe at any dose.

Using high doses of Aloe latex orally is likely unsafe. Aloe latex can cause some side effects such as stomach pain and cramps. Long-term use of large amounts of Aloe latex might cause diarrhea, kidney problems, blood in the urine, low potassium, muscle weakness, weight loss, and heart disturbances. Taking one gr a day of Aloe latex for several days can be fatal. Moreover, there is a concern that chemicals in Aloe latex and/or Aloe whole leaf extract may accelerate the development of cancer.

Does Aloe Vera reduce cholesterol?

Aloe vera can naturally lower high cholesterol and triglyceride levels. According to medical studies, the benefits of Aloe vera gel, when taken internally, have been proved; the results confirmed that when Aloe vera gel was administered to patients with heart disease and high cholesterol, the risks have been reduced.

Is Aloe Vera good for acne?

Aloe vera extracts have antibacterial and antifungal activities, which may help treat minor skin infections such as boils and benign skin cysts, and provide protection to the skin against pollution.

Does Aloe kill viruses?

Aloe vera is known to be virucidal, especially against herpes viruses. Aloe vera strengthens the immune system that in turn protects the body against viral related disorders.

Can Aloe Vera kill fungi?

Aloe vera leaf gel is widely used as a traditional folk medicine for treating various infectious diseases. Several studies have proved the antifungal property of Aloe vera extract.

Is Aloe vera an antibiotic?

Aloe vera contains at least 6 antiseptic agents which kill bacteria, viruses, and fungi. Aloe vera gel at higher concentration shows antibacterial property as well. The antimicrobial effects of Aloe vera have been attributed to the plant's natural anthraquinones. Aloe juice is bacteriostatic against Staphylococcus aureus, Streptococcus pyogenes, and Salmonella paratyphi.

Is Aloe Vera good for liver?

Phytosterols found in Aloe, specifically lophenol and cycloartanol, have the ability to induce the downregulation of fatty acid synthesis and upregulate fatty acid oxidation in the liver, leading to intra-abdominal fat reduction and hyperlipidemia improvement. Aloe vera juice improves liver function and is an excellent antidote in case of excessive ingestion of alcohol. In addition, it prevents scarring of the liver.

Does Aloe increase blood flow?

Aloe vera increases the size of the capillaries; thus, allowing blood to facilitate its flow throughout the body parts. In addition, it is hypothesized that Aloe vera juice is one of the key home remedies to help improve overall heart health. Due to its high amount of vitamin C, it enhances circulation and strengthens veins and arteries.

What are Aloe Vera medicinal uses?

The plant consists of two parts: the outer rind and the inner colorless parenchyma Aloe gel. Both parts have medicinal values.

Medicinal properties of Aloe can be due to the synergistic effects of the combined nutritional elements producing a more powerful effect than the individual components.

Aloe vera gel has various pharmacological actions like antioxidant, analgesic, anti-inflammatory, wound healing, immune-modulating, and anti-tumor activities as well as antiviral, antibacterial, antifungal, and hypoglycemic properties.

It has been used in dentistry and showed good results; it has been used for treating recurrent oral ulceration and oral lichen planus. Various dentifrices contain Aloe vera gel as their constituents because of its medicinal properties.

Can Aloe vera burn fat?

Natural herbal products for weight loss may be effective in treatment of obesity and other associated disorders. Many studies suggest that Aloe Vera is not only used for weight or obesity, but also helps improve some metabolic disorders. Drinking Aloe vera juice can help you decrease your muscle to fat ratio. It will also detoxify your body by purifying your digestive system, which can result in losing weight and belly fat.

Can Aloe stop hair loss?

Aloe vera gel is traditionally used for hair loss prevention and also hair growth and alopecia improvement. According to a study, Aloenin is the major constituent responsible for promoting hair growth without irritating the skin.

Also, the alkaline nature of Aloe vera juice balances the PH level of the hair, which promotes healthy new growth and brings a refreshing and cooling sensation to the scalp. Alopecia or male pattern baldness can be reduced by regular use of Aloe vera; this is mainly because it rejuvenates hair follicles.

Does Aloe Vera help arthritis?

Aloe vera juice is known for its important role in treating arthritis patients. Due to the presence of different enzymes, Aloe juice can act as a stimulant to the immune system. It is analgesic and a powerful anti-inflammatory agent; besides, it can speed up cell growth, thus it repairs arthritis damaged tissue.

Aloe vera juice also helps in the repair process by regenerating cell and detoxifying the affected area, when taken orally and applied externally. Aloe vera is believed to reduce severe arthritis-related joint and muscle pains as well as tendinitis and injuries.

Is Aloe Vera plant toxic?

Most of the Aloe plants are non-toxic but some are extremely toxic, containing a hemlock-like substance. There is usually little cause for concern when using Aloe vera gel, but some people are allergic to it.

Oral uptake of Aloe may cause symptoms that successively will cause solution imbalance, excretory organ pathology, dry mouth, headache, and nausea, whereas topical application could induce dermatitis, erythema, or phototoxicity.