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Aloe has been associated with acute hepatitis (liver inflammation) either in isolation or when consumed as a multinutrient supplement. These effects appear to be reversible and occur in the dosage range of 250-500 mg a day, with the exact mechanism of the toxicity is not understood.
Aloe seems to cause wide-ranging side-effects at a doses 100mg/kg or greater bodyweight in animals. These side effects are observed in all subjects. *
Topical aloe vera is generally considered safe for use. Side effects, if any, tend to be mild and may include skin irritation and redness. Allergies can sometimes occur, especially in people who are allergic to garlic, onions, or tulips.
Aloe vera gel should not be used to treat severe burns or wounds. Seek immediate medical attention if you have a deep cut or a large or severe burn.
Oral Aloe Vera
There remain significant concerns about the long-term safety of aloe vera when taken by mouth. Aloe vera extracts can have a potent laxative effect, causing diarrhea, abdominal cramps, and the potential severe loss of potassium.
A severe loss of potassium can lead to fatigue, muscle weakness, and irregular heartbeats (arrhythmia). The long-term consumption of aloe vera—especially undiluted aloe gel—can result in permanent kidney damage.
Cancer Warning
Several animal studies have shown that whole-leaf aloe extracts can cause cancer of the large intestine. It is believed that aloin, which provides aloe latex its yellowish color, is responsible for this carcinogenic effect.
Decolorized aloe vera (in which aloin is filtered from the gel) is believed to be of low cancer risk, although further research is needed to confirm this.
The safety of aloe in people with liver and kidney disease has not been established. To be safe, do not take oral aloe vera if you have liver disease, kidney disease, diabetes, intestinal problems, heart disease, hemorrhoids, or electrolyte imbalances.
Due to the lack of safety research, oral aloe should not be used in children, pregnant women, or nursing mothers.
Drug Interactions
Aloe vera may cause certain drug interactions if taken internally. In some cases, it can block the action of the co-administered drug. In others, it can enhance the action of the drug, triggering the appearance or worsening side effects. Others still may promote the depletion of potassium.
Speak with your doctor if you intend to use oral aloe and take any of the following drugs or supplements:
- • Diabetes medications, including insulin
- • Diuretics ("water pills") like Lasix (furosemide)
- • Heart rhythm medications like digoxin
- • Laxatives and stool softeners
- • Licorice root
- • Oral or injectable steroids
- • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil (ibuprofen), or Celebrex (celecoxib)
Oftentimes, separating drug doses by two to four hours in all that is needed to avoid an interaction. At others, a dose adjustment or drug substitution may be required.
Topical aloe vera can also enhance the absorption of topical steroid creams, increasing the risk of dermal atrophy and damage. *