Mangosteen: Benefits, Forms, Dosing, and Side Effects

Table of Contents

• Current evidence position
• Key safety points
• Brad's videos on this topic
• Overview
• Forms and Bioavailability
• Evidence for Health Benefits
• Recommended Dosing
• Safety and Side Effects
• Drug Interactions
• Dietary Sources
• References

Current evidence position

Brad has not made a video on this topic; this is a summary of the evidence, not his view. Mangosteen rind xanthones show antioxidant, anti-inflammatory and antibacterial effects, mostly in cell and animal studies ^{[10, 14]}, but absorption by mouth was very low in rats ^[26] and varied widely in adults who drank the juice with a high-fat meal ^[56]. Human trials are small and mixed: mangosteen gel placed in gum pockets improved periodontitis in a meta-analysis of randomized trials, and a 0.5% gel reduced acne lesions about as much as clindamycin ^{[60, 61]}. By mouth, 1,000 mg/day of pericarp extract did not help schizophrenia, and pericarp extract had limited effects in bipolar depression ^{[65, 67]}. One case report linked severe lactic acidosis to mangosteen juice, and laboratory studies show effects on platelets and on the enzymes and pumps that handle many drugs, so people taking blood thinners, diabetes medicines or other prescription drugs should talk to their doctor first ^{[42, 70, 79, 80, 81]}.

Brad's videos on this topic

None yet.

1. Overview

Mangosteen (Garcinia mangostana L.) belongs to the Clusiaceae family; the tree is native to Southeast Asia, and its fruit is known as the "queen of the fruits" ^[14]. It is grown in Indonesia, Malaysia, Sri Lanka, the Philippines and Thailand ^[10].

The health interest lies in the rind (pericarp), not the edible white flesh. The pericarp is a source of prenylated xanthones; the most studied are alpha-, beta- and gamma-mangostin, garcinone E, 8-deoxygartanin and gartanin ^[10]. In laboratory studies these compounds show antioxidant, anti-inflammatory, antibacterial, antifungal, antiviral and antitumour activity ^{[10, 15]}.

In Southeast Asia the pericarp has been used as a traditional medicine for abdominal pain, diarrhoea, dysentery, infected wounds and chronic ulcers ^[10]. Mangosteen products, including juice drinks, are now sold worldwide as supplements ^{[1, 14]}. Marketing has labelled mangosteen a "superfruit", and US sales of mangosteen drinks exceeded $200 million in 2008 despite very limited animal and human studies ^[11]. An analysis of two widely consumed mangosteen juice supplements found that their marketing claims overstated the research they cited and did not disclose its weaknesses ^[58]. Evidence for the health benefits of these products is still lacking, mainly because clinical data are scarce ^[1].

2. Forms and Bioavailability

Commercial Forms

Mangosteen is sold in several forms:

Xanthone Distribution Across Plant Parts

Xanthones have been isolated from the pericarp, whole fruit, heartwood and leaves ^[10]. In a 100% mangosteen juice, nearly all of the xanthones came from rind particles, so the edible flesh contributes little ^[56].

Bioavailability Considerations

Oral absorption: In rats, the oral bioavailability of pure alpha-mangostin was so low that a full blood concentration curve could not be measured ^[26]. In 10 healthy adults who drank 60 mL of 100% mangosteen juice with a high-fat breakfast, free and conjugated xanthones appeared in blood and urine, but absorption varied widely (peak alpha-mangostin 113 ± 107 nmol/L), and urine held 2.0 ± 0.3% of the ingested dose ^[56]. In simulated digestion, only 15.4 ± 0.7% of the xanthones in the rind particles moved into mixed micelles, which suggests limited release from the rind ^[56].

What this means: Effects of pure xanthones in cell studies may not be reached in the body. The authors of the rat study judged it uncertain whether the effects seen in vitro would occur in vivo, given the low bioavailability ^[26].

3. Evidence for Health Benefits

Antimicrobial Activity

Gum disease (clinical evidence): A 2025 meta-analysis of randomized trials found that mangosteen gel placed into gum pockets reduced periodontal pocket depth (effect size -1.08, 95% CI -1.40 to -0.77) and clinical attachment level (effect size -0.96, 95% CI -1.80 to -0.13) compared with placebo or conventional therapies ^[60].

Bad breath (clinical study): In a randomized trial in 60 people with mild or moderate gingivitis, participants rinsed twice daily for 2 weeks with either a placebo rinse or one made with mangosteen pericarp extract ^[34]. Plaque and gum bleeding improved in both groups; between the groups, volatile sulphur compounds, the gases that cause bad breath, differed significantly ^[34]. The authors concluded the mouthwash may help as an adjunct for bad breath ^[34].

Tuberculosis (laboratory): Alpha- and beta-mangostin and garcinone B strongly inhibited Mycobacterium tuberculosis in the laboratory, with a minimum inhibitory concentration of 6.25 µg/mL ^[59]. Whether such levels can be reached by mouth is uncertain, given the low oral bioavailability ^[26].

Other bacteria and fungi (laboratory): A mangosteen pericarp extract killed Cutibacterium acnes, Staphylococcus epidermidis and Staphylococcus aureus, bacteria linked to acne ^[63]. Reviews also report antibacterial and antifungal activity of mangosteen xanthones ^{[10, 15]}.

Skin Health

Applying mangosteen to the skin avoids the poor absorption that limits oral use.

Acne (clinical evidence):

• In a 12-week, split-face, double-blind trial in 28 adults with mild to moderate acne, a 0.5% mangosteen extract gel on one side of the face was compared with 1% clindamycin gel on the other, with benzoyl peroxide on both sides ^[61]. The mangosteen side showed 66.86% and 67.05% reductions in comedones and inflammatory lesions, with no significant difference from clindamycin and no severe side effects ^[61].
• In a 4-week, double-blind, placebo-controlled, split-face study in 10 acne patients, alpha-mangostin nanoparticles applied twice daily improved acne; the particles caused no significant skin irritation in 20 healthy volunteers ^[62].
• A mangosteen hydrogel patch caused no irritation in 30 healthy volunteers, but two had a delayed allergic skin reaction, and the authors advise against it for anyone who has reacted to mangosteen ^[63].

Facial skin texture (clinical evidence): In a split-face study, 20 women aged 35 to 65 with facial wrinkles applied a cream containing green and white tea, mangosteen and pomegranate extracts to one half of the face and a placebo cream to the other, twice daily for 60 days ^[36]. Twice as many participants reported better skin texture on the treated side ^[36]. Critical limitations:

• The cream contained several active ingredients, so the result cannot be credited to mangosteen
• The sample size was very small (n=20) ^[36]
• The study was short

Brain and Mental Health

Human trials: Several randomized trials have now tested mangosteen pericarp extract in brain and mental health conditions, with mixed results.

• In the WECAN-AD trial in mild to moderate Alzheimer's disease, participants took water-soluble pericarp extract at 4 mg/kg/day (n = 33), 4 mg/kg/day rising to 8 mg/kg/day (n = 33), or placebo (n = 42) for 24 weeks ^[64]. More people in the low-dose group reached a clinically important improvement on the ADAS-Cog cognitive scale than with placebo, with a trend in the high-dose group, and the extract appeared safe and well tolerated ^[64].
• In a 24-week trial in 148 people with schizophrenia or schizoaffective disorder, adjunctive pericarp extract at 1,000 mg/day did not differ from placebo in the rate of change of symptoms, functioning or quality of life ^[65]. A secondary analysis found no effect on cognition ^[66].
• In a trial in bipolar depression (70 people on mangosteen, 82 on placebo), adjunctive pericarp extract did not substantially change overall depressive symptoms compared with placebo ^[67]. Some mood, severity and social functioning measures improved more with mangosteen at 24 weeks, but the differences were smaller by week 28, after treatment stopped ^[67].

Laboratory and animal evidence: A 2025 systematic review of 40 studies found that mangosteen extract and xanthones consistently reduced oxidative markers and pro-inflammatory cytokines, acting on the NF-κB and COX-2 pathways, in cell and animal models of neurodegeneration ^[68]. In nerve cells exposed to amyloid beta 42, the xanthone garcinone D improved cell survival, stabilised mitochondrial function, reduced reactive oxygen species and activated the Nrf2 and HO-1 antioxidant pathway ^[69]. The review's authors call for clinical trials before therapeutic use ^[68].

Diabetes and Blood Sugar

Human evidence: In a 26-week pilot trial, 22 women with obesity and insulin resistance but without diabetes were randomized to behavioural therapy alone or with mangosteen extract ^[70]. Among the 20 who finished, insulin resistance (HOMA-IR) fell by 53.22% with mangosteen versus 15.23% without (p = 0.004), and no side effect was attributed to treatment ^[70]. A 2026 systematic review of human studies in type 2 diabetes included this pilot trial and one other study, in which 7 days of a pericarp decoction lowered fasting glucose, and judged the evidence too limited for clinical recommendations ^[71].

Animal studies: In diabetic rats, an ethanol extract of mangosteen pericarp at 50, 100 or 200 mg/kg lowered blood glucose ^[72]. A 2024 network meta-analysis of rodent studies found that all mangosteen extracts lowered blood glucose more than control within 2 weeks, with 200 mg/kg doses ranking highest ^[73].

Antioxidant and Anti-inflammatory Activity

Laboratory evidence: Alpha- and gamma-mangostin from the fruit hull inhibited nitric oxide production in stimulated macrophages (IC50 values 12.4 and 10.1 µM) ^[30]. They reduced iNOS expression and PGE2 production without changing COX-2 expression, and alpha-mangostin reduced paw swelling in mice ^[30].

Human trials:

• In an 8-week trial, 44 adults with obesity and raised C-reactive protein (CRP) were randomized to placebo or a proprietary mangosteen juice blend (XanGo) at 3, 6 or 9 oz twice daily, and 40 completed it ^[74]. CRP fell compared with placebo only at the highest dose of 18 oz per day (p = 0.02); other inflammatory markers did not differ from placebo ^[74].
• In a 30-day trial in 60 healthy adults, a mangosteen-based drink gave 15% more antioxidant capacity in the blood than placebo, and CRP fell by 46% from baseline in the mangosteen group, with no change in liver or kidney tests ^[75].
• In 11 healthy volunteers, a polar fraction of mangosteen pericarp extract taken by mouth for 24 weeks improved the antioxidant capacity of red blood cells ^[76].

Clinical translation gap: These trials were small, used different products, and measured blood markers rather than disease outcomes. A laboratory antioxidant effect does not show a health benefit when taken by mouth.

Obesity and Weight Management

Reviews describe anti-obesity effects of mangosteen xanthones in preclinical studies ^[14]. In an 8-week trial in 60 adults with obesity, 400 mg twice daily of a blend of Sphaeranthus indicus and Garcinia mangostana extracts produced a net weight loss of 3.74 kg compared with placebo ^[77]. The blend combined two plants, so the effect cannot be credited to mangosteen.

Anticancer Activity (Preclinical Only)

Laboratory studies show that mangosteen xanthones inhibit the growth of a wide range of human tumour cell types, acting on cell division, apoptosis, inflammation and metastasis ^[15]. In mice, pure alpha-mangostin showed anticancer activity, and mangosteen slowed human tumours grown in animals, despite alpha-mangostin's low oral bioavailability ^[57].

Critical limitations: Activity against isolated cancer cells does not show efficacy against cancer in living humans. Many compounds that kill cancer cells in test tubes fail in clinical trials due to:

• Insufficient bioavailability to achieve therapeutic concentrations at tumor sites
• Systemic toxicity at doses needed for anticancer effects
• The complex tumor microenvironment (immune evasion, blood supply, stromal interactions) that cell culture cannot replicate
• Pharmacokinetic barriers (metabolism, distribution, excretion)

No clinical trials exist. No human trial has tested mangosteen for cancer prevention or treatment, so claims that it prevents or treats cancer are unsupported.

Cardiovascular Effects (Preclinical)

In diabetic rats, mangosteen pericarp extract lowered triglycerides, total cholesterol and LDL cholesterol and raised HDL cholesterol ^[72]. A network meta-analysis of rodent studies also found improved lipid profiles ^[73], and reviews report lipid-lowering effects in animal models ^[14].

Human evidence: No trial has tested heart or blood vessel outcomes in people. The human CRP results above are blood markers only ^{[74, 75]}.

Antiviral Activity (Preliminary)

Reviews report antiviral activity of mangosteen extracts and xanthones in experimental studies ^{[10, 15]}. In cell culture, alpha- and gamma-mangostin inhibited four strains of SARS-CoV-2, the virus that causes COVID-19 (EC50 0.70 to 3.05 µM) ^[78]. The mangostins interfered with the 3C-like protease, which earlier computer studies had proposed as a target, but this effect was insufficient to be a major target ^[78]. No benefit for COVID-19 or any other viral infection has been shown in people.

Immunomodulatory Effects

Reviews describe antiallergic activity of mangosteen extracts and xanthones ^{[10, 15]}. A 30-day trial in 59 healthy adults of a mangosteen product that also contained multivitamins and minerals reported a rise in T-helper cell frequency and a fall in CRP ^[83]. Because the product held other nutrients, the result cannot be credited to mangosteen.

Summary of Evidence Quality

Most of the evidence for mangosteen comes from cells and animals. The human trials are few and small, and several tested blended products or local dental and skin use.

4. Recommended Dosing

No Established Therapeutic Dose

No official intake exists for mangosteen or its xanthones. Trials have used different products, doses and routes, so their doses cannot be compared directly.

Doses Used in Available Research

Pericarp extract (oral): A schizophrenia trial used 1,000 mg/day for 24 weeks ^[65], and an Alzheimer's trial used water-soluble pericarp extract at 4 to 8 mg/kg/day for 24 weeks ^[64]. These doses come from trials in specific conditions and do not show a benefit for general use.

Topical preparations: An acne trial used a 0.5% mangosteen extract gel ^[61], and a hydrogel patch used 0.5% extract ^[63].

Mangosteen juice: A proprietary juice blend was tested at 3, 6 or 9 oz twice daily for 8 weeks ^[74]. In an absorption study, adults drank 60 mL of 100% mangosteen juice once ^[56].

Preclinical doses (for context only): A rat study used 50, 100 or 200 mg/kg of pericarp extract, and a single dose of 2,000 mg/kg caused no acute toxicity in rats ^[72]. Animal doses do not translate directly to human supplementation, and efficacy in animals does not guarantee efficacy in humans.

Timing and Administration

Xanthones from mangosteen juice were absorbed when taken with a high-fat breakfast ^[56]. Timing has not been compared in trials.

Fruit Consumption

Because nearly all of the xanthones in mangosteen juice came from rind particles, eating the white flesh of the fresh fruit supplies little of the compounds studied in trials ^[56].

5. Safety and Side Effects

Lactic Acidosis Risk

A 2008 case report described severe lactic acidosis associated with mangosteen juice used as a dietary supplement ^[42]. Lactic acidosis can be fatal ^[82]. Its general signs include nausea, vomiting, abdominal pain, fast breathing and shortness of breath ^[82]. If these appear, call your local emergency number (111 in NZ, 000 in Australia, 911 in the US, 999 in the UK).

A single case report does not prove that mangosteen caused the illness, and how it might do so is unknown.

Safety of Rind Extracts

A 2018 review noted conflicting results from mangosteen safety studies that need further investigation ^[57]. In 11 healthy volunteers who took a polar fraction of pericarp extract for 24 weeks, only minor and tolerable side effects were reported, and blood tests showed no liver or kidney damage ^[76]. In a 24-week Alzheimer's trial, water-soluble pericarp extract appeared safe and well tolerated ^[64]. The human safety data come from juice and rind extracts ^{[64, 74, 76]}.

Special Populations

Pregnancy and breastfeeding: There is insufficient safety data on mangosteen supplements during pregnancy and breastfeeding. Avoid concentrated rind extracts.

Children: Safety of mangosteen supplements in children has not been established.

Liver disease: People with liver disease should ask their doctor first, because how they process mangosteen xanthones has not been studied.

Kidney disease: People with kidney disease should ask their doctor first, because how reduced kidney function affects xanthone clearance has not been studied.

Surgery: Alpha- and gamma-mangostin inhibited platelet clumping in laboratory tests, although effects in people have not been assessed ^[81]. A 2022 review advises stopping non-essential supplements 2 weeks before planned surgery, which would include mangosteen ^[85].

Common Side Effects

Trials of mangosteen extract and juice reported few side effects. A juice blend trial reported no side effects in any group ^[74], an insulin resistance pilot attributed no side effect to treatment ^[70], and healthy volunteers reported only minor, tolerable effects during 24 weeks ^[76]. On the skin, two of 30 volunteers had a delayed allergic reaction to a mangosteen patch ^[63].

General Safety of Fruit Supplements

A 2018 review of five fruits sold as supplements in the US, including mangosteen, concluded from safety studies and toxicity case reports that these fruits may generally be considered safe ^[57].

6. Drug Interactions

Formal drug interaction studies of mangosteen in humans are lacking. The interactions below come from laboratory and animal research, and their clinical importance at supplement doses is unknown.

Potential Interactions

CYP450 Enzyme Interactions

In laboratory studies, mangosteen xanthones were both substrates and inhibitors of multiple cytochrome P450 enzymes, which break down many drugs ^[79]. Modelling predicted that blood levels of alpha-mangostin would be well above the levels that inhibit CYP2C8 and CYP2C9 ^[79]. This has not been tested in people, and low oral absorption may limit it ^{[26, 56]}.

P-glycoprotein Interactions

Alpha- and beta-mangostin inhibited P-glycoprotein, a pump that moves drugs out of cells, in cell and mouse intestine studies, and alpha-mangostin increased absorption of a P-glycoprotein substrate ^[80]. The authors conclude these xanthones may change the bioavailability and transport of drugs carried by this pump ^[80].

Practical Guidance

Given the limited formal interaction data, the following precautions are advisable:

1. Consult a healthcare provider. If you take prescription medicines, check with your doctor or pharmacist before starting. This matters most for blood thinners, diabetes medicines and cancer treatment.
2. Avoid concurrent use with anticoagulants or antiplatelet drugs unless your doctor agrees, given the platelet effects seen in laboratory tests ^[81].
3. Monitor blood glucose if combining mangosteen supplements with diabetes medicines ^{[70, 72]}. If someone with diabetes is unconscious, having a seizure, or cannot swallow safely, call your local emergency number (111 in NZ, 000 in Australia, 911 in the US, 999 in the UK). Do not give food or drink by mouth.
4. Stop before surgery: A 2022 review advises stopping non-essential supplements 2 weeks before planned surgery, which would include mangosteen ^[85].

7. Dietary Sources

Mangosteen is eaten as a fresh fruit, valued for its distinctive taste ^[14]. The xanthones studied for health effects come mainly from the rind: in 100% mangosteen juice, rind particles held 99% of the xanthones ^[56].