What are the health benefits of amla and is it safe?

Answer:

What is amla
Amla (Emblica officinalis), also known as Indian gooseberry, is one of the most commonly used ingredients in traditional Ayurvedic medicine. The fruit of amla contains vitamin C, tannins, phenols, and other nutrients that are believed to contribute to its health benefits. Although amla has been promoted for numerous conditions, including diabetes, heart health, digestive health, immunity, kidney and liver function, dementia, Alzheimer's disease, hair growth, age-related macular degeneration, cataract, aging skin, and cancer, many of these uses have not been evaluated in clinical studies. Among the uses that have been evaluated in humans, most of the studies have been small and preliminary. Larger, longer-term studies are needed to confirm the benefits of amla in people.

Health benefits of amla
Diabetes
Amla has been traditionally used in Ayurvedic medicine for type 2 diabetes. While some preliminary evidence supports this use, more research is needed to confirm the benefit. One small study showed that taking powdered amla fruit lowered both pre- and post-meal blood sugar levels after about 2 to 3 weeks of use. However, more research is needed to determine which form and dosage has greatest benefit, whether the short-term effects persist long-term, and whether amla has benefit when taken with diabetes medications.

Heart health
Amla contains flavonoids that have been shown in laboratory studies to block the activity of HMG CoA reductase, an enzyme involved in cholesterol production. This enzyme is also blocked by statin medications. Several small, short-term clinical studies have shown that amla can improve blood lipid levels in humans, but larger, longer-term studies are needed to confirm these benefits.

One small study in India among 60 people with high cholesterol, some of whom were given 20 mg of simvastatin daily and some of whom were given capsules containing 500 mg of amla fruit powder once daily at bedtime for 6 weeks, found that the effects of amla on total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol and high-density lipoprotein (HDL or "good") cholesterol were similar to the effects of taking 20 mg of simvastatin daily, although those in the simvastatin had greater reduction in very low-density lipoprotein (VLDL) cholesterol and triglycerides. Among the 28 people in the amla group and 10 in the simvastatin group who had high blood pressure (hypertension) at baseline, 21 (75%) of those taking amla and 6 (60%) of those taking simvastatin showed reduction in systolic and/or diastolic blood pressure after 6 weeks (Gopa, Indian J Pharmacol 2012).

Another small study among 98 people with abnormal levels of blood lipids (dyslipidemia) showed that taking 500 mg of amla extract standardized to contain about 175 mg of polyphenols and 40 mg of triterpenoids for 12 weeks lowered total cholesterol by 54.67 mg/dL, triglycerides by 89.17 mg/dL, LDL cholesterol by 28.43 and VLDL cholesterol by 17.52 mg/dL compared to baseline, and these reductions were significant compared to the placebo group. Furthermore, people in the amla group showed a 39% reduction in atherogenic index of the plasma (a measure used to predict the risk of excess build-up of plaque in the arteries) compared to baseline, and this reduction was significant compared to placebo (Upadya, BMC Complement Altern Med 2019).

A study in overweight or obese individuals found that taking 500 mg of amla extract standardized to 60% low-molecular-weight hydrolyzable tannins (CAPROS, Natreon Inc.) twice daily for 12 weeks increased HDL cholesterol and decreased high-sensitivity C reactive protein (hs-CRP), a marker for heart disease, compared to baseline. Furthermore, amla reduced the clumping together of platelets in the blood (a process that can lead to blood clots) induced by collagen. There was no significant improvement in total cholesterol or triglyceride levels. The lack of a control group in this study limits the significance of the results (Khanna, J Med Food 2015).

Digestive health
Amla was shown in an animal study to improve the healing of gastric and duodenal ulcers by reducing gastric acid secretion (Al-Rehaily, Phytomedicine 2002).

A small clinical study among 68 people with a form of gastroesophageal reflux disease (GERD) that tends to have a lower response to proton-pump inhibitor [PPI] therapy found that taking two tablets each providing 500 mg of amla fruit powder twice daily after meals (a total daily dose of 2,000 mg) for 4 weeks reduced self-reported frequency and severity of regurgitation and heartburn compared to a placebo group (Varnosfaderani, J Integr Med 2018). Larger, longer-term studies are needed to confirm this effect.

Immunity
Amla fruit juice is commonly promoted as an immune booster to help prevent and treat the common cold or flu. Amla fruit contains high amounts of vitamin C — about 600 to 700 mg per fruit (Goraya, J Food Sci Technol 2015). Taking vitamin C prior to getting a cold may help reduce the duration of severity of colds that do occur. However, it is unclear if amla has these benefits, as no clinical studies have evaluated the effects of amla on cold or flu risk. Most amla supplements do not provide information about the amount of vitamin C provided in the suggested serving size.

Other uses
Amla has shown benefit in animal research for improving liver function and kidney health, but clinical studies supporting these benefits in humans are lacking. Amla has also been shown to possess anticholinesterase activity in animal research, suggesting it may have benefit in the management of dementia or Alzheimer's disease (Golechha, J Environ Biol 2012), but studies in humans are needed to confirm this effect. Alma has also been promoted or used for hair growth, preventing age-related macular degeneration or cataract, improving the appearance of aging skin, and preventing cancer but no clinical studies have assessed the effects of amla on these conditions in humans.

Side effects and drug interactions
Amla fruit is safe to consume in normal dietary amounts, but taking it as a supplement may have some side effects.

Amla might lower blood sugar levels and may affect blood sugar control in people taking medications for diabetes. Talk to your doctor before taking amla if you're taking medications for diabetes, as dose adjustments to diabetes medications might be necessary.

Due to its antiplatelet effects, amla may reduce blood clotting and increase the risk of bleeding. Talk to your doctor before taking amla if you have a bleeding disorder or are taking a blood thinner.

Due to its possible anticholinesterase activity, amla might interfere with anticholinergic drugs such as atropine (Atropen) and benztropine (Cogentin).

Cost
Supplements containing amla fruit powder cost about $7 to $17 for 90 500-mg capsules (about 8 to 19 cents per 500-mg capsule). Supplements containing amla fruit extract standardized to 40% to 45% tannin content may cost slightly more — about $12 to $14 for sixty 450- or 500-mg capsules (about 21 to 23 cents per capsule), although at least one amla fruit extract standardized to 10% gallic acid costs only about $8 for 60 575-mg capsules (about 13 cents per capsule). Amla juice, which may be difficult to find in many grocery stores in the U.S. but can be purchased online, usually sells for about $10 to $15 for 17 fl. oz. (about 62 to 92 cents per ounce).

The Bottom Line:
There is some evidence that amla may help lower blood sugar, improve cholesterol and other blood lipid levels, and reduce symptoms of GERD people with these conditions. However, studies to date have been small and short-term, so larger, longer-term studies are needed to confirm these effects. Amla has been promoted for numerous other conditions, but there's no research in humans confirming these additional effects.