Arjuna extract supplement health benefit and side effects, dosage and research studies
February 24 2018 by Ray Sahelian, M.D.

Ancient medical scientists have mentioned the properties of arjuna herb in their writings. Indian medical knowledge known as Ayurveda goes back millennia. The Vedas and Puranas refer various materials of medical importance including herbs, plants and trees. Modern research has discovered that arjuna has antioxidant properties and may be clinically helpful in cardiovascular health (heart disease).

Substances found in arjuna herb, what the plant contains
Triterpene glycosides, arjunetin, arjunetoside, arjunaphthanoloside, together with oleanolic and arjunic acids, terminic acid, a cardenolide, and strong antioxidants (flavones, tannins, oligomeric proanthocyanidins), have been isolated. The full and detailed role of each of these substances in the body has yet to be determined.

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Benefit for health, uses in medicine
J Tradit Complement Med. 2014. Revisiting Terminalia arjuna - An Ancient Cardiovascular Drug. Most of the studies, both experimental and clinical, have suggested that the crude drug possesses anti-ischemic, antioxidant, hypolipidemic, and antiatherogenic activities. Its useful phytoconstituents are: Triterpenoids, β-sitosterol, flavonoids, and glycosides. Triterpenoids and flavonoids are considered to be responsible for its beneficial antioxidant cardiovascular properties. The drug has shown promising effect on ischemic cardiomyopathy. So far, no serious side effects have been reported with arjuna therapy. However, its long-term safety still remains to be elucidated. Though it has been found quite useful in angina pectoris, mild hypertension, and dyslipidemia, its exact role in primary/secondary coronary prevention is yet to be explored.

Angina pectoris, chest pain
Arjuna has been tested in patients with angina. The herb dilates blood vessels, even in cigarette smokers.

Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate.
Indian Heart J. 2002.
Fifty-eight males with chronic stable angina (NYHA class II-III) with evidence of provocable ischemia on treadmill exercise test received Terminalia arjuna (500 mg 8 hourly), isosorbide mononitrate (40 mg/daily) or a matching placebo for one week each. Arjuna therapy was associated with significant decrease in the frequency of angina and need for isosorbide dinitrate. The total duration of exercise increased, maximal ST depression during the longest equivalent stages of submaximal exercise decreased, time to recovery decreased, and higher double products were achieved. Terminalia arjuna bark extract, 500 mg 8 hourly, given to patients with stable angina with provocable ischemia on treadmill exercise, led to improvement in clinical and treadmill exercise parameters as compared to placebo therapy.

Antioxidant benefit
Antioxidant and hypocholesterolaemic effects of Terminalia arjuna tree-bark powder: a randomised placebo-controlled trial.
J Assoc Physicians India. 2001.
We found this tree bark powder has significant antioxidant action that is comparable to vitamin E. In addition, it also has a significant cholesterol lowering effect.

Anti-platelet actions, blood thinning
Substances in this plant have anti-platelet activity, meaning they can thin the blood.

Inhibitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease.
Platelets. 2009; Department of Experimental Medicine & Biotechnology, Chandigarh, India.
Twenty patients of angiographically proven coronary artery disease were included in Group I and 20 age and sex-matched controls were included in Group II. The bark extract is able to significantly inhibit platelet aggregation both in patient and control groups. Our data clearly demonstrates that the bark extract of terminalia arjuna decreases platelet activation and may possess anti-thrombotic properties.

Cancer influence
Substance in the plant protect against certain forms of cancer.

Effects of Terminalia arjuna bark extract on apoptosis of human hepatoma cell line HepG2.
World J Gastroenterol 2006.
To investigate the effects of Terminalia arjuna extract on human hepatoma cell line (HepG2) and its possible role in induction of apoptosis. T. arjuna induced cytotoxicity in HepG2 cells in vitro. Apoptosis of HepG2 cells may be due to the DNA damage and expression of apoptotic proteins. Depletion of GSH may be involved in the induction of apoptosis of HepG2 cells.

Casuarinin from the Bark of Terminalia arjuna Induces Apoptosis and Cell Cycle Arrest in Human Breast Adenocarcinoma MCF-7 Cells.
Planta Med. 2005.
Casuarinin, a hydrolyzable tannin, was investigated for its antiproliferative activity in human breast adenocarcinoma MCF-7 cells. The results showed that casuarinininhibited the proliferation of MCF-7 by blocking cell cycle progression in the G0/G1 phase and inducing apoptosis.

Cholesterol metabolism
Compounds in Arjuna may help reduce cholesterol levels.

DNA protection
Arjuna has compounds that protect against DNA damage from toxins.

Effect of Terminalia arjuna extract on adriamycin-induced DNA damage.
Phytother Res. 2008; Reddy TK, Seshadri P. Division of Cancer Biology, Sugen Life Sciences, Tirupati, AP, India.
The effect of a bark extract of Terminalia arjuna was studied on the alteration of adriamycin (ADR)-induced micronuclei formation in cultured human peripheral blood lymphocytes. Our results demonstrate that it protects DNA against ADR-induced damage.

Hardening of the arteries
Terminalia arjuna reverses impaired endothelial function in chronic smokers.
Indian Heart J. 2004.
Smoking, largely through increased oxidative stress, causes endothelial dysfunction which is an early key event in atherosclerosis. The present study was aimed to determine whether Terminalia arjuna would improve endothelial dysfunction in smokers. Smokers have impaired endothelium-dependent but normal endothelium-independent vasodilation as determined by brachial artery reactivity studies. Arjuna therapy for two weeks leads to significant regression of this endothelial abnormality amongst smokers.

Heart attack, myocardial infarction
Arjunolic acid, a new triterpene and a potent extract from the bark of Terminalia arjuna, has been shown to provide significant cardiac protection in myocardial necrosis in rats. Arjunolic acid treatment prevents the decrease in the levels of powerful antioxidants such as superoxide dismutase, catalase, glutathione, alpha-tocopherol, and ascorbic acid.

Terminalia arjuna protects rabbit heart against ischemic-reperfusion injury: role of antioxidant enzymes and heat shock protein.
 J Ethnopharmacol. 2005.
The bark of Terminalia arjuna is widely recommended for the treatment of ischemic heart disease (IHD) in Indian system of medicine. Oral administration for 12 weeks in rabbits caused augmentation of myocardial antioxidants; superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) along with induction of heat shock protein72. In vivo ischemic-reperfusion injury induced oxidative stress, tissue injury of heart and haemodynamic effects were prevented in the Terminalia arjuna  treated rabbit hearts.

Cardioprotective effect of the alcoholic extract of Terminalia arjuna bark in an in vivo model of myocardial ischemic reperfusion injury.
Life Sci. 2003.
The present study was designed to investigate the effects of chronic administration of the alcoholic extract of terminalia arjuna bark on isoproterenol induced myocardial injury given orally to Wistar albino rats 6 days/week for 4 weeks. At the end of this period, all the animals, except the normal untreated rats that served as the control group, were administered isoproterenol for two consecutive days to induce in vivo myocardial injury. A significant rise in myocardial thiobarbituric acid reactive substances (TBARS) and loss of reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (suggestive of increased oxidative stress) occurred in the hearts subjected to in vivo myocardial ischemic reperfusion injury. In vivo ischemic reperfusion injury of the arjuna treated rats there was a significant decrease in TBARS in all the groups. The present study demonstrates that arjuna augments endogenous antioxidant compounds of the rat heart and also prevents the myocardium from isoproterenol induced myocardial ischemic reperfusion injury.

Heart disease
J Cardiovasc Transl Res. 2015. Short-Term Adjuvant Therapy with Terminalia arjuna Attenuates Ongoing Inflammation and Immune Imbalance in Patients with Stable Coronary Artery Disease: In Vitro and In Vivo Evidence. The present study evaluated the cardioprotective effects of Terminalia arjuna on classical and immuno-inflammatory markers in coronary artery disease (CAD) as an adjuvant therapy. One hundred sixteen patients with stable CAD were administered placebo / T. arjuna (500 mg twice a day) along with medications in a randomized, double-blind clinical trial. Our data demonstrate the anti-inflammatory and immunomodulatory effects of T. arjuna that may attenuate ongoing inflammation and immune imbalance in medicated CAD subjects.

Testimonial
Do you know anything about Arjuna for afib? I've been taking it for about 6 months now and have noticed a significant improvement to the point of having almost no episodes from having 3 or 4 per week before I started taking it.

Hypertension, lowering of blood pressure
Possible mechanisms of hypotension produced 70% alcoholic extract of Terminalia arjuna in anaesthetized dogs.
BMC Complement Alternative Med. 2003.
Intravenous administration produced dose-dependent hypotension in anaesthetized dogs.

Q. I was reading online that said don't take arjuna bark longer than 3 months. I am currently on Losartan for essential high blood pressure, but I would like to get off it.
   A. Long term studies are not available. It depends on how high the dose of the herb and what kind of extract and how severe the hypertension. But, to be safe, it is a good idea to take 2 days off each week and a week off each month.

Testimonials
My husband and I have used arjuna supplements for the past few months and we both believe it has lowered our blood pressure.

I was diagnosed with hypertension many years ago and since then have been prescribed various allopathic drugs, most recently Atenolol. I reduced the dosage of Atenolol and replaced it gradually with arjuna which we purchased online from you. I have been taking arjuna exclusively for a few week. My blood pressure seems to have been as well controlled by arjuna as it was previously by allopathic drugs and from this aspect, I see no reason why I should not continue taking it exclusively. However, I am concerned about the seeming lack of any documentation regarding its long term effects. Information on such effects is readily available in respect of allopathic anti-hypertensives. If arjuna terminalia has such a long history of use in such conditions, surely there must be some data on the effects of long term use - even if the conclusion is that there is no traceable effect.
   A. Even though Arjuna has a long history of use, this was probably recorded in India and has not make it to the Western medical research information base. As soon as we get any info on this topic we will mention it in our newsletter.

Mitral regurgitation
Role of Terminalia arjuna in ischaemic mitral regurgitation.
Int J Cardiol. 2005. Dwivedi S, Aggarwal A.
We planned a study to evaluate the role of T. arjuna in ischemic mitral regurgitation (IMR) following acute myocardial infarction (AMI). 40 patients with fresh AMI showing IMR were randomly divided into 2 groups of 20 each. They were given placebo or 500 mg of T. arjuna in addition to anti-ischemic treatment. After 1 and 3 months of follow up, patients receiving adjuvant T. arjuna showed significant decrease in IMR and considerable reduction in anginal frequency.

Stroke
I had 2 strokes, can not take Plavix, I have started on natural remedies. I am no longer on Lipitor, Lopressor, or Lotrel. My doctor knows that I am taking natural remedies, and he checks me out, and feel I am o.k. Will Arjuna work with natural products that I am taking to lower my blood pressure and reduce the risk for stroke?
   I have not seen studies in relation to stroke incidence reduction, but it is possible.

Side effects, adverse reactions
No significant side effects have been published in medical journals as of 2016. There may be a slight feeling of warmth, flushing, or increased body temperature after taking a pill and a little temporary weakness when a high dose is used. Perhaps this is due to blood vessel dilation? I am not sure.

Other brands and products, where to buy
I have been ordering my Arjuna from Himalaya for quite some time. I just happened to look at the bottle today and noticed, among its ingredients – colloidal silicon dioxide. I’m no scientist but that doesn’t sound like a good thing to be taking. Is this a “natural” ingredient? I was wondering if your Arjuna has that ingredient in it? If it doesn’t, maybe I should be buying my this herbal product from your company.
    We do not think colloidal silicon dioxide is harmful, the amounts in the capsules are often very very small. The product we carry has Other Ingredients: microcrystalline cellulose, dibasic calcium phosphate, stearic acid, hydroxypropyl cellulose, colloidal silicon dioxide and modified cellulose gum. These are also safe. You may wish to keep using the product you have or try another.

Other products online
buy Arjuna extract supplement herb, 400 mg dosage, 60 Capsules Amount Per Serving Terminalia arjuna Bark 400 mg with 40 mg extract (standardized 10:1 extract, meaning it is 10 times more concentrated than the plain bark powder) Suggested use: Take one Arjuna pill once a day or as recommended by your health care provider. Buy Arjuna extract supplement.

Paradise Herbs, buy Arjuna, 60 Veggie Caps

Dosage: One capsule in the morning. If you are sensitive to herbs, take half a capsule.

Other products online
Himalaya Herbal Healthcare, Arjuna, Cardiac Support, 60 Caplets