Medical research for Aloe Vera
Quite rightly many sensible people have questioned the claims made by some individuals and companies on the benefits of Aloe Vera. Surely if it really can do so many things it would be handed out at doctors surgeries and in hospitals?
There are five major reasons why this hasn't yet happened and each one will be discussed below:
- There is no clear active ingredient
- A natural product cannot be patented
- Limited medical trials have produced conflicting results
- Research by a government funded body has brand issues
- Aloe Vera's claims as a 'cure all' has caused much scepticism in the medical profession
There is no clear 'active ingredient' in Aloe Vera
The way modern medicine works at the moment is to isolate an active ingredient, test it in clinical trials and, if successful, package and patent it for sale as a prescription drug. Such was the case with willow bark from which aspirin is made.
The problem is, for pharmaceutical companies at least, that Aloe Vera has not been very cooperative in offering up 'active ingredients'. There are over seventy five ingredients in the gel in amounts that have not been totally agreed upon.
Dr Peter Atherton, in his book The Essential Aloe Vera, offers this explanation:
So if an active ingredient cannot be found that explains, for example, why Aloe Vera helps so many people with Irritable Bowel Syndrome, then it cannot be packaged or patented. Thus there is no profit for the pharmaceutical companies.
A natural product cannot be profitably patented
So it would follow (from above) that if you can't find an active ingredient, why not just patent the gel itself.
The problem to this is both historical and political. Historically, and we are talking about less than one hundred years ago, there were plenty of quack doctors pedalling miracle potions – very often quite literally from the back of a wagon. Most were useless and simply profited on desperate people.
It was natural, therefore, that authorities in developing countries would put in to place restrictions to stop this practice so that only products that had been thoroughly tested could make medical claims. But this has had a negative effect for many natural remedies. For example:
"A lack of Vitamin C will cause Scurvy"
"If you have Scurvy eat oranges to cure it as they are rich in Vitamin C"
"If you have Scurvy eat brand X Oranges to cure it"
The final statement is illegal because we are making a medical claim about a particular product even though most school children will tell you the great explorers who sailed across oceans in the 16th and 17th centuries took oranges with them to avoid or cure scurvy – Brand X or not.
Brendan Lehane, in his book The Power of Plants summarises the situation:
For speed is of the essence today. Driven by a thirst for profits, the great pharmaceutical companies vie with each other to be the first with some new cure. Thousands of years of testing on people are replaced by a few months experiments on rats, guinea pigs or Rhesus monkeys. Long -term effects cannot be known. Mistakes, when they come, come on a tragically large scale. Meanwhile acreages of wildflowers grow, bloom, and die natural deaths, their offers refused, their powers to heal ignored.”
So why doesn't a pharmaceutical company test and patent Aloe Vera? Because you cannot monopolise a natural product so if an organisation was to spend the millions of dollars required (per ailment) to prove Aloe Vera's effect they would profit every grower and producer of Aloe worldwide with only a small slice of the returns for themselves. From a business point of view it makes no commercial sense.
Lehane, The Power of Plants, 1977
For now the Federal Drugs Agency (FDA) in the United States has approved Aloe Vera for use in clinical trials. The trouble is, for the reasons above - nobody wants to do it. In reality the very organisations set up to protect the public from non-effective lotions and potions are also stopping us understand and correctly access all natural products. In 1997 Hazel Courtney wrote on the subject in Style magasine and noted:
She also pointed out how this situation is not uniform and changes from country to country:
Limited medical research has produced conflicting results
References to Aloe Vera are to be found littered throughout history. Carved on the walls of ancient Egypt, on the Ebers Papyrus (c. 1550 BC) found between the knees of a mummy, in the bible (John 19:39-40), on documents from the Persian Empire (6th century B.C.); from the Greeks in Celsus's De Materia Medica as well as Dioscordes' De Materia Medica (both first century texts); from the Romans with Pliny's Natural History.
There are many, many more and there are also a few claims that are probably more mythical such as the idea that Cleopatra bathed in Aloe Vera. She may have but there has been no documented evidence to prove it.
Yet all this knowledge seems to have been lost somewhere and it was probably in the renaissance, where much of modern day medicine really began. It was at this time that scholars began to return to ancient texts and re-examine what the medical professionals of past empires had documented so many centuries before,
They found the references to Aloe Vera and sought it out to test and re-examine the claims of the ancients. What they had not grasped from the original papers were three very essential facts.
- There are only a few Aloe Vera plants that actually do any good
- the Aloe Vera leaves must be mature (3-5 years old)
- the Aloe Vera must be fresh.
The scholars were mainly based in Northern Europe where Aloe does not grow in the wild so they bought the leaves from the Mediterranean and the middle east. Sometimes they bought the wrong Aloe, sometimes they bought immature leaves, but even when they got the first two right the leaves still oxidised on the long journey and, like an open apple, lost most of their goodness.
The results of experiments based on this Aloe were not promising but the outcomes still cloud medical thinking today.
Perhaps worse still, much of the research carried out in modern times, is still making the same mistakes because some professionals are becoming aware of Aloe Vera through hearsay and then setting up tests without fully understanding it.
The situation can best be described in this analogy.
A group of doctors hear that 'apples' are good for you. They get some 'apples', feed them to patients and see positive results in general health and even some ailments. They publish their research for all to see. A second group of doctors see the paper and decide to carry out their own search. They also get some 'apples' and feed them to patients but they see negative results with even some digestive problems and side effects. They publish their results.
Now the first group used Golden Delicious apples and the second group used Crab apples but both simply talk about 'apples'. For the medical profession the outcome is simply that research into 'apples' is inconclusive. Over time different groups keep coming back and investigating 'apples' because it seems to remain a popular natural remedy. But some use immature apples, some use ones which have been cut and oxidised, and so on.
There is more and more research into 'apples' and more and more conflicting results about 'apples'
Apples seems a strange example because everyone knows when an apple is ready and when it has oxidised. But it is simply to demonstrate a point because you can replace 'Apples' with 'Aloe Vera' in the above analogy to see the problem. For there to be proper research there must be an understanding on what Aloe Vera to test – the right Aloe, fresh Aloe and mature Aloe.
The end result is well meaning health care professionals with limited funds have carried out their own research in carefully controlled studies but while they have had an excellent understanding of statistical methodology they have not always understood what is good quality Aloe Vera
As such the results can suffer the following:
- Small patient numbers which mean the trials cannot be 'conclusive'
- Differing results due to the differing qualities of Aloe Vera that are used
- Almost all tests concluding 'further research is required'
Research by a government funded body has brand issues
As has been discussed above there is no profit for a pharmaceutical company to investigate Aloe Vera. So why not a state funded body? There have been two stoppers to this.
First fresh Aloe Vera only lasts about forty-eight hours so even positive results would not produce a product suitable for storage in hospitals.
Second, if you cannot test the fresh, which brand of 'stabilized' or preserved Aloe should they use? And for what ailment? Each brand would need to have clinical trials for each ailment and each of these clinical trials would cost millions of dollars.
History does not bode well to start with. In 1959 an American, Lieutenant Colonel Hammit was concerned at the number of Aloe Vera preparations that were being offered to army hospitals. He hired a Doctor Truman Blocker to investigate the claims being made by the suppliers. The results were all negative and there was “no conclusive proof … any of the products tested possessed any therapeutic value whatsoever and may even have been harmful or deleterious”. (The full report can be found in American Perfumer, 1959 Vol. 74, p.27)
Proper techniques to preserve Aloe Vera were only achieved in the late 1970s but it is no surprise that Blocker's research still hangs over the viewpoint held by much of the medical profession today. Why spend public money on such investigations when it has already been done?
Aloe Vera's claims as a 'cure all' has caused much scepticism in the medical profession
And not surprisingly. Could one plant or one product really cure or help so much with so many different ailments? Doctors are trained in modern medical thinking. One drug contains specific ingredients and is designed to carry out one action. The following extract from Dr Peter Atherton's book The Essential Aloe Vera describes the conflict accurately:
He goes further to explain that Aloe Vera probably only works in two areas – on surfaces and membranes and on the immune system – but because so many ailments have their foundations here this is the reason it has been so helpful for such a wide array of illnesses.
For a medical doctor well read on the subject this is probably an easy conclusion to digest, for a doctor who knows little about Aloe Vera the blinding list of ailments that many proclaim one plant can provide relief from is often too much.
Summary
Modern medicine, modern society and modern governments have done a great deal to try and protect us from the cons of quack doctors. But the institutions that have been set up also block out natural remedies and the profit motive of drug companies exclude them from proper evaluation.
Past and present mistakes in testing Aloe Vera still hang heavily on the current thinking of the medical profession which also finds it hard to visualise that one product can do more than one thing,
This does not mean Aloe Vera has a bleak outlook. Word of mouth is as strong as ever and an ever increasing number of people are looking for more 'natural' products and more natural remedies. Perhaps for this reason the number of complementary therapists in the United Kingdom has grown from 2,900 in 1981 to over 60,000 in the new millennium.
The medical profession is large, traditional and has embedded attitudes so change can be expected but the time frame will be a long one. After all, many years have past since this was written:
British Medical Journal – Vol. 312. 30/3/1996
In the meantime there will continue to be a lack of medical research on Aloe Vera but public perception continues to grow. Being positive, Douglas Lynch from Unigen Europe puts it: "To say there is a lack of science behind aloe vera is a little harsh on the reality of the situation," he said. "The public are not stupid and they are buying these products because they are proving beneficial in various areas."
Where to find medical research on this site
Current results from the limited clinical trials that there have been are included on the page Articles about Aloe Vera and also together with the ailments they were tested on. For example Can Aloe Vera cure, help, treat or prevent Psoriasis?