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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



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