Aloe Vera

Last Updated: September 28 2022

Aloe vera is a common houseplant that has traditionally been used topically to alleviate burns and pain on the skin. Oral ingestion helps speed up intestinal motility (and has been used against constipation) and aloe vera contains a large amount of antioxidants.

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1.

Sources and Composition

1.1

Sources

Aloe is a genera of over 420 plants (of the family Liliaceae[1]) of which vera (sometimes referred to as Barbadensis) is the specific herb used in many supplements. Other members of this family include Aloe Ferox and Aloe Arborescens.[2] The Aloe vera plant itself is a perennial plant with turgid green leaves joined at the stem in a rosette pattern, and is most well known as a topical ointment for pain relief from burns.[3]

These plants have historically been used topically to heal wounds, and internally (consumption) as a cathartic agent[1] and have been used in Ayurveda,[4] Southern African medicine.[5]

1.2

Composition

The Aloe vera plant specifically contains:

  • The anthraquinone Aloin (aka. Barbalion; divided into Aloin A and Aloin B) and Isoaloin/Isobarbalion[6][7][8] and 7-hydroxyaloin A (7-OHA) and 5-hydroxyaloin A (in Aloe Ferox)[6]
  • Anthraquinones Aloresin A and B[6]

With some bioactive polysaccharides

Aloe vera is known to have a sensitive processing need, and can be damaged during processing.[10]

2.

Interactions with fat metabolism

In fat cells, it also suppresses scavenger receptor A and CD36 on macrophages in white adipose tissue.[11] These are receptors for oxidized LDL particles, and inhibiting their actions may prevent inflammatory responses. This works in concert with Aloe's ability to inhibit nuclear translocation of NF-kB in vivo.[11]

3.

Interactions with Oxidation

3.1

Mechanisms

The anti-inflammatory effects of aloe vera seem to be via aloesin derivatives and inhibiting both thromboxanes and COX2.[12] It has also been implicated in suppressing Nf-kB and downstream inflammatory cytokines.[11]

4.

Interactions with Hormones

4.1

Thyroid

In a study assessing herbal effects on the thyroid, ingestion of 125mg/kg Aloe vera for 15 days in rats was associated with a decrease in serum T4 (-12.88%) and T3 (-25.13%).[13]

5.

Interactions with Organ Systems

5.1

Oral Cavity

One human trial using a topical patch of 0.5% Acemannan (a polysaccharide from Aloe Vera) noted that this patch was more effective than control in reducing the size of oral aphthous ulceration (Canker Sores) when applied thrice a day for a week, but failed to outperform the active control of 0.1% triamcinolone acetonide (a topical corticosterone).[14] This has been noted elsewhere in recurrent canker sores, where thrice daily application of a gel (1.6% dry leaf remnant) was able to reduce the diameter of inflammation and pain and reduced healing time of the lesions.[15]

5.2

Liver

Aloe vera leaf gel given at 1mg/kg for a week prior to administration of alcohol (3g/kg fasted state) did not influence serum alcohol levels nor the increase in serum liver enzymes (GOP, GPT) following alcohol administration, but was able to attenuate the alcohol-induced increase in liver triglycerides via suppressing alcohol's induction of lipogenic gene mRNA expression (DGAT2, FASN, and SREBP-1; lipolytic genes not affected).[16]

1mg/kg Aloe vera can increase hepatic PPARα content by 1.3-fold relative to control without significantly influencing the target genes of CPT-1 and MCAD.[16]

6.

Nutrient-Nutrient Interactions

6.1

Vitamin C and Vitamin E

Coingestion of vitamin C (500mg) or vitamin E (420mg as acetate) with Aloe vera gel results in a near tripling of the Area-Under-Curve and bioavailability for both compounds[1] coupled with a delayed Tmax when consumed in a fasted state. Vitamin C went from 339+/-124 1031+/-513 and Vitamin E from 19.3+/-23.2 to 71.3+/-22.5uM/h with the addition of Aloe gel, with Aloe leaf not being statistically different from control.[1] The dose of Aloe Gel was not specified.

However, this study did not note any vitamin C or E content of the Aloe itself, and was funded by the International Aloe Science Council.[1]

7.

Safety and Toxicology

Aloe has been associated with acute hepatitis (liver inflammation) either in isolation[17][18] or when consumed as a multinutrient supplement.[19] These effects appear to be reversible and occur in the dosage range of 250-500mg a day, with the exact mechanism of the toxicity is not understood.

Aloe seems to cause wide-ranging side-effects at a doses 100mg/kg or greater bodyweight in animals. These side effects are observed in all subjects.[2]

References
1.^Vinson JA, Al Kharrat H, Andreoli LEffect of Aloe vera preparations on the human bioavailability of vitamins C and EPhytomedicine.(2005 Nov)
4.^Nema NK, Maity N, Sarkar BK, Mukherjee PKDetermination of trace and heavy metals in some commonly used medicinal herbs in AyurvedaToxicol Ind Health.(2012 Dec 6)
6.^Fanali S, Aturki Z, D'Orazio G, Rocco A, Ferranti A, Mercolini L, Raggi MAAnalysis of Aloe-based phytotherapeutic products by using nano-LC-MSJ Sep Sci.(2010 Sep)
7.^Kuzuya H, Tamai I, Beppu H, Shimpo K, Chihara TDetermination of aloenin, barbaloin and isobarbaloin in aloe species by micellar electrokinetic chromatographyJ Chromatogr B Biomed Sci Appl.(2001 Mar 5)
10.^Rodríguez Rodríguez E, Darias Martín J, Díaz Romero CAloe vera as a functional ingredient in foodsCrit Rev Food Sci Nutr.(2010 Apr)
11.^Shin E, Shin S, Kong H, Lee S, Do SG, Jo TH, Park YI, Lee CK, Hwang IK, Kim KDietary Aloe Reduces Adipogenesis via the Activation of AMPK and Suppresses Obesity-related Inflammation in Obese MiceImmune Netw.(2011 Apr)
12.^Yagi A, Kabash A, Okamura N, Haraguchi H, Moustafa SM, Khalifa TIAntioxidant, free radical scavenging and anti-inflammatory effects of aloesin derivatives in Aloe veraPlanta Med.(2002 Nov)
14.^Bhalang K, Thunyakitpisal P, Rungsirisatean NAcemannan, a Polysaccharide Extracted from Aloe vera, Is Effective in the Treatment of Oral Aphthous UlcerationJ Altern Complement Med.(2012 Dec 16)
15.^Babaee N, Zabihi E, Mohseni S, Moghadamnia AAEvaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitisDent Res J (Isfahan).(2012 Jul)
16.^Saito M, Tanaka M, Misawa E, Yamada M, Yamauchi K, Iwatsuki KAloe vera Gel Extract Attenuates Ethanol-Induced Hepatic Lipid Accumulation by Suppressing the Expression of Lipogenic Genes in MiceBiosci Biotechnol Biochem.(2012 Nov 23)
17.^Bottenberg MM, Wall GC, Harvey RL, Habib SOral aloe vera-induced hepatitisAnn Pharmacother.(2007 Oct)
18.^Yang HN, Kim DJ, Kim YM, Kim BH, Sohn KM, Choi MJ, Choi YHAloe-induced toxic hepatitisJ Korean Med Sci.(2010 Mar)
19.^Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LMEuforia-induced acute hepatitis in a patient with sclerodermaBMJ Case Rep.(2012 Dec 19)