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Updated 18 February 2013

Bitter almond

The almond is closely related to the peach, apricot, and cherry (all classified as drupes). The most commonly used portion of the almond is the nut. A compound called amygdalin differentiates the bitter almond from the sweet almond. In the presence of water (hydrolysis), amygdalin yields glucose and the chemicals benzaldehyde and hydrocyanic acid (HCN). HCN, the salts of which are known as cyanide, is poisonous. To be used in food or as a flavoring agent, the HCN must be removed from the bitter almond oil. Once it is removed, the oil is called volatile almond oil and is considered to be almost pure benzaldehyde. Volatile almond oil can still be toxic in large amounts.

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RELATED TERMS

Aci badem, almendra amara, amande amere, amendoa amarga, amygdala amara, Amygdalis dulcis amara, bitter almond oil, bittere amandel, bittermandel, gorkiy mindal, karvasmanteli, keseru mandula, ku wei bian tao, ku xing ren, lawz murr, mandorla amara, Prunus amygalus amara, Prunus communis amara, Prunus dulcis (Mill.) D.A. Webb var. amara (DC.) H.E. Moore, Rosaceae (family), volatile almond oil.

Note: Bitter almond should not be confused with "sweet almond." Sweet almond seeds do not contain amygdalin and can be eaten, whereas bitter almonds can be toxic.

BACKGROUND

The almond is closely related to the peach, apricot, and cherry (all classified as drupes). The most commonly used portion of the almond is the nut. A compound called amygdalin differentiates the bitter almond from the sweet almond. In the presence of water (hydrolysis), amygdalin yields glucose and the chemicals benzaldehyde and hydrocyanic acid (HCN). HCN, the salts of which are known as cyanide, is poisonous. To be used in food or as a flavoring agent, the HCN must be removed from the bitter almond oil. Once it is removed, the oil is called volatile almond oil and is considered to be almost pure benzaldehyde. Volatile almond oil can still be toxic in large amounts.

EVIDENCE TABLE

Conditions

Uses
disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*

Cancer (Laetrile)

"Laetrile" is an alternative cancer drug marketed in Mexico and other countries outside of the United States. Laetrile is derived from amygdalin, found in the pits of fruits and nuts such as the bitter almond. Early evidence suggests that laetrile is not beneficial in the treatment of cancer. In 1982, the U.S. National Cancer Institute concluded that laetrile was not effective for cancer therapy. Nonetheless, many people still travel to use this therapy outside the United States. Multiple cases of cyanide poisoning, including deaths, have been associated with laetrile therapy.

D

*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Antibacterial, anti-inflammatory, anti-itch, antispasmodic, cough suppressant, expectorant, hyperoxia (lack of oxygen), local anesthetic, mental health (neuropsychometric symptoms in AIDS patients), muscle relaxant, pain suppressant, psoriasis, sedative.

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

Due to potential toxicity, there is no widely accepted standard dose for bitter almond.

Children (younger than 18 years)

Due to potential toxicity, bitter almond products should be avoided in children.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Allergies to almonds are common and have lead to severe reactions, including throat swelling that interferes with breathing. If allergic to other nuts, it is probably best to avoid almonds.

Side Effects and Warnings

Laetrile, derived from the amygdalin found in the pits of fruits and nuts such as the bitter almond, is considered unsafe in any form due to its potential for causing cyanide toxicity. Reactions are more severe when laetrile is taken by mouth than when injected into a vein or muscle. Some of the side effects have included dilated pupils, dizziness, drooping eyelids, drowsiness, headache, increased breathing, muscle weakness, nausea, stomach pain, and vomiting. High doses of bitter almond or laetrile may lead to a slowing of brain functions or breathing. Several cases of cyanide poisoning (some fatal) have been reported.

Drowsiness or sedation may occur with bitter almond. Use cautiously if driving or operating heavy machinery.

Pregnancy and Breastfeeding

Bitter almonds are not recommended in pregnant or breastfeeding women due to insufficient available data and potential risk for birth defects.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

In theory, bitter almond may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan©) or diazepam (Valium©), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery. Avoid the use of alcohol as almond oil was shown in mice to cause a toxic reaction (nausea, vomiting, increased breathing, sweating) when taken with alcohol.

Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.

Interactions with Herbs and Dietary Supplements

Bitter almond may increase the amount of drowsiness caused by some herbs or supplements. Caution is advised while driving or operating machinery.

Amygdalin, bitter almond, and laetrile may also interact with analgesics (pain-relievers), central nervous system (CNS) depressants, agents that suppress or stimulate the immune system, and agents that are excreted through the kidneys. However, human evidence is lacking.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

  • Araya E, Rodriguez A, Rubio J, et al. Synthesis and evaluation of diverse analogs of amygdalin as potential peptidomimetics of peptide T. Bioorg Med Chem Lett 2005 Mar 1;15(5):1493-6. View abstract
  • Beamer WC, Shealy RM, Prough DS. Acute cyanide poisoning from laetrile ingestion. Ann Emerg Med 1983;12(7):449-451. View abstract
  • Chan TY. A probable case of amygdalin-induced peripheral neuropathy in a vegetarian with vitamin B12 deficiency. Ther Drug Monit 2006;28(1):140-141. View abstract
  • Chang LW, Zhu HP, Li WB, et al. [Protective effects of amygdalin on hyperoxia-exposed type II alveolar epithelial cells isolated from premature rat lungs in vitro]. Zhonghua Er Ke Za Zhi 2005 Feb;43(2):118-23. View abstract
  • Gill JR, Marker E, Stajic M. Suicide by cyanide: 17 deaths. Journal of Forensic Sciences. 2004 Jul;49(4):826-8. View abstract
  • Hamada A, Yoshioka S, Takuma D, et al. The effect of Eriobotrya japonica seed extract on oxidative stress in adriamycin-induced nephropathy in rats. Biol Pharm Bull 2004 Dec;27(12):1961-4. View abstract
  • Liegner KB, Beck EM, Rosenberg A. Laetrile-induced agranulocytosis. JAMA 1981 Dec 18;246(24):2841-2842. View abstract
  • Milazzo S, Ernst E, Lejeune S, et al. Laetrile treatment for cancer. Cochrane Database Syst Rev 2006;(2):CD005476. View abstract
  • Moertel CG, Fleming TR, Rubin J, et al. A clinical trial of amygdalin (Laetrile) in the treatment of human cancer. N.Engl.J.Med. 1982 Jan 28;306(4):201-206. View abstract
  • Moss RW. Patient perspectives: Tijuana cancer clinics in the post-NAFTA era. Integr Cancer Ther 2005 Mar;4(1):65-86. View abstract
  • Shragg TA, Albertson TE, Fisher CJ, Jr. Cyanide poisoning after bitter almond ingestion. West J Med 1982;136(1):65-69. View abstract
  • Vickers A. Alternative cancer cures: "unproven" or "disproven"? CA Cancer J Clin 2004 Mar-Apr;54(2):110-8. View abstract
  • Vickers AJ, Kuo J, Cassileth BR. Unconventional anticancer agents: a systematic review of clinical trials. J Clin Oncol 1-1-2006;24(1):136-140. View abstract
  • Willhite CC. Congenital malformations induced by laetrile. Science 1982 March 19;215(4539):1513-1515. View abstract
  • Zhu H, Chang L, Li W, et al. Effect of amygdalin on the proliferation of hyperoxia-exposed type II alveolar epithelial cells isolated from premature rat. J Huazhong Univ Sci Technolog Med Sci. 2004;24(3):223-5. View abstract
disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)
 
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