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The juniper berry has generally recognized as safe (GRAS) status in the United States. The maximum level used in food is 0.006% for the oil and 0.01% for the extract.
Overdose may lead to kidney and skin damage. Overdose symptoms include albuminuria (excessive protein), hematuria (blood in the urine), purplish urine, tachycardia (increased heart rate), hypertension (high blood pressure), convulsions, and metrorrhagia (non-menstrual bleeding from the uterus).
Juniper may also lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar), and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Although not well studied in humans, juniper may also increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Juniper may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Juniper may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Juniper may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Juniper may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Abrams, PharmD (University of Rhode Island); James David Adams, Jr., PhD (USC School of Pharmacy); Chi Dam, PharmD (Northeastern University); Catherine DeFranco Kirkwood, MPH, CCCJS-MAC, (MD Anderson Cancer Center); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Kristopher Swinney, PharmD (Massachusetts College of Pharmacy); Brian Szczechowski, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University).
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