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Stevia

What is it?

Stevia (Stevia rebaudiana) is a bushy shrub that is native to northeast Paraguay, Brazil and Argentina. It is now grown in other parts of the world, including Canada and part of Asia and Europe. It is probably best known as a source of natural sweeteners.

Some people take stevia by mouth for medical purposes such as lowering blood pressure, treating diabetes, heartburn, high uric acid levels in the blood, for weight loss, to stimulate the heart rate, and for water retention.

Extracts from the stevia leaves are available as sweeteners in Japan, South Korea, Malaysia, Taiwan, Russia, Israel, Mexico, Paraguay, Uruguay, Venezuela, Colombia, Brazil, and Argentina. In the US, stevia leaves and extract are not approved for use as a sweetener, but they can be used as a "dietary supplement" or in skin care products. In December 2008, the U.S. Food and Drug Administration (FDA) granted Generally Recognized as Safe (GRAS) status to rebaudioside A, one of the chemicals in stevia, to be used as a food additive sweetener.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for STEVIA are as follows:

Insufficient evidence to rate effectiveness for...

  • Diabetes. Research on how stevia might affect blood sugar in people with diabetes is inconsistent. Some early research suggests that taking 1000 mg daily of stevia leaf extract containing 91% stevioside might reduce blood sugar levels after meals by 18% in people with type 2 diabetes. However, other research shows that taking 250 mg of stevioside three times daily does not decrease blood sugar levels or HbA1c (a measure over blood sugar levels over time) after three months of treatment.
  • High blood pressure. How stevia might affect blood pressure is unclear. Some research suggests that taking 750-1500 mg of stevioside, a chemical compound in stevia, daily reduces systolic blood pressure (the upper number in a blood pressure reading) by 10-14 mmHg and diastolic blood pressure (the lower number) by 6-14 mmHg. However, other research suggests that taking stevioside does not reduce blood pressure.
  • Heart problems.
  • Heartburn.
  • Weight loss.
  • Water retention.
  • Other conditions.
More evidence is needed to rate the effectiveness of stevia for these uses.

How does it work?

Stevia is a plant that contains natural sweeteners that are used in foods. Researchers have also evaluated the effect of chemicals in stevia on blood pressure and blood sugar levels. However, research results have been mixed.

Are there safety concerns?

Stevia and chemicals contained in stevia, including stevioside and rebaudioside A, are LIKELY SAFE when taken by mouth as a sweetener in foods. Rebaudioside A has generally recognized as safe (GRAS) status in the U.S. for use as a sweetener for foods. Stevioside has been safely used in research in doses of up to 1500 mg daily for 2 years.

Some people who take stevia or stevioside can experience bloating or nausea. Other people have reported feelings of dizziness, muscle pain, and numbness.

Special precautions & warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking stevia if you are pregnant or breast feeding. Stay on the safe side and avoid use.

Allergy to ragweed and related plants: Stevia is in the Asteraceae/Compositae plant family. This family includes ragweed, chrysanthemums, marigolds, daisies, and many other plants. In theory, people who are sensitive to ragweed and related plants may also be sensitive to stevia.

Diabetes: Some developing research suggests that some of the chemicals contained in stevia might lower blood sugar levels and could interfere with blood sugar control. However, other research disagrees. If you have diabetes and take stevia or any of the sweeteners it contains, monitor your blood sugar closely and report your findings to your healthcare provider.

Low blood pressure: There is some evidence, though not conclusive, that some of the chemicals in stevia can lower blood pressure. There is a concern that these chemicals might cause blood pressure to drop too low in people who have low blood pressure. Get your healthcare provider's advice before taking stevia or the sweeteners it contains, if you have low blood pressure.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Lithium
Stevia might have an effect like a water pill or "diuretic." Taking stevia might decrease how well the body gets rid of lithium. In theory, this could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.
Minor
Be watchful with this combination.
Medications for diabetes (Antidiabetes drugs)
Some research shows that stevia might decrease blood sugar in people with type 2 diabetes. In theory, stevia might cause an interaction with diabetes medications resulting in blood sugar levels going too low; however, not all research has found that stevia lowers blood sugar. Therefore, it is not clear if this potential interaction is a big concern. Until more is known, monitor your blood sugar closely if you take stevia. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications for high blood pressure (Antihypertensive drugs)
Some research shows that stevia might decrease blood pressure. In theory, taking stevia along with medications used for lowering high blood pressure might cause your blood pressure to go too low. However, some research shows that stevia does not affect blood pressure. Therefore, it's not known if this potential interaction is a big concern.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Are there interactions with herbs and supplements?

Herbs and supplements that might lower blood pressure
Stevia might lower blood pressure. Using it along with other herbs and supplements that have this same effect might increase the risk of blood pressure dropping too low in some people. Some of these products include andrographis, casein peptides, cat's claw, coenzyme Q-10, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
Herbs and supplements that might lower blood sugar
Stevia might lower blood sugar. Using it along with other herbs and supplements that have the same effect might cause blood sugar to drop too low in some people. Some of these products include alpha-lipoic acid, bitter melon, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut seed, Panax ginseng, psyllium, Siberian ginseng, and others.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The appropriate dose of stevia depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for stevia. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Other names

Azucacaa, Caa-He-É, Ca-A-Jhei, Ca-A-Yupi, Capim Doce, Chanvre d'Eau, Eira-Caa, Erva Doce, Estevia, Eupatorium rebaudianum, Green Stevia, Kaa Jhee, Mustelia eupatoria, Paraguayan Stevioside, Plante Sucrée, Reb A, Rebaudioside A, Rébaudioside A, Rebiana, Stévia, Stevia eupatoria, Stevia Plant, Stevia purpurea, Stevia rebaudiana, Stevioside, Sweet Herb of Paraguay, Sweet Herb, Sweet Leaf of Paraguay, Sweetleaf, Yerba Dulce.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

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Last reviewed - 06/29/2016