INGREDIENTS & RESEARCH

Arjuna

BACKGROUND

Ingredient Type: Botanical, Extract

Also Known As: Terminalia arjuna, Arjuna bark extract, Dhavala, Kakubha, Kumbuk, Nadisarja, Veeravriksha, Partha, Indradru

Arjuna is a large deciduous tree that reaches heights of 25 meters and is usually found along river banks or dry river beds.  Originally, a native of India and Sri Lanka, the arjuna tree is today distributed in the tropical and subtropical regions of Southern Asia and Africa (1,2).

The arjuna tree was mentioned for the first time in the Rig Veda, one of the world’s oldest texts. Its bark has been used as a medicine as early as 700 BC.

Vagbhata, a disciple of the great scholar Charaka, was the first to cite the cardioprotective property of the arjuna bark in his book ‘Ashtanga Hridayam’ written some 1,200 years ago.  Because of its protectant nature, the arjuna tree was given the nickname “Guardian of the heart”.  It is even said that in Theravada Buddhism, the arjuna tree was used to achieve enlightenment, or Bodhi, by tenth Lord Buddha.

 

TRADITIONAL USES

Traditionally, arjuna has been administered as an alcoholic decoction of its stem bark or taken with clarified butter or boiled in milk (3).  The bark, leaves, and fruits of arjuna have been used in the indigenous system of medicine for ailments like heart disease, wounds, ulcers, and hemorrhages.

 

WHAT DOES SCIENCE TELL US?

  Arjuna Probably Helps Support a Healthy Heart:

The arjuna tree bark contains several medically active biomolecules, including tannins, flavonoids, polyphenols, glycosides, sterols (like Sitosterol) and triterpenoid saponins (like arjunic acid and derivatives) (4,5).  The aqueous extract of the bark is used orally as a cardiac tonic because it improves the heart’s muscle tone has a positive inotropic effect (increased strength of myocardial contraction and enhanced pumping activity of the heart) and increases coronary artery flow, which protects the heart muscles against ischemic damage (2).  It also decreases the risk of cardiovascular disease by lowering blood pressure, reducing blood cholesterol (LDL and triglycerides) levels, improving the endothelial function, having anti-inflammatory activity (6,7,8,9,10), and improving the antioxidant defense of the cardiovascular system (11,12,13).

Arjuna preparations potentially increase cardiac performance and have been shown in studies to help in the treatment of hypertension, (14) angina, congestive heart failure, (15) coronary artery disease, myocardial necrosis, and other cardiomyopathies (4,5,16,17,18).

There is mixed evidence available on the effect of arjuna in modulating the left ventricular ejection fraction (LVEF) of the heart. In a double-blind, randomized controlled trial, researchers demonstrated that the water extract of arjuna bark (750 mg, twice daily) administered for 12 weeks, did not improve the reduced LVEF in chronic heart failure patients; although, there was improvement in functional capacity, antioxidant reserves, and symptom-related quality of life in some patients (19).

In another clinical trial conducted by Bharani et al., bark extract of arjuna was given for two weeks (500 mg, three times a day) to patients with refractory chronic congestive heart failure. The study showed that Arjuna was associated with improvement in symptoms and signs of heart failure along with an increase in LVEF (20).  A recent study also assessed the cardiac effects of arjuna in healthy male individuals who perform regular endurance exercises. Results showed that treatment with T. arjuna extract for 8 weeks increased their LVEF by 3.7% and also boosted their cardiac health index (21).

  Arjuna Possibly Promotes a Healthy Balance of Cholesterol:

Arjuna bark extracts also have excellent lipid-lowering properties (22,23,24).  In animal studies, arjuna has been shown to reduce the ‘harmful’ LDL cholesterol and triglycerides and raise ‘protective’ HDL cholesterol (25).  It also reduced the atherosclerotic lesion area, demonstrating effects comparable with atorvastatin (a potent lipid-lowering drug available in the market) (19).

Human subjects having coronary heart disease were treated with 500 mg daily of arjuna tree bark powder and experienced a total cholesterol drop of 9.7% and LDL cholesterol drop of 15.8% (11).

  Arjuna Might Help Support Healthy Blood Vessels:

The arjuna bark powder has also been shown to improve endothelial function (the ability of arteries to dilate and increase blood flow when required) (26) and reduce platelet aggregation in the blood vessels; thus, lowering the risk of thrombotic disorders (27,28).

Several clinical studies have also reported beneficial effects in patients of chronic stable angina (chest pain or discomfort that usually occurs with activity or stress. Angina is chest discomfort due to poor blood flow through the blood vessels in the heart), endothelial dysfunction (a condition in which the endothelium or inner lining of blood vessels does not function normally), and heart failure (29).  A subsequent systematic review conducted on the clinical and experimental studies which compared T. arjuna with the current standard/ conventional treatment regimens in patients with chronic stable angina showed that there was no significant difference in the T. arjuna group and the control groups employed in these studies. Unfortunately, most of the studies conducted on T. arjuna so far have been of poor methodological design and had troubles including insufficient evidence to draw any definite conclusions and lack of well-controlled multi-centric clinical trials (30). 

  Arjuna Possibly Helps Balance Blood Sugar:

The bark and leaf extracts of T. arjuna have been shown to possess significant anti-hyperglycemic activity in animals. However, clinical studies need to be performed to determine its use as a potential anti-diabetic (31,32,33).

  Arjuna Possibly Supports a Healthy Urinary Tract:

Recent research also indicates that arjuna bark preparation in clarified butter might possess anti-diuretic properties as well, which could be useful in managing clinical conditions like nocturia (34).  Another study revealed that the aqueous bark extract of arjuna can potentially protect against urolithiasis (formation of stones in the kidney, bladder and/or urethra) (35).

  Arjuna Possibly Supports Healthy Cell Growth:

Arjuna extracts have also been studied for their anticarcinogenic and antimutagenic potential (13,36,37).  Gallic acid, ethyl gallate, flavone, and luteolin, present in the bark, stem, and leaves of the Arjuna tree has been shown to possibly inhibit cancer cell growth. Luteolin has been shown to have specific anti-bacterial activity against Neisseria gonorrhea as well (1,38).  Another study revealed that Casuarinin, a substance isolated from the bark of T. arjuna arrests breast cancer cell growth (39).

  Arjuna Might Help Protect DNA:

Arjuna also has compounds that protect against DNA damage from toxins (3,40,41).

 

SAFETY

The aqueous extract of Terminalia arjuna bark has been considered a safe cardiotonic (9). However, the organic extracts of the bark have been shown to have detrimental safety concerns like inconsistent positive inotropy with arrhythmias and/or excitability disruption in animal studies (5)

When used orally, for a period of 3 months or less, it is ‘Possibly safe’ (42).  Only a few side effects have been reported like mild gastritis, (43) headache and constipation. No hematological, metabolic, renal and hepatic toxicity was reported even with more than 24 months after its administration (44).

However, a study by Parmar et al. raised questions regarding its safety in healthy human subjects (45).  The study results showed that T. arjuna bark extract in moderate doses potentially decreases thyroid hormones in hyperthyroid individuals and has a beneficial effect on their cardiovascular health; however, high doses of T. arjuna may be toxic in normal or healthy individuals and can cause liver toxicity as well as hypothyroidism. So far this is an isolated report in the literature documenting these side effects.

Interactions:

Moderate

Combine with caution with anti-diabetic drugs like glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase) (42).

In a recent study, T. arjuna was tested for compatibility with some commonly used cardiovascular drugs like metoprolol, atorvastatin, enalapril maleate and aspirin. It was found to have no adverse interactions and can thus be used safely with these drugs (46).

Also, consult a doctor when experiencing any of the following before taking arjuna.

  • Pregnancy: There is some evidence that Terminalia arjuna is ‘possibly unsafe’ during pregnancy.
  • Breastfeeding: There is insufficient evidence to conclude safety of using Arjuna while breastfeeding.
  • Diabetes: T. arjuna might lower the blood sugar levels, (33) which becomes important when it is given concomitantly with anti-diabetic medications. A physician should be consulted because dose adjustment might be required.
  • Surgery: Arjuna might decrease blood sugar levels and interfere with blood sugar control during surgery. Its administration should be stopped at least 2 weeks before a scheduled surgery (42).

 Side-Effects:

  • None reported

 

REFERENCES

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  2. Akinmoladun AC, Olaleye MT, Farombi EO. Cardiotoxicity and Cardioprotective Effects of African Medicinal Plants. In: Toxicological Survey of African Medicinal Plants. Elsevier; 2014:395-421. doi:10.1016/B978-0-12-800018-2.00013-3
  3. Parameswari R, Rao KA, Mano K, et al. Human sperm DNA damage inhibition and antioxidant activity of T. arjuna bark: an in vitro study. 3 Biotech. 2017;7(3):188. doi:10.1007/s13205-017-0853-z
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  41. Phani Kumar G, Navya K, Ramya EM, Venkataramana M, Anand T, Anilakumar KR. DNA damage protecting and free radical scavenging properties of Terminalia arjuna bark in PC-12 cells and plasmid DNA. Free Radicals Antioxidants. 2013;3(1):35-39. doi:10.1016/J.FRA.2013.04.001
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  45. Bharani A, Ganguli A, Mathur LK, Jamra Y, Raman PG. Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate. Indian Heart J2002;54(2):170-175.
  46. Dwivedi S, Aggarwal A, Agarwal MP, Rajpal S. Role of Terminalia arjuna in ischaemic mitral regurgitation. Int J Cardiol. 2005;100(3):507-508. doi:10.1016/J.IJCARD.2004.10.045

See the Examine.com entry for Terminalia arjuna for more information.