Amla (Indian gooseberry)

What the trials found

Two pooled analyses of randomized trials: Setayesh 2023 (5 trials, 3 to 12 weeks) found lower LDL, total cholesterol and triglycerides and higher HDL, but the abstract gives no sizes. Brown 2023 (9 trials, 535 adults, 500 to 1,500 mg a day, 14 to 84 days) found LDL down 15.08 mg/dL, VLDL down 5.43 mg/dL and triglycerides down 22.35 mg/dL; HDL was not listed as changed. Individual trials: Upadya 2019 (98 adults with dyslipidemia, extract 500 mg twice a day, 12 weeks) found lower total cholesterol, triglycerides, LDL and VLDL than placebo; Usharani 2019 (59 adults with metabolic syndrome, 12 weeks) found LDL down 11.4% and 21.8% and HDL up 7.3% and 22.2% at 250 and 500 mg twice a day; Khanna 2015 (overweight adults, no placebo group) found lower LDL. Two trials found nothing: Shanmugarajan 2021 (150 adults with high blood pressure, 12 weeks) found no change in lipids, and a trial of Triphala plus guggulu (Donato 2021, 90 adults, which includes amla but is a mix) was no better than placebo. Older, small or poorly described studies (Amlamax, amla powder for 21 days, Chyawanprash in 10 men) also reported lower cholesterol but cannot be relied on.

Results

Most trials find lower LDL cholesterol and triglycerides after about 12 weeks. The size varies widely between trials, and a new trial might find no change.

Effect sizes as reported

Brown 2023: LDL-C -15.08 mg/dL (95% CI -25.43 to -4.73; I2 77%; prediction interval -48.29 to 18.13); triglycerides -22.35 mg/dL (-39.71 to -4.99; I2 62%; prediction interval -73.47 to 28.77). Setayesh 2023 gives p-values only.

Why this rating

Results lean the same way and two pooled analyses agree, but there are few trials, they are short, they differ a lot, the prediction intervals include no effect, several tested branded extracts and some were run or supplied by makers, and a 150-person placebo trial in people on blood pressure medicines found nothing. No trial measured heart attacks or deaths.

Form and dose studied

Mostly fruit extracts (standardized water or polyphenol extracts, branded products such as Capros and Amlamax) and amla powder. Doses in the trials ranged from 500 mg to 1,500 mg a day of extract and 1 to 3 g of powder. We are not giving advice on amounts.

Who was studied

Adults with high blood fats, metabolic syndrome, overweight, type 2 diabetes, high blood pressure, and healthy adults.

Limits

Short trials (3 to 12 weeks) and surrogate lab results only. Several abstracts do not give numbers, group sizes or funders. Two key trials were registered after they started. Branded extracts differ, so one result may not apply to another product or to plain amla.

Why researchers looked

High LDL cholesterol and triglycerides raise the risk of heart disease. Amla fruit is rich in tannins and vitamin C, and animal studies suggested it lowers blood fats, so researchers tested it in people.

Traditional use

A 2022 review of the fruit (Saini) lists traditional use in Ayurveda for cardiac disorders, diabetes and other complaints. Amla is also one of the three fruits in Triphala and an ingredient of Chyawanprash. Traditional use was not about blood fat tests, and we did not read an original text.

Proposed mechanism Animal research

In rats, amla fractions lowered cholesterol and raised a liver fat-burning protein (PPAR-alpha) and slowed LDL oxidation in test tubes. Whether this happens in people is not shown.

A proposed mechanism does not show that the effect happens in people.

No serious side effects were reported in these trials. Amla may also affect blood sugar and platelets (see those sections). People on cholesterol medicine should not swap it for amla without asking their doctor.

^{35 38 8 45 46 24 39 11 2 3 4 29 52 25}

What the trials found

Setayesh 2023 pooled 5 trials and found lower fasting glucose with amla (p under 0.001; no size in the abstract). Akhtar 2011 gave amla powder (1, 2 or 3 g a day) for 21 days to healthy people and people with type 2 diabetes and reported lower fasting and after-meal glucose compared with their own starting values (no placebo group). Majeed 2022 (open label, newly diagnosed type 2 diabetes with high blood fats, 90 days) compared a beta-glucogallin extract at 1 g or 2 g a day with metformin 500 mg a day; blood sugar, HbA1c and lipids fell in all three groups and fasting sugar, after-meal sugar and HbA1c were lower with 2 g than with metformin. The authors are from the Sabinsa group, which makes amla extracts. Manjunatha 2001 (10 healthy men, Chyawanprash 15 g a day vs vitamin C) found lower fasting glucose and a smaller glucose curve with the jam after 8 weeks, gone by week 16. Shanmugarajan 2021 (150 adults with high blood pressure) found no change in HbA1c. In 98 adults with dyslipidemia, Upadya 2019 reported only a "trend" toward lower fasting sugar.

Results

Lower blood sugar was seen in several small trials. No trial measured long-term diabetes outcomes such as complications.

Effect sizes as reported

Mostly p-values only. Manjunatha 2001: fasting glucose 100.2 vs 116.2 mg/dL at 8 weeks vs week 0 in 5 men on Chyawanprash.

Why this rating

Direction is consistent, but trials are short (21 to 90 days), several have no placebo, the one head-to-head trial was open label with only 500 mg of metformin and was done by the extract's maker, and a 150-person placebo trial in people on blood pressure medicines found no change in HbA1c.

Form and dose studied

Amla powder (1 to 3 g a day), standardized fruit extracts (1 to 2 g a day in the head-to-head trial) and Chyawanprash. We are not giving advice on amounts.

Who was studied

Healthy adults, newly diagnosed type 2 diabetes with high blood fats, and adults with high blood pressure or metabolic syndrome.

Limits

No long-term diabetes outcomes. Abstracts often lack numbers and group sizes. The strongest-looking trial is open label and industry-linked. Chyawanprash is a mixture, so results cannot be credited to amla.

Why researchers looked

Amla is used traditionally for diabetes, according to a 2022 review of the fruit (Saini). Lab work showed amla tannins and gallic acid can block starch-digesting enzymes and change how cells handle glucose.

Traditional use

The 2022 Saini review lists diabetes among the traditional uses of amla fruit. We did not read an original text.

Proposed mechanism Laboratory research

In test tubes a branded amla extract blocked the starch-digesting enzymes alpha-amylase and alpha-glucosidase and DPP-4 (study run by the extract maker). In diabetic rats the extract raised insulin, and gallic acid and ellagic acid changed glucose-handling proteins. This has not been shown in people.

A proposed mechanism does not show that the effect happens in people.

Amla might add to the effect of diabetes medicines. We found no reported case of low blood sugar from amla, but no trial was designed to look for it. People who take insulin or sulfonylureas should talk to their doctor first.

^{35 38 2 28 29 39 45 27 13 47}

What the trials found

Shanmugarajan 2021: 150 adults with essential hypertension took amla extract 500 mg twice a day or placebo for 12 weeks on top of their usual medicines. There was no extra drop in systolic or diastolic blood pressure, and no change in lipids, HbA1c, arterial stiffness, hs-CRP or oxidant status. The Brown 2023 pooled analysis (9 trials) did not list blood pressure among its significant results in the abstract. A 2018 review of cardiovascular studies said there was not enough evidence that amla prevents or treats heart disease.

Results

No blood pressure benefit in the one adequate randomized trial.

Effect sizes as reported

Not significant (numbers not in the abstract).

Why this rating

Only one adequate trial, and it was negative. A pooled analysis that covered blood pressure in its search did not report a result for it in its abstract. We cannot rule out small effects in untreated people.

Form and dose studied

Aqueous extract capsules, 500 mg twice a day, for 12 weeks, in the one trial.

Who was studied

Adults with essential hypertension already taking blood pressure medicine.

Limits

One trial, India only, 12 weeks. Only the abstract was read.

Why researchers looked

Amla is rich in antioxidants and is sold for heart health. Animal and cell studies suggested it widens blood vessels.

Traditional use

The 2022 Saini review lists cardiac disorders among the traditional uses of amla fruit. We did not read an original text.

Proposed mechanism Animal research

A systematic review of mostly animal and lab work says amla showed vessel-widening effects. Not confirmed in human blood pressure trials.

A proposed mechanism does not show that the effect happens in people.

No excess blood pressure fall or low-pressure events were reported in the abstracts, but low blood pressure was not studied as an outcome. Anyone taking blood pressure pills should still tell their doctor about amla supplements.

^{35 39 8 19}

What the trials found

Brown 2023 (9 trials): hs-CRP down 1.70 mg/L (95% CI -2.06 to -1.33, I2 0%) compared with placebo. Setayesh 2023 (5 trials): lower CRP (p = 0.002). Usharani 2019 (59 adults with metabolic syndrome): hs-CRP down 39.68% and 53.77% at 250 and 500 mg twice a day for 12 weeks. Khanna 2015 (no placebo group): lower hs-CRP. Shanmugarajan 2021 (150 adults with high blood pressure): no change in hs-CRP.

Results

Lower CRP in most small trials; one larger trial in a different group found no change.

Effect sizes as reported

Brown 2023: hs-CRP -1.70 mg/L (95% CI -2.06 to -1.33).

Why this rating

Pooled results agree, with no difference between trials in the Brown analysis, but few trials, short duration, no placebo in some, and one larger trial found nothing. CRP is a lab marker, not an illness.

Form and dose studied

Fruit extracts, 500 to 1,000 mg twice a day or 500 mg to 1,500 mg a day depending on the trial. We are not giving advice on amounts.

Who was studied

Adults with metabolic syndrome, overweight or dyslipidemia.

Limits

Lab marker only. Few trials. Different extracts.

Why researchers looked

Amla tannins reduce inflammation signals in cells, and chronic low-grade inflammation goes with heart disease and diabetes.

Traditional use

The 2022 Saini review lists inflammation among the traditional uses of amla fruit. We did not read an original text.

Proposed mechanism Laboratory research

In cultured vessel-lining cells and endotoxin-treated rats, an amla extract lowered clotting and inflammation signals (TNF-alpha, IL-6). Not confirmed in people.

A proposed mechanism does not show that the effect happens in people.

No inflammation-related side effects were reported.

^{35 8 38 46 24 39 34}

What the trials found

Usharani 2019 (59 adults with metabolic syndrome): the reflection index, a measure of vessel stiffness by finger pulse sensor, improved at 8 and 12 weeks versus baseline and placebo with a standardized aqueous extract at 250 and 500 mg twice a day; nitric oxide rose and oxidative markers fell. Kapoor 2020 (15 healthy adults, 18-week crossover, 500 mg a day) found better "blood fluidity" and lower von Willebrand factor, with the authors reporting improved endothelial function; the authors work at a food ingredient company. Martinez 2025 (166 adults starting diet and exercise) found "some evidence" (up to p under 0.10) of better pulse wave velocity and flow-mediated dilation with amla or a chromium mix; the study was funded by Kerry Inc. Shanmugarajan 2021 (150 adults with high blood pressure) found no change in arterial stiffness.

Results

Mixed. One placebo trial showed clear improvement in a vessel-function measure; one trial of similar size found none.

Effect sizes as reported

Not given as numbers in the abstracts we read. Usharani 2019: RI significantly lower at 8 and 12 weeks (p under 0.001).

Why this rating

Three small trials point the same way, but they use different measures, one counts p up to 0.10 as evidence, two are industry-linked, one larger trial was negative, and the measures are not clinical outcomes.

Form and dose studied

Standardized aqueous fruit extract (250 to 500 mg twice a day), 500 mg a day (healthy adults), 500 or 1,000 mg a day (combined with diet and exercise). We are not giving advice on amounts.

Who was studied

Adults with metabolic syndrome, healthy adults, sedentary adults at risk of metabolic syndrome.

Limits

Small trials, lab or device measures, short, industry links. Only abstracts read.

Why researchers looked

Poor blood vessel (endothelial) function is an early step toward artery disease. Amla antioxidants are thought to protect the vessel lining.

Traditional use

Not a traditional use as stated; it is a modern research question.

Proposed mechanism Preliminary mechanism

Higher nitric oxide and lower oxidative stress markers were measured in the metabolic syndrome trial, which suggests but does not prove the mechanism.

A proposed mechanism does not show that the effect happens in people.

No side effects were reported in these trials. Because amla also affects platelets, see the safety file.

^{46 22 30 39 19}

What the trials found

Fatima 2014 (10 adults with type 2 diabetes, open-label crossover): amla extract 500 mg alone (single dose and twice a day for 10 days), clopidogrel, aspirin (ecosprin) and the combinations each lowered platelet aggregation compared with baseline, and bleeding and clotting times were longer after all treatments. Khanna 2015 (overweight adults, no placebo): ADP- and collagen-induced platelet aggregation lower after 12 weeks. Martinez 2025: "some evidence" of lower platelet aggregation. Kapoor 2020 (15 healthy adults): "blood fluidity" improved and thrombin markers were lower.

Results

Platelet clumping was lower in the human studies we read. Bleeding time was longer in the 10-person crossover study.

Effect sizes as reported

No numbers in the abstracts.

Why this rating

Three or four small studies, two without a placebo group, all lab or device measures; none measured bleeding events or clots. Direction is consistent.

Form and dose studied

Extract 500 mg twice a day in the key studies. We are not giving advice on amounts.

Who was studied

Adults with type 2 diabetes (crossover), overweight adults, healthy adults.

Limits

Tiny studies, no placebo in some, no clinical bleeding outcome. Only abstracts read.

Why researchers looked

Sticky platelets help form clots that can block arteries. Amla extract lowered clotting signals in cell studies.

Traditional use

Not a described traditional use that we read.

Proposed mechanism Laboratory research

An amla extract lowered tissue factor and von Willebrand factor in cultured vessel cells exposed to a bacterial toxin. The actual mechanism in people is not shown.

A proposed mechanism does not show that the effect happens in people.

Possible added bleeding risk with aspirin, clopidogrel, warfarin or before surgery. No bleeding events are described in the abstracts, but they were not designed to look for them.

^{12 24 30 22 34 19}

What the trials found

Usharani 2019 (59 adults with metabolic syndrome, placebo-controlled, 12 weeks): nitric oxide up, glutathione up 24.31% and 53.22%, and the damage marker MDA down 21.02% and 31.44% at the two doses. Chen 2009 (patients with kidney failure on dialysis, 4 months, no placebo group): plasma 8-iso-prostaglandin fell from 1415 +/- 1234 to 750 +/- 496 pg/mL and total antioxidant status rose from 2.32 to 2.55 mM. A 2011 trial of a 1:1 amla and green tea (EGCG) mix in 13 dialysis patients with diabetes reported better antioxidant defences, but it is a mix. Kapoor 2020 (15 healthy adults): the DNA-damage marker 8-OHdG was lower. Shanmugarajan 2021 (150 adults with high blood pressure): no change in oxidant status or antioxidant capacity.

Results

Oxidative stress markers improved in small trials, but a larger trial in people with high blood pressure found no change.

Effect sizes as reported

Usharani 2019 at 12 weeks (250 mg / 500 mg twice a day): nitric oxide +41.89% / +50.7%; glutathione +24.31% / +53.22%; MDA -21.02% / -31.44%. Chen 2009: 8-iso-prostaglandin 1415 to 750 pg/mL (p under 0.05).

Why this rating

Biomarker changes only, some in before-and-after studies without a control group, small numbers, and one larger trial found no change. The high vitamin C content may explain part of the effect.

Form and dose studied

Fruit extracts at 500 mg a day to 500 mg twice a day. We are not giving advice on amounts.

Who was studied

Adults with metabolic syndrome, healthy adults, patients on dialysis.

Limits

Marker changes do not equal clinical benefit. No placebo in the dialysis trials. Only abstracts read.

Why researchers looked

Oxidative stress is linked to ageing, diabetes and kidney failure. Amla is promoted as an antioxidant fruit.

Traditional use

The Vishwanatha 2016 trial abstract describes amla preparations (Amalaki rasayana) as used in Ayurveda for healthy living in older people. We did not read an original text.

Proposed mechanism Laboratory research

The fruit contains vitamin C (the authors of one trial cite 1,100 to 1,700 mg per 100 g) and hydrolysable tannins such as emblicanins, which scavenge free radicals in test tubes.

A proposed mechanism does not show that the effect happens in people.

In the dialysis trials, liver and kidney tests did not change. Amla vitamin C may matter for kidney stone risk (see the safety file). People with kidney disease should ask their kidney doctor before taking amla supplements.

^{46 9 10 22 39 51 18}

What the trials found

Lu 2024: a short trial of 26 people and a 28-day double-blind trial (18 per group) found lower volatile sulfur compounds 3, 6 and 12 hours after rinsing with 5% fruit extract and after 28 days of use. Gao 2018 (20 healthy young adults, crossover): sugar-free gum with amla extract raised saliva flow and pH early on, and total bacteria, S. mutans, P. gingivalis and volatile sulfur compounds differed from plain gum at 75 to 80 minutes; no side effects.

Results

Lower breath sulfur gases after rinsing or chewing. Breath gas readings are the measure; no one rated how fresh the breath smelled.

Effect sizes as reported

No numbers for the human part in the abstracts.

Why this rating

Two small trials, short follow-up, only the abstracts read, no named control rinse, results are a gas reading, not a rating by other people.

Form and dose studied

A 5% fruit extract mouth rinse, and a sugar-free chewing gum with fruit extract. We are not giving advice on amounts.

Who was studied

People with halitosis; healthy young adults.

Limits

Small, short. Not a swallowed supplement, so results do not carry over to capsules.

Why researchers looked

Bad breath comes mostly from bacteria in the mouth making sulfur gases. Amla tannins slowed these bacteria in lab tests.

Traditional use

Amla is said to be used traditionally for mouth complaints; we did not read an original text for this.

Proposed mechanism Laboratory research

In test tubes the extract slowed growth of three bacteria linked to bad breath (F. nucleatum, P. gingivalis, S. moorei) and cut their clumping. In oral cell cultures it reduced IL-6 and IL-8 inflammation signals.

A proposed mechanism does not show that the effect happens in people.

No side effects were reported in the gum trial.

^{26 15}

What the trials found

Grover 2016 (46 adults with chronic periodontitis, 40 finished): 10% Emblica officinalis sustained-release gel under the gum after scaling and root planing gave greater reductions in pocket depth and bleeding and more attachment gain than placebo gel at 2 and 3 months (p under 0.05). Nandlal 2021 (180 adults with plaque and gingivitis, 150 finished, 6 months): a toothpaste with clove, aloe vera, amla, neem, tulsi and honey plus zinc salts and fluoride lowered plaque by 23.5%, gingival index by 25.6% and bleeding index by 73.3% compared with a fluoride-only toothpaste (p under 0.001).

Results

Better gum measures with the amla gel (one trial) and with the herbal toothpaste (one trial).

Effect sizes as reported

Nandlal 2021 at 6 months vs control: plaque -23.5%, gingival index -25.6%, bleeding index -73.3%. Grover 2016: numbers not in the abstract.

Why this rating

Two trials. One tested a gel placed by a dentist with the maker's own preparation, and the other tested a mix, so neither shows that drinking or chewing amla helps gums.

Form and dose studied

A dentist-placed 10% gel and a herbal toothpaste. We are not giving advice on amounts.

Who was studied

Adults with chronic periodontitis; adults with plaque and gingivitis.

Limits

Small trial, mixed products, funder not stated in the abstracts, abstracts only.

Why researchers looked

Gum disease is caused by plaque bacteria and inflammation. Amla extract has antibacterial and anti-inflammatory effects in the lab.

Traditional use

Amla is said to be used traditionally for oral hygiene; we did not read an original text for this.

Proposed mechanism Laboratory research

Lab tests show amla extract slows growth of gum-disease bacteria and lowers inflammation signals in oral cells.

A proposed mechanism does not show that the effect happens in people.

Not reported as a problem in the abstracts.

^{17 32}

What the trials found

Karkon Varnosfaderani 2018 (68 adults with heartburn and regurgitation for 3 months or more; two 500 mg amla tablets twice a day or placebo for 4 weeks): symptoms fell in both groups, and more in the amla group for the frequency and severity of heartburn and regurgitation (p under 0.001).

Results

Fewer and milder heartburn and regurgitation episodes with amla than with placebo.

Effect sizes as reported

P under 0.001 for between-group differences; numbers not in the abstract.

Why this rating

One trial of 68 people for 4 weeks, symptom scores only, and symptoms also fell in the placebo group.

Form and dose studied

Amla tablets, 500 mg, two at a time, twice a day, for 4 weeks. We are not giving advice on amounts.

Who was studied

Adults with non-erosive reflux disease.

Limits

One small short trial; no scope assessment or comparison with usual treatment in the abstract.

Why researchers looked

Amla is a traditional remedy for acidity and indigestion, and people are looking for options when usual reflux treatment fails.

Traditional use

The 2022 Saini review lists dyspepsia, hyperacidity and peptic ulcer among the traditional uses of amla fruit. A 1982 trial title mentions amalaki for dyspepsia, but its abstract is not available, so we did not use it.

Proposed mechanism Pharmacological theory

Not established. Amla is high in tannins and vitamin C; how this might reduce reflux symptoms is not shown.

A proposed mechanism does not show that the effect happens in people.

The abstract does not report stomach upset.

^{35 23}

What the trials found

Suhag (Rathore) 2025 (40 adults with obesity, open label, no placebo): amla extract AMX-160 500 mg twice a day for 90 days lowered visceral fat, under-skin fat, waist, waist-to-hip ratio, BMI, weight and lipids and raised muscle mass (p under 0.05); once a day also changed most measures. Martinez 2025 (166 sedentary adults, 109 finished, all on diet and exercise, placebo-controlled, funded by Kerry Inc.): "some evidence" (p under 0.05 or approaching significance up to 0.10) of better body composition, strength and aerobic capacity with amla 500 or 1,000 mg a day or a chromium-based mix.

Results

Better body composition in a small open-label study; weak "some evidence" in a placebo-controlled study.

Effect sizes as reported

No numbers in the abstracts.

Why this rating

One uncontrolled trial and one trial that used a loose significance standard and was industry-funded; both short, and both tested products that may not match what you buy.

Form and dose studied

Amla extract 500 mg once or twice a day; amla alone or a mix with chromium and shilajit. We are not giving advice on amounts.

Who was studied

Adults with obesity; sedentary adults with two or more metabolic syndrome risk factors starting diet and exercise.

Limits

No convincing placebo-controlled weight result; 12 weeks or less; abstracts only.

Why researchers looked

Fats and blood sugar changes in amla trials led researchers to test weight and body fat.

Traditional use

Not a traditional use that we read.

Proposed mechanism Animal research

Not established. A review of animal studies says amla has anti-obesity effects in rodents.

A proposed mechanism does not show that the effect happens in people.

No side effects reported in the abstracts.

^{42 30}

What the trials found

Akhbari 2024 (60 women with female pattern hair loss, 52 finished; amla syrup 10 mL three times a day or placebo for 12 weeks, triple blind): the ratio of growing to resting hairs rose more with amla than with placebo (F = 10.4, p = 0.002) and doctor and patient satisfaction were higher (p under 0.001). One mild case of constipation.

Results

More growing hairs with the syrup on a scalp scan, and higher satisfaction.

Effect sizes as reported

Anagen-to-telogen ratio F = 10.4, p = 0.002; satisfaction p under 0.001.

Why this rating

Single small trial, 12 weeks, not yet repeated. A higher growing-hair share is not the same as thicker hair.

Form and dose studied

Amla syrup, 10 mL three times a day. We are not giving advice on amounts.

Who was studied

Women with female androgenetic alopecia.

Limits

One trial. Other syrup contents are not given in the abstract.

Why researchers looked

Traditional Persian medicine recommends amla for hair loss, taken by mouth and applied to the scalp.

Traditional use

The trial authors say amla fruit is emphasized as a hair tonic in Traditional Persian Medicine.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

One mild constipation case reported.

¹

What the trials found

Uchiyama 2019 (99 healthy women; drinks with 25 mg lingonberry and 30 mg amla extract, double that, or placebo, 50 mL a day for 12 weeks): skin elasticity (primary), thickness, water content and wrinkles improved in a dose-dependent way (p under 0.01 for elasticity and under 0.001 for the others).

Results

Better skin measurements with the drink than with placebo.

Effect sizes as reported

Elasticity P under 0.01; thickness, water content, wrinkles P under 0.001.

Why this rating

One trial of a two-extract drink by company-employed authors; the result cannot be credited to amla.

Form and dose studied

A 50 mL drink with lingonberry and amla extract. We are not giving advice on amounts.

Who was studied

Healthy women.

Limits

Mix of two fruit extracts, industry-linked, abstract only.

Why researchers looked

Amla antioxidants and collagen-related effects in the lab led companies to test it for skin ageing.

Traditional use

Not a described traditional use that we read.

Proposed mechanism Laboratory research

Not established for amla in people.

A proposed mechanism does not show that the effect happens in people.

Not reported in the abstract.

⁴⁴

What the trials found

Boonfueang 2026 (118 patients; placebo, dextromethorphan 60 mg, E. officinalis extract 600 mg, or both): median cough counts were 61.0 with placebo, 20.0 with dextromethorphan, 27.0 with amla extract and 25.5 with both (Kruskal-Wallis p = 0.019). Amla also reduced oxygen dips; dextromethorphan reduced sedative needs. No adverse events.

Results

Fewer coughs with the extract than with placebo, similar to dextromethorphan.

Effect sizes as reported

Median cough count 27.0 (IQR 14.0 to 40.0) vs 61.0 (IQR 26.3 to 90.8) with placebo.

Why this rating

One new trial, one setting, single dose before a hospital procedure, not repeated.

Form and dose studied

A single 600 mg extract dose before the procedure. We are not giving advice on amounts.

Who was studied

Adults undergoing endobronchial ultrasound.

Limits

Single dose, supervised hospital setting, not a daily-cough result.

Why researchers looked

Cough during the procedure is common and can harm the test; amla is traditionally used for cough.

Traditional use

The trial authors say amla is a traditional herbal medicine with reported antitussive (cough-suppressing) properties; human evidence was lacking.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

No adverse events reported in the trial.

⁷

What the trials found

Varnasseri 2022 (61 patients with laboratory-confirmed COVID-19; amla tea added to usual care, 31 vs 30 controls): hospital stay was 4.44 days with amla and 7.18 days in the control group (p under 0.001). PCR results did not differ (p = 0.07). Fever, cough, shortness of breath and muscle pain scored better; oxygen saturation, CT lung involvement and CRP improved.

Results

A shorter hospital stay and milder symptoms, with no clear difference in the virus test.

Effect sizes as reported

Length of stay 4.44 vs 7.18 days (p under 0.001).

Why this rating

One small trial; the abstract does not say what the control group received; hospital stay depends on local discharge practice.

Form and dose studied

Amla herbal tea (amount not stated in the abstract). We are not giving advice on amounts.

Who was studied

Adults hospitalized with COVID-19.

Limits

Small, not repeated, abstract only.

Why researchers looked

Amla is used traditionally for colds and coughs, and has a high vitamin C content (per a dialysis trial abstract).

Traditional use

The 2022 Saini review lists common cold, fever and cough among the traditional uses of amla fruit. We did not read an original text.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

No side effects described in the abstract.

^{35 48}

What the trials found

Sharma 2024 (5 randomized trials in India, 153,343 participants): odds of a positive COVID-19 test 0.45 (0.06 to 3.08), symptomatic COVID-19 0.37 (0.01 to 12.86), health-service use 0.95 (0.18 to 5.04) and adverse events 0.94 (0.63 to 1.40). The authors see a trend but note very high differences between trials (I2 80% and 83%) and bias.

Results

No clear difference; very wide uncertainty ranges.

Effect sizes as reported

OR 0.45 (95% CI 0.06 to 3.08) for a positive test; OR 0.94 (0.63 to 1.40) for adverse events.

Why this rating

All intervals include no effect, there is large inconsistency between trials, and Chyawanprash is a mix, so nothing can be credited to amla.

Form and dose studied

Chyawanprash (a jam). Product amounts not stated in the abstract. We are not giving advice on amounts.

Who was studied

Adults in 5 trials in India.

Limits

A mix of herbs; bias; abstract only.

Why researchers looked

Chyawanprash is an Ayurvedic jam made from amla and many other herbs, widely taken for "immunity".

Traditional use

Chyawanprash is described by the pooled-analysis authors as an Ayurvedic formulation. We did not read an original text.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

The pooled adverse event rate did not differ from controls (OR 0.94, 0.63 to 1.40).

⁴⁰

What the trials found

Vishwanatha 2016 (healthy older adults, randomized to Amalaki rasayana or placebo for 45 days, with follow-up): DNA strand-break repair in blood cells was maintained or improved. Nucleotide excision repair and base excision repair did not change. No adverse effects.

Results

One of three DNA repair measures held steady or improved.

Effect sizes as reported

No numbers in the abstract.

Why this rating

One trial, an unusual lab measure, number of people not given in the abstract, and a traditional multi-step preparation that may not match a shop product.

Form and dose studied

Freshly made Amalaki rasayana taken for 45 days as per a traditional text. We are not giving advice on amounts.

Who was studied

Healthy older adults.

Limits

Lab measure only; not a health outcome; abstract only.

Why researchers looked

DNA repair declines with age. Amalaki rasayana is a traditional "rejuvenating" amla preparation.

Traditional use

Amalaki rasayana is a traditional Ayurvedic preparation of amla used for healthy living in older people (as described by the trial authors).

Proposed mechanism Preliminary mechanism

Not established. The authors suggest amla may help maintain DNA strand-break repair.

A proposed mechanism does not show that the effect happens in people.

No adverse effects reported.

⁴⁹

Results

Animal results only.

Effect sizes as reported

Mice: retention latency 134.4 vs 44.55 sec with 600 mg/kg extract vs scopolamine alone (Golechha 2012).

Why this rating

No human trial of cognition. Animal results often do not carry over to people.

Who was studied

Mice and rats only.

Limits

Injected or high-dose animal studies; no human cognitive test.

Why researchers looked

Amla antioxidant and anti-cholinesterase effects in animals led researchers to test it for memory loss.

Traditional use

The 2022 Saini review lists headache among traditional uses of amla fruit but no memory use that we read. The Teimouri review links amla to Alzheimer risk factors.

Proposed mechanism Animal research

In scopolamine-treated mice an extract reduced brain oxidative stress and acetylcholinesterase activity; in rats on a high-salt and cholesterol diet a tannin fraction improved water-maze scores and raised Nrf2.

A proposed mechanism does not show that the effect happens in people.

Not applicable.

^{43 16 20}

What the trials found

Biswas 2001: an open, multicentre study with no control group of Ophthacare eye drops (8 herbs including Emblica officinalis) in people with conjunctivitis, dry eye, dacryocystitis, pterygium or pinguecula, or after cataract surgery. The authors report improvement in most cases and no side effects.

Results

Not interpretable for amla.

Effect sizes as reported

No numbers in the abstract.

Why this rating

No control group and a mix of many herbs, used as eye drops.

Who was studied

People with various eye problems (drops).

Limits

Uncontrolled, multi-herb, not eaten.

Why researchers looked

Amla is traditionally used for eyes and vision.

Traditional use

The 2022 Saini review lists eye disease (ophthalmopathy) among the traditional uses of amla fruit. We did not read an original text.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

Do not put homemade amla preparations in the eyes.

^{35 6}