Bitter Melon

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Bitter Melon

Common Names

  • Bitter gourd
  • Bitter cucumber
  • Bitter apple
  • Balsam pear
  • Leprosy gourd

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


How It Works

Data on whether bitter melon can reduce lower blood sugar levels are limited.

Bitter melon is a perennial plant found in Asia, South America, East Africa, and the Caribbean. The edible fruit is used both as food and in medicine to treat diabetes, cancer, viral infections, and immune disorders.

Several active substances in bitter melon may act in a way similar to insulin. However, high-quality studies are needed to determine safety and effectiveness, and it cannot be recommended as a replacement therapy for insulin or hypoglycemic drugs.

Human studies on its effects on cancer are also lacking. One study showed it had no effect on the immune system of cervical cancer patients.

Purported uses and benefits
  • To prevent cancer
    Lab studies suggest that bitter melon extracts may kill certain cancer cells, but this has not been studied in cancer patients.
  • To treat diabetes
    Limited data suggest bitter melon may help lower blood sugar, but a meta-analyses concluded the evidence is low quality with little safety data. Larger high-quality studies are needed.
  • To reduce fever
    There is no evidence to support this claim.
  • To treat infections
    Lab studies suggest bitter melon extracts can kill certain viruses, but human data are lacking.
Do Not Take If
  • You are pregnant: Animal studies suggest bitter melon may cause birth defects.
  • You are taking insulin: Bitter melon may have additive effects.
  • You are taking diabetes medications: Bitter melon may have additive effects.
  • You are taking P-gp substrate drugs: Bitter melon may increase the concentration and toxicity of these drugs. Clinical significance is not known.
  • You are taking CYP450 substrate drugs: Bitter melon extract inhibits CYP2C9 and may affect the metabolism of these drugs. Clinical significance has yet to be determined.
Side Effects

Gastrointestinal symptoms

Case Reports

  • Irregular rapid heartbeat: In a 22-year-old man who ingested bitter melon juice for a few days before being admitted for complaints of indigestion. Treatment with medications was needed.
  • Gastric ulcer: In a 40-year-old man who ingested a half-liter of homemade bitter melon extract. IV fluids, GI medications, and blood transfusion were needed.
  • Severe kidney injury: In a 60-year-old man with diabetes and high blood pressure who ingested an Ayurvedic formulation containing bitter melon, and in a 60-year-old woman who ingested a bitter melon extract.
  • Toxicity: Ingestion of vicine from the seed may cause headache, fever, abdominal pain, and coma.
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For Healthcare Professionals

Scientific Name
Momordica charantia
Clinical Summary

Bitter melon is a perennial plant that grows in the tropical and subtropical regions of Asia, South America, East Africa, and the Caribbean. The edible fruit is used both as food and in medicine to treat diabetes, cancer, viral infections, and immune disorders. Its bitterness is attributed to the presence of alkaloids, momordicosides, and momordicines. In vitro and animal studies suggest anticancer (1) (2) (3), antiviral (4) (5) (6), antidiabetic (31), and lipid-lowering (7) effects.

Data in humans are limited. Although bitter melon may lower blood sugar levels in both pre-diabetic (39) and diabetic patients (8) (40) (43), meta-analyses conclude the evidence is low quality with sparse safety data (44), and that more robust studies are needed (9) (40). Other preliminary data suggest supplementation may improve symptoms in knee osteoarthritis patients (41). In a study of cervical cancer patients, bitter melon had no effect on natural killer cell activity (10).

Although bitter melon is consumed as food, ingesting the seeds, extracts, and large quantities of juice can cause adverse effects.

Purported uses and benefits
  • Cancer 
  • Diabetes
  • Fever
  • Infections
Mechanism of Action

In an animal model, bitter melon extract showed hypoglycemic activity by suppressing glucose-6-phosphatase and fructose-1,6-bisphosphatase enzymes in the liver (14). It improved insulin sensitivity, glucose tolerance, and insulin signaling (15). It also reduced insulin resistance by influencing PPAR alpha and gamma expression (16) and by modulating phosphorylation status of insulin receptors and downstream signaling molecules (17). Preventive effects against insulin resistance may also occur via modulation of NF-kappa B and JNK pathways (36).

Animals fed bitter melon showed lower fatty acid synthase (18). It may affect fat and carbohydrate metabolism by stimulating thyroid hormones and adiponectin, and by enhancing AMPK activity (19). In another study, it prevented inflammation and oxidative stress, modulated mitochondrial activity, suppressed apoptosis activation, and inhibited lipid accumulation during the development of fatty liver (32).

Other experiments suggest cytotoxic activity with isolated components such as ribosome-inactivating proteins which inhibited HDAC-1 activity and induced apoptosis in prostate cancer cells (1). A triterpene extracted from bitter melon activated PPAR gamma and induced apoptosis in breast cancer cells (20). Bitter melon juice also caused apoptosis by inducing caspase-3 activation through AMPK in pancreatic cell lines (3). Similar effects were observed with methanol extracts which increased Bax and decreased the antiapoptotic protein Bcl-2 (21) (22). Other studies demonstrated reduction in metastasis via suppression of MMP-2 and MMP-9 enzymatic activities in lung adenocarcinoma cells (23). Bitter melon juice decreased phosphorylation of protein kinases Akt and ERK1/2, and viability of gemcitabine-resistant pancreatic cancer cells (37).

Contraindications

Bitter melon should be avoided if you are pregnant, as animal studies suggest it can cause developmental abnormalities (46) (47).

Adverse Reactions

Gastrointestinal problems

Case Reports

  • Atrial fibrillation: In a 22-year-old man who ingested bitter melon juice for a few days before admission for dyspeptic complaints, and requiring treatment with antiarrhythmics (28).
  • Acute gastric ulceration: In a 40-year-old man following ingestion of a half-liter of homemade bitter melon extract. Intravenous fluids, rabeprazole, and blood transfusion were needed (29).
  • Acute interstitial nephritis: In a 60-year-old man with diabetes and hypertension who ingested an Ayurvedic formulation containing bitter melon (42), and in a 60-year-old woman who ingested a bitter melon extract (45).
  • Toxicity: Ingestion of vicine from the seeds may cause favism characterized by headache, fever, abdominal pain, and coma (38).
Herb-Drug Interactions
  • P-gp substrates: Bitter melon inhibits P-glycoprotein and can increase the interacellular concentration and toxicity of substrate drugs, including vinblastine and paclitaxel (11) (12). Clinical significance has yet to be determined.
  • CYP450 substrates: Bitter melon extract inhibits CYP2C9 and may affect the metabolism of substrate drugs (30). Clinical significance has yet to be determined.
  • Insulin: Bitter melon may have an additive effect when used concomitantly (8).
  • Hypoglycemics: Bitter melon may have additive effects when used concomitantly (8) (34).
  • Chemotherapy drugs: In vitro studies suggest bitter melon extracts may increase bioavailability and efficacy of certain chemotherapy agents (35). Clinical significance has yet to be determined.
Dosage (OneMSK Only)
References
  1. Xiong SD, Yu K, Liu XH, et al. Ribosome-inactivating proteins isolated from dietary bitter melon induce apoptosis and inhibit histone deacetylase-1 selectively in premalignant and malignant prostate cancer cells. Int J Cancer. Aug 15 2009;125(4):774-782.
  2. Ray RB, Raychoudhuri A, Steele R, et al. Bitter melon (Momordica charantia) extract inhibits breast cancer cell proliferation by modulating cell cycle regulatory genes and promotes apoptosis. Cancer Res. Mar 1 2010;70(5):1925-1931.
  3. Kaur M, Deep G, Jain AK, et al. Bitter melon juice activates cellular energy sensor AMP-activated protein kinase causing apoptotic death of human pancreatic carcinoma cells. Carcinogenesis. Jul 2013;34(7):1585-1592.
  4. Lee-Huang S, Huang PL, Chen HC, et al. Anti-HIV and anti-tumor activities of recombinant MAP30 from bitter melon. Gene. Aug 19 1995;161(2):151-156.
  5. Fan JM, Zhang Q, Xu J, et al. Inhibition on Hepatitis B virus in vitro of recombinant MAP30 from bitter melon. Mol Biol Rep. Feb 2009;36(2):381-388.
  6. Waiyaput W, Payungporn S, Issara-Amphorn J, et al. Inhibitory effects of crude extracts from some edible Thai plants against replication of hepatitis B virus and human liver cancer cells. BMC Complement Altern Med. 2012;12:246.
  7. Nerurkar PV, Lee YK, Linden EH, et al. Lipid lowering effects of Momordica charantia (Bitter Melon) in HIV-1-protease inhibitor-treated human hepatoma cells, HepG2. Br J Pharmacol. Aug 2006;148(8):1156-1164.
  8. Fuangchan A, Sonthisombat P, Seubnukarn T, et al. Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2 diabetes patients. J Ethnopharmacol. Mar 24 2011;134(2):422-428.
  9. Ooi CP, Yassin Z, Hamid TA. Momordica charantia for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2012;8:CD007845.
  10. Pongnikorn S, Fongmoon D, Kasinrerk W, et al. Effect of bitter melon (Momordica charantia Linn) on level and function of natural killer cells in cervical cancer patients with radiotherapy. J Med Assoc Thai. Jan 2003;86(1):61-68.
  11. Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. Oct 2004;143(3):379-387.
  12. Pitchakarn P, Ohnuma S, Pintha K, et al. Kuguacin J isolated from Momordica charantia leaves inhibits P-glycoprotein (ABCB1)-mediated multidrug resistance. J Nutr Biochem. Jan 2012;23(1):76-84.
  13. Liu JQ, Chen JC, Wang CF, et al. New cucurbitane triterpenoids and steroidal glycoside from Momordica charantia. Molecules. 2009;14(12):4804-4813.
  14. Shibib BA, Khan LA, Rahman R. Hypoglycaemic activity of Coccinia indica and Momordica charantia in diabetic rats: depression of the hepatic gluconeogenic enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase and elevation of both liver and red-cell shunt enzyme glucose-6-phosphate dehydrogenase. Biochem J. May 15 1993;292 (Pt 1):267-270.
  15. Sridhar MG, Vinayagamoorthi R, Arul Suyambunathan V, et al. Bitter gourd (Momordica charantia) improves insulin sensitivity by increasing skeletal muscle insulin-stimulated IRS-1 tyrosine phosphorylation in high-fat-fed rats. Br J Nutr. Apr 2008;99(4):806-812.
  16. Shih CC, Lin CH, Lin WL. Effects of Momordica charantia on insulin resistance and visceral obesity in mice on high-fat diet. Diabetes Res Clin Pract. Jun 10 2008.
  17. Nerurkar PV, Lee YK, Motosue M, et al. Momordica charantia (bitter melon) reduces plasma apolipoprotein B-100 and increases hepatic insulin receptor substrate and phosphoinositide-3 kinase interactions. Br J Nutr. Mar 5 2008:1-9.
  18. Huang HL, Hong YW, Wong YH, et al. Bitter melon (Momordica charantia L.) inhibits adipocyte hypertrophy and down regulates lipogenic gene expression in adipose tissue of diet-induced obese rats. Br J Nutr. Feb 2008;99(2):230-239.
  19. Saokaew S, Suwankesawong W, Permsuwan U, et al. Safety of herbal products in Thailand: an analysis of reports in the thai health product vigilance center database from 2000 to 2008. Drug Saf. Apr 1 2011;34(4):339-350.
  20. Weng JR, Bai LY, Chiu CF, et al. Cucurbitane Triterpenoid from Momordica charantia Induces Apoptosis and Autophagy in Breast Cancer Cells, in Part, through Peroxisome Proliferator-Activated Receptor gamma Activation. Evid Based Complement Alternat Med. 2013;2013:935675.
  21. Li CJ, Tsang SF, Tsai CH, et al. Momordica charantia Extract Induces Apoptosis in Human Cancer Cells through Caspase- and Mitochondria-Dependent Pathways. Evid Based Complement Alternat Med. 2012;2012:261971.
  22. Fang EF, Zhang CZ, Zhang L, et al. In vitro and in vivo anticarcinogenic effects of RNase MC2, a ribonuclease isolated from dietary bitter gourd, toward human liver cancer cells. Int J Biochem Cell Biol. Aug 2012;44(8):1351-1360.
  23. Hsu HY, Lin JH, Li CJ, et al. Antimigratory Effects of the Methanol Extract from Momordica charantia on Human Lung Adenocarcinoma CL1 Cells. Evid Based Complement Alternat Med. 2012;2012:819632.
  24. Lee-Huang S, Huang PL, Huang PL, et al. Inhibition of the integrase of human immunodeficiency virus (HIV) type 1 by anti-HIV plant proteins MAP30 and GAP31. Proc Natl Acad Sci U S A. Sep 12 1995;92(19):8818-8822.
  25. Lee-Huang S, Huang PL, Sun Y, et al. Inhibition of MDA-MB-231 human breast tumor xenografts and HER2 expression by anti-tumor agents GAP31 and MAP30. Anticancer Res. Mar-Apr 2000;20(2A):653-659.
  26. Cunnick J, Takemoto D. Bitter melon (Momordica charantia). J Naturopath Med.1993;4:16-21
  27. Tennekoon KH, Jeevathayaparan S, Angunawala P, et al. Effect of Momordica charantia on key hepatic enzymes. J Ethnopharmacol. Oct 1994;44(2):93-97.
  28. Erden I, Ordu S, Erden EC, et al. A case of atrial fibrillation due to Momordica charantia (bitter melon). Ann Saudi Med. Jan-Feb 2010;30(1):86-87.
  29. Nadkarni N, D’Cruz S, Sachdev A. Hematemesis due to bitter melon (Momordica charantia) extract-induced gastric ulcerations. Indian J Gastroenterol. Jan 2010;29(1):37-38.
  30. Appiah-Opong R, Commandeur JN, Axson C, et al. Interactions between cytochromes P450, glutathione S-transferases and Ghanaian medicinal plants. Food Chem Toxicol. Dec 2008;46(12):3598-3603.
  31. Wang HY, Kan WC, Cheng TJ, Yu SH, Chang LH, Chuu JJ. Differential anti-diabetic effects and mechanism of action of charantin-rich extract of Taiwanese Momordica charantia between type 1 and type 2 diabetic mice. Food Chem Toxicol. 2014 Jul;69:347-56.
  32. Xu J, Cao K, Li Y, et al. Bitter gourd inhibits the development of obesity-associated fatty liver in C57BL/6 mice fed a high-fat diet. J Nutr. 2014 Apr;144(4):475-83.
  33. Sagkan RI. An in vitro study on the risk of non-allergic type-I like hypersensitivity to Momordica charantia. BMC Complement Altern Med. 2013 Oct 26;13:284.
  34. Nivitabishekam SN, Asad M, Prasad VS. Pharmacodynamic interaction of Momordica charantia with rosiglitazone in rats. Chem Biol Interact. 2009 Feb 12;177(3):247-53.
  35. Kwatra D, Venugopal A, Standing D, et al. Bitter melon extracts enhance the activity of chemotherapeutic agents through the modulation of multiple drug resistance. J Pharm Sci. 2013 Dec;102(12):4444-54.
  36. Yang SJ, Choi JM, Park SE, et al. Preventive effects of bitter melon (Momordica charantia) against insulin resistance and diabetes are associated with the inhibition of NF-κB and JNK pathways in high-fat-fed OLETF rats. J Nutr Biochem. 2015 Mar;26(3):234-40.
  37. Somasagara RR, Deep G, Shrotriya S, Patel M, Agarwal C, Agarwal R. Bitter melon juice targets molecular mechanisms underlying gemcitabine resistance in pancreatic cancer cells. Int J Oncol. 2015 Apr;46(4):1849-57.
  38. Dutta PK, Chakravarty AK, CHowdhury US, and Pakrashi SC. Vicine, a favism-inducing toxin from Momordica charantia Linn. seeds. Indian J Chem 1981;20B(August):669-671.
  39. Krawinkel MB, Ludwig C, Swai ME, Yang RY, Chun KP, Habicht SD. Bitter gourd reduces elevated fasting plasma glucose levels in an intervention study among prediabetics in Tanzania. J Ethnopharmacol. 2018 Apr 24;216:1-7.
  40. Peter EL, Kasali FM, Deyno S, et al. Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis. J Ethnopharmacol. 2019 Mar 1;231:311-324.
  41. Soo May L, Sanip Z, Ahmed Shokri A, Abdul Kadir A, Md Lazin MR. The effects of Momordica charantia (bitter melon) supplementation in patients with primary knee osteoarthritis: A single-blinded, randomized controlled trial. Complement Ther Clin Pract. 2018 Aug;32:181-186.
  42. Beniwal P, Gaur N, Singh SK, Raveendran N, Malhotra V. How Harmful Can Herbal Remedies Be? A Case of Severe Acute Tubulointerstitial Nephritis. Indian J Nephrol. 2017 Nov-Dec;27(6):459-461.
  43. Kim SK, Jung J, Jung JH, et al. Hypoglycemic efficacy and safety of Momordica charantia (bitter melon) in patients with type 2 diabetes mellitus. Complement Ther Med. Aug 2020;52:102524.
  44. Peter EL, Kasali FM, Deyno S, et al. Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis. J Ethnopharmacol. Mar 1 2019;231:311-324.
  45. Bae W, Kim S, Choi J, et al. Acute interstitial nephritis associated with ingesting a Momordica charantia extract: A case report. Medicine (Baltimore). Jul 9 2021;100(27):e26606.
  46. Khan MF, Abutaha N, Nasr FA, et al. Bitter gourd (Momordica charantia) possess developmental toxicity as revealed by screening the seeds and fruit extracts in zebrafish embryos. BMC Complement Altern Med. Jul 24 2019;19(1):184.
  47. Uche-Nwachi EO, McEwen C. Teratogenic effect of the water extract of bitter gourd (Momordica charantia) on the Sprague Dawley rats. Afr J Tradit Complement Altern Med. Oct 15 2009;7(1):24-33.
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