Monday, April 20, 2020

FENUGREEK - (Trigonella foenum-graecum L. (Leguminosae)) -


HERBAL
MEDICINAL
PLANT


FENUGREEK
Trigonella foenum-graecum L. (Leguminosae)







by

RETTODWIKART THENU






FENUGREEK
(fen’yuh-greek)

Trigonella foenum-graecum L. (Leguminosae)




SUMMARY AND PHARMACEUTICAL COMMENT
Fenugreek seeds contain a high proportion of mucilaginous fibre, together with various other pharmacologically active compounds including steroidal and amine components. The majority of the traditional uses of fenugreek are probably attributable to the mucilage content. In addition, hypocholesterolaemic and hypoglycaemic actions have been documented for fenugreek in both laboratory animals and humans. The mechanism by which fenugreek exerts these actions is unclear. Proposed theories include a reduction in carbohydrate absorption by the mucilaginous fibre, and an effect on cholesterol metabolism, cholesterol absorption and bile acid excretion by the saponin components. Toxicity studies indicate fenugreek seeds to be relatively non-toxic, although the presence of pharmacologically active constituents would suggest that excessive ingestion is inadvisable.

SPECIES (FAMILY)
Trigonella foenum-graecum L. (Leguminosae)

SYNONYM(S)
Bockshornsame

PART(S) USED
Seed
Dried mature seed, although leaves are used less commonly.

PHARMACOPOEIAL AND OTHER MONOGRAPHS
BHP 1996(G9)
BP 2007(G84)
Complete German Commission E(G3)
Martindale 35th edition(G85)
Ph Eur 2007(G81)

LEGAL CATEGORY (LICENSED PRODUCTS)
GSL(G37)

CONSTITUENTS
The following is compiled from several sources, including General Reference G2.
Alkaloids Pyridine-type. Gentianine, trigonelline (up to 0.13%), choline (0.05%).
Proteins and amino acids Protein (23–25%) containing high quantities of lysine and tryptophan. Free amino acids include 4- hydroxyisoleucine (0.09%), histidine, lysine and arginine.
Flavonoids Flavone (apigenin, luteolin) glycosides including orientin and vitexin, quercetin (flavonol).
Saponins 0.6–1.7%. Glycosides yielding steroidal sapogenins diosgenin and yamogenin (major), with tigogenin, neotigogenin, gitogenin, neogitogenin, smilagenin, sarsasapogenin, yuccagenin;(1) fenugreekine, a sapogenin-peptide ester involving diosgenin and yamogenin;(2) trigofoenosides A–G (furostanol glycosides).(3–6)
Other constituents Coumarin,(7) lipids (5–8%),(8) mucilaginous fibre (50%),(8) vitamins (including nicotinic acid) and minerals.

Chemistry (Fenugreek) —
Here are a few of the more notable chemicals found in fenugreek. For a complete listing of the phytochemicals and their activities, see the CRC phytochemical compendium, Duke and duCellier, 1993 (DAD) and the USDA database http://www.ars-grin.gov/duke/.
Diosgenin — See alsoCostus speciosus.

Fenugreekine — Antiinflammatory; Antivaccinia; Antiviral; Cardiotonic; Diuretic; Hypoglycemic; Hypotensive; Viristat.

Selenium— Analgesic 200μg/day; Anorectic; Antiacne 200μg/day; Antiaggregant; Antiangiogenic M, 230 μg/kg orl rat; Anticancer; Anticirrhotic; Anticoronary 200μg/day; Antidandruff; Antidote(Mercury); Antikeshan; Antileukemic 1.6 mg/kg ipr mus; Antileukotrienic; Antimelanomic 480μ g/kg; Antimetastatic 480 μg/kg; Antimyalgic 200μg/day; Antiosteoarthritic; Antioxidant 100–200(–400)μg/man/day; Antiproliferant 2 μM; Antiradicular 100–200 (–400)μ g/man/day; Anti-Syndrome-X 100–200 (–400)μg/man/day; Antitumor 100–200 (–400)μg/man/day; Antitumor (Brain) 38–150 μg/kg; Antitumor (Breast) 0.8 mg/kg scu mus, 150 μg/kg diet rat, 230 μg/kg orl rat; Antitumor (Lung) 240 μg/kg diet; Antiulcerogenic; AP-1-Inhibitor 2–50 μM; Apoptotic; Depressant; Fungicide; Immunostimulant 100–200 (–400) μg/man/day; NF-kB-Inhibitor; ODC-Inhibitor; Polyamine-Synthesis-Inhibitor; Protein-Kinase-C-Inhibitor IC50 = 2–50 μM; Prostaglandin-Sparer;
VEGF-Inhibitor; RDA = 10–75 μg/day; PTD = 1 mg/day.

Trigonelline — Antimigraine; Antiseptic; Antitumor (Cervix); Antitumor (Liver); Epidermal-Stimulant; Hypocholesterolemic; Hypoglycemic 500–3000 mg/man/day, 50 mg/kg orl rat; Mutagenic; Osmoregulator; Propecic; LDlo = 5000 scu rat; LD50 = 5000 orl rat.

FOOD USE
Fenugreek is listed by the Council of Europe as a natural source of food flavouring (category N2). This category indicates that fenugreek can be added to foodstuffs in small quantities, with a possible limitation of an active principle (as yet unspecified) in the final product.(G16) Previously fenugreek extracts have been permitted in foods at concentrations usually below 0.05%. In addition, fenugreek has been listed as GRAS (Generally Recognised As Safe).

HERBAL USE
Fenugreek is stated to possess mucilaginous demulcent, laxative, nutritive, expectorant and orexigenic properties, and has been used topically as an emollient and vulnerary. Traditionally, it has been used in the treatment of anorexia, dyspepsia, gastritis and convalescence, and topically for furunculosis, myalgia, lymphadenitis, gout, wounds and leg ulcers.(G2, G7, G22, G64).

OTHER USES (FENUGREEK) —
Widely cultivated as a condiment crop, fenugreek seeds, containing coumarin, are used in curries, salads, and soups (LIL). Seeds are also used in teas, blending nicely with mint flavored combinations (RIN). Roasted seeds are used as a coffee substitute. In Lebanon, a milkshake-like hypotensive beverage is made by grinding the green seed after soaking. In Greece, raw or boiled seeds are eaten with honey. In North Africa, fenugreek is mixed with breadstuffs. I made my own artificial maple syrup with fenugreek seed boiled in water, sweetened with stevia. It had that great maple scent, better on ice cream than on pancakes. The predominant scent in many
prepared curry powders, it can override all other aromas in an Indian spice shop.
In south India, it is found in chutneys, lentil dishes, pickles, and vegetables, and with potato, eggplant, and cauliflower (AAR). Pastirma (or basderma), a spiced dried beef in Armenia and Turkey, is cured with fenugreek powder, garlic, allspice, cumin, black pepper, cinnamon, nutmeg, and cloves, and colored red with paprika and ground red chiles. This spice mixture is called “chaiman” (or chemen), as is the fenugreek itself (AAR). Turks report that a boned piece of beef, roughly 40x20x10 cm, is rubbed with salt and allowed to dry. The spice mix, 34% powdered garlic, 20% fenugreek, 6.5% cayenne, 1.5% cumin and mustard, and 38% water, is applied to the meat, drying to a red crust. The meat is then heated to 60-65° C for around 4 hours, then left to cure up to 12 days at ambient temperature (SPI). Jewish hilbeh is made by pouring boiling water over about 2 tbsp of ground fenugreek and letting it sit undisturbed for several hours overnight. The resulting jelly is beaten at high speeds, adding a pinch of salt, a little lemon juice, some cayenne pepper (or garlic, ginger, caraway or cardamom seeds, chopped tomatoes, finely chopped chiles, and coriander). Refrigerated hilbeh will keep for a week (AAR). Harem women are said to eat roasted fenugreek seed to attain buxomness. Mixed with cottonseed, the seed increases the flow of milk in cows but imparts the fenugreek aroma to milk.
Plant serves as a potherb, much favored in India. Sprouts and seedlings are said to make good salad dressed with oil and vinegar. Sprouted seeds can be braised in olive oil with parboiled cardoon stalks. For sprouts, soak 1 or 2 tbsp seeds in warm water for a few hours, then lay them on wet paper towel in a sealed, opaque glass container. Onefourth inch is ample growth for the sprouts (AAR). In the Near East, sprouting seeds are added to a lamb stew traditionally flavored with honey. In India, green leaves are eaten as methi. Fresh methi, cooked as a green, is a favorite served with fish. Highly seasoned with turmeric, cumin, ajowan, fresh ginger, and chiles, the leaves are mixed with cornmeal and fried as fritters. In Iran, fresh or dried, leaves are used to add strong flavor to stews, soups and ashes, thick, nourishing, amin-course soups.
Leaves are usually first sautéed in oil with other green vegetables and herbs, e.g., celery, leeks, parsley, scallions, or spinach. Fenugreek is in ghormeh sabzi, a rich, dark green mix of herbs, beans, dried limes, and some meat (AAR). With its bitter taste, somewhat like lovage and celery, it might be useful in vegetarian bouillon (LIL). Seeds and leaves may be brewed into a pleasant tea. For northerners, attempting to make liqueurs that call for tonka or vanilla, fenugreek seed may be used as a substitute (LIL). I often add the seed to homemade herbal liqueurs and teas.
The liqueur I call “Lydia’s Downer” has hypoglycemic fenugreek and several reportedly hypotensive herbs, fennel, elecampane, parsley, tarragon, and a dash of rue (caution: photosensitizer), steeped in the cheapest gin (LIL). I now suggest adding methi leaves to Lydia’s Downer as an anesthetic. I also suggest a “Lydia’s Lady’s Liqueur” with angelica, anise, cohosh (not containing formononetin, as per studies in 2001), fenugreek, fennel, and red clover flowers as a poor feminists alternative to Remifemin. The celery-scented oil is used in butterscotch, cheese, licorice, pickle, rum, syrup, and vanilla flavors. Used also in cosmetics, hair preparations, and perfumery. Indians grow the plant as a forage. Considered a good soil renovator.
Fenugreek is a source of diosgenin, used in the synthesis of hormones. As with other chemurgic crops, a large percentage must be thrown into the pot to extract a small percentage (1–2% on a dry weight basis) of pharmaceutical (diosgenin); proteins, fixed oils, oleoresins, e.g., coumarin, mucilages, and/or gums might also be extracted.  Organic residues might be used for biomass fuels or manures, inorganic residues for “inorganic” chemical fertilizers. The husk of the seed might be removed for its mucilage, with the remainder partitioned into oil, sapogenin, and protein-rich fractions. Seed mucilage (ca. 45%) could be prepared from the marc left after extraction of the fixed oil (used as a lactagogue). Its relatively high viscosity makes it a good emulsifying agent to be used in pharmaceutical and food industries. Due to its neutral ionic properties, it is compatible with other drugs or compounds sensitive to acids. Plant is used to make horse hair shiny. Powdered seeds are used locally for a yellow dye (AAR, CRC, FAC, LEG).


DOSAGE
Product Availability
Capsules, crude herb, defatted fenugreek powder, fl uid extract, powder (made from dried seeds)
Plant Part Used: Seeds
Dosages
Diabetes Mellitus
• Adult PO defatted fenugreek powder: 50 g/day (Murray, Pizzorno, 1998)
Other
• Adult PO: 1-6 g seeds tid
• Adult PO: 6 g herb (Blumenthal, 1998)
• Adult PO powdered seeds: 50 mg bid
• Adult topical: 50 g powdered herb dissolved in 250 ml water, daily (Blumenthal, 1998)

Dosages for oral administration (adults) for traditional uses recommended in older standard herbal reference texts are given below.
Seed 1–6 g or equivalent three times daily.(G49)
Dosages (Fenugreek)
1 tbsp mashed seed/8 oz water, up to 3 ×/day as gargle (APA); 1–6 g seed 3 ×/day (CAN); 5–90 g seed/day (SKY); 0.25–0.5 cup seed (PED); 6–12 g dry seed (PED); 50 g powdered seed with 0.25 liter water (HH2); 6.3 g/day (MAD); 1 (620 mg) capsule 2–3 ×/day (NH).

Fenugreek Poultices:
Mix 50 g fenugreek seed with 1 liter of warm water and apply to the affected area of the skin.

Internal use
According to clinical studies
       General dose range: liquid extract (1:2): 2–6 mL/day.
       Diabetes: 50–100 g seed daily taken in divided doses with meals, or 1 g/day ethanolic seed extract.
       Lipid-lowering activity: according to the above studies, 18.0 g germinated fenugreek or 100 g defatted seeds daily taken in divided doses with meals.
External use
       As a poultice: 50 g powdered seed in 0.5–1 L hot water applied topically to affected area.

PHARMACOLOGICAL ACTIONS
In vitro and animal studies
Hypocholesterolaemic activity has been reported for fenugreek in rats(9, G41) and alloxan-diabetic dogs.(10) Activity has been attributed to the fibre and saponin fractions, and not to lipid or amino acid fractions.(9, 10) Studies have reported a reduction in cholesterol but not triglyceride concentrations,(9) or in both cholesterol and triglyceride concentrations, but without significant alterations in high-density lipoprotein (HDL) and lowdensity
lipoprotein (LDL) concentrations.(10) Hypoglycaemic activity has been observed in rabbits, rats and dogs, and attributed to the defatted seed fraction (DSF),(8) trigonelline, nicotinic acid and coumarin.(7, 11) Oral administration of DSF reduced hyperglycaemia in four alloxan-diabetic dogs, and reduced the response to an oral glucose tolerance test in eight normal dogs, whereas the lipid fraction had no effect on serum glucose and insulin concentrations.(8) The high fibre content (50%) of DSF was thought to contribute to its antidiabetic effect although the initial rate of glucose absorption was not affected.(8) Nicotinic acid and coumarin were reported to be the major hypoglycaemic components of fenugreek seeds, following administration to normal and alloxan-diabetic rats.(7) The hypoglycaemic action exhibited by coumarin was still significant 24 hours post administration.(7) In addition, a slight antidiuretic action was noted for coumarin.(7) Trigonelline inhibited cortisone-induced hyperglycaemia in rabbits if administered (250 mg/kg) concomitantly or two hours before, but not two hours after, cortisone.(11)
In addition, trigonelline exhibited significant hypoglycaemic activity in alloxan-diabetic rats (50 mg/kg), lasting 24 hours.(11) A stimulant action on the isolated uterus (guinea-pig), especially during late pregnancy, has been noted for both aqueous and alcoholic extracts.(G41) An aqueous extract is stated to increase the number of heart beats in the isolated mammalian heart.(G41)
In vitro antiviral activity against vaccinia virus has been reported for fenugreekine, which also possesses cardiotonic, hypoglycaemic, diuretic, antiphlogistic and antihypertensive properties.(2)

ACTIVITIES (FENUGREEK)
Analgesic (f; MAD); Anesthetic (1; TAD); Antiatherosclerotic (1; BGB); Antidiabetic (1; BGB; PNC); Antidiuretic (1; CAN); Antiinflammatory (2; KOM); Antiseptic (2; KOM); Antispasmodic (1; PED; PNC); Antitumor (1; PNC); Aperitif (2; APA; CAN; PH2); Aphrodisia (f; CRC; HHB; KAB; SPI); Astringent (f; CRC; PED); Cardiotonic (1; APA; CAN); Carminative (f; APA; CRC; WOI); Cholagogue (f; BGB); Demulcent (2; CAN; PNC); Digestive (f; APA); Diuretic (1; APA; CAN; CRC); Ecbolic (f; CRC); Emmenagogue (1; CRC; FNF; KAB); Emollient (2; APA; CAN; PH2; PNC); Estrogenic (1; JAD); Expectorant (f; CAN; CRC; SPI); Hydragogue (1; PH2); Hyperemic (2; KOM); Hypocholesterolemic (2; BGB; BRU; CRC; PNC); Hypoglycemic (2; BRU; CAN; PHR; PH2; SKY); Hypolipidemic (1; BGB); Hypotensive (1; CAN); Hypotriglyceridemic (1; BGB); Insectifuge (1; WOI); Lactagogue (1; CRC; JAD; PHR; PH2; WOI); Laxative (2; PNC); Lipolytic (1; BRU; PH2; PNC); Mastogenic (1; FNF; HAD); Mucilaginous (1; PED); Myorelaxant (1; PNC); Oxytocic (1; PNC); Parturient (f; BGB); Propecic (f; MAD); Protease Inhibitor (1; HH2); Secretolytic (2; KOM); Spermicide (1; CRC); Steroid Precursor (1; JAD); Tonic (f; CRC; PED; WOI); Uterotonic (1; APA; CAN; PED); Vermifuge (f; CRC; HHB); Vulnerary (1; CAN; PHR; TAD).

INDICATIONS (FENUGREEK)
 Abscess (f; WOI); Adenopathy (f; CRC; HHB); Alactea (1; PH2; WOI); Allergy (f; PED); Alopecia (1; APA; KAP; MAD); Anemia (1; GMH; SPI); Anorexia (2; APA; CAN; KOM; PH2); Aposteme (f; JLH); Arthrosis (1; KOM); Atherosclerosis (1; BGB; SKY); Bacteria (1; WOI); Boil (f; BGB; GMH; KAP); Bronchosis (f; APA; PH2); Burn (f; CRC); Calculus (1; APA); Cancer (1; APA; PNC); Cancer, abdomen (1; FNF; JLH); Cancer, bladder (1; FNF; JLH); Cancer, breast (1; FNF; JLH); Cancer, colon (1; FNF; JLH); Cancer, eye (1; FNF; JLH); Cancer, gland (1; FNF; JLH); Cancer, groin (1; FNF; JLH); Cancer, intestine (1; FNF; JLH); Cancer, kidney (1; FNF; JLH); Cancer, liver (1; FNF; JLH); Cancer, parotid (1; FNF; JLH); Cancer, rectum (1; FNF; JLH; MAD); Cancer, spleen (1; FNF; JLH); Cancer, stomach (1; FNF; JLH); Cancer, testes (1; FNF; JLH); Cancer, throat (1; FNF; JLH); Cancer, uterus (1; FNF; JLH); Cancer, uvula (1; FNF; JLH); Carbuncle (f; GMH; KAP); Catarrh (f; PH2); Childbirth (1; APA; BGB); Chilblain (f; CRC); Cholecystosis (f; CRC); Colic (f; APA; CRC; KAP); Constipation (2; PNC; SKY; SPI); Colitis (f; PH2); Cough (f; APA; PED; PH2); Cramp (1; PED; PNC); Cystosis (f; JLH; SKJ); Debility (f; MAD); Dermatosis (2; APA; CRC; PHR; PH2); Diarrhea (1; APA; CRC; KAP); Diabetes (1; BGB; PNC); Dysentery (f; HHB; KAB); Dusgeuzia (f; KAB); Dysmenorrhea (f; BGB); Dyspepsia (2; APA; CAN; PHR); Eczema (1; BGB; PHR; PH2); Edema (f; BGB; SKJ); Enterosis (f; BGB; PH2; WOI); Fatigue (f; MAD); Fever (f; APA; CRC; PH2); Fistula (f; CRC); Furunculosis (f; BGB; HHB; PHR); Gas (1; APA; CRC; WOI); Gastrosis (f; APA; BGB; CAN; GMH); Gout (f; BGB; CAN; CRC; GMH); Hay Fever (f; PED); Hemorrhoid (f; MAD); Hepatosis (f; CRC; JLH; KAP); Hernia (f; APA; BGB; CRC; PH2); High Blood Pressure (1; CAN); High Cholesterol (2; APA; BGB; BRU; CAN; CRC; PNC; SKY); High Triglyceride (1; BGB; SKY); Hyperglycemia (2; BRU; CAN; PHR; PH2; SKY); Hyperlipidemia (1; BGB); Impotence (f; APA; CRC; PH2); Infection (1; APA; WOI); Inflammation (2; APA; BRU; KOM; PH2); Leukorrhea (f; KAP); Lymphadenosis (f; BGB; CAN); Mastosis (f; JLH); Myalgia (f; BGB; CAN); Nephrosis (f; APA; CRC; JLH); Neuralgia (f; APA; CRC); Neurasthenia (f; GMH); NIDDM (2; APA; BRU; CAN; CRC); Obesity (1; BGB); Ophthalmia (f; JLH); Orchosis (f; JLH); Osteomyelosis (f; HHB; MAD); Oxaluria (1; APA); Pain (1; MAD;  PH2; TAD); Parotosis (f; JLH); PMS (f; BGB); Proctosis (f; JLH; MAD); Rachosis (f; MAD); Respirosis (f; APA; PH2); Rheumatism (f; APA; CRC); Sciatica (f; CRC); Scrofula (f; GMH; HHB); Smallpox (f; KAB; KAP); Sore (f; APA; BGB; MAD; PH2); Sore Throat (1; APA; CRC; MAD); Splenosis (f; HHB; KAP); Splenomegaly (f; CRC; KAB); Stomatosis (f; APA); Swelling (f; HHB; KAB; PHR); Syndrome-X (1; SYN); Syphilis (f; SKJ); Tuberculosis (f; APA; CRC; HHB; MAD; SPI); Tumor (1; CRC; PNC); Ulcer (1; APA; PNC); Ulcus cruris (f; HHB); Uterosis (f; JLH); Vaginosis (f; BGB); VD (f; SKJ); Vomiting (f; PH2); Water Retention (1; APA; CAN; CRC); Worm (f; CRC; HHB); Wound (f; BGB; HHB).

Fenugreek for dermatosis:
·       Analgesic: coumarin; gentianine; pyridoxine; quercetin
·       Antibacterial: apigenin; carpaine; gentianine; isoquercitrin; kaempferol; lignin; luteolin; p-coumaric-acid; quercetin; quercitrin; rutin
·       Antidermatitic: apigenin; biotin; pyridoxine; quercetin; rutin; vitexin
·       Antiinflammatory: apigenin; coumarin; diosgenin; fenugreekine; genistein; gentianine;
·       gitogenin; kaempferol; luteolin; orientin; quercetin; quercitrin; rutin; salicylates; superoxide-
·       dismutase; vicenin-2; vitexin
·       Antiseptic: kaempferol; oxalic-acid; trigonelline
·       Antistress: diosgenin; gamma-aminobutyric-acid
·       COX-2-Inhibitor: apigenin; kaempferol; quercetin
·       Cyclooxygenase-Inhibitor: apigenin; kaempferol; quercetin
·       Demulcent: mucilage
·       Fungicide: coumarin; formononetin; genistein; p-coumaric-acid; phytic-acid; quercetin
·       Immunomodulator: saponins
·       MDR-Inhibitor: genistein
Fenugreek for diabetes:
·       Aldose-Reductase-Inhibitor: coumarin; genistein; isoquercitrin; kaempferol; luteolin; pcoumaric-
·       acid; quercetin; quercitrin; rutin; vitexin
·       Antiaggregant: apigenin; coumarin; genistein; kaempferol; phytic-acid; pyridoxine; quercetin;
·       salicylates
·       Anticapillary-Fragility: quercetin; rutin
·       Antidiabetic: pyridoxine; quercetin; rutin
·       Antioxidant: apigenin; genistein; isoorientin; isoquercitrin; isovitexin; kaempferol; lignin;
·       luteolin; orientin; p-coumaric-acid; phytic-acid; quercetin; quercitrin; rutin; superoxide-
·       dismutase; vitexin
·       Antiperoxidant: isoorientin; p-coumaric-acid; quercetin
·       Antiradicular: isoquercitrin; kaempferol; quercetin; rutin
·       Antithrombic: quercetin
·       Hypocholesterolemic: diosgenin; formononetin; genistein; lignin; nicotinic-acid; phyticacid;
·       rutin; trigonelline
·       Hypoglycemic: coumarin; fenugreekine; gentianine; nicotinic-acid; quercetin; quercitrin;
·       salicylates; trigonelline
·       Insulinase-Inhibitor: nicotinic-acid
·       Insulinogenic: quercetin
·       Insulinotonic: nicotinic-acid
Fenugreek for high cholesterol:
·       Antiaggregant: apigenin; coumarin; genistein; kaempferol; phytic-acid; pyridoxine; quercetin;
·       salicylates
·       Antiatherogenic: rutin
·       Antiatherosclerotic: genistein; pyridoxine; quercetin
·       Antidiabetic: pyridoxine; quercetin; rutin
·       Antihomocystinuric: pyridoxine
·       Antiischemic: genistein
·       Antilipoperoxidant: quercetin
·       Antioxidant: apigenin; genistein; isoorientin; isoquercitrin; isovitexin; kaempferol; lignin;
·       luteolin; orientin; p-coumaric-acid; phytic-acid; quercetin; quercitrin; rutin; superoxide-
·       dismutase; vitexin
·       Choleretic: apigenin; kaempferol; luteolin; nicotinic-acid; p-coumaric-acid; quercitrin
·       Diuretic: apigenin; carpaine; fenugreekine; gamma-aminobutyric-acid; isoquercitrin;
·       kaempferol; luteolin; quercitrin
·       Hepatoprotective: diosgenin; luteolin; quercetin
·       Hypocholesterolemic: diosgenin; formononetin; genistein; lignin; nicotinic-acid; phyticacid;
·       rutin; trigonelline
·       Hypolipidemic: formononetin; phytic-acid
·       Hypotensive: apigenin; carpaine; fenugreekine; gamma-aminobutyric-acid; gentianine;
·       isoquercitrin; kaempferol; quercetin; quercitrin; rutin; vitexin

CLINICAL STUDIES
There is a lack of clinical research assessing the effects of fenugreek and rigorous randomised controlled clinical trials are required. A transient hypoglycaemic effect was observed in 5 of 10 diabetic patients who received 500 mg oral trigonelline whilst fasting.(11) Increasing the dose did not increase this effect, and 500 mg ingested three times a day for five days did not alter the diurnal blood glucose concentration.(11) Hypoglycaemic activity in healthy individuals has been reported for whole seed extracts, with slightly lesser activity exhibited by gum isolate, extracted seeds and cooked seeds.(12) The addition of fenugreek to an oral glucose tolerance test reduced serum glucose and insulin concentrations. Chronic ingestion (21 days) of extracted seeds (25 g seeds daily incorporated into two meals) by non-insulindependent diabetics improved plasma glucose and insulin responses (no control group), and reduced 24-hour urinary glucose concentrations.(12) Furthermore, in two diabetic insulindependent subjects, daily administration of 25 g fenugreek seed powder reduced fasting plasma-glucose profile, glycosuria and daily insulin requirements (56–20 units) after eight weeks. A significant reduction in serum cholesterol concentrations in diabetic patients was also noted.(12)

SIDE-EFFECTS, TOXICITY
None documented. However, there is a lack of clinical safety and toxicity data for fenugreek and further investigation of these aspects is required. Acute toxicity values (LD50) documented for fenugreek alcoholic seed extract are 5 g/kg (rat, oral) and 2 g/kg (rabbit, dermal).(13) The alcoholic seed extract is reported to be non-irritating and non-sensitising to human skin and nonphototoxic (mice, pigs).(13) Coumarin is a toxic seed component.(7) Acute LD50 (rat, oral) values per kilogram documented for various seed constituents are 5 g (trigonelline), 8.8 g (nicotinic acid), 7.4 g (nicotinamide) and 0.72 g (coumarin).(7)

CONTRA-INDICATIONS, WARNINGS
Drug interactions None documented. However, the potential for preparations of fenugreek to interact with other medicines administered concurrently, particularly those with similar or opposing effects, should be considered. There is limited evidence from preclinical and preliminary clinical studies that fenugreek has hypoglycaemic activity. Caution may be advisable in patients receiving monoamine oxidase inhibitor (MAOI), hormonal or anticoagulant therapies in view of amine, steroidal saponin and coumarin constituents, respectively, although their clinical significance is unclear. Cardioactivity has been documented in vitro. The absorption of drugs taken concomitantly with fenugreek may be affected (high mucilaginous fibre content). Pregnancy and lactation Fenugreek is reputed to be oxytocic(G22) and in vitro uterine stimulant activity has been documented. In view of this, and the documented pharmacologically active components, the use of fenugreek during pregnancy and lactation in doses greatly exceeding those normally encountered in foods is not advisable.

CONTRAINDICATIONS, INTERACTIONS, AND SIDE EFFECTS (FENUGREEK)
Class 2b (AHP). “Hazards and/or side effects not known for proper therapeutic dosages” (PH2). Contraindicated in pregnancy (PH2). Due to its oxytoxic and uterine stimulant actions, in vitro, its use in pregnancy and lactation is to be avoided. Commission E reports no contraindications or interactions for oral use of the seed. Adverse skin reactions to repeated external use (AEH). An idiosyncratic gastroenterosis was fingered on fenugreek in LRNP (July 1987). One woman with micromazia complained of mastogenic activity following ingestion of fenugreek sprouts. May interfere with anticoagulant, blood sugar, hormonal, and/or MAOI therapies. High mucilaginous/fiber content may interfere with absorption of other drugs. Since all herbs, spices, and food plants, like drugs, contain pharmacologically active ingredients, it seems it could go without saying, “the presence of pharmacologically active constituents would suggest that excessive ingestion is inadvisable” (CAN). Alcoholic seed extract LD50 = 5000 mg/kg orl rat; 2000 der rabbit (CAN). Converted to niacin and other pyridines and pyrroles when cooked (PED).

CONTRAINDICATIONS
Pregnancy category is 4; breastfeeding category is 2A. Until more research is available, fenugreek should not be used in children. Persons with hypersensitivity to fenugreek should not use it.
SIDE EFFECTS/ADVERSE REACTIONS
INTEG: Hypersensitivity reactions
SYST: Bruising, petechiae, bleeding
INTERACTIONS
Drug
All medications: Because of the rapid rate at which this herb moves through the bowel and coats the gastrointestinal tract, fenugreek may reduce absorption of all medications used concurrently.

INTERACTIONS—CONT’D
Anticoagulants (anisindione, dicumerol, heparin, warfarin), antiplatelets, NSAIDs: There is a possible increased risk of bleeding when fenugreek is used concurrently with anticoagulants, antiplatelets, NSAIDs.
Antidiabetics: Because fenugreek lowers blood glucose levels, increased hypoglycemia is possible when this herb is used concurrently with antidiabetics (theoretical).
Corticosteroids, estrogens: Fenugreek may inhibit the action of these agents (theoretical) (Jellin et al, 2008).
MAOIs: Fenugreek can increase the action of MAOIs (theoretical) (Jellin et al, 2008).
Food
Fabaceace (soybean, chickpea, peanuts, green peas): Fenugreek allergy may develop if allergic to Fabaceace species (theoretical) (Jellin et al, 2008).
Lab Test
Blood glucose, LDL, total cholesterol: Fenugreek may decrease total cholesterol, blood glucose (decoctions, infusions), and LDL cholesterol.

CLIENT CONSIDERATIONS
Assess
·       Assess the reason the client is using fenugreek.
·       Assess for hypersensitivity reactions. If present, discontinue use of this herb and administer an antihistamine or other appropriate therapy.
·       Assess for increased hypoglycemia in diabetic clients who are taking antidiabetics (see Interactions).
·       Assess for bleeding in clients who are using anticoagulants (see Interactions).

Administer
·       Instruct the client to store fenugreek products in a sealed container away from heat and moisture.
Teach Client/Family
·       Inform the client that pregnancy category is 4 and breastfeeding is category 2A.
·       Caution the client not to use this herb in children until more research is available.
·       Instruct the client to report side effects and adverse reactions (bleeding, hypersensitivity, hypoglycemia) to the health care provider.
·       Advise the client that urine may smell like maple syrup.


PREPARATIONS
Proprietary single-ingredient preparations
France: Fenugrene; Sthenorex.

Proprietary multi-ingredient preparations
Australia: Garlic and Horseradish þ C Complex; Panax Complex. India: Happy'tizer. Malaysia: Horseradish Plus.



REFERENCE


Barnes, J., Anderson, L. A., and Phillipson, J. D. 2007. Herbal Medicines Third Edition. Pharmaceutical Press. Auckland and London. 
Braun, L and Cohen, M. 2010. Hebs and Natural Supplements An Evidence Based Guide 3R D Edition. Elsevier Australia. Australia.
Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.
Duke, J. A. with Judi duCellier, Peggy-Ann K. Duke. 2003. Duke’s Handbook of Medicinal Plants of the Bible. CRC Press LLC. USA.
Kraft, K and Hobbs, C. 2004 . Pocket Guide to Herbal Medicine. Thieme. Stuttgart New York.
Linda S-Roth. 2010. Mosby’s Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby Elsevier. USA.
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