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Stevia (Stevia rebaudiana)

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Also listed as: Stevia rebaudiana, Rebaudioside A, Stevioside
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 4,5-Di-O-caffeoyl quinic acid, 13-[(2-O-(3-alpha-O-D-glucopyranosyl)-beta-D-glucopyranosyl-3-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-6-deoxy-beta-D-glucopyranosyl-3-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-6-deoxy-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-(6-O-beta-D-glucopyranosyl)-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] kaur-16-en-18-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-beta-D-glucopyranosyl-3-O-(4-O-alpha-D-glucopyranosyl)-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-beta-D-glucopyranosyl-3-O-beta-D-fructofuranosyl-beta-D-glucopyranosyl)oxy] kaur-16-en-18-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-beta-D-glucopyranosyl-3-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-15-en-19-oic acid, 13-[(2-O-beta-D-glucopyranosyl-3-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl)oxy]-16beta-hydroxy-ent-kauran-19-oic acid, 13-[(2-O-beta-D-xylopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-[(2-O-beta-glucopyranosyl-3-O-beta-D-xylopyranosyl-beta-D-glucopyranosyl)oxy] ent-kaur-16-en-19-oic acid beta-D-glucopyranosyl ester, 13-methyl-16-oxo-17-nor-ent-kauran-19-oic acid-beta-D-glucopyranosyl ester, alpha-monoglucosylrebaudioside A, alpha-monoglucosylstevioside, amaha sutebia (Japanese), Asteraceae (family), azucacaa, brazzein, Ca-A-E, caá-eé (Brazilian Portuguese), caáché (Spanish), caffeoyl-feruloylquinic acids, caffeoylshikimic acids, Canderel Green®, candyleaf, capim doce (Portuguese), Compositae (family), Crystal Light Pure Fitness, curculin, Cweet, dicaffeoylquinic acids, dihydroisosteviol (DHISV), dihydropsuedoivalin, dihydrosteviol A, diterpenoid glycosides, édesfu (Hungarian), ent-kaurenoic acid, epidihydropseudoivalin, erva doce (Portuguese), estevia (Spanish), estévia (Portuguese), estévia-doce (Portuguese), Ex Slim EnergyT, feruloylquinic acid, folhas da stévia (Portuguese), glucosilsteviol, glycosides, gurmaar (Punjabi), heuningblaar (Afrikaans), hierba dulce (Spanish), Honest Tea®, honey leaf, Honigkraut (German), honingkruid (Dutch), hydroxycinnamate, isosteviol, jázmin pakóca (Hungarian), ka'a he'e (Guaraní), kaa he-he (Guaraní), kaa jhee (Guaraní), luteolin, luteolin-7-O-beta-D-glucoside, mabinlin, madhu parani (Marathi), madhu patra (Sanskrit), madhu patri (Telugu), miraculin, monellin, monocaffeoylquinic acids, NPI-028, NSF-02, octa-acetylombuoside, ombuine, ombuoside, Paraguai suhkruleht (Estonian), Paraguayan sweet herb, p-coumaroylquinic acid, pentadin, piccolo arbusto con foglia dolce (Italian), Pure ViaT, quercetin, quercetin-3-O-(4'''-O-trans-caffeoyl)-alpha-L-rhamnopyranosyl-(1-->6)-beta-D-galactopyranoside, quercetin-3-O-beta-D-arabinoside, quercitrin, rebaudioside A (RA), rebaudioside F, Rebiana, retusine, roninowa, ronion, RP44, rubusoside, S6793, sacharol, satiwia (Thai), SE, seeni tulsi (Tamil), SoBe Lifewater drinks, sød stevia (Danish), sötflockel (Swedish), sötstevia (Swedish), Steviacane, Stevia connata, stevia del norte de Paraguay (Spanish), Stevia eupatoria, stevia glycosides, Stevia lita, Stevia pilosa, Stevia PureCircle®, Stevia rebaudiana, Stevia rebaudiana Bertoni (SrB), Stevia rebaudiana standardized extracts (SSEs), Stevia salicifolia, Stevia subpubescens, Stevia tomentosa, Stevia triflora DC., Stevia viscida, steviol (SV), steviolbioside, stevioside (SVS), stevisalioside A, Stevita, stiviyyah (Hebrew), sugar leaf, Sun Crystals All-Natural Sweetener, Süssblatt (German), Süsskraut (German), sweet herb, sweet honey leaf, sweet leaf, sweet leaf of Paraguay, sweet proteins, talin, thaumatin, tian jü (Chinese), tian jü ye (Chinese), tricaffeoylquinic acids, Truvia, UltraMeal® PLUS 360° Stevia, ya wan (Thai), yerba dulce (Spanish).
  • Note: Stevia rebaudiana should not be confused with Stevia salicifolia, also called ronion or roninowa. Stevia salicifolia contains the bitter glycoside stevisalioside.

Background
  • Stevia leaf extracts have been used for many years in traditional treatment of diabetes in South America. Paraguay's rural and native populations have used stevia for birth control.
  • Stevia contains compounds called rebaudioside A (Reb-A) and stevioside. These are used as natural sweeteners or dietary supplements. They reportedly possess up to 250 times the sweetness intensity of sucrose. Reb-A has been given Generally Recognized As Safe (GRAS) status by the U.S. Food and Drug Administration (FDA) and is used in some beverages as a zero-calorie sweetener.
  • Available research is promising for use of stevia in high blood pressure and type 2 diabetes, although more well-designed studies are needed.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Some evidence suggests that stevia may have blood pressure-lowering effects. However, there are conflicting results. More research is needed to compare the effectiveness of stevia to the current standard of care.

C


Limited evidence suggests that stevia may lower blood sugar in people with high blood sugar. However, further research is needed before a firm conclusion can be made.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Alcohol abuse, anti-inflammatory, antimicrobial, antioxidant, antiviral (human rotavirus activity), birth control, cancer, diarrhea, digestive aid, energy, food uses, immune system regulation, improving urine flow, weight loss.

Dosing

Adults (18 years and older)

  • For high blood pressure, 250-500 milligram capsules of stevioside or stevioside powder have been taken by mouth three times daily for three months up to two years. Up to 15 milligrams per kilogram of crude steviosides have been taken by mouth twice daily for 24 months.
  • For high blood sugar, one gram of stevioside has been taken by mouth with a single meal. Five grams of water-based stevia leaf extracts have been taken by mouth every six hours for three days.

Children (under 18 years old)

  • There is no proven safe or effective dose for stevia in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with a known allergy or sensitivity to stevia or to members of the daisy family (Asteraceae/Compositae). Other members of the daisy family include ragweed, chrysanthemums, marigolds, and many other herbs.

Side Effects and Warnings

  • Stevia is likely safe when 250-500 milligrams are taken by mouth three times daily for up to two years in Chinese adults with high blood pressure. This dose range is possibly safe in non-Chinese adults with high blood pressure.
  • Stevia may cause altered kidney function, changes in blood vessel width, changes in sodium excretion, changes in urine flow, decreased body strength, dizziness, muscle pain or weakness, nausea, and stomach fullness.
  • Stevia may cause low blood pressure. Caution is advised in people taking agents, herbs or supplements that lower blood pressure.
  • Stevia may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking agents, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Use cautiously in people with kidney disease or dysfunction or those with low blood calcium.
  • Use cautiously in people who are taking agents that affect blood vessel width, including calcium channel blockers.
  • Use cautiously in children and in pregnant or breastfeeding women.
  • Use cautiously if using stevia for longer than two years.
  • Avoid in people with a known allergy or sensitivity to stevia or to members of the daisy family (Asteraceae/Compositae).

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of stevia during pregnancy or breastfeeding.

Interactions

Interactions with Drugs

  • Stevia may cause low blood pressure. Caution is advised in people taking agents that lower blood pressure, including vasodilators such as calcium channel blockers.
  • Stevia may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or agents for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Stevia may also interact with agents that affect blood vessel width, agents that increase urination, agents used for the heart, anticancer agents, antifungals, anti-inflammatories, antimicrobials, antivirals, appetite suppressants, calcium channel blockers, cholesterol-lowering agents, fertility agents, hormonal agents, memory-enhancing agents, and sodium monoketocholate (MKC).

Interactions with Herbs and Dietary Supplements

  • Stevia may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
  • Stevia may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Stevia may also interact with anticancer herbs and supplements, antifungal herbs and supplements, anti-inflammatory herbs and supplements, antimicrobials, antioxidants, antiviral herbs and supplements, catechin, cholesterol-lowering herbs and supplements, herbs and supplements for appetite suppression, herbs and supplements that affect blood vessel width, herbs and supplements that increase urination, herbs and supplements used for fertility, herbs and supplements used for the heart, hormonal herbs and supplements, and memory-enhancing herbs and supplements.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Ahmad N, Fazal H, Abbasi BH, et al. In vitro larvicidal potential against Anopheles stephensi and antioxidative enzyme activities of Ginkgo biloba, Stevia rebaudiana and Parthenium hysterophorous. Asian Pac.J Trop Med 2011;4(3):169-175.
  2. Anton SD, Martin CK, Han H, et al. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite 2010;55(1):37-43.
  3. Ballali S and Lanciai F. Functional food and diabetes: a natural way in diabetes prevention? Int.J.Food Sci.Nutr. 2012;63 Suppl 1:51-61.
  4. Barriocanal LA, Palacios M, Benitez G, et al. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul.Toxicol.Pharmacol. 2008;51(1):37-41.
  5. Ferri LA, Alves-Do-Prado W, Yamada SS, et al. Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension. Phytother Res 2006;20(9):732-736.
  6. Geuns JM, Buyse J, Vankeirsbilck A, et al. Metabolism of stevioside by healthy subjects. Exp Biol Med (Maywood.) 2007;232(1):164-173.
  7. Goyal SK, Samsher, and Goyal RK. Stevia (Stevia rebaudiana) a bio-sweetener: a review. Int J Food Sci Nutr 2010;61(1):1-10.
  8. Gregersen S, Jeppesen PB, Holst JJ, et al. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism 2004;53(1):73-76.
  9. Hsieh MH, Chan P, Sue YM, et al. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clin Ther 2003;25(11):2797-2808.
  10. Koyama E, Kitazawa K, Ohori Y, et al. In vitro metabolism of the glycosidic sweeteners, stevia mixture and enzymatically modified stevia in human intestinal microflora. Food Chem.Toxicol. 2003;41(3):359-374.
  11. Koyama E, Sakai N, Ohori Y, et al. Absorption and metabolism of glycosidic sweeteners of stevia mixture and their aglycone, steviol, in rats and humans. Food Chem.Toxicol. 2003;41(6):875-883.
  12. Maki KC, Curry LL, Carakostas MC, et al. The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure. Food Chem.Toxicol. 2008;46 Suppl 7:S40-S46.
  13. Puri M, Sharma D, and Tiwari AK. Downstream processing of stevioside and its potential applications. Biotechnol.Adv 2011;29(6):781-791.
  14. Roberts A and Munro I. Stevioside and related compounds: therapeutic benefits beyond sweetness. Pharmacol Ther 2009;122(3):e1-e2.
  15. Taware AS, Mukadam DS, and Chavan AM. Antimicrobial Activity of Different Extracts of Callus and Tissue Cultured Plantlets of Stevia Rebaudiana (Bertoni). Journal of Applied Science Research 2010;6(7):883-887.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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