TERMINALIA: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Terminalia is a tree. Three species of terminalia are used for medicine, especially as part of Ayurvedic medicine. These species are Terminalia arjuna, Terminalia bellerica, and Terminalia chebula.

Terminalia is most commonly used for heart ailments including heart failure and chest pain. It is also used for diabetes, high cholesterol, and many other conditions, but there is no good scientific evidence to support these uses.

How does it work ?

Terminalia contains ingredients that help stimulate the heart. It might also help the heart by lowering cholesterol and blood pressure.

Uses & Effectiveness ?

Possibly Effective for

Chest pain (angina). Some research shows that taking Terminalia by mouth with conventional medications improves symptoms in people experiencing chest pain after a heart attack. Other research shows that taking Terminalia by mouth improves symptoms and reduces the need for chest pain medication in people with long-term chest pain.

Insufficient Evidence for

Heart disease. Early research shows that taking Terminalia by mouth might improve cholesterol levels in in people with heart disease.
Diabetes. Some research shows that taking Terminalia with other ingredients lowers pre-meal blood sugar levels in women with diabetes. But it does not seem to improve HbA1c, which is a measure of average blood sugar.
Heart failure. The role of Terminalia in the treatment of heart failure is inconsistent and unclear. Early research in people with severe heart failure shows that taking Terminalia by mouth for 2 weeks along with heart failure drugs improves symptoms compared to taking heart failure drugs alone. But conflicting research shows that taking Terminalia along with heart failure drugs doesn't improve symptoms in people with mild to moderate heart failure. Larger-scale, longer-term studies are needed to determine the role of Terminalia, if any, in the treatment of heart failure.
High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Some research shows that taking Terminalia with other ingredients lowers LDL (or "bad") cholesterol levels and increases HDL (or "good") cholesterol levels in women with diabetes.
Osteoarthritis. Research shows that taking Terminalia along with turmeric and boswellia reduces pain and stiffness in people with osteoarthritis. But it isn't known if these effects are due to Terminalia or the other constituents.
Earaches.
HIV infection.
Lung conditions.
Severe diarrhea.
Urinary problems.
Water retention.
Other conditions.

More evidence is needed to rate the effectiveness of Terminalia for these uses.

View References

REFERENCES:

Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced diabetic rats. Exp.Clin Endocrinol.Diabetes 2007;115(10):641-646. View abstract.

Patel, R. K., Gondaliya, D. P., and Subramanian, S. Evaluation of commercial "Haradae" (Terminalia chebula). Indian Journal of Natural Products (India) 2004;19:511-518.

Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. View abstract.

Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. View abstract.

Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.

Anand KK, Singh B, Saxena AK, et al. 3,4,5-Trihydroxy benzoic acid (gallic acid), the hepatoprotective principle in the fruits of Terminalia belerica-bioassay guided activity. Pharmacol Res 1997;36:315-21. View abstract.

Aneja KR, Sharma C, Joshi R. Antimicrobial activity of Terminalia arjuna Wight & Arn.: an ethnomedicinal plant against pathogens causing ear infection. Braz J Otorhinolaryngol. 2012;78(1):68-74. View abstract.

Arseculeratne SN, Gunatilaka AA, Panabokke RG. Studies of medicinal plants of Sri Lanka. Part 14: Toxicity of some traditional medicinal herbs. J Ethnopharmacol 1985;13:323-35. View abstract.

Bharani A, Ganguli A, Mathur LK, Jamra Y, Raman PG. Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate. Indian Heart J. 2002;54(2):170-175. View abstract.

Bharani A, Ganguly A, Bhargava KD. Salutary effect of Terminalia Arjuna in patients with severe refractory heart failure. Int J Cardiol 1995;49:191-9. View abstract.

Chevallier A. Encyclopedia of Medicinal Plants. New York, NY: DK Publishing, 1996.

Dwivedi S, Agarwal MP. Antianginal and cardioprotective effects of Terminalia arjuna, an indigenous drug, in coronary artery disease. J Assoc Physicians India 1994;42:287-9. View abstract.

Dwivedi S, Jauhari R. Beneficial effects of Terminalia arjuna in coronary artery disease. Indian Heart J 1997;49:507-10. View abstract.

el-Mekkawy S, Meselhy MR, Kusumoto IT, et al. Inhibitory effects of Egyptian folk medicines on human immunodeficiency virus (HIV) reverse transcriptase. Chem Pharm Bull (Tokyo) 1995;43:641-8. View abstract.

Gupta R, Singhal S, Goyla A, Sharma VN. Antioxidant and hypocholesterolaemic effects of Terminalia arjuna tree-bark powder: a randomized placebo-controlled trial. J Assoc Physicians India. 2001;49:231-235. View abstract.

Hamada S, Kataoka T, Woo JT, et al. Immunosuppressive effects of gallic acid and chebulagic acid on CTL-mediated cytotoxicity. Biol Pharm Bull 1997;20:1017-9. View abstract.

Jagtap AG, Karkera SG. Potential of the aqueous extract of Terminalia chebula as an anticaries agent. J Ethnopharmacol 1999;68:299-306. View abstract.

Karlapudi V, Prasad Mungara AVV, Sengupta K, Davis BA, Rachaudhuri SP. A placebo-controlled double-blind study demonstrates the clinical efficacy of a novel herbal formulation for relieving joint discomfort in human subjects with osteoarthritis of knee. J Med Food. 2018 May;21(5):511-520. View abstract.

Kurokawa M, Nagasaka K, Hirabayashi T, et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37. View abstract.

Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.

Maulik SK, Wilson V, Seth S, Bhargava B, Dua P, Ramakrishnan S, Katiyar CK. Clinical efficacy of water extract of stem bark of Terminalia arjuna (Roxb. Ex DC.) Wight & Arn. In patients of chronic heart failure: a double-blind randomized controlled trial. Phytomedicine. 2016 Oct 15;23(11):1211-9. View abstract.

Pettit GR, Hoard MS, Doubek DL, et al. Antineoplastic agents 338. The cancer cell growth inhibitory. Constituents of Terminalia arjuna (Combretaceae). J Ethnopharmacol 1996;53:57-63. View abstract.

Phadke SA, Kulkarni SD. Screening of in vitro antibacterial activity of Terminalia chebula, Eclapta alba and Ocimum sanctum. Indian J Med Sci 1989;43:113-7. View abstract.

Ram A, Lauria P, Gupta R, et al. Hypocholesterolaemic effects of Terminalia arjuna tree bark. J Ethnopharmacol 1997;55:165-9. View abstract.

Sato Y, Oketani H, Singyouchi K, et al. Extraction and purification of effective antimicrobial constituents of Terminalia chebula RETS. against methicillin-resistant Staphylococcus aureus. Biol Pharm Bull 1997;20:401-4. View abstract.

Shaila HP, Udupa SL, Udupa AL. Hypolipidemic activity of three indigenous drugs in experimentally induced atherosclerosis. Int J Cardiol 1998;67:119-214. View abstract.

Shiraki K, Yukawa T, Kurokawa M, Kageyama S. [Cytomegalovirus infection and its possible treatment with herbal medicines]. Nippon Rinsho 1998;56:156-60. View abstract.

Shokoohi R, Kianbakht S, Faramarzi M, Rahmanian M, Nabati F, Mehrzadi S, Huseini HF. Effects of an herbal combination on glycemic control and lipid profile in diabetic women: a randomized, double-blind, placebo-controlled clinical trial. J evid Baed Complementary Altern Med. 2017 Oct;22(4):798-804. View abstract.

Suthienkul O, Miyazaki O, Chulasiri M, et al. Retroviral reverse transcriptase inhibitory activity in Thai herbs and spices: screening with Moloney murine leukemia viral enzyme. Southeast Asian J Trop Med Public Health 1993;24:751-5. View abstract.

Thakur CP, Thakur B, Singh S, et al. The Ayurvedic medicines Haritaki, Amala and Bahira reduce cholesterol-induced atherosclerosis in rabbits. Int J Cardiol 1988;21:167-75. View abstract.

Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. View abstract.

Yukawa TA, Kurokawa M, Sato H, et al. Prophylactic treatment of cytomegalovirus infection with traditional herbs. Antiviral Res 1996;32:63-70. View abstract.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

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TERMINALIA

Overview

How does it work ?

Uses & Effectiveness ?

Possibly Effective for

Insufficient Evidence for

Side Effects

Special Precautions and Warnings

Interactions ?

Dosing

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