Is Bitter Orange compatible with breastfeeding? Do we have alternatives for Bitter Orange?

Bitter Orange

July 16, 2017 (Very Low Risk)

Fruit, flowers, leaves and seeds of the tree are used.
It contains essential oil (limonene), flavonoids (naringin), citric acid and various sympathomimetic agents (synephrine, tyramine and methyl octopamine) that behave as adrenergic agonists. They are similar to the pseudoefedrina (see specific info) which can decrease milk production.
Attributed properties without clinical evidence are: orexigenic (appetite stimulant), digestive, sedative and to lose weight.

Since some products are sold with slimming purposes due to its content of synephrine, moderate use is recommended overall and during lactation because they have caused serious adverse cardiovascular effects. Avoid consumption of products that provide more than 30 mg of synephrine as well as mixtures with caffeine (like some for colds) and other medications that would contain derivatives of pseudoephedrine.

Ascorbic acid contained in citrus products passes through breast milk and would increase the levels of ascorbic acid in breast milk, especially in women deficient in ascorbic acid.


See below the information of this related product:

Alternatives

We do not have alternatives for Bitter Orange since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Bigarade orange
  • Orange Blossom
  • Seville orange

Writings

  • Citrus aurantium (Latin, botanical name)
  • Апельсин (Cyrillic)

References

  1. Shara M, Stohs SJ, Mukattash TL. Cardiovascular Safety of Oral p-Synephrine (Bitter Orange) in Healthy Subjects: A Randomized Placebo-Controlled Cross-over Clinical Trial. Phytother Res. 2016Abstract
  2. Smith TB, Staub BA, Natarajan GM, Lasorda DM, Poornima IG. Acute myocardial infarction associated with dietary supplements containing 1,3-dimethylamylamine and Citrus aurantium. Tex Heart Inst J. 2014Abstract
  3. Stohs SJ, Preuss HG, Shara M. The safety of Citrus aurantium (bitter orange) and its primary protoalkaloid p-synephrine. Phytother Res. 2011Abstract
  4. Health Canada Guidelines for the use of Synephrine in Natural Health products 2010 Full text (in our servers)
  5. Thomas JE, Munir JA, McIntyre PZ, Ferguson MA. STEMI in a 24-year-old man after use of a synephrine-containing dietary supplement: a case report and review of the literature. Tex Heart Inst J. 2009Abstract
  6. Gange CA, Madias C, Felix-Getzik EM, Weintraub AR, Estes NA 3rd. Variant angina associated with bitter orange in a dietary supplement. Mayo Clin Proc. 2006Abstract
  7. Klontz KC, Timbo BB, Street D. Consumption of dietary supplements containing Citrus aurantium (bitter orange)--2004 California Behavioral Risk Factor Surveillance Survey (BRFSS). Ann Pharmacother. 2006Abstract
  8. Sharpe PA, Granner ML, Conway JM, Ainsworth BE, Dobre M. Availability of weight-loss supplements: Results of an audit of retail outlets in a southeastern city. J Am Diet Assoc. 2006Abstract
  9. Sultan S, Spector J, Mitchell RM. Ischemic colitis associated with use of a bitter orange-containing dietary weight-loss supplement. Mayo Clin Proc. 2006Abstract
  10. Daneel-Otterbech S, Davidsson L, Hurrell R. Ascorbic acid supplementation and regular consumption of fresh orange juice increase the ascorbic acid content of human milk: studies in European and African lactating women. Am J Clin Nutr. 2005Abstract Full text (link to original source) Full text (in our servers)
  11. [No authors listed] Management of insomnia: a place for traditional herbal remedies. Prescrire Int. 2005Abstract
  12. Nykamp DL, Fackih MN, Compton AL. Possible association of acute lateral-wall myocardial infarction and bitter orange supplement. Ann Pharmacother. 2004Abstract
  13. Fugh-Berman A, Myers A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: current status of clinical and basic research. Exp Biol Med (Maywood). 2004Abstract