C. aurantium is still used in traditional culinary ways as described previously. It has also been investigated for a number of other medicinal uses in addition to gastrointestinal disturbances. As a dermatological agent, it has been used as an antifungal and exhibits some evidence of fungicidal and fungistatic activity (6). Other uses cited are as a stimulant, a sedative, and for the treatment of anemia, frostbite, general feebleness, retinal hemorrhage, bloody stools, duodenal ulcers, and prolapsed uterus or anus, among other things (7).
Recently, the most predominant use of C. aurantium has been as a weight loss aid or as an energy-boosting supplement. After the ban of phenylpropanolamine owing to increased risk of hemorrhagic stroke (8), ephedra use in supplements increased substantially. In April of 2004, the Food and Drug Administration (FDA) banned the sale of ephedra (9) because of the dangers of this alkaloid (10-12). Since then, alternatives to this popular supplement have been sought and bitter orange has emerged as the mostly predominantly used substitute (13). Although C. aurantium has been reviewed for this use (14,15), lack of studies make this difficult—as evidenced by a 2004 Cochrane Collaboration Database that identified only one eligible randomized placebo controlled trial (16). Despite this relative lack of data, since the banning of ephedra, C. aurantium has been used extensively in a variety of products — from weight loss pills to two patents for weight-loss toothpaste (17).
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