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Aloe vera juice can be used for a wide range of digestive upsets.

Aloe Vera

Aloe vera Asphodelaceae

The soothing, cooling, moistening and healing juice or gel is extracted from inside the leaf of the aloe vera plant. The juice is used for internal consumption, and as a gel for external application. Both have a high polysaccharide content that heals mucous membranes and calms inflammation and irritation. The juice also steadies sugar and fat levels in the blood after eating.

  • How does it feel?

    The aloe vera juice that is available for consumption should have hardly any of the bitter tasting yellowish aloin constituents and should taste quite watery with a slimy quality, with subtle bitter and acrid qualities and a sweetish aftertaste.

  • What can I use it for?

    Aloe vera juice can be used for a wide range of digestive upsets. It has a direct physical benefit for irritation and inflammations on the gut wall. It can be a simple, immediate and safe alternative to antacids and proton-pump inhibitors like omeprazole in any case of heartburn, hiatus hernia, reflux oesophagitis and other forms of acid dyspepsia or hyperacidity.

    Although its direct effects on the gut wall reduce as the aloe is digested and diluted down the tract there are constituents that bring further benefits to lower intestinal problems. Aloe vera will stabilise bowel movements and may be considered as safe option to manage a wide range upsets in this area.

    Aloe juice can be considered a safe complement to a diet of reduced carbohydrate and fat if you are working on reducing your weight or have been told you are likely to be getting diabetes.

    The gel and juice is often used by women as a tonic. Its cooling and unctuous properties make it a natural resource for menopausal hot flushes.

    Aloe gel is used to soothe skin problems like dermatitis (eczema), lichen planus, psoriasis, leg ulcers and other wounds, burns and for mouth ulcers. It is one of the most common ingredients in many cosmetic products.

  • Into the heart of Aloe Vera

    Aloe vera contains carbohydrates (polysaccharides) which provide the unctuous sensation of the gel and juice, and with other ingredients can also regenerate tissues into which it comes in contact.

    The juice includes an obvious bitter principle that stimulates bile flow from the liver. Although good aloe juice and gel is cleared of the stimulating laxative principles found in the rind and root of aloe plants, this bile-promoting activity accounts of a bowel regulating property of the gel, with a gentle laxative effect in some cases of constipation. These properties, as well as the polysaccharide component also helps to regulate blood sugar and lipid levels.

  • Traditional uses

    Aloe has a long history as a medicine and skin care aid. The root of Cape and Barbados aloes were a standard stimulating laxative to compare with senna and cascara, and for over 6,000 years aloe has been used for a wide range of ailments. The ancient Egyptians used both aloe gel and whole plant extracts to heal battle wounds and cure infections. The early Greeks used it for relieving blisters, burns and leg ulcers as well as bowel and stomach disorders. Legend has it that Aristotle persuaded Alexander the Great to conquer the Isle of Socroto to secure enough aloe vera to heal his soldiers’ wounds. The Roman physician Dioscorides mentioned aloe in his materia medica of 50-70 A.D.

    In England aloe was already used in the 10th century.

  • Traditional actions

    Western herbal medicine actions:

    • Analgesics
    • Antimicrobial
    • Astringents
    • Bitters
    • Demulcents
    • Immunomodulants
    • Laxatives
    • Vulneraries

    Ayurvedic actions:

    • Artava janana
    • Bhedaniya
    • Dipaniya
    • Rasayani
  • What practitioners say

    Skin: The gel contains polysaccharides that nourish the skin and it is specifically indicated in hot, dry and irritated skin conditions such as psoriasis, skin ulcers, eczema, seborrheic dermatitis, mouth ulcers and is one of the best herbs for healing burns, scars, wounds from urticarial and acne and stretch marks. The whole aloe plant has also been used topically and the aloin anthraquinones are said to add local healing and anti-inflammatory activity.

    Digestion: Dry and powdered extract of the leaf is strongly laxative, and some aloe gel and juice preparations may include traces of these constituents. More important is its bitter principle: this works via the liver to encourage the release of bile which itself can have a laxative action. The combination of bitter principle and polysaccharide gel probably accounts for the confirmed benefits in regulating blood sugar and in reducing blood lipid and LDL levels, making aloe gel a useful component of the diet in prediabetics, metabolic syndrome (insulin resistance) and other conditions associated with being overweight. As it is a cooling and demulcent herb that directly clears heat and heals mucous membranes it is a specific for hyperacidity, peptic ulcers, ulcerative colitis and bleeding from the intestines. It has an ability to regulate bacteria levels in the intestines which indicates it in Candida and as a remedy generally for improving gastric and intestinal function.

    Eyes: When applied externally, aloe vera is very soothing for eye inflammation and eyelid swelling.

    Women’s health: The gel and juice is a wonderful tonic for the female reproductive system. Its cooling and unctuous properties make it very effective for treating the hot and dry symptoms of the menopause.

  • Research

    Digestive system: In a double-blind, randomised, placebo-controlled trial of the efficacy and safety of aloe vera gel for the treatment of mildly to moderately active ulcerative colitis, 30 out of 44 subjects who were allocated 100 ml of aloe gel twice a day for 4 weeks had clinical benefits more often than placebo; aloe also reduced histological disease activity (1).

    Skin: There is promising evidence that aloe vera can alleviate pain and improve the symptoms of oral lichen planus (2). In a randomised, double-blind, clinical trial 40 patients with erosive or atrophic variants of oral lichen planus in the mouth were randomly divided into two equal groups. When clinical signs and symptoms were observed after 8 weeks of therapy, it was determined that aloe vera gel was more effective than triamcinolone acetonide in the treatment of oral lichen planus (3). The two treatments were comparable in another study (4) aloe was found to be more effective than placebo in another randomised clinical trial of the same condition (5). Another RCT demonstrated benefits over placebo for lichen planus in the vaginal area (6).

    A randomised, comparative, double-blind, 8-week study was designed. Eighty patients randomly received aloe vera or 0.1% triamcinolone acetonide cream. The aloe was more effective in reducing the clinical symptoms of psoriasis (7). An earlier study showed benefit over placebo (8).

    Metabolic: A systematic review and meta-analysis was conducted on five randomised controlled trials (RCTs) involving 415 participants with pre-diabetes and early non-treated diabetes. Compared with the controls, aloe vera supplementation significantly reduced the concentrations of fasting blood glucose, glycosylated haemoglobin A1c (HbA1c), triglyceride, total cholesterol, and low density lipoprotein-cholesterol. Aloe vera was superior to placebo in increasing serum high density lipoprotein (HDL)- cholesterol. The conclusions were limited by the mixed methodological quality of the trials (9), however  other reviews showed similar reductions in blood glucose levels and HbA1c (10, 11).

    Immune system: Whole-leaf extracts of Aloe vera are a good source of active polysaccharides (a sugar found in plant medicines that have immune properties). The specific polysaccharide found just under the skin of Aloe vera is called acemannan (often not present in Aloe preparations due to the outer leaf being excluded in the extraction process or enzymes used in manufacture destroying the Acemannan). However it was found that doses of 50-100ml of whole leaf aloe vera extract can provide significant doses of acemannan.

    In an open, uncontrolled clinical study 29 people with AIDS received Aloe vera whole leaf juice, along with essential fatty acids and other essential nutrients. The aloe dose was equivalent to 1200mg per day of acemannan. The Karnofsky Performance scale is a scale used to assess a patients functional status and ability to carry out activities of daily living. This study showed Karnofsky scores improved in 100% of patients. The study suggests that these types of polysaccharides are worthy of further research (14, 15).

  • Did you know?

    If you can find an aloe plant, a slice off one of its leaves provides instant gel that makes an excellent first aid skin salve for sunburn or minor abrasions.

Additional information

  • Safety

    Good quality aloe juice is safe to take. However, it is possible that lower quality products may still contain some of the laxative principles found in the rind and root of aloes. Occasional hypersensitivity reactions have been reported.

  • Interactions

    Digoxin (Lanoxin) interacts with aloe vera when aloe vera is taken internally. Aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects from digoxin.

    Diabetes medications: Aloe gel might lower blood sugar levels. Taking aloe along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.  

    Warfarin: Aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels and can cause diarrhoea in some people. Diarrhoea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin, do not take excessive amounts of aloe latex or better yet work with a medical herbalist to discern safe dosages.

  • Contraindications

    Internal use of aloe vera is contraindicated during pregnancy and breastfeeding.

  • Preparation

    • Gel
    • Juice
    • Fresh plant gel (topical)
    • Dried root and rind (gastrointestinal/ laxative)
    • Powder
    • Capsule
  • Dosage

    Juice: Adults should start with 1–2 tbsp. per day, and gradually build up to 3-6 tablespoons per day (depending on the desired effect) before food. Children can have up to 2 tablespoons (30ml) per day, but start with smaller doses and build up. 

    Gel: For skin conditions, apply externally twice daily, or as required.

    Please note: Juice may contain gel (also called pulp), latex (the layer between gel and skin), and leaf parts. These are liquefied together to make the juice. Some juices are only made from gel, while others filter the leaf and latex out. For laxative effects, source an Aloe Juice or dried extract that includes the leaf pulp and latex.

  • Plant parts used

    • Leaf
    • Root
    • Rind
  • Constituents

    • Saccharides (sugars): Both monosaccharides (glucose and fructose) and polysaccharides (glucomannans/polymannose) are present in aloe. They are derived from the mucilage layer of the plant and are known as mucopolysaccharides. Mucopolysaccharides help in binding moisture into the skin, this cohesive effect is also binding to the superficial flaking epidermal cells, which softens the skin (12).
      The most prominent monosaccharide is mannose-6-phosphate, and the most common polysaccharides found in Aloe are glucomannans. 
    • Acemannan, a prominent glucomannan has been noted to have immunostimulant, antiviral, antineoplastic, and gastrointestinal properties (11).
    • Glycoproteins: A glycoprotein with antiallergic properties, called alprogen and novel anti-inflammatory compound, C-glucosyl chromone, has been isolated from aloe vera gel.
    • Enzymes: 8 different enzymes have been identified in Aloe: aliiase, alkaline phosphatase, amylase, bradykinase, carboxypeptidase, catalase, cellulase, lipase, and peroxidase. Bradykinase is thought to be key in the anti-inflammatory properties of aloe when applied to the skin topically (12).
    • Anthraquinone laxatives including aloin A and B, aloinosides, aloe-emodin, chrysophanol  are found in the root and rind. These are very strong laxatives and to be worked with carefully.
    • Vitamins: Vitamins A (beta-carotene), C and E, which are both antioxidants. Vitamin B12, folic acid, and choline (11, 12)
    • Minerals: Calcium, chromium, copper, selenium, magnesium, manganese, potassium, sodium and zinc. They are essential for the proper functioning of various enzyme systems in different metabolic pathways and few are antioxidants.
    • Fatty acids: Aloe contains 4 plant steroids; cholesterol, campesterol, β-sisosterol and lupeol. All these compounds have an anti-inflammatory action. In addition, lupeol is antiseptic and analgesic (12).
    • Hormones: Auxins and gibberellins that help in wound healing and have anti-inflammatory action.
    • Lignins: an inert substance, which has been found to enhance the penetrative effect of the other ingredients into the skin when used in topical preparations.
  • Habitat

    Aloe plants grow wild throughout the dry areas of India but its native country is not clear. It naturally grows in areas of North Africa, Arabia, Egypt and the Mediterranean but is now cultivated across the globe for both medicinal and ornamental purposes.

  • Sustainability

    Barbados aloe is the only species of Aloe not on Appendix II of the CITES list of endangered plants. This means aloe species are not necessarily now threatened with extinction but that may become so unless trade is closely controlled. The list includes the South African Cape aloe (Aloe ferox), that is often used as an alternative aloe source.

  • Quality control

    It is possible that lower quality products may still contain some of the laxative principles found in the rind and root of aloes. These products are particularly unsafe in pregnancy.

    The specific polysaccharide found just under the skin of Aloe vera is called acemannan – often not present in Aloe preparations due to the outer leaf being excluded or due to enzymes used in its manufacture destroying the acemannan. To ensure the medicinal benefits of aloes saccharides / polysaccharides or for its laxative effects, look for an extract that includes the leaf pulp/ rind.

    Herbal Medicines are often extremely safe to take, however it is important to buy herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

    Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific/botanical name is used and that suppliers can provide information about the source of ingredients used in the product.

    A supplier should be able to tell you where the herbs have come from. There is more space for contamination and adulteration when the supply chain is unknown. 

  • How to grow

    Aloe will thrive indoors in a bright, sunny location: a south- or west-facing window is an ideal choice. 

    A terra cotta pot with well-drained soil, equal parts sand and potting soil OR a specialist succulent soil mix.

    Generally speaking, plan to water your Aloe about every 2-3 weeks in the spring and summer and even more sparingly during the fall and winter

  • References

    1. Langmead L, Feakins RM, Goldthorpe S, et al (2004) Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis Aliment Pharmacol Ther. 19(7): 739-47.
    2. Ali S, Wahbi W. (2017) The efficacy of aloe vera in management of oral lichen planus: a systematic review and meta- analysis. Oral Dis. 23(7): 913‐918.
    3. Reddy RL, Reddy RS, Ramesh T, et al. (2012) Randomized trial of aloe vera gel vs triamcinolone acetonide ointment in the treatment of oral lichen planus. Quintessence Int. 43(9): 793‐800.
    4. Mansourian A, Momen-Heravi F, Saheb-Jamee M, et al. (2011) Comparison of aloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: a randomized double-blinded clinical trial. Am J Med Sci. 342(6): 447‐451. 
    5. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. (2008) The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol. 158(3): 573‐577.
    6. Rajar UD, Majeed R, Parveen N, et al. (2008) Efficacy of aloe vera gel in the treatment of vulval lichen planus. J Coll Physicians Surg Pak. 18(10):612‐614.
    7. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. (2010) A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J Eur Acad Dermatol Venereol. 24(2): 168‐172.
    8. Syed TA, Ahmad SA, Holt AH, et al. (1996) Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1(4): 505‐509.
    9. Zhang Y, Liu W, Liu D, et al. (2016) Efficacy of Aloe Vera Supplementation on Prediabetes and Early Non-Treated Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 8(7): 388.
    10. Dick WR, Fletcher EA, Shah SA. (2016) Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis. J Altern Complement Med. 22(6): 450‐457.
    11. Suksomboon N, Poolsup N, Punthanitisarn S. (2016) Effect of Aloe vera on glycaemic control in prediabetes and type 2 diabetes: a systematic review and meta-analysis. J Clin Pharm Ther. 41(2): 180‐188.
    12. Sánchez, M., González-Burgos, E., Iglesias, I. and Gómez-Serranillos, M.P. (2020). Pharmacological Update Properties of Aloe Vera and its Major Active Constituents. Molecules, [online] 25(6), p.1324. doi:10.3390/molecules25061324.
    13. Surjushe, A., Vasani, R. and Saple, D. (2008). Aloe vera: A short review. Indian Journal of Dermatology, [online] 53(4), p.163. doi:10.4103/0019-5154.44785.
    14. Bone, K. and Mills, S. (2013). Principles and practice of Phytotherapy modern herbal medicine. 2nd ed. Edinburgh Churchill Livingstone, Elsevier.
    15. Pulse TL, Uhlig E. a significant improvement in clinical pilot study utilising nutritional supplements, essential fatty acts and stabilised Aloe vera juice in 29 HIV seropositive ARC and AIDs patients. Journal of Advancement Medicine 1990; 3 (4)
Aromatic
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent taste
The puckering taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (eg from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitter
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Blue-purple colouring
Any fruits with a blue-purple colouring contain high levels of the polyphenols known as anthocyanins. These work 1) on the walls of small blood vessels, helping to maintain capillary structure to reduce a key stage in inflammation, and improving the microcirculation to the tissues; 2) to improve retinal function and vision; 3) to support connective tissue repair around the body.
Cooling
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Hot
Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradich or wasabi, generate warmth when taken. In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage. Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold. .
Mucilaginous
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol. .
New-mown hay aroma
The familiar country odour of haymaking, of drying grass and other plants, is largely produced by coumarins (originally isolated from tonka beans – in French coumarou) and widely used in perfumery. They are chemically categorised as benzopyrone lactones and are important phytochemicals, with strong antioxidant activity in the laboratory and likely effects in modulating inflammation. They were most often associated with the calming effect linked to their use in stuffing mattresses and pillows and plants, high In coumarins were commonly used for these properties.
Resinous
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
Salty
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
Sharpness
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
Sweet
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.

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