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Prickly Pear: A Cactus Cure?

I have been told that prickly pear can be used to help control diabetes and reduce cholesterol levels. Is this true? If so, what can you tell me about it?

Answer (Published 1/7/2013)

Originally published June, 2004. Updated October, 2012

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Prickly pear cactus (Opuntia spp), called nopal in Spanish, is a plant native to Mexico and the American southwest that is now widely cultivated in many parts of the world, especially the Mediterranean regions. I’ve long recommended prickly pear extract as a supplement to help control blood sugar levels in those with diabetes or pre-diabetes, as does my friend, colleague, and fellow desert-dweller, Tieraona Low Dog, M.D., an internationally recognized expert in the fields of integrative medicine, dietary supplements and women’s health. Dr. Low Dog routinely recommends prickly pear to patients, as food, in capsules, or as a pulp-rich juice. She also teaches the Fellows how to prepare simple dishes using both the succulent cactus leaves (pads) and the fruit. (She even makes an amazing prickly pear Margarita!)

Dr. Low Dog tells me that prickly pear is popular in Mexico for preventing hangovers, a folk remedy that proved effective in a Tulane University study published in the June 28, 2004 issue of the Archives of Internal Medicine. Researchers found that volunteers who took a prickly pear extract five hours before consuming five to 7 alcoholic drinks had significantly less nausea, dry mouth and loss of appetite the following day compared to those who took a placebo. (The extract did not prevent hangover-related headaches and dizziness, however.) The researchers suggested that the benefits were related to prickly pear’s strong anti-inflammatory effects. The juice contains betalains, a rare class of antioxidants that is responsible for the rich color of beets and red Swiss chard. Prickly pear juice also contains vitamin C.

Some research suggests that prickly pear may also help control cholesterol levels. In 2003, a small Italian study (only 10 patients participated) indicated that prickly pear extract might lower LDL ("bad" cholesterol) but had no effect on levels of HDL ("good") cholesterol or triglycerides. Results of the study were published in Nuclear Medicine Review of Central and Eastern Europe. Another small study (24 participants) at the University of Vienna in Austria found that prickly pear decreased total cholesterol (by 12%), LDL (15%), triglycerides (12%), blood glucose (11%), insulin (11%) and uric acid (10%), while body weight, HDL and other lipid measurements did not change. If you’re concerned about your cholesterol, I suggest reading the high cholesterol article in the Condition Care Guide on this site, which will give you my recommendations for dietary changes, exercise and supplements that can help you get it under control.

In addition to its popular use for hangovers, prickly pear remedies have been used traditionally in Mexico for a wide variety of disorders. The heated cactus pads have served as poultices for rheumatism, and the fruit of the plant is consumed as treatment for diarrhea, asthma and gonorrhea. Mexicans also consume prickly pear to address high blood pressure, gastric acidity, ulcers, fatigue, shortness of breath, glaucoma, and liver disorders.

Andrew Weil, M.D.

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