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Dietary supplements
- 1. Dietary supplements and Herbal medications DrHarikrishnan A R
- 2. Nutraceuticals(“nutrition” and “pharmaceutics”) •Any food or food ingredient considered to provide medical or health benefits, including prevention and treatment of disease • Improve health, delay the aging process, prevent chronic diseases, increase life expectancy, or support the structure or function of the body • Ginseng, Echinacea, green tea, glucosamine, omega-3, lutein, folic acid, and cod liver oil
- 3. Functional food andbeverages Food products which offer additional physiological benefits or help to reduce risk of chronic diseases apart from its basic nutritional aspects a. Functional foods: • Omega fatty acid fortified food • Probiotic fortified food • Branded iodinated salt • Branded wheat flour b. Functional beverages: • Energy drinks • Sports drinks • Fortified drinks
- 4. Dietary supplements a. Vitaminsand minerals b. Herbal supplements c. Protein supplements d. Chavanprash
- 5. Definition A dietary supplement,as defined by the Dietary Supplement Health and Education Act (DSHEA), is a product that: • Intended to supplement the diet • Contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and certain other substances) or their constituents • Intended to be taken by mouth (tablet, capsule, powder, softgel, gelcap, or liquid) • Labeled as being a dietary supplement
- 6. History • 1994 –US congress passed DSHEA GMP • 2007 – final rule on GMP standards • 2006 – dietary supplement and non prescription drug consumer protection act • Submit reports of serious adverse effects
- 7. Distinguish from drugs •Drug intended to diagnose, cure, mitigate, treat, or prevent disease • Both intended to affect structure and function of body • Drug must undergo FDA approval after clinical studies to determine effectiveness and safety • D/S = no pre-market testing
- 8. Distinguish from food •Foodsnot intended to affect structure and function •D/S intended only to supplement diet •Not represented for use as conventional food •Not intended as sole item of a meal or the diet
- 9. Codex Alimentarius • Supplementscontaining vitamins or dietary minerals are included as a category of food in the Codex Alimentarius • Collection of internationally recognized standards, codes of practice, guidelines and other recommendations relating to foods, food production and food safety
- 10. Herbal medicine • Oneor more herbal material(s) or extract(s) or their combination. • Demonstrate that the active substances of the medicinal product have been in well-established medicinal use within the Community for at least ten years, with recognized efficacy and an acceptable level of safety
- 11. Traditional herbal medicinalproduct • They are herbal medicines, which - are administered orally, externally, or by inhalation - are intended to be used without supervision by a medical doctor • The intended use of herbal medicines will only be authorized on the basis of its traditional history and/or the recognized pharmacological properties of the herbal ingredient(s). • Vitamins and minerals may be added to the herbal medicine provided that their use is ancillary to the herbal ingredient(s)
- 12. Clinical aspects • Adverseevents • Chemical analysis rarely performed • Toxic ingredients • Drug interactions
- 13. Echinacea Purpurea/Purple coneflower •Contains flavonoids, polysaccharides • Immune modulation, Anti-inflammatory, Antibacterial,Antifungal • Minimal ADR GI upset, altered taste • Unknown DI • Avoided in patients with immuno-deficiency disorders
- 15. Allium Sativum(Garlic) • Organosulfurcompounds Allicin • CVS Antioxidant, lipid lowering, antiplatelet effets • Antimicrobial Invitro activity against some organisms • Antineoplastic ↓ stomach, oesophageal and colorectal cancers • ADR nausea, hypotension, allergy • DI use cautiously with warfarin, ↓ bioavailability of saquinavir
- 17. Ginkgo Biloba • Leafof Ginkgo tree • Flavone glycosides, terpinoids • CVS vasodilation, ↓blood viscosity • Metabolic antioxidant • CNS antianxiety, antidepressant, cognition enhancement • ADR nausea, headache, GI upset • DI not used with antiplatelet/anticoagulant, efavirenz
- 19. Milk thistle(Silybum Marianum) •Silymarin(2-3% of the dried herb) • Limits hepatic injury caused by some toxins • Anti-inflammatory inhibits lipoxygenase activity • Antineoplastic induces apoptosis • Galactagogue ↑ prolactin production • No DI • Minimal ADR
- 21. St. John’s Wort(HypericumPerforatum) • Hypericin, hyperforin • Antidepressant MAO-A and B inhibition • Antiviral and anticarcinogenic inhibition of protein kinase C • ADR photosensitization • DI use cautiously with other antidepressants, induce CYP 3A4, 2C9, 1A2
- 23. Saw Palmetto • SerenoaRepens/Sabal Serrulata • BPH inhibits 5α-reductase, inhibits binding of DHT to androgen receptors • ADR abdominal pain, nausea, decreased libido • No DI
- 25. Ginger(Zingiber officinale) • Gingerol •Exercise induced muscle pain • Promote digestion and as an antiflatulent or carminative to reduce gas and bloating • Antimicrobial inhibit multiplication of colon bacteria • CVS stimulates blood circulation, ↓BP, antioxidant • Motion sickness
- 27. Turmeric (Curcuma longalinn) • Curcumin • anti-inflammatory, antioxidant, antimutagenic, antidiabetic, antibacterial, hepatoprotective, expectorant and anticancerous
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