Sphaeranthus indicus

Sphaeranthus indicus: A Comprehensive Reference

1. Identity, Taxonomy, and Natural Source

Sphaeranthus indicus, commonly known as the East Indian Globe Thistle, is a flowering plant of the genus Sphaeranthus. It belongs to the family Asteraceae and is classified binomially as Sphaeranthus indicus Linn.

Sphaeranthus indicus L. (Asteraceae) is a strongly scented, branched, and annual erect herb with branched tapering roots, widely distributed throughout the continents of Australia and Asia. It grows in rice fields, dry waste places, and cultivated lands in tropical parts of India, and is distributed throughout India, Sri Lanka, Africa, and Australia from sea level to 1,200 m altitude.

In India, it is distributed across Andamans, Andhra Pradesh, Bihar, Goa, Kerala, Karnataka, Madhya Pradesh, Maharashtra, Orissa, Rajasthan, Sikkim, Tamil Nadu, Uttar Pradesh, and West Bengal. Its native range also extends to Ethiopia, Lesotho, Madagascar, Somalia, South Africa, Sri Lanka, Swaziland, and Australia. The species is also found in parts of Africa where it is employed in traditional medicine to treat fever.

Common Names and Synonyms

Sphaeranthus indicus (Asteraceae) is commonly known as Gorakhmundi in Hindi and is an annual spreading herb which grows approximately 15–30 cm in height. It is also known by other Sanskrit synonyms such as Munditika, Mundi, Shravana, Bhikshu, Tapodhana, Mahashravani, Shravanahva, and Shravanashirshaka. In the Siddha tradition of South India, it is known by the name Koṭṭaikkarantai.

Plant Parts Used and Dosage Forms

Different parts of this plant, including its leaves, stems, bark, roots, flowers, and seeds, have been used in traditional medicine to treat various ailments. The flower heads are the primary medicinal part used in research and dietary supplement contexts. Standardized extracts containing sesquiterpenes, flavonoids, alkaloids, and essential oils are commonly employed in research and commercial preparations.

In commercial and research settings, the plant is typically formulated as:

• Standardized dried flower head extract (ethanolic or methanolic), the basis for products such as Meratrim® and NPS31807
• Whole-plant powder (churna) used in classical Ayurvedic preparations
• Decoctions and aqueous extracts prepared from the whole plant, leaves, or roots
• Essential oil obtained by hydrodistillation, primarily from flowers and aerial parts
• Topical pastes and poultices from fresh or dried plant material
• An ingredient in the Siddha preparation known as "Veezhi Ennai (or Veezhi oil)."

2. Traditional and Historical Use

Ayurvedic Tradition (India)

Herbal medicines have been used by mankind since time immemorial. Ayurveda, the oldest traditional system of India, reveals that ancient Indians had a rich knowledge of the medicinal value of different plants. Sphaeranthus indicus is widely used in the Ayurvedic system of medicine to treat vitiated conditions of epilepsy, mental illness, hemicrania, jaundice, hepatopathy, diabetes, leprosy, fever, pectoralgia, cough, gastropathy, hernia, hemorrhoids, helminthiasis, dyspepsia, and skin diseases.

Sphaeranthus indicus Linn. is traditionally used in Ayurvedic medicine for conditions such as epilepsy, mental illness, skin diseases, jaundice, joint disorders, and it also possesses Rasayana properties. The leaves are used traditionally in Ayurveda for hyperlipidemia, epilepsy, mental illness, jaundice, diabetes, leprosy, fever, cough, gastropathy, hernia, helminthiasis, dyspepsia, and skin diseases, and historically also in the context of AIDS.

In Ayurvedic classification, the herb is considered a "Rasayana" herb — one that promotes rejuvenation and longevity when used appropriately. Dried and powdered leaves are historically applied in the treatment of chronic skin diseases, urethral discharges, and jaundice. The extract is described as diuretic, styptic, and believed to be beneficial against gastric and liver disorders. Seeds and roots are used as anthelmintic and stomachic agents.

Siddha Tradition (South India)

In the Siddha system of medicine, prevalent in South India, Sphaeranthus indicus is known as Koṭṭaikkarantai and is valued for its role in treating gastric disorders, skin diseases, anthelmintic conditions, glandular swelling, nervous depression, and psoriasis. It serves as a key ingredient in preparations like Veezhi Ennai, an oil formulation used for its styptic and restorative effects, particularly in deworming and managing skin ailments. The plant exhibits a bitter taste, hot potency, and acts as a demulcent tonic, stomachic, and restorative agent.

Unani Tradition

In the Unani system, Sphaeranthus indicus, referred to as Mundi, functions as a tonic for vital organs, laxative, emmenagogue, blood purifier, and anti-inflammatory herb, aiding in the balance of humors (Mizaj). It is employed to treat jaundice, sore eyes, epilepsy, and conditions affecting neurological and gastrointestinal systems. In Unani practice, the herb is also used as a tonic, to increase appetite, enrich the blood, lessen inflammation, cool the brain, give luster to the eye, and treat sore eyes, jaundice, scalding of urine, gleet, biliousness, boils, scabies, ringworm in the waist, and diseases of the chest.

Folk and Tribal Use

In folk medicine, the entire herb is used for insanity, epileptic convulsions, vomiting, and hemicranias, and is valued as an aphrodisiac and nervine tonic. The external application of a paste of this herb is described as beneficial in treating pruritus and edema, arthritis, filariasis, gout, and cervical adenopathy. It is widely utilized in traditional medicine across different cultures, particularly in Ayurveda, due to its notable anti-inflammatory, antioxidant, and antimicrobial properties.

3. Phytochemistry: Key Constituents and Active Compounds

A wide range of phytochemical constituents have been isolated from this plant including sesquiterpene lactones, eudesmenolides, flavanoids, and essential oil. The diverse range of phytochemicals present in Sphaeranthus indicus includes eudesmanolides, sesquiterpenoids, and flavone glycosides, found in various parts of the plant. Additionally, the flowers and entire plant contain essential oils with compounds such as monoterpene hydrocarbons and oxygenated sesquiterpenes.

Sesquiterpene Lactones and Eudesmanolides

The most pharmacologically studied class of compounds in S. indicus are its sesquiterpene lactones. 7-Hydroxyfrullanolide (7-HF) is an orally bioavailable small molecule sesquiterpene lactone isolated from the fruit of Sphaeranthus indicus. Additional eudesmanolide compounds have been structurally characterized; these include 7α-hydroxyeudesm-4en-6,12-olide, its β-isomer, dihydrolactone, a new sesquiterpene acid (2-hydroxycostic acid), β-eudesmol, and illicic acid. Further eudesmanoids include 11-alpha-13-dihydro-3alpha,7alpha-dihydroxy-4,5-epoxy-6-beta,7-eudesmanolide, 11alpha,13-dihydro-7alpha-acetoxy-3beta-hydroxy-6beta,7-eudesm-4-enolide, and 3-keto-beta-eudesmol, as well as a sesquiterpene glycoside.

Flavonoids and Isoflavones

An alkaloid sphaeranthine and an isoflavone 5,4-dimethoxy-3-prenylbiochanin 7-O-β-galactoside with some interesting sesquiterpenes and a new flavone glycoside have been isolated from this herb. A range of secondary metabolites are present in different regions of Sphaeranthus indicus, such as eudesmanolides, sesquiterpenoids, sesquiterpene lactones, sesquiterpene acids, flavone glycosides, flavonoid C-glycosides, isoflavone glycosides, sterols, sterol glycosides, alkaloids, and peptide alkaloids.

Essential Oil Constituents

The hydrodistilled essential oil of S. indicus was analyzed by gas chromatography (GC) and GC/MS. Thirty-eight compounds making up 84.0% of the oil were identified. The major compounds were: 2,5-dimethoxy-p-cymene (18.2%), α-agarofuran (11.8%), 10-epi-γ-eudesmol (7.9%), and selin-11-en-4α-ol (12.7%). Several other compounds reported from Sphaeranthus indicus include methyl chavicol, α-ionone, δ-cadinene, and p-methoxycinnamaldehyde as major constituents, and α-terpinene, citral, geraniol, geranyl acetate, β-ionone, sphaerene, indicusene, and sphaeranthol as minor constituents of the essential oil.

4. Mechanisms of Action

Anti-inflammatory Pathway: NF-κB Suppression

The anti-inflammatory potential of 7-hydroxyfrullanolide (7HF) has been specifically investigated. 7HF is an orally bioavailable sesquiterpene lactone isolated from Sphaeranthus indicus. It significantly and dose-dependently diminished induced and spontaneous production of TNF-α and IL-6 from freshly isolated human mononuclear cells, synovial tissue cells isolated from patients with active rheumatoid arthritis, and BALB/c mice.

7-Hydroxyfrullanolide (7HF) was found to be efficacious in multiple animal models of inflammation by suppression of pro-inflammatory cytokines. Investigators studied its effects on lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cells using microarray-based gene expression studies. Gene expression profiles and pathway analysis revealed that 7HF potently suppressed multiple inflammatory pathways induced by LPS. More importantly, 7HF was found to inhibit NF-κB related transcripts. These transcripts were further validated using freshly isolated synovial cells from rheumatoid arthritis patients, clinically validating the findings.

The lipid-independent anti-atherosclerotic activity of S. indicus was associated with reductions in the circulating levels of MCP-1, TNF-α, and IL-6 via phosphorylation and degradation of IkB-α, which prevents translocation of NF-kB in the nucleus to induce proinflammatory cytokines.

Anti-proliferative and Anti-migratory Mechanisms (Psoriasis-relevant)

A standardized extract (NPS31807) reduced levels of pro-inflammatory cytokines from human macrophages and activated epidermal keratinocytes in a dose-dependent manner. Treatment with NPS31807 diminished NFκB and AP-1 transcription activity in human macrophages. Lowered nuclear translocation of the p65 subunit in macrophages confirmed reduced activity of NFκB. Gene expression profiling showed attenuated expression of genes involved with inflammation such as TNF signaling and angiogenesis. Inhibition of angiogenesis and matrix metalloproteinase production in keratinocytes was confirmed using RTq-PCR assays. Pretreatment with NPS31807 led to significant reduction of STAT3 phosphorylation and mitogen-induced cellular migration.

Metabolic Mechanisms (Anti-obesity)

In preclinical models, Meratrim-supplemented mice showed markedly lower triglyceride levels in both serum and liver. Meratrim improved lipid homeostasis by inhibiting hepatic de novo lipogenesis and activating energy catabolic pathways such as non-shivering thermogenesis in brown adipose tissue.

Neurological Mechanisms

Previous reports have suggested that the plant possesses anxiolytic and sedative effects, commonly observed in many anticonvulsants. The plant is also reported to have neuroleptic effects by inhibiting the nigrostriatal dopaminergic system via D1 and D2 mechanisms.

5. Scientific Evidence by Area of Use

5.1 Weight Management and Metabolic Syndrome

The most substantial body of human clinical evidence for S. indicus involves the commercial extract blend Meratrim®, which combines S. indicus flower head extract with Garcinia mangostana fruit rind extract.

Earlier studies reported that an herbal formulation (Meratrim) consisting of extracts of the flower heads from Sphaeranthus indicus and the fruit rinds of Garcinia mangostana demonstrated significant weight loss outcomes in two randomized, double-blind, placebo-controlled clinical studies on obese subjects. An 800 mg daily dose of this supplement resulted in statistically significant reductions in body weight, BMI, waist and hip circumference that exceeded those achieved via diet and exercise alone. The blend's significant effect on body weight and anthropometric parameters occurred as early as 2 weeks and continued to increase during the 8-week trial. Additionally, consuming the herbal blend also yielded significant improvements in lipid and glycemic serum profiles.

A 16-week randomized, double-blind, placebo-controlled trial was subsequently conducted in healthy overweight individuals with an average BMI of 28.3 kg/m². The objective was to assess the efficacy and tolerability of Meratrim in managing body weight in healthy overweight subjects. Sixty participants were randomized into two groups receiving either 400 mg of Meratrim twice daily or two identical placebo capsules for 16 weeks. Subjects were asked to consume about 2,000 kcal/day throughout the study period and walk 5 days a week for 30 minutes daily.

At study conclusion, statistically significant reductions in body weight (5.09 vs. 1.1 kg; p<0.0001) and BMI were observed in the Meratrim versus the placebo group. Meta-analyses suggest that when combined with Garcinia mangostana, it can improve lipid profiles, blood glucose levels, and blood pressure in obese patients at a dosage of 800 mg/day over 8–16 weeks.

A preclinical mechanistic study in high-fat-diet obese mice reinforced these findings: Meratrim was administered orally each day for 20 weeks; the group receiving 450 mg/kg of Meratrim showed a significant reduction in body weight and fat mass without changes in food consumption.

Evidence strength: The human evidence for Meratrim in weight management includes multiple randomized, double-blind, placebo-controlled trials, which represents a relatively high evidence standard for a botanical supplement. However, important limitations include: relatively small sample sizes (60–100 participants per trial), short durations (8–16 weeks), and the fact that Meratrim is a two-ingredient blend — making it impossible to attribute all effects to S. indicus alone from these trials. All trials were conducted with a caloric restriction and exercise protocol, meaning the supplement effects must be interpreted in that context. Independent replication by investigators without commercial ties is limited.

5.2 Anti-inflammatory Activity

7HF significantly and dose-dependently diminished induced and spontaneous production of TNF-α and IL-6 from freshly isolated human mononuclear cells. Oral administration of 7HF significantly protected C57BL/6J mice against endotoxin-mediated lethality. In the dextran sulfate sodium (DSS) model of murine colitis, oral administration of 7HF prevented DSS-induced weight loss, attenuated rectal bleeding, improved disease activity index, and diminished shortening of the colon.

The methanolic extracts of Sphaeranthus indicus and its active ingredient 7-hydroxy frullanolide (7-HF) suppress LPS-induced cytokine production from mononuclear cells and inhibit the expression of VCAM1, ICAM1, and E-selectin by TNF-α-stimulated HUVECs in a concentration-dependent manner. The hypothesis that inhibition of cytokines and adhesion molecules attenuates atherosclerosis progression was tested independently of lipid changes. Studies were carried out in two animal models: a high fat-fed LDLr⁻/⁻ mouse and a high fat-fed hyperlipidemic hamster. Methanolic extract of S. indicus was dosed to hyperlipidemic LDLr⁻/⁻ mice at 100 and 300 mg (equivalent to 20 and 60 mg 7-HF)/kg body weight/day for 8 weeks.

Evidence strength: Anti-inflammatory evidence is primarily from in vitro cell culture assays and in vivo animal models, with some ex vivo validation using primary human cells from rheumatoid arthritis patients. There are currently no published randomized controlled trials in humans evaluating S. indicus specifically for an inflammatory condition as the sole intervention. This area remains at the preclinical stage.

5.3 Skin Conditions and Psoriasis

Chronic inflammation-induced hyper-proliferation and migration of keratinocytes are pathological hallmarks of psoriasis. Extracts from Sphaeranthus spp. demonstrate pharmacological activity in vitro and in vivo. However, the activity in modulating disease-relevant pathways in psoriasis had not been widely reported prior to investigation with the standardized extract NPS31807. The extract was used to study mechanistic activity under conditions of inflammation, keratinocyte proliferation, and migration using cell-based and gene expression assays. These studies provide novel molecular insights into the anti-inflammatory, anti-migratory, and anti-proliferative properties of NPS31807. NPS31807, an extract from S. indicus, is proposed as a therapeutic option in inflammatory and autoimmune conditions such as psoriasis.

NPS31807 is a standardized, orally available, methanolic extract from the fruiting and flowering heads of S. indicus undergoing randomized clinical testing.

Evidence strength: Evidence for psoriasis is currently at the in vitro and early translational stage. The mechanistic data from cell-based assays are promising, but no completed, peer-reviewed randomized controlled trials in psoriasis patients have been published in the open literature at the time of writing. Traditional use of the plant for skin diseases has been consistently reported across multiple traditional systems.

5.4 Antidiabetic and Antihyperlipidemic Activity

Investigation of antidiabetic, antihyperlipidemic, and in vivo antioxidant properties of the root of Sphaeranthus indicus Linn. was conducted in streptozotocin-induced type 1 diabetic rats. Administration of ethanolic extract of Sphaeranthus indicus root (EESIR) at 100 and 200 mg/kg to STZ-induced diabetic rats showed significant (p<0.01) reduction in blood glucose and increase in body weight compared to diabetic control rats. Both doses of EESIR-treated diabetic rats showed significant (p<0.01) alteration in elevated lipid profile levels compared to diabetic control rats. EESIR treatment in diabetic rats also produced significant increases in superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and decreases in thiobarbituric acid reactive substances (TBARS) levels.

Evidence strength: Antidiabetic evidence is limited to preclinical animal models (streptozotocin-induced diabetic rodents). No dedicated human clinical trials specifically examining blood glucose control with S. indicus as a sole agent have been located. The improvements in glycemic and lipid markers observed in the Meratrim human trials provide indirect but not isolable human evidence.

5.5 Hepatoprotective Activity

Studies investigated the antioxidant and hepatoprotective activity of an extract of Sphaeranthus indicus Linn. leaves against carbon tetrachloride (CCl₄)-induced hepatotoxicity in vitro and in vivo. Different extracts were administered to evaluate in vitro human live hepatoma cell line studies and in vivo hepatoprotective activity against CCl₄-intoxicated mice. The results showed reducing power. The treatment with the ethanolic extract prevented the hepatic malondialdehyde level by 22.22, 26.67, and 58.89% with doses of 100, 200, and 400 mg/kg, respectively. This study suggested that the presence of flavonoids in S. indicus leaves exhibits marked antioxidant and hepatoprotective activities.

Studies also explored the hepatoprotective and proteomic mechanisms of Sphaeranthus indicus in paracetamol-induced hepatotoxicity in rats. Oral administration of ethanolic and aqueous extract of S. indicus to paracetamol-induced rats showed increase of both enzymatic and non-enzymatic antioxidant status and decreased lipid peroxide level.

Evidence strength: Hepatoprotective evidence is entirely preclinical (animal models and in vitro), using CCl₄-induced and paracetamol-induced hepatotoxicity models. No human clinical trials are available in this area.

5.6 Anxiolytic, Neuroleptic, and Anticonvulsant Activity

A hydroalcoholic extract of S. indicus (SIE) at doses of 200 and 500 mg/kg (p.o.) decreased locomotor activity but did not affect emotional activity parameters in the open field test, suggesting possible central nervous depressant activity. SIE also increased immobility time in the forced swimming test at an oral dose of 500 mg/kg. SIE protected rats against MES-induced convulsions and mice against PTZ-induced convulsions. Sphaeranthus indicus demonstrated anxiolytic, central nervous depressant, and anticonvulsant activities in rodents, thus supporting the folk medicinal use of this plant in nervous disorders.

The plant is also reported to have neuroleptic effects by inhibiting the nigrostriatal dopaminergic system via D1 and D2 mechanisms, which is considered relevant to antiepileptic treatment.

Evidence strength: All neurological and psychotropic evidence is confined to in vivo rodent models. No human clinical trials evaluating anxiolytic, anticonvulsant, or neuroleptic outcomes are available.

5.7 Immunomodulatory Activity

Extracts from Sphaeranthus indicus exhibit immunomodulatory effects by regulating immune responses in the body. These extracts enhance the activity of immune cells such as macrophages, T cells, and natural killer cells, thereby strengthening the immune system's ability to fight infections and diseases. By modulating immune function, S. indicus extracts may be beneficial in autoimmune disorders, allergies, and other conditions where immune dysregulation plays a role.

Evidence strength: Immunomodulatory evidence is primarily from in vitro studies and animal models. There are no published human interventional trials specifically targeting immune outcomes with S. indicus alone.

5.8 Atherosclerosis

The methanolic extracts of Sphaeranthus indicus and its active ingredient 7-HF suppress LPS-induced cytokine production from mononuclear cells and inhibit the expression of VCAM1, ICAM1, and E-selectin by TNF-α-stimulated HUVECs in a concentration-dependent manner. Investigators tested whether inhibition of cytokines and adhesion molecules would attenuate the progression of atherosclerosis, independent of changes in lipid profile. These findings demonstrate that anti-inflammatory agents that lower pro-inflammatory proteins can inhibit the progression of atherosclerosis. The methanolic extract of S. indicus offers promise to benefit individuals who have high circulating pro-inflammatory cytokines and are predisposed to coronary artery disease.

Evidence strength: Atherosclerosis-relevant evidence is from animal models (LDLr⁻/⁻ mice and hyperlipidemic hamsters) and in vitro endothelial cell assays. No human cardiovascular endpoint trials are available.

6. Body Systems and Health Areas Associated

• Metabolic system: Weight management, obesity, lipid profile, blood glucose regulation
• Cardiovascular system: Atherosclerosis (preclinical), anti-inflammatory vascular effects
• Integumentary system (skin): Psoriasis, eczema, leprosy, wound healing, skin infections
• Central nervous system: Anxiety, convulsions/epilepsy, neuroleptic activity, mental illness (all preclinical)
• Hepatobiliary system: Hepatoprotection (jaundice, drug-induced liver injury models)
• Gastrointestinal system: Dyspepsia, gastropathy, helminthiasis, hernia, hemorrhoids
• Respiratory system: Cough, bronchodilation
• Immune system: Immunomodulation, anti-infective (antimicrobial, antifungal, antiviral)
• Endocrine system: Diabetes, lipid metabolism

7. Dosages Reported in Studies

The following dosages are reported only as stated in the sourced scientific literature:

• In the 16-week overweight-subject trial, 60 participants received either 400 mg of Meratrim twice daily (800 mg/day total) or placebo.
• An 800 mg daily dose of the Meratrim supplement was used in the earlier 8-week obese-subject trials.
• In the diabetic rat model, ethanolic extract of Sphaeranthus indicus root was administered at 100 mg/kg and 200 mg/kg to STZ-induced diabetic rats.
• In the anxiolytic rodent study, the hydroalcoholic extract was tested at doses of 200 and 500 mg/kg (p.o.) in rodents.
• In the atherosclerosis animal study, methanolic extract of S. indicus was dosed at 100 and 300 mg (equivalent to 20 and 60 mg 7-HF)/kg body weight/day for 8 weeks.
• In the high-fat-diet obese mouse study, Meratrim was administered orally each day for 20 weeks; the group receiving 450 mg/kg showed significant reduction in body weight and fat mass.
• In the hepatoprotective study, ethanolic extract of S. indicus leaves was administered at doses of 100, 200, and 400 mg/kg to CCl₄-intoxicated mice.
• In clinical trials reviewed in the literature, Sphaeranthus indicus extract has been studied as generally well-tolerated at doses up to 2.8 g/day for durations of up to 12 weeks.

8. Safety Considerations

General Tolerability

Sphaeranthus indicus extract is generally well-tolerated in clinical trials, even at doses up to 2.8 g/day for durations of up to 12 weeks. Common side effects reported are minimal and have not been significantly different from those observed with placebo in randomized controlled trials.

Sphaeranthus indicus is generally well-tolerated in clinical trials. The most common side effect reported is mild gastrointestinal discomfort, occurring in more than 5% of participants. Uncommon side effects, affecting 1–5% of individuals, include rare reports of headache or dizziness.

Formal Toxicology Studies

The broad spectrum safety of Meratrim was assessed in a battery of in vitro and animal toxicological studies including a sub-chronic repeated-dose 13-week oral toxicity study. The LD₅₀ levels of Meratrim in Sprague-Dawley (SD) rats, as determined by the acute oral and dermal toxicity studies, were >5000 and >2000 mg/kg body weight, respectively. The primary skin and eye irritation tests classified Meratrim as non-irritating to the skin and mildly irritating to the eye. Genotoxicity studies showed that Meratrim is non-mutagenic.

In formal 28-day and 90-day rat oral toxicity studies, doses of 0, 500, 1,000, and 1,500 and 0, 1,000, 1,500, and 2,000 mg/kg body weight/day, respectively, were administered by gavage. Both studies featured a recovery period. Minor effects were random and not treatment-related except for local irritation of the forestomach in the 28-day study, in mid- and high-dose animals. The frequency and severity of these effects were reduced in the recovery group; irritation was not found in the forestomach of rats in the 90-day study. The no-observed-adverse-effect level (NOAEL) was greater than the highest dose tested, i.e., >2,000 mg/kg in the 90-day study.

Eye Irritation

One formulation containing S. indicus extract caused reversible eye irritation at high concentrations in rabbits, leading to a classification as an eye irritant under regulatory schemes. This is relevant mainly for workers handling bulk powder rather than consumers swallowing encapsulated doses.

Allergenicity

Sphaeranthus indicus belongs to the Asteraceae (daisy) family, and rare allergic reactions, especially in people allergic to other members of the Asteraceae family, have been noted as a potential risk.

Special Populations and Interactions

No serious adverse events or significant drug interactions have been reported in the reviewed studies. However, data regarding contraindications and use in special populations, such as pregnant or lactating women, are limited. While no significant drug interactions have been reported, S. indicus has shown potential benefits in lipid profiles, blood glucose levels, and blood pressure that may theoretically interact with medications acting on these pathways. The compound 5-7 in the sesquiterpene lactone class can form adducts with free thiols; these compounds readily form adducts with glutathione or free thiols and can thereby affect the metabolism, activity, and toxicology of a wide array of pharmacological agents.

Evidence Limitations

Many of the plant's traditional effects still need further scientific validation through additional research and clinical trials. Current studies on the Meratrim formulation have not shown any cause for concern. Humans tolerated Meratrim well in short-term clinical studies, but its longer-term effects, if any, are mostly unknown. More human studies are needed before a definitive answer can be given.

References

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