Lowering Blood Sugar: Amla vs Diabetes medication (sulfonylurea)

Image from Neutritionfacts.org Amla vs Diabetes

Fasting blood glucose (FBG) and 2 hours post meal glucose are two tools used to monitor diabetes and treatment. These tools do not tell the entire story. However, they provide valuable insight and are easy to monitor and track overtime.
 
A small study in Pakistan compared amla powder (Indian gooseberry) to glibenclamide (glyburide). This medication belongs to a class of drugs known as sulfonylureas. One of its many functions is to stimulate the pancreas to secrete more insulin.
 
Amla is a tart fruit used in food and as a medicine in Ayurvedic medicine. Over the last few years, several clinical trials conducted in India and Pakistan show promising result for several conditions. These include hyperlipidemia, GERD, and diabetes.
 
The diabetic group used glibenclamide (a sulfonylurea medication) as a control. Carboxymethyl cellulose fiber served as the control for the non-diabetic group. The intervention groups received 1, 2, or 3 grams of Amla powder (Emblica officinalis) for 21 days.
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​The researchers report a statistically significant drop in fasting blood glucose (see table 1). All the Amla groups showed significant results.

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Patients given 3 grams had the most dramatic improvement. They started with an average FBG of 138.5 mg/dl.. On day 21 of the study, this group’s average FBG was 73.0.
 
The results for blood glucose 2 hours post meal (postprandial) are also impressive. All doses of amla power showed a significant decrease in blood glucose (see table 2).

​What are the side-effects of amla?

​This same study found that amla power also lowered LDL (the “bad” cholesterol), lowered triglycerides, and raised HDL (the “good” cholesterol). What could be better? Other studies report positive preliminary results for amla as a treatment for GERD, osteoarthritis, and vertigo. However, these studies are preliminary and there is not enough data.
 
[Warning: Do not stop or change your medication without consulting your doctor!]
 
Even with the absence of adverse reaction in the current published literature, there is a potential for interaction with medications. For example, amla can reduce platelet aggregation. This sounds good. However, theoretically, if combined with medications with similar functions, the risk of bleeding increases.
 
Low blood sugar (hypoglycemia) is possible when combined with medications that lower blood sugar. This is theoretical and has not been reported in human trials.
 
Sulfonylurea medications come with their own risks. This medication forces your pancreas to secrete insulin even if you do not ingest carbohydrates. This can result in sever hypoglycemia is you do not eat enough calories and carbohydrates. Another unwanted effect is weight gain.
 
Bottom Line: Should I take amla?
 
Consult with your doctor! I am not saying that because doctors need more patient visits. Ingesting amla in amounts greater than that consumed as food has potential risks. These risks increase when combined with medication.
 
Research into the medical use of amla is still ongoing. It has not been tested for long-term efficacy and safety at high doses.
 
I use amla, in the context of a holistic treatment plan, with some patients. It is not right for everyone.
 
In the end, amla does not defeat diabetes. For some people, it may form part of a good treatment plan.
 
Our goal at Revive Family Medicine is to help you defeat diabetes and regain your health. A transformation of how we live our lives is at the heart of gaining victory and regaining our health.
 
Amla is not the answer. An herb, or any medication, by itself cannot defeat diabetes. Indian gooseberry is an herbal medication that has several plant chemicals. There is an increasing amount of evidence that these chemicals help our body deal with blood sugar, cholesterol, and fat in a way that appears beneficial.
 
References:

• Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-616. doi:10.3109/09637486.2011.560565
• Chopra A, Saluja M, Tillu G, Sarmukkaddam S, Venugopalan A, Narsimulu G, Handa R, Sumantran V, Raut A, Bichile L, Joshi K, Patwardhan B. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford) 2013;52(8):1408-17
• Karkon Varnosfaderani S, Hashem-Dabaghian F, Amin G, et al. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: a double-blind, randomized, placebo-controlled clinical trial. J Integr Med. 2018;16(2):126-131. doi:10.1016/j.joim.2018.02.008
• D’Souza JJ, D’Souza PP, Fazal F, Kumar A, Bhat HP, Baliga MS. Anti-diabetic effects of the Indian indigenous fruit Emblica officinalis Gaertn: Active constituents and modes of action. Food Funct. 2014;5(4):635-644. doi:10.1039/c3fo60366k
• Hirst JA, Farmer AJ, Dyar A, Lung TWC, Stevens RJ. Estimating the effect of sulfonylurea on HbA1c in diabetes: A systematic review and meta-analysis. Diabetologia. 2013;56(5):973-984. doi:10.1007/s00125-013-2856-6
• Sulfonylureas (Oral Hypoglycemic Agents) https://www.dynamed.com/drug-review/sulfonylureas-oral-hypoglycemic-agents