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 Once much more common in our diet, bitters have been replaced by sweeter-tasting foods over time. What are bitters, how might they improve our health, and what are the potential side effects? Read on to find out.
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.
How Are Bitters Used?
Extracts of bitter herbs can be used in various ways: added to food, poured into drinks such as tea or alcoholic beverages, or taken alone in their pure form. Several herbs are traditionally combined into digestive elixirs, the most well-known ones being Swedish bitters and Iberogast. Bitters are typically used before a meal to stimulate digestive juices.
More recently, some manufacturers have formulated pills with herbal extracts that mask the bitter taste. Although this may sound appealing, it doesn’t work as well. Bitters need to activate specific bitter taste receptors (TAS2Rs) in the body (especially those on the tongue), which means you will not get the full effects by bypassing their somewhat unpleasant flavor [1].
Bitter herbs are so numerous that it’s almost impossible to list them all. Some of the most common and well-researched herbal bitters include artichoke, dandelion, bitter orange, black seed, gentian, and chamomile.
See this post for the best herbal bitters.
For more about the potential benefits of bitters, check out this post.
Mechanism of Action
Despite their historic use, the digestion-promoting mechanism of action of bitters is still somewhat unclear. Bitters probably act by stimulating the vagus nerve and bitter receptors, as well as by increasing blood flow to the gut. As a result, bitters may increase stomach acid, digestive enzymes, and bile, which helps break down food and absorb nutrients.
Vagus Nerve Stimulation
According to the most supported theory, when bitter compounds turn on bitter taste receptors, a signal is sent through the cranial nerve in the tongue (glossopharyngeal) to the brain (cerebral cortex). This allows the brain to “sense” bitterness, which activates the vagus nerve. The vagus nerve sends the message back down to the mouth and stomach to aid digestion by increasing saliva, stomach acid, and bile [2].
Bitterness Receptors in the Gut
According to this theory, bitters promote digestion without getting the brain involved.
Research has identified active bitter receptors in the gut. Bitter compounds can turn on these receptors, which may stimulate digestion directly in the gut by triggering the release of digestive juices [2, 3, 4, 5].
In the mouth, bitter compounds increase saliva production by turning on bitter receptors on the tongue. Based on this outlook, the bitterness signal doesn’t need to reach the brain at all [2].
Increased Gut Blood Flow
Another line of research suggests that activating the cranial nerve in the tongue by bitter receptors leads to increased blood flow to the gut. Increased gut circulation aids digestion by supporting stomach acid release, the passing of food, the absorption of nutrients, and the clearing of waste products [2].
Some have proposed that the alcohol in tinctures is what promotes digestive health, but this is highly unlikely having in mind the small amounts of alcohol in typical doses of bitter tinctures [2].
Ultimately, not all bitters work in the same way. Some may work by one mechanism, and others may work by a different mechanism or by a mixture of effects. Some bitters can be categorized based on their mechanism of action but more research is needed [2].
Bioactive Components in Bitters
Gentian contains a class of bitter compounds called iridoids, including one called gentiopicroside. Gentiopicroside seems to help with the normal flow of food through the gut, and iridoids may be important for stomach acid production [6, 7].
Burdock seeds and leaves have arctigenin, a compound with anti-inflammatory properties. Burdock roots and artichoke have inulin, which helps the growth of probiotics [8, 9, 10].
Cynarin is an important compound found in artichoke and is responsible for increasing bile production, which aids fat digestion and vitamin absorption [11, 12].
In chamomile, certain flavonoids (apigenin, quercetin, and patuletin) can decrease muscle spasms in the gut. The aromatic compound chamazulene found in chamomile has anti-inflammatory effects [13, 14].
Goldenseal roots contain berberine, a bitter compound with many potential health benefits [15].
Side Effects & Precautions
This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects.
Call your doctor for medical advice about side effects. In the US, you may report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada, you may report side effects to Health Canada at 1-866-234-2345.
Digestive bitters are a diverse group of herbs. The most common ones are generally safe. However, polyherbal combinations are common and being aware of any potential side effects or sensitivities to their components can help you avoid negative reactions.
Dandelion is considered generally safe to use and has few side effects. However, it lowered fertility in one study in male rats. In one instance, the consumption of dandelion excessively lowered blood sugar in a 58-year-old woman with diabetes. Be sure to monitor your glucose closely if you have diabetes and are taking bitters [16, 17, 18, 19].
In one study, artichoke leaf extracts caused a few patients (only ~1%) to feel weak, hungry and have gas. Megadoses of artichoke extract triggered DNA mutations in cells and mice. However, the dosage in mice was so extremely high (2 g/kg, which would be about 200 g of the extract for a person of ~220 lbs) that it would be almost impossible to achieve when supplementing [20, 21].
Bitter orange extract is considered to be very safe [22].
Berberine is generally safe, although patients occasionally complain of constipation, diarrhea, nausea, and bloating [23].
Milk thistle and silymarin are also generally safe, but side effects can include nausea, diarrhea, bloating, allergic reactions, and joint pain [24, 25].
Extremely bitter bottle gourd juice can be quite dangerous, as 3 deaths and 26 hospital admissions due to stomach pain and vomiting have been reported [26].
Vulnerable Populations
Dandelion in higher amounts than those found in food is not recommended in children or women who are pregnant or breastfeeding [27].
Bitters that increase bile production, such as artichoke, should not be taken by people with bile duct occlusion or gallstones [11].
Because tinctures contain alcohol, higher amounts are not recommended for pregnant women and children.
Allergies
In one study of 235 people, 1.3% had an allergic skin reaction to dandelion [28].
While there are no reports of skin allergies to oral artichoke, skin contact can cause rashes and inflammation in some cases [11].
Some people are allergic to plants in the daisy family such as chamomile and burdock. Several cases of life-threatening allergic reactions (anaphylaxis) have been reported [29, 30].
Drug Interactions
Supplement/Herb/Nutrient-drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before supplementing and let them know about all drugs and supplements you are using or considering.
In healthy adults, milk thistle extract silymarin blocked the breakdown of the blood-pressure-lowering medicine Cozaar (Losartan). The degree of inhibition depended on the genotype of the CYP2C9 gene [31].
Silymarin may also increase the rate at which the antibiotic metronidazole is removed from the body while having the opposite effect with the beta blocker talinolol [32, 33].
Chamomile, berberine (from Goldenseal), and dandelion may block cytochrome P450 (CYP3A4 and CYP1A2), which break down drugs such as warfarin and cyclosporine. Taking them at the same time can increase blood concentrations of the drugs. In one instance, the combination of warfarin and chamomile led to internal bleeding in a 70-year-old woman [34, 35, 36, 37, 38].
In healthy people and kidney transplant patients, berberine raises the bioavailability of Neoral (cyclosporin), likely by inhibiting CYP3A4. This can be good if monitored in people prone to poor cyclosporin bioavailability but can be dangerous if this the blood levels of this drug get too high [39, 40].
Dandelion might lower the effects of the antibiotic ciprofloxacin, and may, in theory, increase the risk of bleeding in combination with blood thinners (due to its coumarin content). Dandelion may also increase the side effects of vitamin B3 (niacin) such as stomach aches [27].
How to Make Bitters
If you have the time, making your own bitter infusions can be a fun and easy process. You will need bitter herbs (such as artichoke leaf, burdock root, angelica root, dandelion root, etc.), alcohol (at least 100-proof), jars for storage, a strainer, a cutting board, and a knife. You can also mix in additional herbs and spices to add flavor.
Instructions:
- Cut your bitters into small pieces and place them inside a jar. Note: If you have multiple bitters, you can either mix them all together in one jar or keep everything in separate jars and mix them later. The disadvantage of mixing them in the beginning is that different bitters may infuse into the alcohol at different speeds.
- Add the high-proof liquor, making sure that the bitters are fully submerged. Place the lid on the jar and store in a cool, dark place.
- Every day, shake each jar well for around 10 seconds.
- Since infusing speeds are different depending on the bitter, this can take anywhere from one day to a few weeks. You can test whether or not the alcohol has been infused by taking a few drops out and smelling or tasting it. Once the liquid smells or tastes bitter enough, the tincture is ready.
- Once it is ready, strain out the bitters (a cheesecloth works well) and you will be left with your own homemade tincture. From this point, you can combine different tinctures together, add a few drops to food, tea, other beverages, or use them to your preference. They can last for about a year and don’t need to be refrigerated.
Digestive Bitters vs. Alcoholic Bitters
Digestive bitters are used to aid with indigestion or other gut problems and can come in a variety of different forms such as tinctures, pills, powders, and even creams. Tinctures are among the most common forms that are very easy to add to alcoholic beverages. Adding bitters to alcohol is done mostly for flavor – to make the drink taste better.
Thus, digestive bitters are taken for health reasons while alcoholic bitters are savored for taste. That being said, you should still receive the health benefits that bitters provide if you add them to alcohol and consume in moderation.
Supplementation
Herbal bitter supplements have not been approved by the FDA for medical use due to the lack of solid clinical research. Regulations set manufacturing standards for supplements but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing with herbal bitters.
Forms
Bitters come in many different forms. Tinctures are very common and bottled as sprays that can be applied directly to the tongue or droppers to be taken straight or mixed with water.
Other common forms include pills and powders that need to be mixed with water.
Usually, several herbs are combined into a bitter elixir. The content of individual herbs will vary depending on the formulation and brand. The more well-known combinations include:
- Swedish bitters are a blend of many herbs including angelica root, senna leaf, rhubarb root, myrrh stem, valerian root, cinnamon bark, and more
- Angostura bitters are made in Trinidad and Tobago by the House of Angostura and are known for their tinctures with gentian
- The main component of black seed bitters is black cumin (Nigella sativa), and can also contain acai, honey, garlic, and ginger
- Lavender bitters have lavender, orange peel, and other herbs, and Peychaud’s bitters are based on gentian
- Iberogast, a German formulation with 9 herbs commonly found in pharmacies
Dosage
For dandelion leaf, the British Herbal Pharmacopeia recommends 3-5 grams twice daily or 5-10 mL of leaf tinctures twice daily [16].
The recommended dosages of other dandelion preparations in adults include [27]:
- Dried root: 2-8 grams infused in a drink
- Leaf fluid extract: 4-8 mL of a 1:1 alcohol (25%) extract
- Root tincture: 5-10 mL of a 1:5 tincture in 45% alcohol
In one study, 1 gram per day of chamomile extract (one 500mg pill taken twice) was used to effectively reduce vomiting frequency [41].
Berberine doses typically range between 0.5 grams per day to 1.5 grams per day in different clinical trials. One trial used 20 mg for every kilogram for each person [23].
Clinical trials with bitter orange have used doses ranging from 900 to 975 mg of bitter orange extract [42, 43].
For reducing inflammation, one clinical trial used 2 grams of burdock root in 150 mL of boiled water to prepare tea taken 3 times a day [44].
Daily consumption of either 320 or 640 mg of artichoke leaf extract reduced indigestion [45].
For ulcerative colitis, patients took one 140 mg tablet of silymarin once per day for 6 months [46].
Further Reading
- 8 Best Herbal Bitters + Combinations & Synergies
- 4 Surprising Benefits of Bitters (incl. For Digestion)
Takeaway
Digestive bitters are extracted from many herbs and supplements with a bitter taste. Some people use them as a digestive aid to stimulate the stomach, vagus nerve, and cranial nerve. The active components of bitters vary depending on which herbs are used to make them, as do their potential side effects. We therefore recommend caution when choosing and taking bitters.
Bitters are easy to make; bitter herbs (such as burdock, angelica, or dandelion roots) must simply be left to infuse in alcohol for days to weeks. The resulting concoction can then be used as a supplement or to flavor food or drinks.
