Bitter orange

Bitter orange (synephrine) is structurally similar to ephedrine but less potent. Marketed as a 'safe' ephedra alternative for fat loss after ephedra was banned. D-GRADE for all graded outcomes including alertness, anxiety, headaches, and blood glucose (all showing no effect). May modestly increase metabolic rate but lacks compelling fat loss evidence. SAFETY CONCERNS: Case reports of cardiovascular events (stroke, MI) particularly when combined with caffeine. FDA has expressed concerns. Less dangerous than ephedrine but not risk-free.

Quick Answer

What it is

Bitter orange (synephrine) is structurally similar to ephedrine but less potent. Marketed as a 'safe' ephedra alternative for fat loss after ephedra was banned.

Key findings

  • Grade D: Blood glucose (Weight Loss & Maintenance)
  • Grade D: Alertness
  • Grade D: Anxiety Symptoms

Safety

  • Less dangerous than ephedrine but not risk-free.
ℹ️ Quick Facts: Bitter orange

Quick Facts: Bitter orange

  • Best Evidence:Grade D
  • Conditions Studied:7
  • Research Outcomes:20
  • Key Effect:Metabolic Health
Outcomes by grade:
A0
B0
C0
D6
7 conditions · 20 outcomes

Detailed Outcomes

Grade:
Effect:
Sort:
|
D
Blood glucose
No effect
3 studies
none
?
Weight
Worsens
?
Blood Pressure
Worsens
?
Metabolic Rate
1 study
Improves
D
Alertness
No effect
1 study
none
D
Anxiety Symptoms
No effect
1 study
none
D
Alertness
No effect
1 study
none
D
Headaches
No effect
1 study
none
?
Insomnia Signs and Symptoms
1 study
Worsens
?
Sprint Performance Metrics
Improves
D
Alertness
No effect
1 study
none
?
Anxiety Symptoms
1 study
Worsens
?
Appetite
Worsens
?
Headaches
1 study
Worsens
?
Heart Rate
1 study
Worsens
?
Metabolic Rate
1 study
Improves
?
Sedation
1 study
Improves
?
Carbohydrate Oxidation
Improves
?
Carbohydrate Oxidation
Improves
?
Carbohydrate Oxidation
Improves

Research Citations (19)

Effects of p-synephrine alone and in combination with selected bioflavonoids on resting metabolism, blood pressure, heart rate and self-reported mood changes
PMID: 21537493
Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adults.
PMID: 11583473
Safety evaluation of p-synephrine following 15 days of oral administration to healthy subjects: A clinical study.
PMID: 29130542
Blood pressure and heart rate effects following a single dose of bitter orange
PMID: 16317106
Absence of QTc-interval-prolonging or hemodynamic effects of a single dose of bitter-orange extract in healthy subjects
PMID: 16305290
Acute cardiovascular effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine in human subjects: A placebo-controlled, double-blind study.
PMID: 29047215
Cardiovascular Safety of Oral p-Synephrine (Bitter Orange) in Healthy Subjects: A Randomized Placebo-Controlled Cross-over Clinical Trial.
PMID: 26948284
The Safety and Efficacy of (Bitter Orange) Extracts and -Synephrine: A Systematic Review and Meta-Analysis.
PMID: 36235672
A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract.
PMID: 23354394
Acute hematological and mood perception effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine: A placebo-controlled, double-blind study.
PMID: 29672965

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