Benefits
Blood pressure: change seen only in a higher-reading subgroup
In a crossover trial of 70 overweight adults with high-normal or high blood pressure, 162 mg a day of quercetin from onion skin extract for 6 weeks did not change 24-hour or office blood pressure in the whole group. In the subgroup with hypertension, 24-hour systolic pressure fell 3.9 mmHg more than on placebo. A single 54 mg dose had no effect, and a Japanese onion powder trial found no change in clinic or home readings.
Artery dilation (endothelial function)
In 72 healthy overweight adults, onion peel extract supplying 100 mg of quercetin a day for 12 weeks raised flow-mediated dilation, a measure of how well an artery widens, from 12.5% to 15.2% within the extract group, with no change on placebo; circulating endothelial progenitor cells also rose. A German trial at 162 mg a day found no change in a different endothelial test.
Blood lipid levels in healthy male smokers
In 92 healthy male smokers, onion peel extract capsules with 100 mg of quercetin a day for 10 weeks lowered total and LDL cholesterol within the extract group but not the placebo group, and HDL cholesterol rose more than on placebo. Blood pressure and glucose also fell within the extract group. Blood lipids did not change in the 6-week German trial at 162 mg a day.
Body fat in overweight adults
In 72 overweight Korean adults, onion peel extract with 100 mg of quercetin a day for 12 weeks lowered body weight and body fat percentage within the extract group but not on placebo. In 70 Japanese adults, quercetin-rich onion powder did not change visceral fat area versus placebo. A Korean steamed onion powder lowered body fat versus placebo in 70 overweight adults.
Quercetin absorption from onion compared with pure quercetin
In 9 volunteers with an ileostomy, about 52% of the quercetin glucosides in fried onions was absorbed, versus 24% of pure quercetin. In 12 healthy adults, an onion skin extract gave about 4.8 times higher blood quercetin exposure than a similar dose of quercetin dihydrate. These studies measured absorption only, not health outcomes.
Memory and mood test scores in healthy older adults
In 70 healthy Japanese adults aged 60 to 79, 24 weeks of quercetin-rich onion powder (about 50 mg of quercetin a day) improved Mini-Mental State Examination scores and emotional function scores compared with quercetin-free onion powder, while a tablet-based total cognitive score did not differ. An earlier 50-person trial by the same group found no overall change in these scores.
Blood sugar, insulin and inflammation markers
In placebo-controlled comparisons these markers did not change. At 162 mg of quercetin a day for 6 weeks, glucose, insulin, leptin, adiponectin, CRP and TNF-alpha did not differ from placebo. In 37 overweight women, 12 weeks of onion peel extract did not change leptin, TNF-alpha or IL-4 versus placebo. Glucose fell within the extract group in one trial of male smokers.
Mechanism of action
Quercetin glucosides are taken up in the small intestine
In ileostomy volunteers, quercetin bound to glucose (as in onion) was absorbed about twice as well as pure quercetin. In a crossover study, an onion supplement behaved like pure quercetin-4'-glucoside, peaking in blood within about 40 minutes, while the rutin form found in tea and buckwheat peaked after 4 to 7 hours. Only conjugated quercetin, not free quercetin, was found in blood.
Blood pressure mechanism not identified in trials
In the 6-week onion skin extract trial, endothelin-1, adhesion molecules, ADMA, ACE activity, endothelial function and markers of oxidation and inflammation did not change, so the small blood pressure fall in the subgroup with hypertension had no measured explanation. The authors state the mechanism remains unclear.
Effects on drug absorption (animal data)
Quercetin has been reported to affect CYP drug-metabolizing enzymes and the P-glycoprotein drug transporter. In rats, onion given by mouth with cyclosporin sharply cut cyclosporin absorption from the gut, while cyclosporin given by injection was unaffected, which points to an interaction at the gut wall.
Clinical trials
Randomized, double-blind, placebo-controlled crossover trial: 162 mg a day of quercetin from onion skin extract powder (three capsules of 54 mg) or placebo for 6 weeks each, with a 6-week washout. Funded by the German Research Foundation. (Brüll et al. 2015, Br J Nutr)
70 overweight-to-obese adults in Germany with pre-hypertension or stage 1 hypertension.
In the whole group, 24-hour ambulatory and office blood pressure did not change versus placebo. In the subgroup with hypertension, 24-hour systolic pressure fell by 3.6 mmHg (treatment difference versus placebo 3.9 mmHg, P = 0.049); day-time and night-time changes were not significant between treatments. Endothelial function, vasoactive markers, lipids, glucose, oxidation and inflammation markers did not change.
Second report from the same randomized, double-blind, placebo-controlled crossover trial (162 mg a day of quercetin from onion skin extract for 6 weeks). (Brüll et al. 2017, Eur J Nutr)
68 of the 70 overweight-to-obese adults randomized in the 6-week crossover trial above (2 dropped out for personal reasons).
Compared with placebo, quercetin did not change leptin, adiponectin, glucose, insulin or HOMA-IR, and neither treatment changed CRP or TNF-alpha. Liver and kidney function tests, blood counts and electrolytes did not differ from placebo, and the authors judged the dose safe over 6 weeks.
Randomized, double-blind, placebo-controlled trial of onion peel extract soft capsules (50 mg quercetin twice daily, 100 mg a day) for 12 weeks. (Choi et al. 2015, Nutrition)
72 healthy overweight and obese adults in Korea (36 extract, 36 placebo).
Flow-mediated dilation rose from 12.5% to 15.2% in the extract group (P = 0.002 versus baseline), with no change on placebo; nitroglycerin-mediated dilation did not change in either group. Endothelial progenitor cell counts rose in the extract group. The abstract reports changes within each group rather than a direct comparison with placebo.
Randomized, double-blind, placebo-controlled parallel trial of quercetin-rich capsules made from onion peel extract (four capsules a day supplying 100 mg of quercetin dihydrate plus 128 mg of other flavonoids of unknown composition) for 10 weeks. (Lee et al. 2011, Nutr Res Pract)
92 healthy male smokers in Korea (49 quercetin, 43 placebo).
Total and LDL cholesterol fell within the quercetin group but not the placebo group. HDL cholesterol rose in both groups, more with quercetin. Systolic and diastolic blood pressure and glucose fell within the quercetin group. IL-6 and sVCAM-1 did not change. Most results are within-group changes, and no adverse effects were reported.
Randomized, double-blind, placebo-controlled parallel trial of onion peel extract capsules supplying 100 mg of quercetin a day (170 mg extract with 50 mg quercetin per capsule) for 12 weeks, funded by a Korean government agri-food research grant. (Lee et al. 2016, Nutr Res Pract)
72 overweight and obese Korean adults (11 men, 61 women).
Body weight and body fat percentage measured by DXA fell in the extract group (P = 0.02) but not in the placebo group. Blood glucose and leptin fell in both groups, and resting energy expenditure rose in both groups. The abstract reports within-group changes.
Randomized, double-blind, placebo-controlled parallel trial: 9 g a day of quercetin-rich onion powder (about 60 mg quercetin) or quercetin-free onion powder for 12 weeks, funded by a Japanese public research program. (Nishimura et al. 2019, Nutrients)
70 healthy Japanese adults with a BMI of 23 to under 30.
The main outcome, visceral fat area on CT, did not differ between groups. In an exploratory subgroup with HDL cholesterol of 40 to under 74 mg/dL, visceral fat area was lower with the quercetin-rich onion. Clinic and home blood pressure did not improve, and the liver enzyme ALT was lower than on placebo.
Randomized, double-blind, placebo-controlled parallel trial of quercetin-rich onion powder (about 50 mg quercetin a day) versus quercetin-free onion powder for 24 weeks, funded by a Japanese public research grant. (Nishihira et al. 2021, J Clin Biochem Nutr)
70 healthy Japanese adults aged 60 to 79.
Mini-Mental State Examination scores improved more with the quercetin-rich onion than with placebo after 24 weeks. Emotional function scores on a tablet-based assessment also improved, but its total cognitive score did not differ between groups, and a caregiver-burden scale favored the active food. The authors note an earlier 50-person trial of the same design found no overall MMSE difference. No serious adverse events or abnormal laboratory changes were reported.
Randomized, single-blind, diet-controlled crossover study comparing one dose of onion skin extract (about 163 mg quercetin) with quercetin dihydrate (134 mg quercetin) in hard capsules. (Burak et al. 2017, Eur J Nutr)
12 healthy adults aged 21 to 33 (6 men, 6 women).
Blood quercetin exposure (area under the curve) was 4.8 times higher and peak level 5.4 times higher after the onion skin extract; time to peak did not differ. Peak levels of the metabolites isorhamnetin and tamarixetin were 3.8 and 4.4 times higher. A single-dose absorption study with no health outcomes.