Bergamot: benefits, dosage, contraindications

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Bergamot is a citrus fruit likely resulting from a cross between a bitter orange and a lime, primarily grown in the Calabria region of Italy. For a long time, the essential oil obtained from the peel of bergamot was mainly used for its olfactory properties in perfumes. Bergamot zest oil and fruit juice extract are used therapeutically. Bergamot juice contains flavonoids such as neoeriocitrin (15%), neohesperidin, naringin (less than 14%), and rutin. It is also rich in neohesperidosides of hesperetin and naringenin, such as the mélitidine and the brutieridine, two unique active components. Bergamot essential oil is obtained by cold pressing the epicarp and, in part, the mesocarp of the fresh fruit. It is poorly soluble in water, unstable, and its bioavailability is limited. It consists of a volatile fraction (93-96%) that contains monoterpene and sesquiterpene hydrocarbons and derivatives such as limonene, γ-terpinene and β-pinene, the monoterpene alcohol linalool and the monoterpene ester linalyl acetate which together constitute more than 90% of the oil. Bergamot has gained interest in recent years for its effects on dyslipidemia. Bergamot extracts can reduce lipids and therefore represent an interesting preventive option in metabolic syndrome and, more generally, in cardiovascular diseases. Furthermore, bergamot essential oil is commonly used to improve mood and reduce stress as well as anxiety. Caution is advised when using the oil because it contains several components that can cause photosensitization, such as bergapten, citroptene, bergamotene and other furocoumarins.

Scientific name(s)

Citrus bergamia

Family or group: 

Plants

Active ingredients:

Naringin

Neoeriocitrin

Neohesperidin

Furocoumarins

Coumarins

Flavonoids


Indications

Scoring methodology

EFSA approval.

Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with consistently positive conclusions for the indication.
Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with positive conclusions for the indication.
One or more randomized studies, or several cohorts or epidemiological studies, with positive conclusions for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or conflicting.
No clinical studies to date that can demonstrate the indication.


Dyslipidemia
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It has been shown that a polyphenolic fraction of bergamot juice has a beneficial effect in reducing excess plasma lipids (hyperlipidemia), notably by improving the profile of circulating lipoproteins. In fact, a 2013 clinical study was conducted for 1 month on patients who had both hypercholesterolemia and hypertriglyceridemia. The study authors report that a flavonoid extract not only helps reduce levels of LDL cholesterol (bad cholesterol), total cholesterol, and plasma triglycerides, but also increases HDL cholesterol (good cholesterol). The same results were obtained with a bergamot-derived flavonoid extract in a 2016 clinical study carried out for 6 months on subjects with moderate hypercholesterolemia. nnBergamot has also been evaluated in combination with other natural actives such as phytosterols, artichoke, and others. A particularly synergistic composition containing 600 mg of bergamot phytosome and 100 mg of artichoke leaf extract demonstrated its efficacy in patients with mild hypercholesterolemia when taken twice daily for 2 months.nn

Posologie

posologieOrally: fruit

posologie500 - 1000 mg

duration1 - month

formulationconcentrated juice, dry extract


Synergies


Stress
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Studies have reported the beneficial use of bergamot essential oil in aromatherapy to reduce symptoms related to physical and psychological stress. In this context, a randomized, placebo-controlled clinical trial conducted in 2013 evaluated the effect of a 100% natural pure bergamot essential oil on work-related stress symptoms. The results showed a significant decrease in the heart rate of the stressed subjects (teachers) tested, associated with a reduction in physical and psychological stress symptoms. A similar clinical study in 2013 demonstrated the anxiolytic effect of exposure to bergamot essential oil vapors in patients experiencing preoperative anxiety before undergoing ambulatory surgery. Notably, a significant reduction in heart rate and blood pressure was observed in this group. A 2015 clinical study reported decreased salivary cortisol levels in healthy female volunteers subjected to varying workloads after experimental inhalations of bergamot essential oil vapor. This was well correlated with the psychological tests performed.

Posologie

posologieBy inhalation: fruit

populationWomen, Men

formulationessential oil


Metabolic syndrome
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A study suggests that the natural antioxidants contained in bergamot essential oil may be useful in the treatment of vascular disorders involving proliferation of smooth muscle cells and endothelial dysfunction associated with oxy-LDL. In other studies, bergamot juice extract reduced total and LDL cholesterol levels (an effect associated with an increase in HDL-C), triglyceride levels, and produced a significant decrease in blood glucose.

Posologie

posologieOral route: fruit

posologie500 - 1000 mg

formulationconcentrated juice, dry extract


Psoriasis
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Bergamot essential oil may help naturally treat plaque psoriasis. Traditionally, it has been used in folk medicine as an antiseptic to promote wound healing.

Posologie

posologieTopical route: fruit

formulationessential oil


Emotional balance
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Preliminary clinical research shows that a combination of lavender, orange, and bergamot essential oils, administered by inhalation or by massage twice a week for 8 weeks, improves depression symptoms in 55% to 65% of patients compared with the control group. Other studies have shown that bergamot essential oil-based treatment improves parasympathetic and nervous system function: decreased blood pressure and heart rate. Subjects with higher degrees of anxiety benefited more from the treatment than the group suffering from mild anxiety.

Posologie

posologieBy inhalation: fruit

duration8 - weeks

formulationessential oil


Synergies


Properties


Hypolipidemic

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Bergamot juice contains two relatively rare flavonoids, brutieridine and melitidine (derivatives of the flavonoids naringin and hesperidin). They appear to act as direct inhibitors of HMG-CoA reductase, an enzyme involved in the metabolic pathway that produces precursors of cholesterol (namely mevalonate, a conversion product of HMG-CoA). These two flavonoids contain a structural moiety sufficiently similar to bind to HMG-CoA and prevent its conversion to mevalonate. However, pure preparations of naringin and hesperidin have not reduced blood levels of cholesterol, LDL cholesterol and triglycerides in moderately hyperlipidemic patients. In fact, it is possible that in vivo inhibition of HMG-CoA reductase is a more complex phenomenon involving other properties of the flavonoids.

Usages associés

Dyslipidemia, Metabolic Syndrome

Anxiolytic

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It is known that inhalation of the volatile components of essential oils can influence the activity of certain brain regions, such as the hypothalamus, the hippocampus and the piriform cortex. One hypothesis is that stimulation of these areas improves mild mood disorders and may reduce stress-induced anxiety. It has been suggested that the volatile components of bergamot essential oil, among them 5-methoxypsoralen (5-MOP), also known as bergapten, may be responsible for these beneficial effects. In addition, it has been reported that the positive effects of bergamot essential oils on the brain are due to increased release of amino acids, which can modulate synaptic plasticity.

Usages associés

Stress, Emotional balance

Hypoglycemic

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Several studies have shown that different flavonoids from bergamot can activate AMPK (AMP-activated protein kinase), both in vitro and in vivo. AMPK plays a key role in regulating glucose and lipid metabolism and energy production in several organs. Activation of AMPK increases intracellular glucose uptake. This occurs through different mechanisms. For example, it activates a "transporter" of glucose called GLUT1, which functions in all cells, and another called GLUT4, specific to muscle cells. When blood glucose decreases, AMPK prevents the formation of glycogen (a form of glucose storage) to ensure that there is enough glucose available for our immediate needs. At the same time, it promotes glycolysis, a process by which glucose is broken down to produce energy. Metformin, an antidiabetic drug prescribed for type 2 diabetes, also activates AMPK. This activation is responsible for the drug's hypoglycemic effects.

Usages associés

Metabolic syndrome

Antibacterial

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The antimicrobial activity of polyphenols has been the subject of several in-depth studies against various microorganisms. Some authors have reported activity only against Gram-negative bacteria while others have shown activity against Gram-positive bacteria. It has been demonstrated that the antimicrobial activity of bergamot extract may be particularly related to its high content of neoeriocitrin, neohesperidin and hesperetin flavanones. This activity is selective against pathogenic strains and no effect has been observed on beneficial intestinal bacteria (belonging to the gut microbiota).


Anti-inflammatory

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Some in vitro studies have shown that bergamot treatment could inhibit intestinal inflammation caused by ischemia-reperfusion injury by reducing gene expression as well as the levels of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), decreasing the production of reactive oxygen species and reducing neutrophil infiltration and the expression of adhesion molecules.


Antioxidant

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Some in vitro studies have shown that the flavonoid fraction of bergamot juice reduces the generation of reactive oxygen species and membrane lipid peroxidation, improves mitochondrial function and prevents oxidative damage to DNA.


Antifungal

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Some in vitro studies have shown that bergamot essential oil has activity against several species of dermatophytes such as Trichophyton, Microsporum, and Epidermophyton. In addition, it has in vitro activity against species of Candida. nn


Safe dosage

Adult 18 years and older: 500 mg - 1000 mg

Bergamot extract has most often been used at doses ranging from 500 up to 1000 mg per day for 4 to 12 weeks. Sometimes it is standardized to 11% to 19% total flavanones. Bergamot essential oil is generally applied topically either neat or diluted to 2% with other carrier oils.


Interactions

Médicaments

Photosensitizing agents: moderate interaction

Because of its bergapten content, the use of bergamot essential oil may worsen photosensitivity and increase the risk of adverse effects. Concomitant use with medications indicated as "photosensitizing" should be avoided.


Precautions

Children up to 18 years: use with caution

No signs of toxicity have been observed in children after infusion of bergamot extract. However, efficacy is not proven, and more research on this population needs to be conducted. Bergamot should therefore be used with caution in children and adolescents.

Pregnant women: avoid

The safe use of bergamot during pregnancy has not been established. In the absence of sufficient data, use during pregnancy and breastfeeding is not recommended.nn

Nursing woman: avoid

The safe use of bergamot during breastfeeding has not been established.nn