Garcinia gummi-gutta

Share
Print
Share
Print
Garcinia cambogia

Common Names

  • Garcinia
  • Tamarind
  • Brindleberry
  • Hydroxycitric acid
  • HCA
  • Hydroxycut

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

Garcinia gummi-gutta and one of its active compounds, hydroxycitric acid (HCA), have been promoted for weight loss or body building, but evidence is insufficient and mixed.

Garcinia gummi-gutta, better known by its older name Garcinia cambogia, is a plant native to Southeast Asia. The fruit rinds are used as a flavoring agent and in traditional medicine. The extract and its active compound, HCA, can be found in many products promoted for weight loss or body building.

Preclinical animal studies suggest some benefits on weight and feed intake. However, human studies are limited and generally did not find effects on appetite, calorie intake, or weight loss. 

G. cambogia and HCA supplements may cause liver toxicity. Patients who have cancer, diabetes, depression, or other chronic diseases should use garcinia with caution as it may interact with medications.

Purported Uses
  • Appetite suppression
    Humans studies are limited and did not find decreases in calorie intake or appetite.
  • Obesity, weight loss
    Controlled trials are mixed, but showed no benefit over placebo for weight loss.
  • Gastrointestinal problems
    Although garcinia has been used in traditional medicine, studies on its effects for digestive problems have not been conducted.
Do Not Take If
  • You are having lab tests to measure cholesterol or blood sugar levels: Taking garcinia may cause results to be inaccurate.
  • You are taking antidepressants: Several case reports have described manias and potential interactions with antidepressants.
  • You have liver problems: A number of case reports have associated G. cambogia and HCA supplements with liver toxicity and injury.
  • You are pregnant: G. cambogia has not been tested in pregnant women.
  • You have diabetes: G. cambogia can decrease insulin levels and affect blood sugar levels.
  • You are taking CYP2B6 substrate drugs: Lab studies suggest potential interactions with drugs metabolized by this enzyme and garcinia. A number of drug classes may be affected, including antitumor drugs (cyclophosphamide, ifosphamide, and sorafenib), antimalarials (artemisinin), antidepressants (bupropion, selegiline), antivirals (efavirenz), analgesics (methadone, meperidine), and anticonvulsants (valproic acid).
Side Effects

Common: Nausea, headache, GI discomfort
Rare: Itching around the mouth, upper respiratory tract symptoms

Case Reports

Acute hepatitis, livery injury/toxicity: Multiple cases

Liver failure requiring transplant: In a 52-year-old woman and a 34-year old man, both associated with the use of G. cambogia.

Mania, psychosis: Several cases, both with and without psychiatric histories

Skeletal muscle damage: In an 18-year-old man, possibly associated with the ingestion of an herbal supplement that contained HCA in addition to his increased exercise regimen.

Acute kidney injury: In a 38-year-old obese woman after long-term use of an HCA-containing supplement.

Serotonin toxicity: Suspected in a 35-year-old woman taking serotonin reuptake inhibitors (SSRIs) along with a nutritional supplement containing G. cambogia and HCA.

Cardiovascular toxicity: In a previously healthy 48-year-old woman taking G. cambogia extract.

Diabetic complications, pancreatic inflammation, and severe heart muscle weakness: In a 56-year-old woman with a complex medical history and whose outpatient medication had not been adjusted in the last 3 years. These events occurred after several weeks of G. cambogia consumption and sudden weight loss, and was therefore felt to be possibly related.

Acute pancreatitis: Possibly associated with garcinia, in an 82-year-old man with history of obesity and prior gallbladder removal.

Decreased vision and ocular pain: In an obese patient who took garcinia extract at a higher than recommended dose.

Special Point

Garcinia cambogia should not be confused with Garcinia mangostana (Mangosteen).

Back to top

For Healthcare Professionals

Scientific Name
Garcinia gummi-gutta, Garcinia cambogia
Clinical Summary

Garcinia gummi-gutta, better known by its older name Garcinia cambogia, is a plant native to Southeast Asia. The fruit rinds have antioxidant and anticholinesterase activities (1), and are used as a flavoring agent and in traditional medicine to treat gastrointestinal ailments. The extract, rich in hydroxycitric acid (HCA), can be found in many products promoted for weight loss or body building.

In animal studies, G. cambogia increased satiety, fatty acid oxidation, and weight loss (3) (4) and seemed to protect against high-fat and high-sugar diets (5) (6). An ethanol extract of garcinia also showed erythropoietic effects (7).

In humans, clinical trials are limited. HCA did not decrease caloric intake, promote satiety, or affect fat oxidation (8) (9) (10), but improved glycogen synthesis and insulin sensitivity in a small study (10). Other preliminary data suggest garcinia may improve HDL levels, but have minimal effects on other plasma lipids (8). Results from RCTs are mixed, but show no significant effect of G. cambogia extract over placebo for weight reduction (12) (13). A combination of G. cambogia with orlistat had more effects on cardiometabolic profiles and visceral adiposity index than orlistat alone in obese patients (14).

G. cambogia and HCA supplements have been associated with liver toxicity, mania, and herb-drug interactions. Patients who have cancer, diabetes, depression, or other chronic diseases, or women who are pregnant should use G. cambogia with caution.

G. cambogia should not be confused with Garcinia mangostana (Mangosteen).

Purported Uses
  • Suppress appetite
  • GI problems
  • Weight loss
Mechanism of Action

The negative isomer of hydroxycitric acid ((-)-HCA), may be the most active chemical compound of G. cambogia fruit rind. HCA is theorized to affect weight loss via decreased fatty acid synthesis, appetite suppression, and increased fatty acid metabolism. It competitively inhibits ATP-citrate lyase, the enzyme that catalyzes the conversion of citrate to substrates for fatty acid synthesis (3). Increased citrates in the cytoplasm may reduce glycolysis and increase glycogen synthesis. ATP-citrate lyase is also upregulated in cancer cells with high levels of aerobic glycolysis (18).

An animal study observed decreases in leptin and insulin levels in obese mice treated with HCA, which may suggest alterations in glucose metabolism (4). The iron contents in G. cambogia may contribute to the erythropoietic effect observed in animals (7).

Contraindications
  • Diabetes: G. cambogia and HCA may affect blood sugar and insulin levels (4) (10).
  • Pregnant and lactating women: G. cambogia has not been tested in pregnant women (38).
Adverse Reactions

Common: Nausea, headache, GI discomfort (3) (12) (19)
Rare: Itching around the mouth, upper respiratory tract symptoms (3) (19)

Case Reports

Hepatitis, livery injury/toxicity (21) (25) (26) (38) (39) (40) (41)

Liver failure requiring transplant: In a 52-year-old woman (23) and a 34-year old man (24), both associated with the use of G. cambogia.

Mania, psychosis: Several cases, both with and without psychiatric histories (32) (33) (34) (42).

Skeletal muscle damage: In an 18-year-old man, possibly associated with the ingestion of a supplement containing HCA in addition to his increased exercise regimen (27).

Nephropathy: In a 38-year-old obese woman after long-term use of an HCA-containing supplement (28).

Suspected serotonin toxicity: In a 35-year-old woman taking SSRIs along with a supplement containing G. cambogia and HCA, who presented with stuttering, profuse sweating, hypertension, and tachycardia. Although a direct cause could not be proven, she had already used escitalopram without incident for over 1 year and developed serotonin toxicity only after the addition of G. cambogia (29).

Myocarditis: In a previously healthy 48-year-old woman taking G.cambogia extract (30).

Diabetic ketoacidosis, pancreatitis, and stress cardiomyopathy: In a 56-year-old woman with a complex medical history and whose outpatient medications had not been adjusted in the last 3 years. These events transpired after several weeks of G. cambogia consumption and sudden weight loss, and was therefore felt to be possibly related (31).

Acute pancreatitis: Possibly associated with garcinia, in an 82-year-old man with history of obesity and prior cholecystectomy (43).

Decreased vision and ocular pain: In an obese patient who took garcinia extract at a higher than recommended dose (44).

Herb-Drug Interactions

Insulin: G. cambogia and HCA may affect blood sugar and insulin levels (4) (10).

Antidepressants: Case reports indicate HCA may increase serotonin release, which may interact with drugs that affect the serotoninergic system (29) (35).

Leukotriene receptor antagonists: A case report noted fatal liver failure when G. cambogia extract and another weight loss supplement was used along with the leukotriene receptor antagonist montelukast, but it is unclear if liver failure was due to G. cambogia  (36).

CYP2B6 substrate drugs: In vitro studies suggest G. cambogia extract could modulate the pharmacokinetics of these drugs, potentially causing interactions (37). A number of drug classes may be affected, including antitumor drugs (cyclophosphamide, ifosphamide, and sorafenib), antimalarials (artemisinin), antidepressants (bupropion, selegiline), antivirals (efavirenz) analgesics (methadone, meperidine), and anticonvulsants (valproic acid). However, HCA did not exhibit significant effects on CYP450.

Herb Lab Interactions
  • May decrease serum total cholesterol, triglycerides, and NEFA and lower insulin levels (4).
  • May increase levels of HDL-C (8).
Dosage (OneMSK Only)
References
  1. Saito M, Ueno M, Ogino S, et al. High dose of Garcinia cambogia is effective in suppressing fat accumulation in developing male Zucker obese rats, but highly toxic to the testis. Food Chem Toxicol. Mar 2005;43(3):411-419.
  2. Soni MG, Burdock GA, Preuss HG, et al. Safety assessment of (-)-hydroxycitric acid and Super CitriMax, a novel calcium/potassium salt. Food Chem Toxicol. Sep 2004;42(9):1513-1529.
  3. Hayamizu K, Hirakawa H, Oikawa D, et al. Effect of Garcinia cambogia extract on serum leptin and insulin in mice. Fitoterapia. Apr 2003;74(3):267-273.
  4. Amin KA, Kamel HH, Abd Eltawab MA. Protective effect of Garcinia against renal oxidative stress and biomarkers induced by high fat and sucrose diet. Lipids Health Dis. 2011;10:6.
  5. Kim YJ, Choi MS, Park YB, et al. Garcinia cambogia attenuates diet-induced adiposity but exacerbates hepatic collagen accumulation and inflammation. World J Gastroenterol. Aug 7 2013;19(29):4689-4701.
  6. Oluyemi KA, Omotuyi IO, Jimoh OR, et al. Erythropoietic and anti-obesity effects of Garcinia cambogia (bitter kola) in Wistar rats. Biotechnol Appl Biochem. Jan 2007;46(Pt 1):69-72.
  7. Kim JE, Jeon SM, Park KH, et al. Does Glycine max leaves or Garcinia cambogia promote weight-loss or lower plasma cholesterol in overweight individuals: a randomized control trial. Nutr J. 2011;10:94.
  8. Mattes RD, Bormann L. Effects of (-)-hydroxycitric acid on appetitive variables. Physiol Behav. Oct 1-15 2000;71(1-2):87-94.
  9. Kriketos AD, Thompson HR, Greene H, et al. (-)-Hydroxycitric acid does not affect energy expenditure and substrate oxidation in adult males in a post-absorptive state. Int J Obes Relat Metab Disord. Aug 1999;23(8):867-873.
  10. Cheng IS, Huang SW, Lu HC, et al. Oral hydroxycitrate supplementation enhances glycogen synthesis in exercised human skeletal muscle. Br J Nutr. Apr 2012;107(7):1048-1055.
  11. Onakpoya I, Hung SK, Perry R, et al. The Use of Garcinia Extract (Hydroxycitric Acid) as a Weight loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. J Obes. 2011;2011:509038.
  12. Heymsfield SB, Allison DB, Vasselli JR, et al. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA. Nov 11 1998;280(18):1596-1600.
  13. Al-Kuraishy HM, Al-Gareeb AI. Effect of orlistat alone or in combination with Garcinia cambogia on visceral adiposity index in obese patients. J Intercult Ethnopharmacol. Sep-Dec 2016;5(4):408-414.
  14. Mazzio EA, Soliman KF. In vitro screening for the tumoricidal properties of international medicinal herbs. Phytother Res. Mar 2009;23(3):385-398.
  15. Matsumoto K, Akao Y, Kobayashi E, et al. Cytotoxic benzophenone derivatives from Garcinia species display a strong apoptosis-inducing effect against human leukemia cell lines. Biol Pharm Bull. Apr 2003;26(4):569-571.
  16. Guais A, Baronzio G, Sanders E, et al. Adding a combination of hydroxycitrate and lipoic acid (METABLOC) to chemotherapy improves effectiveness against tumor development: experimental results and case report. Invest New Drugs. Feb 2012;30(1):200-211.
  17. Hatzivassiliou G, Zhao F, Bauer DE, et al. ATP citrate lyase inhibition can suppress tumor cell growth. Cancer Cell. Oct 2005;8(4):311-321.
  18. Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr. Apr 2004;79(4):529-536.
  19. Pittler MH, Schmidt K, Ernst E. Adverse events of herbal food supplements for body weight reduction: systematic review. Obes Rev. May 2005;6(2):93-111.
  20. Lobb A. Hepatoxicity associated with weight-loss supplements: a case for better post-marketing surveillance. World J Gastroenterol. Apr 14 2009;15(14):1786-1787.
  21. Chuah LO, Yeap SK, Ho WY, et al. In vitro and in vivo toxicity of garcinia or hydroxycitric acid: a review. Evid Based Complement Alternat Med. 2012;2012:197920.
  22. Corey R, Werner KT, Singer A, et al. Acute liver failure associated with Garcinia cambogia use. Ann Hepatol. Jan-Feb 2016;15(1):123-126.
  23. Lunsford KE, Bodzin AS, Reino DC, et al. Dangerous dietary supplements: Garcinia cambogia-associated hepatic failure requiring transplantation. World J Gastroenterol. Dec 7 2016;22(45):10071-10076.
  24. Mancano MA. Garcinia cambogia-Induced Acute Hepatitis; Varenicline-Induced Parkinsonism; Resistant Hypocalcemia After Zoledronic Acid Administration; Zonisamide-Induced Acute Kidney Injury; Psychosis Associated with Guanfacine. Hosp Pharm. Jul 2015;50(7):564-568.
  25. Melendez-Rosado J, Snipelisky D, Matcha G, et al. Acute hepatitis induced by pure Garcinia cambogia. J Clin Gastroenterol. May-Jun 2015;49(5):449-450.
  26. Dehoney S, Wellein M. Rhabdomyolysis associated with the nutritional supplement Hydroxycut. Am J Health Syst Pharm. Jan 15 2009;66(2):142-148.
  27. Li JW, Bordelon P. Hydroxycitric acid dietary supplement-related herbal nephropathy. Am J Med. Nov 2011;124(11):e5-6.
  28. Lopez AM, Kornegay J, Hendrickson RG. Serotonin toxicity associated with Garcinia cambogia over-the-counter supplement. J Med Toxicol. Dec 2014;10(4):399-401.
  29. Allen SF, Godley RW, Evron JM, et al. Acute necrotizing eosinophilic myocarditis in a patient taking Garcinia cambogia extract successfully treated with high-dose corticosteroids. Can J Cardiol. Dec 2014;30(12):1732.e1713-1735.
  30. Bystrak T, Cervera-Hernandez ME, Reddy N, et al. Garcinia cambogia, Diabetic Ketoacidosis, and Pancreatitis. R I Med J (2013). Oct 2 2017;100(10):48-50.
  31. Nguyen DC, Timmer TK, Davison BC, et al. Possible Garcinia cambogia-Induced Mania With Psychosis: A Case Report. J Pharm Pract. Jan 1 2017:897190017734728.
  32. Hendrickson BP, Shaikh N, Occhiogrosso M, et al. Mania Induced by Garcinia cambogia: A Case Series. Prim Care Companion CNS Disord. 2016;18(2).
  33. Cotovio G, Oliveira-Maia AJ. Hypomania induced by a Garcinia cambogia supplement. Aust N Z J Psychiatry. Jun 2017;51(6):641-642.
  34. Ohia SE, Awe SO, LeDay AM, et al. Effect of hydroxycitric acid on serotonin release from isolated rat brain cortex. Res Commun Mol Pathol Pharmacol. Mar-Apr 2001;109(3-4):210-216.
  35. Actis GC, Bugianesi E, Ottobrelli A, et al. Fatal liver failure following food supplements during chronic treatment with montelukast. Dig Liver Dis. Oct 2007;39(10):953-955.
  36. Yu JS, Choi MS, Park JS, et al. Inhibitory Effects of Garcinia cambogia Extract on CYP2B6 Enzyme Activity. Planta Med. Jul 2017;83(11):895-900.
  37. Lau FC, Bagchi M, Sen C, et al. Nutrigenomic analysis of diet-gene interactions on functional supplements for weight management. Curr Genomics. Jun 2008;9(4):239-251.
  38. Kothadia JP, Kaminski M, Samant H, et al. Hepatotoxicity Associated with Use of the Weight Loss Supplement Garcinia cambogia: A Case Report and Review of the Literature. Case Reports Hepatol. 2018;2018:6483605.
  39. Sharma A, Akagi E, Njie A, et al. Acute Hepatitis due to Garcinia Cambogia Extract, an Herbal Weight Loss Supplement. Case Rep Gastrointest Med. 2018;2018:9606171.
  40. Yousaf MN, Chaudhary FS, Hodanazari SM, et al. Hepatotoxicity associated with Garcinia cambogia: A case report. World J Hepatol. Nov 27 2019;11(11):735-742.
  41. Ferreira V, Mathieu A, Soucy G, et al. Acute Severe Liver Injury Related to Long-Term Garcinia cambogia Intake. ACG Case Rep J. Aug 2020;7(8):e00429.
  42. Nguyen DC, Timmer TK, Davison BC, et al. Possible Garcinia cambogia-Induced Mania With Psychosis: A Case Report. J Pharm Pract. Feb 2019;32(1):99-102.
  43. Iqbal U, Anwar H, Siddiqui HU, et al. Acute Pancreatitis Secondary to Use of Appetite Suppressant: Garcinia cambogia. Cureus. May 16 2019;11(5):e4676.
  44. Cho HK, Han YS, Park JM. Ocular complications of Garcinia cambogia extract diet pills: Case report. Eur J Ophthalmol. Nov 2020;30(6):Np21-np26.
Back to top
Back to top
Email your questions and comments to aboutherbs@mskcc.org.

Last Updated