Supplement
Triphala
Herbs · Haritaki, Bibhitaki, Amalaki (Terminalia chebula, Terminalia bellirica, Phyllanthus emblica)
Triphala is one of the best-known blends in Ayurvedic medicine, traditionally used for digestion. In humans there are mainly small studies with mixed results; the only double-blind placebo-controlled trial from Europe showed no benefit. For the main use, digestion, robust controlled data are lacking. Product quality of Ayurvedic preparations is a separate issue.
What Triphala is
Triphala means “three fruits”: the blend consists of equal parts of the dried fruits of haritaki (Terminalia chebula), bibhitaki (Terminalia bellirica) and amalaki (Phyllanthus emblica, known as amla). In Ayurvedic medicine it is regarded as a mild laxative and digestive aid and is associated there with cleansing and regeneration of the body.
In the BK-Score, human evidence stands at 4 out of 10 points, and the direction is open. That means: the data are not sufficient to confirm or refute the advertised effects.
How it works
The fruits contain many tannins and polyphenols, including gallic acid, chebulagic and chebulinic acid, as well as vitamin C. They are credited with antioxidant, anti-inflammatory and mildly laxative properties. A 2018 review describes these pathways, but they come predominantly from laboratory and animal experiments.
No pathway has been confirmed in humans. What has been measured in humans are blood lipids, blood sugar and weight in small studies – and, for external use as a mouthwash, markers of gum inflammation.
What is well supported
- As a mouthwash, similarly effective to chlorhexidine. In 7 randomized trials on gum inflammation, Triphala mouthwash performed no worse on gingival and plaque index, with high heterogeneity. This concerns external use, not oral intake.
- Well tolerated in small studies. A review of 12 studies with 749 participants reported no serious side effects.
What the studies show
Phimarn 2021: twelve small studies
The systematic review covers 12 randomized trials with 749 participants. In 6 studies, LDL, total cholesterol and triglycerides fell; in 5 studies, weight, BMI and waist circumference fell in people with overweight. Fasting blood sugar fell in people with diabetes, not in healthy people. The authors did not perform a meta-analysis; they call for large, well-designed studies.
Donato 2021: double-blind, no benefit
Randomized, double-blind trial from Italy in 90 people with elevated cholesterol, guggulu plus Triphala versus placebo over three months. Total cholesterol, LDL, BMI and waist circumference did not differ from placebo; LDL fell by just under 5 percent in both groups. Two of 46 participants in the active group developed an allergic skin rash. Because guggulu was given as well, the contribution of Triphala alone cannot be separated out.
Phetkate 2020: safety study in healthy people
Open-label, single-arm study in Thailand in 20 healthy volunteers who received 2,500 mg of aqueous Triphala extract per day for four weeks. No serious side effects occurred; HDL rose and blood sugar fell. Without a control group, these changes cannot be causally attributed.
Where the data stop
- Digestion and constipation. For the traditional main use, no robust placebo-controlled studies could be found; a 2018 review recommends Triphala for further clinical studies, not for use.
- Blood lipids and weight. The positive findings come from small studies; the only double-blind placebo-controlled trial from Europe found no benefit.
- Detoxification and rejuvenation. None of the studies evaluated here tests such an endpoint.
- Long-term safety, pregnancy, children. There are no data on these; the longest safety study lasted four weeks in 20 healthy people.
Status, approval and legal
In Germany, Triphala is offered as a food supplement; no ban could be found, and there is no official maximum amount. No authorized health claim exists – the EU Commission has put claims on botanicals on hold in large numbers; EFSA cites 1,548. Triphala is not on the 2026 WADA Prohibited List.
Safety
No serious side effects were reported in the small studies; in the Italian placebo-controlled trial, 2 of 46 participants developed an allergic skin rash. Interactions have not been studied in humans: in human liver microsomes, Triphala inhibited the metabolizing enzymes CYP1A2, CYP3A4, CYP2C9 and CYP2D6, and in rats the bioavailability of midazolam rose by around 41 percent. Anyone taking medicines with a narrow therapeutic range should discuss this with a doctor.
A known problem concerns Ayurvedic preparations in general: in an investigation published in the Journal of the American Medical Association, 20.7 percent of 193 Ayurvedic preparations bought online contained detectable lead, mercury or arsenic, from US and Indian manufacturers alike. All contaminated products exceeded at least one limit for tolerable daily intake, and 75 percent of them advertised good manufacturing practice. The investigation did not specifically evaluate Triphala products. The same question arises with other Ayurvedic products such as Shilajit. In the BK-Score, safety data stand at 3 out of 10: little studied. This text is for information and does not replace medical advice.
BK-Score Thin human evidence
| Human evidence | 4 | |
|---|---|---|
| Mechanism | 3 | |
| Safety data | 3 | |
| Hype gap | 3 | |
| Track record of use | 7 |
Evidence 4, because for oral intake there are only small studies with surrogate markers – a systematic review of 12 RCTs with 749 participants found inconsistent effects on blood lipids, blood sugar and weight (Phimarn 2021) – and the only double-blind placebo-controlled trial from Europe showed no benefit (Donato 2021); for the traditional main use, digestion, robust controlled data are lacking. Mechanism 3, because the pathways of the polyphenols are described almost only in the laboratory and in animals. Safety 3, because there is only one single-arm safety study in 20 healthy people over four weeks (Phetkate 2020), interactions via CYP enzymes have only been tested in the laboratory and in rats, and Ayurvedic preparations in general have a documented heavy metal problem (Saper 2008). Hype 3, because Triphala is marketed as a comprehensive rejuvenation and detoxification agent without studies supporting this. Use 7, because the blend has been used in Ayurvedic medicine for centuries, but hardly at all in Europe. Direction open: the data are not sufficient to assess the advertised effects.
The score rates the state of knowledge, not the substance. “Safety data 3” means: this is how well safety has been studied – not: this is how harmless the substance is. “Track record of use 7” means: this long and this widely used – that is not proof of efficacy.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)
Frequently asked questions about Triphala
Does Triphala help with constipation?
That is the traditional main use, but no robust placebo-controlled studies on it could be found. A 2018 review describes mildly laxative properties, but relies largely on laboratory and animal data and recommends further clinical studies. Proof of efficacy in humans is therefore lacking.
Does Triphala lower cholesterol or weight?
In some of 12 small randomized trials, blood lipids and weight fell. The only double-blind placebo-controlled trial from Europe, with 90 participants, in which Triphala was given together with guggulu, found no benefit over placebo, however. The data are not sufficient for a reliable statement.
Can Ayurvedic preparations contain heavy metals?
Yes, that is documented. In a US investigation, 20.7 percent of 193 Ayurvedic preparations bought online contained lead, mercury or arsenic, regardless of whether they were made in the US or in India. A claim of good manufacturing practice offered no protection. These measurements did not specifically concern Triphala.
Does Triphala interact with medicines?
This has not been studied in humans. In the laboratory, Triphala inhibited several metabolizing enzymes of the liver, including CYP3A4, and in rats the bioavailability of midazolam rose by around 41 percent. Anyone who takes medicines regularly should raise taking it with a doctor or pharmacist.
What is Triphala made of?
Triphala consists of equal parts of three dried fruits: haritaki (Terminalia chebula), bibhitaki (Terminalia bellirica) and amalaki (Phyllanthus emblica, amla). The fruits contain many tannins and polyphenols such as gallic acid, as well as vitamin C.
Related
- Same goal: Better digestionDGL licorice (deglycyrrhizinated)
- Same goal: Better digestionBetaine HCl (Betaine Hydrochloride)
- Same goal: Better digestionMastic (Mastic Gum)
- Same goal: Better digestionProbiotics
- Same goal: Better digestionOx bile
- Same goal: Better digestionSodium butyrate
Sources
- Phimarn W et al., J Evid Based Integr Med 2021 – systematic review, 12 RCTs, 749 participants (PMID 33886393)
- Donato F et al., Complement Med Res 2021 – double-blind RCT, guggulu and Triphala for elevated cholesterol, 90 participants (PMID 33242870)
- Phetkate P et al., J Integr Med 2020 – safety study, 20 healthy people, four weeks (PMID 31680053)
- AlJameel AH, Almalki SA, Int J Dent Hyg 2020 – meta-analysis, 7 RCTs, Triphala mouthwash (PMID 32383334)
- Nontakham J et al., Heliyon 2022 – CYP inhibition in the laboratory and interactions in rats (PMID 35785236)
- Saper RB et al., JAMA 2008 – lead, mercury and arsenic in Ayurvedic preparations sold online (PMID 18728265)
- Tarasiuk A et al., Chin Med 2018 – review of Triphala in functional gastrointestinal disorders (PMID 30034512)
- EFSA – health claims under Article 13, including 1,548 claims on botanicals put on hold
- WADA – 2026 Prohibited List
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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-10-05.