Author Affiliations
Abstract
Background: Trigonella foenum-graecum (fenugreek) has garnered attention for its potential in modulating glucose metabolism, lipid profiles, and hormonal balance. This study evaluates the clinical efficacy of fenugreek-based interventions in metabolic and endocrine disorders, including type 2 diabetes mellitus (T2DM), polycystic ovary syndrome (PCOS), and age-related testosterone deficiency.
Methodology: Data from randomized controlled trials and open-label studies were synthesized. In T2DM, 114 patients received 25 mg fenugreek seed powder twice daily for 30 days. In PCOS, 50 women were treated with Furocyst 500 mg twice daily for 3 months. Two male-focused trials assessed testosterone-related outcomes following fenugreek extract or TrigozimR supplementation over 12 weeks.
Results: Fenugreek significantly improved lipid profiles, reducing triglycerides, low-density lipoprotein cholesterol (LDL-C), and total cholesterol, while increasing high-density lipoprotein cholesterol (HDL-C) in diabetic patients. In PCOS, Furocyst enhanced luteinizing hormone/follicle-stimulating hormone (LH/FSH) levels, reduced ovarian volume and cysts, and normalized menstrual cycles. In men, fenugreek extract and TrigozimR elevated total and free testosterone levels and improved sexual function. TrigozimR also enhanced serum vitamin D and zinc levels without adverse biochemical effects.
Conclusion: Fenugreek supplementation demonstrates consistent efficacy in improving metabolic and hormonal parameters across diverse populations, with minimal side effects. It presents a promising adjunct or alternative to conventional pharmacotherapy for T2DM, PCOS, and late-onset hypogonadism.
Keywords
Trigonella foenum-graecum, Type 2 diabetes mellitus, Polycystic ovarian syndrome, Testosterone deficiency, Lipid profile, Hormonal regulation.
Introduction
Trigonella foenum-graecum, commonly known as fenugreek, is an herb from the Fabaceae family with a long history of use in traditional medicine across various cultures. The seeds of fenugreek contain a wide range of biologically active compounds including steroidal saponins (notably furostanol glycosides), alkaloids, flavonoids, polyphenols, amino acids, and trace minerals. These compounds are known to exert hypoglycemic, hypolipidemic, and hormone-modulating effects, making fenugreek a promising candidate for managing metabolic and endocrine disorders.[1-5]
Figure 1: Trigonella foenum-graecum
DM is a chronic metabolic condition characterized by elevated blood glucose levels due to impaired insulin secretion or resistance to insulin action. T2DM is the most prevalent form, accounting for over 90% of all cases. It usually develops in adults over the age of 40, but recent trends show increasing incidence among younger individuals due to poor diet, sedentary lifestyle, and rising obesity rates. According to the World Health Organization (WHO), diabetes currently affects over 347 million people globally and is responsible for approximately 4.6 million deaths annually. The prevalence is projected to double by 2030, with the largest increases expected in low- and middle-income countries.[6-10]
T2DM is frequently accompanied by dyslipidemia, a metabolic disturbance characterized by elevated triglycerides, total cholesterol, LDL-C, and reduced HDL-C. These lipid abnormalities are a result of insulin resistance, which contributes significantly to cardiovascular risk in diabetic patients. Furthermore, disturbances in lipid metabolism often precede the clinical onset of T2DM, making early management essential.[11-15] Standard therapies for T2DM primarily include insulin and oral hypoglycemic agents; while these medications are effective in managing blood glucose, they are often associated with side effects such as gastrointestinal discomfort, weight gain, liver enzyme elevation, and other toxicities. Additionally, issues of cost, availability, and patient adherence remain challenges, especially in resource-constrained settings. These limitations have prompted a growing interest in plant-based treatments that are perceived to be safer, affordable, and culturally acceptable.[16-18]
Preclinical and clinical studies have shown that fenugreek may help lower fasting blood glucose, improve insulin sensitivity, and normalize lipid levels. In addition, fenugreek has shown promise in treating PCOS, a common endocrine disorder in women of reproductive age. PCOS is associated with hyperandrogenism, irregular menstrual cycles, multiple ovarian cysts, and metabolic disturbances including insulin resistance. Its etiology remains unclear but is thought to involve genetic predisposition and hormonal imbalance. Elevated insulin levels can worsen androgen excess, further disrupt ovarian function, and increase the risk of infertility, obesity, and cardiovascular disease.[19,20]
Current treatments for PCOS often include insulin sensitizers such as metformin, oral contraceptives, anti-androgens, and ovulation-inducing agents. However, these treatments may cause adverse effects and are not suitable for all patients. Emerging evidence suggests that phytopharmaceuticals, including fenugreek, may provide a natural and effective alternative. In animal studies, fenugreek has demonstrated anti-androgenic activity and the ability to reduce ovarian volume and cysts. In one human study, fenugreek extract (Furocyst) improved ovarian parameters and symptoms in women with PCOS over a 3-month period.[21]
Fenugreek has also gained attention for its potential to address age-related testosterone decline in men, a condition often referred to as andropause or late-onset hypogonadism. After the age of 40, testosterone levels in men decline by approximately 1-2% per year. This decline is associated with reduced libido, fatigue, depression, muscle weakness, increased fat mass, and diminished quality of life. Conventional testosterone replacement therapy (TRT) can restore hormone levels but carries potential risks such as cardiovascular events, prostate complications, and suppression of natural testosterone production.[22] Fenugreek’s saponins, particularly protodioscin and furostanol glycosides, may support endogenous testosterone production by influencing steroidogenesis and modulating key enzymes like aromatase and 5-alpha reductase. Several studies have reported that fenugreek supplementation can increase both total and free testosterone levels, enhance libido, and improve mood and physical performance, without the severe side effects associated with synthetic hormones.[23]
In response to the growing interest in natural supplements for hormonal and metabolic health, proprietary formulations such as TrigozimR have been developed. TrigozimR is a standardized fenugreek extract enriched with essential micronutrients, including vitamin D, zinc, and magnesium-each of which plays an important role in metabolic and reproductive health. Zinc, for instance, is essential for male fertility and testosterone metabolism, while vitamin D has been linked with improved insulin sensitivity and hormonal regulation.[24] Initial findings from human trials suggest that TrigozimR may improve testosterone levels and libido in healthy aging men and may also contribute to modest weight loss. Additionally, studies have shown increased serum levels of 25-hydroxyvitamin D and plasma zinc following TrigozimR supplementation. These changes were achieved without significant alterations in liver or kidney function markers, suggesting a favorable safety profile.[25]
Given the multifaceted therapeutic potential of Trigonella foenum-graecum in improving glucose metabolism, lipid profiles, androgen balance, and reproductive function, this study aims to further investigate its clinical efficacy. The primary objective is to assess the effect of fenugreek-based formulations on hormonal and metabolic biomarkers in individuals with conditions such as type 2 diabetes, PCOS, and age-related testosterone deficiency. Secondary objectives include evaluation of safety parameters, patient-reported outcomes, and potential improvements in quality of life.[26]
Effect of Trigonella foenum-graecum on lipid profiles: a 30-day intervention study
An experimental study by Geberemeskel et al. (2019) was conducted in Mekelle, Ethiopia, from July 2015 to January 2016, involving 114 newly diagnosed type II diabetic patients. Eligible participants were randomized into treatment (25 mg Trigonella foenum-graecum seed powder twice daily) and control groups. Eligible participants include patients not on antidiabetic/lipid-lowering therapy, non-pregnant, and HIV-negative. Participants. Fasting blood samples were collected pre- and post-intervention for lipid and glucose analysis. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) (t-tests; p < 0.05). Ethical approval and informed consent were obtained. The treatment with 25 mg of Trigonella foenum-graecum seed powder for 30 days led to significant improvements in lipid profiles in the treatment group compared to baseline and control values.[27]
| Parameter | Group | Baseline (Mean ± SD) | Post-treatment (Mean ± SD) | % Change | p-value (within group) | Comparison with Control (P-value) |
| Total cholesterol (TC)
|
Treatment | 219.1 ± 35.51 | 189.29 ± 29.06 | ↓13.6% | < 0.001 | < 0.001 |
| Control | 210.02 ± 41.18 | 208.2 ± 40.2 | NS | 0.22 | – | |
| Triglycerides (TG)
|
Treatment | 256.1 ± 15.4 | 195.8 ± 82.95 | ↓23.53% | < 0.001 | < 0.05 |
| Control | 250.35 ± 96.9 | 244.1 ± 96.9 | NS | 0.21 | – | |
| HDL-C
|
Treatment | 37.8 ± 1.51 | 48.3 ± 11.9 | ↑21.7% | < 0.001 | < 0.001 |
| Control | 37.41 ± 9.2 | 36.01 ± 9.5 | NS | 0.15 | – | |
| LDL-C
|
Treatment | 137.9 ± 26.9 | 105.6 ± 24.2 | ↓23.4% | < 0.001 | < 0.001 |
| Control | 142.71 ± 23.8 | 144.1 ± 23.3 | NS | 0.333 | – |
Table 1: Effects of treatment on lipid profile parameters compared to control group
Furocyst’s multifaceted benefits: hormonal balance, ovarian health, and cycle restoration
Swaroop et al. 2015 conducted a multi-centric, open-label clinical study on 50 subjects using Furocyst (Trigonella foenum-graecum seed extract, 2×500 mg/day for 3 months). Over a 3-month period, Furocyst supplementation led to notable hormonal and clinical improvements. LH levels showed a significant increase by the end of treatment (p=0.045), while FSH levels rose significantly after 2 months (p=0.010) and further after 3 months (p = 0.000). Although the LH/FSH ratio decreased over time, this change was not statistically significant. Significant reductions in ovary volumes were recorded, with a 17.82% decrease in the left ovary (p=0.101) and a 28.25% reduction in the right ovary (p=0.000). Cyst size reduced in 47 subjects, with 36 becoming cyst-free and six achieving pregnancies during the study, indicating a 94% overall response rate.
Menstrual patterns also improved: initially, 81% had prolonged cycles, 10% irregular cycles, and 10% primary infertility. Post-treatment, 71% had regular cycles, 19% prolonged cycles, and no participants reported irregular cycles; primary infertility persisted in 10%. Of 12% of participants who became pregnant during the study, pregnancies were reported at 30, 39, 70, and 84 days. A significant increase in haemoglobin (Hb) levels was observed post-treatment (p=0.000), though total leukocyte count (TLC) and hemogram remained unchanged. Liver and kidney function markers, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), blood urea nitrogen (BUN), Creatinine showed no significant changes, and alkaline phosphatase (ALP) decreased slightly but remained within normal range. Similarly, plasma glucose, serum triglycerides, and HDL cholesterol levels remained stable and within normal limits throughout the study.[28]
Improved hormonal and sexual function outcomes with Trigonella foenum-graecum supplementation
In the study by Rao et al. (2016), a 12-week, double-blind, randomized clinical trial was conducted in Brisbane from Feb 2014 to Nov 2014, involving 120 healthy males (aged 43-75 years), who were randomized to receive either a placebo or Trigonella foenum-graecum seed extract. Inclusion required good general health; exclusions included hormonal therapy, erectile dysfunction, major illnesses, psychiatric disorders, genitourinary issues, alcohol/drug abuse, and chickpea allergy. Primary outcome was aging male symptom questionnaire (AMS) score; while secondary outcomes included Derogatis interview for sexual functioning-self report (DISF-SR), serum hormones, sleep, fatigue, activity, and anthropometry. Compliance, randomization, and statistical analysis followed standard protocols. Ethics approval and informed consent were obtained.
Approximately 111 out of 120 enrolled men completed the trial (55 in the treatment group and 56 in the placebo group). Both groups were comparable in age, overall health, and baseline hormone levels. There were no significant changes in BMI, grip strength, sleep, fatigue, or physical activity in either group during the study. By Week 12, Total and free testosterone levels increased significantly in the treatment group compared to placebo, even after adjusting for age and body mass index (BMI) (p<0.001 and p=0.002, respectively). AMS scores, particularly in the somatic and sexual sub-domains, improved significantly over time in the treatment group (p< 0.05), with no notable changes in the placebo group. Sexual function also improved significantly in the treatment group, with higher scores in arousal (p=0.001), drive/relationship (p=0.007), and increased frequency of erections (p=0.001) and sexual activity (p=0.004). No changes were seen in other sexual function domains or in the placebo group. Other hormones and biochemical parameters, including dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), oestradiol, prolactin, and lipid profiles, remained unchanged in both groups.[29]
Clinical and biochemical impact of TrigozimR supplementation
In a study by Lee-Ødegård et al., 2024, a double-blind, randomized trial was conducted in Oslo, enrolling 245 healthy men aged 40-80. Participants were included based on their ability to complete a libido/lifestyle questionnaire and tolerate 1.2 g/day of fenugreek extract for 12 weeks. Exclusion criteria included: steroid use, substance abuse, psychiatric illness. Ninety-five participants completed the intervention. Participants received 01800 mg/day of fenugreek in 3 tablets. Blood/saliva were sampled at baseline at 2, 6, and 12 weeks. Testosterone was quantified via High-performance liquid chromatography-Mass spectrometry (HPLC-MS). Analyses were conducted using mixed models in R. Ethical approval was obtained (Approval No. 418176). Adherence was assessed through pill counts and serum 25(OH) vitamin D levels.
There were no baseline differences in participant characteristics among the four groups. Subjective questionnaire responses revealed no significant differences between groups or across the intervention period. Notably, only the group receiving 1800 mg/day of TrigozimR showed a modest weight loss of 1.1 kg. Participants receiving any dose of TrigozimR demonstrated a significant increase in total blood testosterone levels at weeks 2 and 6, and a consistent rise in the free testosterone index (FTI) throughout the study. However, these effects were not significantly different from placebo. When stratified by dosage, significant improvements in testosterone were seen with 600 and 1200 mg/day at weeks 2 and 6, without significant differences from placebo. Sex hormone-binding globulin (SHBG) levels remained unchanged across all groups.
Salivary testosterone, a proxy for free plasma testosterone, showed a significant increase for all TrigozimR-treated participants compared to placebo, with the most notable rise (19%) in the 1800 mg/day group. After adjusting for ≥90% tablet compliance, the results remained generally consistent. However, the statistical significance for FTI over the 12-week period was lost, likely due to the reduced sample size and lower statistical power.
All participants receiving TrigozimR had a significant rise in plasma 25-hydroxy vitamin D levels, consistent with the 10 µg of vitamin D content. Plasma zinc levels increased significantly in all groups, reflecting the 10 mg zinc content per tablet; an important addition given zinc’s essential role in male fertility. No significant changes were noted in high-sensitivity C-reactive protein (hs-CRP), alanine aminotransferase (ALAT), or creatinine versus placebo. However, serum ALAT and creatinine levels increased slightly yet remained within normal reference ranges post-intervention.[30]
| Study | Population | Intervention | Duration | Key outcomes | Safety findings |
| Geberemeskel et al.[27] | 114 newly diagnosed T2DM patients in Ethiopia | 25 mg fenugreek seed powder twice daily | 30 days | ↓ Total cholesterol (13.6%) ↓ LDL-C (23.4%) ↓ Triglycerides (23.5%) ↑ HDL-C (21.7%) |
No adverse events reported |
| Swaroop et al.[28] | 50 women with PCOS | Furocyst® (2 × 500 mg/day) | 3 months | ↑ LH & FSH ↓ Ovary volume & cysts (94% response) ↑ Menstrual regularity (71%) 6 pregnancies achieved |
Normal liver, renal, lipid, glucose levels ↑ Hb without adverse changes |
| Rao et al.[29] | 120 healthy aging males (43–75 years) | Fenugreek extract (Testofen®) | 12 weeks | ↑ Total & free testosterone (p<0.001) ↑ Sexual function (arousal, drive, erection frequency) Improved AMS score |
No adverse changes in BMI, lipids, or hormones |
| Lee-Ødegård et al.[30] | 245 healthy men (40–80 years), 95 completed | TrigozimR (0–1800 mg/day) | 12 weeks | ↑ Salivary testosterone (notably 19% in 1800 mg/day group) ↑ Plasma vitamin D and zinc Modest weight loss (1.1 kg in 1800 mg/day) |
ALAT and creatinine slightly increased but remained normal No serious adverse effects |
Table 2: Summary of clinical studies evaluating the therapeutic effects of Trigonella foenum-graecum
Discussion
Findings across the four clinical studies underscore the therapeutic promise of Trigonella foenum-graecum in addressing metabolic and endocrine dysfunctions, particularly T2DM, PCOS, and age-related testosterone deficiency. In the T2DM study, daily administration of 25 mg fenugreek seed powder for 30 days resulted in statistically significant reductions in total cholesterol, LDL-C, and triglycerides, along with a marked increase in HDL-C. These improvements are consistent with the hypolipidemic effects of fenugreek’s bioactive compounds, particularly steroidal saponins and polyphenols, that modulate lipid metabolism and reduce cardiovascular risk in diabetic individuals. The control group’s lack of significant change reinforces the treatment’s specific metabolic benefits.[27]
The Furocyst trial in women with PCOS demonstrated fenugreek’s hormone-modulating properties. Over a 3-month course, the extract normalized menstrual cycles in 71% of participants, reduced ovarian volume, and restored ovulatory function. The increase in LH and FSH levels, alongside reduced cyst count and pregnancies achieved during the study, indicates fenugreek’s ability to modulate the hypothalamic-pituitary-ovarian axis. The favourable safety profile evidenced by stable glucose, liver, and renal parameters further supports its use as a viable alternative to standard PCOS treatments, which often carry significant adverse effects.[28]
In aging men, fenugreek supplementation also demonstrated hormonal and functional benefits. The randomized controlled trial by Rao et al. confirmed significant increases in both total and free testosterone levels in the treatment group. Sexual function domains such as arousal, erection frequency, and relationship satisfaction improved, with no adverse impact on other hormonal or biochemical markers. These results support the anabolic and libido-enhancing potential of fenugreek via modulation of enzymes like 5-alpha reductase and aromatase.[29]
The TrigozimR trial further extended these findings, highlighting its effect on serum and salivary testosterone levels. While differences from placebo were not statistically significant across all measures, subgroup analyses showed notable improvements in those receiving 600-1800 mg/day. The enrichment of TrigozimR with zinc and vitamin D may contribute to its metabolic benefits, as evidenced by significant increases in plasma zinc and 25(OH)D levels. The formulation’s safety was affirmed by stable liver and kidney markers and the absence of serious adverse effects.[30]
Collectively, these studies suggest that fenugreek offers a multi-targeted approach-improving insulin sensitivity, lipid metabolism, reproductive hormone regulation, and quality of life. However, variability in formulation, dosage, and population characteristics warrants caution. Larger, longer-duration trials with standardized preparations are needed to validate these promising effects and optimize therapeutic recommendations.
Conclusion
Trigonella foenum-graecum demonstrates strong potential in managing metabolic and hormonal disorders. In T2DM, it significantly improves lipid profiles and supports glycemic control. For women with PCOS, Furocyst supplementation enhances reproductive hormone balance, reduces ovarian volume, and regulates menstrual cycles. In aging men, fenugreek extract and TrigozimR raise testosterone levels and improve sexual health, with added benefits from zinc and vitamin D. All studies reported good safety, with no major adverse effects. Its natural origin, affordability, and accessibility make it especially valuable in resource-limited settings. While results are promising, further large-scale, standardized trials are needed to confirm and refine its clinical use.
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Acknowledgments
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Funding
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Author Information
Corresponding Author:
Samatha Ampeti, PhD
Department of Pharmacology
Kakatiya University, University College of Pharmaceutical Sciences, Warangal, TS, India
Email: ampetisamatha9@gmail.com
Co-Authors:
Mansi Srivastava, Sonam Shashikala BV, Raziya Begum Sheikh, Patel Nirali Kirankumar, Shubham Ravindra Sali
Independent Researcher
Department of Content, medtigo India Pvt Ltd, Pune, India
Authors Contributions
All authors contributed to the conceptualization, investigation, and data curation by acquiring and critically reviewing the selected articles. They were collectively involved in the writing – original draft preparation and writing – review & editing to refine the manuscript. Additionally, all authors participated in the supervision of the work, ensuring accuracy and completeness. The final manuscript was approved by all named authors for submission to the journal.
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Conflict of Interest Statement
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