If you read my last article about bitter orange or citrus aurantium, it was pretty clear how I felt about herb. I'd read available research concerning bitter orange, and while there was some evidence supporting bitter orange, overall picture did not look good. So that's picture I painted, however, there were some facts that I was unaware of at time, which I felt you might be interested in if you're researching bitter orange.
In order to lay these out, I want to answer four questions:
1. What Is Bitter Orange (Citrus Aurantium) Really ? 2. So does Bitter Orange act similarly to ephedrine ? 3. What about reports of adverse ill effects of bitter orange ? 4. Is bitter orange safe to use and does it work ?
It's a bit long, but what heck !
What Is Bitter Orange Really ?:
The Bitter Orange extract found in popular fat burners, is made from unripe fruit of citrus aurantium tree. The fruit is picked when they are a dark green in color, halved, dried and then milled into a powder. This makes herb Zhi Shi[1]. Bitter orange is western name for Zhi Shi.
The bitter orange herb contains five alkaloids (see alkaloid definition[5]), most dominant of which is Synephrine (the compound I referred to in my last article), structurally similar to ephedrine. However, while they are similar, they're not same.
Chemically, both synephrine and ephedrine stimulate sympathetic nervous system and at a cellular level, affect classes of cells called alpha cells, and to a lesser extent, beta cells[6]. Alpha and beta cells can then be divided into classes of beta and alpha cells. Beta(1) and beta(2) cell receptors are believed to be responsible for cardiac and pulmonary functions. Beta(3) cell receptors are believed to be responsible for fat burning or thermogenesis. Ephedrine will affect beta(1), beta(2) and beta(3) cell receptors, however, of beta-cell receptors, synephrine appears to only affect beta(3) cells.[7].
So does Bitter Orange act similarly to ephedrine ?
Does it ? While previously, I've presented a very black and white view of whether it acts similarly to ephedrine, I am now not so sure.
Generally speaking because synephrine stimulates beta(3) cells but not beta(2) and beta(1) cells, it can provide thermogenic effects without undesirable cardiac side effects that ephedrine did.
What about reports of adverse ill effects of bitter orange ?
The American Herbal Products Association has found that there were errors by FDA in reported adverse event reports attributed to use of bitter orange in September 2004[3]. The association found that numbers reported in media were in fact duplicates for adverse event reports for ephedrine, and when all was said and done, there was really only one report of an adverse reaction attributed to a bitter orange supplement, where no other ingredient was included in supplement. In this particular case, it involved a 74 year old woman who had been taking prescription medication and two other herbal preparations simultaneously. This one case occurred more than five years ago[3].
What about 55 year old woman reported by Nykamp DL, Fackih MN, Compton AL (2004), who experienced chest pain after consuming a supplement containing bitter orange. Researchers in this case study had commented "Based on Naranjo probability scale, C. aurantium is possibly associated with this cardiovascular event"[4], however, as bitter orange was not only ingredient in supplement, it cannot be known whether in this case, that bitter orange was herb responsible.
Is bitter orange safe to use and does it work ?
Now there are many others, who felt as I did, that bitter orange is another Ephedra waiting to happen, and will have same consequences. However, when bitter orange is taken in isolation, it does not have adverse side effects.
In fact, when it is combined with other selected herbs, it may have benefits for health and weight loss. Research performed with 20 individuals over six weeks found no adverse reactions occurred when citrus aurantium was combined with caffeine and St. Johns Wort[2]. They also found that individuals who were given supplement (group A) lost an average of 2.9% body fat. "In terms of actual fat loss, group A lost a significant amount (3.1 kg), whereas control group demonstrated a tendency toward fat loss." So, this study has demonstrated that there are weight loss benefits involved here, but also control group who received nothing exhibited a tendency towards fat loss, suggesting that if study had been extended beyond 6 weeks, control group would have lost body fat as well.