Food and Drug Administration banned the use of ephedra in dietary supplements because it raises blood pressure and is linked to heart attack and stroke. Bitter orange is commonly used as a substitute for ephedra in dietary supplements. How Much Do We Know?

A small number of studies have investigated the usefulness of bitter orange for health purposes in people. What Have We Learned? What Do We Know About Safety? Bitter orange is likely safe when used orally in amounts commonly found in foods.

There is one case report of a woman having a faster-than-normal heart rate at rest after taking a dietary supplement that contained only bitter orange. There are other case reports of healthy people experiencing fainting, angina, heart attack, and stroke after taking bitter orange as part of multicomponent products.

However, because these products contained multiple ingredients, it is difficult to know the role that bitter orange played. Evidence regarding the effects of bitter orange alone or combined with other substances, such as caffeine and green tea on the heart and cardiovascular system is inconclusive.

Keep in Mind. Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions. For More Information. Using Dietary Supplements Wisely Know the Science: How Medications and Supplements Can Interact Know the Science: How To Make Sense of a Scientific Journal Article.

NCCIH Clearinghouse The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature.

Toll-free in the U. gov Email: info nccih. PubMed® A service of the National Library of Medicine, PubMed® contains publication information and in most cases brief summaries of articles from scientific and medical journals.

Office of Dietary Supplements ODS , National Institutes of Health NIH ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public.

gov Email: ods nih. Key References. Bitter orange. Natural Medicines website. Accessed at naturalmedicines. com on November 14, Bouchard NC, Howland MA, Greller HA, et al. Ischemic stroke associated with use of an ephedra-free dietary supplement containing synephrine.

Mayo Clinic Proceedings. Firenzuoli F, Gori L, Galapai C. Adverse reaction to an adrenergic herbal extract Citrus aurantium. Gange CA, Madias C, Felix-Getzik EM, et al. Variant angina associated with bitter orange in a dietary supplement.

Mannucci C, Calapai F, Cardia L, et al. Clinical pharmacology of Citrus aurantium and Citrus sinensis for the treatment of anxiety. Evidence-Based Complementary and Alternative Medicine. Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement.

Annals of Pharmacotherapy. Office of Dietary Supplements website. Dietary Supplements for Weight Loss. Orange peel, bitter.

In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; Rasmussen CB, Glisson JK, Minor DS. Dietary supplements and hypertension: potential benefits and precautions.

Journal of Clinical Hypertension. Shara M, Stohs SJ, Smadi MM. Safety evaluation of p -synephrine following 15 days of oral administration to healthy subjects: a clinical study. Phytotherapy Research. Smith TB, Staub BA, Natarajan GM, et al. Acute myocardial infarction associated with dietary supplements containing 1,3 dimethylamine and Citrus aurantium.

Texas Heart Institute Journal. These include 2 :. Bitter orange is a citrus fruit with several household and industrial uses, ranging from food additives to perfumery.

You may want to avoid this fruit and its extracts if you have high blood pressure, an irregular heartbeat, or glaucoma.

Likewise, bitter orange supplements are banned for NCAA athletes. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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How Well Do You Sleep? Health Conditions Discover Plan Connect. Nutrition Evidence Based What Is Bitter Orange, and Does It Aid Weight Loss? Medically reviewed by Adrienne Seitz, MS, RD, LDN , Nutrition — By Amber Charles Alexis, MSPH, RDN on March 17, The fruit and its extracts.

Compounds and nutrients. Does bitter orange aid weight loss? Health benefits of bitter orange. Downsides and side effects of bitter orange. Dosage and safety information. Culinary uses of bitter orange. The bottom line. How we reviewed this article: History.

Mar 17, Written By Amber Charles Alexis, MSPH, RDN. Medically Reviewed By Adrienne Seitz, MS, RD, LDN. Share this article. Read this next. Can You Eat Orange Peels, and Should You? By Kelli McGrane, MS, RD. Is Orange Juice Good or Bad for You?

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Like ephedra, synephrine may speed up your heart rate and raise your blood pressure. Strokes and heart attacks have been reported in some people after taking bitter orange alone or in with other stimulants such as caffeine. In addition, bitter orange may interact with some prescription medications.

Remember, just because an herbal supplement might be natural doesn't mean it's safe. Talk with your doctor before taking herbal supplements.

All rights reserved. Terms of Use. Weather: Closings and Delays Weather: Closings and Delays. Home Mayo Clinic Health Information Library FAQs Bitter orange weight-loss supplements: Do they work?

Exactly which synephrine alkaloids does Citrus aurantium bitter orange contain? International Journal of Obesity, 29 4 , — Bouchard, N. Ischemic stroke associated with use of an ephedra-free dietary supplement containing synephrine. Mayo Clinic Proceedings, 80 4 , — Haaz, S.

Citrus aurantium and synephrine alkaloids in the treatment of overweight and obesity: An update. Obesity Reviews, 7 1 , 79— Bitter orange. Coates, J. Betz, M. Blackman, G. Cragg, M. Levine, J. White Eds. New York, NY: Informa Healthcare.

Jack, S. Bitter orange synephrine : Update on cardiovascular reactions. Canadian Adverse Reaction Newsletter, 17 2 , 2—3. Natural Medicines. Stephensen, T. Ventricular fibrillation associated with use of synephrine containing dietary supplement.