Terminalia chebula (haritaki)
Summary
Terminalia chebula is the haritaki fruit used in Ayurveda and triphala. Small trials of standardised fruit extracts at 250–500 mg twice daily, two of them funded by extract makers, reported better knee comfort with activity (105 adults, 12 weeks), improved endothelial function in type 2 diabetes (60 people) and less facial sebum (38 women). No large or independent trials exist.
Key facts
- Fruit of the Terminalia chebula tree, one of the three fruits in Ayurvedic triphala; standardised aqueous fruit extracts are sold as AyuFlex and Synastol TC[6][1][3]
- 105 overweight adults with activity-related knee discomfort: 250 or 500 mg twice daily for 84 days improved a global knee score (mKOOS) versus placebo; knee discomfort and 6-minute walk distance improved only versus baseline. Funded by the extract maker (Natreon)[1]
- 60 patients: 250 or 500 mg twice daily for 12 weeks improved endothelial function versus placebo, most at 500 mg[2]
- 38 women: 250 mg twice daily for 8 weeks cut forehead sebum 33% in those with oily skin and wrinkle scores 4.3% versus increases on placebo; a co-author is employed by the extract maker (Sytheon)[3]
- Extracts inhibited cytochrome P450 enzymes in rat liver microsomes, though less than ketoconazole[5]
- 4 graded human outcomes on this page
- October 13, 2026
How it works
ProposedThe fruit contains gallic acid (about 2.5% of one standardised extract) and has shown antioxidant and anti-inflammatory potential in preclinical studies. In the diabetes trial, extract groups had higher nitric oxide and lower oxidative-stress markers. How these translate into joint or skin effects is not established.[5][1][2]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Joint comfort | Grade D | Improved | RCT · n = 105 · 2017 | 2 rows |
| Heart and vessels | Grade D | Improved | RCT · n = 60 · 2020 | 1 row |
| Skin | Grade D | Improved | RCT · n = 38 · 2023 | 1 row |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Knee comfort, function and walking in overweight adults | Improved | Grade D | RCT · n = 105 · 2017 Overweight adults aged 35–70 with knee discomfort only during activity (USA) Form: Standardised aqueous fruit extract (AyuFlex) · Dose: 250 mg or 500 mg twice daily · Duration: 84 days Versus placebo, mKOOS global scores improved; knee discomfort with activity, whole-body joint function and 6-minute walk distance improved relative to baseline. The two doses did not differ on most outcomes. | 28969626 (opens PubMed)Source [1] |
| Endothelial function and cardiovascular risk markers in type 2 diabetes | Improved | Grade D | RCT · n = 60 · 2020 Adults with type 2 diabetes (India) Form: Aqueous Terminalia chebula extract · Dose: 250 mg or 500 mg twice daily · Duration: 12 weeks Both doses improved endothelial function versus placebo (reflection index −2.55% and −5.21% vs +1.40%), and other cardiovascular risk markers improved, most with 500 mg twice daily. | 32618037 (opens PubMed)Source [2] |
| Facial sebum, redness and wrinkles | Improved | Grade D | RCT · n = 38 · 2023 Healthy women aged 25–65 (USA); 21 extract, 17 placebo completed Form: Standardised fruit extract (Synastol TC) · Dose: 250 mg twice daily · Duration: 8 weeks In women with oily skin, forehead sebum fell 33% versus a 29% rise on placebo; cheek redness fell 2.2% and wrinkle severity 4.3% versus increases on placebo. | 36836126 (opens PubMed)Source [3] |
| Pain threshold and tolerance in a lab pain test | Improved | Grade D | Crossover RCT · n = 12 · 2016 Healthy volunteers (India) Form: Terminalia chebula capsules · Dose: 1,000 mg single dose (two 500 mg capsules) · Duration: Single dose, tested at 3 hours Pain threshold rose about 21% and pain tolerance about 13% versus placebo in a mechanical pressure test; no adverse reactions. | 27625480 (opens PubMed)Source [4] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Standardised aqueous fruit extract (capsules) | Varies[1][3] | No human absorption data were found in the cited sources.[1][3] | Safety blood tests stayed within normal limits over 84 days; no adverse reactions in an 8-week skin trial or after a single 1,000 mg dose.[1][3][4] | Joint, diabetes, skin and lab-pain trials (500–1,000 mg/day) |
Studied doses
Doses studied in human trials ranged from 500 mg/day (250 mg twice daily, 8–12 weeks) to 1,000 mg/day (500 mg twice daily for 12 weeks, or a single 1,000 mg dose).[1][2][3][4]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Medicines
- Drugs cleared by cytochrome P450 enzymesReviewA standardised fruit extract inhibited cytochrome P450 activity in rat liver microsomes in a concentration-dependent way (weaker than ketoconazole). Human relevance is unknown.[5]
- Diabetes and cholesterol medicinesRCTA 12-week trial in type 2 diabetes reported improvements in cardiovascular risk markers, including lipids, versus placebo; whether effects add to these drugs has not been studied.[2]
Who should be careful
- Pregnancy, breastfeeding and children
- Trials enrolled adults only, so there are no safety data for these groups.[1][2][3]
- People on narrow-range medicines
- Because extracts inhibited drug-metabolising enzymes in lab tests, people on drugs such as warfarin or tacrolimus should check with their prescriber.[5]
- People with diabetes on medication
- The extract changed cardiometabolic markers in type 2 diabetes; anyone on glucose-lowering drugs should involve their clinician.[2]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
How to read the label
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Frequently asked questions
What is haritaki?
The fruit of Terminalia chebula, an Ayurvedic herb and one of the three fruits in triphala.[6]
Does Terminalia chebula help joints?
One 12-week industry-funded trial in 105 overweight adults with activity-related knee discomfort found better knee scores and walking distance. Independent confirmation is lacking.[1]
Does it help with type 2 diabetes?
A 60-person trial found better endothelial function and risk markers over 12 weeks. It has not been tested as a replacement for diabetes medicines.[2]
Is there evidence for skin?
One 8-week trial in 38 women, funded by the extract maker, found less facial sebum (in oily skin) and slightly lower wrinkle scores versus placebo.[3]
Can it interact with medicines?
Possibly. Extracts inhibited drug-metabolising enzymes in rat liver tests; human data are missing.[5]
Sources
- [1]Effects of dietary supplementation with a standardized aqueous extract of Terminalia chebula fruit (AyuFlex(®)) on joint mobility, comfort, and functional capacity in healthy overweight subjects: a randomized placebo-controlled clinical trial.. BMC Complement Altern Med, 2017. RCT
- [2]Effect of an aqueous extract of Terminalia chebula on endothelial dysfunction, systemic inflammation, and lipid profile in type 2 diabetes mellitus: A randomized double-blind, placebo-controlled clinical study.. Phytother Res, 2020. RCT
- [3]Randomized Double-Blind Placebo-Controlled Supplementation with Standardized Terminalia chebula Fruit Extracts Reduces Facial Sebum Excretion, Erythema, and Wrinkle Severity.. J Clin Med, 2023. RCT
- [4]A randomized, double-blind, placebo-controlled, cross-over study to evaluate analgesic activity of Terminalia chebula in healthy human volunteers using a mechanical pain model.. J Anaesthesiol Clin Pharmacol, 2016. crossover-RCT
- [5]Cytochrome P450 inhibition assay for standardized extract of Terminalia chebula Retz.. Phytother Res, 2011. animal-study
- [6]Exploring scientific validation of Triphala Rasayana in ayurveda as a source of rejuvenation for contemporary healthcare: An update.. J Ethnopharmacol, 2021. review
What changed
- Independent adversarial review: joint key fact no longer implies walking distance beat placebo (it improved only versus baseline) and names Natreon funding; skin trial now discloses Sytheon funding and a Sytheon-employed co-author, and that the sebum result is a subgroup; summary corrected from "one industry-sponsored" to two maker-funded trials.
- Second-pass self-review: every PMID re-checked against NCBI esummary (title, year, no retraction or expression-of-concern flag), every dose, n and duration re-read against the PubMed abstract or PMC full text, grades held conservative, and interactions limited to what a cited source supports.
- First draft. Source titles and years taken from NCBI E-utilities esummary; abstracts read for every evidence row.