Aloe Vera Juice and Oral Supplements

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Aloe Vera Juice and Oral Supplements
Aloe vera supplements and juices commonly are used for relief of constipation. Aloe vera seems to help with blood glucose control in people with diabetes and to decrease cholesterol levels.
Preliminary evidence shows that aloe consumption may reduce the risk of lung cancer or tumor growth. Early evidence suggests that aloe, in addition to chemotherapy, may improve chemotherapy effects on tumor growth and survival. Aloe gel may benefit people with ulcerative colitis. Acemannan, a component in aloe gel, is shown to stimulate the immune system and fight the human immunodeficiency virus (HIV), but early results from human trials are mixed.
Suggested doses

For constipation:

  • 0.04 to 0.17 grams of dried juice, corresponding to 10-30 milligrams (mg) of hydroxyanthraquinones

For diabetes:

  • 5 to 15 milliliters (mL) of aloe juice twice daily by mouth

  • One capsule containing 300 mg of aloe extract taken by mouth twice daily for 2 months

  • 1 tablespoon of aloe taken by mouth twice daily for 42 days

For high cholesterol:

  • 10 to 20 mL of aloe taken by mouth daily for 12 weeks

  • One capsule containing 300 mg of aloe extract taken by mouth twice daily for 2 months

For HIV infection:

  • 1000 to 1600 mg of acemannan (aloe extract) taken by mouth in four equal doses daily for 48 weeks

  • In addition, 30 to 40 mL of aloe gruel taken by mouth daily for an unknown duration

For inflammatory bowel disease (ulcerative colitis):

  • Aloe gel taken by mouth at a dose of 100 mL twice daily for 4 weeks

Study findings

In one study, aloe-emodin blocked the growth of head and neck cancer cells in test tubes and also stopped the growth of liver cancer cells. Acemannan, a substance found in the aloe vera leaf, stimulates mouse immune cells to make cytokines, which kill cancer, and in test tubes, aloeride, a substance found in aloe juice, stimulated the immune system to produce cancer-killing chemicals. The di-2-ethylhexyl phthalate (DHEP) made from aloe vera is found to stop the development of leukemia cells in test tubes.

In some animal studies, aloe seems to reduce the number of skin cancers. However, in another study, certain aloe products actually increased the number of skin cancers caused by ultraviolet light.
One study in Italy, reported in 2009, had 240 patients with lung cancer, bowel cancer, or stomach cancer that had spread test aloe vera alongside chemotherapy. One-half of the patients took aloe arborescens as a liquid three times a day during standard chemotherapy treatment. In this study, the cancer was controlled or shrank for a time in 67% of patients who had the combined aloe and chemotherapy treatment and in 50% of patients who had chemotherapy alone. The researchers said that patients taking the aloe vera had a better quality of life and that they had fewer chemotherapy side effects, such as numb fingers and fatigue.
Side effects and precautions
Extended use: Oral aloe can cause cramping and diarrhea, which can lead to electrolyte imbalances and dehydration if used for an extended period time. Long-term use of aloe may increase the risk of colorectal cancer.
Gastrointestinal symptoms: Aloe gel should not contain aloin, which is the compound most often responsible for gastrointestinal symptoms.
Before a colonoscopy: Individuals must avoid using aloe vera for 1 month prior to having a colonoscopy, because it can stain the colon and make visualization difficult.
Allergies: People who are allergic to garlic, onions, and tulips are more likely have an allergy to aloe.
Carcinogenic activity: The 2-year study of a nondecolorized whole leaf extract of aloe vera given in an animal’s drinking water found clear evidence of carcinogenic activity in male and female rodents, based on tumors of the large intestine.
Use not recommended: People with intestinal problems, heart disease, hemorrhoids, kidney problems, or electrolyte imbalances should not take aloe. People with diabetes should use caution if taking aloe vera, and check blood glucose levels regularly.
Liver toxicity and hepatitis: A report of liver toxicity and hepatitis has led many people to question the safety of aloe supplements.
Bleeding: Aloe may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding.
Increased risks: Aloe may cause increased risk of irregular heartbeat, kidney failure, thyroid dysfunction, urinary stones, and uterine contractions. Because aloe contains estrogen-like chemicals, this may alter the effects of other agents believed to have estrogen-like properties.
Other interactions

Aloe may also interact with:

  • Agents for cancer

  • Agents for the brain, heart, intestines, liver, skin, or stomach

  • Agents that increase potassium excretion (loop diuretics, thiazide diuretics)

  • Agents that increase urination

  • Agents that protect against radiation

  • Agents toxic to the liver

  • Anesthetics

  • Antifungals

  • Anti-inflammatories

  • Antiretrovirals

  • Antivirals

  • Cardiac glycosides

  • Cholesterol-lowering agents

  • Contraceptives

  • Hormonal agents

  • Insulin preparations

  • Laxatives

  • Oral corticosteroids

  • Oral hydrocortisone

  • Sevoflurane

  • Steroids

  • Sunscreen

  • Thyroid hormones

  • Topical hydrocortisone

  • Water-soluble agents

  • Wound healing agents

  • Zidovudine (AZT)


A product called T-UP is made of concentrated aloe. Some people promote T-UP as an alternative cancer therapy that you can either drink or inject directly into a tumor or the bloodstream. T-UP injections have caused death in several patients with cancer. They are illegal in the United States and are not available in the United Kingdom.

Advice from the Center for Science in the Public Interest

“Save it for sunburns,” said Michael F. Jacobson, executive director of the Center for Science in the Public Interest. “Used topically, aloe vera is safe. But the fanciful health claims manufacturers are slapping on various drinks and pills are unfounded, so people simply shouldn’t expose themselves to the risks.”

References and recommended readings

Aloe. Cancer Research UK Web site. Accessed April 23, 2014.

CSPI says consumers should avoid aloe vera taken orally. Center for Science in the Public Interest Web site. Published August 21, 2013. Accessed April 23, 2014.
National Standard Research Collaboration. Aloe (aloe vera). Mayo Clinic Web site. Updated November 1, 2013. Accessed April 24, 2014.
Toxic/carcinogenic effects of dietary supplements and food container materials: aloe vera water studies. US Food and Drug Administration Web site. Accessed April 24, 2014.
Vitamins and supplements lifestyle guide: aloe vera. WebMD® Web site. Accessed April 24, 2014.

Contributed by Elaine Koontz, RDN, LD/N

Review Date 4/14


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