Phyllanthus's therapeutic uses
Phyllanthus is a genus of tropical plants that has been traditionally used in Ayurvedic medicine for a variety of health conditions, particularly related to the liver and kidneys. The most researched species, P. amarus, has been explored primarily for its potential therapeutic effects on chronic hepatitis B, though recent studies suggest it may not be effective for this purpose. Other proposed uses of Phyllanthus species include improving overall liver health, supporting kidney and urinary health, and managing blood sugar levels, making it of interest for diabetes treatment. Additionally, some species are noted for their antioxidant and anti-inflammatory properties, potentially aiding in the protection against chronic health issues.
While there have been numerous studies on the efficacy of Phyllanthus, particularly against hepatitis B, results have often been inconclusive or disappointing in human trials, with only one flawed study suggesting any significant benefit. Other species, such as P. niruri, have shown promise in reducing urinary tract stones and may have antiviral effects, but further clinical studies are needed to confirm these findings. Importantly, while Phyllanthus plants are generally considered safe at recommended dosages, comprehensive safety evaluations have not been conducted, and their effects on pregnant or nursing women remain unclear.
Phyllanthus's therapeutic uses
DEFINITION: Natural plant product used to treat specific health conditions.
PRINCIPAL PROPOSED USE: Chronic hepatitis B
OTHER PROPOSED USE: Acute hepatitis B, overall liver health, antiviral, kidney health, urinary health, antioxidant, anti-inflammatory, blood sugar management
Overview
Tropical plants in the genus Phyllanthus have a long history of use in Ayurvedic medicine (the traditional medicine of India) for treating hepatitis, kidney and bladder problems, intestinal parasites, and diabetes. The most-studied species is P. amarus.
Therapeutic Dosages
The usual dose of P. amarus used in studies is 600 to 900 milligrams (mg) daily.
Therapeutic Uses
Hepatitis B is a two-stage illness. Its acute phase causes jaundice, severe fatigue, and other symptoms. These symptoms usually resolve in a month or so; however, the infection may become chronic. Long-term infection with hepatitis B can spread the disease to other people and can also lead to liver injury or liver cancer.
P. amarus has undergone considerable evaluation as a treatment for chronic hepatitis B and some study for acute hepatitis. However, the results have not been promising. While early studies appeared to show benefits, emerging studies suggest the herb is not helpful for hepatitis. P. urinaria also appears to be ineffective.
Other species in the Phyllanthus family showed promise in treating a variety of medical issues as well, including urinary tract stones, additional viral infections, diabetes, and ulcers, though more human clinical studies are needed. Plants in the Phyllanthus genus have also shown promise for their antioxidant and anti-inflammatory properties, which may protect against free radicals that can lead to chronic health conditions. They may also help with blood sugar management, suggesting benefits for diabetes management. Limited evidence suggest plants in the Phyllanthus genus may boost immunity, have anti-cancer and antimicrobial effects, help wounds heal, and provide pain relief.
Scientific Evidence
Despite numerous test-tube and animal studies showing efficacy against the hepatitis B virus, P. amarus has generally not done well in human trials. Only one study found benefits, and it was seriously flawed. In this thirty-day double-blind, placebo-controlled trial of sixty people with chronic hepatitis B, treatment with Phyllanthus (200 mg three times daily) dramatically increased the odds of full recovery. In the treated group, almost 60 percent were hepatitis B-negative at follow-up, compared with only 4 percent in the placebo group. However, the high drop-out rate in the placebo group significantly reduces the reliability of the results. Furthermore, multiple follow-up studies attempting to reproduce these findings found no benefits.
Another double-blind, placebo-controlled trial enrolled fifty-seven people with acute hepatitis B to see whether treatment with P. amarus (300 mg three times daily for one week) could improve the speed of recovery. The results showed no benefit. However, because acute hepatitis B usually lasts a month or more, the duration of treatment in this study was oddly short.
One highly preliminary study suggested that P. urinaria, a related species, might be more effective against hepatitis than other species of Phyllanthus. However, a subsequent double-blind, placebo-controlled study designed to test this hypothesis failed to find benefit.
As the twenty-first century progressed, researchers looked into other possible health benefits provided by species of Phyllanthus. Phyllanthus niruri (P. niruri) showed promising health benefits in clinical studies. In 2018, a study in humans showed its potential to reduce the size of urinary tract stones. Cell cultures suggested P. niruri could help prevent viral infections like hepatitis B, the herpes simplex virus, and Human Immunodeficiency Virus (HIV). Animal studies point to the potential for P. niruri to act as a diuretic, provide anti-inflammatory properties, and treat diabetes and ulcers.
Safety Issues
There are no indications that P. amarus is toxic when used at recommended doses, but comprehensive safety studies have not been performed. In double-blind studies, significant side effects have not been reported. Safety in pregnant or nursing women and individuals with severe liver or kidney disease has not been established.
Bibliography
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Calixto, J. B., et al. "A Review of the Plants of the Genus Phyllanthus: Their Chemistry, Pharmacology, and Therapeutic Potential." Medical Research Review, vol. 18, 1998, pp. 225-258.
Carter, Alan, et al. "Phyllanthus Niruri: Everything You Need to Know." Medical News Today, 25 Feb. 2020, www.medicalnewstoday.com/articles/phyllanthus-niruri#benefits. Accessed 21 Sept. 2024.
Chan, H. L., et al. "Double-Blinded Placebo-Controlled Study of Phyllanthus urinaris for the Treatment of Chronic Hepatitis B." Alimentary Pharmacology and Therapeutics, vol. 18, 2003, pp. 339-345.
Liu, J., et al. "Genus Phyllanthus for Chronic Hepatitis B Virus Infection: A Systematic Review." Journal of Viral Hepatitis, vol. 8, no. 5, 2001, pp. 358-366, doi.org/10.1046/j.1365-2893.2001.00307.x. Accessed 21 Sept. 2024.
Narendranathan, M., et al. "A Trial of Phyllanthus amarus in Acute Viral Hepatitis." Tropical Gastroenterology, vol. 20, 1999, pp. 164-166.
"Phyllanthus." PeaceHealth, 2015, www.peacehealth.org/medical-topics/id/hn-2146004. Accessed 21 Sept. 2024.