Apricot

Scientific Name(s): Prunus armeniaca L.
Common Name(s): Apricot, Apricot kernel oil, Semen Armeniacae, Vitamin B17

Medically reviewed by Drugs.com. Last updated on Dec 1, 2021.

Clinical Overview

Use

Apricots are used as a dietary source of vitamins and minerals, as well as in confectionery. Seeds or dried fruit have been clinically evaluated for cardiovascular, endocrine, glycemic, and hepatic effects, but studies have been small and/or shown equivocal results. Clinical data are lacking to support use of apricot for any indication.

Dosing

Clinical data are lacking to provide dosing guidance for apricot or apricot-containing products.

Contraindications

Contraindications have not been identified. Consumption of P. armeniaca dried ripe seeds is not recommended during pregnancy or breastfeeding, or in children.

Pregnancy/Lactation

Apricot fruit has generally recognized as safe (GRAS) status per the US Food and Drug Administration (FDA). Doses greater than amounts found in food should be avoided because safety and efficacy are unproven. Consumption of apricot kernels or laetrile, a chemical constituent found in the apricot kernel, is not recommended during pregnancy or breastfeeding.

Interactions

None well documented.

Adverse Reactions

Hypersensitivity and adverse reactions similar to cyanide poisoning have been reported.

Toxicology

Cyanide poisoning and death have resulted from laetrile and apricot kernel ingestion.

Scientific Family

• Rosaceae (rose)

Botany

Apricot trees grow up to 9 m in height. The plant leaves are oval and finely serrated, and the 5-petaled white flowers grow in clusters. The downy, orange-red drupe (fruit) ripens in late summer and has a fleshy outer layer and inner hard stone containing the seed (kernel). The apricot is native to China and Japan but is also cultivated in warmer, temperate regions of the world, including Turkey, Iran, southern Europe, South Africa, Australia, and California. The many varieties and species of apricot differ in flavor, color, and size, and are related to other members of the plum genus, including the peach.(Khan 2010, USDA 2021, WHO 2007) Synonyms include P. armeniaca L. var. vulgaris Zabel, Armeniaca vulgaris Lam., and Amygdalus armeniaca (L.) Dumort.

History

Apricot has been used medicinally for more than 2,000 years in India and China. The Greeks wrongly assumed that the apricot originated in Armenia, hence its botanical name P. armeniaca. The Romans named apricot praecocium, meaning "precocious," which refers to the fruit's early ripening. From this word, the name "apricot" evolved.(Chevallier 2001, WHO 2007)

In Chinese medicine, the amygdalin present in apricot kernels has been used traditionally in very small amounts for treating asthma, cough, and constipation.(Chevallier 2001, WHO 2007) A decoction of the plant's bark has been used as an astringent to soothe irritated skin. In folk medicine, other uses include the treatment of hemorrhage, infertility, eye inflammation, and spasms. Apricot kernel paste has been used in vaginal infections. The oil has been used in cosmetics and as a vehicle in certain pharmaceutical formulations.(Chevallier 2001, Duke 2002)

Chemistry

The fresh apricot fruit contains carbohydrates, vitamins C and K, beta-carotene, thiamine, niacin, and iron. Organic acids, phenols, volatile compounds (eg, benzaldehyde), some esters, norisoprenoids, and terpenoids have also been isolated.(Duke 1992, Karakaya 2001, Riu-Aumatell 2005) When apricot seed essential oil was evaluated under spectroscopy, benzaldehyde was the predominant compound; lesser amounts of benzoic acid and the cyanogenic glycoside amygdalin were also identified.(Duke 1992, Karakaya 2001, Lee 2014) Oleic acid, sterols (including campesterol, beta-sitosterol, and others), and squalene have been identified in the seed oil.(Matthäus 2015, Rudzińska 2017)

Amygdalin, a cyanogenic glycoside from the apricot kernel, can be hydrolyzed to form glucose, benzaldehyde, and hydrocyanic acid. Enzymatic release of cyanide occurs in the presence of beta-glucuronidase, an enzyme found in human intestines.(Shragg 1982) "Laetrile" is a term often used interchangeably with "amygdalin," but these are not the same chemical entity. Laetrile is a purified form of amygdalin. Both laetrile and amygdalin have a common structural component (mandelonitrile) that contains cyanide.(Milazzo 2015) The US patent for laetrile specifies a semisynthetic derivative of amygdalin that is different from the Mexican laetrile/amygdalin made from crushed apricot seeds.(Milazzo 2015) Amygdalin may also be referred to as vitamin B₁₇ or amygdaloside.(FDA 2021)

Uses and Pharmacology

Antiamyloidogenic activity

In vitro data

The carotenoid fraction, especially lutein, from apricot fruit exerted antiamyloidogenic properties in vitro, suggesting a potential application as a food source for the prevention of amyloid-associated diseases such as Alzheimer disease.(Katayama 2011)

Anti-inflammatory effects

Animal data

Anti-inflammatory effects of the kernel extract and/or oil were demonstrated in rats with induced ulcerative colitis.(Minaiyan 2014) In rats with induced benign prostatic hyperplasia administered an extract of P. armeniaca bark, histological and biochemical parameters were improved, possibly due to reduced inflammation from phytosterol activity.(Jena 2016)

Antimicrobial activity

In vitro data

Equivocal findings on the antimicrobial activity of the essential oil have been reported.(Hammer 1999, Lee 2014)

Antioxidant effects

Apricots are consumed as a dietary source of vitamins A and C.(Karakaya 2001, Ruiz 2005)

Animal and in vitro data

In a study evaluating the antioxidant activity of foods, including fruits, containing phenolic compounds, the total antioxidant activity of apricots was lower than that of grapes, raisins, plums, and cherries.(Karakaya 2001) Protective antioxidant effects of apricot kernel oil were demonstrated in a reperfusion injury study in rats.(Zhang 2011)

Cancer

Animal and in vitro data

Amygdalin demonstrated activity against renal cell carcinoma in vitro(Juengel 2016) and inhibited the growth of implanted tumors in rats.(Yamshanov 2016) When fed to rats with induced hepatic carcinogenesis, apricot fruit demonstrated protective qualities by increasing the resistance of healthy cells.(Karabulut 2014)

One experiment reported a potential effect of apricot extract on intestinal P-gp substrates, suggesting a possible role in multidrug-resistant cancer.(Deferme 2002)

Clinical data

Despite promising in vitro experiments, the efficacy of amygdalin to treat cancer has not been validated by any rigorous clinical trials. The National Cancer Institute sponsored phase 1 and 2 clinical trials in the 1980s but found no evidence to support the use of laetrile in cancer treatment.(NCI 2021)

Although interest in the efficacy of laetrile/amygdalin in cancer treatment continues, a Cochrane meta-analysis found no controlled clinical trials to form an opinion regarding this use.(Milazzo 2015) The FDA and the European Commission have banned use of laetrile in cancer therapy due to lack of effectiveness and risk of adverse effects; laetrile remains an unapproved drug product in the United States.(FDA 2021, Meijer 2001, Milazzo 2015)

Cardiovascular disease

Clinical data

In 12 healthy volunteers who consumed bitter apricot seeds (60 mg/kg) for 12 weeks, a significant improvement was observed in some but not all lipid and other cardiovascular risk factors from baseline to the end of the study. Average total cholesterol decreased by 0.24 mmol/L (P<0.05), and low-density lipoprotein (LDL) decreased by 0.62 mmol/L (P<0.001); however, triglycerides increased from 0.84 to 1.17 mmol/L (P<0.001). Although AST and gamma-glutamyltransferase increased significantly, all liver enzyme values remained within normal limits; changes in high-density lipoprotein (HDL), high-sensitivity C-reactive protein, and creatinine kinase were nonsignificant.(Kopcekova 2018) In contrast, no significant changes were observed in total cholesterol, HDL, or triglycerides in 18 healthy women of reproductive age (mean age, 41.6 years) following consumption of bitter apricot seeds (60 mg/kg) for 42 days. However, LDL improved significantly after 42 days (P<0.05). While day 21 assessments documented significant increases in both total cholesterol and triglycerides, levels had returned to near baseline by day 42 (P<0.05).(Kopcekova 2021)

Endocrine effects

Clinical data

In 18 healthy women of reproductive age (mean age, 41.6 years), consumption of bitter apricot seeds (60 mg/kg) for 42 days led to significant increases in follicle-stimulating hormone, testosterone, and androstenedione (P<0.05) but not in luteinizing hormone, prolactin, progesterone, or 17 beta-estradiol.(Kopcekova 2021)

Glycemic effects

Clinical data

In an acute-feeding randomized, multiple crossover trial in 10 healthy adults, dried apricots were the only fruit tested that significantly lowered postprandial glycemic response when half the carbohydrates in a white bread test meal were replaced with dried fruit (displacement effect). The displacement effect with dried dates, raisins, and sultanas was not significant. When compared with the high-glycemic white bread test meal alone, each of the dried fruits had a lower glycemic index and provided a lower postprandial glycemic response.(Viguiliouk 2018)

Hepatic disease

Animal data

Studies in rats with induced hepatic fibrosis suggest positive effects of ground apricot kernel due to its fatty acid content.(Abdel-Rahman 2011) A protective effect of beta-carotene from apricot fruit was also demonstrated on the livers of ethanol-fed rats.(Shivashankara 2012)

Clinical data

Clinical data are limited regarding the use of apricot seed extract in liver disease. However, small clinical trials have reported improvement in enzyme activity, as observed with ultrasound, in participants with fatty liver disease.(Liu 2013)

Immune system effects

Animal data

In a rat model of cyclophosphamide-induced immunosuppression, dietary apricot seed oil appeared to have positive effects on immune system functions.(Tian 2016)

Psoriasis

In vitro data

Apricot seed oil inhibited keratinocyte proliferation and induced apoptosis in an in vitro study evaluating potential applications in psoriasis.(Li 2016)

Dosing

Clinical data are lacking to provide guidance on dosing of apricot or apricot-containing products.

Pregnancy / Lactation

Apricot fruit has GRAS status. Doses greater than amounts found in food should be avoided because safety and efficacy are unproven.

Consumption of apricot kernels or laetrile is not recommended during pregnancy or breastfeeding because of insufficient data and a potential risk of birth defects.(WHO 2007)

Cyanide has not been reported to directly cause human birth defects. However, birth defects occurred in rats that ate cassava root diets, harmful effects on the reproductive system occurred in rats and mice given water containing sodium cyanide, and skeletal abnormalities occurred in the offspring of pregnant hamsters administered oral laetrile.(Willhite 1982) Infants born to mothers exposed to cyanide and thiocyanate during pregnancy have exhibited thyroid disease.(ATSDR 2011)

Interactions

None well documented.

Adverse Reactions

Contact dermatitis from apricot kernels has been reported, and allergy to apricots is common. Cross-reactivity to peaches has been demonstrated in clinical and in vitro experiments.(Pastorello 2000, Rodriguez 2000) Adverse effects of amygdalin consumption (eg, nausea, vomiting, headache, dizziness) are similar to those of neurotoxic cyanide.(WHO 2007)

Potentially fatal asymptomatic, low-grade chronic cyanide toxicity was identified in a 67-year-old male who was self-medicating with 2 apricot kernel extracts (Novodalin and a homemade extract), resulting in a cyanide dose of 17.32 mg/day. During routine cytoscopy requiring general anaesthesia, the patient's pulse oximetry showed potentially life-threatening low oxygen saturation (89%), which improved minimally with inhalation of 100% oxygen. After 3 days of discontinuing the apricot extracts, patient oxygen saturation on room air returned to normal (97%).(Konstantatos 2017)

Exercise- and nonsteroidal anti-inflammatory drug (NSAID)–induced anaphylaxis to Japanese apricot (Prunus mume) has been described in an adult female. Symptoms included itching of the oral and nasal mucosa, conjunctival hyperemia and itching, lacrimation, and sneezing that progressed to shortness of breath and throat swelling. Upon testing, symptoms manifested within 30 minutes of consuming apricot subsequent to taking an NSAID (loxoprofen) and within 10 minutes of commencing exercise, but not in the absence of exercise or the NSAID. The woman also had positive immunoglobulin E and skin-prick tests for peach, as well as for other pollens and fruits. Other cases of allergic reactions to Japanese apricot (specifically the gibberellin-regulated protein) have been documented when combined with exercise or aspirin.(Yamanaka 2019)

Ingestion of an apricot kernel led to development of a neuroendocrine tumor of the small intestine in a 70-year-old male. The patient was admitted with a 2-week history of abdominal pain; mechanical ileus was subsequently noted on CT scan. Resection revealed a well-differentiated tumor with 4 metastatic lymph nodes close to the apricot kernel.(Patane 2020)

Toxicology

Cyanide poisoning, sometimes fatal, due to laetrile and apricot kernel ingestion continues to be reported.(Akıl 2013, Cigolini 2011, Dalkiran 2020, Sauer 2015, Seghers 2013, Suchard 1998, Vlad 2015) A minimum lethal dose of cyanide is estimated at 50 mg (ranging from 0.5 to 1.5 mg/kg of body weight in the literature).(Cigolini 2011, Sauer 2015, Suchard 1998) Oral amygdalin/laetrile is considered 40 times more toxic than the intravenous form because of its conversion to hydrogen cyanide by enzymes in the human intestine.(Abdel-Rahman 2011, Shragg 1982)

Symptoms of cyanide poisoning (eg, coma, cyanosis, dizziness, headache, hypotension, nausea, neuropathies, ptosis, vomiting) may be potentiated by eating foods containing beta-glucosidase (eg, bean sprouts, carrots, celery, peaches) or high doses of vitamin C.(Abdel-Rahman 2011, WHO 2007)

Acute reference doses for cyanide of 0.005 mg/kg of body weight (via consumption of bitter apricot kernels) and of 0.075 mg/kg (for cyanides or hydrocyanic acid as well as of unprocessed foods with cyanogenic glycosides also containing intact beta-glucosidase) have been suggested, based on studies in healthy adults; adverse effects may occur at these doses.(Abraham 2016)

A 33-year-old woman presented to the emergency department with cyanide toxicity after intentionally ingesting 20 g of an amygdalin supplement (Apricot POWER B17 Amygdalin). After initial successful antidotal therapy that included hydroxocobalamin, cyanide toxicity reoccurred (rebound metabolic acidosis); redosing of combination antidotal therapy (hydroxocobalamin and sodium thiosulfate) resulted in resolution of toxicity.(Shively 2020)

A 3-year-old girl who had consumed 3 apricot kernels developed cyanide intoxication resulting in coma. Because hydroxocobalamin was unavailable, a 3-hour hemodialysis session was used and successfully mitigated the severe symptoms (ie, respiratory distress, lactic acidosis, metabolic derangements, convulsions, severe hypotension), with improvement observed immediately after the session. The patient was extubated, and consciousness normalized. Several hours later, hydroxocobalamin was obtained and infused. The patient was completely asymptomatic within 48 hours.(Dalkiran 2020)

There are no toxicology data regarding the flesh or skin of apricot fruits.

Index Terms

• Amygdalus armeniaca (L.) Dumort.
• Armeniaca vulgaris Lam.
• Prunus armeniaca L. var. vulgaris Zabel

References

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