Natural Products

Fenugreek

Trigonella foenum-graecum, Fenugrec

Efficacy

• Indications with proven efficacy:
  Local inflammation (poultice)
• Indications with possible, but poorly documented efficacy - the use of this product cannot be recommended:
  Loss of appetite
• Also used for these other indications, but with no proof of efficacy:
  Atherosclerosis
  Constipation
  Diabetes
  Dyspepsia
  Gastritis
  Hypercholesterolemia/hypertriglyceridemia
  Lactation stimulation

Security

• Risk of Drug Interactions: Moderate
• Adverse Effects: Not Frequent

What is it?

In Europe, fenugreek is a common herbaceous annual plant that can reach 50cm in height. The applicable part of the plant is the seed. Fenugreek seeds have been used for centuries as a spice and probably, in folk medicine, for their medicinal properties. They are used to treat boils, diabetes, tuberculosis, skin infections (cellulitis) as well as gastrointestinal disturbances. They have been attributed anti-inflammatory properties. Animal studies have shown that fenugreek might reduce cholesterol and blood glucose levels. Fenugreek affects intestinal transit and delays glucose absorption. In addition, the constituent 4-isoleucine may have a direct stimulatory effect on insulin.

In manufacturing, fenugreek extract is used in soaps and cosmetics, in spice blends and as flavoring agent in imitation maple syrup as well as in some beverages.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

There is evidence that fenugreek can effectively stimulate appetite and act locally to reduce inflammation. It is also used in other medical conditions, in which it may be of some benefits:

• Local inflammation (poultice):
  As a poultice, 50 grams of powdered fenugreek seeds are mixed with enough hot water (250 to 1000 mL) to make a paste.
• Diabetes, hypercholesterolemia/hypertriglyceridemia, loss of appetite:
  A typical dose is 1 to 2 grams of seeds or its equivalent, 3 times a day. The maximum recommended dose is 6 grams of fenugreek seeds daily. People can also drink a tea several times a day. Tea is prepared by steeping 500 mg seeds in 150 ml cold water for 3 hours.

There is insufficient reliable information to conclude that fenugreek seeds are effective in any other indication.

Is it safe?

• Fenugreek seeds are associated with no serious toxicity but it is not without adverse effects. There have been reports of diarrhea and flatulence. Large amounts are thought to cause hypoglycemia. Inhaling powdered seeds may trigger allergy symptoms and fenugreek paste may sometimes cause skin allergy. It may cause an allergic reaction in individuals known to be allergic to leguminosae (such as chickpea).
• Pregnant women should avoid fenugreek seeds since they may cause uterine stimulation, which could induce premature labor (oxytoxic effect). Since there are no safety data concerning their use during breast-feeding, lactating women should avoid fenugreek seeds.
• Fenugreek seeds may apparently increase the effects of anticoagulants and thus increase the risk of bleeding. Since blood glucose levels could be modified, diabetics should monitor their blood glucose levels closely. Take fenugreek 2 hours before or after other drugs because it could decrease their absotption.
• Before taking fenugreek, check with your pharmacist to make sure that there are no drug interactions with your regular medication.

Clinical notes

• At this time, fenugreek has only limited clinical usefulness. Because fenugreek tastes and smells like maple syrup, it has been used to mask the taste of some medicines.

References

1. Blumethal M et al. The Complete German Commission E monographs, 1998
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
3. Facts and Comparisons, The review of Natural Products, 2000
4. Passeportsanté.net. Fenugrec. http://www.passeportsante.net
5. Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002
6. Barnes J. et Al. Herbal Medicines, 2e édition, Pharmaceutical Press, 2002
7. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79