STEVIA: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Stevia (Stevia rebaudiana) is a bushy shrub native to northeast Paraguay, Brazil, and Argentina. It's best known as a natural sweetener.

Stevia contains chemicals that are 200-300 times sweeter than sucrose sugar.

People take stevia for obesity, high blood pressure, diabetes, and many other conditions, but there is no good scientific evidence to support these uses.

In the US, stevia leaves and extracts are available as supplements, but are not approved for use as sweeteners. Rebaudioside A (also called rebiana), one of the chemicals in stevia, is approved as a food sweetener.

Uses & Effectiveness ?

We currently have no information for STEVIA overview.

Side Effects

When taken by mouth: Certain chemicals in stevia, including stevioside and rebaudioside A, are likely safe when used as a food sweetener. Side effects might include bloating, nausea, dizziness, and numbness.

There isn't enough reliable information to know if whole stevia or stevia extracts are safe or what the side effects might be.

Special Precautions and Warnings

Pregnancy and breast-feeding: There isn't enough reliable information to know if it is safe to take stevia when pregnant or breast-feeding. Stay on the safe side and avoid use.

Allergy to ragweed and related plants: Stevia is in the Asteraceae/Compositae plant family. This family includes ragweed, chrysanthemums, marigolds, daisies, and many other plants. In theory, people who are sensitive to ragweed and related plants may also be sensitive to stevia.

Interactions ?

Moderate Interaction

Be cautious with this combination

Lithium interacts with STEVIA
Stevia might have an effect like a water pill or "diuretic." Taking stevia might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.

Minor Interaction

Be watchful with this combination

Medications for diabetes (Antidiabetes drugs) interacts with STEVIA
Stevia might lower blood sugar levels. Taking stevia along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Medications for high blood pressure (Antihypertensive drugs) interacts with STEVIA
Stevia might lower blood pressure. Taking stevia along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Dosing

Certain chemicals in stevia are commonly used as natural food sweeteners.

As medicine, there isn't enough reliable information to know what an appropriate dose of stevia might be. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult a healthcare professional before using.

View References

REFERENCES:

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Gardana, C., Simonetti, P., Canzi, E., Zanchi, R., and Pietta, P. Metabolism of stevioside and rebaudioside A from Stevia rebaudiana extracts by human microflora. J.Agric.Food Chem. 10-22-2003;51(22):6618-6622. View abstract.

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Jeppesen, P. B., Gregersen, S., Alstrup, K. K., and Hermansen, K. Stevioside induces antihyperglycaemic, insulinotropic and glucagonostatic effects in vivo: studies in the diabetic Goto-Kakizaki (GK) rats. Phytomedicine 2002;9(1):9-14. View abstract.

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Abdel-Aal RA, Abdel-Rahman MS, Al Bayoumi S, Ali LA. Effect of stevia aqueous extract on the antidiabetic activity of saxagliptin in diabetic rats. J Ethnopharmacol 2021;265:113188. View abstract.

Ajami M, Seyfi M, Abdollah Pouri Hosseini F, et al. Effects of stevia on glycemic and lipid profile of type 2 diabetic patients: A randomized controlled trial. Avicenna J Phytomed. 2020;10(2):118-127. View abstract.

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Brusick DJ. A critical review of the genetic toxicity of steviol and steviol glycosides. Food Chem Toxicol 2008;46 Suppl 7:S83-91. View abstract.

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Chan P, Tomlinson B, Chen YJ, et al. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol 2000;50:215-20. View abstract.

Chan P, Xu DY, Liu JC, et al. The effect of stevioside on blood pressure and plasma catecholamines in spontaneously hypertensive rats. Life Sci 1998;63:1679-84. View abstract.

Curi R, Alvarez M, Bazotte RB, et al. Effect of Stevia rebaudiana on glucose tolerance in normal adult humans. Braz J Med Biol Res 1986;19:771-4. View abstract.

EFSA Panel on Food Additives and Flavourings (FAF), Younes M, Aquilina G, et al. Safety of a proposed amendment of the specifications for steviol glycosides (E 960) as a food additive: to expand the list of steviol glycosides to all those identified in the leaves of Stevia Rebaudiana Bertoni. EFSA J 2020;18(4):e06106. View abstract.

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Hsieh MH, Chan P, Sue YM, et al. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clin Ther 2003;25:2797-808. View abstract.

Hubler MO, Bracht A, Kelmer-Bracht AM. Influence of stevioside on hepatic glycogen levels in fasted rats. Res Commun Chem Pathol Pharmacol 1994;84:111-8. View abstract.

Jeppesen PB, Gregersen S, Poulsen CR, Hermansen K. Stevioside acts directly on pancreatic beta cells to secrete insulin: actions independent of cyclic adenosine monophosphate and adenosine triphosphate-sensitive K+-channel activity. Metabolism 2000;49:208-14. View abstract.

Lailerd N, Saengsirisuwan V, Sloniger JA, et al. Effects of stevioside on glucose transport activity in insulin-sensitive and insulin-resistant rat skeletal muscle. Metabolism 2004;53:101-7. View abstract.

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Maki KC, Curry LL, Carakostas MC, et al. The hemodynamic effects of rebaudioside A in healthy adults with normal and low-normal blood pressure. Food Chem Toxicol 2008;46 Suppl 7:S40-6. View abstract.

Matsui M, Matsui K, Kawasaki Y, et al. Evaluation of the genotoxicity of stevioside and steviol using six in vitro and one in vivo mutagenicity assays. Mutagenesis 1996;11:573-9. View abstract.

Melis MS, Sainati AR. Effect of calcium and verapamil on renal function of rats during treatment with stevioside. J Ethnopharmacol 1991;33:257-622. View abstract.

Melis MS. Effects of chronic administration of Stevia rebaudiana on fertility in rats. J Ethnopharmacol 1999;67:157-61. View abstract.

Melis MS. A crude extract of Stevia rebaudiana increases the renal plasma flow of normal and hypertensive rats. Braz J Med Biol Res 1996;29:669-75. View abstract.

Melis MS. Chronic administration of aqueous extract of Stevia rebaudiana in rats: renal effects. J Ethnopharmacol 1995;47:129-34. View abstract.

Pezzuto JM, Compadre CM, Swanson SM, et al. Metabolically activated steviol, the aglycone of stevioside, is mutagenic. Proc Natl Acad Sci USA 1985;82:2478-82. View abstract.

Prakash I, Dubois GE, Clos JF, et al. Development of rebiana, a natural, non-caloric sweetener. Food Chem Toxicol 2008;46 Suppl 7:S75-82. View abstract.

Sambra V, Vicuña IA, Priken KM, et al. Acute responses of stevia and d-tagatose intake on metabolic parameters and appetite/satiety in insulin resistance. Clin Nutr ESPEN 2022;49:217-224. View abstract.

Simoens C, Philippaert K, Wuyts C, et al. Pharmacokinetics of Oral Rebaudioside A in Patients with Type 2 Diabetes Mellitus and Its Effects on Glucose Homeostasis: A Placebo-Controlled Crossover Trial. Eur J Drug Metab Pharmacokinet 2022;47(6):827-839. View abstract.

Stamataki NS, Crooks B, Ahmed A, McLaughlin JT. Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults. Nutrients 2020;12(10):3049. View abstract.

Stamataki NS, Scott C, Elliott R, McKie S, Bosscher D, McLaughlin JT. Stevia Beverage Consumption prior to Lunch Reduces Appetite and Total Energy Intake without Affecting Glycemia or Attentional Bias to Food Cues: A Double-Blind Randomized Controlled Trial in Healthy Adults. J Nutr. 2020;150(5):1126-1134. View abstract.

Tomita T, Sato N, Arai T, et al. Bactericidal activity of a fermented hot-water extract from Stevia rebaudiana Bertoni towards enterohemorrhagic Escherichia coli O157:H7 and other food-borne pathogenic bacteria. Microbiol Immunol 1997;41:1005-9. View abstract.

Toskulkao C, Sutheerawatananon M, Wanichanon C, et al. Effects of stevioside and steviol on intestinal glucose absorption in hamsters. J Nutr Sci Vitaminol (Tokyo) 1995;41:105-13. View abstract.

US Food and Drug Administration. Import Alert 45-06: Detention without Physical Examination of Stevia Leaves, Crude Extracts of Stevia Leaves and foods Containing Stevia Leaves and/or Stevia Extracts. October 4, 2021. Available at: https://www.accessdata.fda.gov/cms_ia/importalert_119.html. Accessed on: May 6, 2022.

Wasuntarawat C, Temcharoen P, Toskulkao C, et al. Developmental toxicity of steviol, a metabolite of stevioside, in the hamster. Drug Chem Toxicol 1998;21:207-22. View abstract.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

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STEVIA - Uses, Side Effects, and More

Overview

Uses & Effectiveness ?

Side Effects

Special Precautions and Warnings

Interactions ?

Moderate Interaction

Lithium interacts with STEVIA

Minor Interaction

Medications for diabetes (Antidiabetes drugs) interacts with STEVIA

Medications for high blood pressure (Antihypertensive drugs) interacts with STEVIA

Dosing

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