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Spirulina

Introduction:

Spirulina, present in many supplements and food products, has been described as an excellent food source because of its positive effects upon the immune system, antioxidant ability, and improvement of cholesterol. Spirulina is a simple, one-celled microscopic blue-green algae which contains many nutrients including protein, beta carotene, iron, manganese, zinc, copper, selenium, and chromium. B complex vitamins, vitamin E, manganese, zinc, copper, iron, and gamma linolenic acid (an essential fatty acid). These nutrients may work in a similar manner to promote health in the form of a highly nutritional vegetable-like source to help fight free radicals or cell-damaging molecules. Research suggests that Spirulina may provide a concentrated nutritional source used to help treat health problems including allergies, cancer, fatigue, and high cholesterol.

 

Spirulina and allergies:

Research has shown that Spirulina has the ability to counteract allergic reactions, anaphylactic response, and has been found to reduce levels of histamine (1,2). Pretreatment with Spirulina has demonstrated reduction of allergic response (2,4), and it was noted that as Spirulina doses increased, there was a greater reduction in histamine levels (2). Spirulina at a dose of 2000 mg oral daily is the dose most commonly used which appears to be effective for allergic rhinitis. Supportive research is provided below.

 

Spirulina and allergic rhinitis symptoms:

In a study evaluating the effectiveness and tolerability of Spirulina for treating patients with allergic rhinitis, Spirulina at a dose of 2000 mg oral daily for 6 months significantly improved symptoms and physical findings of allergic rhinitis compared with placebo in signs and symptoms of congestion, sneezing, drainage, and itching (3).

 

Spirulina and allergy immune response in allergic rhinitis:

Spirulina may assist in prevention of allergic rhinitis by lowering the degree of allergic response.  In a random double-blinded crossover 12-week study, one group was provided with either 1,000 mg/day or 2,000 mg/day of Spirulina, while the other group took a placebo.  The study used peripheral blood mononuclear cells which were isolated before and after Spirulina. It was found that the cells developed a reduction in the cytokine interleukin-4(IL-4) by 32%. IL-4 is a substance produced after exposure to allergy stimulus resulting in inflammation. Results showed that Spirulina taken at 2,000 mg/day resulted in reduced cytokine production in immune cells which were protective toward allergic rhinitis. (4)

 

Spirulina and the lipid profile:

Spirulina, LDL and HDL cholesterol: Nakaya N et al performed a study in which 4.2 grams daily of Spirulina was given to 15 male volunteers which showed no significant increase in high-density lipoprotein (HDL) levels, but a significant reduction of LDL cholesterol after 8 weeks of treatment was seen. (5)

A study by Ramamoorthy and Premakumari provided 2 grams or 4 grams per day of Spirulina for 3 months to hypocholesterolemic patients with ischemic heart disease. Spirulina groups were found to show a reduction in total cholesterol, LDL cholesterol, and triglyceride levels as well as an increase in HDL cholesterol. (6)

A high cholesterol diet was fed to rabbits for 4 weeks, followed by continuation of the high cholesterol diet plus either 1% or 5% Spirulina added to the diet for another 8 weeks. Following the 8 weeks of Spirulina, LDL cholesterol was reduced by over 41% in the 5% Spirulina group and by over 26% in the 1% Spirulina group. Additional positive effects in the Spirulina groups included lower total cholesterol, reduced triglycerides, an increase in HDL cholesterol, and a decrease in aortic intimal surface. (7)

 

Spirulina and neuroprotective effects in stoke:

A study looked at diets enriched with blueberry, spinach, or Spirulina (a type of blue-green algae) to determine if they had neuroprotective effects on focal brain ischemia, a condition in which there is insufficient blood flow to a specific area in the brain. For 4 weeks, rats were fed with equal amounts of diets including blueberry, spinach, and Spirulina, or with control diet. After this time, the brains of the animals were examined. Results indicated that rats that received blueberry, spinach, or Spirulina enriched diets had a significant reduction in the volume of tissue death in the brain and an increase in post-stroke activity. Animals treated with blueberry, spinach, or Spirulina had significantly lower caspase-3 activity, a stimulator of cell death. In conclusion, treatment with blueberry, spinach, or Spirulina reduced not only ischemia, but also cell death and tissue death. (8)

 

Spirulina and cancer:

A study in India evaluated the use of Spirulina at a dose of 1 gram oral daily for one year in the treatment of oral leukoplakia on 44 tobacco chewers. It was determined that complete regression of the condition was seen in 45% of the Spirulina group compared to 7% of the placebo group. (9)

 

Safety data of Spirulina:

Spirulina supplementation has a promising application in allergic disease (especially allergic rhinitis), treatment of hyperlipidemia, and for use in oral leukoplakia. The information below supports the need to have a pure standardized Spirulina product to be free of microcystins, heavy metals, bacteria, and anatoxin-a. A basic online search by Preventive Health Advisor has not located a Spirulina product which meets these requirements. If a product with these standards is able to be located, it would be the most suitable for use by patients.

A safety data review of Spirulina by the Dietary Supplements Information Expert Committee (DSI-EC) of the United States Pharmacopeial Convention (USP) reported that use of Spirulina maxima and Spirulina platensis does not convey a serious health risk but addressed the following concerns with this supplement (10):

Adverse events of Spirulina have been reported by the DSI-EC, which include liver damage, nausea, diarrhea, vomiting, fatigue, headache, dizziness, itching, rash, headache, dehydration, dysphasia, renal failure, oropharyngeal pain, malaise, abdominal pain, chest pain, pyrexia, tachycardia, tachypnea, vomiting, and abdominal cramps. However, the amount, purity, and duration of Spirulina ingredients being taken were unknown and combined with other ingredients in these reports.

The FDA has allowed nutrition companies to include up to 3 grams of Spirulina per serving in supplements and food products. The FDA has not formally determined Spirulina to be GRAS (Generally Recognized as Safe), but has not had any objections to several companies declaring it to be GRAS. The Dietary Supplements Labels Database recommends a maximum of 7 grams per day.

The DSI-EC recommended that Spirulina products be subject to the following testing standards: 1) Testing for microcystins, a hepatotoxic and carcinogenic substance, should be performed with a limit of under 1 part-per-million. 2) Spirulina should not contain more than 10 micrograms per gram of heavy metals. 3) Spirulina should be evaluated for microbial enumeration which includes cyanobacteria.

 

Spirulina and anatoxin-a exposure:

Tests were conducted on a sampling of 39 Spirulina supplements and found that 7.7% (3 samples) contained anatoxin-a, a neurotoxin, at concentrations ranging from 2.50 to 33 micrograms per gram (11).

 

 

Assessment and Plan: Spirulina

  • Spirulina is a concentrated nutrient food source containing protein, beta carotene, iron, manganese, zinc, copper, selenium, and chromium. B complex vitamins, vitamin E, manganese, zinc, copper, iron, gamma linolenic acid (an essential fatty acid), and others.

 

  • Spirulina and allergies:
    •  Spirulina has the ability to counteract allergic reactions, anaphylactic response, and has been found to reduce levels of histamine (1,2,4).
    • For allergic rhinitis: Spirulina at a dose of 2000 mg oral daily for 6 months significantly improved symptoms and physical findings of allergic rhinitis compared with placebo in signs and symptoms of congestion, sneezing, drainage, and itching (3).

 

  • Spirulina and cholesterol:
    • Spirulina at a dose of 4.2 grams daily given to 15 male volunteers did not improve high-density lipoprotein (HDL) levels, but reduced LDL cholesterol after 8 weeks (5).
    • Hypocholesterolemic patients with ischemic heart disease taking 2 or 4 grams of  Spirulina for 3 months resulted in a lower total cholesterol, LDL cholesterol, and triglyceride levels as well as an increase in HDL cholesterol (6). An animal study also supported these findings (7).

 

  • Spirulina and neuroprotective effects in stoke: When blueberry, spinach, or Spirulina was included in rats with ischemic stroke, the nutrients from these foods appeared to reduce not only cerebral ischemia, but also cell death and tissue death. (8)

 

  • Spirulina and oral leukoplakia, a precancerous condition associated with oral cancer: Spirulina at a dose of 1 gram oral daily for one year for oral leukoplakia in tobacco chewers resulted in complete regression in 45% of the Spirulina group compared to 7% of the placebo group (9).

 

  • Spirulina adverse reactions and interactions:
    • After reviewing the following information, a healthcare provider may advise patients currently taking a Spirulina supplement, or consider the use of Spirulina in patients with allergic rhinitis, hyperlipidemia, or oral leukoplakia:
    • An ideal Spirulina product should be pure, and standardized to be free of microcystins, heavy metals, bacteria, and anatoxin-a. A basic online search by Preventive Health Advisor has not located a Spirulina product which meets these requirements. If a product with these standards is able to be located, it would be the most suitable for use by patients.
    • A safety data review of Spirulina by the Dietary Supplements Information Expert Committee (DSI-EC) of the United States Pharmacopeial Convention (USP) reported that use of Spirulina does not present a serious health risk but addressed the following concerns with this supplement (10):
    • Adverse events of Spirulina have been reported by the DSI-EC, which include liver damage, nausea, diarrhea, vomiting, fatigue, headache, dizziness, itching, rash, headache, dehydration, dysphasia, renal failure, oropharyngeal pain, malaise, abdominal pain, chest pain, pyrexia, tachycardia, tachypnea, vomiting, and abdominal cramps. However, the amount, purity, and duration of Spirulina ingredients being taken were unknown and combined with other ingredients in these reports.
    • The FDA has allowed nutrition companies to include up to 3 grams of Spirulina per serving in supplements and food products. The FDA has not formally determined Spirulina to be GRAS (Generally Recognized as Safe), but has not had any objections to several companies declaring it to be GRAS. The Dietary Supplements Labels Database recommends a maximum of 7 grams per day.
    • The DSI-EC recommended that Spirulina products be tested to contain less than 1 ppm of microcystins, less than 10 mcg per gram of heavy metals, and tested for microbial contaminants.
    • Spirulina should also be tested to be free of anatoxin-a since 3 out of 39 samples tested positive in a study (11).

 

 

References:

1.Yang HN, Lee EH, Kim HM. Spirulina platensis inhibits anaphylactic reaction. Life Sci. 1997;61(13):1237-44. http://www.ncbi.nlm.nih.gov/pubmed/9324065

 

2.Kim HM, Lee EH, Cho HH, Moon YH. Inhibitory effect of mast cell-mediated immediate-type allergic reactions in rats by Spirulina. Biochem Pharmacol. 1998 Apr 1;55(7):1071-6. http://www.ncbi.nlm.nih.gov/pubmed/9605430

 

3.Cingi C, Conk-Dalay M, Cakli H, Bal C. The effects of Spirulina on allergic rhinitis. Eur Arch Otorhinolaryngol. 2008 Oct;265(10):1219-23. http://www.ncbi.nlm.nih.gov/pubmed/18343939

 

4.“Effects of Spirulina-based dietary supplement on cytokine production from allergic rhinitis patients.”  Division of Rheumatology/Allergy and Clinical Immunology, University of California at Davis, School of Medicine, Davis, California, USA.  J Med Food.  2005 Spring;8(1):27-30  http://www.ncbi.nlm.nih.gov/pubmed/15857205

 

5.Wang Y, Chang CF, Chou J, Chen HL, Deng X, Harvey BK, Cadet JL, Bickford PC. Dietary supplementation with blueberries, spinach or Spirulina reduces ischemic brain damage. Exp Neurol. 2005;193(1):75-84. http://www.ncbi.nlm.nih.gov/pubmed/15817266

 

6.Ramamoorthy A, Premakumari S. Effect of suplementation of Spirulina on hypercholesterolemic patients. J. Food Sci. Technol, 1996, 33 (2),124-128.

 

7.Cheong SH1, Kim MY, Sok DE, Hwang SY, Kim JH, Kim HR, Lee JH, Kim YB, Kim MR. Spirulina prevents atherosclerosis by reducing hypercholesterolemia in rabbits fed a high-cholesterol diet. J Nutr Sci Vitaminol (Tokyo). 2010;56(1):34-40. http://www.ncbi.nlm.nih.gov/pubmed/20354344

 

8.Nakaya N, Honma Y, Goto Y. Cholesterol lowering effect of Spirulina. Nutr. Rep. Int. 1988, 37, 1329-1337. http://agris.fao.org/agris-search/search.do?recordID=US19890065227

 

9.Mathew B1, Sankaranarayanan R, Nair PP, Varghese C, Somanathan T, Amma BP, Amma NS, Nair MK. Evaluation of chemoprevention of oral cancer with Spirulina fusiformis. Nutr Cancer. 1995;24(2):197-202. http://www.ncbi.nlm.nih.gov/pubmed/8584455

 

10.Robin J. Marles, Marilyn L. Barrett, Joanne Barnes, Mary L. Chavez, Paula Gardiner, Richard Ko, Gail B. Mahady, Tieraona Low Dog, Nandakumara D. Sarma, Gabriel I. Giancaspro, Maged Sharaf & James Griffiths. United States Pharmacopeia Safety Evaluation of Spirulina.  Critical Reviews in Food Science and Nutrition. Volume 51,  Issue 7, 2011  http://www.tandfonline.com/doi/full/10.1080/10408391003721719

 

11.“First detection of anatoxin-a in human and animal dietary supplements containing cyanobacteria.”  Departamento de Química Analítica y Alimentaria, Facultad de Química, Edificio de Ciencias Experimentales, Campus Universitario, Universidad de Vigo, Vigo, Spain.  Food Chem Toxicol. 2009 Sep;47(9):2189-95. Epub 2009 Jun 9.  http://www.ncbi.nlm.nih.gov/pubmed/19520132

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