ALOE (Aloe vera, Aloe barbadensis)

 Botany
The aloe plant originally came from Africa. The leaves are used; they are long, green, fleshy, and have spikes along the edges. The fresh leaf gel and latex are used for many purposes. Aloe latex is the sticky residue left over after the liquid from cut aloe leaves has evaporated.

Historical or Traditional Use
Aloe has been historically used for many of the same conditions it is used for today—particularly constipation and minor cuts and burns. In India, it was also used to treat intestinal infections and for suppressed menses. The root was used for colic.

Active Constituents and Proposed Mechanism of Action
The constituents that cause the cathartic laxative effects of aloe latex are known as anthraquinone glycosides. These molecules are split by the normal bacteria in the large intestines to form other molecules (aglycones), which exert the laxative action. Various constituents have been shown to have anti-inflammatory effects as well as to stimulate wound healing.¹ Preliminary evidence also suggests an antibacterial effect.² Blood sugar lowering effects of aloe have been shown in diabetic mice³ and confirmed in placebo-controlled human studies.⁴ Aloe vera creams have been very effective in double-blind, placebo-controlled studies in people with psoriasis.⁵ Numerous older case studies reported aloe gel applied topically could help heal radiation burns.⁶ However, a large, modern, placebo-controlled study did not find aloe effective in this regard.⁷ Most clinical studies suggest topical aloe gel for healing burns.⁸ Early clinical reports suggest aloe gel may help with the healing of ulcers as well.⁹

Recommended Dosage
For constipation, a single 50–200 mg capsule of aloe latex can be taken each day for a maximum of ten days.

Topically for minor burns, the stabilized aloe gel is applied to the affected area of skin three to five times per day. Treatment of more serious burns should only be done after first consulting a healthcare professional. For internal use of aloe gel, 30 ml TID is used by some people for inflammatory bowel conditions such as ulcerative colitis.

Contraindications
Except in the rare person who is allergic to aloe, topical application of the gel is harmless. For any burn that blisters significantly or is otherwise severe, medical attention is absolutely essential. In some severe burns and wounds, aloe gel may actually impede healing.¹⁰

The latex form of aloe should not be used by anyone with intestinal diseases such as Crohn’s disease or appendicitis. It should also not be used by children or by women during pregnancy.¹¹

Laxative preparations, if used for more than ten consecutive days, can aggravate constipation and cause dependency. Constipation that doesn’t resolve within a few days of using laxatives may require medical attention.

Long-term use of latex aloe could result in a potassium deficiency.¹²

References:

1. Penneys NS. Inhibition of arachidonic acid oxidation in vitro by vehicle components. Acta Derm Venerol Stockh 1981;62:59–61.
2. Bruce W. Investigations of the antibacterial activity in the aloe. S Afr Med J 1967;41:984.
3. Ajabnoor M. Effect of aloes on blood glucose levels in normal and alloxan diabetic mice. J Ethnopharmacol 1990;28:215–20.
4. Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, Chokechaijaroenposn O. Antidiabetic activity of Aloe vera L juice. II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomedicine 1996;3:5–8.
5. Syed TA, Ahmad 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;1:505–9.
6. Loveman AB. Leaf of aloe vera in treatment of Roentgen ray ulcers. Arch Derm Syph 1937;36:838–43.
7. Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Rad Oncol Biol Phys 1996;36:345–9.
8. Visuthikosol V, Choucheun B, et al. Effect of aloe vera to healing of burn wound: A clinical and histologic study. J Med Assoc Thai 1995;78:403–9.
9. Blitz J, Smith J, Gerard J. Aloe vera gel in peptic ulcer therapy: Preliminary report. J Am Osteopathic Assoc 1963;62:731–5.
10. Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol 1991; 78:115–7.
11. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 80–1.
12. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 80–1.

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