Aloe - Good Herbal For Health

Aloe

Other common name(s): aloe vera, aloe vera gel, T-UP

Scientific/medical name(s): Aloe barbadensis, Aloe capensis

Description

The aloe plant, a member of the lily family, is a common household plant that was first found in northern Africa. The most common and widely-known species of aloe plant is aloe vera. Aloe vera plants have thick dark green leaves that look like small cacti but are soft and supple.

Aloe vera gel is the thin, clear, jelly-like substance that oozes from the fleshy inside of the aloe leaves. The extract taken from inside the outer lining of the leaves is called aloe latex, a bitter yellow liquid that is often dried into brownish granules. Aloe products made from the whole crushed leaves contain both gel and latex. Unprocessed aloe gel often contains some aloe latex.

Overview

Available scientific evidence does not support claims that aloe can treat any type of cancer. In fact, used as a cancer treatment, aloe may be dangerous and possibly even deadly.

The gel inside aloe leaves may help minor burns and skin irritations. There are safety concerns about taking aloe products by mouth as laxatives. Doctors around the world have reported hepatitis cases that were linked to taking aloe by mouth for a few weeks or more.

How is it promoted for use?

Aloe latex is used mostly for constipation, whereas aloe gel is used for skin problems. However, supporters of alternative treatments claim aloe also boosts the immune system and acts directly on abnormal cells, thus preventing or treating cancer.

The main aloe product promoted as a cancer cure was an unapproved drug called T-UP, which was sold in forms that could be swallowed or injected. Aloe proponents claimed it worked against all types of cancer, including liver and prostate cancer. Concentrated aloe products are still sold, but most no longer make these kinds of claims.

What does it involve?

Aloe vera gel is a common ingredient in many skin creams and lotions, cosmetics, and burn and wound ointments. When used on skin for minor burns or irritations, aloe gel is usually applied to the affected area three to five times a day. You can buy aloe gel, but many people apply it directly from a cut aloe leaf. Since some compounds in aloe gel break down quickly, some supporters recommend fresh aloe gel taken fresh from the leaf as the best source.

Commission E (Germany's regulatory agency for herbs) has approved aloe for treating constipation. A common dose is 50 to 200 milligrams of aloe latex, taken in liquid or capsule form once a day for up to ten days. The U.S. Food and Drug Administration (FDA) ruled that aloe products cannot be sold to treat constipation because there isn’t enough information on their safety and effectiveness. Aloe latex and aloe gel can be sold as dietary supplements in the United States.

T-UP, a concentrated liquid form of aloe, was promoted to be taken by mouth or injected directly into the tumor or bloodstream. Practitioners give injections of concentrated aloe to people with advanced cancer. Aloe injections are illegal in the United States but may be offered at clinics in other countries. Although T-UP is no longer sold in the United States, concentrated aloe can still be found under other names.

What is the history behind it?

The earliest known references to the medicinal use of aloe come from the ancient Egyptians, who used it as a treatment for cuts, burns, and skin irritations. Many other cultures have also used aloe for similar purposes. Since the 1930s, aloe has been used frequently for the treatment of minor skin ailments and skin reactions to radiation burns.

In 1996, a company based in Maryland began producing and selling a concentrated form of aloe called T-UP to be used orally and by injection for the treatment of cancer, AIDS, herpes, and other autoimmune disorders. In the summer of 1999, the U.S. Attorney's Office and the FDA indicted the makers of T-UP on twenty different charges including fraud, promoting and selling an unapproved drug, and conspiracy. The marketer of T-UP was charged with misleading cancer patients by making false claims, including claiming FDA approval for their drug when approval was never granted. He was sentenced to 46 months in prison and fined. A doctor who had given T-UP injections to patients was also imprisoned and fined.

What is the evidence?

Aloe contains many chemicals. Some of these chemicals called anthraquinones give aloe its stimulant laxative properties, and are mainly found in the aloe latex.

Preliminary studies of cell cultures (grown in laboratory dishes) and laboratory animals suggest that some of the chemicals found in aloe may have helpful effects on the immune system. However, the safety and effectiveness of most of these chemicals have not been tested in humans. The aloe products being promoted for internal use contain a wide variety of chemicals, some of which may cause serious side effects. However, aloe gel has been approved by the FDA as a natural flavoring, so small quantities may be used in foods.

Available scientific evidence does not support the claim that aloe is safe and effective in treating people with cancer. In fact, several people with cancer have died after getting aloe injections. Animal and laboratory studies have found mixed results. One study reported that aloe reduced the growth of liver cancer cells in rats but another found that it promoted the growth of human liver cancer cells in tissue culture. Another rat study reported aloe reduced pre-cancerous liver changes in rats treated with cancer-causing chemicals. Another recent laboratory study reported that aloe promotes the growth of endothelial (blood vessel) cells, raising the concern that it might promote angiogenesis (growth of blood vessels that help "feed" a cancer). Two studies published in 2010 reported opposite effects regarding skin cancer in mice. In one study of mice treated with chemicals that cause skin cancer, aloe products (applied to the skin and taken by mouth) reduced the number of skin cancers. However, in the other study, certain aloe products increased the number of skin cancers (especially in female mice) caused by ultraviolet light.

Although aloe has been used since the 1930s in the treatment of skin reactions resulting from radiation therapy, recent clinical trials found that an aloe vera gel did not protect against dermatitis (a skin reaction) caused by radiation therapy. Some studies suggest that aloe gel may help minor cuts and burns, but other studies report that aloe can delay healing of infected surgical wounds. People with severe skin trauma or deep injuries usually need other treatments.

Aloe leaves and aloe latex contain chemicals with laxative properties. These substances are classified as stimulant laxatives and can irritate the intestines. There are a number of dietary and medical approaches to treating constipation that are proven to be safer and work better than aloe products. Finally, there have been reports from doctors that aloe taken by mouth can cause hepatitis (serious liver inflammation) when taken for more than a few weeks.

Are there any possible problems or complications?

This product is sold as a dietary supplement in the United States. Unlike companies that produce drugs (which must be tested before being sold), the companies that make supplements are not required to prove to the Food and Drug Administration that their supplements are safe or effective, as long as they don't claim the supplements can prevent, treat, or cure any specific disease.

Some such products may not contain the amount of the herb or substance that is on the label, and some may include other substances (contaminants). Actual amounts per dose may vary between brands or even between different batches of the same brand. In 2007, the FDA wrote new rules to improve the quality of manufacturing for dietary supplements and the proper listing of supplement ingredients. But these rules do not address the safety of the ingredients or their effects on health.

Most such supplements have not been tested to find out if they interact with medicines, foods, or other herbs and supplements. Even though some reports of interactions and harmful effects may be published, full studies of interactions and effects are not often available. Because of these limitations, any information on ill effects and interactions below should be considered incomplete.

The use of aloe on the skin for the relief of minor cuts and burns appears to be safe. Some people who have used aloe gel on their skin for long periods of time have had allergic reactions such as hives and rashes. Those who are allergic to garlic, onions, tulips, and similar plants may be more likely to have an allergic reaction to aloe.

There are mixed reports about the safety of taking aloe internally. Part of the confusion is that safety outcomes may be different depending on whether a person took pure aloe gel, aloe latex, or used aloe leaves that contained both gel and latex. Not all reports single out which type of aloe preparation was used, so this information is limited.

One report suggested that aloe taken by mouth might increase cancer risk to humans. Side effects of taking aloe by mouth may include abdominal pain, nausea and vomiting, diarrhea, and electrolyte (chemical) imbalance in the blood, especially at high doses. It should not be used as a laxative. Women who are pregnant or breastfeeding should not take aloe by mouth.

Doctors around the world have reported a few cases of hepatitis (liver inflammation) in people who had taken aloe by mouth for a few weeks or longer. Some of these people had to be hospitalized, but no deaths were reported. Aloe injections are illegal in the United States, and may have caused or contributed to the deaths of several people with cancer. Taking aloe by mouth may cause dangerous interactions with prescription drugs and with other herbal supplements.

Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

References

Aloe Vera. Memorial Sloan-Kettering Cancer Center Web site. Accessed at www.mskcc.org/mskcc/html/69116.cfm on March 29, 2011.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines.Austin, TX: American Botanical Council; 1998.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 4th ed. Montvale, NJ: Thomson Healthcare Inc; 2007. pp.19 26.

Heggie S, Bryant GP, Tripcony L, et al M, Heath J. A phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs. 2002;25:442-451.

James M. Doctor pleads guilty in scheme to market unapproved drug. Baltimore Sun, March 30, 2000.

Meadows M. Investigators' reports: Maryland man, Virginia physician sentenced for illegally marketing aloe vera 'treatments.' FDA Consumer: The Magazine of the US Food and Drug Administration. May-June 2002. Accessed at www.fda.gov/fdac/departs/2002/302_irs.html on June 4, 2008. Content no longer available.

National Toxicology Program. Photocarcinogenesis study of aloe vera [CAS NO. 481-72-1(Aloe-emodin)] in SKH-1 mice (simulated solar light and topical application study). National Toxicology Program Technical Report Series. (553):7-33, 35-97, 99-103 passim, 2010.

Olsen DL, Raub W Jr, Bradley C, Johnson M, Macias JL, Love V, Markoe A. The effect of aloe vera gel/mild soap versus mild soap in preventing skin reactions in patients undergoing radiation therapy. Oncol Nurs Forum. 2001;28:543-547.

Saini M, Goyal PK, Chaudhary G. Anti-tumor activity of Aloe vera against DMBA/croton oil-induced skin papillomagenesis in Swiss albino mice. Journal of Environmental Pathology, Toxicology & Oncology. 29(2):127-135, 2010.

US Food and Drug Administration. Electronic Code of Federal Regulations, Title 21, Part 172: Food additives permitted for direct addition to food for human consumption. Accessed at http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=%2Findex.tpl on March 31, 2011.

US Food and Drug Administration. Status of certain additional over-the-counter drug category II and III active ingredients. May 9, 2002. 21 CFR Part 310. [Docket No. 78N-036L]. RIN 0910-AA01. Accessed at www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/Over-the-CounterOTCDrugs/StatusofOTCRulemakings/ucm094018.pdf on March 30, 2011.

Willis L. Man gets term of 46 months in aloe vera case: Concoction distributed as a treatment for cancer. Baltimore Sun, Dec 1, 2001.

Yang HN, Kim DJ, Kim YM, et al. Aloe-induced toxic hepatitis. J Korean Med Sci. 2010 Mar;25(3):492-5.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.