Ceylon cinnamon
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| Summary | |
|---|---|
| Binomial | Cinnamomum verum J.Presl |
| Family | Lauraceae |
| Common names | Ceylon cinnamon, true cinnamon, kurundu (Sinhala), karuvapatta (Tamil), tvak (Sanskrit, "bark"), dalchini (Hindi), darchini (Persian and Urdu), qirfa or dar-cini (Arabic), kayu manis (Indonesian and Malay, "sweet wood"); the synonymic binomial Cinnamomum zeylanicum Blume is widely used in older botanical and pharmacopoeial literature |
| Native range | Sri Lanka and the Malabar coast of southwestern India; cultivated also in the Seychelles, Madagascar, Java, Sumatra, southern India, and parts of the Caribbean |
| Cultivars / varieties | grade-based rather than cultivar-based: from the highest grade Alba (small, thin, tightly rolled sticks of the finest quality) through C5, C4, M5, M4, M, H1, H2 in decreasing order of stick uniformity, color, and aromatic potency; Cinnamomum loureirii (Saigon cinnamon, Vietnam) and Cinnamomum burmannii (Indonesian cinnamon, Java) are different species frequently sold under the generic "cinnamon" name in the American market, neither of them C. verum |
| Parts used | inner bark of coppiced young branches (the characteristic multi-layered quill scrolls or "stick" form); the leaf (Ceylon leaf essential oil is eugenol-dominant and distinct in flavor and pharmacology from the cinnamaldehyde-dominant bark oil); the root bark, camphor-rich, used historically |
| Cultivation | tropical lowland to mid-elevation evergreen tree to 10 to 15 m at full size but maintained as coppice in plantation production; trees are cut to stumps at two to three years and the resulting straight new shoots are harvested every 18 to 24 months for the inner bark; bark stripping is a specialized craft (the outer cork and green outer cambium are scraped away, and the inner bark separates as it dries and curls into the multi-quill scrolls) |
| Pharmacy | |
| Preparations | bark powder 1 to 4 g daily (the culinary and traditional therapeutic form); bark essential oil 0.05 to 0.2 mL daily (concentrated, used dilute, never undiluted on skin or mucosa); infusion 0.5 to 1 g per cup, three times daily; tincture 1:5 in 70 percent alcohol, 2 to 4 mL three times daily; leaf essential oil (eugenol-dominant) for topical dental and flavoring use; aqueous extract for some glycemic-effect supplement formulations |
| Pregnancy | culinary doses safe; therapeutic-dose supplementation or essential oil caution |
| Legal status | unscheduled; GRAS for culinary use; widely sold worldwide as culinary spice and as dietary supplement |
| Pharmacology | |
| Active constituents | cinnamaldehyde 65 to 80 percent of bark essential oil (the principal pungent and antimicrobial component); eugenol 5 to 10 percent of bark essential oil (the Ceylon-distinctive marker, contributing a clove-like aromatic note; cassia bark oil contains less than 1 percent eugenol); coumarin trace, typically below 0.004 percent of bark dry weight (contrasting sharply with cassia at 0.4 to 4 percent, the basis of the cassia hepatotoxicity concern that does not apply to Ceylon); cinnamyl acetate, cinnamyl alcohol, beta-caryophyllene, linalool, alpha-pinene; proanthocyanidins (the type A doubly-linked condensed-tannin oligomers characteristic of Cinnamomum); MHCP (methylhydroxychalcone polymer, the putative insulin-mimetic, identified primarily in cassia with variable presence in verum); cinnamic acid and derivatives |
| Mechanism (summary) | cinnamaldehyde and eugenol produce broad-spectrum antimicrobial effect through membrane disruption and thiol-disulfide exchange with bacterial enzymes; proanthocyanidins provide astringent gut-mucosa stabilization (the basis of the mild antidiarrheal traditional use); MHCP and other cinnamon constituents have been proposed to enhance insulin-receptor autophosphorylation and downstream glycogen-synthase signaling, providing the mechanistic rationale for the modest hypoglycemic effect (the evidence base is dominated by cassia studies and the mechanism is incompletely characterized); cinnamaldehyde is a TRPA1 ion-channel agonist, accounting for the characteristic warmth-and-pungency sensation |
Ceylon cinnamon is the dried inner bark of Cinnamomum verum J.Presl, a small evergreen tree of the Lauraceae native to Sri Lanka and the Malabar coast of southwestern India. The species is the original "true" cinnamon of antiquity and stands in commercial and pharmacological contrast to its better-known relative Cinnamomum cassia (Chinese cinnamon, the dominant supermarket cinnamon of the modern English-speaking world), with which it has been confused since Greek antiquity and which carries a substantially higher coumarin content and a corresponding chronic-intake hepatotoxicity concern that Ceylon cinnamon does not share. The bark has been an article of long-distance trade since the second millennium BCE, documented in Egyptian, Hebrew, Greek, Roman, Sanskrit, Arabic, and Persian sources as a costly imported spice whose botanical origin was deliberately obscured by the Arab and Sinhalese merchants who controlled the trade. Herodotus, writing in the fifth century BCE in the third book of his Histories, reported that cinnamon "comes from countries unknown to us" and circulated the trade-secret legend (which he did not himself credit) that the sticks were gathered from the nests of giant birds in the cliffs of Arabia. The Hebrew Bible includes cinnamon (qinnamon) and cassia (qiddah) among the ingredients of the sacred anointing oil prescribed in Exodus thirty, alongside myrrh and calamus; lists cinnamon among the perfumes of the bridal bed in the Song of Songs; and counts it among the cargoes of the merchants of Tyre in the prophecy of Ezekiel. Dioscorides, in book one of his De Materia Medica of about 60 CE, distinguished kinnamomon (true cinnamon, the Ceylon product) from kasia (cassia) and ranked the former among the most valued and most adulterated of all imported spices. The botanical separation of the two species was not formally settled until the eighteenth and nineteenth centuries, by which time the cinnamon trade had passed successively through Sinhalese, Portuguese, Dutch, and British control, and the term "cinnamon" had become commercially ambiguous in a way that persists to the present day.
History and traditional use
The earliest documented use of cinnamon is in the trade goods, perfumes, and sacred preparations of the ancient Near East, where the spice arrived by sea from Sri Lanka and the southern Indian coast via the Arabian peninsula at a time when neither the Egyptian nor Hebrew civilizations had any direct contact with the Indian Ocean source. The Hebrew Bible names cinnamon (qinnamon) and cassia (qiddah) separately among the ingredients of the holy anointing oil prescribed in Exodus chapter thirty, alongside myrrh and calamus, and lists cinnamon among the perfumes of the bridal bed in the Song of Songs (chapter four, verse fourteen) and among the cargoes of the merchants of Tyre in the prophecy of Ezekiel (chapter twenty-seven). The Egyptian medical and aromatic record is fragmentary on cinnamon because the spice arrived through intermediaries who concealed its source, but cinnamon-like bark aromatics appear in the embalming and incense formulations of the New Kingdom and Late Period.[1][2]
The Greek tradition documented cinnamon as kinnamomon and the related but distinct cassia as kasia. Theophrastus in his Enquiry into Plants of about 300 BCE distinguished the two and noted both as imported from "Arabia" (the geographical knowledge of the period treating the Arabian peninsula as the source rather than the Indian Ocean origin beyond it). Dioscorides in book one of his De Materia Medica of about 60 CE listed cinnamon as warming, digestive, diuretic, and emmenagogue, prescribed for chronic cough, indigestion, and bites of venomous animals; he also recorded the principal adulterants and methods of detection, an indication of how valuable the genuine product had become.[3] Pliny the Elder in book twelve of his Naturalis Historia (first century CE) gave the most extensive ancient account of cinnamon, devoting several chapters to the spice and its trade; he debunked the bird-nest story circulated by Herodotus as a merchant fiction, recorded the price of genuine cinnamon at fifteen hundred denarii per Roman pound during the reign of Nero (an extraordinary sum, several times the annual wage of a soldier), and reported with characteristic moralizing disapproval that Nero burnt a year's harvest of Arabian aromatics at the funeral of his wife Poppaea Sabina in 65 CE as a gesture of grief.[4] The cinnamon of Roman use crossed the eastern Mediterranean trade routes from the Indian Ocean and reached the empire at very high cost; the commodity is among those whose Indian Ocean origin Pliny and his contemporaries had begun to suspect, though the actual route remained a closely guarded trade secret.
The Islamic and Persian medical traditions documented cinnamon as qirfa (Arabic) and dar-cini (literally "Chinese wood," Persian), reflecting an Iranian-mediated trade route that named the spice by its eastern direction without (initially) distinguishing the Ceylon and Chinese species. Avicenna (Ibn Sina) in book two of his Canon of Medicine of about 1025 CE listed cinnamon as warming in the second degree, drying in the third, indicated for chronic cough, asthmatic complaints, dyspepsia, vomiting, and as a strengthener of weak constitutions; he distinguished the higher-grade darchini-yi-suluqi (the Sri Lankan product, prized for delicacy) from inferior grades, an indication that the species distinction was practically (if not botanically) understood within the Unani tradition.[5] Cinnamon entered the Unani tradition of South Asia by the mediation of Islamic medicine and remains a standard simple in the Unani pharmacopoeia of Pakistan and northern India to the present.
The Ayurvedic tradition documented cinnamon bark as tvak in the Charaka Samhita and Sushruta Samhita (the foundational Ayurvedic texts compiled in the early centuries of the common era), with the related leaf as tejpata (botanically Cinnamomum tamala, a distinct species, the Indian bay leaf) and the root bark as a separate aromatic.[6] Tvak is classed as warming, deepana (kindling the digestive fire), pachana (digestive), and kapha-vata-shamaka (pacifying the cold-and-damp and cold-and-windy doshas), and is included in classical formulations for chronic cough (kasa), indigestion (agnimandya), polyuric sweet-urine disease (madhumeha, the classical Ayurvedic recognition of diabetes mellitus), and as a flavoring synergist in many compound preparations.[7]
The Chinese tradition uses several species of Cinnamomum, but the central TCM cinnamon is C. cassia rather than C. verum: cassia bark (rou gui) is the chief warming yang herb of the Chinese materia medica, and the cassia twig (gui zhi) is the surface-resolving herb of the foundational Han dynasty formula tradition. Ceylon cinnamon is not part of the formal TCM materia medica; its use in Chinese herbal pharmacy is recent and chiefly through imported and Western-influenced practice.[8] The clinical implication is that "cinnamon" in TCM context almost invariably means cassia, with its characteristic high coumarin content; a patient who substitutes Ceylon for cassia in a classical formula is altering the chemistry substantively (much less coumarin, but also a somewhat different cinnamaldehyde-eugenol balance), and the substitution is reasonable in modern Western-influenced practice but is not a like-for-like exchange.
The medieval European tradition received cinnamon as the most expensive of the long-distance spice imports, with the Venetian and (later) Genoese merchants controlling the European trade and the Arab middlemen controlling the source. Hildegard von Bingen in her Physica of the twelfth century listed cinnamon as warming and aromatic, prescribed for chronic cough, melancholy, and digestive weakness.[9] Nicholas Culpeper in The English Physitian of 1652 wrote of cinnamon as an herb of the sun and prescribed it for chronic cough, weak digestion, and as a uterine-supporting aromatic in difficult labor; Culpeper noted that the genuine "Cinnamon of Ceylon" was hard to obtain and frequently adulterated, an observation that recurs throughout the European pharmacopoeial literature of the period.
The botanical home of Ceylon cinnamon is the wet coastal lowlands of southwestern Sri Lanka, where the species grows wild and where cultivated plantation production has been the principal export industry for five centuries. The Portuguese reached Ceylon in 1505 and within a generation had secured control of the cinnamon-producing coast through a combination of treaty with the Kingdom of Kotte and military pressure on the neighboring kingdoms. The Portuguese-Sinhalese cinnamon monopoly lasted until 1640, when the Dutch East India Company (Verenigde Oostindische Compagnie) supplanted the Portuguese and intensified plantation cultivation, introducing systematic coppice management and quality grading; the Dutch period produced the high-grade product that established Ceylon cinnamon as the international standard. The British took the colony from the Dutch in 1796 and within a generation ended the strict cinnamon monopoly that had supported the Portuguese and Dutch colonial budgets, opening Ceylon to broader colonial development and allowing cinnamon cultivation to expand to the Seychelles, Madagascar, and other tropical British possessions.[10] The botanical separation of Cinnamomum verum from Cinnamomum cassia was settled in the eighteenth and nineteenth centuries against this background of colonial commerce; the species name verum (Latin "true") encodes the European pharmacopoeial preference of the period for the Ceylon product over the cheaper Chinese cassia.
The modern Western pharmacopoeial tradition recognizes cinnamon (Cinnamomi cortex) in both Ceylon and cassia forms, with most modern monographs distinguishing the two species and treating the cassia coumarin content as the principal safety consideration. The German Commission E approved cinnamon bark for loss of appetite and dyspepsia at daily doses of 2 to 4 g of bark or 0.05 to 0.2 g of essential oil, without distinguishing between species in the published monograph.[11] The European Medicines Agency Committee on Herbal Medicinal Products issued separate monographs for Cinnamomum verum bark and Cinnamomum cassia bark, with the cassia monograph carrying a specific coumarin-intake warning that the verum monograph does not.[12] The contemporary controlled-trial literature on cinnamon for type 2 diabetes is mixed: meta-analyses have produced positive findings (modest reductions in fasting glucose), null findings, and intermediate findings, with the trial populations mostly receiving cassia or mixed/unspecified species rather than Ceylon-specific preparations.[13] Where the observational and short-trial evidence has supported the glycemic-effect claim, larger and more recent randomized trials have tended toward modest or null effect, and the most rigorous meta-analyses note substantial between-study heterogeneity and a substantial risk-of-bias profile in the underlying literature. The Ceylon-specific glycemic-effect evidence base is sparse, and the modest clinical recommendation to consider cinnamon for diabetic glycemic adjunct rests primarily on cassia evidence; Ceylon is the safer cinnamon for chronic intake (because of the coumarin distinction) but is not the cinnamon best supported by the glycemic-effect trial literature.
Botany and identification
Cinnamomum verum is an evergreen tree of the Lauraceae reaching 10 to 15 m at full size in undisturbed forest but maintained as coppice bushes of 2 to 3 m in plantation production. The leaves are opposite, elliptic to ovate, 7 to 18 cm long and 3 to 10 cm wide, with three (occasionally five) prominent palmate-pinnate veins running from the base to near the leaf apex (the characteristic Cinnamomum venation pattern). Young leaves are pinkish-red, deepening to dark glossy green with maturity. The bark of mature trunks is rough, fissured, and grey-brown; the medicinally used bark is the smooth, light-tan inner bark of two-to-three-year-old coppice shoots, scraped of the outer corky layer and dried to form the multi-layered quill scrolls. The flowers are small (5 to 6 mm), greenish-yellow, in lax panicles; the fruit is a small ellipsoid drupe 1 to 2 cm long, ripening dark purple-blue, single-seeded. The whole plant is aromatic in all parts, with cinnamaldehyde dominant in the bark and eugenol dominant in the leaf, reflecting the chemotype divergence between bark oil and leaf oil that is characteristic of the species. Distinguished from Cinnamomum cassia (Chinese cinnamon, the most likely confusion in commerce) by leaf venation (three prominent veins in verum, five in cassia), by bark structure (multi-layered thin quill in verum, single-layer thick quill in cassia), and by bark color (light tan in verum, darker red-brown in cassia); these distinctions hold for whole-stick material and are lost in ground powder, where chemical or spectroscopic distinction is required.
Active constituents
The principal medicinally active constituents of Ceylon cinnamon bark are the volatile oil (3 to 4 percent of dry bark by weight) and the proanthocyanidin polyphenol fraction. The volatile oil composition is the principal pharmacognostic distinction between Ceylon and the related cassia species: Ceylon bark oil contains cinnamaldehyde at 65 to 80 percent of the oil, eugenol at 5 to 10 percent, and coumarin at trace amounts (typically below 0.004 percent of bark dry weight, at the analytical detection limit in some studies), with smaller amounts of cinnamyl acetate, cinnamyl alcohol, beta-caryophyllene, linalool, and alpha-pinene. Cinnamomum cassia bark oil, by contrast, contains cinnamaldehyde at 75 to 90 percent of the oil, eugenol below 1 percent, and coumarin at 0.4 to 4 percent of bark dry weight (the basis of the chronic-intake hepatotoxicity concern that applies to cassia and not to Ceylon).[14] The chemotype distinction is the practical fingerprint by which the two species are distinguished in modern pharmacopoeial quality control.
The Ceylon leaf essential oil is chemotypically distinct from the bark oil: eugenol at 70 to 95 percent dominates, with cinnamaldehyde at low percentage and a different aromatic profile (clove-like rather than warm-sweet). The Ceylon leaf oil is the basis of some natural eugenol production for dental and flavoring applications.
The non-volatile fraction includes proanthocyanidins, particularly the type A doubly-linked oligomers that are characteristic of Cinnamomum and that contribute to the astringent gut-mucosa effect and the antioxidant capacity of cinnamon extracts; cinnamic acid and its derivatives (cinnamyl alcohol, cinnamyl acetate, methyl cinnamate); and MHCP (methylhydroxychalcone polymer, the proposed insulin-mimetic identified primarily in cassia and variably in verum). Cinnamic acid and its derivatives are aromatic but contribute less to the characteristic warmth-and-pungency of the bark than cinnamaldehyde does.
Preparations
The traditional therapeutic forms are the whole bark (the multi-quill stick, used in decoction or infusion at 0.5 to 1 g per cup, three times daily); the bark powder (ground from whole stick, 1 to 4 g daily, in honey or warm water for digestive complaint, or sprinkled on food for the carminative effect); the tincture (1:5 in 70 percent alcohol, 2 to 4 mL three times daily, the Western herbalist's form); the essential oil from bark (steam-distilled, used at 0.05 to 0.2 mL daily, diluted in carrier oil for topical use or in capsule form internally, never undiluted on skin or mucosa given the cinnamaldehyde concentration); and the aqueous extract (used in some glycemic-effect supplement formulations to concentrate the polyphenol fraction while reducing essential-oil content). The leaf essential oil (eugenol-dominant) is used externally for dental analgesia and toothache (similar role to clove oil) and as a flavoring component. Whole sticks store well in dry conditions for years with gradual loss of volatile oil potency; ground powder loses aromatic intensity within months and is best ground at use from whole stick when therapeutic potency matters.
Pharmacokinetics
Cinnamaldehyde is rapidly absorbed from the gastrointestinal tract and rapidly oxidized to cinnamic acid and then conjugated to hippuric acid (the principal urinary metabolite); elimination of the cinnamaldehyde-derived metabolites is largely complete within 24 hours of administration. Eugenol is similarly rapidly absorbed and conjugated, with biliary and urinary excretion. Coumarin (in trace amounts from Ceylon, or substantial amounts from cassia) is absorbed and metabolized hepatically via CYP2A6 to 7-hydroxycoumarin and via a smaller fraction to 3-hydroxycoumarin; the chronic hepatotoxicity of cassia coumarin at high intake involves the 3-hydroxycoumarin pathway and the variable individual susceptibility of CYP-mediated metabolism, which is the basis of the rare-but-real cassia hepatotoxicity case reports. Ceylon's negligible coumarin content places it well outside the relevant exposure range at any realistic intake.
Pharmacodynamics
Cinnamaldehyde is a TRPA1 ion-channel agonist, accounting for the characteristic warming-and-pungent sensation of cinnamon on the tongue and gut mucosa and contributing to the carminative effect through smooth-muscle modulation and gastric motility effect. Cinnamaldehyde and eugenol both produce broad-spectrum antimicrobial effect against bacteria, fungi (including Candida species), and some viruses, mediated by membrane disruption and thiol-disulfide exchange with bacterial enzymes; the antifungal effect against Candida is the basis of the traditional and modern dental and oral-hygiene indication. The proanthocyanidins of cinnamon are potent in vitro antioxidants and produce astringent gut-mucosa stabilization, the mechanistic basis of the mild antidiarrheal effect. The glycemic effect of cinnamon (insofar as it is real at clinically relevant intake) has been proposed to involve MHCP enhancement of insulin-receptor autophosphorylation and downstream glycogen-synthase signaling, but the mechanistic literature is incomplete and the trial-level effect is modest; the role of cinnamon in type 2 diabetes management is a useful adjunctive at best, not a primary intervention.
Experience
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Problems
Carminative and digestive aid for postprandial bloating, mild dyspepsia, and flatulence (the principal Commission E and EMA HMPC indication). Mild antidiarrheal effect from the proanthocyanidins (astringent gut-mucosa stabilization). Antimicrobial use, traditionally for oral hygiene and mild upper respiratory complaint. Adjunctive for glycemic control in type 2 diabetes mellitus, with the caveat that most controlled-trial evidence is from cassia or mixed/unspecified species and Ceylon-specific evidence is sparser; the effect, where present, is modest. Folk indications: warming for cold-pattern complaint, dysmenorrhea (mild emmenagogue), and as a flavoring synergist that improves the palatability and acceptance of bitter herbal formulations. Topical leaf oil for dental analgesia and gingivitis. Not a first-line indication for any major condition; the role of cinnamon in modern Western practice is as a culinary spice with mild medicinal benefit, a Commission-E-approved digestive support, and an occasional adjunctive in diabetic supplement regimens.
Titration and dosing
Bark powder: 1 to 4 g daily, divided. Whole bark in decoction or infusion: 0.5 to 1 g per cup, three times daily. Bark essential oil: 0.05 to 0.2 mL daily, diluted; never undiluted on skin or mucosa. Tincture 1:5 in 70 percent alcohol: 2 to 4 mL three times daily. For glycemic-effect supplementation: 1 to 6 g of cinnamon (mixed species in most trials) daily has been the typical trial range; Ceylon-specific dosing recommendations are sparse and follow the bark-powder range above. Topical leaf oil for dental use: single drop on cotton pellet, brief contact only.
Effects
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Interactions
The clinically significant interactions of Ceylon cinnamon are modest in number and degree. Modest hypoglycemic potentiation with insulin and oral antidiabetic medicines is the principal pharmacodynamic interaction; the effect is small at culinary doses, somewhat more substantial at therapeutic-dose supplementation, and the trial evidence is dominated by cassia rather than Ceylon studies. Patients on antidiabetic regimens who add cinnamon supplementation should monitor for hypoglycemia, particularly during dose titration of the antidiabetic medicine.
The cassia-coumarin hepatotoxicity concern (chronic high dietary cassia intake, particularly the powdered form in baked goods, can exceed the European Food Safety Authority tolerable daily intake of 0.1 mg/kg coumarin at common American consumption levels in heavy users) does not apply to Ceylon, where the coumarin content is too low to be clinically relevant at any reasonable intake. This is the principal safety distinction between the two cinnamons and the principal reason a prescriber concerned about chronic high-intake cinnamon should specify Ceylon.
The widely repeated concern that cinnamon potentiates warfarin or other anticoagulants appears to be an extrapolation from the cassia-coumarin content combined with a misunderstanding of coumarin pharmacology: the coumarin of cinnamon is the parent 2H-1-benzopyran-2-one compound, not the 4-hydroxycoumarin (warfarin) class, and lacks direct anticoagulant activity in either species. The interaction is theoretical at best and has not been substantively documented in case reports or pharmacokinetic studies; no specific preoperative discontinuation recommendation is necessary for Ceylon cinnamon at culinary or supplementation doses.
Pregnancy and lactation
Culinary amounts of Ceylon cinnamon are considered safe in pregnancy and lactation, with a long historical record of routine use in essentially all cinnamon-using cultures. Therapeutic-dose supplementation (multi-gram daily for glycemic effect, or essential oil for any indication) has not been formally studied in pregnancy and is best avoided; the traditional caution about medicinal cinnamon in pregnancy derives from the emmenagogue use in late-pregnancy difficult labor (the Culpeper indication, in the European tradition) and the warming-doshic concern in Ayurveda. The Ayurvedic and Unani traditions allow culinary cinnamon throughout pregnancy and add medicinal doses postpartum for the standard postnatal warming, digestive, and lactation-supporting roles.
Monitoring
For patients on insulin or oral antidiabetic medicines who add cinnamon supplementation at therapeutic dose, fasting glucose monitoring at baseline and at two to four weeks of regular supplementation is the conservative practice; no monitoring is required for culinary use.
Patient counseling
The most important counseling distinction for cinnamon is the species. The cinnamon sold as a culinary spice in most American grocery stores and used in commercial baked goods is C. cassia (Chinese cinnamon, the higher-coumarin species), not C. verum (Ceylon cinnamon, the lower-coumarin species). For patients consuming cinnamon at routine culinary levels (gram or fraction of gram per day, sprinkled on food), the coumarin exposure from cassia is unlikely to reach the tolerable daily intake threshold; for patients consuming cinnamon at therapeutic supplementation levels (multi-gram daily, particularly the powdered form in capsules) or at high dietary levels (large quantities in baked goods, or the social-media "cinnamon challenge" of swallowed dry powder), the coumarin exposure from cassia can substantially exceed safe daily intake, and the Ceylon species is the appropriate choice.
The visual distinction between Ceylon and cassia is possible with whole sticks but lost in ground powder. Ceylon cinnamon is light tan in color, composed of many thin papery layers tightly rolled into a multi-quill scroll, brittle and easily crushed, with a delicate, complex, sweet aroma; cassia is darker reddish-brown, composed of a single thick rigid layer rolled into a hollow tube, hard and resistant to crushing, with a strong, simple, pungent aroma. Patients seeking Ceylon for safety reasons should buy whole sticks (most reliably labeled as "Ceylon" or "true" cinnamon at specialty grocers and Sri Lankan or Indian markets) and grind at use, or buy reputable powdered Ceylon labeled by species rather than by the generic "cinnamon" name.
Cinnamon essential oil (either species) is concentrated and irritating; it should never be applied undiluted to skin or mucosa, and oral consumption of essential oil at more than a few drops daily can produce gastritis, oral mucositis, and (with chronic high-dose cassia oil specifically) hepatotoxicity. Cinnamon chewing-gum stomatitis is a recognized presentation of intra-oral mucosal hypersensitivity to high-concentration cinnamaldehyde, generally resolving on cessation. Contact dermatitis from cinnamon, especially the essential oil and especially cassia, is a regular occupational concern in spice-handling industries and culinary work.
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See also
Cassia cinnamon, Cinnamomum cassia, Ginger, Turmeric, Cardamom, Cloves, Garlic
References
- ↑ Hebrew Bible, Exodus 30:23-25 (the holy anointing oil); Song of Songs 4:14 (perfumes of the bridal bed); Ezekiel 27:19 (cargoes of the merchants of Tyre).
- ↑ Miller JI. The Spice Trade of the Roman Empire, 29 B.C. to A.D. 641. Oxford: Clarendon Press; 1969.
- ↑ Beck LY (translator). Pedanius Dioscorides of Anazarbus: De Materia Medica. Hildesheim: Olms-Weidmann; 2005 (translation of c. 60 CE original).
- ↑ Bostock J, Riley HT (translators). Pliny the Elder: The Natural History. London: Taylor and Francis; 1855.
- ↑ Gruner OC (translator). A Treatise on the Canon of Medicine of Avicenna, Incorporating a Translation of the First Book. London: Luzac and Co.; 1930.
- ↑ Sharma PV (translator). Charaka Samhita: Text with English Translation. Varanasi: Chaukhambha Orientalia; 1981.
- ↑ Williamson EM (editor). Major Herbs of Ayurveda. Edinburgh: Churchill Livingstone; 2002.
- ↑ Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd ed. Seattle: Eastland Press; 2004.
- ↑ Throop PM (translator). Hildegard von Bingen's Physica: The Complete English Translation of Her Classic Work on Health and Healing. Rochester, VT: Healing Arts Press; 1998 (translation of twelfth-century original).
- ↑ de Silva KM. A History of Sri Lanka. London: C. Hurst and Co.; 1981.
- ↑ Blumenthal M, Goldberg A, Brinckmann J (editors). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
- ↑ European Medicines Agency, Committee on Herbal Medicinal Products. Community herbal monograph on Cinnamomum verum J. S. Presl, cortex and Community herbal monograph on Cinnamomum cassia (L.) D. Don, cortex (paired HMPC monographs). Available at https://www.ema.europa.eu/en/medicines/herbal.
- ↑ Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Annals of Family Medicine. 2013 Sep-Oct;11(5):452-459. PMID 24019277.
- ↑ Wang YH, Avula B, Nanayakkara NP, Zhao J, Khan IA. Cassia cinnamon as a source of coumarin in cinnamon-flavored food and food supplements in the United States. Journal of Agricultural and Food Chemistry. 2013 May 8;61(18):4470-4476. PMID 23627682.