Washington Post Runs Story on Potential Risks of Bitter Orange

On Tuesday, August 31 ABC Founder and Executive Director Mark Blumenthal was interviewed by Lisa Barrett-Mann, a freelance writer for the Health section of the Washington Post. She was writing an article about the paper by Adriane Fugh-Berman, MD and Adam Myers of Georgetown University in which the authors speculated on the potential adverse effects associated with bitter orange extract (Citrus aurantium). Bitter orange is an increasingly popular ingredient in dietary supplements for weight loss, especially since the FDA banned ephedra (Ephedra sinica) earlier this year.

The Fugh-Berman and Myers paper, “Citrus aurantium, an Ingredient of Dietary Supplements Marketed for Weight Loss: Current Status of Clinical and Basic Research” was just published in Experimental Biology and Medicine (vol. 229). In it the authors review literature on bitter orange and its primary alkaloid synephrine. After reviewing studies on humans and animals, the authors suggest that until short- and long-term safety studies are published on bitter orange extract, consumers should avoid dietary supplements containing the ingredient. The authors also noted that they were not aware of any adverse event reports associated with bitter orange-containing supplements.

When asked to comment on the paper, Blumenthal noted that he knows Dr. Fugh-Berman quite well and that she is a valued member of the ABC Advisory Board. He stated that the paper demonstrated a hypertensive effect of synephrine and bitter orange formulations when administered by injection or when a synthetic form of synephrine was used, but that the authors acknowledged that oral administration of bitter orange (the authors often refer to it by its synonym Seville orange) may have a hemodynamic effect different from synephrine. The bottom line, said Blumenthal, is the distinction between injection versus ingestion. Injected synephrine and bitter orange showed a raise in BP, not so with oral use.

Blumenthal also stated that there are no authoritative published reviews available on C. aurantium, so papers like this one that attempt to summarize much of the safety data, drug interactions, and evidence (or lack thereof) for clinical efficacy are welcome additions to the scientific and medical literature. But, he cautioned, that based on this paper’s data and conclusions, warnings about bitter orange safety are speculative and not based on solid scientific or medical data.

The Washington Post article appeared on Tuesday, September 7.