Aloe vera (latex/sap/juice)

Other Botanical Names: Aloe barbadensis

Common Name: Aloe

Family: Aloaceae

Parts used: Latex/sap/juice (the sticky, yellow juice from beneath the outer skin of the leaf). It is completely different from the gel.

Constituents: Laxative-inducing anthraquinone glycosides (barbaloin)

Taste/smell: The whole leaf is bitter due to its yellow latex

Tendencies: Cooling, drying, stimulating

Actions

• Purgative laxative in large doses

• Cathartic laxative in moderate doses

• Stomachic aperient in small doses

• Emmenagogue in large doses

• Cholagogue/Choleretic

• Abortifacient

Uses

Laxative/Aperient:

• Atonic, non-spastic constipation

• Achlorhydria/hypochlorhydria

• Improve protein digestion and assimilation

• Reduce bacterial putrefaction

Emmenagogue:

• Amenorrhea

Cholagogue/Choleretic:

• Biliary insufficiency due to low bile production only, not obstruction

• Biliary dyskinesia

Abortifacient:

• Abortion

Contraindications

• Pregnancy due to emmenagogue, uterine stimulant (leading to miscarriage), abortifacient, and/or teratogenic effects

• Lactation due to its purging effect on the suckling child and passage into milk of potentially genotoxic aloe-emodin

• Use for > 10 days consecutively due to loss of peristalsis from intestinal smooth muscle and mesenteric plexi nerve damage. Plus prolonged use frequently exacerbates atonicity in the colon and can lead to dependence on the laxatives for a bowel movement to occur.

• Recurrent use or abuse (especially in patients with bulimia) can lead to electrolyte imbalances like hypokalemia (low potassium in the blood), dehydration, and muscle and kidney destruction with hematuria (blood in urine) and albuminuria (albumin in the urine)

• Do not consume with chronic anthranoid laxative abuse of > 9-12 months since this results in 3x the risk of developing colon cancer

• Avoid using when there is profuse menstruation or bleeding between periods due to an increase in blood flow to the uterus

• Bulimia

• Intestinal obstruction due to stimulation of peristalsis

• Spastic constipation

• Acute intestinal inflammation

• Abdominal pain of unknown origin due to intestinal stimulation

• Appendicitis due to intestinal stimulation that increases the risk of rupturing an inflamed appendix

• Ulcerative colitis (UC)

• Crohn’s disease

• Colitis

• Irritable bowel syndromes (IBS) such as diarrhea or chronic constipation due to its irritant anthraquinone content

• Inflamed hemorrhoids due to possible induction of stenosis, thrombosis, and prolapse

• Kidney disorders since large doses can cause nephritis

• Children under age 12 due to depletion of water and electrolytes

• Dehydration due to depletion of water and electrolytes

• Allergic hypersensitivity to aloe

Adverse Effects

• Acute intestinal cramping and pain (aka colic) often occur which can be offset by combination with carminatives

• Harmless reddish discoloration of urine and feces may occur

• Pseudomelanosis coli (reversible deposition of active anthraquinone glycosides in the colon wall) occurs frequently

Toxicity

• In large doses, aloe is an efficient purgative

• Acts as an intestinal irritant

Interactions

• Laxatives may reduce the absorption of oral drugs due to a decrease in bowel transit time

• Should not be combined with drugs that cause hypokalemia (low potassium in the blood), such as cardiac glycosides, thiazide diuretics, antiarrhythmic, and corticosteroids

• Should not be combined with herbs that cause hypokalemia (low potassium in the blood), such as Adonis, Apocynum, Convallaria, Urginea, Helleborus, Strophanthus, Digitalis, and Glycyrrhiza