Senna: Uses, Benefits, Side effects and More By Dr. Rajeev Singh

Introduction:

You must have enjoyed the site of beautiful yellow senna blossom landscaping highways and home gardens. Senna is a member of a large genus of tropical flowering plants. It has frequently been used in herbal medicine. Senna is the leaf or fruit (pod) of the plant Senna Alexandrina. Senna is also called Fletcher’s Castoria, Ex-lax and SenokotIt as trade names. It has been employed as a laxative and stimulant in folk medicine. Many herbal teas used for weight loss and bowel movements contain senna.^1,2 Let us discuss the health benefits of senna.  

Nutritional Value of Senna:

The nutritional value of the leaves of Senna suggests that they can be consumed for their nutritional benefits. The nutritional contents of senna are given below: 

• Calcium: 68.95 mg/L
• Copper: 0.23 mg/L
• Magnesium: 1.10 mg/L
• Zinc: 0.59 mg/L
• Sodium: 18.51 mg/L
• Potassium: 202.05 mg/L
• Crude protein: 13.1%
• Crude fibre: 11.3%
• Fat: 3.8%
• Carbohydrate: 45.5%

Further, there are phytochemicals also present in senna. They are saponins, tannins, terpenoids, alkaloids, cardiac glycosides and sterols.³  

Properties of Senna:

Several properties of senna studied by multiple research teams make it potentially beneficial. Some of the beneficial properties of senna are: 

• It might have laxative properties 
• It can act as an anti-allergic agent  
• It may have anti-inflammatory benefits 
• It might act as an antioxidant 
• It might work as an anti-bacterial 
• It can show antifungal activity 
• It might act as a painkiller 
• It might act as an antitumour agent  
• It might have liver protective activities⁴ 

Potential Uses of Senna for Overall Health:

Senna is potentially beneficial in several conditions. Some of the potential uses and senna benefits are as follows: 

1. Potential Uses of Senna for Infections

Researchers in recent studies are attempting to explore plant products to prepare drugs against microbial diseases. Senna is well known for its anti-fungal activity, and it may act against fungal infection. It also possesses activity against E. coli bacterial DNA. Studies by Kumar et al. 2013, have shown that the phenolic compounds present in senna may act against microbial diseases. These compounds were extracted from the plant and may act against Gram-negative Pseudomonas aeruginosa and Escherichia coli, Gram-positive bacteria-Staphylococcus aureus. Further, they may act against fungi-Aspergillus flavus, Aspergillus niger, Rhizopus stolonifera and Fusarium oxisporum.⁴ However, many detailed studies are needed to prove the benefits of senna for such infections in humans. If you have any infection-related problems, consult your doctor and do not self-medicate. 

2. Potential Uses of Senna for Diabetes Mellitus

It is established that oxidative stress can negatively affect the normal functioning of several body organs. Studies have also shown that oxidative stress may also be responsible for diseases like diabetes mellitus, which can increase the blood glucose level. The antioxidant properties of senna may be responsible for its anti-diabetic usage.⁴ However, the data available is insufficient to establish the mentioned benefits of senna on blood sugar levels in humans. Further, more studies are needed to validate these benefits. 

3. Potential Uses of Senna Against Obesity

The antioxidant activity of the senna may help to control obesity. The senna may help properly function the digesting enzyme in obese patients. It might exhibit anti-obesity benefits.⁴ However, we need to conduct further studies to manifest the effects of senna on obesity conditions in humans. 

4. Potential Uses of Senna for its Anticancer Activities

The bioactive compounds in senna leaves are responsible for their potential health benefits. Studies by Onyegeme-Okerenta et al. 2017 show that the bioactive compounds present in senna might be responsible for their potential activity against cancer cells. It might lower lipid peroxidase levels and thus kill cancer cells. Further, it also restricts cancer cell spread. These studies are insufficient to give humans the same benefits as the herb. Thus, further studies are required to prove this claim.⁵  

5. Other Potential Uses of Senna

• Senna might be helpful in healing different skin diseases and external body infections.  
• Senna leaf powder might help to treat rheumatoid arthritis, abdominal worms, and gout, and you may use senna for constipation after consulting your doctor. 
• Senna leaves, or dried pods, are beneficial for digestion. 
• Senna can potentially cleanse and purify the blood.  
• Senna might be helpful for haemorrhoids.⁴ 

Though studies show Senna’s benefits in various conditions, these are insufficient, and there is a need for further studies to establish the true extent of the benefits of Senna on human health.  

Unregulated Senna consumption for a long duration may be linked to liver damage accompanied with a reliance on laxatives. If you have one or more of the following conditions, I suggest you should consider your doctor’s opinion before taking Senna: colon issues, heart disease, or liver illness. With drugs like blood thinners and diuretics, senna may cause interactions. Senna should not be used by those having Crohn’s disease, intestinal blockages, or stomach discomfort. Additionally, it might react negatively with cardiac medicines.

Dr. Siddharth Gupta, B.A.M.S, M.D (Ayu)

How to Use Senna?

Adults can consume senna. While children and the elderly may take senna only when advised by an Ayurvedic doctor.²  

You must consult a qualified doctor before taking any Senna supplements. Do not discontinue or replace an ongoing treatment of modern medicine with an ayurvedic/Senna preparation without consulting a qualified doctor.  

Fun fact: Traditionally, the seeds of Parijat (pods) are used as a sore throat remedy. I recently read an article that suggests regular use of Parijat extracts may keep all the diseases at bay.

Dr. Rajeev Singh, BAMS

Side Effects of Senna:

Senna is safe for adults if taken in the recommended doses for a limited period. FDA approved Senna as a non-prescription medicine. However, it might cause side effects if taken at a higher dosage. Most side effects are related to senna’s laxative effect. Some common side-effects of senna are as follows: 

• It might cause stomach electrolyte imbalance, discomfort, cramps, and diarrhoea.  
• If taken in higher doses, Senna can cause normal bowel movements and laxative dependency.  
• In children, ingesting senna in higher doses may cause nausea, vomiting, tremor, abnormal and violent behaviour, grimacing, self-mutilation, numbness and coma, elevated serum proteins, and bilirubin in the blood. 
• Taking senna for a long period at a higher dose can cause adverse events like liver injury.^{1, 2} 

Precautions to Take with Senna:

Senna must be taken in the recommended dosage for a limited period. Further, the following precautions must be taken while consuming senna for its medicinal benefits: 

1. Pregnancy

Since senna is linked to serious side effects, including laxative dependence and liver damage. It is advisable not to take any herbs without consulting a qualified doctor during pregnancy. 

2. Breastfeeding

Senna is known to have side effects; it would be better to consult a doctor before taking any herbal supplement if you are breastfeeding your baby. 

3. Children

Senna is considered safe for children over the age of 2 years. However, it may have some side effects in children. Thus it is recommended to be given to children with precaution only under the guidance of a qualified Ayurvedic doctor.  

4. Gastrointestinal (GI) Conditions

People suffering from intestinal blockage, stomach pain, diarrhoea, appendicitis, stomach inflammation, inflammatory bowel disease, and haemorrhoids must avoid consuming senna.² 

Interactions with Other Drugs:

Senna might show some moderate interactions with medicines. Some interactions of senna are as follows: 

1. Warfarin

Senna can cause diarrhoea in some people. Diarrhoea may enhance warfarin effects and thus increase bleeding risks in people taking the combination of these two. It is advisable to avoid senna if you are taking warfarin. ⁴    

2. Digoxin (Lanoxin)

Senna is a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Less potassium levels can increase the risk of side effects from digoxin.  

3. Oestrogens

Senna might decrease oestrogen effects by affecting oestrogen absorption in the body.  

4. Diuretic Drugs

Senna can potentially cause diarrhoea as it is a laxative. It may also decrease potassium levels. Thus the combination of senna with diuretics might lead to dropping in potassium levels.² 

5. Herbal Supplements

When you use senna with herbal supplements, it might cause potassium levels to drop too low. Taking senna with other herbal supplements might show a laxative effect, leading to diarrhoea. Therefore, it is advisable to avoid taking senna along with herbs such as buckthorn, liquorice, aloe, horsetail, gossypol and rhubarb. ² 

Frequently Asked Questions (FAQs):

References:

1. National centre for biotechnology information. LiverTox: Clinical and Research Information on Drug Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Senna. [Internet] Updated: April 1, 2020. Available from: LiverTox – NCBI Bookshelf (nih.gov) 

2. National Library of Medicine. Medline plus, Senna [Internet] Last reviewed – October 20, 2021 Available from: Senna: MedlinePlus Supplements 

3. Ishaku GA, Arabo AA, Bassey EE, Uwem AA, Godwin EU. Physicochemical characterization and antibacterial activity of Senna occidentalis Linn. Journal of Chemistry and Chemical Sciences. 2016;6:9-18. Available from: http://chemistry-journal.org/dnload/Gali-Adamu-Ishaku-Abudulhamid-Abdulrahman-Arabo-4-Effa-Emmanuel-Bassey-Adebiyi-Adedayo-Useh-Mercy-Uwem-and-Etuk-Udo-Godwin4/CHEMISTRY-JOURNAL-CHJV06I01P0009.pdf 

4. Abbas SR, Rani G. Medicinal significance of Alexandrian senna. J. Natural Sciences. 2020;8:24-9. Available from: https://www.researchgate.net/profile/Syed-Abbas-11/publication/344571234_Medicinal_Significance_of_Alexandrian_Senna/links/5f80b79da6fdccfd7b552c35/Medicinal-Significance-of-Alexandrian-Senna.pdf  

5. Bm OO, Nwosu T, Mo W. Proximate and phytochemical composition of leaf extract of Senna alata (L) Roxb. ~ 320 ~ J Pharmacogn Phytochem. 2017;6(2). Available from:  https://www.researchgate.net/profile/Blessing-Onyegeme-Okerenta/publication/349255238_Proximate_and_phytochemical_composition_of_leaf_extract_of_Senna_alata_L_Roxb/links/6026dac4299bf1cc26c0cc25/Proximate-and-phytochemical-composition-of-leaf-extract-of-Senna-alata-L-Roxb.pdf 

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