Triphala: Traditional Use, Research and Safety

What triphala is

Triphala is a classical Ayurvedic formulation made from the fruits of three plants: amalaki (Emblica officinalis, also called Phyllanthus emblica), bibhitaki (Terminalia bellerica) and haritaki (Terminalia chebula). [1] Its name is commonly translated as "three fruits." In Ayurveda it is described as a cornerstone of digestive and "rejuvenative" treatment. [1] That is a traditional description, not a tested result. This page gives no doses, recipes or preparation steps.

Traditional use and what research measured are different things

Ayurvedic texts and practitioners describe triphala in the terms of the tradition. Researchers ask narrower questions: in a defined group of people, did a specific product change a measured outcome compared with a placebo or another treatment? Labels used below: promising but limited, mixed, insufficient evidence, preclinical, traditional use only.

One caution about the literature itself. A 2017 review of triphala's uses was written by authors linked to the Chopra Foundation, which partly funded one author. [1] Reviews that list many possible effects often rely on laboratory and animal work, so look for trials in people.

What the evidence shows, use by use

Read the first row with care: the review authors concluded the benefit is only possible "under certain conditions" and not confirmed. [2]

Safety, quality and interactions

• Side effects in trials. The lipid and glucose review reported no serious adverse events linked to triphala. [2] In the guggulu plus triphala trial, 2 of 46 people in the treatment group developed a hypersensitivity rash and none on placebo. [3] Those trials were short, so long-term safety is not established.
• Product quality. Surveys of Ayurvedic products sold in the United States found lead, mercury or arsenic in about one in five, and these reports were about Ayurvedic products in general, not triphala specifically. [6] The National Center for Complementary and Integrative Health (NCCIH) says some Ayurvedic preparations may contain these metals in amounts that can be toxic. [7] Triphala sold as a US dietary supplement is not approved by the FDA before sale. [8]
• Pregnancy, breastfeeding, children and medicines. NCCIH advises pregnant or nursing people to check with a health care provider because some Ayurvedic products could be harmful. [7] Ask a clinician or pharmacist before combining triphala with prescribed medicines, especially if you take several.
• Medicines handled by liver enzymes. Memorial Sloan Kettering says triphala inhibits two liver enzymes (CYP3A4 and CYP2D6) and advises against taking it with medicines those enzymes clear, because side effects may be more likely. [9]
• Blood sugar and surgery. The trial review above found lower fasting glucose in people with diabetes, [2] and a supplement monograph on Terminalia (the genus of two of the three fruits) says it may lower blood sugar, may need diabetes-medicine adjustment, and advises stopping it at least 2 weeks before planned surgery. [10] Tell your prescriber and surgical team. See supplements and diabetes and supplements before surgery.
• Pregnancy and breastfeeding. The same monograph advises avoiding Terminalia species in pregnancy and breastfeeding because safety is unknown or reliable data are lacking. [10]
• Do not use it to delay care. NCCIH advises against using Ayurvedic medicine to postpone seeing a conventional provider about a medical problem. [7]

Where it fits

If your goal is digestion, see Ayurveda for digestion, IBS and constipation. For cholesterol, see Ayurveda for blood pressure and cholesterol, and for the herb-by-herb map, Ayurvedic ingredients and where to find each guide. The forms triphala is sold in are explained in Ayurvedic herbal preparations. Lead and other metal concerns are covered in Ayurvedic products: heavy metals and product quality. The related resin-based formulations are in guggulu formulations.