Cinnamon (Cinnamomum verum & cassia): Benefits, Uses, Safety and Dosing

Cinnamon is a hardy tropical perennial common spice used in spiritual, herbal, and culinary settings. It belongs to the family Lauraceae and can be found in two varieties: cassia (the spicier variety) and Ceylon (the sweeter variety) cinnamon. Cinnamon is native to Sri Lanka, Southeast India (Ceylon), and South China (cassia). It is currently cultivated in Seychelles, Madagascar, and Vietnam.

Cinnamon uses involve the following:

• Glycemic control in diabetes
• Reduction of total cholestrol and bad (LDL) cholesterol
• Reduction in blood pressure
• As support in polycystic ovarian syndrome by regulating insulin
• Oral candidiasis treatment in People with HIV
• May help suppress H. pylori

Medical Uses and ethnopharmacological profile

Traditional Uses

The twig was used for the common cold, joint aches, joint pain, and promoting circulation to the extremity. The bark was used to alleviate lower back pain, persistent digestive weakness, and intolerance to cold. It was also used as a digestive aid (fire) to boost appetite and digestion and reduce flatulence. In a concoction with honey and ginger, it was used to alleviate coughs, chest congestion, and air circulation.

It was also used as an emmenagogue and an antiseptic mouthwash.

Clinical Uses and Research

Obesity and hyperlipidemia: In adults with obesity, powder extract at a dose of 3-90 grams daily decreased levels of bad fat (low-density lipoproteins) and increased the levels of good fat (high-density lipoproteins). The polyphenols and dietary fiber increased the activity of triglycerol lipase, thus promoting fat hydrolysis in the adipose tissue.

Type 2 diabetes: Ground powder at dosages of 1, 3, and 6 grams daily for 40 to 90 days elicited an 18-20% reduction in fasting blood glucose and a 28-30% reduction in triglycerides. Cinnamaldehyde and phenols stimulated GLUT-4 translocation, thus inhibiting glucosidase and amylase enzymes.

In prediabetics, an aqueous extract at 500 mg thrice daily for 12 weeks was able to slow down the onset of type 2 diabetes. The compound type A procyanidins enhanced insulin receptor phosphorylation that mimics insulin activity. (Costello 2016)

Stage 1 hypertension: powdered gram extract at a dose of 2 grams daily for 12 weeks reduced both systolic and diastolic pressure. Coumarin and cinnamaldehyde induced peripheral vasodilation in the nitric oxide pathway and normalized vascular contractility.

Polycystic ovarian syndrome: Ground powder administered at a dose of 1.5 grams daily reduced resistance to insulin sensitivity and improved the menstrual cycle. This was through the action of activating sirtuin 1, which in turn reduces insulin resistance and modulation of the endocrine axis.

In Vivo Uses and Research

Alzheimer’s: In a mice study, aqueous bark extract at 100 mg/kg for 4 months increased spatial memory and cognitive performance. Proanthocyanidins and cinnamaldehyde inhibited protein aggregation and prevented filament formation.

Atherosclerosis: In a rat model, ground powder at a dose of 0.75 mg/kg for 12 weeks reduced aortic plaque formation. This was through the action of flavonoids and cinnamic acid that suppressed NF-κB activation and adhesion molecules, effectively reducing inflammatory cytokines.

Gastric ulcer: In a rat model, bark ethanolic extract at a 500 mg/kg repeated dose reduced the ulcer index, protected the gut mucosa, and inhibited H. pylori. Eugenol and terpenoids increased gastric mucus and reduced excess acid production. (Asad 2014)

In Vitro Uses and Research

Human breast cancer cells: Bark methanolic extract, when applied to cancer cell lines, induced apoptosis and depicted a dose-dependent inhibition of cancer proliferation and migration. This was identified to be the action of cinnamaldehyde. (Banerjee 2023)

S. aureus and H. pylori clinical isolates: Essential oil vapor showed bactericidal activity against resistant strains. Cinnamaldehyde disrupted cell membrane integrity and prevented biofilm through inhibiting ATPase activity.

Anti-inflammatory: In mouse macrophages, bark essential oil reduced pro-inflammatory cytokines. Eugenol inhibited nitric oxide production and suppressed activity of cyclooxygenase 2 enzymes.

Safety and Dosing profile of Cinnamon

Forms and Dosing

Quills– 1-3 grams a day

Ground powder– 1gram (Cassia), up to 6 grams (Ceylon) daily

Tea (tea bag chips)– 1 cup thrice a day

Tinctures– 2-4 ml up to thrice a day

Essential oils– 1 drop dilluted in carrier oil (0.5-1% dilution)

Syrups– 5- 10 ml up thrice daily

Capsules and tablets– 500 -1500 mg

• Type 2 diabetes- 1-6 grams daily
• Prediabetes- 500 mg thrice daily
• metabolic syndrom- 3 grams daily
• Hyperlipidemia- 1.5-6grams a day
• polycystic ovarian syndrome- 1.5g a day
• Functional dyspesia- 1-2 gram a day
• Helicobacter Pylori- 80-200mg a day
• Obesity- 2-3 grams a day

Note: Do not exceed more than 12 weeks of continuous supplementation. For daily dosing, cassia is kept at 1-2 grams and Ceylon at 3-4 grams.

Interactions

• Diabetes medications- may lead to hypoglycemia
• Blood thinners- possible risk of bleeding and bruising, especially with cassia cinnamon.
• Statins, paracetamol, methotrexate (long-term concurrent use)- possible risk of liver inflammation
• Non-heme iron- disrupts absorption of iron

Side effects

• Liver toxicity in high amounts
• Allergic reactions and irritations
• Lowering blood pressure
• Breathing issues with inhalation of cinnamon

Contraindications

• People with liver disease
• 2 weeks to surgery
• Severe biliary or gastric issues
• Children should generally avoid cassia cinnamon
• Pregnancy and breastfeeding