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Bitter Orange Extract Health Risks

Bitter orange (citrus aurantium), is a perennial fruit-bearing tree. The fruit has been used in Chinese medicine for centuries to improve gastrointestinal processes and to treat colds and congestion. More recently, bitter orange has been touted as a weight-loss supplement and this has caused some controversy due to potential health risks.

  1. The constituents of Bitter Orange

    • A number of phytochemicals have been isolated throughout the plant in the leaf, fruit, flower and peel. These include coumarins (anticoagulants); esters (aromatic chemicals); tyrosine, valine and alanine (amino acids); hydrocarbons; alcohols; pectin (a polysaccharide); mineral salts; and synephrine alkaloids. Synephrine is the chemical that is isolated for use in weight-loss supplements. After the U.S. Food and Drug Administration ban on ephedra-based weight-loss pills, many diet-drug manufacturers looked to herbal and synthetic replacements that had similar effects on the body as ephedra.

    The Effects of Synephrine

    • Synephrine is one of the chemicals that affects the body like ephedra does. It releases adrenaline and nonadrenaline, which are chemicals released in response to stress, to stimulate the body's metabolism. It is a stimulant, and users can develop as much as a dependency on it as on caffeine. Synephrine suppresses appetite, stimulates fat metabolism, increases energy levels, promotes calorie burn and has an overall stimulating effect.

    Serious Side Effects

    • Bitter orange synephrine has been connected to several cardiovascular conditions. Dangers including cardiac arrest, blackout, tachycardia and ventricular fibrillation are outlined in a study by Scott R. Penzak, "Seville (sour) Orange Juice: Synephrine Content and Cardiovascular Effects in Normotensive Adults," which appeared in the October 2001 issue of the Journal of Clinical Pharmacology. You should contact your physician immediately if you are taking bitter orange tablets and you experience high blood pressure, arrhythmia (irregular heart beat), heart palpitations, chest pain, symptoms of a heart attack, racing heart, blood in your stool, abdominal pain, vertigo, severe diarrhea or an allergic reaction such as swelling, hives, or difficulty breathing or swallowing.

    Drug Interactions

    • Synephrine from bitter orange can react adversely with prescription medications. If taken with antiviral medications, bitter orange may deplete their concentration. Bitter orange may cause a dangerous interaction if taken with calcium channel blockers. It should not be taken with dextromethorphan, as synephrine may significantly increase the drug's bioavailability. Bitter orange may increase the adverse effects of antidepressants and antianxiety medications. It can also cause dangerous interactions with Monoamine oxidase inhibitors. Bitter orange overdose may result in vomiting, dizziness, diarrhea and insomnia. It should not be used by pregnant or breast -feeding women. It should not be used with other stimulants or other weight-loss medications. Do not take bitter orange if you have glaucoma. There is no established safe bitter orange dosage.

    Combined Ingredients

    • In weight-loss supplements, synephrine is often combined with additional ingredients such as guarana and kola nut to enhance its effects. Both of these ingredients are caffeine sources. Another common additional ingredient is willow extract, which is a natural form of aspirin. Sometimes octopamine is also added to help suppress appetite. These ingredients may increase adverse side effects.

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