Bitter Orange in pregnancy and breastfeeding

What NCCIH says about safety

Bitter orange is likely safe when used orally in amounts commonly found in foods. Bitter orange oil is generally well tolerated when used topically or in aromatherapy. Serious concerns have been raised about possible risks of dietary supplements containing bitter orange. Cases of serious medical events, including abnormal heart rhythms, heart attacks, and strokes, have been reported in people who had taken bitter orange products, but most of the products contained multiple ingredients rather than bitter orange alone. Therefore, it is unclear whether bitter orange (or its component p -synephrine) played a role in causing the events. Evidence regarding the effects of bitter orange on the cardiovascular system is inconclusive. Some studies indicate that bitter orange raises blood pressure and heart rate, but others do not. Researchers from the FDA analyzed 59 bitter orange supplements for synephrine and related substances, all of which belong to a group of chemicals called amines. Several products contained higher amounts of amines than would be expected in a bitter orange extract. Of 23 products with labels that stated the amount of synephrine in the product, only 5 contained amounts of synephrine close to that indicated on the label (between 80 and 120 percent of the stated amount). Of particular concern, six products were adulterated with synthetic amines (methylsynephrine or isopropyloctopamine) that are not legal dietary ingredients in the United States and therefore are not permitted in dietary supplements. If you take any type of medicine, talk with your health care provider before using bitter orange or other herbal products; some herbs and medicines interact in harmful ways. It may not be safe to use bitter orange during pregnancy or while breastfeeding, and data from animal experiments suggest that substances in bitter orange might decrease milk production.

Quoted in full from NCCIH so nothing is lost in summarising. Where they say “little is known”, that means the studies do not exist — not that the herb is known to be safe, and not that it is known to be harmful.

How much is actually known

Studies have been done on the effects of bitter orange on weight loss or athletic performance in people, but most of them were small, some were not scientifically rigorous, and many evaluated the effects of products that contain a combination of ingredients, making it difficult to distinguish the effects of bitter orange from those of the other components.

What the research has found

Bitter orange has not been clearly shown to be helpful for any health-related purpose. The effects of bitter orange on body weight are unclear. Studies on this topic involved small numbers of people, usually evaluated combination products rather than bitter orange alone, and had conflicting results. Several small studies have evaluated the effects of bitter orange, with or without caffeine, on athletic performance. The results were inconsistent, but most of the studies did not show a beneficial effect. It is unclear whether applying bitter orange oil to the skin is helpful for fungal infections of the skin (ringworm, athlete’s foot, or jock itch). The one study that tested bitter orange oil for these infections did not compare it to other treatments or a placebo, so the study’s results are difficult to interpret. Bitter orange oil has been used in aromatherapy for various conditions including anxiety and insomnia, but it is unclear whether this is beneficial.

Before you take this

Dose and form change the answer completely. A culinary amount of a spice, a cup of tea, and a concentrated supplement extract are three different things, and most research is done on the last of them.

Supplements are also not regulated like medicines, so strength and purity vary between products. Bring the actual bottle to your midwife, doctor or pharmacist — that conversation is worth more than any page, including this one.