Comprehensive Guide to Aloe Vera

Aloe VeraDr. James Meschino DC, MS, ND
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General Features
Aloe Vera is a perennial plant with yellow flowers. The leaves contain active ingredients, including the polysaccharide acemannan and anthraquinones.1 Aloe Vera gel and juice has been used therapeutically for the treatment of peptic ulcers and other intestinal disturbances, including its use as a natural laxative. Aloe Vera gel can also be applied topically to aid in the healing of burns, wounds, and other skin conditions.
Principle Active Constituents

Acemannan and Other Polysaccharides - Acemannan, in particular, has shown impressive immune-stimulating and anti-viral effects. Anthraquinones -these agents have been shown to account for the natural laxative effect induced by Aloe Vera ingestion.

Clinical Application and Mechanism of Action
1. Peptic Ulcer and Gastritis Aloe Vera gel inactivates pepsin release when the stomach is empty. The gel also inhibits the release of hydrochloric acid by interfering with the binding of histamine to parietal cells. Clinical studies on humans have shown that Aloe Vera gel can be effective in healing peptic ulcers in a percentage of patients.2 (Author's Note: More substantial evidence exists for the use of DGL-licorice chewable tablets in regards to the natural treatment of peptic ulcers, although both interventions can be used concurrently (see Licorice in this document).

Once delivered to the cells via the bloodstream Vitamin A is extracted from the bloodstream and binds to intracellular proteins within the cell known as CRBP (cellular retinal-binding protein) and CRABP (cellular retinoic acid-binding protein). Within the cells of the body Vitamin A modulates many biochemical reactions, which promote growth, replication, differentiation, and provides additional antioxidant protection.

2. Improved Protein Digestion

Aloe Vera Juice (50% Aloe gel plus 50% other fluids) has been shown to improve protein absorption and reduces the degree to which intestinal bacteria are engaged in putrefactive processes. This may be of benefit in cases of poor protein digestion.1 (also consider the use of Digestive Enzymes and/or Betaine Hydrochloride supplementation).

3. Laxative Effect

The latex form of Aloe Vera is reported to have a natural laxative effect.

Oral Dosage Range

1. General Intestinal Tract Support (e.g., improved digestion, laxation) Up to 1 quart per day of Aloe Vera juice can be consumed. No formal dosages are established.

2.Peptic Ulcers For Aloe gel, a tablespoon of the gel in mineral oil was taken once daily for the treatment of peptic ulcers.

Topical Application of Aloe Gel

1. Burns: Aloe Vera Gel has been used successfully to treat sunburn, radiation burn, and chemical burns. In 1935 a group of physicians first documented improvement in the treatment of facial burns due to X-rays, using topically applied fresh Aloe Vera juice.3,4,5 Scientists think Aloe enhances the body's natural-healing systems while stimulating the activity of collagen and elastin synthesis, which are responsible for regenerating and maintaining connective tissue structure and integrity.6 As such, Aloe Vera is a common ingredient in many topical creams and lotions intended to heal the skin from sunburn, as well as other burns and wounds

2. Diabetic and Chronic Pressure Ulcers (leg ulcers and deeper wounds) - in more severe cases including, leg ulcers, diabetic and pressure ulcers, Aloe gel is applied to ulcers on gauze bandages.

3. Genital Herpes : several double-blind, placebo-controlled trials have shown that Aloe cream applied topically reduced the time necessary for lesions to heal (4.9 days versus 12 days) compared to the placebo group.

4.Psoriasis and Seborrhea : double-blind, placebo-controlled studies have also shown that topical Aloe Vera extract (0.5%) has been effective in minimizing the severity of psoriasis and seborrhea. The usual application is three time daily.

Topical Dosage

Aloe Vera Gel can be applied liberally for topical applications.3 The usual application for the skin lesions noted above is three times per day, using a 0.5% Aloe Vera cream.

Adverse Side Effects, Toxicity, and Contraindications
Although rare, allergic reactions by the skin have been reported with use of Aloe Vera creams and lotions. Aloe Vera gel may also delay wound healing in cases of surgical wounds such as those produced during laparotomy or cesarean delivery, thus it is contraindicated for deep, vertical (surgical) wounds
Drug-Nutrient Interactions

Laxative Effect : as Aloe Vera is known to act as a laxative it may reduce the absorption of medications, if taken at the same time. Thus, other medications and supplements should not be taken at the same time as Aloe Vera ingestion.

Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal vitamin and mineral supplements. All other supplements or dose alterations may pose a threat to the developing fetus and there is generally insufficient evidence at this time to determine an absolute level of safety for most dietary supplements other than a prenatal supplement. Any supplementation practices beyond a prenatal supplement should involve the cooperation of the attending physician (e.g., magnesium and the treatment of preeclampsia.).

Pregnant women - increased risk of birth defects has occurred with maternal intakes as low as 25,000 IU/day.

References: Pregnancy and Lactation
1. Sheltom RW, Aloe Vera, Its Chemical and Therapeutic Properties, Int J Dermatol 1991;30:679-83

2. Blitz JJ, Smith JW, and Gerard JR, Aloe Vera Gel in Peptic Ulcer Therapy: Preliminary Report, J Am Osteopathol Soc 1963;62:731-5.

3. Davis RH, Kabbani JM, and Maro NP, Aloe and Wound Healing, J Am Pod Med Assoc 1987;77:165-9.

4. Dietary Supplement Information Bureau. www.content.intramedicine.com: Aloe Vera.

5. Collins CE, et al. Roentgen dermatitis treated with fresh whole leaf Aloe vera. Am J Roentgenol.1935; 33: 396-97.

6. Chithra P et al. Influence of Aloe Vera on collagen characteristics in healing wounds in rats. Mol Cell Biochem. 1998; 181 (I-2): 71-6.

7. Ishii Y, et al. Studies of Aloe .III. Mechanism of cathartic effect. (2). Chem Pharm Bull.Tokyo.1990; 38 (1): 197-200.

8. Syed TA, Cheeman KM, Ashfaq A, et al. Aloe Vera extract 0.5% in a hydrophilic cream versus Aloe Vera gel for the management of genital herpes in males. A placebo-controlled, double-blind, comparative study. J Eur Acad Detmatol Venereol. 1996;7: 294-95.

9. 9 Syed TA, Ahmed SA, Holt AH, et al. Management of psoriasis with Aloe Vera extract in a hydrophilic cream: a placebo-controlled, double blind study. Trop Med Int Health. 1996; 1: 505-509.

10.Vardy DA, Cohen AD, Tchetov T, et al. A double-blind, placebo-controlled trial of Aloe Vera emulsion in the treatment of seborrheic dermatitis. J Dermatol Treat. 1999; 10: 7-11