Taking Blood Thinners or Antidepressants? You May Need to Avoid This Popular Spice

Your spice rack’s secret weapon could complicate your body’s ability to metabolize drugs, a new study suggests.

-High doses of cinnamon, especially in supplements or oils, may interfere with how the body metabolizes medications by activating or inhibiting liver enzymes.

-These interactions could make medications less effective or increase side effects, particularly for drugs like blood thinners, antidepressants, NSAIDs, and some hormonal treatments.

-Culinary use of ground cinnamon is generally considered safe, but experts advise caution with concentrated forms and recommend consulting a doctor if you’re on medication.

If cinnamon is a staple in your spice cabinet, welcome to the club. Whether it’s sprinkled atop oatmeal, mixed into baked goods, or whipped into a frothy coffee, this popular ingredient is clearly a fan favorite. However, before you indulge in this sweet spice, you should check your medications.

A recent study published in Food Chemistry: Molecular Science found that high concentrations of cinnamon can cause dangerous interactions with some medications. Researchers examined how cinnamaldehyde—the strong-smelling compound that gives cinnamon its signature scent—is processed in the body by simulating digestion and using liver cell models to explore what happens once the compound is absorbed.

Interestingly, cinnamaldehyde is highly absorbable and quickly converts into cinnamic acid in the body, says Pamela Tambini, MD, an internal physician and medical director at Engage Wellness. “Higher doses, like concentrated supplements or oils, can activate a liver receptor called PXR, which plays a role in how our bodies break down many medications, and this means that cinnamon, especially in stronger forms, could affect how some drugs are metabolized,” she explains.

The study was conducted in a controlled laboratory, indicating that further research is necessary. However, the findings highlight a significant potential for drug interactions if cinnamon is consumed in large amounts, says Nicholas Church, MD, a family medicine physician and founder of Somerset Medical.

Curious about which medications should not be taken with cinnamon? Keep reading for everything you need to know and tips on how to stay safe.

According to the study, cinnamon can interfere with medications in two primary ways.

First, cinnamon oil and cinnamic acid can activate receptors such as PXR and AhR, which regulate the production of liver enzymes responsible for drug metabolism, Church says. The activation of these receptors can then accelerate drug metabolism, potentially reducing the effectiveness of medications.

Second, cinnamon oil and cinnamaldehyde can directly inhibit certain liver enzymes, specifically CYP2C9 and CYP1A2, which are involved in processing many common medications, such as warfarin, some diabetes medications, certain NSAIDs, and a few antidepressants, Church says. Depending on the situation, this could either slow down or speed up the rate at which drugs are cleared from the body.

That said, the issue is not so much the cinnamon spice in your kitchen — it’s when cinnamaldehyde enters your system in larger amounts, Tambini says. “The study found that cinnamaldehyde can ‘turn on’ the PXR receptor in the liver, and this receptor controls enzymes that help your body clear medications,” she explains. “If it’s activated, it could either speed up how quickly your body gets rid of a drug, making it less effective, or slow it down, which could raise the drug’s levels and side effects.”

In other words, cinnamon does not block medications — it subtly changes how your body processes them.

The study did not list specific medications to avoid when consuming cinnamon, but Tambini says drugs that rely on liver enzymes affected by PXR, such as CYP2C9 and CYP1A2, may be impacted. This is not an extensive list, nor are the medications to avoid mixing with cinnamon limited to these examples; this includes blood thinners, some antidepressants, certain pain relievers, and even some hormonal medications, Tambini says.

“It’s likely fine if you have a cinnamon-flavored coffee or dessert now and then; however, if you’re taking cinnamon supplements or essential oils, it could be a different story, so always check with your doctor first,” Tambini says. “There is no ‘safe window,’ but a good rule of thumb is to avoid taking your meds within two to four hours of a high cinnamon intake to create a buffer.”

When in doubt, Church recommends always consulting your doctor. You may not notice immediate symptoms, but regularly consuming high amounts of cinnamon could have a more lasting impact on drug metabolism.

No. Not all forms of cinnamon carry the same risk, Tambini says. “The concern is primarily with forms that contain a high concentration of cinnamaldehyde, like cinnamon oil or concentrated supplements.”

This is because ground cinnamon used in food contains significantly lower concentrations of active compounds compared to cinnamon oil or concentrated supplements. “Cinnamon oil, in particular, is much more potent and was the form most strongly linked to receptor activation and enzyme inhibition in the study,” Church says. “Regular culinary use of cinnamon in reasonable amounts is much less likely to cause problems.”

To break it down a bit more, cinnamon oil is the distilled essential oil that is highly concentrated in cinnamaldehyde and other active chemicals, Church says. Ground cinnamon, by contrast, is simply powdered bark that contains only small amounts of the essential oil, he explains. So, because cinnamon oil delivers a much higher dose of active compounds, it has a stronger effect on drug-metabolizing systems, while classic cinnamon used in cooking is far more diluted and less likely to interfere unless consumed in very large quantities.

Put differently, there is likely no need to entirely give up cinnamon. “For most people, cinnamon in food is completely safe and may even have health benefits, like helping regulate blood sugar or acting as an antioxidant (which promotes overall well-being and reduces the risk of chronic disease),” Tambini says. Again, the study mainly raises concerns about high-dose cinnamon supplements or concentrated oil products taken regularly.

Cinnamon effects the Cytochrome P450 group of enzymes in the liver. These are the CYP enzymes mentioned above. They are responsible for detoxing the body. They are what creates the half life of medications that is then used to determine the frequency of dosage.

The other effect of cinnamon is on allosteric enzymes that can act as switches, either turning enzymes, and thus the corresponding biochemical reaction in the body, either on or off.

A close friend of mine spent his entire career at the medical school researching allosteric enzymes in the liver. It’s the topic of study for his PhD and he stayed with it for 40 years. He authored the textbook on liver enzymes used by universities teaching this topic.

My interest in these enzymes is that it appears these allosteric enzymes are the root cause of auto immune disorders such as MS. By reversing, they can turn the body against itself.

“Beneficial effects of cinnamon and its extracts in the management of cardiovascular diseases and diabetes”

https://pubs.rsc.org/en/content/articlehtml/2021/fo/d1fo01935j

Numerous lines of findings have elucidated that cinnamon has beneficial effects against CVDs in various ways, including endothelium protection, regulation of immune response, lowering blood lipids, antioxidative properties, anti-inflammatory properties, suppression of vascular smooth muscle cell (VSMC) growth and mobilization, repression of platelet activity and thrombosis and inhibition of angiogenesis. Furthermore, emerging evidence has established that cinnamon improves diabetes, a crucial risk factor for CVDs, by enhancing insulin sensitivity and insulin secretion; regulating the enzyme activity involved in glucose; regulating glucose metabolism in the liver, adipose tissue and muscle; ameliorating oxidative stress and inflammation to protect islet cells; and improving diabetes complications. In this review, we summarized the mechanisms by which cinnamon regulates CVDs and diabetes in order to provide a theoretical basis for the further clinical application of cinnamon.

Cinnamon, a common spice, is an herbal medicine and an anti-inflammatory dietary supplement recommended for the primary and secondary prevention of coronary artery disease.8 Furthermore, cinnamon has been found to decrease fasting blood glucose (FBG) and homeostatic model assessment for insulin resistance (HOMA-IR) level, thus bringing benefits to diabetic patients.

More than 80 compounds were separated and characterized from different parts of cinnamon. The major compounds of cinnamon include eugenol, cinnamaldehyde, camphor, cinnamyl acetate, and copane, as well as other minor constituents.

Cinnamaldehyde has been revealed to exert antioxidation, anti-inflammatory, blood vessel protection and hypoglycaemic and antibacterial effects.

The main component of cinnamon leaf essential oil is eugenol.19 Nineteen ingredients were extracted from the volatile oil of C. zeylanicum Blume leaves, and eugenol accounted for 87.3%.26 Eugenol showed very powerful activities of inhibiting peroxynitrite-induced lipid peroxidation.

Cinnamaldehyde has also been found to possess substantial antimicrobial, anticancer and anti-inflammatory properties.

Inhibition of angiogenesis. Angiogenesis can aggravate inflammatory responses, induce hemorrhages in the plaque, affect the stability of the plaque, and consequently lead to the occurrence of acute cardiovascular events. A water extract of C. cassia represses vascular endothelial growth factor (VEGF)-induced angiogenesis in HUVECs by suppressing the tyrosine phosphorylation of VEGFR2 and induces a decrease in VEGF-stimulated microvessel outgrowth in an ex vivo angiogenesis. (a friend of mine has wet macular degeneration in his one eye. Cinnamon could repress the angiogenesis by suppressing the VEGF creating the hemorrhages.)

This is a very long comprehensive article on cinnamon (27 pages), and also covers its uses in Chinese medicine. (Published in 2021)

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