# Aloe Vera

> Aloe Vera (Aloe barbadensis Mill. (syn. Aloe vera (L.) Burm.f.)) is a plant used in Ayurveda. WHO Monograph exists in WHO Monographs on Selected Medicinal Plants, Volume 1 (Aloe Vera|Aloe Vera Gel).

## Key facts

- **Botanical name:** Aloe barbadensis Mill. (syn. Aloe vera (L.) Burm.f.)
- **Pharmacopoeia status:** WHO Monograph exists in WHO Monographs on Selected Medicinal Plants, Volume 1 (Aloe Vera|Aloe Vera Gel). European Medicines Agency (EMA) has published assessment reports and herbal monographs on Aloe barbadensis Mill. addressing both gel and latex preparations. Listed in multiple national pharmacopoeias including USP, BP, and Indian Pharmacopoeia.

## Names and identification

| Language | Name |
|----------|------|
| English | [aloe vera](/herb/aloe-vera/) |
| Latin/Botanical | *Aloe barbadensis Mill. (syn. [Aloe vera](/herb/aloe-vera/) (L.) Burm.f.)* |

## How does it work?

- [Acemannan](/glossary/compounds-1-a/#acemannan) (primary bioactive polysaccharide) activates innate immune cells (macrophages, dendritic cells) producing IL-1, IL-6, IL-12, TNF-alpha, colony-stimulating factors, and stem cell factors.
- Acemannan induces IL-12 release, triggering natural killer cell activation and T cell proliferation/activation (adaptive immune response).
- Breakage of acemannan chains into smaller fragments enhances biological effects; fragments boost vaccine efficacy via mannose receptor agonism of macrophages/dendritic cells.
- Wound healing: activated macrophage cytokines (IL-1, IL-6, TNF-alpha) promote robust fibroblast proliferation and collagen synthesis.
- Acemannan/chitosan combinations accelerate wound closure by promoting granular tissue formation.
- Aloe-[emodin](/glossary/compounds-d-g/#emodin) and other [anthraquinones](/glossary/compounds-1-a/#anthraquinones) exhibit antiproliferative and proapoptotic effects on cancer cell lines.
- [Barbaloin](/glossary/compounds-a-c/#barbaloin) acts as a stimulant [laxative](/reference/laxative/) by increasing colonic motility and water/electrolyte secretion.

## What do recent clinical trials show?

- Sadoyu S, Rungruang C, Wattanavijitkul T and others 2021. [Aloe vera and health outcomes: An umbrella review of systematic reviews and meta-analyses](https://pubmed.ncbi.nlm.nih.gov/32924222/). *Phytotherapy research : PTR*. PMID [32924222](https://pubmed.ncbi.nlm.nih.gov/32924222/) · [doi:10.1002/ptr.6833](https://doi.org/10.1002/ptr.6833)  
  Of 71 unique outcomes reviewed, 47 (67%) were nominally statistically significant, but only 3 outcomes supported by highly suggestive evidence (prevention of second-degree infusion phlebitis, chemotherapy-induced mucositis), while 42 outcomes had weak evidence.
- Catalano A, Ceramella J, Iacopetta D and others 2024. [Aloe vera-An Extensive Review Focused on Recent Studies](https://pubmed.ncbi.nlm.nih.gov/38998660/). *Foods (Basel, Switzerland)*. PMID [38998660](https://pubmed.ncbi.nlm.nih.gov/38998660/) · [doi:10.3390/foods13132155](https://doi.org/10.3390/foods13132155)  
  Updated review documenting broad spectrum of pharmacological activities with focus on recent clinical and preclinical evidence for therapeutic applications.

*4 further claims previously listed here could not be traced to a published paper and have been removed. An absence here means we could not identify the source, not that no work exists.*

## Recent safety updates

- 48 known moderate drug interactions documented (Drugs.com interaction checker).
- Hepatotoxicity concern: 22 reported cases of liver injury attributed to Aloe vera preparations (17 women, 5 men, mean age 50). Hepatocellular injury most common manifestation (86.3%). Latency 3-24 weeks.
- [Alkaloids](/glossary/compounds-1-a/#alkaloids) in aloe vera enhance hepatic [enzymes](/glossary/compounds-d-g/#enzymes) and alcohol dehydrogenase activity, potentially interfering with detoxification mechanisms.
- Oral ingestion associated with diarrhea, hypokalemia, pseudomelanosis coli, and kidney failure.
- Topical use may cause phototoxicity and hypersensitive reactions in susceptible individuals.
- Anthraquinone-containing latex (aloin) is a potent laxative; chronic use may cause electrolyte imbalance and dependency.
- Herbal/dietary supplements implicated in 19% of drug-induced acute liver failure cases; Aloe vera is among recognized causes.
- Avoid during pregnancy (potential uterine stimulant effects) and breastfeeding.

## Dosage forms and preparation

**Dosage Forms:** Swarasa (fresh gel juice), Kumari Asava (fermented preparation), Capsule (freeze-dried gel), Tablet, Topical gel, [Ghrita](/herb/ghrita/) (medicated ghee), Churna (dried powder)

**Standard Dosage:** 15-30ml fresh juice twice daily; 15-30ml [Kumaryasava](/formulation/kumaryasava/) after meals; 300-500mg dried extract capsule; topical gel application as needed

**Bioavailability:** Acemannan (primary polysaccharide) has limited oral bioavailability but significant [immunomodulatory](/reference/immunomodulatory/) action in the gut (Peyer's patches). Anthraquinone [glycosides](/glossary/compounds-g-l/#glycosides) (aloin A/B) have good oral absorption and undergo colonic bacterial metabolism to active aglycones. Aloe-emodin reaches peak plasma levels in 6-8 hours. Fresh gel matrix enhances absorption of co-administered nutrients. Decolorized inner fillet gel has better tolerability profile.

**Optimal Timing:** Fresh juice early morning on empty stomach for detox/digestive health. Kumaryasava after meals. Topical gel as needed. Avoid during pregnancy (uterine stimulant effect of anthraquinones).

**Standardized Extract:** Inner fillet gel: standardized to minimum 10% acemannan (dry weight), aloin < 10ppm. Whole leaf extract: standardized to 20% aloin (laxative grade). 200:1 freeze-dried gel concentrate.

**Shelf Life:** 2 days (fresh gel, refrigerated); 2 years (freeze-dried powder); 3 years (capsules/tablets); 5 years (Kumaryasava); 1 year (preserved liquid gel)

**Storage:** Fresh gel: refrigerated 2-8°C, use within 48 hours. Dried extracts: cool, dry place below 25°C, airtight containers. Liquid products: avoid direct sunlight, store below 25°C. Kumaryasava: room temperature in amber glass.

**Marker Compounds:** Acemannan, Aloin A (barbaloin), Aloin B (isobarbaloin), Aloe-emodin, [Aloesin](/glossary/compounds-1-a/#aloesin), Beta-[sitosterol](/glossary/compounds-q-t/#sitosterol), Glucomannans

### Extraction Methods

- Cold stabilization of fresh inner fillet gel (no heating above 40°C)
- Freeze-drying for powder (200:1 concentration ratio)
- Spray-drying with maltodextrin carrier
- Charcoal filtration for decolorized (low-anthraquinone) gel
- Ethanol precipitation for acemannan isolation

### Synergistic Combinations

- With [Haridra](/herb/haridra/) ([turmeric](/herb/turmeric/)) for wound healing and anti-inflammatory action
- With Kumari + [Guduchi](/herb/guduchi/) in Kumaryasava for liver and uterine health
- With [Shatavari](/herb/shatavari/) for female reproductive health
- With Ghrita (ghee) for Pitta pacification and internal lubrication
- With Amalaki for digestive tract healing

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Canonical version of this page: https://nighantu.ageayurveda.com/herb/aloe-vera/

## Sources

- Amidha Ayurveda Herb Database (700+ herbs, CC-BY-4.0)
- Web research (clinical trials, WHO monographs, safety databases)
- Ayurvedic Pharmacopoeia of India

Published by Age Ayurveda in the Nighantu. Educational reference only, not medical advice.
Incorporates material from the Amidha Ayurveda Herb Database under CC BY 4.0.