Talk:Fenugreek

Exaggerated Health Claims

The health claims make fenugreek look like magic potion. I don't have the time to track down the references but this page reads like a pamphlet in a naturopath's office. —Preceding unsigned comment added by 71.237.182.219 (talk) 03:06, 6 February 2009 (UTC)

The author cites references. Please refute them authoritatively or withdraw your objection.Enstardavid (talk) 15:26, 7 February 2009 (UTC)

I'm new to Wikipedia, so I don't feel comfortable making an edit, but as far as the "900%" increase in breast milk production - the citation points to a dead link. The only relevant line on the breasfeeding.org site that it points to is this- "Options are herbal galactogogues such as fenugreek (no controlled studies but generally recognized as safe)..." The previous commenter is correct. — Preceding unsigned comment added by 108.14.103.108 (talk) 00:56, 12 June 2011 (UTC)

I review the citation to back up the claims of increased libido and to be honest I am not impressed... 2 of the references point toward newspaper article with 0 scitific values, 1 link points toward a studies that made the claim: a study of such poor quality should not even been considered in Wikipedia. And the last link points towards a reviews of studies about type 2 diabetes (the author of this paper also noted the very poor quality of all the studies on the matter)

It's not a magic potion. See the recent https://www.sci.news/medicine/trigonelline-cognitive-function-12296.html, original paper https://link.springer.com/article/10.1007/s11357-023-00919-x — Preceding unsigned comment added by 68.46.21.155 (talk) 15:17, 17 October 2023 (UTC)

Lactation stimulant? No

This revert concerning this low-quality publication was justified because Phytotherapy Research is not a WP:MEDRS source (no high-quality clinical research would be published there), and the low number of subjects (122) and inconsistent dosing cited in a low-quality meta-analysis of only 4 poorly-controlled studies does not convince or qualify as a good source per WP:BURDEN. We have two reliable overview sources for the article: NIH and Drugs.com, both of which conclude the study quality to date is insufficient to conclude anything about using fenugreek effectively (and safely) as a lactation stimulant. If there was any truth of useful effect, there would be widespread clinical use and regulatory approval, which of course do not exist. We cannot be careless by using low-quality publications as sources for content of concern to breastfeeding mothers. Zefr (talk) 19:24, 4 March 2022 (UTC)

@Zefr: You can't just keep moving goalposts! Medline-indexed wasn't enough for you, impact factor of >5 wasn't enough for you. Now it's just your vague assertion that "no high-quality clinical research would be published" in Phytotherapy Research, which seems to hinge on your personal interpretation of "high-quality". Continuously citing WP:MEDRS does not make your case stronger; it makes it clear you are rules-lawyering to try and justify your grudge against anyone who wants WP:MED to be more than a mirror for drugs.com.

The notion that you can apply the efficient market hypothesis to the pharmaceutical industry belies your fundamental lack of understanding about the realities of modern biomedical research and the drug development/approval process.

Also included in that edit was a removal of the objectively false claim that fenugreek is not recommended by any governmental health agency. This assertion completely ignores fenugreek's well-described uses in both the Pharmacopoeia of the People's Republic of China and the Ayurvedic Pharmacopoeia of India. Those are endorsed by governmental health agencies, by any reasonable definition of the phrase. I am reverting the original edit. WhichDoctor (talk) 22:19, 4 March 2022 (UTC)

By any standard for medical content on Wikipedia, TCM and Ayurveda are considered quackery and pseudoscience, so those publications are not acceptable by WP:MEDRS. Reputable clinical research of an agent affecting lactation would be found in high-quality clinical journals, but there are such publications on PubMed. This Cochrane review reports that studies of low to moderate quality have found mixed results for a galactogogue effect for fenugreek, which is not strong enough evidence to suggest a safe and effective treatment. The studies in the review were considered inadequate "due to substantial heterogeneity and imprecision of measurements and incomplete reporting." If you wish to start a discussion among experienced medical editors, post a topic at WT:MED. Zefr (talk) 22:49, 4 March 2022 (UTC)

Do you not see the issue with arguing "if it worked, people would be using it", but writing off the millions of people actually using it under the banner of "quackery"? If you want to WP:WL about it, the issue of whether it is or is not recommended by any governmental health agencies is not biomedical information and therefore only requires ordinary RS. With respect to that component of the edit, it is not a question of whether you consider the Chinese or Indian pharmacopoeias to be WP:MEDRS. They are endorsed by health ministries of their countries. WhichDoctor (talk) 23:37, 4 March 2022 (UTC)

I'm going to interject here as an uninvolved editor and only very occasional contributor to medical articles. First, WhichDoctor, thank you for your contributions so far. Truly. Wikipedia, as you are surely aware, can be a bit of an intense place, and it's good to see editors become active again. You're clearly very genuinely interested in contributing to this project as a whole and in line with its norms.

Those guidelines and norms have a lot of epistemological assumptions baked into them that we more or less take for granted, often simply because that is the only way this project could function. They are flawed (and some may well be outright false when it comes to deeper philosophical truth, whatever that means), but they allow the project to move forward in what would otherwise be an endless online original research project in search of the Truth, which is not what this is all about. I can think of several examples where I personally very strongly believe based on my own expertise and research that what is a consensus in what we call reliable sources is woefully inadequate. For example: I have a more-than-layman's background in Chinese politics and policy and have done quite a bit of research on the crimes against humanity occurring in Xinjiang; I also believe, based on my own analysis of the circumstances and relevant international law, that what is happening there is not genocide. Even so, we have the Uyghur genocide article, and on the talk page, you can see my involvement in a massive discussion on how to frame the issue. I have a lot of issues with how e.g. NYT covers China, but there's not a whole lot I can do with that; if NYT says it, for better or for worse, we give that a lot of weight here because we have to have some sort of heuristic to adjudicate claims of reality when our job is not to actively discover what reality is. At its core, it's to catalogue how reality is described in sources that we believe, as a community, are most likely to resemble reality.

This problem becomes a lot more acute in medical articles, which is why WikiProject Medicine people can come off a bit aggressive about it. Zefr is correct that the body of evidence that English Wikipedia considers reliable comes decidedly down against stating the fenugreek has effects on lactation: A Cochrane Review is about as good as it gets per WP:MEDRS. Wikipedia's guidelines absolutely end up prioritizing knowledge in certain forms, particularly that created and sustained by predominantly Western institutions. That is not a perfect standard. It takes very little time to figure out holes in "if it worked, people would be using it"; at the same time, though, widespread use does not make for reliability, either. Millions currently use ivermectin as a prophylactic against COVID-19 despite the lack of substantial, comprehensive evidence that it is effective for that purpose (even though there are some small-scale (and flawed, as I understand) studies that suggest it might be) — but we do not talk about ivermectin based on those studies. We go with the medical hegemony, if you will, and while fenugreek is relatively harmless, the implications for broader public health re: COVID help illustrate, I think, why we rely on this hierarchy of sourcing as a general rule. WhinyTheYounger (WtY)(talk, contribs) 05:18, 5 March 2022 (UTC)

Also, there is absolutely room for description of fenugreek as an element of traditional medicine in various capacities, including claims to its supposed efficacies; that is inherently worthwhile cultural and historical information fit for an encyclopedic article. Per WP:MEDRS et al., though, that sort of information needs to be properly attributed and qualified and should not be presented as an established medical claim. WhinyTheYounger (WtY)(talk, contribs) 05:24, 5 March 2022 (UTC)

Thanks for weighing in, @WhinyTheYounger:. Totally understand your points about the "search for truth", and I'll try and find us a middle ground.

I gotta say, I feel like it'd be one thing if the Cochrane review found no evidence of effect, or evidence of no effect, but all it came up with was "inconclusive". That should be in the article, but if we truly have a hierarchy of sourcing, and your gold-standard source's conclusion is "¯\_(ツ)_/¯", then isn't it also worth mentioning the first-runner-up's conclusion?

Also: can we all agree that the "not recommended by any government health agency" is objectively false and should go? @Zefr:, replace it with a statement about the US FDA specifically if you want. WhichDoctor (talk) 07:45, 5 March 2022 (UTC)

There's definitely room for compromise. A quick outline of what I think that might look like (forgive my lazy refs): Fenugreek has been used for a variety of purposes in traditional medicine, including ________. [We could name specific practices such as TCM here as well.] In some parts of the world [India, North Africa, or wherever a source indicates], fenugreek is said to increase lactation, but systemic clinical research does not support such uses of fenugreek as effective, and medical sources generally hold that fenugreek is likely unsafe to use during pregnancy and lactation. The United States Food and Drug Administration does not approved fenugreek for any medical purposes.

Note that we need to tread lightly when describing its purported benefits and citing alternative medicinal sources. As is the case with a lot of alternative medical therapies, the purported benefits of fenugreek are extremely broad, and listing them all out is probably not useful (see e.g. here — listing out these dozens of supposed benefits would have the effect of impressing on the reader that fenugreek is some sort of superfood, which is not supported by high-quality clinical research). For those where there is some sort of secondary evidence, a citation thereto is appropriate, but as medical consensus does not view fenugreek as e.g. a useful aid in lactation, it's important that we don't imply an equivalence between the two views (see WP:PROPORTION.) WhinyTheYounger (WtY)(talk, contribs) 16:41, 6 March 2022 (UTC)

References

It's better not to list many of the specific ways fenugreek was/is used in traditional medicine, as there is no good science to justify giving them light except where reputable sources indicate, such as the NIH, Drugs.com, and two Cochrane reviews, which adequately address this generally, as should we per WP:MEDREV and scientific consensus, WP:MEDSCI. This edit reorganized the sections, and highlights the research weaknesses and invalidity of traditional practices. Zefr (talk) 19:53, 6 March 2022 (UTC)

I have no objection to your latest addition, because the biomedical basis for these uses is obviously unattested to. If other editors wish to add the historical and contemporary uses of the herb, that should not be a problem in and of itself as long as there is not an implication that these uses are backed by high-quality research. That's what the above outlined paragraph was an attempt at getting at. This article is not about fenugreek as a medicine, after all; this article is about fenugreek. WhinyTheYounger (WtY)(talk, contribs) 21:28, 6 March 2022 (UTC)

Staple food in Galilee?

The source mentioned (Josephus) does not support the claim that fenugreek was grown as a staple food in Galilee. The quote (see ann. 9) only mentions it as an (unusual) means in warfare. In De Bello there is not more than what is quoted here.--Anfeld (talk) 07:53, 7 May 2022 (UTC)

Whether to cite a weak review

This edit concerning this 2022 review is highlighted as a concern because the review's authors plainly explain the extensive weaknesses of studies included, such as by concluding "the low quality of the included papers, the vast amount of heterogeneity in the data, and research involving patients with various metabolic conditions; extrapolating of our findings to the general population should be with caution." In the review under 3.1. Systematic review and study characteristics, the authors explain the high degree of variability in studies included, all of which were observational in design, i.e., in the category of low-quality evidence, according to WP:MEDASSESS.

Studies like this are of dubious value in writing for the encyclopedia - I recommend we not include it. Until we have higher quality research to report, the last paragraph of the research section adequately explains the weak state of science and absence of effect by fenugreek on human health. Zefr (talk) 02:04, 8 December 2022 (UTC)

Hypoglycemia Risk - Mechanism?

Source 4 specifies: "Several coumarin compounds have been identified in fenugreek seeds, as well as a number of alkaloids (eg, trigonelline, gentianine, carpaine), including the alkaloid hydroxyisoleucine, which is considered to stimulate insulin secretion." (The drugs.com source)

Helpful data to include, especially for further researching the potential side effects. Bromallium (talk) 20:49, 2 July 2023 (UTC)

Dubious effects on metabolic syndrome

This revert was justified because the review authors describe in the results and conclusions the study's "significant limitations" which include 1) low quality of the included research, 2) vast heterogeneity of the data analyzed, 3) heterogeneity of the subjects having various disorders of metabolic syndrome, which is a complex of several subdiseases, and 4) extreme range of doses and durations used in the studies included (25 to 60000 mg/day and durations of dosing for 2 to 144 weeks). Not assessed or discussed are dietary and lifestyle factors impossible to control unless the subjects in the underlying studies were in a controlled environment (such as a hospital clinical trial unit).

These variations and limitations in study design and error control emphasize the overall variable, poor quality of dietary supplement and food studies of fenugreek or any dietary element. Reaching a conclusion for the article "that fenugreek could meaningfully " affect biomarkers of metabolic diseases is misleading and not a conclusion that any reputable clinical organization would state - see top of left pyramind, WP:MEDASSESS.

For the encyclopedia - which should be presenting clear facts supported by scientific consensus (not available for any review on fenugreek) - such limitations warrant the review not be included in the article. Zefr (talk) 17:48, 9 February 2024 (UTC)

• The authors acknowledge the limitations of the study, but I think this should be included in the research section because it points to research being done and research which should be continued. --Ben Best:Talk 13:39, 11 February 2024 (UTC)