On The Shelf
Mickie Cathers
Fenugreek is widely known for its potential benefit in managing diabetes, reducing menstrual cramps and high cholesterol, and lifting energy and testosterone levels. However, robust evidence supporting the use of fenugreek supplements is lacking.
Background
Fenugreek (Trigonella foenum-graecum) is a legume native to the Mediterranean, Europe, and Asia that has been used for thousands of years as alternative medicine to treat various conditions. Fenugreek’s golden-brown seeds can be used to spice all types of dishes with their distinctive nutty aroma and flavor of maple syrup.
Fenugreek supplements are advertised as aiding diabetes, easing menstrual cramps, and stimulating milk production during breastfeeding, as well as having other health benefits.
Is there a benefit?
Recent studies highlight fenugreek’s potential in lowering blood glucose, though evidence quality varies. The authors of a systematic review and meta-analysis published on January 25, 2024, in the Annals of Medicine and Surgery, evaluated randomized controlled trials that explored fenugreek supplementation in patients with T2D. Results indicated that 2 to 5 mg of powdered fenugreek significantly reduced fasting blood glucose, A1C, and postprandial glucose levels in patients with diabetes when compared with the control.
Another meta-analysis and systematic review of fenugreek on hyperglycemia published the previous year demonstrated a similar reduction in fasting blood glucose, postprandial blood glucose, and A1C levels with fenugreek consumption. However, the authors of both reviews expressed concern over the quality and heterogeneity of each of the included studies.
A systematic review and meta-analysis published in the February 2024 issue of Current Drug Research Reviews aimed to determine the effect of fenugreek supplementation and its adverse effects on patients with dysmenorrhea. While results showed that the pain intensity caused by primary dysmenorrhea decreased with fenugreek compared with placebo, available evidence was of low quality. The authors concluded that the effect of fenugreek on pain intensity in dysmenorrhea was highly uncertain.
Similarly, recent studies on milk volume in breastfeeding interventions showed mixed results due to high data variability and low certainty of evidence.
A February 27, 2023, systematic review published in the Journal of Personalized Medicine by Albaker aimed to provide a scientific and comprehensive analysis of the literature on the effects of fenugreek extracts on muscle performance. Six out of 81 randomized controlled trials were included in the qualitative analysis. Only four observed that fenugreek supplementation had significantly improved muscle strength, repetitions to failure (i.e., muscle endurance), submaximal performance index, lean body mass, and reduced body fat. However, the authors noted that these trials had small sample sizes adversely affecting the quality of evidence.
Dosage and availability
Fenugreek is available online and in food stores as capsules, seeds, and powder. Some people use the seeds for sprouting to sprinkle on salads and the powder to add to smoothies. Most supplements follow the dosages seen in clinical studies that ranged from 5 to 10 grams daily.
What to tell your patients
While fenugreek is generally considered safe in the amounts commonly found in foods, some adverse effects may include bloating, diarrhea, and upset stomach. Fenugreek may also cause adverse reactions in patients allergic to soybeans, peanuts, green peas, and other legumes. Advise patients that large doses of fenugreek may cause precipitous drops in blood glucose levels and slow blood clotting. ■