Herbs & Supplements:
Phyllanthus
Phyllanthus amarus, Phyllanthus niruri, Phyllanthus urinaria
Principal Proposed Uses
•
Chronic Hepatitis B
Other Proposed Uses
•
Acute Hepatitis B
Tropical plants in the genus Phyllanthus have a long history of folk use for the treatment of hepatitis, kidney and bladder problems, intestinal parasites, and diabetes. The most studied species is Phyllanthus amarus, historically used for the treatment of jaundice. This traditional practice has led to scientific study of the herb in humans.
What Is Phyllanthus Used for Today?
Hepatitis B is a two-stage illness. Its has an acute phase which 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.
Promising results in animal and test tube trials have led to numerous double-blind studies evaluating P. amarus as a treatment for hepatitis B.
Most of the human studies have evaluated whether the herb can eradicate the hepatitis B virus from people in the chronic phase of the disease, but the results have not been promising. A study on P. amarus for the acute phase of hepatitis also had negative findings.
Test tube and animal research of other Phyllanthus species has revealed numerous active constituents of these plants as well. However, at present, properly designed double-blind human trials are lacking.1
What Is the Scientific Evidence for Phyllanthus?
Despite numerous test tube and animal studies showing efficacy against the hepatitis B virus,2P. amarus has generally not done well in human trials.
One 30-day double-blind placebo-controlled trial of 60 individuals with chronic hepatitis B found that treatment with phyllanthus (200 mg 3 times daily) dramatically increased the odds of full recovery.3 In the treated group, almost 60% were hepatitis B–negative at follow-up, as compared to only 4% in the placebo group.
However, the high drop-out rate in the placebo group significantly reduces the reliability of the results. Furthermore, follow-up studies attempting to reproduce these findings have produced negative results.4–11
Another double-blind placebo-controlled trial enrolled 57 individuals with acute hepatitis B to see whether treatment with P. amarus (300 mg 3 times daily for 1 week) could improve speed of recovery.12 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 study suggests that P. urinaria, a related species, might be more effective against hepatitis than other species of phyllanthus.13 However, because this study was not placebo-controlled, its results can't be taken as more than highly preliminary.
Dosage
The usual dose of P. amarus used in studies is 600 to 900 mg daily.
Safety Issues
There are no indications that P. amarus is toxic when used at recommended doses, but comprehensive safety studies have not been performed.14 In double-blind studies, significant side effects have not been reported. Safety in pregnant or nursing women, or individuals with severe liver or kidney disease, has not been established.
View References
Last reviewed March 2002 by Medical Review Board
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