Noix d'arec

Related Terms

Amaska, Areca catechu, areca quid, areca nut, arecoline, arequier, betal, betel quid, betelnusspalme, chavica etal, gutkha, hmarg, maag, marg, mava, mawa, paan, Palmaceae (family), pan, pan masala, pan parag, pinang, pinlang, Piper betel Linn. (leaf of vine used to wrap betel nuts), pugua, ripe areca nut without husk, quid, Sting? (Tantric Corporation), supai, ugam.

Background

Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. Anecdotal reports have indicated that small doses generally lead to euphoria and increased flow of energy while large doses often result in sedation. Although all three ingredients may contribute to these effects, most experts attribute the psychoactive effects to the alkaloids found in betel nuts.
Betel nut is reportedly used by a substantial portion of the world's population as a recreational drug due to its stimulant activity. Found originally in tropical southern Asia, betel nut has been introduced to the communities of east Africa, Madagascar, and the West Indies. There is little evidence to support the clinical use of betel nut, but the constituents have demonstrated pharmacological actions. The main active component, the alkaloid arecoline, has potent cholinergic activity.
Constituents of betel nut are potentially carcinogenic. Long-term use has been associated with oral submucous fibrosis (OSF), pre-cancerous oral lesions (mouth wounds), and squamous cell carcinoma (cancer). Acute effects of betel chewing include worsening of asthma, low blood pressure, and rapid heart beat.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Early poor-quality research reports that betel nut chewing may lessen anemia in pregnant women. Reasons for this finding are not clear, and betel nut chewing may be unsafe during pregnancy.

C


Early poor-quality research reports that betel nut chewing may lessen anemia in pregnant women. Reasons for this finding are not clear, and betel nut chewing may be unsafe during pregnancy.

C


Due to the known toxicities of betel nut use and the availability of other proven products for dental hygiene, the risks of betel nut may outweigh potential benefits.

 C


Due to the known toxicities of betel nut use and the availability of other proven products for dental hygiene, the risks of betel nut may outweigh potential benefits.

 C


Betel nut chewing may increase salivation. However, it is not clear if this is helpful for any specific health condition. Due to known toxicities from betel nut use, the risks may outweigh any potential benefits.

 C


Betel nut chewing may increase salivation. However, it is not clear if this is helpful for any specific health condition. Due to known toxicities from betel nut use, the risks may outweigh any potential benefits.

 C


Preliminary poor-quality studies in humans suggest improvements in symptoms of schizophrenia with betel nut chewing. However, side effects such as tremors and stiffness have been reported. More research is necessary before a firm conclusion can be drawn.

 C


Preliminary poor-quality studies in humans suggest improvements in symptoms of schizophrenia with betel nut chewing. However, side effects such as tremors and stiffness have been reported. More research is necessary before a firm conclusion can be drawn.

 C


Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. It is believed that small doses can lead to stimulant and euphoric effects, and betel nut chewing is popular due to these effects. Chronic use of betel nuts may increase the risk of some cancers, and immediate effects can include worsening of asthma, high or low blood pressure, and abnormal heart rate. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.

 C


Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. It is believed that small doses can lead to stimulant and euphoric effects, and betel nut chewing is popular due to these effects. Chronic use of betel nuts may increase the risk of some cancers, and immediate effects can include worsening of asthma, high or low blood pressure, and abnormal heart rate. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.

 C


Several poor-quality studies report the use of betel nut taken by mouth in patients recovering from stroke. In light of the potential toxicities of betel nut, additional evidence is needed in this area before a recommendation can be made.

 C


Several poor-quality studies report the use of betel nut taken by mouth in patients recovering from stroke. In light of the potential toxicities of betel nut, additional evidence is needed in this area before a recommendation can be made.

 C


Currently, there is a lack of satisfactory evidence to recommend the use of betel nut for ulcerative colitis. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.

 C


Currently, there is a lack of satisfactory evidence to recommend the use of betel nut for ulcerative colitis. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Betel nut can be chewed alone, but it is often chewed in combination with other ingredients (called a "quid") including calcium hydroxide, water, catechu gum, cardamom, cloves, anise seeds, cinnamon, tobacco, nutmeg, and gold or silver metal. These ingredients may be wrapped in a betel leaf, followed by sucking the combination in the side of the mouth. It is reported that ingestion of 8-30 grams of areca nut may be deadly.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
The effects of anticholinergic drugs may decrease when used in combination with betel nut or its constituent arecoline. Use with cholinergic drugs may cause toxicity (salivation, increased tearing, incontinence, sweating, diarrhea, vomiting, or fever). Betel nut may slow or raise the heart rate and could alter the effects of drugs that slow the heart, such as beta-blockers, calcium channel blockers, or digoxin.
Betel nut may alter blood sugar levels. Caution is advised when using medications that may also alter blood sugar. Patients taking drugs for diabetes by mouth or using insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.
Betel nut may increase the effects of monoamine oxidase inhibitors (MAOIs), angiotensin-converting enzyme (ACE) inhibitors, phenothiazines, cholesterol-lowering drugs, stimulant drugs, and thyroid drugs. Betel may increase or decrease the effects of anti-glaucoma eye drops. Reliable human study is lacking in these areas.
Other medications that betel nut may interact with include: antibiotics, medications that alter blood pressure, anti-inflammatory medications, or medications taken for cancer or immunosuppression. Patients taking anti-psychotic drugs should use cautiously due to reports of increased side effects. Based on the way betel nut is processed in the body, there may be interactions when taken with muscarinic antagonists. Furthermore, chronic use of betel nut and alcohol may lead to an increased risk of oral cancer.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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Liao CT, Chen IH, Chang JT, et al. Lack of correlation of betel nut chewing, tobacco smoking, and alcohol consumption with telomerase activity and the severity of oral cancer. Chang Gung Med J 2003;26(9):637-645.
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Shiu MN, Chen TH, Chang SH, et al. Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan. Br J Cancer 2000;82(11):1871-1874.
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Sullivan RJ, Andres S, Otto C, et al. The effects of an indigenous muscarinic drug, Betel nut (Areca catechu), on the symptoms of schizophrenia: a longitudinal study in Palau, Micronesia. Am J Psychiatry 2007;164(4):670-673.
Tsai JF, Chuang LY, Jeng JE, et al. Betel quid chewing as a risk factor for hepatocellular carcinoma: a case-control study. Br J Cancer 3-2-2001;84(5):709-713.
Tung TH, Chiu YH, Chen LS, et al. A population-based study of the association between areca nut chewing and type 2 diabetes mellitus in men (Keelung Community-based Integrated Screening programme No. 2). Diabetologia 2004;47(10):1776-1781.
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