Amla

The fruit of a small deciduous tree grown across India and Southeast Asia — pale green-yellow, 2 to 3 cm across, marked with six shallow vertical furrows, and sour enough to make your jaw ache. AFTER uses a dried fruit extract rather than the fruit.

Amla's chemistry is hydrolysable tannins and simple phenolics — gallic acid, ellagic acid, mucic acid gallates and relatives — which behave as reducing agents in a test tube, and that behaviour is what most "antioxidant capacity" figures are actually measuring. Whether it survives digestion and does anything inside a person is the unsettled part: the intact tannins are poorly absorbed, and what circulates is a set of smaller metabolites. One twelve-week trial in 59 people with metabolic syndrome did move oxidative-stress markers — nitric oxide, glutathione, malondialdehyde — at 500 to 1,000 mg a day. Markers are not sensations. Nobody has measured an antioxidant effect a person could feel, and nobody has run any of this at 15 mg.

Traditionally taken as a rasayana: a restorative used steadily over long periods rather than on one night. Standardised extracts have been studied in adults over twelve weeks for blood lipids and for endothelial function. At 15 mg it is here for the completeness of a traditional formula, not to reproduce any of that.

Anyone who wants the traditional botanical set in its traditional proportions, and who is not expecting a dose. Not for anyone taking warfarin, a DOAC, clopidogrel or daily aspirin, anyone with a bleeding disorder, or anyone within two weeks of surgery. Care if you take insulin or a sulfonylurea. Not in pregnancy or breastfeeding. Anyone in active cancer treatment should clear it with their oncologist first.

One strip on the tongue at the end of the night. It dissolves in under a minute and needs no water, which is the whole argument for the format. Food makes no difference at this amount. If you want amla for what the trials actually tested, that is a separate supplement at 1,000 mg a day for twelve weeks — and those trials were run in people who already had raised cholesterol, metabolic syndrome or reflux, which makes it a conversation for your doctor rather than a reason to chew more strips.

Nothing you will notice. There is no sensation attached to 15 mg of amla extract, no onset time to wait for and no outcome to measure. The trials that moved anything ran twelve weeks at thirty to one hundred and thirty times this amount, and even then the change showed up on a blood panel rather than in how anyone felt.

The human evidence sits between 500 and 2,000 mg a day. Upadya et al. (BMC Complementary and Alternative Medicine, 2019;19(1):27; doi 10.1186/s12906-019-2430-y) randomised 98 dyslipidaemic adults to 500 mg twice daily or placebo for 12 weeks and reported lower total cholesterol and triglycerides. Usharani et al. (BMC Complementary and Alternative Medicine, 2019;19(1):97) gave 59 people with metabolic syndrome 250 mg or 500 mg twice daily for 12 weeks and reported improved endothelial function, oxidative-stress markers, hsCRP and lipid profile. Against those, Shanmugarajan et al. (Phytotherapy Research, 2021;35(6):3275–3285) randomised 150 patients with essential hypertension to 500 mg twice daily or placebo as add-on therapy for 12 weeks and found no additional reduction in blood pressure and no improvement in oxidant status, antioxidant capacity, lipid profile, HbA1c, arterial stiffness or hsCRP. Karkon Varnosfaderani et al. (Journal of Integrative Medicine, 2018;16(2):126–131) gave 68 patients with non-erosive reflux disease two 500 mg tablets twice daily after meals for four weeks and reported reduced heartburn and regurgitation. The platelet finding comes from Khanna et al. (Journal of Medicinal Food, 2015;18(4):415–420), registered as NCT01858376: a single-group, unblinded study with no placebo arm and 24 people enrolled, in which 500 mg of the CAPROS extract twice daily for 12 weeks significantly reduced both ADP- and collagen-induced platelet aggregation against averaged baseline visits. That study is the source of our bleeding caution, not of a benefit claim. On vitamin C, Majeed et al. (Journal of Agricultural and Food Chemistry, 2009;57(1):220–225) reported that amla's high ascorbic acid figures are questionable because coeluting mucic acid gallates had not previously been identified, and found no evidence for the presence of emblicanins A and B. Not supported: any effect of amla on alcohol, hangovers or next-morning anything, and any effect at all from 15 mg.