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4 Surprising Benefits of Bitters (incl. For Digestion)

Written by Carlos Tello, PhD (Molecular Biology) | Last updated:
Jonathan Ritter
Puya Yazdi
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology), Puya Yazdi, MD | Written by Carlos Tello, PhD (Molecular Biology) | Last updated:

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Digestive bitters are a potential way to jump-start your digestion. Once much more common in our diet, bitters have been replaced by sweeter-tasting foods over time. While sugars might satisfy your taste buds, bitters may stimulate digestive juices, soothe gut inflammation, and increase nutrient absorption. Keep reading to find out what bitters can do for your digestive health.

What Are Digestive Bitters?

Digestive bitters broadly include all herbs or supplements with a bitter taste. Their bitterness stimulates digestive juices to help the body overcome gut problems such as indigestion, bloating, heartburn, nausea, and more. A number of bitters have been used for hundreds of years across the world to promote digestive health.

Digestive enzymes and bile acid supplements became more popular over the years, slowly pushing bitters out of the picture. Digestive enzymes are presented as more advanced targeted products, while bile supplements are regarded as more potent. While both can certainly improve digestion by making up for a physiological lack of gut enzymes and bile acids, they are only a temporary solution. Neither will stimulate your gut to re-establish healthy digestion.

Over time, you may even get into a state of constantly requiring bile and digestive enzymes to properly digest food. You may be happy enough that anything at all is working to improve your digestion but you’re probably also aware that you haven’t arrived at an ideal solution. Long-term, the goal of natural remedies should be to bring you back into a state of health and balance, not to keep you dependent on numerous supplements.

That’s where bitters come in! These herbs are gentle and beneficial in the long run. By incorporating bitters into your diet or supplement regime, you are telling your gut (and brain!) to gradually produce more digestive juices. Often times, this crucial difference between digestive enzymes and bile supplements, on the one hand, and herbal bitters, on the other, goes unnoticed.

Of course, you will need to take into account many other factors if you want to get to the bottom of your indigestion issues. These will often also involve adapting your diet, working on food sensitivities, reducing inflammation, stress, circadian rhythm disruptions, and others. Learning how to use bitters and discussing it with your doctor can be one additional step in the right direction.

Digestive bitters are extracted from many herbs and supplements with a bitter taste. They are becoming more popular as a digestive aid.

Snapshot

Proponents

  • May improve digestion and support gut health
  • May stimulate the release of stomach acid, digestive enzymes, and bile
  • May increase the absorption of nutrients
  • Versatile, easy to find and incorporate into a daily routine

Skeptics

  • Many bitters with varying effects exist
  • Not all traditional health benefits have been scientifically validated
  • Some people find the bitter taste intolerable
  • Some bitters may cause side effects, allergic reactions, and drug interactions

Health Benefits of Bitters

Bitters have not been approved by the FDA for medical use and generally lack solid clinical research. Regulations set manufacturing standards for them but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing.

Possibly Effective

1) Indigestion

Most of the research and traditional use of bitters focuses on their benefits for improving digestion.

The popular multi-herbal product Iberogast (which contains bitters such as milk thistle, chamomile, and angelica) was effective at improving indigestion in an analysis of 6 clinical trials [1].

Celandine capsules improved stomach pain, nausea, passing gas, and bloating over 6 weeks in a trial of 30 people [2].

The well-known spice turmeric is also a mild bitter. In a clinical trial of 116 people, turmeric (Curcuma domestica) improved indigestion in 87% of the cases [3].

Black cumin is another powerful herb with bitter qualities. In one study with 88 patients, grounded black seed (Nigella sativa) helped eliminate ulcer-causing Helicobacter pylori infections and improved indigestion [4].

In multiple clinical trials, artichoke leaf extracts (alone or with other herbs) improved indigestion. In a survey of patients with irritable bowel syndrome and indigestion, nearly all said that artichoke was at least as helpful as other past interventions. In a study of 311 patients, the herbal mixture Cinarepa (artichoke, dandelion, and turmeric) relieved indigestion [5, 6, 7, 8, 9].

The most popular health-related use of bitters is as a digestive aid. Some clinical evidence suggests that using bitters could prevent or improve indigestion.

Traditional Chinese Medicine Formulas

Chaihu Shugan powder is a popular Chinese multi-herbal formula used for many years to relieve indigestion. An analysis of 22 clinical trials with nearly 2,000 patients showed that modified Chaihu Shugan powder could be an effective option for improving indigestion [10].

The Xiaoyao pill is another bitter multi-herb formula used in traditional Chinese medicine. In a study of 180 depressed women with indigestion, it improved digestion by boosting the flow of food through the digestive system, and by increasing stomach acid and digestive proteins (by raising motilin and gastrin hormones) [11].

A multi-herbal bitter (Yukgunja-Tang) reduced symptoms of indigestion, bloating, nausea, vomiting, and stomach pain in a clinical trial with 96 people after 8 weeks. The participants took 5g of the powder 3 times per day [12].

Another multi-herbal extract (Ban Xia Xie Xin) similarly reduced indigestion, bloating, and stomach pain in a clinical trial of 101 people after 4 weeks. The extract was given as a powder mixed in hot water twice a day. The benefits were maintained even 4 weeks after the extract was stopped, which supports the idea that a short course of bitters can improve digestion in the long term [13].

All in all, the evidence suggests that herbal bitters may improve indigestion. You may discuss with your doctor if any of these herbs may be helpful in your case and how to use it as a complementary approach. Importantly, follow their recommendations carefully and never use herbal bitters to replace any treatments prescribed by your doctor.

Traditional Chinese medicine uses multi-herbal bitters to reduce symptoms of indigestion. Modern clinical research suggests that such herbal blends could be helpful.

2) Gut Inflammation and Ulcers

In addition to improving digestion, bitters have anti-inflammatory properties. This can be beneficial to those with chronic inflammatory disorders such as ulcerative colitis, a disease that can cause ulcers throughout the digestive tract.

In a study with 94 patients, Dong Quai (Angelica sinensis) injections helped improve ulcerative colitis (by blocking platelet activation). Chamomile, myrrh, and coffee charcoal stopped ulcerative colitis from coming back at the same rate as standard drugs in a clinical trial of almost 100 people [14, 15].

Helicobacter pylori infections are the main cause of stomach and gut ulcers. In a clinical trial of 36 people with H. pylori, a combination of bitter herbs (burdock, angelica, gromwell, and sesame) lowered inflammation and healed ulcers [16].

A mixture of dandelion, St. John’s wort, lemon balm, and other herbs lowered stomach pain by over 95% after 2 weeks in a study of 24 people with colon inflammation [17].

Many animal studies support the anti-inflammatory effects of bitters. Bitter orange decreased colon inflammation, diarrhea, and inflammatory molecules (TNF-alpha, COX-2) in rats with IBS [18].

Berberine was also effective at lowering gut inflammation (especially in the colon) in rodents. Dandelion could ease stomach inflammation in rats (by lowering TNF-alpha and stopping mast cells from reaching the stomach) [19, 20, 21, 22, 23, 24].

Artichoke, chamomile, gentian, and burdock could all protect against or heal stomach ulcers from excessive alcohol intake in rodents. Burdock healed ulcers caused by other harmful substances as well [25, 26, 27, 28, 29, 30, 31, 32, 33].

Although a bit limited, the evidence suggests that herbal bitters may help with gut inflammation and ulcers. You may use some of them as an add-on to your treatment regime if your doctor determines that they may help in your case.

3) Diabetes

While bitters are mostly known for their ability to boost digestion, they may also help people with type 2 diabetes by lowering blood sugar levels and body weight.

A Chinese herbal bitter (TM81) lowered blood sugar levels, BMI, weight, waist size, and improved diabetes symptoms in a clinical trial with 480 overweight type 2 diabetic patients in early phases of the disease [34].

In clinical trials of over 122 people with type 2 diabetes, another Chinese herbal bitter, as well as berberine, reduced blood sugar levels to the same extent as metformin, the standard anti-diabetic drug. Berberine normalized blood sugar levels after and in between meals, while also reducing blood fats such as triglycerides [35, 36].

Chamomile tea can also help with diabetes, probably due to a mix of bitter and antioxidant qualities. In a clinical trial with 64 people with type 2 diabetes, chamomile tea (3X day) significantly lowered cholesterol, insulin, sugar-bound hemoglobin (HbA1C), and fat (triglyceride) blood levels [37].

Limited evidence suggests that herbal bitters may help with blood sugar control in diabetics. You may discuss their potential use as complementary approaches with your doctor.

Insufficient Evidence

The following purported benefits are only supported by limited, low-quality clinical studies. There is insufficient evidence to support the use of bitters for any of the below-listed uses. Remember to speak with a doctor before taking bitters as a supplement, and never use them in place of something your doctor recommends or prescribes.

4) Acid Reflux and GERD

Although it may seem counterintuitive, stimulating the release of stomach acid and digestive enzymes can help people with acid reflux. While most conventional drugs for acid reflux work to only temporarily reduce stomach acid secretion or neutralize it (like Tums), bitters help to re-establish proper digestion and strengthen the esophagus in the long run.

In one observational study, 50 patients with acid reflux were given an Ayurvedic syrup called Acidinol for 4 weeks. This multi-herbal formula with bitters such as neem (Azadirachta indica), relieved symptoms of heartburn, stomach pain, bloating, nausea, indigestion, and loss of appetite in over 75% of patients [38].

The extract of the bitter fruit quince mildly reduced symptoms of GERD in a clinical trial with 80 children after 4 weeks [39].

Most people with acid reflux have a weakened valve that separates the esophagus tube from the stomach. In rats, red sage (Salvia miltiorrhiza) helped manage GERD by keeping the lower esophageal muscle contracted, which prevents acid from regurgitating out of the stomach [40].

In rats, a type of daisy (Artemisia asiatica) prevented ulcers along the esophagus and decreased inflammation (lowered NF-KB levels) [41].

In rats with GERD, Iberogast decreased inflammatory molecules and protected against damage to the esophagus [42].

Two clinical trials and some animal research cannot be considered conclusive evidence to support the use of herbal bitters in people with acid reflux. Further clinical research is needed to validate these preliminary results.

Limitations and Caveats

Many of the studies examine mixtures of multiple herbs or drugs at once. Since some of these components are not bitter, it cannot be known for certain if the herbal bitters are the ones responsible for the beneficial effects in these studies.

Additionally, a lot of the studies were conducted in animals or cells. While these are helpful, more clinical trials would present stronger evidence for the benefits of bitters.

The Genetics of Bitter Taste

Genetics play a role in how you perceive bitter taste, as different types of bitter receptors sense bitterness in different ways.

One study found that variants (polymorphisms) in the TAS2R38 gene can lead to 3 main categories of bitter perception to bitter compounds. People with the AVI type of receptor have difficulty in tasting bitterness, while those with the PAV type are sensitive to bitter taste. The 3rd AAI type falls somewhere in between [43].

These genetic predispositions can impact dietary choices. People who are sensitive to bitters have a lower preference towards certain vegetables like spinach, cabbage, kale, and others, often resulting in a lower vegetable and fruit intake than those who are not sensitive. Additionally, people who are sensitive to bitters also have a decreased preference for alcohol [44].

If you’re more sensitive to bitter taste, you will find bitters hard to tolerate. However, since these receptors also play a role in producing the effects of bitters by increasing digestive juices, you may need a smaller amount to get the benefits.

Being more sensitive to bitters can have additional health benefits. One study found that European Americans who are sensitive to bitters (PAV type) were less likely to be smokers. This might be because people who can taste bitters are more likely to be turned off by the bitter compounds in tobacco smoke. This relationship did not hold for African Americans, however [45].

These genetic predispositions can broadly affect your diet, lifestyle, and disease risk. Mutations in the TAS2R38 gene are associated with conditions such as thyroid dysfunction, obesity, and colon polyps [44].

Genetic variations in bitter taste receptors can change the way different people perceive bitters. People who are more sensitive to bitter tastes may require lower doses of bitters to benefit from them.

User Experiences

The opinions expressed in this section are solely those of herbal bitter users, who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.

Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.

Most people who took bitters had a positive experience. One user reported that their digestion had improved greatly after incorporating bitters into their daily routine. Another said that they had been taking bitters for over 6 years and couldn’t imagine life without them. Others found that daily use greatly improved digestion and bloating.

One pregnant user reported heartburn relief from bitters, although there was an adjustment period. She also said that it helped with her children’s digestion.

Some people added bitters to green tea. One user mentioned improved digestion from doing this in the morning, before and after meals, even more so than when taking digestive enzymes.

One user took bitter pills after meals, which reportedly helped with gas, acid reflux, burping, and bloating.

A couple of users did have mildly negative experiences. One person said that they took bitters seeking heartburn relief, but they actually made it worse. A few users complained about the taste, saying that it is so overwhelmingly bitter that they could not bring themselves to drink the elixirs.

Takeaway

Digestive bitters are extracted from many herbs and supplements with a bitter taste. They are most commonly used (and best-studied) for their potential to reduce the symptoms of indigestion, while other research suggests that they may improve gut inflammation and reduce blood sugar as well.

Genetic variations in bitter taste receptors can change the way different people perceive bitters. People who are more sensitive to bitter tastes may require lower doses of bitters to benefit from them.

Further Reading

About the Author

Carlos Tello

Carlos Tello

PhD (Molecular Biology)
Carlos received his PhD and MS from the Universidad de Sevilla.
Carlos spent 9 years in the laboratory investigating mineral transport in plants. He then started working as a freelancer, mainly in science writing, editing, and consulting. Carlos is passionate about learning the mechanisms behind biological processes and communicating science to both academic and non-academic audiences. He strongly believes that scientific literacy is crucial to maintain a healthy lifestyle and avoid falling for scams.

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