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When taken in usual dietary amounts, fenugreek is likely to be safe; however, the safety of larger doses has not been scientifically evaluated.

PRACTICE POINTS/PATIENT COUNSELLING

• Fenugreek's seeds and leaves are used not only as food but also as an ingredient in traditional medicine systems.

• Clinical studies have identified significant hypoglycaemic and lipid-lowering activity;

however, dosage forms and treatment regimens varied. Fenugreek 412

• In animal studies fenugreek has been shown to exert Immunostlmulant, anti-Inflammatory and antinociceptive activity, stimulate digestive enzyme production and provide significant antiulcerogenic effects.

• In practice it is used to manage blood sugar levels in patients with diabetes, to lower cholesterol levels, to provide symptom relief in dyspepsia and to promote lactation.

• Externally it is made into a poultice with hot water and used as an antiinflammatory application.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this herb do for me?

Fenugreek can lower blood sugar levels in patients with diabetes, reduce cholesterol levels and stimulate digestion. It may also protect the gastrointestinal tract from ulcers, stimulate immune function and provide anti-inflammatory and antipyretic effects. Traditionally, it has also been used to promote lactation. When will it start to work?

Studies suggest that blood sugar effects can be seen within 10 days in type 1 diabetes, whereas lipid-lowering effects can take up to 3 months to establish. Traditionally, digestive effects are thought to occur soon after ingestion of the seeds. Are there any safety issues?

Used as a food, fenugreek appears extremely safe but may interact with blood-thinning medicines. When used in high doses as a medicine, it may cause flatulence, diarrhoea and mild stomach discomfort. Allergies to fenugreek are possible. When used with diabetic medicine, it may increase sugar-lowering activity and safety should be monitored.

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