Many claims are made for the health benefits of aloe vera, used both topically and orally. The scientific evidence is lacking.
I had heard of aloe vera. I’ve seen it grown in flowerpots in the home and broken open to apply its juices to irritated or injured skin. I’ve encountered it many times in crossword puzzles. I know a woman who has taken it orally. But recently it seems to have developed miraculous new properties. I’ve been seeing ads for aloe vera products claiming that it is a leading acid reflux pill and is now being recognized as an Anti-Aging Phenomenon. In fact, this is being called “the greatest accidental discovery in decades.”
Who knew? I decided it was time to look into the many health claims for aloe vera and see which ones were supported by scientific evidence.
What the National Center for Complementary and Integrative Health (NCCIH) says
Aloe vera is featured on the NCCIH website. They say aloe vera’s use can be traced back 6,000 years to early Egypt, where the plant was depicted on stone carvings. Known as the “plant of immortality,” aloe was presented as a funeral gift to pharaohs.
They say its uses have historically included treatment of wounds, hair loss, and hemorrhoids; it has also been used as a laxative.
They say it is used in health products today both topically, for burns, frostbite, psoriasis, and cold sores; and orally, for osteoarthritis, bowel diseases, fever, and constipation.
They don’t mention acid reflux or anti-aging. They do say “There’s not enough evidence to show whether aloe vera is helpful for most of the purposes for which people use it.”
What the Natural Medicines Comprehensive Database says
The NMCD is a reliable source of information about natural remedies, rating them for safety and effectiveness and providing links to the scientific studies that its ratings are based on. It doesn’t give aloe vera any ratings of “effective” or “likely effective” for any condition. It rates it as “possibly effective” for a long list of conditions: acne, burns, constipation, diabetes, herpes simplex, lichen planus, oral submucous fibrosis, psoriasis, and weight loss. It rates it as “possibly ineffective” for burning mouth syndrome, HIV/AIDS, and radiation-induced skin toxicity. It says there is some preliminary evidence but “Insufficient Reliable Evidence to Rate” it for other uses including alveolar osteitis, anal fissures, cancer, canker sores, chronic radiation proctitis, dental plaque, diaper rash, dry skin, frostbite, gingivitis, hepatitis, hyperlipidemia, insect repellent, oral mucositis, pressure ulcers, scabies, seborrheic dermatitis, ulcerative colitis, and wound healing. Nowhere does it mention using it for acid reflux or anti-aging.
Aloe contains both a gel and a latex. The NMCD considers it “likely safe” when used topically, “possibly safe” when the gel is used orally and short-term, “possibly unsafe” when aloe latex is used orally, and “likely unsafe” when used orally in doses of 1 gram or more daily. There have been reports of renal failure and death. They recommend against oral use in pregnancy or lactation.
It covers interactions with drugs. It warns that using it with Digoxin can cause toxicity, and it advises caution with anticoagulant and platelet drugs, anti-diabetes drugs, diuretics, sevoflurane (a surgical anesthetic), stimulant laxatives, and warfarin.
It says aloe vera should be discontinued at least two weeks before elective surgery, and it is contraindicated in hemorrhoids and gastrointestinal conditions such as intestinal obstruction, inflammation (Crohn’s disease, ulcerative colitis, appendicitis), ulcers, nausea and vomiting, and undiagnosed abdominal pain.
What the FDA said
In 2002, the FDA removed over-the-counter aloe vera laxatives from the shelves, saying they had not been proven safe or effective, and there was inadequate data on toxicity.
What the ads for AloeCure say
My local newspaper has repeatedly published half-page ads for AloeCure, thinly disguised as a news story from a health correspondent. The claims:
- AloeCure is a leading acid reflux pill. (I couldn’t find it on any list of acid reflux pills.)
- Backed by clinical data documenting its ability to provide all day and night relief from heartburn, acid reflux, constipation, irritable bowel, gas, bloating, and more. (I couldn’t find any such clinical data.)
- Improves the pH balance of your stomach; “scientists now believe that this acid imbalance is what contributes to painful inflammation throughout the rest of the body.” (Not any scientists I know of; sounds like they’ve bought into the nonsensical acid/alkaline theory of disease.)
- A healthy gut is the key to reducing swelling and inflammation that can wreak havoc on the human body. (No evidence. Sounds like they’ve bought into the “leaky gut syndrome”)
- In clinical studies, participants taking the active ingredient in AloeCure saw a stunning 100% improvement in digestive symptoms. (I couldn’t find any such studies, and I question whether anything could be 100%.)
- No known side effects. (Demonstrably untrue.)
- Helps users feel decades younger. (Just as any placebo might.)
- Suppresses the inflammation that contributes to premature aging. (No evidence from human studies. There is evidence that it ameliorates cardiac inflammation in rats with autoimmune myocarditis.)
- Soothes stiff and aching joints. (I couldn’t find any evidence.)
- Reduces appearance of wrinkles and increases elasticity. (I couldn’t find any evidence.)
- Manages cholesterol. (Some preliminary suggestive evidence of a small effect, but other studies reported no effect. No credible evidence of a clinically significant benefit.)
- Supports healthy immune system. (A typical claim from alternative medicine sources; meaningless, since a healthy immune system doesn’t need any extra support from dietary supplements.)
- Improves sleep and brain function. (Again, no evidence.)
- “Readers can now reclaim their energy, vitality, and youth regardless of age or current level of health.” (Evidence?)
The ad includes the usual meaningless anecdotes and testimonials, the usual special deal if you act now, and the usual warning that phone lines will be busy.
Conclusion: “aloe” those claims not “vera”-fied
I was able to confirm that the NCCIH got it right when they said, “There’s not enough evidence to show whether aloe vera is helpful for most of the purposes for which people use it.”
This article was originally published in the Science-Based Medicine Blog.