Stevia

safety

Allergies

Avoid in individuals with a known allergy or hypersensitivity to stevia or the daisy family (Asteraceae/Compositae). Other members of the daisy family include ragweed, chrysanthemums, marigolds, and many other herbs.

Side Effects and Warnings

Stevioside may lower blood glucose levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar), and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
Myalgia (muscle pain), muscle weakness, dizziness, asthenia (loss of strength), nausea, and abdominal fullness have been reported after taking stevioside. These effects resolved after the first week of treatment. Stevia may also lower systolic and diastolic blood pressure in patients with high blood pressure. Use cautiously in patients with hypotension (low blood pressure) or taking hypotensive drugs since various human and animal studies have shown that stevioside may significantly decrease systolic and diastolic blood pressure.
Higher doses of stevia may affect renal activity and perfusion, sodium excretion, and urinary flow. Avoid using stevia therapeutically in patients with impaired kidney function or other kidney diseases until human safety data is available.

Pregnancy and Breastfeeding

Stevia is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

dosing

Adults (18 years and older):

For hyperglycemia (high blood sugar), 1 gram of stevioside has been taken with meals to lower blood sugar in patients with type 2 diabetes. Water extracts of 5 grams of leaves have also been used at regular six-hour intervals for three days to increase glucose tolerance.
For hypertension (high blood pressure), stevioside (250-500mg) capsules given three times daily decreased systolic and diastolic blood pressure after three months of therapy, and have been studied for up to two years. Despite early evidence that this may be an effective dose, a recent study did not find any benefit of crude stevosides (up to 15mg/kg taken twice daily) for two years.

Children (younger than 18 years):

There is no proven safe or effective dose for stevia, and use in children is not recommended.

interactions

Interactions with Drugs

Stevia may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar), and in those taking drugs that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
Based on clinical observations in humans, stevioside may decrease systolic and diastolic blood pressure. Caution is advised in patients taking blood pressure lowering medications.
Although not well researched, stevia may also interact with monoketocholate (a substance that may affect glucose and lipid levels), diuretics (medications that increase urine flow), or hypocalcemic agents. Caution is advised.
Steviol is a vasodilator (medication that causes the blood vessels to dilate or expand). Caution is advised when taking stevia with other vasodilators. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.
Verapamil is a calcium antagonist and may exhibit additive effects with stevioside. In an animal study, verapamil tended to increase the renal (kidney) and systemic effects of stevioside. Caution is advised.

Interactions with Herbs and Dietary Supplements

Although not well researched, stevia may also interact with monoketocholate, diuretics (herbs and supplements that increase urine flow), or hypocalcemic agents. Caution is advised.
Stevia may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Stevioside may decrease systolic and diastolic blood pressure. Caution is advised in patients taking blood pressure lowering herbs and supplements.
Steviol is a vasodilator. Caution is advised when taking stevia with other herbs and supplements that are vasodilators. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.