Depression, mood
Pak J Pharm Sci. 2014. Antidepressant effect and categorization of inhibitory activity of monoamine oxidase type A and B of ethanolic extract of seeds of Trigonella foenum graecum.

Diabetes and blood sugar
For millennia, fenugreek has been used both as a medicine and as a food spice in Egypt, India, and the Middle East. Present interest in fenugreek focuses on its potential benefits for people with diabetes or high cholesterol. Numerous animal studies and preliminary trials in humans have found that fenugreek can help support healthy blood sugar and serum cholesterol levels in people with diabetes.
   In a study conducted at the Jaipur Diabetes and Research Centre in India, 25 newly diagnosed patients with type 2 diabetes were randomly divided into two groups. Group received 1 gram a day of fenugreek seed extract and Group 2 received usual care (dietary control, exercise) and placebo capsules for two months. Serum triglycerides decreased and HDL (the good cholesterol) increased significantly in group 1 as compared to group 2. In addition, fenugreek seeds improved blood sugar control and decreased insulin resistance in those with mild type-2 diabetic patients.

Fenugreek seeds are known for their characteristic smell of soup seasoning and as an ingredient of Indian curry. Traditionally the seeds are used as macerate for the treatment of diabetes, cough, and flatulence, to increase breast milk secretion, and for anti-inflammatory and aphrodisiac effects. The use is limited by its unpleasant smell and bitter taste which can be modified by adding mint leaves to the macerate. Antidiabetic properties are attributed mainly to galactomannan, 4-hydroxyisoleucin (4-OH-Ile), diosgenin and trigonelline.

J Indian Soc Periodontol. 2018. Fenugreek, diabetes, and periodontal disease: A cross-link of sorts! The aim of this study was to observe the sequelae of fenugreek adjunctive to nonsurgical periodontal therapy and its comparison to a group treated with scaling and root planing (SRP) and metformin alone by assessing their respective effects on periodontal parameters, glycemic status, and serum lipid levels. This study shows that fenugreek powder can be used adjunctive to SRP to control the glycemic status and serum lipid levels in uncontrolled NIDDM patients.

Int J Vitam Nutr Res. 2014. Effect of Fenugreek Seeds on Serum Metabolic Factors and Adiponectin Levels in Type 2 Diabetic Patients. This triple-blind randomized controlled clinical trial was conducted on type 2 diabetic (T2DM) patients (males and females). Subjects in the fenugreek seed (n=44) and placebo (n=44) groups consumed 10 g/d of powdered whole fenugreek seeds or 5 g/d of wheat starch for 8 weeks. Fasting blood samples, anthropometric measurements and dietary records were collected at the baseline and at the end of the trial. Fenugreek seeds significantly decreased fasting blood glucose and HbA1c, serum levels of insulin, homeostatic model assessment for insulin resistance, total cholesterol and triglycerides and increased serum levels of adiponectin compared with placebo. No significant changes were shown in serum low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in both groups. In conclusion, fenugreek seeds improved glucose metabolism, serum lipid profile and adiponectin levels in studied subjects, and may be useful in the control of diabetes risk factors in TD2M patients.

Nutr J. 2014. Effect of fenugreek (Trigonella foenum-graecum) intake on glycemia: a meta-analysis of clinical trials. Fenugreek is a herb that is widely used in cooking and as a traditional medicine for diabetes in Asia. It has been shown to acutely lower postprandial glucose levels, but the long-term effect on glycemia remains uncertain. We systematically reviewed clinical trials of the effect of fenugreek intake on markers of glucose homeostasis. Results from clinical trials support beneficial effects of fenugreek seeds on glycemic control in persons with diabetes. However, trials with higher methodology quality using a well characterized fenugreek preparation of sufficient dose are needed to provide more conclusive evidence.

Mechanism of action of a hypoglycemic principle isolated from fenugreek seeds.
Indian J Physiol Pharmacol. 2002.
Mechanism of action of an orally active hypoglycemic principle isolated from water extract of seeds of Trigonella foenum graecum (fenugreek) was investigated in alloxan induced subdiabetic and overtly diabetic rabbits of different severities. The active principle was orally administered to the subdiabetic and mild diabetic rabbits (five in each group) at a dose of 50 mg/kg body weight for 15 days. The fenugreek treatment produced significant attenuation of the glucose tolerance curve and improvement in the glucose induced insulin response, suggesting that the hypoglycemic effect may be mediated through stimulating insulin synthesis and/or secretion from the beta pancreatic cells of Langerhans.

Effect of Trigonella foenum extract on blood glucose, blood lipid and hemorheological properties in streptozotocin-induced diabetic rats.
Asia Pac J Clin Nutr. 2007.
Fenugreek seeds have previously been shown to have hypoglycemic and hypocholesterolemic effects on type 1 and type 2 diabetes mellitus patients and experimental diabetic animals. Fenugreek seed extract has now been investigated for its effects on general properties, blood glucose and blood lipid, in experimental diabetic rats. Streptozotocin-induced diabetic rats were administrated Fenugreek seed extract, and Metformin HCl for 6 weeks. Compared with diabetic group, rats treated with fenugreek seed extract had an increase in body weight and a decrease in kidney /body weight. Compared with diabetic group, rats treated fenugreek seed extract had lower blood glucose, glycated hemoglobin, triglycerides, total cholestrol and higher higher-density-lipoprotein-cholesterol in a dose-dependent manner . The plasma viscosity, whole blood viscosity of high shear rate and low shear rate, erythrocyte sedimentation rate, whole blood reduction viscosity and platelet conglutination were significantly reduced in diabetic rats treated with high and middle doses of fenugreek seed extract, but not in those treated with low dose of fenugreek seed extract. It may be concluded that fenugreek seed extract can lower kidney /body weight ratio, blood glucose, blood lipid levels and improve hemorheological properties in experimental diabetic rats following repeated treatment for 6 weeks.

Effect of Trigonella foenum-graecum seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study.
J Assoc Physicians India 2001.
Twenty five newly diagnosed patients with type 2 diabetes (fasting glucose < 200 mg/dl) were randomly divided into two groups. Group I received 1 gm/day hydroalcoholic extract of fenugreek seeds and Group II received usual care (dietary control, exercise) and placebo capsules for two months. Adjunct use of fenugreek seeds improves glycemic control and decreases insulin resistance in mild type-2 diabetic patients. Fenugreek also has a favorable effect on hypertriglyceridemia.

Effect of fenugreek seeds on the fasting blood glucose level in the streptozotocin induced diabetic rats.
Mymensingh Med Journal. 2004.
In this experiment defatted Trigonella foenum seeds is used as the antidiabetogenic herbal medicine. The experiment was carried out in Bangabandhu Sheikh Mujib Medical University and BIRDEM on a total of 58 Long Evans rats of either sex. Ten rats were treated with only vehicle called as non-diabetic control rats, 48 rats were treated with Streptozotocin, among which 20 were diabetics. Ten diabetic rats were again treated with fenugreek called as Fenugreek-treated diabetic rats and the rest 10 diabetic rats were called as diabetic control rats. The change in the mean fasting blood glucose level in different groups of rat from day 5 from streptozotocin injection were higher in diabetic control group and in fenugreek-treated diabetic group than in non diabetic control group. From this experiment it may be concluded that fenugreek decreases the fasting blood glucose level considerably by improving diabetes mellitus.

Lipid lowering
Supplementation of fenugreek leaves lower lipid profile in streptozotocin-induced diabetic rats.
Our results show that blood glucose and serum and tissue lipids were elevated in STZ-induced diabetic rats. Supplementation of fenugreek leaves lowered the lipid profiles. J Med Food. 2004.

Liver protection due to alcohol excess
Protective effect of fenugreek (Trigonella foenum) seeds in experimental ethanol toxicity.
Phytother Res. 2003.
The study investigates the effect of aqueous extract of fenugreek seeds on lipid peroxidation and antioxidant status in experimental ethanol toxicity in rats. Ethanol feeding for 60 days resulted in significant increases in the activities of serum aspartate transaminase, alanine transaminase and alkaline phosphatase. The levels of serum lipid hydroperoxides and thiobarbituric acid reactive substances in liver and brain were also significantly elevated. The fenugeek seeds exhibited appreciable antioxidant property in vitro which was comparable with that of reduced glutathione and alpha-tocopherol. Further, histopathological examination of liver and brain revealed that, aqueous extract of fenugreek seeds could offer a significant protection against ethanol toxicity.

Diosgenin, 4-Hydroxyisoleucine, and Fiber from Fenugreek: Mechanisms of Actions and Potential Effects on Metabolic Syndrome. Adv Nutr 2015.

Metabolic syndrome
Diosgenin, 4-Hydroxyisoleucine, and Fiber from Fenugreek: Mechanisms of Actions and Potential Effects on Metabolic Syndrome. Metabolic syndrome and its complications continue to rise in prevalence and show no signs of abating in the immediate future. Therefore, the search for effective treatments is a high priority in biomedical research. Products derived from botanicals have a time-honored history of use in the treatment of metabolic diseases including type 2 diabetes. Trigonella foenum-graecum, commonly known as fenugreek, is an annual herbaceous plant that has been a staple of traditional herbal medicine in many cultures. Although fenugreek has been studied in both clinical and basic research settings, questions remain about its efficacy and biologic mechanisms of action. Diosgenin, 4-hydroxyisoleucine, and the fiber component of the plant are the most intensively studied bioactive constituents present in fenugreek. These compounds have been demonstrated to exert beneficial effects on several physiologic markers including glucose tolerance, inflammation, insulin action, liver function, blood lipids, and cardiovascular health. Adv Nutr 2015.

Polycystic Ovary Syndrome (PCOS)
Int J Med Sci. 2015. Efficacy of a Novel Fenugreek Seed Extract (Trigonella foenum, Furocyst) in Polycystic Ovary Syndrome (PCOS). Polycystic ovary syndrome (PCOS) is one of the most prevalent hormonal disorders among women of reproductive age causing irregular menstrual cycles, excessive body or facial hair, miscarriage and infertility. The latter being a most common PCOS symptoms. The present study is an open label, one-arm, non-randomized, post-marketing surveillance study in 50 premenopausal women (18-45 years, BMI<42) diagnosed with PCOS using a novel fenugreek seed extract, Furocyst, 2 capsules of 500 mg each day, enriched in approximately 40% furostanolic saponins, over a period of 90 consecutive days. The study was conducted to determine its efficacy on the reduction of ovarian volume and the number of ovarian cysts. Furocyst treatment caused significant reduction in ovary volume. Approximately 46% of study population showed reduction in cyst size, while 36% of subjects showed complete dissolution of cyst. It is important to mention that 71% of subjects reported the return of regular menstrual cycle on completion of the treatment and 12% of subjects subsequently became pregnant. Overall, 94% of patients benefitted from the regimen. Significant increases in luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels were observed compared to the baseline values. Extensive blood chemistry, hematological and biochemical assays demonstrated the broad-spectrum safety. Furocyst caused significant decrease in both ovarian volume and the number of ovarian cysts. Serum ALT, BUN and CK were assessed to demonstrate the broad-spectrum safety of Furocyst. No significant adverse effects were observed. In summary, Furocyst was efficacious in ameliorating the symptoms of PCOS.

Sexuality and libido
Phytother Res. 2011. Physiological Aspects of Male Libido Enhanced by Standardized Trigonella foenum-graecum Extract and Mineral Formulation. Testofen demonstrated a significant positive effect on physiological aspects of libido and may assist to maintain normal healthy testosterone levels.

Safety of fenugreek and side effects
As a commonly eaten food, fenugreek is generally regarded as safe. The only common side effect is mild gastrointestinal distress when it is taken in high doses. Animal studies have found it to be essentially non-toxic.

Genotoxicity testing of a fenugreek extract.
Food Chem Toxicol. 2004.
Rich in protein, fenugreek seeds contain the unique major free amino acid 4-hydroxyisoleucine (4-OH-Ile), which has been characterized as one of the active ingredients for blood glucose control. As part of a safety evaluation of novel ingredients for use in blood glucose control, the potential genotoxicity of a fenugreek seed extract, containing a minimum of 40% 4-OH-ILE, was evaluated using the standard battery of tests (reverse mutation assay; mouse lymphoma forward mutation assay; mouse micronucleus assay) recommended by US Food and Drug Administration for food ingredients. Fenugreek extract was determined not to be genotoxic under the conditions of the tested genetic toxicity battery.

Fenugreek dosage
Fenugreek capsules typically contain about 600 mg. A typical dosage is about one to two grams two times a day with breakfast and lunch. Fenugreek tea is also available.

Additional benefits
Studies in rodents indicate that fenugreek has immune stimulating, antioxidant and anti-tumor properties, and protects the liver against alcohol toxicity. Administration of fenugreek seed extract with ethanol to rats prevented the enzymatic leakage and the rise in lipid peroxidation. The seeds exhibited appreciable antioxidant property in vitro which was comparable with that of reduced glutathione and vitamin E. Further, examination of liver and brain revealed that, extract of fenugreek seeds could offer a significant protection against ethanol toxicity. It also has anti- ulcer properties.  

Fenugreek extract sold by herb and ingredient suppliers
Fenugreek herb is sold as plain powder and in various extract potencies.
FuranoMax Fenugreek Extract (proprietary source of fenugreek furans, stanols and furanostanols from whole Trigonella foenum-graecum seed).
Testofen.

Gencor Announces Study Results 2009, press release
A new human clinical study was recently completed in Australia on Testofen, Gencor's proprietary extract of fenugreek, to evaluate its effect on libido in healthy men. The randomized, double blind placebo study tested sexual function, performance, and libido levels in 60 healthy males aged between 21 and 50 years over a 6 week period. Results showed Testofen produced a positive change in all parameters of libido, including sexual cognition, sexual arousal, sexual experience and orgasm. The effect may be a result of interaction with testosterone via alpha-5 reductase activity. A presentation of this study was made at SupplySide West in a VendorWorks seminar on November 13, 2009, by Ms. Amanda Rao, Director of Applied Science and Nutrition Pty., the CRO that conducted the study. Ms. Amanda Rao has degree and postgraduate qualifications in science and over 15 years experience in the natural medicine industry in Australia, including product development, regulatory affairs, manufacture and education.

Questions
I am a fan of Dr. Sahelian's website and use it as a reference when I am considering natural substances over prescription drugs. I was looking at your listing for fenugreek when I noticed a reference for Testofen. When I looked at the ingredients for that product, I noticed that the majority active herbal ingredient was safed musli which has a traditional use in Indian medicine for sexual dysfunction. I have not see much reference to fenugreek as a sexual aid. The proprietary blend of Testofen includes ginseng and b-vitamins also. I am curious about fengreek's role in this topic so I am hoping your site might address that at some point. I do know Dr Sahelian is affiliated with some of the products mentioned on the site but I really appreciate the fact-based answers and reviews of the various herbal remedies and the medical viewpoints as to dosage, use, limits and side effects. This is unique on the web. It's so hard to get unbiased information on alternative remedies on the internet.
    A. As far as I know, Testofen is a fenugreek extract, perhaps there is a product that includes this extract with the other herbs and nutrients that you mention?

I came across a web site promoting a standardized form of fenugreek called Testofen. It said those given 600 mg a day had a great increase in free testosterone levels compared to the placebo group. Is Testofen a good thing to take for health?
   A. The human body is very complicated and just looking at levels of one hormone tells us very little regarding the long term benefit of Testofen or any supplement that increases testosterone levels. Increasing testosterone levels through this fenugreek extract may or may not be a healthy thing to do until we have a few human trials published.

Advance Physician Formulas, Inc., Fenugreek Extract, 60 Capsules
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Usage, dosage: Take 2 fenugreek seed capsules daily, preferably with food or as recommended by your doctor.
Fenugreek (Trigonella foenum graecum) is an annual Mediterranean and Asiatic herb with aromatic seeds.
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