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Terminalia Chebula

Terminalia chebula (Haritaki) is one of the three fruits in Triphala, an important Ayurvedic formula. Considered 'king of medicines' in Tibet. Contains tannins and antioxidants. Traditional uses include digestive issues, oral health, and as a general 'rejuvenative.' NO GRADED OUTCOMES - human research is very limited. Preclinical research shows antimicrobial, antioxidant, and anti-diabetic potential. Primarily available as part of Triphala rather than alone.

Quick Answer

What it is

Terminalia chebula (Haritaki) is one of the three fruits in Triphala, an important Ayurvedic formula. Considered 'king of medicines' in Tibet.

Key findings

  • Grade B: Oral Health
  • Grade C: Inflammation
  • Grade C: Antioxidant Status

Safety

  • No adverse effects associated with chlorhexidine (staining) were observed.
  • chebula extracts and chebulagic acid protect PC12 and SH-SY5Y neuronal cells against H2O2-induced and amyloid-beta-induced toxicity via ROS inhibition and autophagy induction.
ℹ️ Quick Facts: Terminalia Chebula

Quick Facts: Terminalia Chebula

  • Best Evidence:Grade C
  • Conditions Studied:4
  • Research Outcomes:12
  • Grade B Findings:1
  • Key Effect:Aging
Outcomes by grade:
A0
B1
C6
D5
4 conditions · 12 outcomes

Detailed Outcomes

|
B
Oral Health
Three RCTs (total ~208 participants) found T. chebula mouthwash comparable to chlorhexidine for reducing dental plaque, gingival inflammation, and Streptococcus mutans counts, with favorable effects on salivary pH. No adverse effects associated with chlorhexidine (staining) were observed.
moderate↑Improves
C
Inflammation
One RCT in type 2 diabetics (n=60) showed significant reductions in CRP and IL-6 with 500 mg BID for 12 weeks. Extensive preclinical studies demonstrate inhibition of COX-2, 5-LOX, TNF-alpha, IL-1beta, and NF-kappaB pathway, with chebulagic acid identified as a key anti-inflammatory compound.
moderate↓Improves
C
Blood Glucose and Diabetes Markers
One double-blind RCT (n=60 type 2 diabetics) found 500 mg BID T. chebula extract significantly improved endothelial function, reduced CRP and IL-6, and improved lipid profile over 12 weeks. Multiple animal studies confirm anti-diabetic effects including improved insulin sensitivity, decreased HOMA-IR, and increased SIRT1 expression.
moderate↓Improves
C
Pain Threshold
Two small human volunteer studies using mechanical (Randall-Selitto) and hot air pain models found a single 1000 mg oral dose of T. chebula significantly increased pain threshold and pain tolerance compared to placebo (P<0.001 in crossover design, n=12).
small↑Worsens
D
Liver Protection
In rodent models, T. chebula water extract (50-200 mg/kg) significantly attenuated elevations in AST, ALT, and LDH after toxic liver injury, reduced pro-inflammatory cytokines, and improved antioxidant capacity. Chebulinic acid blocked ROS production in hepatocytes. Also protective against anti-tuberculosis drug-induced hepatotoxicity in animals.
moderate↑Improves
D
Antimicrobial Activity
In vitro studies demonstrate broad-spectrum antibacterial activity against S. aureus, S. typhi, P. aeruginosa, Klebsiella, and B. subtilis (MIC 94-556 ug/mL). Shows synergistic effects with tetracycline against GI pathogens. Also exhibits antiviral activity against HSV-1 and HSV-2, with chebulagic acid and chebulinic acid inhibiting viral attachment more effectively than acyclovir in vitro.
moderate↑Improves
D
Wound Healing
In rat models, T. chebula-treated wounds showed faster healing, improved contraction rates, increased collagen and protein content, and ~40% greater tensile strength. In burn wound models, T. chebula extract outperformed silver sulfadiazine 1% cream with complete granulation tissue formation by day 14.
moderate↑Improves
D
Neuroprotection
In vitro studies show T. chebula extracts and chebulagic acid protect PC12 and SH-SY5Y neuronal cells against H2O2-induced and amyloid-beta-induced toxicity via ROS inhibition and autophagy induction. Also inhibited LPS-induced microglia activation. A combination product (T. chebula + Boswellia) improved memory in one RCT, but effects cannot be attributed to T. chebula alone.
small↑Improves
C
Antioxidant Status
Extensive in vitro and animal studies demonstrate strong DPPH radical scavenging, ferric-reducing antioxidant activity, superoxide dismutase stimulation, and improved glutathione levels. Key polyphenols include gallic acid, ellagic acid, chebulagic acid, and chebulinic acid. Human RCTs report improvements in oxidative stress biomarkers.
moderate↑Improves
C
Joint Pain and Mobility
A double-blind, placebo-controlled RCT (n=105 overweight adults) found standardized T. chebula extract (AyuFlex, 250-500 mg BID for 84 days) significantly improved knee joint comfort, 6-minute walk distance, and overall joint function scores compared to placebo.
moderate↑Improves
C
Skin Aging
A double-blind, placebo-controlled RCT in healthy females found 250 mg T. chebula extract (Synastol TC) twice daily for 8 weeks significantly reduced facial wrinkles by 4.3%, decreased forehead sebum excretion by 33% in high-sebum subjects, and reduced cheek erythema compared to placebo.
small↓Improves
D
Cardiovascular Health
In animal models, ethanolic extract (500 mg/kg) ameliorated isoproterenol-induced myocardial damage. Studies in cholesterol-fed rabbits showed anti-atherogenic activity with liver cholesterol decreased by 50% and heart cholesterol by 60%. One RCT protocol for coronary artery disease adjunct therapy is registered but results not yet available.
small↑Improves

Research Citations (21)

Comprehensive review on fruit of Terminalia chebula: traditional uses, phytochemistry, pharmacology, toxicity, and pharmacokinetics
(2024)
PMID: 39683707
Randomized, double-blind, placebo-controlled trial of oral Terminalia chebula extract on skin health parameters
(2023)
PMID: 36836126
A comprehensive review on the diverse pharmacological perspectives of Terminalia chebula Retz
(2022)
PMID: 36051270
Effect of aqueous extract of Terminalia chebula on endothelial dysfunction, systemic inflammation, and lipid profile in type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled clinical study
(2020)
PMID: 32618037
Anticancer activity of Terminalia chebula against lung and breast carcinoma cell lines
(2020)
PMID: 33043490
Effects of a standardized aqueous extract of Terminalia chebula (AyuFlex) on joint comfort, functional mobility, and related biomarkers: a randomized, double-blind, placebo-controlled study
(2017)
PMID: 28969626
Anti-HSV-2 activity of Terminalia chebula fruit extract and its constituents chebulagic acid and chebulinic acid
(2017)
PMID: 28196487
Analgesic activity of standardized aqueous extract of Terminalia chebula in healthy human participants using mechanical pain model
(2016)
PMID: 27625480
Evaluation of the anti-plaque efficacy of a herbal-based toothpaste: a double-blind, randomized controlled clinical trial with Terminalia chebula mouthwash
(2015)
PMID: 25386630
Analgesic activity of standardized aqueous extract of Terminalia chebula in healthy human participants using hot air pain model
(2015)
PMID: 26155489

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