Health benefits of Aloe vera

Aloe vera health benefits
Common names of Aloe vera
Aalwyn (Afrikaans), 芦荟/Lúhuì (Chinese), Aloès (French), Aloí (Greek), Aloe (German), Áloe (Spanish), मुसब्बर/musabbar (Hindi).
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Brief history

Aloe vera (Aloe barbadensis miller) belongs to the family Asphodelaceae (Liliaceae). Aloe is derived from the Arabic word “alloeh” which means “bitter” while “vera” means “true” in Latin. In India, it is also known as Gheegwar or Ghrit kumari. Due to its’ medicinal properties, it has been used as a herbal remedy since ancient times. So, people often call it the miracle plant42. It is a perennial, xerophytic, succulent plant that prefers dry and hot climates, like deserts. It grows particularly in the dry regions of Africa, Asia, Europe, and America.

Historically, Aloe vera has been used as a medicine for several purposes and is also a very common plant in homeopathy, allopathy and Ayurveda. Nefertiti and Cleopatra, the Egyptian queens and icons of beauty, used it for their daily routines. It is also known that the soldiers of Christopher Columbus and Alexander the Great used it to treat their wounds. In the United States, Aloe vera was used as a laxative in the early 1800s and for the treatment of chronic and severe dermatitis in the mid-1930s. Finally, in Afrika people use it for the treatment of malaria. Aloe has also emollient, anti-inflammatory, cleansing, anti-microbial, aphrodisiac, antifungal and, antioxidant properties43. Interestingly, some tribes are also using it as a food6. Nowadays, Aloe vera is one of the most common natural ingredients in cosmetics.

How to grow Aloe vera

 

If you want to grow Aloe vera at home, make sure to plant it in a medium sized pot (~25-30cm high) and keep it in a warm place, with direct sun. As it is a succulent, it can last for long periods without water, so water it once or twice per week, and keep the soil well drenched. 

Health benefits
 
To date more than 200 active compounds have been isolated from the gel in the leaves of Aloe1. Some of the most important ones are polysaccharides, sugars, minerals, proteins, lipids (4%) and phenolic compounds. Moreover, the Aloe vera gel contains also many vitamins such as A, C, E, B1 (thiamine), niacin, B2 (riboflavin), B12 (cyanocobalamin), choline and folic acid1.
 

Skin care

The Aloe vera gel contains glycoproteins and lectins that are molecules with cell proliferating properties. This is why aloe is commonly used in dermatology and cosmetology2, 7. There are several scientific studies and clinical trials that have also shown that Aloe vera is effective against several skin conditions:

Acne

Acne can occur due to several reasons. Some of the most common and important ones are hormonal changes, high stress levels and diet. There are several scientific studies that have tested the treatment of acne with products that contained Aloe vera. It seems that if Aloe is combined with other natural ingredients, such as Gingko biloba and green tea, it is effective against acne. This happens because Aloe has great anti-inflammatory and moisturizing properties7, 8.

Wound healing

There are numerous clinical studies that have shown the magical wound healing properties of aloe11, 15, 16. These properties of Aloe vera are attributed to the hormones that it contains, such as auxins and giberellins, which promote growth and have anti-inflammatory action16. Thus, Aloe is effective for treating post-operative wounds created for example by C-section, hemorrhoids removal, skin biopsies or skin grafts11.

Aloe vera gel is also great for healing cracked nipples during breastfeeding10. Although Aloe is not toxic for the baby, it is better to be removed from the nipples before breastfeeding, because its’ bitter taste may avert the baby. Something else to keep in mind is that in some people, Aloe gel may induce itching, burning, or topic allergic reactions. This usually happens if during its’ preparation has been mixed with latex, a compound found in the leaves. Thus, purchasing a latex-pure product is important.

You can also use Aloe gel or cream to treat melasma, a skin condition that occurs mostly in women during pregnancy. People who get exposed too much to the sun, may also develop brown patches on their skin and Aloe vera gel can help reduce the coloration17.

Psoriasis

Psoriasis is an autoimmune disease and people that suffer from it have skin areas that are red, itchy and dry. As Aloe contains mucopolysaccharides, it is very effective in maintaining the skin moisture. In two scientific studies, aloe cream was applied twice a day for 4-8 weeks to these skin regions and it was shown that it is effective12, 13,14. A recent study also showed that Aloe vera gel is also effective against psoriasis due to another compound contained in it, aloe-emodin. Finally, according to a study in Palestine, Aloe vera is one of the four most used plants for the traditional treatment of psoriasis.

Moisturizing and anti-aging effect

Aloe is used a lot in the cosmetic industry for its moisturizing effect. It contains mucopolysaccharides which are effective in maintaining the skin moisture and gibberellin, a hormone that stimulates the growth of new cells15. Aloe, activates also the fibroblasts, skin cells that produce collagen and elastin fibers, making the skin more elastic and less wrinkled17.

Eczema

Due to Aloe’s moisturizing effect, it is often used for skin diseases related to dry skin and scaling, such as eczema24ALHYDRAN®, is a cream based on Aloe, vitamins and natural essential oils with regenerating properties that has been tested in 18 people with venous eczema. It was applied twice per day on the affected skin for 4 weeks. The results were very encouraging as the itchiness was reduced and the color of the skin improved. So, the authors concluded that ALHYDRAN® is a safe, effective and feasible treatment for the skin symptoms of venous eczema24.

Antimicrobial and antiviral properties

Aloe vera has been studied extensively in the food and medical industry due to its antimicrobial and antiviral properties3, 20. It can inhibit the growth of bacteria and fungi, as well as viruses because it contains many antiviral molecules.

There are 6 antiseptic agents in Aloe vera: lupeol, salicylic acid, nitrogen urea, cinnamonic acid, phenols, and sulfur. All of them have inhibitory effects on the growth of fungi, viruses and bacteria. The most studied compounds found in Aloe for their antiviral activity are the anthraquinones, but there are also other ones like quercetin, catechin hydrate, kaempferol, acemannan, azidothymidine, acyclovir, aloin and emodin20.

For example, lectins inhibit the growth of cytomegalovirus22, chrysophanic acid inhibits the growth of polioviruses and from preliminary experiments in cats, acemmanans can inhibit the growth of HIV23. Moreover, in another scientific study, the gel extract of Aloe was tested in cell lines and was effective against herpes virus (HSV-2)23.

Finally, in a very recent research article it has also been suggested as a natural treatment against Covid19, due to its well-studied antiviral effects20. However, more research is needed in order to show its potential for Covid19 treatment.

Anti-inflammatory

Some phytochemicals that Aloe Vera contains have the ability to reduce inflammation by directly modulating some components of our immune system, such as cytokinins, interleukin and leukocyte cells’ production16, 29. It also contains fatty acids, such as cholesterol, campesterol, β-sitosterol, and lupeol, which also have anti-inflammatory action16. Thus, if you are suffering from a chronic inflammation disease, such as arthritis, joint and muscle pain, any kind of infection or even allergies, it is worth adding some Aloe vera juice without sugar to your daily diet.

Phlebitis

According to an extensive analysis of scientific studies, Aloe vera is a great alternative and natural therapy for intravenous phlebitis and chemotherapy induced phlebitis. So, it can be used topically as a cream, gel or ointment and it is a cheap and effective way to prevent serious side complications29. Our go to cream is ALHYDRAN®.

Improves intestinal health and reduces IBS symptoms

Aloe vera contains anthraquinones. These compounds have laxative properties and can help reduce constipation as they can increase the water content of your intestine, they induce mucus secretion and they improve the movement of the intestine. For these reasons, Aloe vera juice is often used as complementary and alternative therapy for the irritable bowel syndrome (IBS)16. Thus, dinking Aloe vera juice can help you prevent stomach ulcers, reduce IBS symptoms and improve the bowel transit and digestion.

Oral health

According to a scientific review, that summarizes different research articles about the effects of Aloe vera on oral health, this plant can be used as a natural treatment for several oral diseases. Some of them are gingivitisperiodontitis, aphthae (aphthous stomatitis), mucositis or dry socket (alveolar osteitis). Basically, the antimicrobial and anti-inflammatory properties, as well as some unique compounds that Aloe contains, make this plant unique for maintaining a good oral health.
A few studies have also shown that Aloe vera can be used as an effective mouthwash for the prevention of plaque formation38-40.

Other potential, but understudied health effects

 

Sun burns or acute radiation dermatitis

Aloe vera has not been proven to be effective for the treatment of sunburns, frostbitten skin or radiation dermatitis. However, as it has great moisturizing, nourishing, anti-microbial and anti-inflammatory properties you can consider using it for prevention and for keeping your skin hydrated. Thus, using it as a complementary aid alongside with other treatments could also help you accelerate the healing process of your skin.

Most of the people that go through radiation treatment because of cancer, suffer from topical skin “burns” (also known as acute radiation dermatitis). Unfortunately, there is still not enough scientific proof that shows the effectiveness of Aloe vera against radiation dermatitis symptoms. However, using a cream that contains Aloe vera combined with other anti-inflammatory, moisturizing and skin healing plants is important for the prevention of acute radiation dermatitis.

Basically, taking care of your skin since day 1 of radiation therapy is very important for the prevention of radiation dermatitis. It has been proven that the most effective practice is to wash and cleanse well the zone of treatment with mild soap and water9. Doing this 3-4 times per day and putting some hydrating, nourishing and anti-microbial cream after drying well the place is very important for keeping your skin clean and healthy.

One cream that we like and recommend is Actinike from RNV. 

Ulcer prevention and treatment

Ulcers usually occur due to chronic inflammation, infections or long-term pressure on the skin (i.e. bedsores). To date there are a few studies that show the effectiveness of Aloe to prevent them or treat them. According to these studies, the use of aloe cream for 2-3 weeks was effective for the treatment of ulcers, created due to diabetes, bedsores, herpes or hemorrhoids11.

Cancer Prevention

Aloe vera gel contains a molecule called emodin, which has been shown to be effective for cancer prevention and metastasis. More specifically, emodin is very effective in the prevention of breast cancer metastasis and proliferation of breast cancer cells25, 26. There is also one study that showed that Aloe emodin inhibited the growth of polyp formation in mice that were fed with high-lipid diet27.

Vaginal health

Many women suffer from vaginal atrophy after menopause. This happens because our estrogen levels drop after menopause and the vaginal cell layers get more dry, inflated and thinner. Usually, medical doctors try to treat these symptoms with estrogen creams, but a recent scientific study has demonstrated that an Aloe vera cream is equally effective. Although, more research is needed to prove this, given the fact that Aloe gel has well-proven moisturizing and anti-inflammatory effects it could be effective and worth trying it.

Analgesic

Salycilic acid is the main compound of aspirin, but it is also contained in the Aloe vera gel. Furthermore, Aloe contains a substance called lupeol that has analgesic effects. Thus, consuming Aloe vera juice could help you relieve pain, related to chronic disease such as arthritis.

Diabetes type 2 and high cholesterol natural prevention

To date, there are only a few studies in mice and fish that show the potentially beneficial action of Aloe vera on metabolic diseases like hyperlipidemia and diabetes33-37. These studies show that consuming Aloe could reduce the levels of triglycerides, cholesterol and free fatty acids in the plasma, liver, and kidney41. However, a recent meta-analysis of the scientific data, shows that Aloe vera juice can reduce the levels of triglyceride, total cholesterol and LDL cholesterol, and increase the levels of HDL cholesterol in prediabetes and early non-treated diabetic patients. The authors suggest that more randomized controlled trials should be performed in humans, so as to prove the potential health benefits of Aloe on human health.

Take home message

 

Aloe has been well-studied for its’ effective properties on skin care, wound healing, and skin related diseases, like psoriasis and eczema. On the top of that, Aloe can also be used for maintaining a good intestinal and oral health, but it is better to be consumed in low amounts (30-40ml/day) to avoid reverse effects.

From preliminary research, it seems that Aloe may also be effective for cancer and diabetes prevention. It may also have good analgesic effects or help you maintain a good vaginal health. However, more research is needed for these properties to be proven.

Important Note

Regarding the safety of Aloe vera products, there is very little evidence and the scientific community is divided into two groups. One group claims that Aloe vera is very healthy for consumption by humans, while the other group advises to use it with caution and utmost care. This is because the Aloe vera gel, contains aloin, a laxative compound that may also cause damage to the DNA and subsequently cancer. On the contrary, researchers have indicated that anthroquinones found in Aloe vera leaf, like aloin, are beneficial when used in small amounts.

However, Aloe vera gel has been confirmed to be safe for external use, allergies are uncommon and adverse reactions to other drugs have not been reported. Aloe should not be used internally or by people with stomach pain, appendicitis or intestinal obstruction during pregnancy, lactation or infancy.

Aloe should not be used internally during pregnancy, lactation or childhood1. If you are pregnant, you can use Aloe vera gel topically to treat skin wounds or pregnancy patches (melasma), but you should not eat or drink Aloe, because it can stimulate contractions and lead to abortion18.

Due to aloin, a laxative compound contained in the gel of Aloe, the maximum amount of Aloe juice consumed daily should be 30-40ml31. If you consume more Aloe vera juice daily, you may experience abdominal cramps and diarrhea. Overconsumption of Aloe vera gel can also interfere with the absorption of drugs or cause toxicity. In the long-term overuse of anthraquinones may result in intestine inflammation, it may prolong menstrual bleeding, as well as cause difficulties in the absorption of nutrients31. Finally, there is a study that showed in laboratory experiments that Aloe vera juice affects the growth of Lactobacilli, important bacteria for your gut health32.

Tips and tricks

 
  • In order to benefit the most by Aloe vera, it’s better to consume it fresh or in powder form. The longer it is preserved in the fridge the more the gel’s composition changes.
  • Aloe vera powder can be used as a preservative agent for your food due to it’s antimicrobial properties. You can use it to maintain chicken nuggets in the fridge, up to 6 days or you can use it to marinate your chicken in order to make it softer6.

References

 
  1. Pandey, A. and Singh, S., 2016. Aloe Vera: A Systematic Review of its Industrial and Ethno-Medicinal Efficacy. International Journal of Pharmaceutical Research & Allied Sciences, 5(1).
  2. Surjushe, A., Vasani, R. and Saple, D.G., 2008. Aloe vera: a short review. Indian journal of dermatology, 53(4), p.163.
  3. Ahlawat, K.S. and Khatkar, B.S., 2011. Processing, food applications and safety of aloe vera products: a review. Journal of food science and technology, 48(5), pp.525-533.
  4. Manvitha, K. and Bidya, B., 2014. Aloe vera: a wonder plant its history, cultivation and medicinal uses. Journal of Pharmacognosy and Phytochemistry, 2(5), pp.85-88.
  5. Kumar, Sandeep. (2014). Ethnobotanical and pharmacological properties of Aloe vera: A review. journal of medicinal plants research.
  1. Pandey, A. and Singh, S., 2016. Aloe Vera: A Systematic Review of its Industrial and Ethno-Medicinal Efficacy. International Journal of Pharmaceutical Research & Allied Sciences, 5(1).

  2. Surjushe, A., Vasani, R. and Saple, D.G., 2008. Aloe vera: a short review. Indian journal of dermatology, 53(4), p.163.

  3. Ahlawat, K.S. and Khatkar, B.S., 2011. Processing, food applications and safety of aloe vera products: a review. Journal of food science and technology, 48(5), pp.525-533.

  4. Manvitha, K. and Bidya, B., 2014. Aloe vera: a wonder plant its history, cultivation and medicinal uses. Journal of Pharmacognosy and Phytochemistry, 2(5), pp.85-88.

  5. Kumar, Sandeep. (2014). Ethnobotanical and pharmacological properties of Aloe vera: A review. journal of medicinal plants research.

  6. Sonawane, S. K., Gokhale, J. S., Mulla, M. Z., Kandu, V. R., & Patil, S. (2020). A comprehensive overview of functional and rheological properties of aloe vera and its application in foods. Journal of Food Science and Technology, 58(4), 1217–1226. https://doi.org/10.1007/s13197-020-04661-6

  7. Sánchez-Machado, D. I., López-Cervantes, J., Sendón, R., & Sanches-Silva, A. (2017). Aloe vera : Ancient knowledge with new frontiers. Trends in Food Science & Technology, 61, 94–102. https://doi.org/10.1016/j.tifs.2016.12.005

  8. Draelos ZD. Cosmetics and Dermatological Problems and Solutions. 3rd ed. London: Informa Healthcare; 2011.

  9. Rosenthal, A., Israilevich, R., & Moy, R. (2019). Management of Acute Radiation Dermatitis: A Review of the Literature and Proposal for Treatment Algorithm. Journal of the American Academy of Dermatology. doi:10.1016/j.jaad.2019.02.047

  10. Hanieh Alamolhoda, S., Mirabi, P., & Mojab, F. (2020). Effects of both Aloe Vera gel and breast milk on the improvement of nipple soreness in lactating women—A randomized controlled trial. Journal of Herbal Medicine, 21, 100327. https://doi.org/10.1016/j.hermed.2019.100327

  11. Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2019). The Effect of Aloe Vera Clinical Trials on Prevention and Healing of Skin Wound: A Systematic Review. Iranian journal of medical sciences, 44(1), 1–9.

  12. Choonhakarn, C., Busaracome, P., Sripanidkulchai, B., & Sarakarn, P. (2010). A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. Journal of the European Academy of Dermatology and Venereology, 24(2), 168–172. https://doi.org/10.1111/j.1468-3083.2009.03377.x

  13. Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1:505-9. PubMed PMID: 8765459.

  14. Farahnik, B., Sharma, D., Alban, J., & Sivamani, R. K. (2017). Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review. American Journal of Clinical Dermatology, 18(4), 451–468. doi:10.1007/s40257-017-0266-0

  15. Maan, A. A., Nazir, A., Khan, M. K. I., Ahmad, T., Zia, R., Murid, M., & Abrar, M. (2018). The therapeutic properties and applications of Aloe vera : A review. Journal of Herbal Medicine, 12, 1–10. https://doi.org/10.1016/j.hermed.2018.01.002

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  17. Shafaie, S., Andalib, S., Shafaie, H., Montaseri, A., & Tavakolizadeh, M. (2020). Differential Biological Behavior of Fibroblasts and Endothelial Cells under Aloe Vera Gel Culturing. International Journal of Molecular and Cellular Medicine, 9(3). https://doi.org/10.22088/IJMCM.BUMS.9.3.234

  18. Cuzzolin, L., Francini-Pesenti, F., Verlato, G., Joppi, M., Baldelli, P., & Benoni, G. (2010). Use of herbal products among 392 Italian pregnant women: Focus on pregnancy outcome. Pharmacoepidemiology and Drug Safety, 19(11), 1151–1158.

  19. Ghafarzadeh, M., & Eatemadi, A. (2017). Clinical efficacy of liposomeencapsulated Aloe vera on melasma treatment during pregnancy. Journal of Cosmetic and Laser Therapy, 19(3), 181–187.

  20. Mpiana, P.T., Ngbolua, K.N., Tshibangu, D.S.T., Kilembe, T.J., Gbolo, B.Z., Mwanangombo, T.D., Inkoto, L.C., Lengbiye, M.E., Mbadi M.C., Matondo, A., Bongo, N.G., Tshilanda, D.D. (2020a). Aloe vera (L.) Burm. F. as a Potential Anti-COVID-19 Plant: A Mini-review of Its Antiviral Activity. European Journal of Medicinal Plants 31(8): 86-93. Doi: http://doi.org/10.9734/ejmp/2020/v31i830261

  21. Sharrif MM, Sandeep KV. Aloe vera their chemicals composition and applications: A review. Int J Biol Med Res. 2011;2(1):466- 471.

  22. Morin E. Aloe vera (L.) Burm.f.: Aspects pharmacologiques et cliniques. Thèse de doctorat en pharmacie, Faculté de Pharmacie, Université de Nantes. 2008; 224.

  23. Keivan Z, Moloud AZ, Kohzad S, Zahra R. Antiviral activity of Aloe vera against herpes simplex virus type 2: An in vitro study. African Journal of Biotechnology. 2007;6(15):1770-1773.

  24. AALM, R., & JMGA, S. (2017). Application of Medical Moisture Retention Cream (ALHYDRAN®), A New Option in the Treatment of Venous Eczema. Journal of Gerontology & Geriatric Research, 06(01). https://doi.org/10.4172/2167-7182.1000395

  25. Mulakayala C, Banaganapalli B, Mulakayala N, Pulaganti M, C M A, Chitta SK, et al. Design and evaluation of new chemotherapeutics of aloe-emodin (AE) against the deadly cancer disease: An in silico study. J Chem Biol 2013;6:141-53.

  26. Huang PH, Huang CY, Chen MC, Lee YT, Yue CH, Wang HY, et al. Emodin and aloe-emodin suppress breast cancer cell proliferation through ER α inhibition. Evid Based Complement Alternat Med 2013;2013:376123.

  27. Haddad P, Amouzgar-Hashemi F, Samsami S, Chinichian S, Oghabian MA. Aloe vera for prevention of radiation-induced dermatitis: A self-controlled clinical trial. Curr Oncol 2013;20:e345-8.

  28. Mosayebi G, Ghazavi A, Aghili B, Mirshafiei A. Immunomodulating activity of Aloe Vera in animal model of multiple sclerosis. Arak Medical University Journal. 2009;12:109-15. Persian.

  29. Sadoyu, S., Rungruang, C., Wattanavijitkul, T., Sawangjit, R., Thakkinstian, A., & Chaiyakunapruk, N. (2020). Aloe vera and health outcomes: An umbrella review of systematic reviews and meta‐analyses. Phytotherapy Research, 35(2), 555–576. https://doi.org/10.1002/ptr.6833

  30. Dana N, Javanmard SH, Asgary S, Asnaashari H, Abdian N. The effect of Aloe vera leaf gel on fatty streak formation in hypercholesterolemic rabbits. J Res Med Sci 2012;17:439-42.

  31. Hęś, M., Dziedzic, K., Górecka, D., Jędrusek-Golińska, A., & Gujska, E. (2019). Aloe vera (L.) Webb.: Natural Sources of Antioxidants – A Review. Plant Foods for Human Nutrition, 74(3), 255–265. https://doi.org/10.1007/s11130-019-00747-5

  32. Nagpal R, Kaur V, Kumar M, Marotta F. Effect of Aloe vera juice on growth and activities of lactobacilli in-vitro. Acta Biomed 2012;83:183-8.

  33. Kumar M, Rakesh S, Nagpal R, Hemalatha R, Ramakrishna A, Sudarshan V, et al. Probiotic Lactobacillus rhamnosus GG and Aloe vera gel improve lipid profiles in hypercholesterolemic rats. Nutrition 2013;29:574-9.

  34. Rajasekaran, S., Ravi, K., Sivagnanam, K., & Subramanian, S. (2006). BENEFICIAL EFFECTS OF ALOE VERA LEAF GEL EXTRACT ON LIPID PROFILE STATUS IN RATS WITH STREPTOZOTOCIN DIABETES. Clinical and Experimental Pharmacology and Physiology, 33(3), 232–237. https://doi.org/10.1111/j.1440-1681.2006.04351.x

  35. Kim, K., Kim, H., Kwon, J., Lee, S., Kong, H., Im, S.-A., Lee, Y.-H., Lee, Y.-R., Oh, S.-T., Jo, T. H., Park, Y. I., Lee, C.-K., & Kim, K. (2009). Hypoglycemic and hypolipidemic effects of processed Aloe vera gel in a mouse model of non-insulin-dependent diabetes mellitus. Phytomedicine, 16(9), 856–863. https://doi.org/10.1016/j.phymed.2009.02.014

  36. Gabriel, N. N., Qiang, J., Ma, X. Y., He, J., Xu, P., & Liu, K. (2015). Dietary Aloe vera improves plasma lipid profile, antioxidant, and hepatoprotective enzyme activities in GIFT-tilapia (Oreochromis niloticus) after Streptococcus iniae challenge. Fish Physiology and Biochemistry, 41(5), 1321–1332. https://doi.org/10.1007/s10695-015-0088-z

  37. Palermo, F. A., Cocci, P., Angeletti, M., Felici, A., Polzonetti-Magni, A. M., & Mosconi, G. (2012). Dietary Aloe vera components’ effects on cholesterol lowering and estrogenic responses in juvenile goldfish, Carassius auratus. Fish Physiology and Biochemistry, 39(4), 851–861. https://doi.org/10.1007/s10695-012-9745-7

  38. Kumar, G., Devanand, G., John, B., Ankit, Y., Khursheed, O., & Sumit, M. (2014). Preliminary Antiplaque Efficacy of Aloe Vera Mouthwash on 4 Day Plaque Re -Growth Model: Randomized Control Trial. Ethiopian Journal of Health Sciences, 24(2), 139. https://doi.org/10.4314/ejhs.v24i2.6

  39. Chhina, S., Singh, A., Menon, I., Singh, R., Sharma, A., & Aggarwal, V. (2016). A randomized clinical study for comparative evaluation of Aloe Vera and 0.2% chlorhexidine gluconate mouthwash efficacy on de-novo plaque formation. Journal of International Society of Preventive and Community Dentistry, 6(3), 251. https://doi.org/10.4103/2231-0762.183109

  40. Parwani, S., Parwani, R., Chitnis, P., Dadlani, H., & Sai Prasad, S. (2013). Comparative evaluation of anti-plaque efficacy of herbal and 0.2% chlorhexidine gluconate mouthwash in a 4-day plaque re-growth study. Journal of Indian Society of Periodontology, 17(1), 72. https://doi.org/10.4103/0972-124x.107478

  41. Rajasekaran, S., Sivagnanam, K., Ravi, K., & Subramanian, S. (2004). Hypoglycemic Effect ofAloe veraGel on Streptozotocin-Induced Diabetes in Experimental Rats. Journal of Medicinal Food, 7(1), 61–66. https://doi.org/10.1089/109662004322984725

  42. Rajasekaran, S., Sivagnanam, K., & Subramanian, S. (2005). Modulatory effects of Aloe vera leaf gel extract on oxidative stress in rats treated with streptozotocin. Journal of Pharmacy and Pharmacology, 57(2), 241–246. https://doi.org/10.1211/0022357055416

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