Health Care Professional Information

Scientific Name
Cymbopogon citratus, Cymbopogon flexuous
Common Name

Fever grass, barbed wire grass, silky heads

Clinical Summary

The genus Cymbopogon consists of several species (1) that are prevalent in the tropical regions of Africa and Asia, (2) including C. citratus (West Indian lemongrass) and C. flexuous (East Indian lemongrass). Lemongrass is widely used in perfumery, as a flavoring agent in Asian cuisine, and also has medicinal effects (1). While not generally used as a dietary supplement, it is traditionally consumed as a tea. It has been used in folk medicine as a sedative (3), to reduce gastrointestinal problems (4), and for its CNS-depressant effects (5). Lemongrass has also been used as an insect repellent (6), has antifungal/antibacterial properties (1) (7) (21) and may help reduce oral thrush (7). The oil extract from C.citratus leaves demonstrated anti-inflammatory effects via COX-2 enzyme inhibition (8), and citral, an active constituent, showed antioxidant activity (9). Lemongrass stalk may have vasorelaxation effects, but the mechanism has not been elucidated (10).
Lemongrass and its constituents were shown to induce apoptosis in some cancer cell lines (11) (12) but it has not been studied in cancer patients.

Food Sources

Lemongrass is used to flavor many foods and beverages. The dried leaves are used to make tea.

Purported Uses
  • Anticancer
  • Food flavoring
  • Perfumery/Aromatherapy
  • Insect repellent
  • Vasorelaxation
  • Sedative
  • Antifungal
  • Anti-inflammatory
  • Anxiolytic
Constituents

Essential oil from C.citratus

  • Citral
  • Myrcene

Essential oil from C.flexuous

  • Isointermedeol
  • Geraniol
  • Geranyl Acetate
  • alpha-bisabolol
  • Limonene

(3) (9) (11)

Mechanism of Action

The oil extracted from C. flexuous oil contains isointermedeol, which along with other constituents demonstrates anticancer activity (2) (11) by upregulating tumor necrosis factor receptor 1 leading to apoptosis through the extrinsic Fas pathway. It also increases mitochondrial expression and activation of caspase-9 via the intrinsic cell death pathway. Citral, the major constituent of C. citratus, was shown to induce glutathione S-transferase (GST) through an electrophilic interaction with glutathione (GSH) in rat liver epithelial cells. GST functions in cell detoxification by rescuing cells from oxidative damage and carcinogenic compounds (9). In human leukemia and breast cancer cells, citral induced apoptosis by inducing caspase-3 enzymatic activity (8). Cytotoxicity was noted to significantly affect the cancer cell lines, up to 90% cell death in some cases (12). This is attributed to the presence of an unsaturated aldehyde group, which is specific to the geranial isomer of citral (9).

The essential oil extract of C. citratus leaves was found to alter the onset and duration of pentylenetetrazol (PZT)-induced convulsions and potentiate sleep time possibly through GABAergic mechanisms in mice (3). It also increased seizure threshold by blocking seizure propagation (15).
Citronellol, a compound present in the essential oil of C. Citratus, demonstrated analgesic effects thought to be mediated via inhibition of peripheral mediators as well as central inhibitory mechanisms (22). C. citratus inhibits release of myeloperoxidase (a marker of inflammation) from neutrophils. It also suppresses IL-6 and IL-1alpha production in mice peritoneal macrophages (13) and inhibits COX-2 enzyme in human breast cancer cells (8).

Contraindications
  • Because of its antioxidant potential, lemongrass may interfere with the actions of some chemotherapeutic agents.
  • Lemongrass should be avoided during pregnancy as citral and myrcene, in high doses, can cause birth defects in rats (16) (17).
Adverse Reactions
  • Dizziness, drowsiness, dry mouth, polyuria, and increased appetite (5) (7).
  • In high doses, the essential oil of C.citratus can damage the liver and stomach mucosa (18).
Herb-Drug Interactions
  • Citral, found in the essential oil of lemongrass, was shown to induce glutathione-S-transferase (9).
  • Beta-myrcene, another constituent of lemongrass, can interfere with cytochrome P450 liver enzymes (19) (20). But lemongrass-prescription drug interactions have not been reported.
Literature Summary and Critique

Wright SC, Maree JE, Sibanyoni M. Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet. Phytomedicine 2009; 16(2-3):118-24.
Ninety AIDS patients with oral thrush were randomly assigned to receive either a 0.5% gentian violet aqueous solution orally 3 times daily; a mouth rinse consisting of 20ml of fresh-squeezed lemon juice diluted with 10ml of water followed by 2-3 drops of non-diluted juice; or 125ml of lemongrass infusion. The study was performed over 10 days. Researchers report that both lemon juice and lemongrass were superior to gentian violet in the treatment of oral thrush. However, these effects should be confirmed in larger trials.

Dosage (Inside MSKCC Only)
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References
  1. Ganjewala D and Luthra R. Essential oil biosynthesis and regulation in the genus Cymbopogon. Nat Prod Commun 2010;5(1):163-72.
  2. Sharma PR, et al. Anticancer activity of an essential oil from Cymbopogon flexuosus. Chem Biol Interact 2009; 179(2-3):160-8.
  3. Silva MR, et al. Comparative anticonvulsant activities of the essential oils (EOs) from Cymbopogon winterianus Jowitt and Cymbopogon citratus (DC) Stapf. in mice. Naunyn Schmiedebergs Arch Pharmacol 2010; 381(5):415-26.
  4. Carlini EA, et al. Pharmacology of lemongrass (Cymbopogon citratus Stapf). I. Effects of teas prepared from the leaves on laboratory animals. J Ethnopharmacol 1986; 17(1):37-64.
  5. Leite JR, et al. Pharmacology of lemongrass (Cymbopogon citratus Stapf). III. Assessment of eventual toxic, hypnotic and anxiolytic effects on humans. J Ethnopharmacol 1986; 17(1):75-83.
  6. Nerio LS, Olivero-Verbel J, Stashenko E. Repellent activity of essential oils: a review. Bioresour Technol 2010;101(1):72-8.
  7. Wright SC, Maree JE, Sibanyoni M. Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet. Phytomedicine 2009;16(2-3):118-24.
  8. Chaouki W, et al. Citral inhibits cell proliferation and induces apoptosis and cell cycle arrest in MCF-7 cells. Fundam Clin Pharmacol 2009;23(5):549-56.
  9. Nakamura Y, et al. A phase II detoxification enzyme inducer from lemongrass: identification of citral and involvement of electrophilic reaction in the enzyme induction. Biochem Biophys Res Commun 2003;302(3):593-600.
  10. Runnie I, et al. Vasorelaxation induced by common edible tropical plant extracts in isolated rat aorta and mesenteric vascular bed. J Ethnopharmacol 2004; 92(2-3):311-6.
  11. Kumar A, et al. An essential oil and its major constituent isointermedeol induce apoptosis by increased expression of mitochondrial cytochrome c and apical death receptors in human leukaemia HL-60 cells. Chem Biol Interact 2008; 171(3):332-47.
  12. Dudai N, et al. Citral is a new inducer of caspase-3 in tumor cell lines. Planta Med 2005;71(5):484-8
  13. Sforcin JM, et al. Lemongrass effects on IL-1beta and IL-6 production by macrophages. Nat Prod Res 2009;23(12):1151-9.
  14. Ernst E. Herbal remedies for anxiety - a systematic review of controlled clinical trials. Phytomedicine 2006;13(3):205-8.
  15. Blanco MM, et al. Neurobehavioral effect of essential oil of Cymbopogon citratus in mice. Phytomedicine 2009;16(2-3):265-70.
  16. Delgado IF, Carvalho RR, Nogueira AC, et al. Study on embryofoetotoxicity of b-myrcene in the rat. Food and Chemical Toxicology 1993;31(1):31-35.
  17. Nogueira AC, Carvalho RR, Souza CA, Chahoud I, Paumgartten FJ. Study on the embryofeto-toxicity of citral in the rat. Toxicology 1995;96(2):105-113.
  18. Fandohan P, Gnonlonfin B, Laleye A, et al. Toxicity and gastric tolerance of essential oils from Cymbopogon citratus , Ocimum gratissimum and Ocimum basilicum in Wistar rats. Food Chem Toxicol 2008;46(7):2493-2497.
  19. De-Oliveira AC, Ribeiro-Pinto LF, Paumgartten JR. In vitro inhibition of CYP2B1 monooxygenase by beta-myrcene and other monoterpenoid compounds. Toxicol Lett 1997;92(1):39-46.
  20. De-Oliveira AC, Ribeiro-Pinto LF, Otto SS, Goncalves A, Paumgartten FJ. Induction of liver monooxygenase by beta-myrcene. Toxicology 1997;124(2):135-140. 
  21. Chaudhari LK, Jawale BA, Sharma S, Sharma H, Kumar CD, Kulkarni PA. Antimicrobial activity of commercially available essential oils against Streptococcus mutans. J Contemp Dent Pract.2012 Jan 1;13(1):71-4.
  22. Brito RG, Guimarães AG, Quintans JS, et al. Citronellol, a monoterpene alcohol, reduces nociceptive and inflammatory activities in rodents.J Nat Med. 2012 Oct;66(4):637-44.

Consumer Information

How It Works

Bottom Line: Lemongrass has antioxidant, anticancer, and antifungal properties. But it has not been studied in cancer patients.

There are over 140 species of lemongrass that are prevalent in many parts of Africa and Asia. West Indian lemongrass has been traditionally used in Brazilian folk medicine to treat anxiety, gastrointestinal problems, and to induce sleep. These effects were demonstrated in rats but not in humans. Lab studies showed that lemongrass can lower blood pressure and has anti-inflammatory and antioxidant properties. More research is needed.

Purported Uses
  • Flavoring Agent
    Lemongrass extract is used to flavor food and beverages.
  • Perfume/Aromatherapy
    Essential oils from lemongrass are commonly used in perfumes and aromatherapy.
  • Anticancer
    In vitro studies showed that citral, the main component of lemongrass, can cause cancer cell death. Clinical evidence is lacking.
  • Insect repellent
    Essential oils of lemongrass can repel insects, but the effects are not long lasting.
  • Vasodilation
    Lab studies suggest that lemongrass can lower blood pressure by relaxing blood vessels. Human studies are needed.
  • Sedative
    Animal studies have shown that lemongrass injections can produce sedative effects. However, drinking lemongrass tea does not have the same effect in humans.
  • Antifungal
    A clinical trial of HIV/AIDS patients with oral thrush indicated that lemongrass is an effective antifungal treatment.
  • Anti-inflammatory
    Lab studies showed favorable results but human data are lacking.
  • Antioxidant
    Studies in mice showed that lemongrass acts as an effective antioxidant; however, clinical evidence is lacking.
  • Anxiolytic
    Clinical studies show that lemongrass tea does not lower anxiety or produce calming effects.
Research Evidence

Fungal Infections:
Ninety HIV/AIDS patients with oral thrush were randomly assigned to receive gentian violet solution, fresh lemon juice, or lemongrass tea. Gentian violet is the standard treatment for oral thrush in South Africa. Researchers found that both fresh lemon juice and lemongrass were better than gentian violet. Large scale studies are needed to confirm these results.

Do Not Take If
You are undergoing chemotherapy, because lemongrass can act as an antioxidant and may reduce the effectiveness of some chemo agents.
You are pregnant, because citral and myrcene present in lemongrass can cause birth defects in rats.
Side Effects
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Polyuria (excessive production or passage of urine)
  • Increase in appetite
  • In high doses, the essential oil of C.citratus can damage the liver and stomach mucosa.
E-mail your questions and comments to aboutherbs@mskcc.org.