Fenugreek

Purported Benefits, Side Effects & More
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Fenugreek

Purported Benefits, Side Effects & More
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Fenugreek

Common Names

  • Bird's foot
  • Greek hayseed
  • Bockshornsame
  • Methi
  • Hu lu ba

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For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

Fenugreek may help lower blood sugar and cholesterol levels, but data is limited and more studies are needed.

Fenugreek comes from the dried seeds of the plant, and has a scent and taste similar to maple syrup. It is used in Middle Eastern, African, and Indian cuisine, and in traditional medicine such as Ayurveda to treat inflammation, diabetes, and gastrointestinal disorders.

Research on this botanical is limited. Small studies in humans suggest fenugreek may help reduce blood fats and sugars, or relieve menopause symptoms, but larger-well designed studies are needed.

In vitro, fenugreek acted as an estrogen receptor modulator and stimulated breast cancer cells. Therefore, patients with hormone-sensitive cancers should consult their physician before using this product in amounts greater than typically found in food.

What are the potential uses and benefits?
  • To treat diabetes
    Small studies suggest that fenugreek can lower blood glucose levels when taken with meals. However, more research is needed.
  • As a laxative
    Although fenugreek seeds contain high levels of fiber, clinical data are lacking.
  • To treat disorders of the digestive tract
    Evidence is lacking to support this claim.
  • To lower high cholesterol
    A few trials support this use, but additional studies are needed.
  • To fight infections
    Lab studies suggest fenugreek has antibacterial properties, but this has not been studied in humans.
  • To reduce inflammation
    Evidence is lacking to support this claim.
  • As a lactation stimulant
    Although fenugreek is used in folk medicine to stimulate lactation, evidence is lacking to support this claim and side effects have been reported.
  • For wound healing
    Evidence is lacking to support this claim.
What are the side effects?

Case reports

  • Allergic reactions: Runny nose, wheezing, shortness of breath, nausea, abdominal pain, facial swelling, hives, and fainting 
  • Severe clotting failure: With excessive use of fenugreek milk porridge, in a patient with cirrhosis.
  • Serotonin syndrome: Nausea, anxiety, dilated pupils, sweating, rapid heartbeat, twitching, and spasms in a 38-year-old woman with postnatal depression and anxiety who was being treated with the antidepressant sertraline, but had also taken daily fenugreek supplements to aid in lactation.  
What else do I need to know?

Do Not Take if:

  • You are taking warfarin: Case reports indicate that fenugreek may increase bleeding risk.
  • You are taking SSRI antidepressants: A case report suggests supplemental fenugreek may increase the risk for serotonin syndrome, a serious medical condition.
  • You are taking cyclophosphamide: Animal studies suggest fenugreek may interfere with the actions of cyclophosphamide.
  • You have a hormone-sensitive cancer: Lab studies show that fenugreek acts as an estrogenic receptor modulator and may increase growth of breast cancer cells.
  • You are pregnant or breastfeeding: Fenugreek has been linked to an increased risk of birth defects and its safety in amounts greater than typically found in food are unknown.
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For Healthcare Professionals

Scientific Name
Trigonella foenum-graecum
Clinical Summary

Fenugreek is derived from the dried seeds of the plant, with a scent and taste similar to maple syrup. It is used in ayurvedic medicine as a demulcent, laxative, and to increase breast milk supply. It is also used as a dietary supplement to treat various conditions including diabetes, high cholesterol, wounds, inflammation, and gastrointestinal complaints.

Preclinical studies suggest fenugreek has hypocholesterolemic (1), hypolipidemic (2) (23), hypoglycemic (3), antimicrobial (20), hepatoprotective (5) (6), and antinociceptive (30) effects.

Data in humans are limited. Small studies showed benefits of fenugreek for mild asthma (33), metabolic syndrome (48), as well as menopausal (34), postmenopausal (35), polycystic ovary syndrome symptoms (42), and Alzheimer’s disease (49). Data also suggest it may improve exercise performance (50), lipid parameters and glycemic control (51), and decrease insulin resistance in type-2 diabetic patients (36) (43). More research is needed to confirm these effects (37).

Fenugreek demonstrated chemopreventive (7) (8) (9) (24) and chemoprotective properties (25), but human studies have not been conducted. Fenugreek also acts as an estrogen receptor modulator and stimulates breast cancer cells in vitro (26), but evidence of its potential to stimulate lactation is limited (52).

Purported Uses and Benefits
  • Diabetes
  • GI disorders
  • High cholesterol
  • Infections
  • Inflammation
  • Lactation
  • Laxative
  • Wounds
Mechanism of Action

The hypoglycemic activity of fenugreek may be associated with the galactomannan fiber and saponin components that reduce gastrointestinal glucose and cholesterol absorption, and increase bile acid excretion (14). 4-Hydroxyisoleucine, an amino acid constituent, potentiates insulin secretion in non-insulin-dependent diabetic rats when administered intraperitoneally (15). In addition to lower fasting and postprandial glucose levels, fenugreek-treated diabetic rats had higher hemoglobin, GSH, and plasma antioxidant levels and lower glycosylated hemoglobin, plasma lipids, and TBARS levels than diabetic controls (4). Dietary fenugreek also normalizes the activities of glucose and lipid-metabolizing enzymes in diabetic rats (3). Other animal studies suggest dietary fenugreek increases serum T4, liver GSH, glyoxalase I, and GST activities, and decreases T3 levels and T3/T4 ratio (17) (18) (19). In humans, fenugreek intake was associated with an increase in molar insulin binding sites of erythrocytes, which may enhance glucose utilization (16).

Fenugreek has also been studied for its anticancer potential. In MCF-7 estrogen receptor-positive breast cancer cells, a fenugreek extract induced cell cycle arrest and apoptosis (9). Dioscin, a steroidal saponin isolated from fenugreek, suppressed cell viability of ovarian cancer cells by regulating VEGFR2, PI3K, phosphorylated AKT and phosphorylated p38 MAPK signaling pathways (39).

In a case report of serotonin syndrome likely caused by an interaction between fenugreek and sertraline, the authors point to animal studies that posit 4-hydroxyisoleucine may increase serotonin turnover in the brain (47).

Contraindications
  • Fenugreek acts as an estrogen receptor modulator and stimulated breast cancer cells in vitro (26). Patients with hormonal-sensitive cancers should consult their physicians before using fenugreek.
  • Patients taking SSRI antidepressants should avoid using fenugreek products outside of typical food intake, as a case of serotonin syndrome has been reported (47).
  • Fenugreek should be avoided in those who are pregnant or breastfeeding as it has been linked to an increased risk of birth defects in animals and humans (44) (45), and its safety in amounts greater than typically found in food are unknown.
Adverse Reactions

Case reports

  • Allergic reactions: Rhinorrhea, wheezing, numbness of head, facial angioedema and fainting following inhalation and external application of fenugreek seed powder (31).
  • IgE-Mediated anaphylaxis: Hives, abdominal pain, nausea, and dyspnea in a 34-year-old woman with multiple food allergies. A challenge test with fenugreek caused anaphylaxis, but symptoms resolved with treatment (46).
  • Serotonin syndrome: In a 38-year-old woman with postnatal depression and anxiety who was being treated with sertraline, but had also taken daily fenugreek supplements to aid in lactation (47).
  • Severe coagulation failure: Related to excessive use of fenugreek milk porridge in a patient with compensation cirrhosis (40).
  • Pulmonary embolism: Associated with use of a fenugreek-containing supplement for erectile dysfunction, in a 75-year-old man (53).
Herb-Drug Interactions
  • Warfarin: Case reports indicate that fenugreek may potentiate the effects of warfarin (28) (29).
  • SSRI antidepressants: A case report suggests supplemental fenugreek may increase the risk for serotonin syndrome (47).
  • Cyclophosphamide: Animal studies suggest fenugreek may interfere with the cytotoxic effects of cyclophosphamide (25). Clinical relevance has yet to be determined.
  • Theophylline: Fenugreek altered theophylline bioavailability in an animal model (32). Clinical relevance has yet to be determined.
Herb Lab Interactions
  • Increased INR (28).
  • False diagnosis of maple syrup urine disease: In infants due to presence of sotolone in the urine from either infant or maternal ingestion of fenugreek (21) (22).
Dosage (OneMSK Only)
References
  1. Sharma RD, et al. Hypolipidaemic effect of fenugreek seeds: a chronic study in non-insulin dependent diabetic patients. Phytother Res 1996;10:332-4.
  2. Sharma RD, et al. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6.
  3. Vijayakumar MV, Bhat MK. Hypoglycemic effect of a novel dialysed fenugreek seeds extract is sustainable and is mediated, in part, by the activation of hepatic enzymes. Phytother Res. Apr 2008;22(4):500-505.
  4. Ravikumar P, Anuradha CV. Effect of fenugreek seeds on blood lipid peroxidation and antioxidants in diabetic rats. Phytother Res 1999;13:197-201.
  5. Kaviarasan S, Viswanathan P, Anuradha CV.Fenugreek seed (Trigonella foenum graecum) polyphenols inhibit ethanol-induced collagen and lipid accumulation in rat liver. Cell Biol Toxicol. Nov 2007;23(6):373-383.
  6. Kaviarasan S, Sundarapandiyan R, Anuradha CV. Protective action of fenugreek (Trigonella foenum graecum) seed polyphenols against alcohol-induced protein and lipid damage in rat liver. Cell Biol Toxicol. Oct 2008;24(5):391-400.
  7. Amin A, Alkaabi A, Al-Falasi S, Daoud SA. Chemopreventive activities of Trigonella foenum graecum (Fenugreek) against breast cancer. Cell Biol Int 2005 Aug;29(8):687-94.
  8. Raju J, Patlolla JM, Swamy MV, Rao CV. Diosgenin, a steroid saponin of Trigonella foenum graecum (Fenugreek), inhibits azoxymethane-induced aberrant crypt foci formation in F344 rats and induces apoptosis in HT-29 human colon cancer cells. Cancer Epidemiol Biomarkers Prev 2004;13(8):1392-8.
  9. Sebastian KS, Thampan RV. Differential effects of soybean and fenugreek extracts on the growth of MCF-7 cells. Chem Biol Interact. Nov 20 2007;170(2):135-143.
  10. Fetrow CW, Avila JR. Professional’s Handbook of Complementary and Alternative Medicines. Philadelphia: Springerhouse; 1999.
  11. Kaviarasan S, Sundarapandiyan R, Anuradha CV. Protective action of fenugreek (Trigonella foenum graecum) seed polyphenols against alcohol-induced protein and lipid damage in rat liver. Cell Biol Toxicol. Oct 2008;24(5):391-400.
  12. Petit PR, Sauvaire YD, Hillaire-Buys DM, et al. Steroid saponins from fenugreek seeds: extraction, purification, and pharmacological investigation on feeding behavior and plasma cholesterol. Steroids. 1995;60(10):674-80.
  13. Perla V, Jayanty SS. Biguanide related compounds in traditional antidiabetic functional foods. Food Chem. 2013;138(2-3):1574-80.
  14. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar, and platelet aggregation in patients with coronary artery disease. Prostagl Leukot Ess Fatty Acids 1997;56:379-84.
  15. Broca C, et al. 4-Hydroxyisoleucine: experimental evidence of its insulinotropic and antidiabetic properties. Am J Physiol 1999;277:E617-23.
  16. Raghuram TC, Sharmar RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients. Phytother Res 1994;8:83-6.
  17. Choudhary D, et al. Modulation of glyoxalase, glutathione S-transferase and antioxidant enzymes in the liver, spleen and erythrocytes of mice by dietary administration of fenugreek seeds. Food Chem Toxicol 2001;39:989-97.
  18. Panda S, Tahiliani P, Kar A. Inhibition of triiodothyronine production by fenugreek seed extract in mice and rats. Pharmacol Res 1999;40:405-9.
  19. Raju J, et al. Trigonella foenum graecum (Fenugreek) seed powder improves glucose homeostasis in alloxan diabetic rat tissues by reversing the altered glycolytic, gluconeogenic and lipogenic enzymes. Mol Cell Biochem 2001;224:45-51.
  20. Zia T, Siddiqui IA, Hasnain N. Nematicidal activity of Trigonella foenum-graecum L. Phytother Res 2001;15:538-40.
  21. Korman SH, Cohen E, Preminger A. Pseudo-maple syrup urine disease due to maternal prenatal ingestion of fenugreek. J Paediatr Child Health 2001;37:403-4.
  22. Sewell AC, Mosandl A, Bohles H. False diagnosis of maple syrup urine disease owing to ingestion of herbal tea. N Engl J Med 1999;341:769.
  23. Hasani-Ranjbar S, Nayebi N, Moradi L, et al. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr Pharm Des. 2010;16(26):2935-47.
  24. Li F, Fernandez PP, Rajendran P, Hui KM, Sethi G. Diosgenin, a steroidal saponin, inhibits STAT3 signaling pathway leading to suppression of proliferation and chemosensitization of human hepatocellular carcinoma cells. Cancer Lett. 2010 Jun 28;292(2):197-207.
  25. Bhatia K, Kaur M, Atif F, et al. Aqueous extract of Trigonella foenum-graecum L. ameliorates additive urotoxicity of buthionine sulfoximine and cyclophosphamide in mice. Food Chem Toxicol. 2006 Oct;44(10):1744-50.
  26. Sreeja S, Anju VS, Sreeja S. In vitro estrogenic activities of fenugreek Trigonella foenum graecum seeds. Indian J Med Res. 2010 Jun;131:814-9.
  27. Khalki L, M’hamed SB, Bennis M, Chait A, Sokar Z. Evaluation of the developmental toxicity of the aqueous extract from Trigonella foenum-graecum (L.) in mice. J Ethnopharmacol. 2010 Sep 15;131(2):321-5.
  28. Lambert JP, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy. 2001 Apr;21(4):509-12.
  29. Izzo AA, Di Carlo G, Borrelli F, Ernst E. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol. 2005 Jan;98(1):1-14.
  30. Morani AS, Bodhankar SL, Mohan V, Thakurdesai PA. Ameliorative effects of standardized extract from Trigonella foenum-graecum L. seeds on painful peripheral neuropathy in rats. Asian Pac J Trop Med. 2012 May;5(5):385-90.
  31. Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol. 1997;78(3):297-300.
  32. Al-Jenoobi FI, Ahad A, Mahrous GM, Al-Mohizea AM, AlKharfy KM, Al-Suwayeh SA. Effects of fenugreek, garden cress, and black seed on theophylline pharmacokinetics in beagle dogs. Pharm Biol. 2015 Feb;53(2):296-300.
  33. Emtiazy M, Oveidzadeh L, Habibi M, et al. Investigating the effectiveness of the Trigonella foenum-graecum L. (fenugreek) seeds in mild asthma: a randomized controlled trial. Allergy Asthma Clin Immunol. 2018 May 2;14:19.
  34. Steels E, Steele ML, Harold M, Coulson S. Efficacy of a Proprietary Trigonella foenum-graecum L. De-Husked Seed Extract in Reducing Menopausal Symptoms in Otherwise Healthy Women: A Double-Blind, Randomized, Placebo-Controlled Study. Phytother Res. 2017 Sep;31(9):1316-1322.
  35. Shamshad Begum S, Jayalakshmi HK, Vidyavathi HG, et al. A Novel Extract of Fenugreek Husk (FenuSMART™) Alleviates Postmenopausal Symptoms and Helps to Establish the Hormonal Balance: A Randomized, Double-Blind, Placebo-Controlled Study. Phytother Res. 2016 Nov;30(11):1775-1784.
  36. Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study. J Assoc Physicians India. 2001 Nov;49:1057-61.
  37. Demmers A, Korthout H, van Etten-Jamaludin FS, Kortekaas F, Maaskant JM. Effects of medicinal food plants on impaired glucose tolerance: A systematic review of randomized controlled trials. Diabetes Res Clin Pract. 2017 Sep;131:91-106.
  38. Rampogu S, Parameswaran S, Lemuel MR, Lee KW. Exploring the Therapeutic Ability of Fenugreek against Type 2 Diabetes and Breast Cancer Employing Molecular Docking and Molecular Dynamics Simulations. Evid Based Complement Alternat Med. 2018 Jul 11;2018:1943203.
  39. Guo X, Ding X. Dioscin suppresses the viability of ovarian cancer cells by regulating the VEGFR2 and PI3K/AKT/MAPK signaling pathways. Oncol Lett. 2018 Jun;15(6):9537-9542.
  40. Philips CA, Augustine P. Rare cause of isolated severe coagulation failure in cirrhosis: traditional healing with fenugreek. BMJ Case Rep. 2018 Jan 12;2018. pii: bcr-2017-223479.
  41. Majumdar J, Chakraborty P, Mitra A, Sarkar NK, Sarkar S. Fenugreek, A Potent Hypoglycaemic Herb Can Cause Central Hypothyroidism Via Leptin - A Threat To Diabetes Phytotherapy. Exp Clin Endocrinol Diabetes. 2017 Jul;125(7):441-448.
  42. Swaroop A, Jaipuriar AS, Gupta SK, Bagchi M, Kumar P, Preuss HG, Bagchi D. Efficacy of a Novel Fenugreek Seed Extract (Trigonella foenum-graecum, Furocyst) in Polycystic Ovary Syndrome (PCOS). Int J Med Sci. 2015 Oct 3;12(10):825-31.
  43. Askarpour M, Alami F, Campbell MS, et al. Effect of fenugreek supplementation on blood lipids and body weight: A systematic review and meta-analysis of randomized controlled trials. J Ethnopharmacol. May 10 2020;253:112538.
  44. Samavati R, Ducza E, Hajagos-Tóth J, et al. Herbal laxatives and antiemetics in pregnancy. Reprod Toxicol. Sep 2017;72:153-158.
  45. Ouzir M, El Bairi K, Amzazi S. Toxicological properties of fenugreek (Trigonella foenum graecum). Food Chem Toxicol. Oct 2016;96:145-154.
  46. Aurich S, Spiric J, Engin A, et al. Report of a Case of IgE-Mediated Anaphylaxis to Fenugreek. J Investig Allergol Clin Immunol. Feb 2019;29(1):56-58.
  47. Doolabh K, Finnegan D, Pehlivan N, et al. Oral fenugreek seed consumption and serotonin syndrome. Aust N Z J Psychiatry. Dec 2019;53(12):1225.
  48. Fakhr L, Chehregosha F, Zarezadeh M, Chaboksafar M, Tarighat-Esfanjani A. Effects of fenugreek supplementation on the components of metabolic syndrome: A systematic review and dose-response meta-analysis of randomized clinical trials.  Pharmacol Res. 2023 Jan;187:106594.
  49. Foroumandi E, Javan R, Moayed L, Fahimi H, Kheirabadi F, Neamatshahi M, Shogofteh F, Zarghi A. The effects of fenugreek seed extract supplementation in patients with Alzheimer’s disease: A randomized, double-blind, placebo-controlled trial.  Phytother Res. 2023 Jan;37(1):285-294. 
  50. Rao A, Clayton P, Briskey D. Libifem® (Trigonella foenum-graecum) in conjunction with exercise on muscle strength, power, endurance, and body composition in females aged between 25 and 45 years.  Front Sports Act Living. 2023 Aug 11;5:1207013.
  51. Kim J, Noh W, Kim A, Choi Y, Kim YS. The Effect of Fenugreek in Type 2 Diabetes and Prediabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.  Int J Mol Sci. 2023 Sep 12;24(18):13999.
  52. Simbar M, Nazarpour S, Mojab F, Kholosi Badr F, Khorrami M, Jafari Torkamani Z, Alavi-Majd H. A Comparative Study on the Effects of “Honey and Fenugreek” with “Fenugreek” on the Breastfeeding Success: A Randomized Trial.  Evid Based Complement Alternat Med. 2022 Jun 23;2022:6048280.
  53. Alakhras H, Yelton BR, Beano H. First-Time Submassive Pulmonary Embolism Likely Caused by Testosterone-Enhancing Supplement.  Cureus. 2022 May 18;14(5):e25103. 
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