If Aloe vera were a pop group, it would undoubtedly be The Beatles. It is probably the single most popular - and possibly the best known - alternative remedy around. Mirroring this is the fact that there are over 189,000 sites on the Web dedicated to this supposedly 'wonder plant', and at least a hundred aloe products available in shops in the UK alone.
Many people testify to its curative, almost miraculous, qualities, although some go too far, as did a Baltimore businessman jailed for four years last December for selling Aloe vera as an intravenous cure for cancer.
Aloe vera - a succulent plant belonging to the lily family chiefly from southern Africa - has been hailed as a miraculous healing agent for thousands of years. Legend has it that Aristotle urged his pupil Alexander the Great to invade the island of Socrota to collect its aloe plants so that the wounds of his soldiers could be treated. Cleopatra and Nefertiti are said to have included aloe in their skincare regimes. Throughout the 18th and 19th centuries in Britain, aloe was by far the most popular remedy for a wide range of ailments.
Nevertheless, despite its widespread use for thousands of years, the chemistry of Aloe vera is still not truly understood. We know that it contains over 10,000 proteins and that hundreds of other substances have been identified, many of them useful in the healing of body tissue.
Given all of its apparently noteworthy properties, possibly the most remarkable thing of all is that Aloe vera is 99 per cent water. It grows in tropical areas, and its leaves have to retain water for long periods of time. This means that its active ingredients are present in very minute proportions, thus suggesting that they work synergistically.
The main ingredients found in the remaining one per cent of solid matter - as found in Aloe barbadensis miller and Aloe arborescens, the two most popular species used for medicinal purposes - range from minerals, vitamins, amino acids, proteins and essential fatty acids (EFAs) to anti-inflammatory agents, antiseptics, analgesics and antiparasitics.
Aloe vera also contains polysaccharides, long-chain sugar molecules believed to have a wide range of medicinal benefits. At low levels of between 50 and 600 molecules, polysaccharides are supposed to reduce inflammation, and so could prove helpful in disorders such as ulcerative colitis, arthritis and gastric reflux. At moderate levels of up to 1500 molecules, they are supposedly able to work as intracellular antioxidants, and so may be useful for people with heart disease or Parkinson's. At very high levels - up to 9000 molecules - the theory goes that polysaccharides can have a healing effect on immune disorders such as cancer and AIDS.
One manufacturer, Carrington Laboratories in Texas, is so convinced of aloe's efficacy as an immune builder that it has spent millions of dollars developing a product called Acemannan, a generic version of the aloe polysaccharide.
It should be stressed that none of these benefits has been proved absolutely in any scientific medical trials.
The aloe plant yields both aloe gel and aloe juice. These products are different from each other and have different uses, even though the terms are often misused or interchanged in advertisements for aloe products.
The clear gel, or mucilage, comes from the inner part of the aloe leaf. Aloe gel is famous for its wound-healing properties and as a remedy for minor burns, abrasions and other skin irritations, such as eczema. Its ability to heal skin lesions has been observed in many studies, and it's probably safe to say that, despite a few studies to the contrary, its healing powers on the skin are indisputable.
One study showed that burns wounds treated with aloe healed significantly faster than those treated with Vaseline (J Med Assoc Thailand, 1995; 78: 403-9). Another study showed that 0.5 per cent aloe extract cured 83 per cent of a group of psoriasis patients in 16 weeks compared with 6.6 per cent with a placebo gel (Trop Med Intern Hlth, 1996; 1: 505-9).
What is disputable, and certainly controversial, is the use of aloe internally. Aloe juice, or latex, comes from just beneath the 'skin' of the leaves. It contains the powerful laxative aloin, an anthraquinone glucoside also found in senna, rhubarb and cascara sagrada. Aloin is present in the sap and rind of the aloe plant, and so it is vital that the manufacturer strips the plant carefully, or you might get more than you bargained for.
So why drink aloe juice? Its advocates claim that it can help improve the cardiovascular system and lower cholesterol, that it can improve gastrointestinal problems such as ulcers and irritable bowel syndrome (IBS), and that it can ease bone and joint problems such as arthritis. Aloe's fans point to a range of studies suggesting that aloe juice can help all or some of these problems, but any objective observers would have to declare that the jury is still out.
To be fair, double-blind, placebo-controlled studies are extremely expensive to mount, and few organisations in the complementary camp have the type of budgets that pharmaceutical companies have to launch such research.
However, having said that, one major aloe manufacturer, Forever Living Products, is starting a double-blind placebo-controlled trial of aloe in the treatment of IBS with the Morriston Hospital in Swansea. The Prince Charles Foundation for Integrated Medicine is part-funding the study, which involves 200 patients, to the tune of lb86,000.
Many of the benefits of aloe tend to be anecdotal so, if you know people who've improved by drinking aloe juice, you might still want to try it for yourself. In this case, you are then faced with another problem - finding the product that is going to deliver what it says on the label.
Aloe juice seems to be open to more abuse from manufacturers than most other natural remedies, possibly because of its popularity and because it's so easy to cheat. However, trading standards authorities are now taking a keen interest, and we hear that legislation is on the way to provide better safeguards for the consumer.
An early trick was watering down the ingredients. One test in the mid-1980s found that, of the 200 aloe juices tested, only three contained enough aloe to be of any medicinal value. It's been reckoned that, as recently as 1993, fewer than one per cent of brands contained acceptable levels of aloe (Ritter L, Aloe Vera: A Mission Discovered, ISBN 0 9638 6090 9). One brand from the US, which claims to be a distillate of aloe, contains no aloe whatsoever. As most aloe products on the market come from the States or Mexico, UK consumers can take little comfort in being on this side of the Atlantic.
However, water dilution is easily detected and many of the manufacturers who suddenly emerged just to cheat the consumer have almost as quickly disappeared. Cleverer methods of distillation have included the use of maltodextrin, a cheap carbohydrate obtained from cornstarch, and others have used glucose and glycerine.
Aware of these abuses, the International Aloe Science Council (IASC) set itself up to test the purity of the aloe contained in products. This can range from close to 100 per cent down to just 15 per cent of contents, depending on the mix. Many manufacturers add fruit juices to the aloe to make it more palatable (aloe being one of Nature's more revolting tastes).
Unfortunately, this could be confusing for the consumer who doesn't have at least a basic grounding in Logic. While a bottle may contain 100-per-cent pure aloe (as the label often says it does), the actual amount of aloe could be as low as five per cent - even though it may be 100-per-cent pure!
The IASC test has also been open to abuse, and some manufacturers have won themselves an IASC seal by producing a cocktail of chemicals that was able to pass muster as real aloe. (Our lawyers would no doubt like us to add that we're not aware of any current holders of an IASC seal who have doctored their products!)
Aloe juice comes in one of three ways: as a pure, undiluted drink or supplement; as part of a mixture that may also include a fruit juice or herbs and other supplements; and as a capsule containing the gel.
In assessing these products for our road test, we've looked for a number of features that should add up to a package that delivers a reasonable level of aloe. This includes cold-processing (or heat-processed at a low temperature), a polysaccharide content of 1500-3000 mg/L, aloin of at most 50 ppm, a minimum use of preservatives and an IASC certificate. (For a more complete overview of what to look for in these products, see box on p 2.)
Aloe Vera Gel
Manufacturer: Forever Living Products
Price: lb18 for 1000 mL
This Forever Living product was the first to ever win an IASC seal, and is the first to be used in a double-blind placebo-controlled trial as a treatment for IBS. It is arguably the best-selling aloe product in the world, a position built up over 24 years.
Its polysaccharide content falls within the IASC range, but varies from 1500 to 3000 mg/L, depending on when the plant was harvested. Aloe gel makes up 97-98 per cent of the content; the rest includes 62 ppm of aloin, and the preservatives potassium sorbate and sodium benzoate.
Unlike many of its competitors that use the whole aloe leaf, Forever Living uses just the inner leaf. The company says there is no evidence to suggest that the whole leaf is any more potent - a moot point within the industry.
Forever Living offers a full, 90-day, money-back guarantee, which is one reason, it says, that the product is not available in shops. Instead, it is sold either by mail order or through its large network-marketing distribution chain (call 0870 755 5805 for more information).
Morley's Aloe Vera
Manufacturer: Natural Living Products
Price: lb16.50 for 1000 mL
Morley's Aloe Vera delivers more polysaccharides than the guidelines suggest, and just 4.4 ppm of aloin. It is made from the whole leaf of the plant, and uses cold-processing techniques. The plants used to make this product are grown organically in Mexico.
This offers 99.8-per-cent stabilised Aloe vera, and contains 0.1 per cent of sodium benzoate and 0.1 per cent of potassium sorbate as preservatives.
>From tests we have seen, Morley's appears to offer more polysaccharide than any of its competitors - but are the levels so high that they are affecting the overall synergistic qualities of the juice?
Natural Living is a UK company, and the product is available only in the UK. Unfortunately, it cannot be bought in shops, but has to be ordered by telephone (020 8668 9728 or 01795 420 447), or by contacting one of their 'representatives', aka network marketeers. The website is www.natural-living.co.uk. For security reasons, credit card orders are not taken via the site.
Whole Leaf Aloe Vera Juice
Manufacturer: Forever Young
Price: lb14.95 for 1000 mL
This product contains polysaccharides to a level that is nearly twice that recommended by the IASC, although it's not quite as potent as Morley's. As the name suggests, it uses the whole leaf of plants that are organically grown; it is also cold-processed. It claims to contain no aloin, and comes with the IASC seal of approval.
The juice is made up of 99.8-per-cent Aloe vera juice; the preservatives are 0.1- per-cent sodium benzoate, and 0.1-per-cent potassium sorbate.
The bottle should last you around 30 days, and it's available from good healthfood stores. It wins an extra star for a price that represents good value.
Aloe Vera Juice
Manufacturer: Aloe Pura
Price: lb10.49 for 500 mL
This is a pure Aloe vera juice product with the IASC seal. The 100-per-cent mark appears all over the bottle - it's 100-per- cent fresh, the juice is 100-per-cent pure, and the bottle contains 100-per-cent aloe juice.
But if it really is 100-per-cent aloe juice, there's no way it can be 100-per-cent fresh. As a natural plant, it would go off within days without preservatives. The truth is that it has to contain preservatives, so one of the 100-per-cent claims should be taken off.
Nevertheless, this seems to be a good product. It's been cold-processed, and the aloin has been removed. The bottle represents a 10-day supply and the price may suit some pockets better.
Aloe Vera Colon Cleanse
Manufacturer: Aloe Pura
Price: lb7.99 for 500 mL
Aloe Pura claims to be the first European aloe company to be awarded the IASC seal. Its formulation includes herbs such as milk thistle, dandelion and liquorice as well as aloe.
As a colonic cleanser, we were a little surprised not to find any aloin. Like most of these products, it uses the whole leaf in "a unique formulation" using both the gel and pulp. Preservatives are potassium sorbate, sodium benzoate and citric acid.
It is taken from a 'naturally grown aloe plant' - although we cannot imagine what an unnatural one would be - and offers a 10-day supply.
Price: lb14.95 for 950 mL
This is another blended product, including 120 mg of milk thistle seed, burdock root, dandelion root, green tea leaf, red clover tops and Echinacea angustifolia root.
Around 10 per cent of its content is polysaccharides, with 29.6 mL of aloe gel and 600 mg of Aloe vera pulp. The plants from which the gel is made are organically grown. The manufacturer says the product is free of aloin.
One worry: the manufacturer prides itself on its concentrated formula that provides 32 servings - but has that adulterated the natural aloe's properties?
A further note on the subject. If you find the taste of pure aloe simply too unpalatable, and you feel that, by adding fruit juice you're adulterating the aloe, you could try some of the aloe capsules that are starting to appear in shops.
First into the marketplace is BioCare, with its high-potency Aloe Vera Capsules. These contain 500 mg of Aloe vera while the non-active ingredients include silica and vegetable oil. A pack of 60 capsules costs lb6.95.
Lamberts offers a pack of 60 capsules for lb5.95 which delivers 50 mg of aloe per capsule. This is equivalent to 10,000 mg of aloe juice.
Finally, Holland & Barrett offer 100 aloe capsules for lb6.99, but with the lowest potency, delivering just 25 mg of aloe.