X

Bitters and Digestion

What You Will Learn in This Article

  • History of Bitters
  • Bitters Used Around The World
  • The Mechanism of Bitters
  • Benefits of Bitters
  • New Research! Ovaries Are Designed for Bitters
  • Who Should Not Take Bitters

“Agh, this is bitter!” you may say after a taste of juiced greens. Or, maybe this is your response to a bite of green olive. Admittedly, the bitter taste doesn’t always have the best reputation in modern circles. Commenting on food or drink being bitter is rarely perceived as a compliment to the chef. Yet, bitterness is one of the traditional five tastes for which our tongue has receptors (“taste buds”): sweet, sour, salty, bitter, and savory/umami. (1).

Taste, like our other four senses (sight, hearing, smell, and touch), is there to take in information and send signals to our central nervous system. As a response, our brain and nervous system will cause us to make adjustments, based on the information that comes through our senses. That could mean jumping back from a hot stove, covering our ears to block out loud noise, or spitting out a bitter-tasting food.

While the bitter taste can sometimes indicate a toxic substance that we should avoid, there are health-promoting bitter foods and beverages as well. Examples include the herbs rosemary and chamomile, and the spices ginger and clove. Even green leafy vegetables and coffee fall under this category. These foods and beverages (and many others) have a long history of use around the world.

History of Bitters

Bitters have long been a part of our culinary heritage. No matter where you are in the world, bitters have had a place at the table. This goes back to ancient times.

In ancient Egypt, bitter herbs were added to wines to enhance digestion. Traditional Chinese Medicine has used bitter herbs to treat conditions of “too much heat.” The Bible mentions bitter herbs a number of times, including as a part of the Passover Feast. Ayurvedic Medicine, developed 3,000 years ago in India, also has a collection of bitter herbs used for medicinal purposes. These herbs are sometimes added to meals in the form of teas (including chai) or chutneys. (2)

Bitters is a term that covers certain plant metabolites including iridoids, sesquiterpenes, monoterpenes, alkaloids, and more. The bitter taste indicates the presence of these therapeutic compounds. Bitters generally come from the roots, leaves, barks, and stems of plants. Occasionally, bitters will be derived from a part of the fruit, such as the rind of citrus fruits. These components are usually then preserved in alcohol or added to condiments.

Bitters Used Around The World

Bitters continue to be used around the globe today. Some examples of bitters used in other parts of the world include:

  • Ayurveda (and Siddha), The Traditional Medicine of India: Nymphaea stellata (also called Nymphaea nouchali) is an Asian bitter herb that’s used for conditions such as diabetes, inflammation, liver problems, urinary problems, women’s health issues, and even as an aphrodisiac. (3)
  • Traditional Chinese Medicine (TCM) bitter herb formulas: There are a number of TCM bitter herb combinations that are used to treat digestive issues:
    – Xiaoyao pill: A study of perimenopausal women with indigestion found that this pill helped to improve movement of food through the digestive system. (4)
    – Chaihu Shugan powder is used for indigestion. A meta-analysis of 22 studies showed this blend to be effective for symptoms of indigestion. (5)
    – Ban Xia Xie Xin: In a 4-week clinical trial, this blend of bitters, given twice a day, reduced indigestion, pain, and bloating. The effects continued even after the bitters were stopped. (6)
  • Traditional Korean Medicine: Traditional Korean Medicine also uses bitter herbs. For example:
    – Yukgunja-Tang: This blend of bitters was used in a clinical trial of 96 people with indigestion over 8 weeks. The Yukgunja-Tang powder improved symptoms of indigestion, including nausea, bloating, vomiting, and stomach pain. The powder was taken 3 times a day. (7)
  • Swedish Bitters (“Schwedenbitter”): This formula was originally made up of seven bitters: aloe, rhubarb, saffron, myrrh, gentian, zedoary, and agarikon. The original formula was first attributed to Paracelsus and goes back centuries. Then in the 1700s, a couple of Swedish doctors created the mixture that is now known as Swedish Bitters. It was thought to protect against the plague. (8)
  • German formula, Iberogast: This herbal formula (chamomile, milk thistle, angelica, licorice, peppermint, and more) was shown to improve symptoms of indigestion in a meta analysis of 6 clinical trials. (9).
  • Alomo Bitters: Originally from Ghana, in West Africa, these bitters are given for high blood sugar, detoxification, and improving libido in Nigeria. (10)
  • Angostura bitters: The bitters, originally from Venezuela, are especially known for their use in mixed drinks – especially gin and soda. In the United States, Angostura bitters are a key ingredient in whiskey cocktails like Old Fashioned and Manhattans.
  • Apéritifs and Digestifs: These bitter alcoholic beverages are used before (Apéritifs) or after meals (Digestifs) to improve digestion. An apéritif prepares the stomach to receive food and a digestif helps digest the food after it was consumed. Examples of apéritifs include dry white wine, champagne, vermouth, pastis, and dry sherry, Digestifs include Jagermeister in Germany, Gammel Dansk in Denmark, and Campari in Northern Italy.

The Mechanism of Bitters

Bitters especially serve to “prime” the body for digestion. The mechanism of bitters begins with the tongue. It is truly the taste that stimulates the action. The bitter taste triggers a response in the nervous system which then releases the gut hormone, gastrin. As a result, saliva production goes up, the stomach increases its pepsin and hydrochloric acid, and the pancreas, liver, and gallbladder are all stimulated to secrete their juices. Peristalsis, the movement of the intestines, also kicks in, which gets things moving along. All of these things are components of optimal digestion. As a result, nutrient absorption is much improved. (11)

The key player here is bitter taste receptors. Obviously, they are a part of the mouth so that you know what you’re tasting. But taste receptors aren’t just located along the digestive system. Researchers have found these bitter taste receptors in other places in the body, like the lungs, kidneys, thyroid, white blood cells, and even the heart. (2, 12, 13) That means bitters affect more than just digestion, and it isn’t just a theory. Research on the benefits of bitters is still limited, but there are already plenty of signs that they benefit the whole body.

Benefits of Bitters

Bitters have many actions that benefits digestion, but they impact other body systems as well. Some of the benefits of digestive bitters include:

  • Improving digestion, likely by increasing enzyme secretion and stomach acid production. (13)
  • Stimulating bile production (13), which can ease constipation, improve fat digestion which is key to HDL “good” cholesterol formation, estrogen metabolism, and regular bowel movements (14)
  • Binding estrogen—This is thanks to the increase in bile, which can help address Estrogen Dominance.
  • Lowering inflammation in the gut—a bitters combination of myrrh, chamomile, and coffee charcoal was comparable to the drug mesalamine in helping ulcerative colitis patients maintain remission. (15)
  • Lessening acid reflux by improving the tone of the esophageal sphincter, according to animal studies. (16)
  • Potentially activating the parasympathetic nervous system, by stimulating the vagus nerve. This helps get you out of “fight or flight” mode. (17)
  • Lowering blood sugar levels—Chinese herb bitter TM81 lowered blood sugar levels in a clinical trial of 480 overweight patients. (18) And the herb formula Kaiyu Qingre-Jiangzhuo was comparable to the drug Metformin in a 12 week study. (19)
  • Curbing sugar cravings—Bitters help offset our brain receptors that get excited by sugar. (20)
  • Liver support—For example, artichoke leaf is a bitter herb that has been shown to protect the liver and help it regenerate. (21)
  • Heathy skin—As you support the liver, so you support the skin. When the liver gets overwhelmed as a detoxification system, the skin can be used as a second resort for elimination of toxins. Even psoriasis has a liver connection (22). Other examples include “liver rashes” and jaundiced skin associated with liver disease.

The benefits of bitters continue to be discovered. In fact, there’s new research that bitters can be especially beneficial for women.

New Research! Ovaries Are Designed for Bitters

This may sound crazy, but bitters may be able to enhance fertility. As it turns out, there are bitter taste receptors in the ovaries. Polycystic Ovarian Syndrome (PCOS) is the leading cause of infertility in women, and now there’s a possibility bitters could help. In an animal model of PCOS, hops-derived bitters were able to improve reproductive functioning due to their impact on ovarian taste receptors. (23)

Who Should Not Take Bitters

If you have stomach ulcers, you should avoid bitters for the time being – although it depends on the blend of herbs. The herb gentian, as an example, stimulates the stomach’s production of hydrochloric acid (HCL), which will irritate the ulcer. The same goes for if you have gastritis. You can use gentian and other HCL-promoting herbs once you heal your stomach lining.

If you have an allergy to Asteraceae herbs, like feverfew, chamomile, or echinacea, bitters may cause an allergic reaction. This applies to any herbs you may have an allergy to. Additionally, if you are currently pregnant or may become pregnant, please check with your healthcare practitioner about any new herbs or formulas you want to try.

How I Formulated Our Before and After Bitters

I have a personal affinity for digestive bitters because my body craves them, and my digestion behaves better when I take them. I’ve developed the Before Meal Digestive Bitter and After Meal Digestive Bitters to create a special experience for you.

The Before Meal Bitters warm up your digestion, preparing it for receiving food and extracting maximum nutrition from it. It contains bitter and warming herbs such as gentian, schisandra, angelica, ginger, rosemary, meadowsweet, and cloves. Creating heat in the digestion is essential–this is why patients of Traditional Chinese Medicine are always advised not to drink iced drinks before or with a meal, as you are shutting your digestion down.

The After Meal Digestive Bitters were developed to feel like having tiny dessert. It feels slightly sweet, licorice-y, and calming to the digestive system. This formula contains burdock root, chamomile, angelica, anise, andrographis, catnip, and fennel.

They Taste Better Than Other Bitters…

The digestive bitters you have tried might have been so intense (from the alcohol and the bitter herbs) that you are now reluctant to try them again. Luckily, we spent months formulating our Before and After Digestive Bitters to create a well-rounded flavor. By including some glycerin, we were able to balance the bitter herbs with a subtle sweetness, making them a pleasure to indulge in before and after every meal. You may fall in love with them even more after experiencing less stomach pain, less bloating, less heartburn, more regular bowel movements, fewer food sensitivities, lower inflammation, and more energy.

I hope you try them and make them a part of your daily meal ritual.

How the Formulas Were Developed

Lisa Ganora who is a renowned herbalist, biochemist, and former Director at the Colorado School of Clinical Herbalism helped formulate these bitters.

We set ourselves a few objectives for the formulas.

Objective #1

To use bitter herbs with a proven track record of being digestive aids.

Objective #2

To create a flavor that is not only tasty, but refined and complex–like a great glass of wine. In herbalism and the world of formulations, this is called organoleptics.

Objective #3

We wanted them to be used long term without the usual side-effects of a long-term use of bitters. This required developing a balanced formula which wasn’t too drying and cooling.

Part of my herbal training was based on the energetics of herbs. We would evaluate herbs on their influence on the human body, using terms such as cooling, drying, moistening, astringent/tonic, warm, warming, aromatic, vital stimulant, diffusive, etc.

If you are a seasoned herbalist, you know that most herbs are drying and cooling. If you aren’t an herbalist you might relate when I say that perhaps you experienced dry skin, itching, constipation, and feeling cold after a long-term use of potent herbal concoctions. These symptoms are a sign that your body has become too cold and/or too dry.

We wanted to create a product that won’t cause these side-effects if taken on a daily basis. We were able to achieve this by creating a balanced formula that evens out the cooling herbs with warming ones, and the drying ones with moistening ones.

For example, in the Before Digestive Bitter, heavy bitters such as Gentian and Andographis are highly drying and cooling. To balance them out, we added demulcents with moistening qualities, Schisandra and Ginger. Adding Ginger and Clove warmed up this formula.

Creating a balanced formula that tastes good wasn’t easy and therefore took months of work. It’s far easier to create a supplement in a capsule or pill when you don’t have to taste it!

What’s in the Before Digestive Bitter

Gentian (Gentiana lutea)–A classical bitter herb used in many digestive bitters. Gentian creates significant “digestive fire.” The flavor is Initially sweet and warm followed by an intense bitter that lingers, leaving behind a balanced moisture. Benefits include: anti-inflammatory, increases bile flow, liver decongestant, stimulates GI secretions (promotes digestion, promotes peristalsis, and relieves constipation).

Schisandra (Schisandra chinensis)–I’m personally drawn to this Siberian, resilient berry and take it often. Its complex flavor comes from a unique combination of sour, salty, warm pungent and slight bitterness. While there is a dominating sour flavor, it’s followed by deeper almost-umami-like aromatics with a slight acidity; next, a warming quality arises, ending on subtle sweetness as the sourness fades. It’s a mighty adaptogen which restores the adrenal cortex, generates strength, and improves fatigue. Schisandra benefits include: helps with sleep, protects the liver from toxins, increases bile flow, antibacterial, anti-ulcer, immunomodulator, antioxidant, and supports liver detoxification.

Angelica (Angelica archangelica)–This is a hot pungent, mildly to moderately bitter herb with a slight celery saltiness. The complex smoky aroma is followed by a distinct bitter aftertaste. Angelica benefits include: helps with dyspepsia (heartburn), flatulence, nocturia (overnight urination), arthritis, stroke, dementia, circulation problems, “runny nose”, nervousness and anxiety, and trouble sleeping (insomnia). It also has strong expectorant properties (loosens up mucus and expels it).

Ginger (Zingiber officinale)–. Ginger is warming, pungent, and moist. A big digestive stimulant, ginger is also a relaxant of the GI and nervous system. Its many benefits include: anti-inflammatory, aromatic, stomachic (salivary and gastric secretagogue effect), GI tonic, antiemetic (acts on the parasympathetic nervous system), analgesic (pain reliever by inhibiting biosynthesis of prostaglandins and leukotrienes), relieves flatulence, iincreases bile flow, cholesterol reducing, antispasmodic, antimicrobial, and antifungal.

Rosemary (Rosmarinus officinalis)–Rosemary is a moderately bitter, warm and pungent herb with camphor-resin-lemon notes. This drying herb stimulates circulation, warms stomach-intestines, promotes digestion, resolves mucus-damp, relieves bloating, promotes bile flow, and helps with chronic gastroenteritis and colitis. Rosemary is also antibacterial and antiviral (rosmarinic acid and caffeic acid inhibit the biosynthesis of leukotrienes and prostaglandins), anti-inflammatory, a mild neurocirculatory stimulant, a mild cholesterol and triglycerides reducer, and diuretic.

Meadowsweet (Filipendula ulmaria)–You’ll find a hint of wintergreen in this slightly bitter, highly aromatic herb. Meadowsweet is GI anti-inflammatory (can help gastritis, ulcers, dyspepsia), relieves acid, and helps relieve pain.

Clove (Syzygium aromaticum)–Clove is a warm and sour herb, followed with a menthol-like cooling flavor. This herb warms the stomach, aids digestion, and is a circulatory stimulant.

What’s in the After Digestive Bitters

Burdock (Arctium lappa)–Burckdock is a cool and dry herb. Benefits include: diffusive (bringing blood circulation to the skin), promotes detoxification: soothes muscle aches, reduces infections, calms allergies, decreases inflammation, stimulates the immune system. Burdock may also help incontinence, help ease irregular, painful periods and help promote bile flow.

Angelica (Angelica archangelica)–This is a hot pungent, mildly to moderately bitter herb with a slight celery saltiness. The complex smoky aroma is followed by a distinct bitter aftertaste. Angelica benefits include: helps with dyspepsia (heartburn), flatulence, nocturia (overnight urination), arthritis, stroke, dementia, circulation problems, “runny nose”, nervousness and anxiety, and trouble sleeping (insomnia). It also has strong expectorant properties (loosens up mucus and expels it).

Anise (Pimpinella anisum)–This warm and pungent herb has a characteristic licorice-like note, with a slight bitterness. Anise is an excellent carminative (relieves flatulence), expectorant (loosens up mucus and expels it), and circulatory relaxant (relaxes the chest).

Andrographis (Andrographis paniculate)–In Ayurveda, Andrographis is known as the “King of Bitters.” It is a dirty bitter and almost ash-like. This herb stimulates appetite, digestion, bile flow; clears liver decongestion, calms GI nerves; and stimulates the parasympathetic nervous system. Andrographis also helps restore liver health) and is antibacterial, antiviral, and anti-inflammatory with a special affinity for the GI tract.

Chamomile (Matricaria recutita)–Chamomile is mildly bitter with a buttery, apple-like taste. Chamomile can help indigestion, gassiness, and pain from gastritis and gastric and peptic ulcers. Other benefits of chamomile include: nervine (supports the nervous system), mild sedative (rather calming, not making you fall asleep), diaphoretic (helps to sweat), emmenagogue (promotes menstrual flow), anti-inflammatory, antispasmodic, antibacterial, antifungal, anti-ulcer, immune-stimulant effect, anti-allergenic, and pain relief.

Catnip (Nepeta cataria)–Catnip is mildly bitter, gently rounded, cooling and dry. We use fresh catnip in our After Bitters to retain the aromatics. The minty herb has a special affinity for the GI tract, and is carminative (gas) and antispasmodic (pain, cramping). Catnip is also effective in treating nervousness and anxiety.

Fennel (Foeniculum vulgare)–Fennel’s flavor is a cross between licorice, celery, and nutmeg. It is mildly warming with a hint of astringency with dessert-like aromatics. Fennel helps promote digestion, reduces bloating, and also tonifies urinary tract–helping to relieve incontinence, urinary sand and stones. Fennel also helps regulates menstruation, promotes expectoration, and stimulates immunity–preventing the flu and colds and intestinal parasites.

What Does a “Vital Stimulant” Mean?

As you will see in the description of many of the herbs, “vital stimulant” is among many of them (burdock, schisandra, chamomile, catnip). The herbal training I received is based on “vitalism” which is a belief system that it’s best to support the body’s vital energy to heal, rather than working with one herb per specific symptom. This is aligned with my own nutritional philosophy–rather than finding a food for each ailment, I take on an anti-inflammatory diet to help resolve a host of nagging health issues.

Wellena’s Digestive Bitters

Our Before and After Digestive Bitters are now available in our store.

Wellena’s Digestive Bitters

If you decide to get the Before and After as a set, you will save $5.40 and get a FREE organic, Fair Trade cotton bag. We love this little bag to then put it in our purse so we don’t forget the bitters wherever we go. You can get the full Digestive Bitters set with the bag here.

Key takeaways

Perhaps after reading this article, you have a newly gained curiosity and appreciation for digestive bitters. In summary, digestive bitters have a proven record of helping digest food better which may result in feeling lighter after meals, experiencing less acid reflux, burping, flatulence, and constipation. The liver loves bitters, too, the bitter taste facilitates detoxification. Bitters also stimulate bile flow which is helpful in digestive fatty meals and metabolism of “dirty” estrogens (present in estrogen dominance). Bitters have also been shown to balance blood sugar levels and activate the parasympathetic (rest-and-relax) nervous system.

If you choose to use them long-term, be sure you pick a balanced formula that isn’t too drying and cooling for your body.

If you choose to support us at Wellena, the link to our Digestive Bitters is here.

FAQs

When should I take digestive bitters?

For best results, take the bitters any time between 15 minutes or immediately before or after a meal.

How often can I use digestive bitters?

The Wellena Digestive Bitters can be taken every day. If you are using bitters from other brands, that might not be the case.

Can I dilute digestive bitters?

You can but the bitter receptors in your body need a higher concentration of bitters for you to gain the medicinal benefits.

Who should not take digestive bitters?

Pregnant women, children, and people with ulcers and gastritis, and former alcoholics should avoid bitters. If you are sensitive to any of the herbs present in the bitters, avoid the product.

Are your digestive bitters organic?

Our Wellena Before Digestive Bitters are 90% organic and After Digestive Bitters are 80% organic. The non-organic herbs are responsibly wildcrafted and confirmed not to contain any harmful compounds.

What is your glycerin derived from?

Our glycerin is derived from coconut.

What is your alcohol/ethanol derived from?

Our alcohol/ethanol is derived from sugarcane.

Are the digestive bitters gluten-free?

Yes.

Do you have alcohol-free digestive bitters?

Unfortunately, we do not. Many of the medicinal constituents found in herbs are only alcohol-soluble and won’t get extracted by water or glycerin alone.

What is the shelf life of the digestive bitters?

It’s officially 3 years but they are likely to last much longer. We hope you use them much sooner than that!

How will digestive bitters help me?

Digestive bitters have a proven track record to helping digest food better which may result in feeling lighter after meals, experiencing less acid reflux, burping, flatulence, and constipation. The liver loves bitters, too, the bitter taste facilitates detoxification. Bitters also stimulate bile flow which is helpful in digestive fatty meals and metabolism of “dirty” estrogens (present in estrogen dominance). Bitters have also been shown to balance blood sugar levels and activate the parasympathetic (rest-and-relax) nervous system.

Can digestive bitters help constipation?

Yes, many bitter users swear that bitters have relieved their constipation.

Can I take digestive bitters at night?

Before dinner, yes. Before bedtime, we don’t recommend it as it may make you feel hungry and cause night waking.

Have digestive bitters been used for many years?

Yes, almost every culinary tradition has an element of bitterness. Some in the form of aperitifs (like Campari in North Italy, pastis in France, ouzo in Greece), others as condiments (green mango chutney in India, mustard in many countries).

Can I use digestive bitters with digestive enzymes?

The role of digestive bitters is to stimulate your own body to produce and release the various enzymes that aid digestion. Taking digestive enzymes is giving your body these enzymes. For some people, taking bitters creates enough enzymatic activity that they don’t need enzymes. For others, it’s not enough and they need to supplement with enzymes. So, it really depends on your age and digestive “fire.” We suggest starting with the bitters and see if that’s enough. If not, add the digestive enzymes. You know you’ve taken too many digestive aids when you develop nausea, diarrhea, abdominal cramping or discomfort, headache, neck pain or nasal congestion.

Resources

1. Beauchamp G. K. Why do we like sweet taste: A bitter tale? Physiology & behavior. 2016.
2. Wszelaki, Magdalena. Overcoming Estrogen Dominance. New Type Publishing. January 2021.
3. Raja MK, Sethiya NK, Mishra SH. A comprehensive review on Nymphaea stellata: A traditionally used bitter. Journal of Advanced Pharmaceutical Technology & Research. 2010.
4. Du, H. G., Ming, L., Chen, S. J., & Li, C. D. Xiaoyao pill for treatment of functional dyspepsia in perimenopausal women with depression. World journal of gastroenterology, 2014.
5. Yang, N., Jiang, X., Qiu, X., Hu, Z., Wang, L., & Song, M. Modified Chaihu Shugan Powder for Functional Dyspepsia: Meta-Analysis for Randomized Controlled Trial. Evidence-based complementary and alternative medicine. 2013.
6. Zhao, L. et al. Efficacy of modified ban xia xie xin decoction on functional dyspepsia of cold and heat in complexity syndrome: a randomized controlled trial. Evidence-based complementary and alternative medicine. 2013.
7. Ko, S. et al. An Herbal Medicine, Yukgunja-Tang is more Effective in a Type of Functional Dyspepsia Categorized by Facial Shape Diagnosis: A Placebo-Controlled, Double-Blind, Randomized Trial. Evidence-based complementary and alternative medicine. 2018.
8. Ahnfelt, N. O., & Fors, H. Making Early Modern Medicine: Reproducing Swedish Bitters. Ambix, 2016.
9. Melzer, J., Rösch, W., Reichling, J., Brignoli, R., & Saller, R. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Alimentary pharmacology & therapeutics. 2004.
10. Oshikoya, K. A., et al. Herbal medicines supplied by community pharmacies in Lagos, Nigeria: pharmacists’ knowledge. Pharmacy practice, 2013.
11. Walker, J. M. The Bitter Remedy. The European Journal of Herbal Medicine. n.d..
12. Foster, S.R., Blank, K., Hoe, L.E.S., Behrens, M., Meyerhof, W., Peart, J.N. and Thomas, W.G. Bitter taste receptor agonists elicit G‐protein‐dependent negative inotropy in the murine heart. The FASEB Journal. 2014.
13. Lu, P., Zhang, C-H., Lifshitz, L. M., & ZhuGe, R. Extraoral bitter taste receptors in health and disease. Journal of General Physiology. February, 2017.
14. Mayo Clinic. Researchers find new treatment for constipation. ScienceDaily. May 16, 2011.
15. Langhorst, J., et al. Randomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis–a double-blind, double-dummy study. Alimentary pharmacology & therapeutics, 2013.
16. Tsai, C. C., et al. Salvia miltiorrhiza Induces Tonic Contraction of the Lower Esophageal Sphincter in Rats via Activation of Extracellular Ca2+ Influx. Molecules (Basel, Switzerland). 2015.
17. Ano, Y., et al. Hop bitter acids containing a β-carbonyl moiety prevent inflammation-induced cognitive decline via the vagus nerve and noradrenergic system. Scientific reports, 2020.
18. Tong, X. L., et al. The safety and effectiveness of TM81, a Chinese herbal medicine, in the treatment of type 2 diabetes: a randomized double-blind placebo-controlled trial. Diabetes, obesity & metabolism, 2013.
20.Lvovskaya, S., & Smith, D. P. A spoonful of bitter helps the sugar-response go down. Neuron, 2013.
21. Ben Salem, M., Affes, H., Ksouda, K., Dhouibi, R., Sahnoun, Z., Hammami, S., & Zeghal, K. M. Pharmacological Studies of Artichoke Leaf Extract and Their Health Benefits. Plant foods for human nutrition (Dordrecht, Netherlands),2015.
22. Mantovani, A., Gisondi, P., Lonardo, A., & Targher, G. Relationship between Non-Alcoholic Fatty Liver Disease and Psoriasis: A Novel Hepato-Dermal Axis?. International journal of molecular sciences. 2016.
23. Wu, S., Xue, P., Grayson, N., Bland, J. S., & Wolfe, A. Bitter Taste Receptor Ligand Improves Metabolic and Reproductive Functions in a Murine Model of PCOS. Endocrinology. 2019.