Is Jiaogulan Safe? Gynostemma Side Effects, Interactions, Dosage
Jun 1,2023 | Read Time: 25 min.
Jason Dunn
Key Points
- 1.Jiaogulan (Gynostemma pentaphyllum) is generally considered safe and non-toxic. It also does not change your genes.
- 2.Jiaogulan side effects are rare and typically mild and temporary. They include nausea, increased frequency of bowel movement, vomiting, abdomen tension, diarrhea, constipation, dizziness, blurred vision, and tinnitus.
- 3.People on any sort of prescription medications and/or suffering from serious or chronic conditions must consult with their healthcare provider before taking Gynostemma, since it can interact with a variety of medications.
- 4.Drugs known to interact with Gynostemma include but are not limited to opioids, antidepressants, antipsychotics, beta-blockers, antiemetics, antiarrhythmics, antihistamines, and immunosuppressants.
- 5.Drugs with potentially adverse synergistic effects include antidiabetics, as well as medications and herbs affecting the circulatory system, including blood thinners.
- 6.Jiaogulan is not recommended for pregnant or breastfeeding women, people with bleeding disorders or problems with the circulatory system, and people scheduled to undergo surgery.
Jiaogulan, also known as Gynostemma Pentaphyllum Makino or southern ginseng, is a plant that grows wild in the high mountains of East and South East Asia.
Although it has been used traditionally as a health tonic for centuries in parts of China, it is only in the past 50 years that scientific research on the benefits of Jiaogulan earned a place for it in Traditional Chinese Medicine (TCM).
Jiaogulan is often touted for its health benefits, which range from reducing stress and improving heart health to helping with diabetes, obesity, high cholesterol, and boosting the immune system.
However, as with any supplement or herb, there are questions about safety and potential side effects.
Let's explore the safety profile of Gynostemma and examine the available evidence on its toxicity, side effects, contraindications, and recommended dosage in order to understand the potential risks and make informed decisions about its use.
Jiaogulan Safety and Toxicity
The available evidence from animal and human studies suggests that Gynostemma pentaphyllum is generally safe and non-toxic, with rare and typically mild adverse effects.
Several studies specifically designed to look for signs of toxicity and a potentially lethal dose to animals (LD50) have failed to find any.
In one study of Gynostemma pentaphyllum in rats published in the Journal of Ethnopharmacology, a dose of 5000 mg per kilogram of body weight of Gynostemma extract was administered, followed by daily doses of 1000 mg/kg for 90 days, and no deaths or signs of toxicity were observed.
Another study showed that rats who were given up to 750 mg/kg of Gynostemma for 6 months did not report any toxicity or loss of life (mortality).
Finally, in a small study for acute toxicity, 80,360 mg (80.36 g) per kilogram of body weight of Gynostemma pentaphyllum extract was given in 2 doses to 10 mice. The mice were observed for 14 days and did not display any signs of toxicity. At the end of the observation period, the animals were dissected and no abnormalities in any of their organs were observed. The study concluded that LD50 for Gynostemma pentaphyllum must be greater than 80.36g/kg.
Considering that the daily recommended dose is usually somewhere between 50-300 milligrams of gypenosides (the main active ingredients) per day, or 4-6 grams of dry leaves, it does not seem practically possible for an individual to consume enough Gynostemma to get anywhere close to these concentrations.
Similarly, in studies with humans, a phase I clinical trial conducted on healthy volunteers showed that doses of up to 400 mg twice daily for 2 months did not cause any significant adverse effects or changes in immune or biochemical parameters.
Another clinical trial published in the Journal of Phytochemistry Reviews involving 537 patients with bronchitis who were treated with Gynostemma pentaphyllum revealed some rare adverse reactions, such as vomiting, abdomen tension, diarrhea or constipation, dizziness, blurred vision, and tinnitus. However, these symptoms were not severe enough to stop the patients from taking the herb.
Furthermore, a recent randomized, double-blind, placebo-controlled clinical trial published in the Journal of Phytotherapy and Phytopharmacology involving 72 healthy adults with chronic psychological stress also showed no adverse effects from consuming Jiaogulan extract.
Finally, a study on the mutagenic (ability to change the DNA) effect of Gynostemma pentaphyllum on Salmonella bacteria found that it did not cause any changes in the DNA, whether another substance to help the process was added or not. Also tested was what would happen if Gynostemma tea was mixed with substances known to cause cancer. The researchers found that the tea actually had protective effects on the bacteria from most of these substances.
The results of these studies seem to support the anecdotal evidence from centuries of traditional use in China, and indicate that Jiaogulan is generally safe to use and well-tolerated, with some mild common side effects reported.
However, it is important to note that the safety of Gynostemma pentaphyllum has not yet been extensively studied in humans, and there may well be some unknown risks.
It is always advisable to consult a healthcare professional before using Jiaogulan, especially if you have any underlying medical conditions or are taking other medications.
Gynostemma Interactions And Contraindications
Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbs.
Jiaogulan can interact with certain medications and supplements, and individuals currently on these substances should consult with their healthcare provider before use.
One of the key points of concern is the use of medications metabolized by a liver enzyme called CYP2D6, which may interact with Gynostemma pentaphyllum and lead to adverse effects.
Additionally, caution should be exercised when using Jiaogulan with antiplatelet or anticoagulant medications, immunosuppressants, and diabetes medications.
Medications Metabolized by Liver Enzyme CYP2D6
It is important to consult with a healthcare provider before using Gynostemma if taking medications metabolized by the CYP2D6 enzyme to avoid potential danger from drug interactions and toxicity.
These include but are not limited to some opioids, antidepressants, antipsychotics, beta-blockers, antiemetics, antiarrhythmics, and antihistamines.
A gypenoside saponin found in Jiaogulan has been shown to inhibit the CYP2D6 enzyme, which is responsible for breaking down certain medications by the liver. When the liver cannot produce enough of the enzyme, these medications can build up in the body and can lead to toxicity and harmful adverse reactions.
Examples of medications metabolized by CYP2D6 include the following drugs and some of the brand names that contain them:
- Nortriptyline (Antidepressant)
- Pamelor
- Aventyl
- Noritren
- Nortrilen
- others (outside the USA)
- Paroxetine (Antidepressant)
- Paxil
- Paxil CR
- Brisdelle
- Pexeva
- others (outside the USA)
- Fluoxetine (Antidepressant)
- Prozac
- Sarafem
- Rapiflux
- Selfemra
- Phl-Fluoxetine
- Venlafaxine (Antidepressant)
- Effexor XR
- Effexor
- Haloperidol (Antipsychotic)
- Haldol
- Haldol Decanoate
- Peridol
- Haloperidol LA
- others (outside the USA)
- Risperidone (Antipsychotic)
- Risperdal
- Risperdal M-Tab
- Perseris
- Risperdal Consta
- Rykindo
- Aripiprazole (Antipsychotic)
- Abilify
- others (outside the USA)
- Metoprolol (Beta-blocker)
- Kapspargo Sprinkle
- Lopressor
- Toprol-XL
- Propranolol (Beta-blocker)
- Hemangeol
- Inderal LA
- Inderal XL
- InnoPran XL
- Inderal
- Propranolol Hydrochloride ER
- Ondansetron (Antiemetic)
- Zofran
- Zofran ODT
- Zuplenz
- Diphenhydramine (Antihistamine)
- Flecainide (Antiarrhythmic)
- Tambocor
- Propafenone (Antiarrhythmic)
- Rythmol
- Rythmol SR
- Codeine (Opoid)
- Hydrocodone (Opoid)
- Hysingla ER
- Zohydro ER
- Methadone (Opoid)
- Dolophine
- Methadose
- Methadose Sugar-Free
- Diskets
It is important to inform your healthcare provider if you are currently taking ANY of the above medications before taking Gynostemma Pentaphyllum to avoid potential drug interactions and toxicity.
Blood Thinner Medications and Herbs
The use of blood thinner (antiplatelet and anticoagulant) medications has become increasingly common in the management of cardiovascular diseases.
However, because Jiaogulan may act as an anticoagulant, taking it along with medications or supplements that also slow blood clotting might increase the risk of bleeding and bruising.
This is particularly important for people who are scheduled to undergo surgery, as they should stop taking Gynostemma at least two weeks before the procedure to avoid any risk of over-bleeding.
Medications
You should consult a doctor before using Gynostemma if you are on any of the following medications with antiplatelet or anticoagulant effects, including but not limited to:
- aspirin
- naproxen
- Aleve
- EC Naprosyn
- Anaprox
- Anaprox DS
- Naprosyn
- Naprox Sodium
- Naproxen EC
- Naproxen SR
- Naprelan
- Menstridol
- others (outside the USA)
- enoxaparin
- Lovenox
- Clexane
- Lovenox HP
- Clexane Forte
- others (outside the USA)
- dalteparin
- Fragmin
- warfarin
- Coumadin
- Jantoven
- others (outside the USA)
- apixaban
- Eliquis
- edoxaban
- Savaysa
- fondaparinux
- Arixtra
- rivaroxaban
- Xarelto
- ticlopidine
- Ticlid
- heparin
- Heparin Sodium
- indomethacin
- Indocin
- Indocin SR
- Indocin IV2
- Tivorbex
- clopidogrel
- Plavix
- others (outside the USA)
- diclofenac
- Voltaren
- Voltaren Gel
- Voltaren-XR
- Cataflam
- Cambia
- Zipsor
- Zorvolex
- Dyloject
- Arthrotec
- Flector
- Pennsaid
- Solaraze
- ibuprofen
- Advil
- Advil Liqui-Gels
- Motrin
- Motrin IB
- IBU
- others (outside the USA)
Herbal Products
The potential for bleeding and bruising may increase when using Gynostemma with certain herbs that may act as anticoagulants, such as:
- Danshen, also known as red sage or Chinese sage (Salvia miltiorrhiza)
- Devil's Claw (Harpagophytum procumbens)
- Eleuthero or Siberian ginseng (Eleutherococcus senticosus)
- Garlic
- Ginger
- Ginkgo (Ginkgo Biloba)
- Horse Chestnut (Aesculus hippocastanum)
- Panax Ginseng, also known as Asian ginseng, Chinese ginseng, Japanese ginseng or Korean ginseng
- Papain (enzyme extracted from the raw papaya fruit)
Caution should be taken when using these herbs in combination with Gynostemma, or medications that have blood thinning effects.
It is important to consult with a healthcare professional before using Gynostemma if you have a history of bleeding disorders or are taking medications that affect blood clotting.
Medications that Suppress the Immune System (Immunosuppressants)
Immunosuppressant medications are commonly prescribed to individuals who have undergone organ transplants or who have autoimmune diseases.
These medications work by suppressing the immune system, thereby preventing it from attacking the transplanted organ or the body's own tissues.
Taking Gynostemma along with medications that suppress the immune system may diminish their effectiveness because it has been shown to strengthen the activity of the immune system.
Therefore, people on immunosuppressant medications should avoid taking Gynostemma to ensure the safety and efficacy of their prescribed treatment.
Drugs having immunosuppressant properties include, but are not limited to:
- basiliximab
- Simulect
- azathioprine
- Imuran
- Azasan
- others (outside the USA)
- daclizumab
- Zenapax
- Zinbryta
- prednisone
- Deltasone
- Orasone
- Sterapred
- Rayos
- Meticorten
- cyclosporine
- Sandimmune
- Neoral
- Gengraf
- sirolimus
- Rapamune
- mycophenolate
- mofetil (MMF)
- CellCept
- Myfortic
- muromonab-CD3
- Orthoclone OKT3
- OKT3
- tacrolimus
- FK506
- Prograf
- Astagraf XL
- Hecoria
- Envarsus XR
- others (outside the USA)
- corticosteroids (glucocorticoids)
Diabetes Medications
It is important to consider the potential effects of taking Jiaogulan along with medications for diabetes.
Jiaogulan contains saponins that can be beneficial for type 2 diabetic patients because they have been found to lower blood sugar levels.
In addition, Gynostemma pentaphyllum tea improves insulin sensitivity in type 2 diabetic patients (reduces insulin resistance).
However, caution must be exercised when taking Gynostemma alongside diabetes medications as it could potentially lead to hypoglycemia (lower than normal blood glucose level).
It is important to consult with a health care professional before taking Jiaogulan along with diabetes medications.
If you are cleared to go ahead, please make sure to monitor your blood sugar closely.
Commonly prescribed medications for people with diabetes are:
-
-
- metformin
- Fortamet
- Glucophage
- Glucophage XR
- Glumetza
- Riomet
- pioglitazone
- Actos
- others (outside the USA)
- glipizide
- Glucotrol
- sitagliptin
- Januvia
- others (outside the USA)
- metformin
-
Warnings and Precautions
Pregnancy and breastfeeding
It is not known if Jiaogulan is safe for pregnant women, as there has been no research on the effects of Jiaogulan on human pregnancy and breastfeeding.
However, it is important to note that one of Gynostemma's components, a ginsenoside, has been found to cause fetal abnormalities in rats.
To be on the safe side, it is recommended to avoid Gynostemma during pregnancy and breastfeeding until more research has been done.
Problems with the Circulatory System, Bleeding, or Blood Clotting
People with bleeding disorders or who are taking blood-thinning medications should exercise caution when using herbal supplements, including Gynostemma.
This is because it acts as an anticoagulant and may increase the risk of bleeding by slowing down blood clotting.
It is important to consult with a healthcare provider before supplementing with Gynostemma if you have a bleeding disorder, are taking blood-thinning medications, or have a history of problems with the circulatory system.
By taking precautions and seeking medical advice, you can ensure your safety and avoid potential complications.
Allergic Reaction to Gynostemma
Although so far there is no evidence that taking Jiaogulan causes allergic reactions, they can theoretically occur in some individuals.
It is possible that some people may be allergic to specific biomolecules in Jiaogulan. For example, some may be allergic to plants in the Cucurbitaceae family, which includes squash, pumpkin, and watermelon. Jiaogulan is a plant belonging to this family, and people with this allergy may theoretically also experience a reaction to Jiaogulan and possible side effects.
Symptoms of an allergic reaction can include hives, difficulty breathing, and swelling of the face or throat. Anyone experiencing these symptoms after using Jiaogulan should immediately seek medical attention.
It is best to consult with your doctor if you have any known allergies or concerns about potential allergic reactions to Gynostemma.
Planning to Undergo a Surgery
Undergoing surgery is like embarking on a journey that requires careful planning and preparation, and individuals who are considering surgery should be aware that herbal supplements may interact with medications used during the procedure, as well as the procedure itself.
Because of Jiaogulan's ability to slow blood clotting, it is recommended that patients stop taking it at least two weeks before their surgery to avoid any potential complications due to the increased risk of uncontrolled bleeding.
Additionally, the plant may affect blood sugar levels, blood pressure, and heart rate, which can also impact the surgical outcome.
Therefore, it is important for patients to inform their healthcare provider about any herbal supplements they are taking before undergoing surgery.
Serious and Chronic Medical Conditions
Serious and chronic medical conditions require a cautious approach due to potential interactions with medications and Gynostemma.
It is important to consult with a healthcare professional before taking any supplements, including Gynostemma, if you have a history of medical conditions such as heart disease, diabetes, autoimmune diseases, liver or kidney disease, or if you are taking any prescription medications.
Jiaogulan has been shown to have a range of health benefits, including anti-inflammatory and antioxidant properties.
However, it is important to note that there is limited research on its safety in individuals with chronic medical conditions.
Therefore, it is vital to carefully consider Jiaogulan benefits and risks in consultation with a healthcare professional, particularly if you have a pre-existing medical condition or are on any prescription drugs.
Jiaogulan Dosage
There is no scientifically established standard dose for Jiaogulan, and the amount you should take may depend on several factors, such as your age, weight, health condition, and purpose of use.
Generally speaking, Gynostemma is considered safe and well-tolerated by most people. However, it may have side effects, such as nausea and diarrhea, especially if a person takes too much or is sensitive to the herb. Therefore, it is advisable to start with a low dose and gradually increase it until you find the optimal level for your needs.
A common way to consume Jiaogulan is by making tea from its dried leaves. You can use about 1-2 grams of Jiaogulan leaves per 8oz (250ml) cup of water and steep it for 10-15 minutes. You can drink up to 4 cups of Gynostemma tea per day.
Alternatively, you can take 2 capsules (roughly equivalent to 1 cup of tea), which usually contain about 500 mg of Jiaogulan each, 2 to 4 times per day with a glass of water.
For extracts and powders, you can follow the instructions on the product label or consult your doctor for the appropriate dosage.
You should preferably take Jiaogulan 30 minutes before a meal or on an empty stomach. However, if you feel stomach irritation or discomfort, please switch to consuming it after a meal.
It is advised to spread your intake throughout the day instead of taking it all at once.
Frequently Asked Questions
How much Jiaogulan tea should I drink?
It is usually recommended to drink between 2 to 4 cups of Jiaogulan tea per day, with 1 to 2 grams of dried leaves per cup, for a total of somewhere between 2 to 8 grams per day.
Individuals should start with a low dose and gradually increase it if needed, while monitoring for any potential adverse reactions.
Can I take too much Jiaogulan? Is there a recommended maximum daily amount?
A recommended maximum daily dose has not been clearly established.
No toxicity from Gynostemma has ever been observed in either animal studies or clinical trials.
An animal study attempting to determine a dose of acute toxicity found that a dose of over 80 grams per kilogram of body weight did not produce any toxicity.
Other animal studies for chronic toxicity with up to 1g/kg per day for 90 days also did not observe any toxicity.
In one human study, doses of up to 800 mg a day for two months appeared to be safe and non-toxic.
However, it is important to note that taking high doses of any herbal supplement can cause adverse reactions, and Jiaogulan is no exception.
Therefore, individuals should start with a low dose and gradually increase it if needed, while monitoring for any potential side effects.
Overall, when taken as directed and under the supervision of a healthcare provider, jiaogulan can be safely used as a dietary supplement.
Is Jiaogulan safe to take long-term?
One clinical trial with 117 people suffering from obesity lasted 16 weeks (4 months). Another 4-month trial studied 56 people with nonalcoholic fatty liver disease. Neither study found any chronic toxicity.
These studies suggest that Gynostemma is possibly safe in humans for at least 4 months of continuous consumption, although their sample size is quite small.
Anecdotally, the plant has been consumed daily for centuries in China without any known adverse long-term effects.
In fact, it is traditionally believed that it is thanks to the daily drinking of Jiaogulan tea that there were so many centenarians living in the regions where the herb grows wild.
Who should not take Gynostemma?
Jiaogulan should not be taken by people currently taking opioids, antidepressants, antipsychotics, beta-blockers, antiemetics, antiarrhythmics, antihistamines, and immunosuppressants.
In addition, it should be avoided by pregnant or breastfeeding women, people with bleeding disorders or problems with the circulatory system, and people scheduled to undergo surgery.
People on any prescription medications and/or with serious or chronic diseases must consult their doctor before supplementing with Jiaogulan.
Does the way you consume Jiaogulan (tea, capsule, extract) affect its safety and efficacy?
The method of preparation for Jiaogulan may potentially affect its safety and efficacy. While it can be consumed as a tea, capsule, or extract, the concentration of active compounds may differ depending on the method chosen.
For example, the brewing time and water temperature used to make Jiaogulan tea may influence the potency or concentrations of its bioactive components. Additionally, the use of low-quality plant material or improper extraction methods may compromise the safety and efficacy of Jiaogulan supplements.
Therefore, it is recommended to buy Jiaogulan products from reputable sources that adhere to good manufacturing practices and quality control standards.
Is Gynostemma safe for cancer patients?
Gynostemma has been shown to have anti-cancer properties and to have many benefits for cancer patients.
However, it is important to discuss this with your healthcare provider before considering adding Gynostemma to your current treatment.
