Bhumyamalaki: Benefits, Evidence, Dosage & Safety

TL;DR

Bhumyamalaki (Phyllanthus niruri) is Ayurveda's jaundice and liver herb, though what's sold under the name is often a mix of related species. One small 1988 hepatitis B trial cleared surface antigen in 59% of carriers; a later trial found no benefit. Reviews call the evidence low-quality. Stone data are mixed.

What it is

Bhumyamalaki is the Ayurvedic name for the drug attributed to Phyllanthus niruri L., a small annual herb (AYU pharmacognostic study). Its identity is genuinely complicated, and I don't want to gloss over it: true P. niruri is native to the West Indies and is not found in India, so commercial Indian material sold as "Bhumyamalaki" commonly includes related species such as P. amarus, P. fraternus, P. maderaspatensis, P. simplex, and P. urinaria (same AYU study). Much of the clinical literature, including the hepatitis trials below, was conducted on P. amarus or mixed Phyllanthus material, so results do not map neatly onto one species. The whole plant (leaves, roots) is the part used.

Traditional use

In Ayurveda, Bhumyamalaki is one of the principal herbs used for liver disorders, and a literature survey records its traditional use for jaundice, dysentery, diabetes, gonorrhea, excessive menstruation, and skin ulcers and sores (AYU review). It is also known in Brazil as "quebra-pedra" (stone-breaker), reflecting folk use for urinary stones. These are traditional claims, not clinical proof. The trial evidence gets its own section below.

What modern research says

Hepatitis B

The most-cited human evidence comes from a 1988 preliminary randomized controlled trial by Thyagarajan and colleagues, published in The Lancet: 37 chronic hepatitis B carriers received a P. amarus extract (200 mg three times daily) for 30 days, while 23 received placebo. Fifteen to twenty days after treatment ended, 22 of 37 treated patients (59%) had lost hepatitis B surface antigen (HBsAg), versus 1 of 23 (4%) on placebo, and the antigen had not returned in subjects followed for up to 9 months. The authors reported few or no toxic effects (Thyagarajan et al., Lancet 1988). A dramatic result from a small, preliminary study. It has not been cleanly replicated.

A later randomized, placebo-controlled trial of P. niruri in chronic hepatitis B concluded the opposite: "This study does not support the use of Phyllanthus niruri for the treatment of chronic hepatitis B" (Karger RCT).

The systematic review picture: a review of 22 RCTs (1,947 patients) of Phyllanthus species for chronic hepatitis B, published in the Journal of Viral Hepatitis, found a positive effect on HBsAg clearance versus placebo or no intervention, and no significant difference versus interferon on HBsAg/HBeAg/HBV-DNA clearance. But the authors flagged substantial heterogeneity and high risk of bias across the trials. My read: the 1988 result stands essentially alone, and the evidence base is weak (systematic review).

How it might work (laboratory evidence)

Anti-HBV activity has a laboratory basis: an early study showed Phyllanthus extract binds hepatitis B surface antigen and inhibits viral DNA polymerase in vitro and in vivo (Venkateswaran, Blumberg & Millman, PNAS 1987, cited in the Karger trial's reference list), and the lignan niranthin isolated from P. niruri reduced HBsAg/HBeAg secretion in HBV-transfected human liver cells in vitro and lowered serum HBV DNA, HBsAg, HBeAg, ALT, and AST in ducklings infected with duck hepatitis B virus over 14 days of dosing (Liu et al., Journal of Ethnopharmacology 2014, PMID 25009077). Laboratory and animal findings. Not proof of benefit in people.

Kidney stones

In a randomized, prospective study of 150 patients with calcium oxalate renal stones who had undergone shock-wave lithotripsy, 78 patients took a P. niruri extract (2 g daily) for at least 3 months and 72 served as controls. The stone-free rate at 180 days was 93.5% versus 83.3% (p = 0.48, not statistically significant overall), but for lower-caliceal stones (56 patients) it was 93.7% versus 70.8% (p = 0.01), and no side effects were recorded (Micali et al., Journal of Urology 2006).

In a separate randomized trial of 69 calcium-stone-forming patients taking P. niruri (450 mg three times daily) or placebo for 3 months, there were no overall differences in urinary biochemical parameters and no significant difference in stone voiding or pain. In a subset analysis, urinary calcium fell significantly only in patients who started with hypercalciuria (Nishiura et al., Urological Research 2004, PMID 15221244). A subgroup win in one trial, a null overall in the other. Thin.

What the evidence does not support (yet)

It is not a substitute for proven hepatitis B antivirals, and the "stone-breaker" reputation rests on small, mixed trials. Claims beyond the above go ahead of the data.

Dosage

There is no established dose. The doses used in the clinical trials cited above were **200 mg of P. amarus extract three times daily (600 mg/day total) for 30 days in the hepatitis B trial (Thyagarajan et al.) and 2 g/day of P. niruri extract for at least 3 months** after lithotripsy (Micali et al.). These were specific trial preparations. Do not assume a retail product matches them.

Safety & contraindications

In the trials cited, few or no toxic effects were reported (Thyagarajan), no side effects were recorded (Micali), and the systematic review found no intolerable or serious adverse events attributable to Phyllanthus (review). That said, human safety data are limited overall, and there are no adequate data on use in pregnancy or breastfeeding. Avoid use in those situations. Because the commercial drug may be a mix of Phyllanthus species, product identity is unreliable. Talk to a qualified clinician before use, especially with liver disease or alongside prescribed antivirals.

FAQs

Does bhumyamalaki cure hepatitis B?

No. One small 1988 RCT reported HBsAg loss in 59% of carriers, but a later RCT found no benefit, and a systematic review of 22 RCTs judged the evidence to have high risk of bias (Thyagarajan et al.; Karger RCT; review). It is not a substitute for proven antiviral therapy. Discuss any use with your doctor.

Can bhumyamalaki dissolve kidney stones?

Evidence is limited and mixed. A randomized study found a P. niruri extract improved stone clearance after lithotripsy only for lower-caliceal stones, while another RCT found no difference in stone voiding or pain versus placebo (Micali et al.; Nishiura et al.). The "stone-breaker" name is folk tradition, not a proven effect.

Which plant is the real bhumyamalaki?

Classical Ayurvedic literature attributes Bhumyamalaki to Phyllanthus niruri L., but true P. niruri does not grow in India. Commercial material commonly includes P. amarus, P. fraternus, P. maderaspatensis, P. simplex, and P. urinaria (AYU pharmacognostic study). This species confusion makes product identity, and therefore trial comparability, uncertain.

Is bhumyamalaki safe?

Trials reported few or no adverse effects and no serious events attributable to Phyllanthus (systematic review). However, human safety data are limited, species identity in products is unreliable, and there are no adequate pregnancy data. Use it only under qualified guidance, especially with liver disease.

Can I take bhumyamalaki instead of my prescribed liver medicine?

No. There is no evidence it replaces antiviral therapy or standard liver care (systematic review). Do not stop or change prescribed treatment on your own. If you are considering bhumyamalaki alongside it, talk to your doctor first.

Sources

Disclaimer

This article is for educational purposes only and is not medical advice. Herbal products can interact with medications and are not suitable for everyone. Talk to a qualified healthcare practitioner before use, especially if you are pregnant, breastfeeding, managing a medical condition, or taking prescription medicines.