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Bilimbi

Averrhoa bilimbi

Sour tropical fruit; kidney-risk oxalate bomb

Preliminary evidence 🍎Fruits

✚ Updated · How we grade evidence

Evidence tier
Preliminary
Research weight
Citations
10 verified / 10
Classification
Fruits
❝
What the evidence says. Early or small human trials; promising but not yet conclusive.

Nutrition per serving About 5 fruits (50 g)

50gSERVING
  • Water 46.6 g94%
  • Sugars 1 g2%
  • Fibre 0.3 g1%
  • Other carbs 1.2 g2%
  • Protein 0.4 g1%
  • Fat 0.2 g0%
What's in one serving, by weight — average composition (USDA).
Vitamin C26%Iron9%Fiber1%Calcium0%Magnesium1%Manganese6%
One serving as % of the adult daily requirement (FDA Daily Values). The bold outer ring = 100% of a day's needs.
13 kcal0.36 g protein0.3 g fiber0.16 g fat
NutrientPer serving% daily value
Vitamin C24 mg26%
Iron1.6 mg9%
Fiber0.3 g1%
Calcium3.2 mg0%
Magnesium2.6 mg1%
Manganese0.13 mg6%
Beta-carotene80 µg1%
Oxalic acid500 mg0%

Composition data: USDA FoodData Central ↗

What is Bilimbi?

Bilimbi (Averrhoa bilimbi) is a fruit used for vitamin c / antioxidant source. NutriDex grades the human evidence as Preliminary. Bilimbi is an intensely sour Southeast Asian fruit traditionally used as a culinary acidulant and folk remedy for diabetes, hypertension and inflammation. It is genuinely rich in vitamin C (around 48 mg/100 g) and contains flavonoids, phenolics and carotenoids that show antioxidant, antimicrobial and antidiabetic activity in vitro. The most cited pharmacology comes from rodent studies: ethanolic leaf extract lowered blood glucose ~50%, lowered triglycerides and raised HDL in streptozotocin-diabetic rats, and fruit fractions attenuated hyperglycemic oxidative stress comparably to metformin. However, there are essentially no human clinical trials for any of these benefits, so efficacy in people is unproven. The dominant human evidence is in fact harm: multiple case reports and a 10-patient case series document acute oxalate nephropathy and kidney failure after drinking concentrated bilimbi juice, owing to its very high oxalic-acid content (the fruit is roughly 0.8–1.5% oxalic acid by weight, among the highest of common fruits). As a small culinary garnish the fruit is generally fine, but it should not be treated as a supplement or consumed as concentrated juice, especially on an empty stomach or by anyone with kidney disease.

Purported Benefits

✓Vitamin C / antioxidant source
✓Blood-glucose lowering (animal data only)
✓Lipid-lowering & HDL-raising (animal data only)
✓Antihypertensive effect (preclinical)
✓Antimicrobial activity (in vitro)
✓Anti-inflammatory potential (preclinical)

Dosing & Compounds

Typical Dose
A few fruits (~5–50 g) used as a souring agent in cooking; no established therapeutic dose. Concentrated juice should be avoided.
Active Compounds
Ascorbic acid (vitamin C)Oxalic acid (very high; predominant organic acid)Flavonoids (e.g. luteolin, apigenin glycosides)Phenolic acids & tanninsTriterpenes and saponins (leaf)Carotenoids (beta-carotene, beta-cryptoxanthin)Organic acids (citric, malic)Volatiles (palmitic acid, 2-furaldehyde)

Safety & Cautions

Extremely high oxalic-acid content: laboratory analyses report roughly 8.5–14.7 mg/g (≈850–1,470 mg per 100 g of fruit), with oxalic acid making up 90–95% of total fruit acids and far higher concentrations in pressed juice. Drinking the juice—particularly fasting, dehydrated, or in large amounts—has caused acute oxalate nephropathy and acute kidney injury, with several reported patients requiring dialysis. Avoid in chronic kidney disease, prior kidney stones, dehydration, or with nephrotoxic drugs. Theoretical additive effects with antidiabetic and antihypertensive medications. Use only as a small culinary souring agent, not as a supplement or juice. Educational only — always check with your doctor or pharmacist before combining Bilimbi with any medicine.

Key Studies ★ 10 studies

Compositional study Ferreira 2022 ✓ Source
Compositional analysis of family-farmed bilimbi: 93.2 g water, 25.4 kcal, 47.6 mg vitamin C and 3.21 mg iron per 100 g, confirming high vitamin C and low energy.
Compositional study Carambola/Bilimbi acid analysis 1991 ✓ Source
Oxalic acid in bilimbi fruit measured at 8.45–10.8 mg/g (ripe) and 10.5–14.7 mg/g (green), comprising 90–95% of total acids—among the highest of common fruits.
Narrative review Alhassan 2016 ✓ Full text
Review of A. bilimbi ethnomedicine, phytochemistry and pharmacology: documents antidiabetic, antihypertensive, antioxidant and antimicrobial activity—almost entirely preclinical, with no human clinical trials.
Case report Wong 2021 ✓ Full text
34-year-old man developed acute kidney injury after eating ~1 kg of bilimbi fruit; recovered fully with supportive care WITHOUT dialysis, reinforcing oxalate-nephropathy risk from the fruit itself.
Case report Miah 2018 ✓ PubMed
Acute oxalate nephropathy and AKI after bilimbi fruit juice ingestion, with full recovery on conservative management.
Case series Bakul 2013 ✓ Full text
Case series of 10 patients in Kerala who developed acute renal failure after drinking concentrated bilimbi juice; 7 required hemodialysis, 3 recovered conservatively, attributed to calcium-oxalate tubular deposition (fruit oxalate measured at 25.1 mg/100 g).
Case report Nair 2014 ✓ PubMed
Two patients developed acute kidney injury with biopsy-confirmed tubular oxalate deposition after ingesting Averrhoa bilimbi juice; both recovered, one needing dialysis.
Animal study Kurup 2016 ✓ Full text
Ethyl-acetate fruit fraction (25 mg/kg, 60 d) lowered serum glucose and HbA1c and raised insulin in STZ-diabetic rats, attenuating oxidative stress comparably to (or better than) metformin.
Animal study Pushparaj 2000 ✓ PubMed
Ethanolic A. bilimbi leaf extract lowered blood glucose ~50% and triglycerides ~130%, and raised HDL ~60% in streptozotocin-diabetic rats.
Animal study Tan 2005 ✓ PubMed
Semi-purified aqueous fraction of A. bilimbi (125 mg/kg) lowered blood glucose and triglycerides and raised hepatic glycogen in high-fat-diet/STZ diabetic rats.
10 sources cited · 10 verified Search all studies on PubMed ↗

Common questions about Bilimbi

What is Bilimbi used for?

Bilimbi is most often taken for Vitamin C / antioxidant source, Blood-glucose lowering (animal data only), Lipid-lowering & HDL-raising (animal data only), Antihypertensive effect (preclinical). Sour tropical fruit; kidney-risk oxalate bomb

Does Bilimbi work — what does the evidence say?

Preliminary evidence. Early or small human trials; promising but not yet conclusive. Bilimbi is an intensely sour Southeast Asian fruit traditionally used as a culinary acidulant and folk remedy for diabetes, hypertension and inflammation. It is genuinely rich in vitamin C (around 48 mg/100 g) and contains flavonoids, phenolics and carotenoids that show antioxidant, antimicrobial and antidiabetic activity in vitro. The most cited pharmacology comes from rodent studies: ethanolic leaf extract lowered blood glucose ~50%, lowered triglycerides and raised HDL in streptozotocin-diabetic rats, and fruit fractions attenuated hyperglycemic oxidative stress comparably to metformin. However, there are essentially no human clinical trials for any of these benefits, so efficacy in people is unproven. The dominant human evidence is in fact harm: multiple case reports and a 10-patient case series document acute oxalate nephropathy and kidney failure after drinking concentrated bilimbi juice, owing to its very high oxalic-acid content (the fruit is roughly 0.8–1.5% oxalic acid by weight, among the highest of common fruits). As a small culinary garnish the fruit is generally fine, but it should not be treated as a supplement or consumed as concentrated juice, especially on an empty stomach or by anyone with kidney disease.

What is the typical dose of Bilimbi?

A few fruits (~5–50 g) used as a souring agent in cooking; no established therapeutic dose. Concentrated juice should be avoided.

Is Bilimbi safe? Any cautions or side effects?

Extremely high oxalic-acid content: laboratory analyses report roughly 8.5–14.7 mg/g (≈850–1,470 mg per 100 g of fruit), with oxalic acid making up 90–95% of total fruit acids and far higher concentrations in pressed juice. Drinking the juice—particularly fasting, dehydrated, or in large amounts—has caused acute oxalate nephropathy and acute kidney injury, with several reported patients requiring dialysis. Avoid in chronic kidney disease, prior kidney stones, dehydration, or with nephrotoxic drugs. Theoretical additive effects with antidiabetic and antihypertensive medications. Use only as a small culinary souring agent, not as a supplement or juice.

How many studies support Bilimbi?

NutriDex cites 10 sources for Bilimbi, graded "Preliminary".

Cite this page
APA

Peh, D. (2026). Bilimbi (Averrhoa bilimbi): Benefits, Dosage, Side Effects & Evidence. NutriDex — The Supplement Research Compendium. Retrieved 26 Jun 2026, from https://nutridex.info/s/bilimbi

BibTeX
@misc{nutridex_bilimbi,
  author       = {Peh, Daryl},
  title        = {Bilimbi (Averrhoa bilimbi): Benefits, Dosage, Side Effects \& Evidence},
  year         = {2026},
  howpublished = {NutriDex --- The Supplement Research Compendium},
  url          = {https://nutridex.info/s/bilimbi},
  note         = {Reviewed by Dr Daryl Peh, MBBS Singapore, MMed FM. Accessed 2026-06-26}
}

For medical claims, citing the underlying primary studies linked above is preferred. NutriDex is an educational reference, not medical advice.

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