# Fenugreek: New Therapeutic Resource or Emerging Allergen?
## 4 Discussion  
### Fenngreek Is a Pharmaceutical Product  
The advent of phytotherapeutic products is increasing the trade of substances for medicinal and preventive purposes and in daily and household use. Phytotherapeutic extracts, however, precisely because of their medicinal capabilities, are, to all intents and purposes, substances with their own pharmacodynamics and pharmacokinetics, with the possibility of drug interactions and the occurrence of adverse and undesirable reactions related to overdose and to the immunological setup of the person taking them. Fenngreek appears to have health benefits, so it may be increasingly used as nutraceutical formulations (powder, herbal teas, tablets, and various combinations). Recent studies have shown the promising uses of fenugreek as a medicinal herb, given the presence of seeds of simple alkaloids, including trigonelline, choline, gentianine, and carpaine. Trigonelline has antidiabetic, lipid-lowering, oestrogenic, neuroprotective, and anti-invasive properties [21; 22]. Fenugreek also contains a significant amount of galactomannan and protein and various substances with antitumor action: diosigenin, which reduces cardiovascular risks [23] and has chemopre/therapeutic action against various tumors of different organs, such as gingerol, cedrene, zingerone, vanillin, squalene, naringenin, and eugenol. Finally, fenugreek contains substances with antioxidant action, such as vitamins, minerals, and antioxidants, which prevent free-radical-induced cellular damage [24]. Fenugreek extract induces apoptosis of human breast cancer cells expressing MCF-7. The inhibition of cell proliferation is time- and dose-dependent and could be the result of alterations in the cell death receptor (Fas) pathway [25]. A study on colon cancer cells showed that fenugreek extract exerted only antiproliferative effects on cancer cells, without affecting normal cells. This could be due to the fact that tumor cells express phosphatidylinositolserine on the outer layer of the cell membrane, which acquires a net negative charge that allows electrostatic interaction with the positively charged antitumor peptides of fenugreek [26]. [PERSON] et al. reported that fenugreek has anti-inflammatory activity by reducing the cytotoxicity of fibroblasts via LPS-mediated mechanisms, restoring the levels of antioxidant enzymes such as glutathione and antioxidant enzymes such as glutathione peroxidase, glutathione-S transferase, catalase, and superoxide dismutase [27]. The antioxidant effects of fenugreek have also been demonstrated at cardiac, hepatic, renal, and plasma levels, resulting in improved antioxidant enzyme activity, and are enhanced by its association with onion [28; 29]. The largest number of studies on the pharmacological properties of fenugreek have been conducted in patients with diabetes. Diabetic patients treated with fenugreek showed a significant reduction in fasting blood glucose, blood pressure, and transaminase levels compared with controls. Therefore, fenugreek could promote better control of not only the glycemic profile but also the entire metabolic profile of patients with diabetes, helping to prevent chronic complications of diabetes mellitus, such as reduced renal function [30]. The administration of 25 g of fenugreek for 30 days in patients with type II diabetes resulted in a significant increase in HDL-C and a significant reduction in total cholesterol, LDL-C, and TGs [31]. Fenugreek, an add-on therapy to metformin, also showed greater results in improving glucose metabolism in patients with type II diabetes mellitus than sulfanilurea + metformin combination therapy. A statistically significant improvement in fasting insulin levels in the HOMA-IR and an increase in the HDL/LDL ratio were observed. In addition, a decrease, although not significant, in fasting blood glucose and glycated haemoglobin levels (which were outside the normal range) was observed after three months of combined fenugreek and metformin treatment.