The dangerous side of Averrhoa Bilimbi (Kamias) that you must know



Did you know that this attractive fruit that we commonly used as a souring agent in our famous dishes can be dangerous on our kidney? But before we talk about that let’s get to know this fruit better first.

KAMIAS with a scientific name averrhoa bilimbi is a fruit-bearing tree of the genus Averrhoa, family Oxalidaceae. It is a close relative of carambola tree or Balimbing in Tagalog. Averrhoa is commonly known as Cucumber tree, Bilincha, Blimbin, Mimbro, Kaling Pring, Pepino de Indias, Birambi, Vinagrillo & Tirigur. It’s fruit is cylindrical and ellipsoid in shape and has a mildy sour and juicy taste.

Possibly originated in Moluccas, Indonesia, the species is now cultivated and found throughout the Philippines, Indonesia, Sri Lanka, Bangladesh, Maldives, Myanmar (Burma) and Malaysia. It is also common in other Southeast Asian countries.

My great grandmother had a kamias tree on her backyard a long time ago and my mother always asked me to pick some fruits as a souring agent when she cooked “paksiw” and i love it rather than vinegar.


According to a study about Nutritional and biochemical evaluation of Averrhoa bilimbi L. published at Archives of Pharmacy and Biological Sciences, averrhoa bilimbi is a nutrition-packed, starchy fruit with a rich source of ascorbic acid. Other than the vitamins, the fruit also consists of fibre, ash, protein and moisture as well as minerals. Phytochemical screenings have shown the presence of carbohydrates, flavonoids, tannins and hydrolysable tannins.





Kamias fruits are rich in polyphenolic antioxidants with strong radical scavenging capacity Unripe fruits have a higher amount of polyphenolics when compared to the ripe fruits. The presence of phenols, flavonoids and tannins is responsible for maintaining an antioxidant pool within the body that has a role in free radical scavenging . Thereby, it has been associated with decreased risk of some age related and chronic diseases.


According to the experiment published at Journal of Dentistry Indonesia. There is a color change of enamel after application of averrhoa bilimbi. Teeth discoloration is mainly treated with dental bleaching but use of chemical bleaching has side effects, so it is important to find an alternative natural dental bleaching agent. Averrhoa bilimbi contains peroxide and oxalate acid that possess tooth whitening properties.


An investuigation was done for the hypoglycemic and hypolipidemic activity of the semi-purified fractions of an ethanolic leaf extract of Averrhoa bilimbi in high fat diet (HFD)-streptozotocin (STZ)-induced diabetic rats. The long term administration of aqueous fraction at a dose of 125 mg/kg significantly lowered blood glucose and triglyceride concentrations. The investigation revealed that A. bilimbi was a good source of antioxidants; however, the drying process of the fruit significantly affected the bioactive compounds. 


According to a study by Faculty of Agro Based Industry, Universiti Malaysia Averrhoa bilimbi fruit extracts at all stages of ripening has some inhibitory activities against selected bacterial strains. However, extracts from younger fruits are more effective against the bacteria. 

Nurul Huda et al extracted the fruits with hexane, chloroform and methanol. They have subjected all fractions for the the phytochemical screening and antimicrobial activity against grampositive and gram-negative bacteria using discdiffusion method. Their study revealed that the fruit extracts have good inhibitory activity against the tested pathogens compared with the standard antibiotic, streptomycin.


Ambili et al have studied the antihyperlipidaemic properties of Averrhoa bilimbi fruit using Tritoninduced hypercholesterolemia in rats as a model. The fruit and its water extract showed remarkable antihypercholesterolemic activity. Thus, they have concluded this fruit can be used as a dietary ingredient to prevent as well as treat hyperlipidemia. 



Use of various plant parts like leaves, bark, flowers, fruits, seeds, roots or the whole plant as such for medicinal purpose has a long tradition in different culture. Averrhoa bilimbi is medicinally used as a folk remedy for many symptoms.



  • Malaysians take the leaves fresh or fermented as a treatment for venereal disease.
  • The fruits is used to clean the blade of a kris (dagger) and they serve as mordants in the preparation of an orange dye for silk fabrics.
  • Because of its oxalic acid content, fruit juice is useful for bleaching stains from the hands and rust from white cloth, and also tarnishes from brass. 
  • It’s fruit is also made into a sweet jam.



  • In some villages in India, the fruit of the averrhoa bilimbi was used in folk medicine to control obesity.
  • In Kerala & Bhatkal India it is used for making pickles and to make fish curry, especially with Sardines.
  • While around Karnataka, Maharashtra and Goa the fruit is commonly eaten raw with salt and spice.



  • In Java, the fruits combined with pepper are eaten to cause sweating when people are feeling “under the weather”.
  • A paste of pickled averrhoa bilimbi is smeared all over the body to hasten recovery after a fever.
  • It is preserved by sun-drying. The sun-dried is called asam sunti. Bilimbi and asam sunti are popular in Acehnese cuisine. It can replace mango in making chutney.
  • Its red flowers are sought as an ingredient of natural red dye for traditional textiles.



  • The leaves serve as a paste on itches, swelling, rheumatism, mumps or skin eruptions.
  • A leaf infusion is used as an after-birth tonic.
  • Flower infusion is used for thrush, cold, and cough.
  • A leaf decoction is taken to relieve rectal inflammation.
  • The fruits are eaten either raw or dipped in rock salt.
  • It can be either curried or added as a souring agent for common Filipino dishes such as sinigang and paksiw.
  • It is often used in rural places as an alternative stain remover. In our province we used this as a rust remover on clothes.
  • The fruit conserve is administered as a treatment for coughs, beri-beri and biliousness.



  • In Seychelles, it is often used as an ingredient to give a tangy flavor to many Seychellois creole dishes, especially fish dishes.
  • It is often used in grilled fish and also (almost always) in a shark meat dish, called satini reken.




Aside from its numerous traditional health benefits and uses too much ingestion of this fruit juice can lead to kidney failure. Freshly made concentrated juice has a very high oxalic acid content and consumption carries a high risk of developing acute renal failure by deposition of calcium oxalate crystals in renal tubules.

At Indian Journal of Nephrology, there were ten patients from five hospitals in the State of Kerala who developed ARF (Acute Renal Failure) after intake of kamias fruit juice. Seven patients needed hemodialysis whereas the other three improved with conservative management.

Kidney biopsy showed acute tubular necrosis with many polarizable fractured crystals in the tubular lumina of these patients. All of them had history of consuming kamias juice and developed renal failure.

Kamias is a traditional ingredient of different pinoy dishes, and is also used in other South East Asian countries as a local remedy for various ailments like hypertension, diabetes, and dyslipidemia. When used in high concentrations, the fruit juice can lead to ARF due to acute tubular necrosis, owing to its high oxalate content, which results in intratubular oxalate crystal deposition. Therefore, it is not safe to consume high oxalate-containing fruits in large quantities.


So be careful in consuming too much of this fruit. Please pass this word of caution to family and friends whom you know loves to eat kamias to share awareness.

Sources:  Wikipedia I Research Gate I WorldWideScience.Org I International Journal or Drug Development & Research I US National Library of Medicine