Bottom Line: Fenugreek may lower blood glucose and cholesterol levels in people with diabetes.
Plentiful research has been conducted in India and other countries studying the medicinal effects of fenugreek, focusing on its potential in diabetes. In healthy and diabetic animals and humans, fenugreek lowers cholesterol, blood triglyceride levels, and blood glucose levels. Scientists are not certain how this effect happens, but propose that the fiber in fenugreek binds to glucose and cholesterol in the digestive tract and prevents it from being absorbed by the body, or increases insulin secretion. Laboratory studies in rats show that fenugreek normalizes their blood levels of antioxidants and metabolic enzymes, but it is unclear whether this effect occurs in humans.
To prevent and treat hair loss No scientific evidence supports this use.
To treat cancer No scientific evidence supports this use.
To treat diabetes Several animal studies and a few clinical trials show that fenugreek can lower blood glucose levels when taken with meals. However, not nearly enough research has been performed with fenugreek to support its use as a replacement for diabetes medications.
As a laxative No clinical trials have studied this use, but fenugreek seeds do contain high levels of fiber.
To treat disorders of the digestive tract No scientific evidence supports this use. Fenugreek seeds contain high levels of fiber.
To lower high cholesterol Several animal studies and a few clinical trials support this use.
To induce childbirth Although laboratory studies show that fenugreek stimulates contraction of the uterus, there is no proof from clinical trials that this effect occurs in humans.
To fight infections Fenugreek shows antibacterial properties in laboratory experiments, but there is no proof from clinical trials that this effect occurs in humans.
To reduce inflammation No scientific evidence supports this use.
As a lactation stimulant Although fenugreek is often used to stimulate lactation in folk medicine, no clinical trials have actually studied this use in humans.
Topically, to treat skin ulcers No scientific evidence supports this use.
Topically, to speed wound healing Fenugreek shows antibacterial properties in laboratory experiments, but otherwise no scientific evidence supports this use.
Diabetes: Most of the clinical research studying the effects of fenugreek on blood sugar and lipid levels in diabetes have been conducted in India. Most are small and not designed very well, so larger clinical trals must be done to ensure that fenugreek is effective.
Sixty patients with type II diabetes, 40 of whom took glucose-lowering edication, consumed a controlled diet for one week, followed by 24 weeks of the same diet plus a soup containing 25 grams of fenugreek seed powder. After 24 weeks, on average, the patients had lower blood levels of total cholesterol, LDL ("bad") cholesterol, and triglycerides compared to the start of the study. Because this study has no control group (eating the controlled diet only), we cannot tell if these effects are from eating the diet or from the additional fenugreek.
Ten diabetic patients who were taking daily glucose-lowering medication daily were randomly assigned to consume their regular diet plus bread containing 25 grams of fenugreek daily or bread containing no fenugreek. After following one diet for 15 days, patients switched to the other diet for another 15 days. After each 15-day period, doctors conducted a postprandial (after eating) glucose tolerance test. The results showed that the group eating fenugreek bread had significantly lower average blood glucose levels after eating, and a higher number of insulin receptors on their red blood cells. This study is too small to reflect the general response of diabetics to dietary fenugreek, and patients should have had a "washout" period between the different diets to remove the effects of fenugreek from their systems.
A higher dose of dietary fenugreek was used in a study of ten insulin-dependent diabetic patients. For ten days, patients consumed a planned diet with or without 100 grams of fenugreek seed powder. For another ten days, patients switched to the opposite diet. For the entire time, they were given lower dosages of insulin than usual so that the effects of fenugreek could be seen. After ten days of eating fenugreek, patients had significantly reduced blood glucose levels, urine sugar levels, total cholesterol, LDL ("bad" cholesterol), and triglyceride levels compared to their normal diet levels. Though these results are promising, this study is too small and should be conducted again with more patients.
Because it is not regulated by the F.D.A., this product may be contaminated with other botanicals and/or the concentration listed on the label may be inaccurate.
Ingestion of fenugreek seeds or tea in infants or late-term pregnant women can lead to false diagnosis of maple syrup urine disease in the infant. The physician should be informed of fenugreek use so that this confusion can be avoided.
You are pregnant (Fenugreek may induce childbirth).
You have a known allergy to fenugreek.
You are taking warfarin or other blood thinners (Fenugreek may increase the risk of bruising and bleeding).
You are taking MAOIs (Fenugreek may have an additive effect).
You are taking medication for diabetes (Your dosage may have to be adjusted because of fenugreek's glucose-lowering effects. Blood glucose levels should be monitored by your doctor so that dose adjustments can be made if necessary).
You are taking insulin (Your dosage may have to be adjusted with regular use of fenugreek. Blood glucose levels should be monitored by your doctor so that dose adjustments can be made if necessary).
You are taking any other oral medications (Absorption of other oral medications administered at the same time as fenugreek may be reduced because of fenugreek's high fiber content).
Fenugreek is derived from the dried seeds of the plant and is used traditionally in ayurvedic medicine as a demulcent, laxative, and lactation stimulant. It is also used as a dietary supplement to treat various conditions including diabetes, high cholesterol, wounds, inflammation, and gastrointestinal complaints. Fenugreek exhibits hypocholesterolemic, hypolipidemic and hypoglycemic activity in healthy and diabetic animals and humans (1)(2)(3). The defatted seed material may reduce gastrointestinal glucose and cholesterol absorption and increase bile acid secretion (4). In addition, fenugreek may have hepatoprotective effects in animals with alcohol-induced liver damage (5)(6). A few in vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers although human studies have yet to be performed (7)(8)(9). Insufficient evidence is available to evaluate its use as a lactation stimulant.
Fenugreek may potentiate the activity of anticoagulants and may interact with MAOIs and hormonal agents. Diabetic patients taking this herb should monitor their blood glucose closely and may require dose adjustments of antidiabetic agents. Pregnant women should not use this herb due to its uterine stimulant activity (10).
Fenugreek exhibits hypocholesterolemic, hypolipidemic, and hypoglycemic activity in healthy and diabetic animals and humans (1)(2). The mechanism is uncertain, but its activity may be associated with the galactomannan fiber and saponin components that reduce gastrointestinal glucose and cholesterol absorption and increase bile acid excretion (14). Hypoglycemic activity is also attributed to the trigonelline, nicotinic acid, and coumarin fractions. 4-Hydroxyisoleucine, an amino acid constituent of fenugreek, potentiates insulin secretion in NIDDM rats when administered intraperitoneally (15). Fenugreek intake in humans is associated with an increase in molar insulin binding sites of erythrocytes, which may enhance glucose utilization (16). In addition to lower fasting and postprandial glucose levels, fenugreek-treated diabetic rats have higher hemoglobin, GSH, and plasma antioxidant levels and lower glycosylated hemoglobin, plasma lipids, and TBARS levels than diabetic controls (4). Dietary fenugreek normalizes the activities of glucose and lipid-metabolizing enzymes in diabetic rats (3). In healthy mice and rats, dietary fenugreek is associated with increased serum T4, liver GSH, glyoxalase I, and GST activities, and decreased T3 levels and T3/T4 ratio (17)(18)(19). Extracts of fenugreek show antimicrobial and nematocidal activity in vitro (20). In MCF-7 estrogen receptor-positive breast cancer cells, fenugreek extract induces cell cycle arrest as well as apoptosis (9).
Common: Doses of 100 g/day fenugreek cause flatulence, diarrhea, and other GI symptoms. Reported: Bleeding, bruising, hypoglycemia. Repeated topical use can cause skin sensitization. Inhalation of the powder can cause asthma and allergic symptoms. (10)
Anticoagulants: Fenugreek may potentiate effects due to coumarin content. Antidiabetic agents: Possible enhanced glucose-lowering effects. May require dosage adjustments. Insulin: Insulin dosage may have to be adjusted with regular use of fenugreek. Other oral medications: Absorption of other oral medications administered concomitantly may be impaired due to high mucilaginous fiber content of fenugreek seeds. MAOIs: Fenugreek may potentiate their effect due to amine content. (10)
Increased PT, INR Decreased blood glucose Urine odor: False diagnosis of maple syrup urine disease in the infant due to presence of sotolone in the urine (21)(22)
Sharma RD, et al. Hypolipidaemic effect of fenugreek seeds: a chronic study in non-insulin dependent diabetic patients. Phytother Res 1996;10:332-4. A prospective, one-arm study of dietary fenugreek in 60 patients with non-insulin dependent diabetes of differing severity levels. 40 patients were taking oral hypoglycemic drugs. Each subject underwent 7 days of control diet followed by 24 weeks of consuming 25 g/day fenugreek seed powder prepared in a soup. Diets in each period were similar in calorie and nutrient composition, except for higher fiber content in the fenugreek diet. Mean serum cholesterol decreased from baseline (approx. 241 mg/dl) to 24 weeks (approx. 199 mg/dl), as did LDL cholesterol (approx. 143 to 114 mg/dl), LDL+VLDL cholesterol (approx. 179 to 148 mg/dl), and triglycerides (approx. 187 to 159 mg/dl). Diarrhea and flatulence were reported in a few patients.
Raghuram TC, Sharma RD, Sivakumar B. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients. Phytother Res 1994;8:83-6. A randomized, controlled, crossover evaluation of dietary fenugreek in 10 non-insulin dependent diabetics taking glibenclamide, 2.5-7.5 mg/day, with stabilized diet and drug dose. The study consisted of two 15-day periods: 5 patients received bread containing 25 g fenugreek powder daily for the first 15 days, while the other 5 received it in the second 15-day period. Control bread contained the same nutrient content without fenugreek. Food intake and body weight were similar between treatment arms. An intravenous glucose tolerance test at the end of each period showed significantly lower mean plasma glucose levels at 40, 50, and 60 min and an 11% reduction in the area under the curve (AUC) in the fenugreek group. Erythrocyte insulin receptors were significantly higher in number in the fenugreek group. A washout period should have been instituted between test periods.
Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6. A prospective, controlled crossover evaluation of high-dose dietary fenugreek in 10 insulin-dependent diabetic patients. In two 10-day periods, patients consumed isocaloric diets with or without 100 g defatted fenugreek seed powder in divided doses. Five patients received the fenugreek diet in the first period and the rest received it in the second period. Patients were maintained on suboptimal insulin doses so that the effects of fenugreek could be seen. Oral glucose tolerance tests (administered with insulin) at the end of each study period showed significantly reduced blood glucose levels (p<0.01), but unchanged serum insulin levels. Urinary sugar excretion (p<0.01), serum total cholesterol (p<0.001), VLDL and LDL cholesterol (p<0.01), and triglyceride levels (p<0.01) were also reduced in the fenugreek group.
Sebastian KS, Thampan RV. Differential effects of soybean and fenugreek extracts on the growth of MCF-7 cells. Chem Biol Interact. Nov 20 2007;170(2):135-143.
Fetrow CW, Avila JR. Professional's Handbook of Complementary and Alternative Medicines. Philadelphia: Springerhouse; 1999.
Barnes J, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Healthcare Professionals. 2nd ed. London: Pharmaceutical Press; 2002.
DerMarderosian A. he Review of Natural Products. St. Louis: Facts and Comparisons;1999.
Newall C. Herbal Medicines: A Guide for Health-Care Professionals. 1st ed. London: Pharmaceutical Press; 1998.
