Garcinia cambogia (hydroxycitric acid, HCA)

Plant extract of Garcinia gummi-gutta (cambogia) fruits; weight-loss supplement; not registered as a medicine by AEMPS; FDA Safety Communications 2009 and 2017 on hepatotoxicity

ATC code: A08AX-GARCINIA

Brand names: NOW Garcinia Cambogia, Nature's Bounty Garcinia, Hydroxycut

Updated 24 Sep 2026 · Methodology

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Weight loss

Not recommended

Garcinia is among the most heavily marketed weight-loss supplements. The large Onakpoya 2020 systematic review pooled 12 RCTs: average weight loss vs placebo was about 0.88 kg over 8–12 weeks, clinically insignificant and with high heterogeneity. rejected the corresponding health claim. The main risk is rare but severe liver injury: pulled Hydroxycut from the market in 2009 after a cluster of hepatitis cases and issued a repeat warning in 2017. LiverTox 2023 describes cases of fulminant hepatic failure requiring transplantation and fatal outcomes. If you take garcinia and develop jaundice, dark urine, right upper quadrant pain, marked weakness or nausea, stop the supplement immediately and seek medical help.

Sources

Supplement-induced liver injury (DILI)

Not recommended

Garcinia ranks among the top LiverTox entries for supplement-induced liver injury. Reported patterns include acute hepatocellular hepatitis 1–3 months after starting the supplement, cholestatic hepatitis, fulminant liver failure with transplantation and isolated fatalities. Women aged 30–50 are most often affected. Concomitant paracetamol, statins or alcohol increase risk. pulled Hydroxycut in 2009 and updated the garcinia warning in multi-ingredient formulas in 2017. If you take garcinia and develop jaundice, dark urine, pale stools, right upper quadrant pain or marked weakness, stop the supplement immediately and seek medical help. This is not a «detox effect», this is acute hepatitis.

Sources

LiverTox: Garcinia cambogia – LiverTox monograph (2023)

ICD-10: K71.9 · ICD-11: DB95.Z

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

The main active compound is hydroxycitric acid (HCA), 50–60% of the dry extract. HCA competitively inhibits ATP-citrate lyase, the enzyme converting citrate to acetyl-CoA. Theoretically this reduces hepatic fatty acid synthesis and suppresses appetite via raised serotonin. In humans the effects are weak, inconsistent and not reproducible in large RCTs. The most significant issue is rare but severe drug-induced liver injury with hepatitis and reported cases of fulminant failure and transplantation.

Safety

Contraindications

Pregnancy and lactation
Any acute or chronic liver disease, raised ALT and AST
Concomitant paracetamol, statins, isoniazid, methotrexate
Diabetes mellitus on glucose-lowering therapy (hypoglycaemia risk)
Concomitant SSRIs (serotonin syndrome risk)
Age under 18 years
Bipolar disorder and psychotic illnesses

Serious adverse effects

Acute hepatocellular hepatitis
Cholestatic hepatitis
Fulminant hepatic failure requiring transplantation
Fatal outcomes have been reported
Serotonin syndrome when combined with SSRIs, SNRIs, triptans
Severe hypoglycaemia in type 2 diabetes on sulphonylureas or insulin

Common adverse effects

Nausea
Headache
Dry mouth
Diarrhoea
Dizziness

Pregnancy: can you take Garcinia cambogia (hydroxycitric acid, HCA)?

Contraindicated in pregnancy: safety data are lacking and maternal drug-induced liver injury with fetal risk has been reported. AESAN does not permit garcinia supplements in pregnancy.

Breastfeeding: can you take Garcinia cambogia (hydroxycitric acid, HCA)?

Incompatible. No milk transfer data are available; risk of maternal hepatotoxicity and infant exposure through milk. AESAN does not recommend use during lactation.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Garcinia cambogia (hydroxycitric acid, HCA) used for?

Garcinia cambogia (hydroxycitric acid, HCA) is evaluated for the following indications with varying evidence strength: Weight loss (evidence tier D), Supplement-induced liver injury (DILI) (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Garcinia cambogia (hydroxycitric acid, HCA)?

Common side effects of Garcinia cambogia (hydroxycitric acid, HCA) (≥ 1 in 100): Nausea, Headache, Dry mouth, Diarrhoea, Dizziness. See the Safety section for uncommon and serious reactions.

Is Garcinia cambogia (hydroxycitric acid, HCA) safe during pregnancy?

Contraindicated in pregnancy: safety data are lacking and maternal drug-induced liver injury with fetal risk has been reported. AESAN does not permit garcinia supplements in pregnancy.

Is Garcinia cambogia (hydroxycitric acid, HCA) compatible with breastfeeding?

Incompatible. No milk transfer data are available; risk of maternal hepatotoxicity and infant exposure through milk. AESAN does not recommend use during lactation.

Who should not take Garcinia cambogia (hydroxycitric acid, HCA)?

Garcinia cambogia (hydroxycitric acid, HCA) is contraindicated in: Pregnancy and lactation; Any acute or chronic liver disease, raised ALT and AST; Concomitant paracetamol, statins, isoniazid, methotrexate; Diabetes mellitus on glucose-lowering therapy (hypoglycaemia risk); Concomitant SSRIs (serotonin syndrome risk). Full list in the Safety section.

Other drugs in this group

Conjugated linoleic acid (CLA), Glucomannan (Amorphophallus konjac), Orlistat