Herbs & Botanicals · Herbs · A gourd-family fruit used as a zero-calorie sweetener and a traditional Chinese throat remedy
Monk fruit (Luo Han Guo)
Siraitia grosvenorii (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang · also called Monk fruit, luo han guo, lo han kuo, arhat fruit; fruta del monje (Spanish)
Monk fruit is the fruit of a climbing vine from southern China. It is used in two very different ways. The purified sweet extract (mogrosides, mainly mogroside V) is a zero-calorie food sweetener. The dried whole fruit is boiled into a traditional tea or soup for cough and sore throat. Most of the safety work is about the sweetener. Short trials in healthy people suggest it does not spike blood sugar the way sugar does, but no trial has tested it in people with diabetes, and no human trial supports the cough tea. The US FDA has had no questions about certain companies' safety conclusions, while the EU's EFSA found the toxicity data insufficient in 2019. Ask a doctor or pharmacist if you take diabetes medicines, are pregnant or breastfeeding, or have food allergies.
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About Monk fruit (Luo Han Guo)
Monk fruit (Siraitia grosvenorii, luo han guo) is the fruit of a southern Chinese climbing vine in the gourd family. Two products must be kept apart. The first is the purified sweet extract, rich in mogrosides, used as a zero-calorie food sweetener (a food additive that has been through US GRAS notices). The second is the traditional dried-fruit tea or decoction used in Chinese medicine for cough and sore throat. Short sugar-swap trials in healthy people suggest the sweetener does not spike blood sugar like sugar. No trial in people with diabetes was found, and no human trial supports the cough tea. The US FDA has not questioned certain GRAS notices, but made no safety finding of its own; EFSA concluded in 2019 that the data were insufficient, citing testis changes in rats and a lack of long-term studies. Allergy cannot be ruled out (gourd family, extracts can be up to 36% protein). No pregnancy or breastfeeding data exist. No interaction study with medicines was found; diabetes medicines need attention if you change your sweetener. EMA, NCCIH, LiverTox and LactMed entries were not found.
What it is
Monk fruit is the fruit of Siraitia grosvenorii, a climbing vine in the gourd family (Cucurbitaceae), the family of melon, cucumber and squash. GBIF accepts the name Siraitia grosvenorii (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang. Reviews describe it as grown in southern China, mainly Guangxi.
The sweet taste comes from compounds called mogrosides, mainly mogroside V, which a review says is up to about 425 times sweeter than sugar.
Sweetener versus traditional tea
The sweetener is made by extracting the fruit with water and purifying it. EFSA assessed extracts of 25% to 55% mogroside V. FDA's 2016 letter describes a juice concentrate that is only about 5% mogrosides and over half sugars. These are different products from the whole-fruit tea.
The traditional tea or soup uses the dried whole fruit, sometimes with other herbs. Regulators did not assess the tea. A result on one form should not be assumed for another, and many retail sweeteners are blends.
Traditional and current uses
Reviews say the dried fruit has been used for 300 years or more in China for sore throat, cough and phlegm and is listed in the Chinese Pharmacopoeia. This is traditional use, not proof it works.
Today the main use worldwide is as a sweetener in drinks and foods.
What the research shows
The human evidence is short sugar-swap trials in healthy people. A 2025 review of five trials reports smaller post-meal glucose and insulin responses. A 30-man trial found no difference from sugar in total 3-hour glucose, and one 2026 trial found only sugar raised glucose and insulin. Nothing has tested people with diabetes, long-term weight, or the cough tea in humans.
Reviews of the fruit's lab effects (inflammation, cough, blood sugar) are from cells and animals. Several are written by authors who work for a sweetener company.
At a glance
Traditional uses history, not proof
- Traditional Chinese medicine: boiled dried fruit for cough, sore throat and phlegm, described as clearing heat and moistening the lungs
- Also described for easing constipation, including in teas and a pork broth
- Sweet food and drink in southern China, where it is mostly grown
Studied for research
- Blood sugar and insulin after a sweetened drink compared with sugar, low certainty (small crossover trials in healthy people)
- Diabetes treatment, insufficient (no trial in people with diabetes)
- Weight and appetite, insufficient (no benefit shown; WHO advises against non-sugar sweeteners for weight control)
- Brain reward response to sweet taste, very low certainty (one small imaging trial)
- Cough, sore throat and constipation, insufficient (traditional use only, no human trial)
Main compounds
- Mogroside V, the main sweet compound, up to about 425 times sweeter than sucrose according to one review
- Smaller mogrosides, for example mogroside III-E
- Mogrol, formed from mogrosides by gut bacteria
- Flavonoids, sugars and protein; extracts can contain up to 36% protein
Common forms
- Purified mogroside extract used as a sweetener (EFSA assessed extracts of 25% to 55% mogroside V)
- Fruit juice concentrate (the form in FDA's 2016 letter, about 5% mogrosides and 56% sugars)
- Table-top and retail sweeteners, often blends with other sweeteners
- Traditional dried fruit tea, decoction or soup (a different product, not assessed by regulators)
- Results from one form should not be assumed for another
Research links: EFSA opinion on monk fruit extract (2019) · FDA letter, GRAS notice GRN 627 · Monk fruit extract systematic review of RCTs (2025) · WHO on non-sugar sweeteners (2023) · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Siraitia grosvenorii (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang
- Naming authority
- (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang; published in Guihaia 4(1): 29 (1984) per GBIF
- Synonyms
- Momordica grosvenorii Swingle; Siraitia grosvenorii (Swingle) C.Jeffrey; Thladiantha grosvenorii (Swingle) C.Jeffrey
- Common names
- Monk fruit (English); Luo han guo (Chinese (pinyin)); Lo han kuo (English (alternative spelling)); Arhat fruit (English); Fruta del monje (Spanish); Luohanguo, Siraitiae fructus (Pharmacopoeia / Latin drug name)
- Botanical family
- Cucurbitaceae (the gourd family, which also includes melon, cucumber and squash)
- Classification
- Plantae > Tracheophyta > Magnoliopsida > Cucurbitales > Cucurbitaceae > Siraitia > Siraitia grosvenorii
- Native range
- Reviews describe it as grown in southern China, mainly Guangxi (one review says Guangxi has about 80% of the cultivated area). A formal native-range statement was not found in the sources read.
- Habitat
- A perennial climbing vine (liana) grown on trellises in warm, humid hill areas; details beyond the review summaries were not verified.
- What the plant looks like
- Roots: Not verified from a primary source read.; Stems: Climbing vine (liana), per review abstracts.; Leaves: Not verified from a primary source read.; Flowers: Plants are male or female (dioecious) and reviews note artificial pollination is needed in cultivation.; Fruit: The fruit is the part used; fresh fruit contains about 0.55 to 0.65% mogrosides, per EFSA.
- Cultivation
- Grown by cuttings or tissue-cultured seedlings; a review says planting is mostly in mid-March to mid-April with trellis sheds and hand pollination.
- Harvest and processing
- Fruit is eaten dried or processed. The sweetener is made by water extraction of the fruit followed by filtration and resin purification (EFSA, FDA letter); purities range from 25% up to 55% or more mogroside V.
- Look-alikes and adulterants
- Name: Other Siraitia species; Note: GBIF lists related species such as Siraitia siamensis and Siraitia sikkimensis. We did not verify whether any is sold as monk fruit.; Name: Stevia (Stevia rebaudiana); Note: A different plant (daisy family) sold as another natural zero-calorie sweetener; retail sweeteners often blend the two.; Name: Fruit juice concentrate vs purified extract; Note: The US GRN 627 concentrate is about 5% mogrosides and 56% sugars; purified extracts are 25 to 55%+ mogroside V. They are different products.
- Sustainability and conservation
- Not assessed in the sources read. It is an intensively cultivated crop.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| Traditional Chinese medicine, southern China | Reviews say the dried fruit has been used for 300 years or more as a sweetener and as a remedy for sore throat, cough and phlegm; described as cool and sweet, clearing heat and moistening the lungs and bowels. A review dates a lung-moistening, sore-throat use to 2,000 years ago, but the 300-year figure is more widely repeated, and the older dating was NOT verified. | p31849659 |
| Chinese Pharmacopoeia (2015 edition, as cited by a review) | Listed for cough, sore throat and excessive phlegm. We read this only secondhand through a review. | p31849659 |
| Modern sweetener use | The extract is used as a zero-calorie sweetener. Reviews say China approved it as a sweetener in the 1990s; US GRAS notices followed (GRN 627 in 2016); EFSA assessed it in 2019. Statements in reviews that FDA 'approved' it in 1995 or 2011 were NOT verified. | s-efsa-2019-monk-fruit |
| EU status | EFSA noted the Novel Food Catalogue said Siraitia was not used as a food or ingredient before 15 May 1997 in the EU. | s-efsa-2019-monk-fruit |
Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.
What is inside, and how it may work
What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Mogroside V PubChem 24721270 | cucurbitane triterpene glycoside (sweet) | Fruit Main mogroside of the extract; fresh fruit has about 0.55 to 0.65% total mogrosides (EFSA). | The main sweet compound; a review says up to about 425 times sweeter than sucrose. Absorbed to some extent and broken down by gut bacteria. Lab and animal effects only beyond sweetness. 3 6 26 14 | Animal research |
| Mogroside III-E PubChem 102350789 | cucurbitane triterpene glycoside | Fruit Not stated in sources read | A minor mogroside; rats produced many metabolites, more after drug-metabolising enzymes were induced. 24 | Animal research |
| Mogrol PubChem 14525327 | cucurbitane triterpene (the sugar-free core, aglycone) | Formed in the gut from mogrosides Not stated in sources read | The end product of gut-bacteria breakdown; EFSA said its genotoxic potential could not be assessed from the tests provided. 3 23 | Laboratory research |
| Other fruit components: flavonoids, sugars, protein, amino acids | mixed | Fruit Extracts up to 36% protein (EFSA); juice concentrate about 56% sugars (FDA letter). | Reviews list flavonoids, amino acids, polysaccharides and volatile oils; the protein matters for allergy and the sugars for the concentrate. 3 19 8 | Laboratory research |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Sweet taste receptor | Not studied in the sources read | Mogrosides taste very sweet without being used as sugar by the body. The reason it does not raise blood sugar like sugar is not shown in the human trials. 17 16 | Human data |
| AMPK and insulin signalling | AMPK; PI3K/AKT | A review says mogroside V modulates glucose and lipid metabolism through AMPK in lab models. A mouse study linked mogroside V to PI3K/AKT and NF-kB changes in the gut lining. 26 9 | Animal research |
| Gut bacteria breakdown | Gut microbial glycosidases (not identified) | Human gut bacteria in a lab dish removed sugar units from mogroside V, forming smaller mogrosides and mogrol, and made more short-chain fatty acids. 23 3 | Laboratory research |
| Anti-inflammatory and airway effects | TLR4 and NF-kB (named in the reviewed mouse studies) | Mouse and cell studies report less lung inflammation with mogroside V; reviews list this as the basis for the traditional cough use. No human test. 8 11 | Animal research |
Absorption, metabolism and elimination
- Absorption
- EFSA says mogroside V is absorbed to some extent and is systemically available in rats; in humans only single-dose glucose and liver-enzyme studies were described, and no human blood-level data were found.
- Distribution
- In rats, mogroside V and its breakdown products were found in all analysed organs, blood plasma and urine (EFSA, describing Xu 2015).
- Metabolism
- Gut bacteria remove sugar units stepwise (siamenoside I, mogrosides IV to II, mogrol). Mogroside III incubated with human intestinal bacteria gave mogrol. In rats, enzyme induction increased the number of mogroside metabolites.
- Elimination
- In rats, faeces held mostly mogrol and smaller mogrosides, about 61% of one dose; the rest was not accounted for (EFSA).
- Bioavailability
- Not established in humans.
Isolated compounds versus whole extracts
Two different products are in use. The traditional product is the whole dried fruit, boiled as a tea or soup, with its sugars, flavonoids, protein and other compounds. The sweetener is a water extract purified to concentrate mogrosides (25% to 55%+ mogroside V) or a juice concentrate (about 5% mogrosides, 56% sugars in the GRN 627 product). Regulators looked only at the sweetener forms. The cough and sore-throat tradition belongs to the whole fruit, and the blood-sugar trials used drinks sweetened with extract. Results from one form should not be applied to another.
Nutritional composition
We did not read a food composition table for monk fruit. EFSA gives fresh fruit about 0.55 to 0.65% mogrosides, and the FDA letter lists a juice concentrate as about 56% sugars, 35% water and 5% mogrosides.
1 low certainty2 very low certainty6 not enough evidence
What is Monk fruit (Luo Han Guo) good for?
The main proposed uses and how strong the human evidence is for each. Ratings are our reading of small, short studies, not formal grades. The first four rows are about the purified sweetener; the cough and constipation rows are about the traditional whole-fruit tea.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Sweetener use: smaller blood sugar rise after a drink than with sugar
Low certaintyWhen a drink is sweetened with monk fruit extract instead of sugar, blood sugar and insulin do not shoot up the way they do after sugar. This is mostly a sugar-swap effect, not a treatment. Trials are small, short and in healthy people. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction.
7 studiesTrials used drinks or beverage preloads; the monk fruit amount was no…
Studies, doses and limits
What the trials found
A 2025 systematic review of five randomized trials reports lower post-meal glucose (10-18%) and insulin (12-22%) with monk fruit extract and no severe adverse effects, but the abstract does not say what it was compared with. In a 30-man crossover trial, a sucrose drink caused a big glucose and insulin spike in the first hour, but total 3-hour glucose (P=0.960) and insulin (P=0.216) did not differ between a monk fruit drink and sucrose, because the low-calorie drinks led to higher responses after lunch. In 10 men, 24-hour glucose by continuous monitor did not differ between a monk fruit drink and sucrose. In a 2026 crossover trial in 30 healthy adults, only sucrose raised glucose and insulin; the monk fruit drink did not. In a 60-person trial of a monk fruit plus stevia blend, insulin response was lower than with sucrose (P<0.001). EFSA also describes two older single-dose studies in healthy adults where the extract itself did not change blood glucose.
Results
Lower or equal blood sugar response than sugar in healthy people over hours; no long-term data.
Effect sizes as reported
Review: glucose -10% to -18%, insulin -12% to -22% (comparator not stated in abstract). Tey 2017: no difference in 3-h glucose AUC (P=0.960) and insulin AUC (P=0.216) vs sucrose. SWEET blend: insulin iAUC lower than sucrose (P<0.001).
Why this rating
Several small crossover trials in healthy people agree that monk fruit drinks do not spike blood sugar, but all are single-dose, mostly in healthy people, and one pooled review does not report details. Certainty is low, not higher, because no long-term or diabetes-patient trial was found.
Form and dose studied
Trials used drinks or beverage preloads; the monk fruit amount was not given in the abstracts we read. Retail products are often blends.
Who was studied
Healthy adults, mostly men in the Singapore trials; adults with overweight in the SWEET trial.
Limits
Short, single-dose designs. The pooled review's abstract does not list its five trials. The blend trial is industry-linked (beverage industry funding and an employee of a sweetener supplier). One 2026 trial has an author at a sweetener company.
Why researchers looked
Monk fruit extract is 'zero-calorie' and is sold to replace sugar, so researchers asked what happens to blood sugar and insulin after a sweetened drink.
Traditional use
The whole fruit has long been eaten as a sweet fruit and drink in southern China, but traditional texts did not use it as a diabetes treatment in the sources we read.
Proposed mechanism Preliminary mechanism
Mogrosides taste intensely sweet but are not broken down into sugars that raise blood glucose. They are changed by gut bacteria into smaller mogrosides and mogrol.
A proposed mechanism does not show that the effect happens in people.
No severe adverse effects reported in the review; stomach and gut symptoms were mostly mild in the blend trial.
Treating or controlling diabetes
Not enough evidenceNot shown. No trial in people with diabetes was found. Animal and lab studies suggest glucose-lowering, but reviewers say clinical evidence is insufficient. Do not use monk fruit instead of diabetes treatment. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction.
5 studiesNo dose was tested in people with diabetes.
Studies, doses and limits
What the trials found
We found no randomized trial of monk fruit in people with diabetes. A 2024 review (full text) says there is currently insufficient clinical evidence to confirm the fruit works in diabetes treatment. The 2025 systematic review covers short meal-response trials. A 2025 mouse study found mogroside V improved gut barrier and inflammation signs in diabetic mice and did best of several sweeteners, but it comes from a group linked to a sweetener maker. A 2024 general article says the effects of natural sweeteners such as monk fruit extract are not well studied.
Results
No human diabetes trial found; animal data only.
Effect sizes as reported
None in people.
Why this rating
No trial in people with diabetes; animal and lab findings do not show benefit in humans.
Form and dose studied
No dose was tested in people with diabetes.
Who was studied
People with diabetes were not studied.
Limits
Animal findings come partly from industry-linked groups.
Why researchers looked
Because monk fruit extract does not raise blood sugar, people with diabetes or prediabetes use it as a sugar swap, and lab studies suggested it might also lower blood sugar.
Traditional use
Chinese reviews list glucose-lowering as one of its experimental effects, but traditional use centred on cough, sore throat and constipation.
Proposed mechanism Animal research
Mouse studies suggest mogrosides activate the AMPK pathway and improve insulin handling and the gut lining.
A proposed mechanism does not show that the effect happens in people.
If you take diabetes medicines, a change from sugar to a sweetener can change your blood sugar. Talk to your prescriber or pharmacist.
Weight control and appetite
Not enough evidenceNo monk fruit trial shows weight loss. In one trial men who drank a monk fruit drink ate more at the next meal, making up the saved calories, so daily intake was the same. WHO advises against using non-sugar sweeteners for weight control. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction.
3 studiesDrink servings only; no weight-loss trial.
Studies, doses and limits
What the trials found
In the 30-man Singapore crossover trial lunch intake was higher after low-calorie sweetener drinks (including monk fruit) than after sucrose (P=0.010), but total daily energy intake did not differ (P=0.831). The 60-person blend trial found small changes in fullness and desire to eat that did not change next-24-hour energy intake. WHO (2023), using a systematic review, recommends against non-sugar sweeteners for weight control for everyone except people with pre-existing diabetes, and its recommendation includes naturally occurring sweeteners; monk fruit is not named in the news item we read. No long-term monk fruit trial on weight was found.
Results
No weight benefit shown; one-day trials show full compensation of energy.
Effect sizes as reported
Tey 2017: total daily energy intake no difference (P=0.831).
Why this rating
Only one-day trials for monk fruit; WHO's class-wide advice rests on a review of all non-sugar sweeteners, and its link to harm may be confounded.
Form and dose studied
Drink servings only; no weight-loss trial.
Who was studied
Healthy men; adults with overweight in the blend trial.
Limits
WHO's advice is conditional and class-wide; it does not test monk fruit alone.
Why researchers looked
A zero-calorie sweetener is often used to cut sugar calories, so researchers test whether that helps people eat less.
Traditional use
No traditional weight-loss use was found in the sources we read.
Proposed mechanism Pharmacological theory
Swapping sugar for a sweet taste with no calories could leave people hungrier later, so they eat more.
A proposed mechanism does not show that the effect happens in people.
See the Safety section for gut symptoms.
Brain reward response to sweet taste
Very low certaintyIn one small lab trial, a monk fruit drink affected a reward area of the brain like water and like sucralose, and unlike sugar. This is a research measure, not a health benefit. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction.
1 studies500 mL flavored water matched in sweetness to 25 g sucrose.
Studies, doses and limits
What the trials found
In a 2026 crossover trial of 30 healthy young adults, blood flow in the hypothalamus (the main outcome) did not differ between drinks. In the midbrain reward area, blood flow changed about 8% less after sucrose than after water, sucralose or the monk fruit drink at 30 minutes. Only sucrose raised glucose and insulin.
Results
Monk fruit drink behaved like water in this area; sucrose differed.
Effect sizes as reported
About 8% +/- 3% difference vs sucrose (P-FDR<0.05).
Why this rating
One small single-drink brain-imaging trial; the measure is not a health outcome.
Form and dose studied
500 mL flavored water matched in sweetness to 25 g sucrose.
Who was studied
Healthy young adults after fasting.
Limits
Single drink; no eating or health outcome; one author works at a sweetener company.
Why researchers looked
Sweet taste without sugar may not satisfy the brain's reward system in the same way, which could change later eating.
Traditional use
No traditional link.
Proposed mechanism Preliminary mechanism
Sugar and low-calorie sweeteners may act differently on midbrain reward circuits.
A proposed mechanism does not show that the effect happens in people.
None reported in the abstract.
Cough, sore throat and phlegm (traditional use of the whole fruit)
Not enough evidenceFor several hundred years, dried luo han guo fruit has been boiled into teas and soups in southern China for cough, sore throat and hoarse voice. No human trial was found. This is traditional use only. It is not the purified sweetener.
4 studiesTraditional decoctions and teas of the dried whole fruit; amounts are…
Studies, doses and limits
What the trials found
We found no randomized trial or other human study of monk fruit for cough, sore throat or phlegm. Reviews of the fruit's pharmacology list cough-relief and phlegm-relief effects from animal and cell experiments. Recent mouse studies of mogroside V in allergic asthma and lung injury are not a test in people.
Results
No human results.
Effect sizes as reported
None in people.
Why this rating
No human study was found; traditional use and animal work only.
Form and dose studied
Traditional decoctions and teas of the dried whole fruit; amounts are not given here.
Who was studied
Traditionally used in adults and children in southern China; not studied.
Limits
Traditional texts are not evidence of effect. Many traditional recipes mix several herbs, so a result cannot be assigned to monk fruit.
Why researchers looked
It is one of China's food-medicine fruits and is listed in the Chinese Pharmacopoeia for cough, sore throat and phlegm.
Traditional use
Reviews say the fruit has been used for 300 years or more as a sweetener and as a remedy for pharyngitis, sore throat and cough, and is described as clearing heat and moistening the lungs; traditional recipes pair it with other plants.
Proposed mechanism Animal research
Lab and mouse studies suggest mogrosides lower airway inflammation and reduce cough and allergic-asthma signs. This has not been shown in people.
A proposed mechanism does not show that the effect happens in people.
A cough lasting more than a few weeks, with blood, or with fever or breathlessness needs medical care.
Constipation (traditional use of the whole fruit)
Not enough evidenceTraditional Chinese medicine describes the fruit as helping dry-type constipation. No human trial was found.
2 studiesDried fruit teas and soups; amounts not given.
Studies, doses and limits
What the trials found
A 2022 review says the fruit is used traditionally for lung congestion, sore throat and constipation. No human study was found.
Results
None.
Effect sizes as reported
None.
Why this rating
Traditional use only.
Form and dose studied
Dried fruit teas and soups; amounts not given.
Who was studied
Not studied.
Limits
Traditional claim; cannot be assessed.
Why researchers looked
Reviews list moistening the intestines and easing constipation among its traditional uses, including in teas and a pork broth.
Traditional use
Described as clearing heat and moistening the lungs and bowels in traditional Chinese medicine.
Proposed mechanism Animal research
Not established in people.
A proposed mechanism does not show that the effect happens in people.
See Safety for stomach effects of concentrated extracts.
Gut bacteria and gut lining
Very low certaintyIn a lab dish, human gut bacteria broke mogroside V down, the mix of bacteria changed, and they made more short-chain fatty acids. In diabetic mice, mogroside V improved the gut lining. No human trial was found.
2 studiesMogroside V in lab concentrations.
Studies, doses and limits
What the trials found
The lab-dish study of human gut bacteria (24 hours) found bacteria types shifted and short-chain fatty acids increased; the authors suggest a possible prebiotic role. A 2025 mouse study of mogroside V in diabetic mice found better gut barrier and less inflammation than several other sweeteners. Neither tests people.
Results
No human results.
Effect sizes as reported
Not applicable.
Why this rating
Lab dish and mouse studies only; one mouse study is from a sweetener-maker-linked group.
Form and dose studied
Mogroside V in lab concentrations.
Who was studied
None.
Limits
Test-tube and mouse results do not show any change in people.
Why researchers looked
Mogrosides are mostly not absorbed whole; gut bacteria break them down, so researchers ask what that does to the gut.
Traditional use
None.
Proposed mechanism Laboratory research
Gut bacteria remove sugar units from mogroside V, producing smaller mogrosides and mogrol. Mouse work suggests effects on the gut barrier through PI3K/AKT and NF-kB signals.
A proposed mechanism does not show that the effect happens in people.
None specific.
Liver (a safety question, not a benefit)
Not enough evidenceAnimal studies give mixed answers about the liver. Reviews describe liver-protective effects in lab models. EFSA saw a reversible liver weight increase in rats. One 2026 rat study found raised liver enzymes. Two single-dose studies in healthy adults saw no liver enzyme change. See Safety.
4 studiesSee Safety file.
Studies, doses and limits
What the trials found
EFSA reports two single-dose human studies (10 and 6 healthy adults) with no change in liver enzymes, which it called too small and short. In the 60-person blend trial, transaminases did not differ from sucrose. The 2026 rat study (5 rats per group, 4 weeks) found higher ALT and oxidative stress and tissue damage in a dose-dependent pattern.
Results
Human: no change in liver enzymes after a single dose; rats: mixed.
Effect sizes as reported
ALT up in rats (p=0.001); no change in people after single dose.
Why this rating
Conflicting animal findings and only single-dose human data.
Form and dose studied
See Safety file.
Who was studied
Healthy adults, rats.
Limits
Very small rat study not yet replicated.
Why researchers looked
Mogrosides are absorbed to some extent and reach the liver, so liver effects are checked for safety.
Traditional use
None.
Proposed mechanism Animal research
Unclear; protective effects reported in disease-model animals, possible liver stress at high doses in one healthy-rat study.
A proposed mechanism does not show that the effect happens in people.
Report yellow skin or eyes, dark urine or severe tiredness to a doctor.
Anti-inflammatory, antioxidant, cancer, brain and other lab claims
Not enough evidenceReviews list many other effects (anti-inflammatory, antioxidant, anti-fatigue, protection of nerves, anti-tumour, anti-allergy, tooth decay). All are from cells and animals. None has been tested in a human trial that we found.
4 studiesNot applicable.
Studies, doses and limits
What the trials found
Review articles from 2014 to 2025 summarise these findings as lab and animal results and call for clinical studies. A 2024 review says the same about the fruit and mogrosides. We found no human trial for any of these uses.
Results
No human results.
Effect sizes as reported
Not applicable.
Why this rating
Lab and animal evidence only; several reviews are written by groups with sweetener-industry ties.
Form and dose studied
Not applicable.
Who was studied
None.
Limits
Reviews may overstate: they summarise lab results, not patient outcomes.
Why researchers looked
Mogrosides and other fruit compounds change inflammation and oxidative stress signals in lab models.
Traditional use
Not part of the traditional use described in the reviews.
Proposed mechanism Animal research
Cell and animal experiments, for example on NF-kB and AMPK signals.
A proposed mechanism does not show that the effect happens in people.
None.
Connections to the rest of health
How Monk fruit (Luo Han Guo) connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Blood Sugar Balance | Demonstrated clinical effect | Low certainty | Sweetener use: smaller blood sugar rise after a drink than with sugar: When a drink is sweetened with monk fruit extract instead of sugar, blood sugar and insulin do not shoot up the way they do after sugar. This is mostly a sugar-swap effect, not a treatment. Trials are small, short and in healthy people. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 10 17 18 1 16 3 20 |
| Metabolic Health | Demonstrated clinical effect | Low certainty | Sweetener use: smaller blood sugar rise after a drink than with sugar: When a drink is sweetened with monk fruit extract instead of sugar, blood sugar and insulin do not shoot up the way they do after sugar. This is mostly a sugar-swap effect, not a treatment. Trials are small, short and in healthy people. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 10 17 18 1 16 3 20 |
| Blood Sugar Balance | Preliminary mechanism | Not enough evidence | Treating or controlling diabetes: Not shown. No trial in people with diabetes was found. Animal and lab studies suggest glucose-lowering, but reviewers say clinical evidence is insufficient. Do not use monk fruit instead of diabetes treatment. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 6 9 12 10 26 |
| Metabolic Health | Preliminary mechanism | Not enough evidence | Treating or controlling diabetes: Not shown. No trial in people with diabetes was found. Animal and lab studies suggest glucose-lowering, but reviewers say clinical evidence is insufficient. Do not use monk fruit instead of diabetes treatment. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 6 9 12 10 26 |
| Weight Management | Potential benefit | Not enough evidence | Weight control and appetite: No monk fruit trial shows weight loss. In one trial men who drank a monk fruit drink ate more at the next meal, making up the saved calories, so daily intake was the same. WHO advises against using non-sugar sweeteners for weight control. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 17 1 21 |
| Metabolic Health | Potential benefit | Not enough evidence | Weight control and appetite: No monk fruit trial shows weight loss. In one trial men who drank a monk fruit drink ate more at the next meal, making up the saved calories, so daily intake was the same. WHO advises against using non-sugar sweeteners for weight control. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 17 1 21 |
| Mental Clarity | Biological association | Very low certainty | Brain reward response to sweet taste: In one small lab trial, a monk fruit drink affected a reward area of the brain like water and like sucralose, and unlike sugar. This is a research measure, not a health benefit. This benefit concerns the purified sweet extract (mogrosides, mostly mogroside V) used as a food sweetener, not the traditional whole-fruit tea or decoction. | 16 |
| Immune Support | Traditional use | Not enough evidence | Cough, sore throat and phlegm (traditional use of the whole fruit): For several hundred years, dried luo han guo fruit has been boiled into teas and soups in southern China for cough, sore throat and hoarse voice. No human trial was found. This is traditional use only. It is not the purified sweetener. | 5 11 22 8 |
| Digestive Support | Traditional use | Not enough evidence | Constipation (traditional use of the whole fruit): Traditional Chinese medicine describes the fruit as helping dry-type constipation. No human trial was found. | 22 5 |
| Gut Health | Traditional use | Not enough evidence | Constipation (traditional use of the whole fruit): Traditional Chinese medicine describes the fruit as helping dry-type constipation. No human trial was found. | 22 5 |
| Gut Health | Preliminary mechanism | Very low certainty | Gut bacteria and gut lining: In a lab dish, human gut bacteria broke mogroside V down, the mix of bacteria changed, and they made more short-chain fatty acids. In diabetic mice, mogroside V improved the gut lining. No human trial was found. | 23 9 |
| Digestive Support | Preliminary mechanism | Very low certainty | Gut bacteria and gut lining: In a lab dish, human gut bacteria broke mogroside V down, the mix of bacteria changed, and they made more short-chain fatty acids. In diabetic mice, mogroside V improved the gut lining. No human trial was found. | 23 9 |
| Liver Support | Adverse effect or risk | Not enough evidence | Liver (a safety question, not a benefit): Animal studies give mixed answers about the liver. Reviews describe liver-protective effects in lab models. EFSA saw a reversible liver weight increase in rats. One 2026 rat study found raised liver enzymes. Two single-dose studies in healthy adults saw no liver enzyme change. See Safety. | 3 1 25 15 |
| Inflammation Balance | Preliminary mechanism | Not enough evidence | Anti-inflammatory, antioxidant, cancer, brain and other lab claims: Reviews list many other effects (anti-inflammatory, antioxidant, anti-fatigue, protection of nerves, anti-tumour, anti-allergy, tooth decay). All are from cells and animals. None has been tested in a human trial that we found. | 8 26 6 11 |
| Healthy Aging | Preliminary mechanism | Not enough evidence | Anti-inflammatory, antioxidant, cancer, brain and other lab claims: Reviews list many other effects (anti-inflammatory, antioxidant, anti-fatigue, protection of nerves, anti-tumour, anti-allergy, tooth decay). All are from cells and animals. None has been tested in a human trial that we found. | 8 26 6 11 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Endocrine system | Drug or supplement interaction | Not enough evidence | Sugar swap may change blood sugar and medicine needs; no interaction study. Sugar swap may change blood sugar and diabetes medicine needs; no interaction study. Preparation or compound: Monk fruit sweetener extract |
17 10 8 |
| Immune system | Adverse effect or risk | Not enough evidence | EFSA could not rule out allergy; gourd family. Preparation or compound: Extracts with protein |
3 |
| Endocrine System | Biological association | Low certainty | Studied for: Sweetener use: smaller blood sugar rise after a drink than with sugar Studied for: Treating or controlling diabetes | 10 17 18 1 16 3 20 6 9 12 26 |
| Metabolism Weight | Biological association | Low certainty | Studied for: Sweetener use: smaller blood sugar rise after a drink than with sugar Studied for: Treating or controlling diabetes | 10 17 18 1 16 3 20 6 9 12 26 21 |
| Nervous System | Biological association | Very low certainty | Studied for: Brain reward response to sweet taste Studied for: Anti-inflammatory, antioxidant, cancer, brain and other lab claims | 16 8 26 6 11 |
| Respiratory System | Biological association | Not enough evidence | Studied for: Cough, sore throat and phlegm (traditional use of the whole fruit) | 5 11 22 8 |
| Digestive System | Biological association | Not enough evidence | Studied for: Constipation (traditional use of the whole fruit) Studied for: Gut bacteria and gut lining | 22 5 23 9 |
| Hepatic System | Biological association | Not enough evidence | Studied for: Liver (a safety question, not a benefit) | 3 1 25 15 |
| Immune System | Biological association | Not enough evidence | Studied for: Anti-inflammatory, antioxidant, cancer, brain and other lab claims | 8 26 6 11 |
C. Body parts and organs
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Liver | Adverse effect or risk | Not enough evidence | No human case; mixed animal findings. Preparation or compound: Monk fruit sweetener |
3 25 |
| Reproductive organs | Adverse effect or risk | Not enough evidence | Testis changes in rats at the highest dose; EFSA could not dismiss them. Preparation or compound: Extract-52% mogroside V |
3 |
D. Symptoms
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Blood sugar after meals | Potential benefit | Low certainty | Smaller rise than with sugar in short trials in healthy people; not tested in diabetes. Preparation or compound: Monk fruit sweetener extract |
10 17 16 |
| Cough and sore throat | Traditional use | Not enough evidence | Traditional whole-fruit tea; no human trial. Preparation or compound: Dried whole fruit tea or decoction |
5 11 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Blood glucose after a drink or meal | Biological association | Low certainty | Measured in trials: no-change. A lab change is not the same as a health benefit. | 17 18 16 10 |
| Insulin after a drink or meal | Biological association | Low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 17 1 16 10 |
| Midbrain reward-area blood flow (MRI) | Biological association | Very low certainty | Measured in trials: mixed. A lab change is not the same as a health benefit. | 16 |
| Liver enzymes (ALT, AST) | Biological association | Low certainty | Measured in trials: mixed. A lab change is not the same as a health benefit. | 3 1 25 15 |
J. Genes, receptors and enzymes
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Drug-metabolising enzymes (not named) | Preliminary mechanism | Animal | Rat metabolism of mogroside III and IIIE changed with enzyme induction; not tested in people. | 24 |
K. Biological pathways
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Mogroside V | Biological association | Animal | The main sweet compound; a review says up to about 425 times sweeter than sucrose. Absorbed to some extent and broken down by gut bacteria. Lab and animal effects only beyond sweetness. Preparation or compound: Fruit |
3 6 26 14 |
| Mogroside III-E | Biological association | Animal | A minor mogroside; rats produced many metabolites, more after drug-metabolising enzymes were induced. Preparation or compound: Fruit |
24 |
| Mogrol | Biological association | In vitro | The end product of gut-bacteria breakdown; EFSA said its genotoxic potential could not be assessed from the tests provided. Preparation or compound: Formed in the gut from mogrosides |
3 23 |
| Other fruit components: flavonoids, sugars, protein, amino acids | Biological association | In vitro | Reviews list flavonoids, amino acids, polysaccharides and volatile oils; the protein matters for allergy and the sugars for the concentrate. Preparation or compound: Fruit |
3 19 8 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).
Evidence at a glance: what changed in 4 lab markers
Tap a number to show only those markers. Counts are markers, not people.
The evidence
The research centre for Monk fruit (Luo Han Guo). Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed and read the EFSA opinion, the FDA GRAS letter and sweetener page, WHO's news item, Health Canada's notice, and checked GBIF, NCBI and PubChem. Only abstracts were read for most studies. We could not find an EMA/HMPC monograph, NCCIH page, LiverTox or LactMed entry, so these are marked not found, not confirmed absent. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify.
Study library: every study we checked 26
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Almiron-Roig 2023 Impact of acute consumption of beverages containing plant-based or alternative sweetener blends on postprandial appetite, food intake, metabolism, and gastro-intestinal symptoms: Results of the SWEET beverages trial. Appetite · PMID 36849009 · DOI |
Controlled trial |
60 60 healthy adult volunteers with overweight or obesity (53% male), 4 hours per visit |
Zero-energy 330 mL beverage with a BLEND of mogroside V and stevia (Reb M) fruit extract (mogroside V) plus stevia one beverage per visit, then a standard breakfast one visit per drink · vs 8% sucrose beverage (26 g); two other zero-energy blends (stevia Reb A + thaumatin; sucralose + acesulfame-K) |
All three blends lowered the 2-hour insulin response compared with sucrose (p<0.001). Glucose response was lowered only by the stevia Reb A and sucralose blends (p<0.05), not stated for the mogroside V blend. Triglycerides and liver enzymes (transaminases) did not differ across drinks. Gastro-intestinal symptoms were mostly mild. Insulin response lower than with sucrose for all blends (p<0.001); liver enzymes and triglycerides no difference (p>0.05) Methods, limits and fundingOutcomes: Insulin and glucose after a carbohydrate-rich breakfast, appetite, food intake, blood fats, liver enzymes, stomach and gut symptoms Limitations: This tested a BLEND of two sweeteners, not monk fruit alone. Single-dose, healthy adults with overweight. Industry links: some authors receive research funding from the American Beverage Association or honoraria from the International Sweeteners Association, and one author is an employee of Cargill. Funding and conflicts: Industry-linked (see limitations). Read: abstract |
| Compiler's searches 2026 Searches for NCCIH, EMA/HMPC, LiverTox and LactMed entries on monk fruit (2026-10-25) nccih.nih.gov; ema.europa.eu; NCBI Bookshelf · Source |
Search record n/a |
No NCCIH page was found (guessed monk-fruit and luo-han-guo URLs returned 404, and a site search returned no monk fruit match). An EMA site search page returned no Siraitia result when fetched, but that page is dynamic, so this is NOT confirmed. An NCBI Bookshelf search for monk fruit, luo han guo or Siraitia together with LiverTox or LactMed returned no records. These are marked 'not found', not 'confirmed absent'. Methods, limits and fundingLimitations: Negative searches only; the LiverTox and LactMed sites were not browsed directly. Read: summary-only | ||
| EFSA Panel on Food Additives and Flavourings (FAF) 2019 Safety of use of Monk fruit extract as a food additive in different food categories (EFSA Journal 2019;17(12):5921) EFSA Journal · Source |
Authoritative guidance animal |
EFSA concluded the toxicity database on monk fruit extract is insufficient to conclude on its safety as a food additive and could not set a health-based guidance value. Mogroside V is absorbed to some extent. Extracts of 25% and 55% mogroside V were negative in a bacterial mutation test and an in-vitro chromosome test, but the tests could not assess the gut-bacteria breakdown products including mogrol. In a rat 90-day study (extract-52% mogroside V) there was reversible liver weight increase in females (considered adaptive) and, at the high dose, lower testis weight with more tubular degeneration/atrophy in males; EFSA said these testis effects cannot be dismissed. No chronic or cancer studies were provided. A rat reproduction screening study and a rat prenatal study showed no effects (parents, pups, or mothers and fetuses); the screening study noted sticky soft faeces at 2000 and 4000 mg/kg/day. Allergy cannot be ruled out because extracts contain up to 36% protein. Human data: two single-dose studies (10 and 6 healthy adults, extract at 200 mg/kg) found no effect on blood glucose and no change in liver enzymes; EFSA judged them too short and small. Estimated intake from proposed uses: mean 0.6-36.4 and 95th percentile 2.5-71.5 mg mogroside V/kg/day in the general population, considered conservative. JECFA: monk fruit was listed for a 2016 meeting but no data were submitted and the item was removed. Methods, limits and fundingLimitations: Opinion adopted 13 November 2019, about the water-extracted extract proposed as a food additive, not the whole fruit tea. Later EU developments after 2019 were not checked. The human studies are described second-hand by EFSA (original papers not read). The JECFA statement is EFSA's description, not a JECFA document read by us. Read: full-text | ||
| GBIF Secretariat 2026 GBIF Backbone Taxonomy: Siraitia grosvenorii (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang (usageKey 3623059) GBIF API · Source |
Reference database n/a |
Accepted species in Cucurbitaceae, order Cucurbitales. Published in Guihaia 4(1): 29 (1984). Synonyms listed: Momordica grosvenorii Swingle; Siraitia grosvenorii (Swingle) C.Jeffrey; Thladiantha grosvenorii (Swingle) C.Jeffrey. Methods, limits and fundingLimitations: Taxonomy only; no native-range text was read. Read: full-text | ||
| Gong 2019 The Fruits of Siraitia grosvenorii: A Review of a Chinese Food-Medicine. Front Pharmacol · PMID 31849659 · DOI |
Narrative review animal |
Review of botany, traditional use, chemistry, pharmacology and toxicology | Fruit fruit |
Says the fruit has been used for over 300 years as a sweetener and as a traditional medicine for pharyngitis, sore throat and cough. Cites the Chinese Pharmacopoeia (2015) for use in cough, sore throat and phlegm. Reports a 90-day dog study with no changes and says toxicity is considered low. Notes only a few studies on pharmacokinetics and clinical use. Notes a cited study found cadmium well over the standard in fruits from four producing areas. Not a trial Methods, limits and fundingOutcomes: Traditional use, pharmacology, toxicology Limitations: Narrative review (secondary source for the dog study and the cadmium finding; the primary cadmium paper was not read). Traditional-use and toxicity statements are the reviewers' summary. There is an erratum for this paper. Read: full-text |
| Guo 2024 Recent Advances in the Distribution, Chemical Composition, Health Benefits, and Application of the Fruit of Siraitia grosvenorii. Foods · PMID 39063362 · DOI |
Narrative review animal |
Review of distribution, chemistry, health effects and uses of the fruit | Fruit and mogrosides fruit |
Describes antioxidant, anti-inflammatory, respiratory, metabolic, antitumor, neuroprotective and gut effects, mostly from cell and animal work. The full text says there is currently insufficient clinical evidence to confirm that the fruit works for treating diabetes, and calls for human trials. It says mogroside V is up to 425 times sweeter than sucrose. Not a trial Methods, limits and fundingOutcomes: Health benefits (mostly lab and animal), traditional use, applications Limitations: Narrative review; the sections on diabetes and sweetness were read in full text, the rest not. Read: full-text |
| Health Canada 2013 Notice of Proposal to Enable the Use of the New Food Additive Monk Fruit Extract (Luo Han Guo Extract) as a Sweetener in Table-Top Sweeteners (NOP/ADP-0002, 14 March 2013) canada.ca · Source |
Authoritative guidance n/a |
Health Canada proposed allowing monk fruit extract with no less than 30% mogroside V in table-top sweeteners at up to 0.8% (as mogroside V), and said the data support its safety under those conditions. It stated there were no reports linking ingestion of monk fruit extract to allergies. Pregnancy is not mentioned. Methods, limits and fundingLimitations: A 2013 proposal (page now archived) read via a page-fetch summary, not as a primary document download. Later Canadian decisions were not checked. Covers table-top sweeteners only. Read: summary-only | ||
| Huang 2024 A comprehensive review of Siraitia grosvenorii (Swingle) C. Jeffrey: chemical composition, pharmacology, toxicology, status of resources development, and applications. Front Pharmacol · PMID 38638866 · DOI |
Narrative review animal |
Review of lab, animal and food-use literature on the fruit and its extracts | Fruit, mogrosides and extracts fruit |
Describes mostly animal and cell findings (cough and phlegm relief, anti-inflammatory, blood sugar lowering, others). Its toxicology section reports a transient reduction in food and water intake but no deaths in mice given a very large dose of fruit water extract, and says mogroside doses of 5 g/kg or more modestly affected micronucleus frequency and sperm abnormalities in mice, so possible genotoxicity at high doses should be considered with caution. Not a trial; no effect sizes Methods, limits and fundingOutcomes: Chemistry, pharmacology, toxicology, applications Limitations: Narrative review, not systematic. Full text read for the toxicology section. Industry-linked: six authors are employed by Hunan Huacheng Biotech (a natural sweetener company) and the work was supported in part by the Hunan Natural Sweetener Engineering Technology Research Center. Its statement that the FDA 'approved' mogrosides in 1995 was NOT verified (FDA does not approve GRAS ingredients) and is not used. Funding and conflicts: Industry-linked (authors employed by a sweetener maker). Read: full-text |
| Huang 2025 Comparative effects of different sugar substitutes: Mogroside V, stevioside, sucralose, and erythritol on intestinal health in a type 2 diabetes mellitus mouse. Food Funct · PMID 39969196 · DOI |
Animal study animal |
Mice with induced type 2 diabetes | Mogroside V vs stevioside, sucralose, erythritol and sucrose fruit compound equal doses; amount not in abstract 4 weeks · vs Sucrose and other sweeteners |
In diabetic mice, mogroside V improved gut barrier and lowered gut inflammation signals, and did best of the sweeteners compared. The authors suggest it could be an alternative to sugar in diabetes. Not applicable (mouse study) Methods, limits and fundingOutcomes: Gut lining, inflammation, gut bacteria Limitations: Mouse study only; nothing here shows the same in people. Industry-linked: first author and several co-authors are the same Hunan Huacheng Biotech group as in the 2024 review. Funding and conflicts: Industry-linked. Read: abstract |
| Kaim 2025 Monk Fruit Extract and Sustainable Health: A PRISMA-Guided Systematic Review of Randomized Controlled Trials. Nutrients · PMID 40362742 · DOI |
Systematic review |
Adults in 5 randomized controlled trials of monk fruit extract (2015 to 2025) | Monk fruit extract (type and mogroside content not given in the abstract) fruit not given in abstract not given in abstract · vs not given in abstract |
Five RCTs met the inclusion criteria. The review reports monk fruit extract reduced post-meal glucose by 10-18% and insulin responses by 12-22%. No severe adverse effects were observed. It reports the extract is approved in the United States and China, and under review in the European Union. Post-meal glucose -10% to -18%; insulin -12% to -22% (what these were compared with is not stated in the abstract) Methods, limits and fundingOutcomes: Post-meal glucose and insulin, lipids, inflammation, regulatory status Limitations: Only the abstract was read. The abstract does not say which five trials, the comparator, the populations or the size of the groups. Short trials; the authors call for long-term trials. The abstract's claim of EU 'under review' status is not what EFSA's 2019 opinion says (EFSA found the data insufficient). Quality was checked with the Cochrane risk-of-bias tool and the Jadad scale, but the results of those checks are not in the abstract. Funding and conflicts: Authors declare no conflicts of interest. Read: abstract |
| Li 2014 Chemistry and pharmacology of Siraitia grosvenorii: a review. Chin J Nat Med · PMID 24636058 · DOI |
Narrative review animal |
Review based on 93 literature sources | Fruit extracts and compounds fruit |
Says the fruit has been used for hundreds of years as a sweetener and as a traditional medicine for pharyngitis, sore throat and cough. Lists antitussive, phlegm-relieving, antioxidant, glucose-lowering and other effects from extracts and compounds, and concludes extracts and compounds are basically non-toxic. Not a trial Methods, limits and fundingOutcomes: Chemistry, biological effects and toxicity Limitations: Narrative review of mostly Chinese and lab literature; the 'basically non-toxic' conclusion predates EFSA's 2019 call for more toxicity data. Read: abstract |
| Mooradian 2024 Sugar or Sweetener? South Med J · PMID 39094805 · DOI |
Narrative review |
General review of sugar and sweeteners | Low- and no-calorie sweeteners incl. monk fruit extract |
Says large cohort studies link sweetener use with weight gain and metabolic risk, a recent meta-analysis found small improvements without evidence of harm, WHO advises against non-sugar sweeteners, and the biological effects of natural sweeteners such as monk fruit extract are not well studied. Not a trial Methods, limits and fundingOutcomes: Sweetener safety and metabolic effects Limitations: Short narrative article; abstract read only. Read: abstract |
| NCBI 2026 NCBI Taxonomy: Siraitia grosvenorii (taxid 190515) NCBI Entrez · Source |
Reference database n/a |
Entry exists for Siraitia grosvenorii with taxonomy id 190515 (found by an Entrez search). Methods, limits and fundingLimitations: Only the existence and id were checked. Read: summary-only | ||
| NCBI PubChem 2026 PubChem: Mogroside V (CID 24721270), Mogrol (CID 14525327), Mogroside III-E (CID 102350789) PubChem PUG REST · Source |
Reference database n/a |
Mogroside V C60H102O29, molecular weight 1287.4; mogrol C30H52O4, 476.7; mogroside III-E C48H82O19, 963.2. Methods, limits and fundingLimitations: Identity data only. Read: summary-only | ||
| Qin 2006 Subchronic 90-day oral (Gavage) toxicity study of a Luo Han Guo mogroside extract in dogs. Food Chem Toxicol · PMID 17011100 · DOI |
Animal toxicity study animal |
6 Dogs, 3 per sex per group |
PureLo, a mogroside sweetener extract (aqueous solution) fruit extract 3000 mg/kg body weight per day by gavage 28 or 90 days · vs Distilled water |
No significant adverse effects on any measure. The authors set a no-observed-adverse-effect level of 3000 mg/kg/day, the only dose tested. NOAEL 3000 mg/kg/day (only dose tested) Methods, limits and fundingOutcomes: Clinical signs, weight, blood and urine tests, organ weights, tissue examination Limitations: Tiny groups, one dose. EFSA called it poorly reported, not in line with test guidelines, with some statistically significant blood count and urine changes. Co-author J. Heimbach also appears as the notifier's consultant in FDA letter GRN 627, so industry links are likely (sponsor not stated in the abstract). Funding and conflicts: Likely industry-linked (not stated). Read: abstract |
| Smeets 2026 Brain and physiological responses to flavored waters with different sweeteners: a randomized crossover study in healthy young adults. Am J Clin Nutr · PMID 42323164 · DOI |
Controlled trial |
30 30 healthy young adults after an overnight fast |
Flavored water sweetened with monk fruit extract (500 mL, matched in sweetness to 25 g sucrose) fruit 500 mL single drink single drink per visit; six treatments in random order · vs Plain water; 25 g sucrose; sucralose; stevia extract; allulose plus stevia |
Blood flow in the hypothalamus (main outcome) did not differ between drinks. In the midbrain reward area (ventral tegmental area), blood flow change was about 8% lower after sucrose than after water, sucralose or the monk fruit drink at 30 minutes. Only sucrose raised glucose and insulin. ~8% +/- 3% difference in midbrain blood flow vs sucrose (all P-FDR<0.05) Methods, limits and fundingOutcomes: Brain blood flow (MRI), stomach emptying, blood glucose and insulin, appetite Limitations: Single drink in healthy young adults; brain blood flow is a lab measure, not a health outcome. One author is affiliated with Tate & Lyle PLC (a sweetener company); the paper's conflict statement says other authors have none. Registered NCT05575687. Funding and conflicts: One author affiliated with a sweetener company. Registration: NCT05575687 Read: abstract |
| Tey 2017 Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake. Int J Obes (Lond) · PMID 27956737 · DOI |
Controlled trial |
30 30 healthy men in Singapore |
Beverage sweetened with monk fruit (extract type and amount not given in the abstract) fruit not given in abstract (comparison drink: 65 g sucrose) single serving per test day; each man tried all four drinks · vs Aspartame, stevia and sucrose (65 g) beverages |
Sucrose caused large glucose and insulin spikes in the first hour. After the test lunch, glucose and insulin responses were higher for all three low-calorie sweetener drinks. Over 3 hours there was no difference in total glucose (P=0.960) or insulin (P=0.216) area under the curve between the four drinks. Lunch intake was higher after the low-calorie sweetener drinks (P=0.010), but total daily energy intake did not differ (P=0.831). No difference in total 3-hour glucose or insulin between monk fruit and sucrose drinks Methods, limits and fundingOutcomes: Blood glucose and insulin for 3 hours, lunch intake, daily energy intake Limitations: Healthy men only. Monk fruit result is not shown separately in the abstract. One serving only. Funding not stated in the abstract. Read: abstract |
| Tey 2017 Effects of non-nutritive (artificial vs natural) sweeteners on 24-h glucose profiles. Eur J Clin Nutr · PMID 28378852 · DOI |
Controlled trial |
10 10 healthy men |
Beverage sweetened with monk fruit (extract type and amount not given in the abstract) fruit one mid-morning serving (comparison: 65 g sucrose) 24 hours of glucose monitoring per drink; each man tried all four drinks · vs Aspartame, stevia and sucrose (65 g) beverages |
No significant differences in mean 24-hour glucose, area under the curve or glucose variability between the four drinks. No difference over 24 hours between monk fruit, other sweeteners and sucrose Methods, limits and fundingOutcomes: 24-hour glucose by continuous monitor Limitations: Only ten healthy men; one serving. Not people with diabetes. Funding not stated in the abstract. Read: abstract |
| U.S. Food and Drug Administration 2016 Agency Response Letter, GRAS Notice No. GRN 000627 (FDA, 11 October 2016) fda.gov · Source |
Authoritative guidance n/a |
Notice about Siraitia grosvenorii fruit juice concentrate (3.5% mogroside V plus 1.5% other mogrosides, with about 56% sugars) as sweetener and flavouring in conventional foods and infant and toddler foods (not infant formula). FDA had no questions at this time about the notifier's GRAS conclusion, but made no determination of its own, and the firm remains responsible for safety. The notice relied on earlier notices GRN 301, 359, 522 and 556 (extracts from 12.5% to 90% mogroside V). Notifier's estimated exposure: mean 29.3 and 90th percentile 76.4 mg/kg bw/day of the concentrate; baby foods up to 47.9 mg/kg bw/day (about 2.4 mg/kg bw/day of mogrosides). Methods, limits and fundingLimitations: Concerns one product from one company. The company's own panel did the safety review. The other notices (GRN 301, 359, 522, 556) were not opened. Read: full-text | ||
| U.S. Food and Drug Administration 2017 High-Intensity Sweeteners (FDA) fda.gov · Source |
Authoritative guidance n/a |
Lists extracts of Siraitia grosvenorii fruit (luo han guo, monk fruit) among high-intensity sweeteners used as GRAS. Says that for certain highly purified steviol glycosides and monk fruit extracts FDA has not questioned the notifiers' GRAS determinations under the intended conditions of use described in the notices. Says high-intensity sweeteners generally will not raise blood sugar levels. The ADI statement on the page refers to the five sweeteners approved as food additives; no ADI for monk fruit extracts is given. Methods, limits and fundingLimitations: FDA's page is general to the sweetener class; its text on blood sugar is not specific to monk fruit trials. Page date as read: not noted (earlier notes say current as of December 2017). A 'no questions' letter is not an FDA safety finding. Read: full-text | ||
| World Health Organization 2023 WHO advises not to use non-sugar sweeteners for weight control in newly released guideline (15 May 2023) who.int · Source |
Authoritative guidance n/a |
WHO recommends against using non-sugar sweeteners (NSS) to control body weight or reduce noncommunicable disease risk, based on a systematic review finding no long-term reduction in body fat in adults or children and possible long-term undesirable effects (higher risk of type 2 diabetes, cardiovascular disease and death in adults, from observational data that may be confounded). The recommendation is conditional and applies to everyone except people with pre-existing diabetes, and covers naturally occurring non-nutritive sweeteners. The list of common NSS in the news item names stevia but not monk fruit. Methods, limits and fundingLimitations: A class-wide recommendation; monk fruit is not named in the news item. The full guideline document and its review were not read. Read: full-text | ||
| Wu 2022 A Review of the Phytochemistry and Pharmacology of the Fruit of Siraitia grosvenorii (Swingle): A Traditional Chinese Medicinal Food. Molecules · PMID 36235155 · DOI |
Narrative review animal |
Review of chemistry and pharmacology of the fruit | Fruit fruit |
Describes the fruit as used for lung congestion, sore throat and constipation, and lists antitussive, expectorant, antiasthmatic, antioxidant, glucose-lowering and other activities from experimental studies. Says it provides theoretical support for potential clinical applications. Not a trial Methods, limits and fundingOutcomes: Chemistry and pharmacology Limitations: Narrative review; findings are experimental, not clinical. Read: abstract |
| Xiao 2021 Modulation of Gut Microbiota Composition and Short-Chain Fatty Acid Synthesis by Mogroside V in an In Vitro Incubation System. ACS Omega · PMID 34632206 · DOI |
In vitro study in-vitro |
Human gut bacteria in a lab dish for 24 hours | Mogroside V fruit compound lab concentration not in abstract 24 hours · vs Control incubation |
Gut bacteria changed in type and made more short-chain fatty acids. Mogroside V was broken down into smaller mogrosides and mogrol. The authors suggest a possible prebiotic role. Not applicable (lab dish) Methods, limits and fundingOutcomes: Gut bacteria types, short-chain fatty acids, breakdown products Limitations: Test-tube study; does not show any effect in people. Read: abstract |
| Yang 2023 Metabolism of Two Mogroside Isomers, Mogroside III and Mogroside IIIE, in Normal and Drug-Metabolizing Enzyme-Induced Rats. J Agric Food Chem · PMID 38100610 · DOI |
Animal pharmacokinetic study animal |
Rats, normal and enzyme-induced | Mogroside III and IIIE (minor fruit sweet compounds) fruit compound oral, dose not in abstract · vs Normal rats vs enzyme-induced rats |
Many metabolites were found (76 to 121 depending on group). Inducing drug-metabolising enzymes increased the number of metabolites. The authors say this helps understanding interactions with food compounds or drugs. Not applicable Methods, limits and fundingOutcomes: Metabolite profile Limitations: Rat study of minor compounds, not mogroside V, and no drug interaction was actually tested. It shows the compounds are changed by body enzymes; it is not evidence of a human interaction. Read: abstract |
| Yusuf 2026 Impact of monk fruit sweetener on liver architecture, oxidative stress, and enzyme markers in adult Wistar rats. J Complement Integr Med · PMID 42242754 · DOI |
Animal toxicity study animal |
20 20 adult male Wistar rats, 5 per group |
Monk fruit sweetener (composition not stated in the abstract) fruit extract (presumed) 100, 150 and 200 mg/kg body weight by mouth daily 4 weeks · vs Untreated control group |
ALT and malondialdehyde (an oxidative stress marker) rose significantly (p=0.001 and p=0.002). AST rose but not significantly. Liver tissue showed dose-dependent changes including vacuolation, necrosis, congestion and more collagen. The authors raise concern about liver safety with sustained use and say longer studies are needed. ALT up (p=0.001); MDA up (p=0.002); AST not significant Methods, limits and fundingOutcomes: Liver enzymes (ALT, AST), malondialdehyde, liver tissue Limitations: Very small study (5 rats per group), one lab, published online ahead of print, product not described, and it conflicts with earlier animal studies in which EFSA found liver changes only as reversible weight increases. Not replicated and not a human result. Funding and conflicts: Not stated. Read: abstract |
| Zhang 2025 Mogroside V: A Review of Its Structure, Synthesis, Pharmacokinetics, and Toxicity. Arch Pharm (Weinheim) · PMID 41047617 · DOI |
Narrative review animal |
Review of mogroside V research | Mogroside V fruit extract component |
The abstract describes anti-inflammatory, antioxidant and other effects in lab models and says a critical evaluation of therapeutic potential is given. The abstract gives no toxicity findings or numbers. None in the abstract Methods, limits and fundingOutcomes: Structure, synthesis, pharmacology Limitations: Only the abstract was read, so the toxicity section named in the title was NOT read. Lab-model findings only. Read: abstract |
What we do not know yet
- What the evidence supports: short sugar-swap trials in healthy people, low certainty; nothing above low.
- What is uncertain: whether monk fruit helps people with diabetes, weight or long-term blood sugar; no such trial was found.
- No human trial of the whole-fruit tea for cough, sore throat or constipation.
- No human pregnancy, breastfeeding or child safety study.
- No interaction study with any medicine.
- No chronic or cancer study (EFSA); testis effects in rats unresolved; one rat liver study unreplicated.
- EMA/HMPC, NCCIH, LiverTox and LactMed entries were not found (not confirmed absent); JECFA only secondhand through EFSA.
- Only abstracts were read for most studies.
- Dosage and product comparison are not covered yet. For amounts, ask a doctor or pharmacist.
How new research is added
New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating, safety wording or dose information. New publications never change ratings automatically.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Metabolic 2
Blood glucose after a drink or meal
No clear change in trials
Blood sugar measured at set times after a drink or meal.
Low certaintyResults and what it means
Why it was measured
Used to see how a food or sweetener affects blood sugar.
Statistical vs. clinical meaning
A change over hours in healthy people, compared with sugar; it is not evidence that blood sugar control improves over time.
Safety implication
People on diabetes medicines should ask a prescriber before changing sweeteners.
| Study | Result | People | Product |
|---|---|---|---|
| 17 | No difference in total 3-hour glucose (P=0.960) between monk fruit, aspartame, stevia and sucrose drinks; sucrose spiked more in the first hour. | 30 healthy men | Monk fruit-sweetened beverage vs sucrose 65 g |
| 18 | No significant differences in mean 24-hour glucose, incremental or total area under the curve, or variability. | 10 healthy men | Monk fruit-sweetened beverage vs sucrose 65 g |
| 16 | Only the sucrose drink raised glucose; the monk fruit drink did not. | 30 healthy adults | Monk fruit flavored water vs sucrose 25 g |
| 10 | Reports post-meal glucose reduced 10-18% across five trials (comparator not stated in the abstract). | Adults in 5 RCTs | Monk fruit extract |
Insulin after a drink or meal
Lowered in trials
The hormone released after eating to move sugar out of the blood.
Low certaintyResults and what it means
Why it was measured
A lower insulin response after a drink is often read as a lower sugar load.
Statistical vs. clinical meaning
Lower insulin response than with sugar, over hours; clinical meaning is unknown.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 17 | No difference in 3-hour insulin area under the curve (P=0.216) vs sucrose; early spike was lower with low-calorie drinks. | 30 healthy men | Monk fruit drink |
| 1 | All three sweetener blends, including the mogroside V plus stevia blend, lowered 2-hour insulin vs sucrose (P<0.001). | 60 adults with overweight | Mogroside V + stevia Reb M blend, 330 mL |
| 16 | Only sucrose increased insulin. | 30 healthy adults | Monk fruit flavored water |
| 10 | Reports insulin responses reduced 12-22%. | Adults in 5 RCTs | Monk fruit extract |
Organ function 1
Liver enzymes (ALT, AST)
Mixed results in trials
Blood tests that rise when liver cells are stressed or damaged.
Low certaintyResults and what it means
Why it was measured
Used as a safety check on the liver.
Statistical vs. clinical meaning
No change after one dose in people; one small rat study found a rise. Long-term human liver tests were not found.
Safety implication
Stop and get care for signs of liver trouble.
| Study | Result | People | Product |
|---|---|---|---|
| 3 | After a single dose of extract (200 mg/kg), no significant change in ALP, GGT, ALT, AST or LDH. | 6 healthy men (as described by EFSA) | Monk fruit extract, composition not reported |
| 1 | Transaminases did not differ from sucrose (p>0.05). | 60 adults with overweight | Mogroside V + stevia blend, single beverage |
| 25 | ALT rose significantly (p=0.001), AST rose but not significantly. | 20 male rats | Monk fruit sweetener 100 to 200 mg/kg for 4 weeks |
| 15 | No significant effects on blood chemistry or organ tissue. | Dogs, 3 per sex | Mogroside extract 3000 mg/kg/day for 90 days |
Other 1
Midbrain reward-area blood flow (MRI)
Mixed results in trials
How much blood reaches a reward-related midbrain area, measured by brain scan.
Very low certaintyResults and what it means
Why it was measured
Used as a lab marker of brain reward response to sweet taste.
Statistical vs. clinical meaning
A research marker; no known health meaning.
Safety implication
None.
| Study | Result | People | Product |
|---|---|---|---|
| 16 | About 8% lower change after sucrose than after water, sucralose or monk fruit at 30 minutes; hypothalamus no difference. | 30 healthy adults | Monk fruit flavored water |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 5
- Two different things: the purified sweetener and the traditional whole-fruit tea. Most safety work is on the purified sweet extract used in foods. The US FDA has had no questions about certain companies' conclusions that highly purified monk fruit extracts and a juice concentrate are generally recognized as safe (GRAS) for stated food uses, but made no safety finding of its own. The EU food safety agency EFSA found in 2019 that the toxicity data were not enough to conclude the extract is safe as a food additive. The traditional dried-fruit tea or decoction was not assessed by these regulators. Authoritative guidance 20 19 3
- People with diabetes or taking blood sugar medicines. Monk fruit extract is not shown to treat diabetes and no human trial in people with diabetes was found. Short trials in healthy people suggest it does not raise blood sugar like sugar. If you swap sugar for a sweetener while on insulin or other diabetes medicines, your blood sugar and dose needs can change. Tell your prescriber or pharmacist. Controlled trial 10 17 18 6
- Allergy: it is in the gourd family. Monk fruit belongs to the gourd family (Cucurbitaceae), the same family as melon, cucumber and squash. EFSA said allergy could not be ruled out because extracts can contain up to 36% protein. Health Canada said it found no reports of allergy. We found no human allergy case report. People with a food allergy should be cautious. Authoritative guidance 3 7
- Pregnancy, breastfeeding and children. No human data were found for pregnancy or breastfeeding. Rat studies reviewed by EFSA showed no harm to mothers, fetuses or pups, but EFSA said a longer study was needed because of testis changes in a different rat study. Ask a doctor or pharmacist before using concentrated monk fruit products in pregnancy, while breastfeeding, or for a child. Animal research 3 19
- Open questions on long-term safety. EFSA noted no chronic (lifetime) or cancer studies and said testis effects in a 90-day rat study could not be dismissed. One 2026 rat study reported higher liver enzymes. These are animal findings; human long-term data are missing. Animal research 3 25
Side effects 4
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Stomach and gut symptoms In a 60-person trial of a monk fruit plus stevia beverage blend, gut symptoms were mostly mild. In rats, very high doses (2000 and 4000 mg/kg/day of extract) caused sticky soft faeces. No frequency in people could be given, and no gut study of monk fruit alone in people was found. | Not established | mild Not stated | Controlled trial 1 3 |
| No severe adverse effects in short trials A 2025 review of five trials says no severe adverse effects were observed. The abstract does not list the trials or numbers, and the trials were short. | Not established | not applicable Not applicable | Systematic review 10 |
| Allergic reaction Possible in theory (protein in extracts). No human case report was found. The statement that no allergy has been reported in China and Japan was made by the applicant to EFSA without supporting data. | Not established | unknown Unknown | Authoritative guidance 3 7 |
| Testis changes (rat only) At the highest dose of a 90-day rat study, testis weight was lower and tubule degeneration/atrophy was higher. The authors considered them within normal ranges; EFSA did not accept that. It is not known whether this applies to people. | Not established | unknown Not present in the rats after the recovery period | Animal research 3 |
Liver
No human case of liver injury from monk fruit was found, and we found no LiverTox entry. Two single-dose studies in healthy adults, as described by EFSA, showed no change in liver enzymes. In rats, EFSA saw a reversible increase in liver weight in females that it agreed was adaptive. One small 2026 rat study (5 per group, 4 weeks) reported higher ALT and liver tissue damage at 100 to 200 mg/kg of a monk fruit sweetener, which conflicts with the dog and rat studies reviewed by EFSA; it has not been replicated. 3 25 15 1
How often. No frequency could be given because no human cases were found. Not finding reports is not proof of safety.
Monitoring. No agency monitoring advice was found. Stop and seek care for yellow skin or eyes, dark urine or unusual tiredness.
This is a safety connection. It is not evidence that Monk fruit (Luo Han Guo) supports liver health.
Medicines and supplements 4
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Insulin and diabetes medicines (metformin, sulfonylureas and others) prescription | Monk fruit sweetener does not raise blood sugar like sugar, so replacing sugar can lower your glucose and change medicine needs. Animal studies also report glucose-lowering by mogrosides. No direct interaction study with diabetes medicines was found. | Unknown. In healthy people, short trials show no blood-sugar spike. In people on insulin or sulfonylureas, a change in sugar intake could contribute to low blood sugar; this is a general principle, not tested for monk fruit. | Pharmacological theory Not enough evidence 17 6 8 | Tell your prescriber or pharmacist if you switch to monk fruit products, and keep checking your blood sugar as advised. |
| Medicines broken down by liver enzymes prescription | A rat study of minor mogrosides found that inducing drug-metabolising enzymes changed how they are broken down, and the authors say this relates to possible interactions. No human or enzyme-inhibition study of monk fruit with a medicine was found. | Unknown. | Animal research Not enough evidence 24 | Ask your pharmacist if you take medicines with narrow safety margins. |
| Warfarin and other blood thinners; blood pressure medicines; other medicines prescription | No interaction was described in the sources we read. | Proper evidence not found in the sources we read. | Authoritative guidance Not enough evidence 3 2 | Ask a pharmacist if you take any prescription medicine and use concentrated monk fruit products regularly. |
| Other herbs and supplements (including other glucose-lowering herbs) and the other ingredients in blended sweeteners herb-supplement | Retail sweeteners are often blends; the other ingredients are not covered by monk fruit data. Combined glucose-lowering herbs were not studied with monk fruit. | Unknown. | Pharmacological theory Not enough evidence 1 20 | Read the ingredient list; results for one product do not apply to another. |
Who should check first 4
| Situation | Advice | Evidence |
|---|---|---|
| Known allergy to monk fruit or an allergy to melon, cucumber, squash or other gourd-family plants | Be cautious and ask an allergist or doctor first. Cross-reactivity with the gourd family has not been studied in the sources we read. | Authoritative guidance 3 7 |
| Pregnancy and breastfeeding | No human safety data. Ask a doctor or pharmacist before using concentrated extracts. Foods that contain small amounts of monk fruit sweetener were not tested in pregnancy. | Animal research 3 |
| Children and infants | US FDA's 2016 letter covered the juice concentrate in fruit-based baby foods and infant cereals at the company's exposure estimates, but no child trial was found. EFSA estimated children aged 3 to 9 could have high intakes if every food contained the extract. Ask a pediatrician. | Authoritative guidance 19 3 |
| Diabetes treated with insulin or sulfonylureas | Do not replace treatment. Expect blood sugar to change if you swap sugar; check with your care team. | Pharmacological theory 17 |
Overdose, product quality and regulators
Summary. Animal studies of the purified extract found low acute toxicity, but EFSA considered the full toxicity set insufficient because there were no chronic or cancer studies and testis effects could not be dismissed.
Animal. Dogs: no significant effects at 3000 mg/kg/day for 90 days (only dose tested, poorly reported per EFSA). Rats, 90-day (extract-52% mogroside V): reversible liver weight rise in females and, at the highest dose, lower testis weight with more tubular degeneration/atrophy and higher kidney weight in males; reproduction screening and prenatal studies showed no effect on parents, pups or fetuses. Mice: a review says very large doses of fruit extract caused transient reduced food and water intake without deaths, and mogroside doses of 5 g/kg or more modestly affected micronucleus frequency and sperm abnormalities.
Human doses studied. Human studies are single-dose studies in 10 and 6 healthy adults (EFSA), short beverage trials, and a pooled review of five short RCTs. These show what was studied, not advice.
High dose or long term signals. Testis changes at the highest dose in rats; possible chromosome effects at very high mouse doses (a review's summary); one rat liver study. EFSA could not rule out harm from the gut-breakdown products including mogrol because the genotoxicity tests did not cover them.
Overdose response. No human overdose case was found.
Genotoxicity. Extracts of 25% and 55% mogroside V were negative in a bacterial reverse mutation test and did not induce chromosome damage in cultured human lymphocytes (EFSA); EFSA said the tests could not evaluate gut-bacteria breakdown products including the aglycone mogrol.
Toxic plant parts. The fruit is the part used. Toxicity of leaf, root or seed was not found in the sources read.
Quality is unknown for most products. Purity of extracts differs (25% to 55% or more mogroside V in EFSA's file) and lower-purity extracts carry more protein and sugars. A cited study found cadmium well above the standard in dried fruit from four growing areas in China.
Heavy metals in dried fruit. A 2019 review reports a study of four producing areas in which the fruit's cadmium content seriously exceeded the standard. We did not read the original paper and found no test of retail products. 5
Purity and blends. EFSA described extracts from 25% to 55% mogroside V. The FDA letter described a juice concentrate that is 56% sugars. Many retail sweeteners combine monk fruit with other sweeteners or fillers; the sources do not say which. 3 19
Adulteration. No documented substitution of monk fruit with another plant was found in the sources read. 4
| Body | Action | Date |
|---|---|---|
| US Food and Drug Administration (United States) | GRAS notices: FDA has not questioned the notifiers' GRAS conclusions for certain highly purified monk fruit extracts under the intended conditions of use (page says this). GRN 627 letter, 11 October 2016, for juice concentrate (sweetener and flavouring in conventional foods and infant/toddler foods other than formula). FDA made no determination of its own. No ADI is given for monk fruit extracts on the page read. source | 2016-10-11 |
| European Food Safety Authority, Panel on Food Additives and Flavourings (European Union) | 2019 scientific opinion: toxicity database insufficient to conclude on safety of monk fruit extract as a food additive; no health-based guidance value could be set. source | 2019-11-13 |
| Health Canada, Food Directorate (Canada) | 2013 notice of proposal: monk fruit extract with at least 30% mogroside V in table-top sweeteners at up to 0.8% (as mogroside V); data support safety under those conditions. source | 2013-03-14 |
| World Health Organization (International) | 2023 guideline: recommends against non-sugar sweeteners for weight control or reducing noncommunicable disease risk (conditional); excludes people with pre-existing diabetes. Monk fruit is not named in the news item. source | 2023-05-15 |
When to get medical help
- Swelling of the face, lips or throat, trouble breathing, hives or fainting after eating or drinking a monk fruit product: get emergency care.
- Yellow skin or eyes, dark urine or severe tiredness: stop and see a doctor.
- Very low blood sugar signs (shaking, sweating, confusion) if you take insulin or other diabetes medicines after changing your sweetener: treat and call your care team.
Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
Is monk fruit sweetener safe?
It depends on which authority you ask. The US FDA has not questioned certain companies' conclusions that highly purified monk fruit extracts are generally recognized as safe, but made no finding of its own. The EU's EFSA said in 2019 that the toxicity data were insufficient to conclude it is safe as a food additive. Ask a doctor if you are pregnant, breastfeeding or allergic.
Does monk fruit raise blood sugar?
Can monk fruit treat diabetes?
Can I use monk fruit with diabetes medicines?
Does monk fruit help weight loss?
Why did EFSA not approve monk fruit extract?
In 2019 EFSA said the toxicity data were insufficient. Reasons included testis weight loss and tubule changes in a 90-day rat study, no long-term or cancer studies, and unanswered questions about gut breakdown products and allergy.
Can monk fruit cause allergy?
Possibly. It is in the gourd family, and EFSA said allergy could not be ruled out because extracts can contain up to 36% protein. Health Canada said it found no allergy reports, and we found no human case report. Cross-reactivity with melon or squash allergy was not studied in the sources we read.
Is monk fruit safe in pregnancy or breastfeeding?
Not known. No human data were found. Rat studies reviewed by EFSA showed no harm to mothers, fetuses or pups, but animal results do not settle it. Ask a doctor or pharmacist.
Does monk fruit upset the stomach?
Does monk fruit tea work for cough or sore throat?
Is monk fruit bad for the liver or testes?
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Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-25
- Last substantive update
- 2026-10-25
- How we research
- We searched PubMed and read the EFSA opinion, the FDA GRAS letter and sweetener page, WHO's news item, Health Canada's notice, and checked GBIF, NCBI and PubChem. Only abstracts were read for most studies. We could not find an EMA/HMPC monograph, NCCIH page, LiverTox or LactMed entry, so these are marked not found, not confirmed absent. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.
Sources 26
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Almiron-Roig E, Navas-Carretero S, Castelnuovo G, et al.. Impact of acute consumption of beverages containing plant-based or alternative sweetener blends on postprandial appetite, food intake, metabolism, and gastro-intestinal symptoms: Results of the SWEET beverages trial.. Appetite. 2023. PMID 36849009. DOI 10.1016/j.appet.2023.106515. (abstract)
- Compiler's searches. Searches for NCCIH, EMA/HMPC, LiverTox and LactMed entries on monk fruit (2026-10-25). nccih.nih.gov; ema.europa.eu; NCBI Bookshelf. 2026. (summary-only)
- EFSA Panel on Food Additives and Flavourings (FAF). Safety of use of Monk fruit extract as a food additive in different food categories (EFSA Journal 2019;17(12):5921). EFSA Journal. 2019. (full-text)
- GBIF Secretariat. GBIF Backbone Taxonomy: Siraitia grosvenorii (Swingle) C.Jeffrey ex A.M.Lu & Zhi Y.Zhang (usageKey 3623059). GBIF API. 2026. (full-text)
- Gong X, Chen N, Ren K, et al.. The Fruits of Siraitia grosvenorii: A Review of a Chinese Food-Medicine.. Front Pharmacol. 2019. PMID 31849659. DOI 10.3389/fphar.2019.01400. (full-text)
- Guo Q, Shi M, Sarengaowa, et al.. Recent Advances in the Distribution, Chemical Composition, Health Benefits, and Application of the Fruit of Siraitia grosvenorii.. Foods. 2024. PMID 39063362. DOI 10.3390/foods13142278. (full-text)
- Health Canada, Food Directorate. Notice of Proposal to Enable the Use of the New Food Additive Monk Fruit Extract (Luo Han Guo Extract) as a Sweetener in Table-Top Sweeteners (NOP/ADP-0002, 14 March 2013). canada.ca. 2013. (summary-only)
- Huang H, Peng Z, Zhan S, et al.. A comprehensive review of Siraitia grosvenorii (Swingle) C. Jeffrey: chemical composition, pharmacology, toxicology, status of resources development, and applications.. Front Pharmacol. 2024. PMID 38638866. DOI 10.3389/fphar.2024.1388747. (full-text)
- Huang H, Liu S, Peng Z, et al.. Comparative effects of different sugar substitutes: Mogroside V, stevioside, sucralose, and erythritol on intestinal health in a type 2 diabetes mellitus mouse.. Food Funct. 2025. PMID 39969196. DOI 10.1039/d4fo04446k. (abstract)
- Kaim U, Labus K. Monk Fruit Extract and Sustainable Health: A PRISMA-Guided Systematic Review of Randomized Controlled Trials.. Nutrients. 2025. PMID 40362742. DOI 10.3390/nu17091433. (abstract)
- Li C, Lin LM, Sui F, et al.. Chemistry and pharmacology of Siraitia grosvenorii: a review.. Chin J Nat Med. 2014. PMID 24636058. DOI 10.1016/S1875-5364(14)60015-7. (abstract)
- Mooradian AD. Sugar or Sweetener?. South Med J. 2024. PMID 39094805. DOI 10.14423/SMJ.0000000000001714. (abstract)
- NCBI. NCBI Taxonomy: Siraitia grosvenorii (taxid 190515). NCBI Entrez. 2026. (summary-only)
- NCBI PubChem. PubChem: Mogroside V (CID 24721270), Mogrol (CID 14525327), Mogroside III-E (CID 102350789). PubChem PUG REST. 2026. (summary-only)
- Qin X, Xiaojian S, Ronggan L, et al.. Subchronic 90-day oral (Gavage) toxicity study of a Luo Han Guo mogroside extract in dogs.. Food Chem Toxicol. 2006. PMID 17011100. DOI 10.1016/j.fct.2006.07.023. (abstract)
- Smeets PA, Veit R, Oosterink E, et al.. Brain and physiological responses to flavored waters with different sweeteners: a randomized crossover study in healthy young adults.. Am J Clin Nutr. 2026. PMID 42323164. DOI 10.1016/j.ajcnut.2026.101401. (abstract)
- Tey SL, Salleh NB, Henry J, et al.. Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake.. Int J Obes (Lond). 2017. PMID 27956737. DOI 10.1038/ijo.2016.225. (abstract)
- Tey SL, Salleh NB, Henry CJ, et al.. Effects of non-nutritive (artificial vs natural) sweeteners on 24-h glucose profiles.. Eur J Clin Nutr. 2017. PMID 28378852. DOI 10.1038/ejcn.2017.37. (abstract)
- U.S. Food and Drug Administration. Agency Response Letter, GRAS Notice No. GRN 000627 (FDA, 11 October 2016). fda.gov. 2016. (full-text)
- U.S. Food and Drug Administration. High-Intensity Sweeteners (FDA). fda.gov. 2017. (full-text)
- World Health Organization. WHO advises not to use non-sugar sweeteners for weight control in newly released guideline (15 May 2023). who.int. 2023. (full-text)
- Wu J, Jian Y, Wang H, et al.. A Review of the Phytochemistry and Pharmacology of the Fruit of Siraitia grosvenorii (Swingle): A Traditional Chinese Medicinal Food.. Molecules. 2022. PMID 36235155. DOI 10.3390/molecules27196618. (abstract)
- Xiao R, Liao W, Luo G, et al.. Modulation of Gut Microbiota Composition and Short-Chain Fatty Acid Synthesis by Mogroside V in an In Vitro Incubation System.. ACS Omega. 2021. PMID 34632206. DOI 10.1021/acsomega.1c03485. (abstract)
- Yang X, Xu F, Lu F, et al.. Metabolism of Two Mogroside Isomers, Mogroside III and Mogroside IIIE, in Normal and Drug-Metabolizing Enzyme-Induced Rats.. J Agric Food Chem. 2023. PMID 38100610. DOI 10.1021/acs.jafc.3c07938. (abstract)
- Yusuf I, Umar SM, Fage RI. Impact of monk fruit sweetener on liver architecture, oxidative stress, and enzyme markers in adult Wistar rats.. J Complement Integr Med. 2026. PMID 42242754. DOI 10.1515/jcim-2026-0007. (abstract)
- Zhang T, Gao Z, Zeng D, et al.. Mogroside V: A Review of Its Structure, Synthesis, Pharmacokinetics, and Toxicity.. Arch Pharm (Weinheim). 2025. PMID 41047617. DOI 10.1002/ardp.70112. (abstract)