Bitter Orange
Background
Native
to eastern Africa and tropical Asia, bitter orange now is grown
throughout the Mediterranean region and elsewhere, including California
and Florida.
Bitter orange has been used in traditional Chinese
medicine and by indigenous people of the Amazon rainforest for
constipation. Amazonian natives also used it for nausea
and indigestion.
Today, people use various bitter orange
products as a dietary supplement for heartburn, loss of appetite, nasal
congestion, and weight loss. It is also applied to the skin for pain,
bruises, and bed sores.
Bitter orange, used in some weight-loss
products, contains synephrine, which is similar to the main chemical in
the herb ephedra. Ephedra is banned by the U.S. Food and Drug
Administration because it raises blood pressure and is linked to heart
attack and stroke.
The National Collegiate Athletic Association (NCAA) placed synephrine
(bitter orange) on its current list of banned drugs.
The
fruit, peel, flower, and oil are used and can be taken by mouth in
tablets and capsules. Bitter orange oil can be applied to
the skin.
How Much Do We Know?
Only a few studies have investigated the usefulness of bitter orange as
a dietary supplement for health purposes in people.
What Have We Learned?
Applying bitter orange oil to the skin may help with ringworm, jock
itch, and athlete’s foot infections.
There’s not enough scientific evidence to support the use of bitter
orange for other health purposes.
What Do We Know About Safety?
There
are case reports of healthy people experiencing fainting, heart attack,
and stroke after taking bitter orange alone or with caffeine. However,
evidence regarding the effects of bitter orange (alone or combined with
other substances, such as caffeine and green tea) on the heart and
cardiovascular system are inconclusive.
Because products that contain bitter orange may be unsafe, pregnant
women and nursing mothers should avoid them.
Keep in Mind
Tell
all your health care providers about any complementary or integrative
health approaches you use. Give them a full picture of what you do to
manage your health. This will help ensure coordinated and
safe care.
Key References
- Bitter
orange. Natural Medicines Web site. Accessed at
naturalmedicines.therapeuticresearch.com/ on March 26, 2015.
[Database subscription].
- Orange
peel, bitter. In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded
Commission E Monographs. Newton,
MA: Integrative Medicine Communications; 2000:287-289.
- Rasmussen
CB, Glisson JK, Minor DS. Dietary
supplements and hypertension: potential benefits and precautions. Journal of Clinical Hypertension. 2012;14(7):467-471.
- Thomas
JE, Munir JA, McIntyre PZ, et al. STEMI
in a 24-year-old man after use of a synephrine-containing dietary
supplement: a case report and review of the literature. Texas Heart Institute Journal. 2009;36(6):586-590.
- U.S.
Department of Health & Human Services. Why Is Ephedra Banned by the FDA? U.S.
Department of Health & Human Services Web site. Accessed at
answers.hhs.gov/questions/7040 on September 30, 2013.
-NIH