Emblica officinalis

• How It Works

  Emblica officinalis has antioxidant effects. It has not been shown to treat cancer in humans.

  E. officinalis is commonly used in Ayurveda, the traditional medicinal system of India, for various ailments including diarrhea, jaundice, headaches, inflammation, and as a tonic. It is also one of the constituents of a popular Ayurvedic formulation, Triphala. All parts of the tree including the dried and fresh fruits, seeds, leaves, root bark, and flowers are used. Studies done in the lab and in animals suggest that E. officinalis has antioxidant, antibacterial, liver protective, cardioprotective, antiulcer, antitumor, antidiabetic properties. Small studies in humans show that it has antioxidant and lipid-lowering effects.

  Although adverse effects have not been reported with consumption of E. officinalis fruit, it shows strong antioxidant effects, and may therefore interfere with chemotherapy and radiation therapy.

• Purported Uses
  • Diabetes
    A small study showed that E. officinalis reduces HDL cholesterol and improves LDL levels in diabetic individuals.
  • Cancer
    Studies in mice that indicate that E. officinalis may inhibit tumor growth. However, human studies are needed in order to confirm this effect.
  • Cardioprotective Effects
    Lab studies suggest protective effects against doxorubicin toxicity.
  • Diarrhea
    There is no scientific evidence to support this use.
  • Jaundice
    Used in traditional medicine for jaundice. Clinical data are lacking.
  • Headaches
    Animal studies suggest E. officinalis can reduce fever and pain.
  • Inflammation
    E. officinalis was shown to reduce inflammation in lab studies. Human data are lacking.
  • Chronic ulcers
    Traditional use and results from lab studies support this use.
  • Hyperlipidemia
    Data from lab studies and small human studies indicate hyperlipidemic effects.
• Scientific Name

  Emblica officinalis, Phyllanthus emblica L.

• Clinical Summary

  Emblica officinalis is a deciduous tree prevalent in some parts of Asia. All parts of the tree, especially the fruit, are commonly used in traditional medicine for various ailments including diarrhea, jaundice, headaches, inflammation, and as a tonic ⁽¹⁾. It is also one of the constituents of a popular Ayurvedic formulation, Triphala.

  The activity of E. officinalis is often attributed to its antioxidant constituents, such as ascorbic acid, polyphenols, flavonoids, and tannins ^(2) (3). In vitro and in vivo studies indicate antioxidant ^{(1) (4) (5)}, antibacterial ⁽⁶⁾, hepatoprotective ⁽⁷⁾ , cardioprotective ⁽³⁾ radioprotective ⁽⁸⁾, antiulcerogenic ⁽⁹⁾, antitumor ⁽¹⁰⁾, analgesic ⁽¹¹⁾, antidiabetic ⁽¹²⁾ and antihyperlipidemic ⁽¹³⁾ properties.

  Clinical data are limited to a few studies that show benefit in patients with uremia (accumulation of constituents in the blood that are normally eliminated in the urine) by reducing oxidative stress ⁽⁵⁾; improving HDL and lower LDL-cholesterol levels in diabetic patients ⁽¹⁶⁾; and lowering lipid levels and blood pressure in patients with hyperlipidemia ⁽¹⁷⁾. Supplementation with an E. officinalis extract was shown to lower multiple risk factors associated with cardiovascular disease in overweight adults ⁽²¹⁾.

  Because E. officinalis exhibits strong antioxidant effects, it may interfere with chemotherapy and radiation therapy.

• Purported Uses
  • Diabetes
  • Diarrhea
  • Jaundice
  • Headaches
  • Inflammation
  • Chronic ulcers
  • Hyperlipidemia
• Mechanism of Action

  The antioxidant activity of E. officinalis is attributed to the high content of ascorbic acid ⁽⁴⁾, but it was discovered that such effects may be due to the tannins, Emblicanin A and Emblicanin B ⁽¹⁾. The antidiabetic property is thought to be due to the herb’s ability to reduce release of inflammatory cytokines that cause insulin resistance ⁽¹²⁾. E. officinalis may also play a role in preventing age-related hyperlipidemia by reducing nitric oxide synthase and cyclooxygenase-2 (COX-2) protein levels via inhibiting NF-kappa B activation ⁽¹³⁾. In another study, the herb extracts were shown to induce apoptosis in mature osteoclasts, an effect that may limit bone resorption in pathologies associated with bone loss ⁽¹⁵⁾. And a hydroalcoholic extract of E. officinalis demonstrated anti-inflammatory effects by increasing glutathione, superoxide dismutase, and catalase activities, and subsequently decreasing lipid peroxidation ⁽¹⁹⁾.

  Several studies have also investigated the antitumor properties of E. officinalis. Pyrogallol, a component of E. officinalis extract, was found to cause cell cycle arrest in the G2/M phase, inhibit proliferation, and induce apoptosis in human lung adenocarcinoma (H441) and squamous cell cancer (H520) cell lines ⁽²⁾. Intraperitoneal pyrogallol injections also suppressed subcutaneous tumor growth in mice ⁽²⁾. An aqueous extract decreased tumor volume through inhibiting the cell cycle regulating enzyme CDC25 ⁽¹⁰⁾. Progallin, extracted from E. officinalis leaves, also caused cell cycle arrest in the G1/M and G2/M phase, inhibited proliferation, and induce apoptosis in human hepatocellular carcinoma cells (BEL-7404) ⁽¹⁴⁾. In other studies, E. officinalis extracts were shown to inhibit cell growth both in vitro and in vivo possibly via inhibition of angiogenesis and activation of autophagy in ovarian cancer cells ⁽²⁰⁾; and demonstrated cardioprotective effects against doxorubicin toxicity in vitro ⁽³⁾, attributed to antioxidants.

• Herb-Drug Interactions
  • Clopidogrel: When used concomitantly, E. officinalis extract was found to increase the antiplatelet activity ⁽²²⁾.
  • Ecosprin: The above study found increased antiplatelet activity with Ecosprin as well ⁽²²⁾.
• References

  1. Scartezzini P, Speroni E. Review on some plants of Indian traditional medicine with antioxidant activity. J Ethnopharmacol. 2000;71(1-2):23-43.

  2. Yang CJ, Wang CS, Hung JY, et al. Pyrogallol induces G2-M arrest in human lung cancer cells and inhibits tumor growth in an animal model. Lung Cancer. 2009 Nov;66(2):162-8.

  3. Wattanapitayakul SK, Chularojmontri L, Herunsalee A, et al. Screening of antioxidants from medicinal plants for cardioprotective effect against doxorubicin toxicity. Basic Clin Pharmacol Toxicol. 2005 Jan;96(1):80-7.

  4. Scartezzini P, Antognoni F, Raggi MA, Poli F, Sabbioni C. Vitamin C content and antioxidant activity of the fruit and of the Ayurvedic preparation of Emblica officinalis Gaertn. J Ethnopharmacol. 2006;104(1-2):113-118.

  5. Chen TS, Liou SY, Chang YL. Supplementation of Emblica officinalis (Amla) extract reduces oxidative stress in uremic patients. Am J Chin Med. 2009;37(1):19-25.

  6. Ahmad I, Mehmood Z, Mohammad F. Screening of some Indian medicinal plants for their antimicrobial properties.J Ethnopharmacol. 1998;62(2):183-193.

  7. Hiraganahalli BD, Chinampudur VC, Dethe S, et al. Hepatoprotective and antioxidant activity of standardized herbal extracts. Pharmacogn Mag. 2012 Apr;8(30):116-23.

  8. Singh I, Sharma A, Nunia V, Goyal PK. Radioprotection of Swiss albino mice by Emblica officinalis. Phytother Res. 2005;19(5):444-446.

  9. Sairam K, Rao Ch V, Babu MD, et al. Antiulcerogenic effect of methanolic extract of Emblica officinalis: an experimental study. J Ethnopharmacol. 2002;82(1):1-9.

  10. Jose JK, Kuttan G, Kuttan R. Antitumour activity of Emblica officinalis. J Ethnopharmacol. 2001;75(2-3):65-69.

  11. Perianayagam JB, Sharma SK, Joseph A, et al. Evaluation of anti-pyretic and analgesic activity of Emblica officinalis Gaertn. J Ethnopharmacol. 2004;95(1):83-85.

  12. Sabu MC, Kuttan R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160.

  13. Yokozawa T, Kim HY, Kim HJ, et al. Amla (Emblica officinalis Gaertn.) prevents dyslipidaemia and oxidative stress in the ageing process. Br J Nutr. 2007;97(6):1187-1195.

  14. Zhong ZG, Wu DP, Huang JL, et al. A isolated from the acetic ether part of the leaves of Phyllanthus emblica L. induces apoptosis of human hepatocellular carcinoma BEL-7404 cells by up-regulation of Bax expression and down-regulation of Bcl-2 expression. J Ethnopharmacol. 2011 Jan 27;133(2):765-72.

  15. Piva R, Penolazzi L, Borgatti M, et al. Apoptosis of human primary osteoclasts treated with molecules targeting nuclear factor-kappaB. Ann N Y Acad Sci. 2009 Aug;1171:448-56.

  16. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of Amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011 Sep;62(6):609-16.

  17. Gopa B, Bhatt J, Hemavathi KG. A comparative clinical study of hypolipidemic efficacy of Amla (Emblica officinalis) with 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitor simvastatin. Indian J Pharmacol. 2012 Mar;44(2):238-42.

  18. Mahata S, Pandey A, Shukla S, et al. Anticancer activity of Phyllanthus emblica Linn. (Indian gooseberry): inhibition of transcription factor AP-1 and HPV gene expression in cervical cancer cells. Nutr Cancer. 2013;65 Suppl 1:88-97.

  19. Golechha M, Sarangal V, Ojha S, Bhatia J, Arya DS. Anti-Inflammatory Effect of Emblica officinalis in Rodent Models of Acute and Chronic Inflammation: Involvement of Possible Mechanisms.Int J Inflam. 2014;2014:178408.

  20. De A, De A, Papasian C, et al.Emblica officinalis extract induces autophagy and inhibits human ovarian cancer cell proliferation, angiogenesis, growth of mouse xenograft tumors. PLoS One. 2013 Aug 15;8(8):e72748.

  21. Khanna S, Das A, Spieldenner J, Rink C, Roy S. Supplementation of a Standardized Extract from Phyllanthus emblica Improves Cardiovascular Risk Factors and Platelet Aggregation in Overweight/Class-1 Obese Adults. J Med Food. 2015 Apr;18(4):415-20.

  22. Fatima N, Pingali U, Muralidhar N. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus. Phytomedicine. 2014 Apr 15;21(5):579-85.