bitter orange

Action and Spectrum

Actions and Spectrum: 

Actions: 

While some studies suggest bitter orange (Citrus aurantium) may aid weight reduction with diet and exercise, its associated health risks likely outweigh benefits. Although considered safe in food amounts, its main component, synephrine, resembles ephedra, a banned substance linked to heart attacks and increased blood pressure. Bitter orange supplements, common in weight loss pills, may also interact with medications. It’s essential to recognize that “natural” doesn’t guarantee safety, urging consultation with a doctor before using herbal supplements. Bitter orange’s impact on the nervous system varies, leading to side effects like increased blood pressure, blood vessel constriction, and a quicker heartbeat. 

Spectrum: 

Bitter orange, widely used in alternative medicine, offers various health benefits supported by research. Applied topically, it has shown effectiveness against skin issues such as ringworm and athlete’s foot, reducing fungal growth significantly. Notably, there are minimal reported negative side effects when using bitter orange externally. Additionally, fresh bitter orange promotes skin health, providing vitamin C (50% to 100% of the daily requirements), a crucial component for skin integrity and repair. When combined with caffeine, bitter orange exhibits promising effects on weight loss, as its active ingredient, p-synephrine, acts as a stimulant, increasing metabolic rate and energy expenditure over a 6- to 12-week period. Moreover, studies indicate its potential role in diabetes management by inhibiting enzymes linked to the condition. The presence of antioxidant flavonoids in bitter orange, such as hesperidin and limonene, suggests preventive effects against certain cancers by inducing apoptosis and modulating genes related to cancer development. While not a substitute for evidence-based cancer therapy, ongoing studies on bitter orange may unveil innovative supplementary treatment options. 

Though lacking solid scientific proof, bitter orange is thought to have potential benefits. Inhaling its essential oil may reduce anxiety in acute coronary syndrome patients, and consuming bitter orange blossom may help postmenopausal women with moderate anxiety. Conflicting research exists on its impact on sports performance, with some studies suggesting improvement in squat performance. Preliminary studies also indicate potential blood sugar-lowering effects when combined with Indian snakeroot leaves for people with diabetes. Additionally, bitter orange may positively affect dyspepsia, premenstrual syndrome (emotional symptoms), anxiety before surgery, obesity (when combined with diet and exercise), and certain skin conditions like jock itch, ringworm, and athlete’s foot. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Headache 

Jitters 

Higher sensitivity to the sun 

Increased heart rate 

Migraine 

Heart attack 

Fainting 

Stroke 

Abdominal pain 

Vomiting 

Diarrhea 

Allergic reactions 

Angina 

Black Box Warning

Actions and Spectrum: 

Actions: 

While some studies suggest bitter orange (Citrus aurantium) may aid weight reduction with diet and exercise, its associated health risks likely outweigh benefits. Although considered safe in food amounts, its main component, synephrine, resembles ephedra, a banned substance linked to heart attacks and increased blood pressure. Bitter orange supplements, common in weight loss pills, may also interact with medications. It’s essential to recognize that “natural” doesn’t guarantee safety, urging consultation with a doctor before using herbal supplements. Bitter orange’s impact on the nervous system varies, leading to side effects like increased blood pressure, blood vessel constriction, and a quicker heartbeat. 

Spectrum: 

Bitter orange, widely used in alternative medicine, offers various health benefits supported by research. Applied topically, it has shown effectiveness against skin issues such as ringworm and athlete’s foot, reducing fungal growth significantly. Notably, there are minimal reported negative side effects when using bitter orange externally. Additionally, fresh bitter orange promotes skin health, providing vitamin C (50% to 100% of the daily requirements), a crucial component for skin integrity and repair. When combined with caffeine, bitter orange exhibits promising effects on weight loss, as its active ingredient, p-synephrine, acts as a stimulant, increasing metabolic rate and energy expenditure over a 6- to 12-week period. Moreover, studies indicate its potential role in diabetes management by inhibiting enzymes linked to the condition. The presence of antioxidant flavonoids in bitter orange, such as hesperidin and limonene, suggests preventive effects against certain cancers by inducing apoptosis and modulating genes related to cancer development. While not a substitute for evidence-based cancer therapy, ongoing studies on bitter orange may unveil innovative supplementary treatment options. 

Though lacking solid scientific proof, bitter orange is thought to have potential benefits. Inhaling its essential oil may reduce anxiety in acute coronary syndrome patients, and consuming bitter orange blossom may help postmenopausal women with moderate anxiety. Conflicting research exists on its impact on sports performance, with some studies suggesting improvement in squat performance. Preliminary studies also indicate potential blood sugar-lowering effects when combined with Indian snakeroot leaves for people with diabetes. Additionally, bitter orange may positively affect dyspepsia, premenstrual syndrome (emotional symptoms), anxiety before surgery, obesity (when combined with diet and exercise), and certain skin conditions like jock itch, ringworm, and athlete’s foot. 

Contraindication / Caution

Contraindication/Caution: 

Contraindications 

• Hypersensitivity 
• HTN 

Cautions 

• Renal impairment 
• Hepatic impairment 
• Drug interactions 
• Pregnancy  
• Breastfeeding 

Pregnancy / Lactation

Pregnancy consideration:  

No data is available regarding the administration of the drug during pregnancy. 

Breastfeeding warnings:  

No data is available regarding the excretion of drug in breast milk. 

Pregnancy categories: 

Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

Bitter orange, a versatile plant used in medicine, has various parts, such as the peel, flower, leaf, fruit, and juice, with oil extracted from the peel. It’s applied topically for treating fungal skin infections and has the dual purpose of enhancing appetite and aiding in weight loss. Other uses include addressing nasal congestion, upset stomach, and chronic fatigue syndrome. The flower and oil are utilized for blood regulation, diabetes, circulatory stimulation, gallbladder issues, liver and gastrointestinal disorders, and sleep disorders. Bitter orange is also used in aromatherapy and culinary practices, contributing to cosmetics, pharmaceuticals, and soaps in manufacturing. Because of the possibility of drug interactions and the fact that taking it with caffeine can raise blood pressure and heart rate, caution is advised. Notably, bitter orange (synephrine) is a banned substance by the National Collegiate Athletic Association (NCAA). Understanding its diverse chemical effects on the nervous system is crucial, and consultation with a healthcare professional is recommended before usage, especially for those on medications. 

Pharmacodynamics: 

Bitter orange, or Citrus aurantium, is a plant-filled with phytochemicals like p-octopamine and synephrine alkaloids. Synephrine, with its α-adrenergic and some β-adrenergic properties, has become popular after the ban on ephedrine and ephedra preparations. People turn to supplements with bitter orange, hoping for effects on energy, fat breakdown, or appetite. Sadly, the evidence for these impacts on humans is thin. A systematic review found limited data and a single trial with 20 subjects showed no significant weight loss. Recent small studies paint a mixed picture, with one group gaining weight and another experiencing minimal weight loss. Worries about cardiovascular safety have cropped up, raising doubts about how effective bitter orange really is for us. 

Pharmacokinetics: 

Limited data is available 

Adminstartion

Administration: 

It is commonly taken orally, often in the form of capsules, tablets, or liquid extracts, with supplements promoted for purposes such as weight loss or increased energy. Topical application of bitter orange essential oil is recommended for treating fungal skin infections. The essential oil is also employed in aromatherapy, either applied to the skin or inhaled for potential therapeutic benefits. In culinary practices, bitter orange peel serves as a flavoring agent and is used to create marmalades and liqueurs. Furthermore, bitter orange oil finds applications in manufacturing, particularly in pharmaceuticals, cosmetics, and soaps. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: bitter orange 

Pronounced: BIT-er ORR-inj 

Why do we use bitter orange? 

Bitter orange finds versatile applications across culinary, medicinal, and cosmetic domains. In the kitchen, its peel adds a citrusy and slightly bitter flavor to dishes, while in traditional medicine, extracts from the fruit and flowers have been historically employed to address digestive issues. Bitter orange is also featured in weight loss supplements due to its potential metabolism-boosting properties. Extracts and essential oils from bitter orange are utilized in aromatherapy and the cosmetic industry, contributing to fragrances in perfumes and skincare products. Additionally, the fruit is a key ingredient in liqueurs like Triple Sec. While bitter orange offers diverse uses, caution is advised, particularly in medicinal contexts, as its compounds can have stimulant effects and may interact with medications. Always consult with a healthcare professional before incorporating bitter orange into medicinal or dietary practices.