Indications
Hyperlipidemia, atherosclerosis, diabetes, obesity, digestive disorders, dyspepsia, diarrhea, dysentery, joint pain, and osteoarthritis. Also used as an anti-inflammatory and antimicrobial.
Mechanism of Action
Triphala inhibits lipid peroxide and promotes scavenging of hydroxyl and superoxide radicals in vitro.1
The precise mechanisms of its antiobesity effects have not yet been elucidated.
Evidence-Based Research
In a mouse model of diet-induced obesity, triphala administration was associated with a reduction in overall energy intake, percentage of body fat, serum lipids, and serum glucose compared with controls. It also improved glucose tolerance; reversed pathological liver changes; and decreased the relative weight of visceral adipose fat pads.2
A randomized controlled trial compared triphala to placebo in a study of obese subjects. Participants received 5 g/day of triphala or a placebo. Baseline and posttreatment levels of glucose and fasting insulin were recorded. Participants were also evaluated for weight, body mass index, waist circumference, and hip circumference monthly for 12 weeks. The study found that triphala supplementation supported weight loss and promoted an average loss of 4 cm in waist circumference and 3 cm in hip circumference. No comparable changes were noted in the placebo group.3
Research suggests triphala may act as an anti-inflammatory and antinociceptive agent,4 be protective against ionizing radiation,5 and be antimutagenic in certain doses.6 Studies also suggest that triphala may protect against stress-induced immune suppression.7
Safety in Pregnancy and Breastfeeding
There have been no published studies on the use of triphala in pregnancy and lactation.
General Safety
One study dosing triphala at 5 g/day for 12 weeks reported no significant side effects and no alteration in lab markers of renal and liver function.3 Acute oral toxicity studies in animals report both the aqueous and alcohol extracts of triphala to be safe up to a dose of 1750 mg/kg.8
Triphala protects nuclear material from a variety of genotoxins9; yet, it may significantly increase DNA damage at concentrations above 500 ppm.10 Thus, both mutagenic and antimutagenic properties have been demonstrated, depending on the dosage and the test performed.6
Triphala inhibits cytochromes p45011and may interfere with some pharmaceutical agents.
Dosage
Five grams per day was used in a clinical trial of obesity. Smaller amounts are used in herbal formulas for synergistic effect, especially formulas containing Commiphora spp. Triphala has been used in animal studies at doses of 300, 600, and 1200 mg/kg.
Traditional Uses
Because those with hypothyroid function can suffer lipid accumulation and elevated lipid and glucose levels because of low metabolic rate, triphala can potentially be a supportive herb to include in formulas for metabolic insufficiency. Triphala means “three fruits.” It is an age-old herbal combination known in the Ayurvedic medical system as “Itrifal Saghir.” Triphala is a combination of Terminalia bellirica (bibhitaki), Terminalia chebula (haritaki), and Emblica officinalis (amalaka), traditionally used for diabetes,12,13 obesity, and diarrhea9 and to promote digestion and satiety.
References
J Ethnopharmacol. 2002;81(2):155–60. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. Sabu MC, Kuttan R.
2 Altern Ther Health Med. 2012;18(6):38–45. Triphala and its constituents ameliorate visceral adiposity from a high-fat diet in mice with diet-induced obesity. Gurjar S, Pal A, Kapur S.
3 Daru. 2012;20(1):33. Efficacy of ‘Itrifal Saghir’, a combination of three medicinal plants in the treatment of obesity; A randomized controlled trial. Kamali SH, Khalaj AR, Hasani-Ranjbar S, Esfehani MM, Kamalinejad M, Soheil O, Kamali SA.
4 Afr J Tradit Complement Altern Med. 2012;10(2):246–50. Evaluation of anti-inflammatory and antinociceptive activity of Triphala recipe. Sireeratawong S, Jaijoy K, Soonthornchareonnon N.
5 Mutat Res. 2006;609(1):17–25. Protection against radiation oxidative damage in mice by Triphala. Sandhya T, Lathika KM, Pandey BN, Bhilwade HN, Chaubey RC, Priyadarsini KI, Mishra KP.
6 Food Chem Toxicol. 2002;40(4):527–34. The in vitro antimutagenic activity of Triphala–an Indian herbal drug. Kaur S, Arora S, Kaur K, Kumar S.
7 Biol Pharm Bull. 2005;28(8):1398–403. Immunomodulatory activity of triphala on neutrophil functions. Srikumar R, Jeya Parthasarathy N, Sheela Devi R.
8 J Herb Pharmacother. 2007;7(3–4):203–12. Evaluation of anti-diarrhoeal property and acute toxicity of Triphala Mashi, an Ayurvedic formulation. Biradar YS, Singh R, Sharma K, Dhalwal K, Bodhankar SL, Khandelwal KR.
9 Food Chem Toxicol. 2013;62:521–7. Genotoxic, antigenotoxic and phytochemical assessment of Terminalia actinophylla ethanolic extract. Pádua PF, Dihl RR, Lehmann M, de Abreu BR, Richter MF, de Andrade HH.
10 J Environ Pathol Toxicol Oncol. 2005;24(3):193–200. Evaluation of genotoxicity of medicinal plant extracts by the comet and VITOTOX tests. Arora S, Brits E, Kaur S, Kaur K, Sohi RS, Kumar S, Verschaeve L.
11 J Ethnopharmacol. 2011;133(1):120–5. Cytochrome P450 inhibitory potential of Triphala–a Rasayana from Ayurveda. Ponnusankar S, Pandit S, Babu R, Bandyopadhyay A, Mukherjee PK.
12 Anc Sci Life. 2008;27(3):45–9. Hypoglycemic effect of triphala on selected non insulin dependent Diabetes mellitus subjects. Rajan SS, Antony S.
13 J Ethnopharmacol. 2013;149(2):490–8. Constituents from Terminalia species increase PPARα and PPARγ levels and stimulate glucose uptake without enhancing adipocyte differentiation. Yang MH, Vasquez Y, Ali Z, Khan IA, Khan SI.