What Pharmacy Professional Should Know About Nutraceuticals
It was in 1989 when the Foundation for Innovation in Medicine in New York coined the term “Nutraceuticals” in response to the global medical community’s growing interest in the field at the time, particularly the Japanese, who introduced the term “functional foods” for “foods that provide health benefits beyond basic nutrition”.
It is considered one of the most exciting innovations in nutrition science, even though ancient civilizations have been using food to treat diseases.
This interest in the possible curative properties of food spread to Western countries, which led to the popularity of supplements, superfoods, and the entire nutraceutical industry. There are over 50,000 nutraceutical products in the US, many of which are dietary supplements.
However, dietary supplements are categorized as food and are regulated by the US Food and Drug Administration (FDA) as such. Unlike drugs, which need to be reviewed and approved by the FDA before being released to the public, dietary supplements only need to follow the less stringent safety regulations for food items.
This article discusses everything a pharmacy professional should know about nutraceuticals, including its advantages, disadvantages, limitations, and some examples.
What’s In The Article?
An Overview of Nutraceuticals
Advantages, Disadvantages, and Limitations Of Nutraceuticals
Examples of Nutraceuticals and Drug Interactions
Final Thoughts
An Overview of Nutraceuticals
The term “nutraceuticals” is a portmanteau of nutrition and pharmaceuticals. At its core, nutraceuticals are food substances that aid in preventing illnesses and maintaining health. The term is often used interchangeably with its close family terms, functional food and dietary supplement, although different countries have different definitions.
In the US, the definition was given by Stephen De Felice, the founder and chairman of the organization that originally coined the term. He defines a nutraceutical as a “food, or parts of a food, that provide medical or health benefits, including the prevention and treatment of disease”.
On the other hand, functional food is widely accepted as any food normally consumed that has a component with a specific medical benefit aside from its nutritional benefit.
The term dietary supplement is a regulatory term in the US and not a separate specific category. A dietary supplement looks more like medicine and can be derived wholly from foods, food-like sources, biochemically similar sources, or a mixture of them all.
Advantages, Disadvantages, and Limitations Of Nutraceuticals
One obvious disadvantage of nutraceuticals is that most manufacturers’ products do not undergo testing and clinical research before being marketed. Since nutraceuticals are categorized as food, it can be quite costly to conduct proper research and apply for a patent for natural food substances.
Manufacturers must also follow FDA’s restrictions when marketing food items. One of the most relevant restrictions is that nutraceutical labels must not have any health or medical claims.
This restriction affects nutraceuticals in two ways: manufacturers cannot advertise the benefits of their products. On the other hand, their product cannot be held liable if the consumer does not experience the nutraceutical’s purported benefits since there will be no such claim on the label.
Another disadvantage is that nutraceuticals are not meant to treat or cure illnesses, or at least not at the same speed and efficacy as conventional drugs. Nutraceuticals are more akin to food than medicine and are geared toward preventing diseases.
Furthermore, nutraceuticals might have unwanted drug interactions with other medications already approved by the FDA.
However, nutraceuticals also have certain advantages. They are generally deemed safe for consumption, barring those with allergies. Nutraceuticals are also often cheaper than drugs and can sometimes help in satiating the consumer.
Examples of Nutraceuticals and Drug Interactions
The US nutraceutical market has tens of thousands of products. Here are some nutraceuticals listed by their pharmacological benefits and known drug interactions.
Pharmacological Action | Nutraceuticals | Drug Interactions | |
Anti-Alzheimer’s | Beta-carotene, curcumin, lutein, lycopene | Lycopene slows blood clotting and should not be taken with anticoagulants Beta-carotene interacts with niacin and can decrease its effects. | |
Antiarthritic | Glucosamine, chondroitin methylsulfonylmethane | Glucosamine should not be taken with anticoagulants. There are few reports of glucosamine reducing the effectiveness of some chemotherapy drugs (e.g., etoposide, doxorubicin, teniposide), acetaminophen, and diabetes drugs (e.g., glyburide, insulin, rosiglitazone). | |
Anticancer | Curcumin, selenium present in fruits and vegetables | ||
Antidiabetic | Ethyl esters of omega-3 fatty acids (docosahexaenoic lipoic acid), dietary fibers | ||
Antioxidant | Ascorbic acid, lycopene, tocopherol | Ascorbic acid renders antacids ineffective. It also decreases the elimination of estrogen. Ascorbic acid also should be avoided if taking niacin, indinavir, and warfarin. | |
Anti-Parkinson’s | Ascorbic acid, creatine | ||
Eye health | Lutein, zeaxanthin | ||
Lipid-lowering agent | Polyunsaturated fatty acids | ||
Inhibition of LDL oxidation | Niacin, green tea, resveratrol, garlic, policosanol, sesame | Resveratrol can slow blood clotting. Do not take it on anticoagulants. Garlic interacts with saquinavir, an HIV medication. Garlic also changes how the body absorbs Isoniazid. | |
Reduction of total and LDL cholesterol | Plant sterols, flaxseed, garlic, dietary fiber, soy protein | ||
HMG-CoA reductase inhibition | Red yeast rice, green tea, garlic, omega-3-fatty acids, plant sterols | ||
Reduction of triglycerides | Niacin, red yeast rice, orange juice, flaxseed, resveratrol | ||
Increase in total HDL | Niacin, pomegranate, curcumin | ||
Prevention of cardiovascular diseases | Omega-3 polyunsaturated fatty acids, vitamins, minerals, polyphenols, dietary fibers, flavonoids present in onion, vegetables, grapes, red wine, apples, and cherries | ||
Weight loss | Ephedrine, caffeine, ma huang-guarana, chitosan, green tea, 5- hydroxytryptophan, glucomannan, fenugreek, conjugated linoleic acid, capsaicin, M. charantia | Ephedrine should not be taken with sympathomimetics and MAO Inhibitors. | Capsaicin interacts with ACE inhibitors (e.g., captopril, benazepril, enalapril, etc.) |
Since many other nutraceuticals exist and many side effects and drug interactions have not been exhaustively researched, patients should always be advised to consult their physicians before taking nutraceuticals and dietary supplements.
Final Thoughts
The use of food to maintain health and prevent disease has been around for thousands of years. Modern medical technology can harness the benefits of all of nature’s apothecary much more effectively today. Many of the marketed nutraceuticals have scientific research to back up their claims. However, the nutraceutical industry is far from perfect.
Unless dietary supplements are subjected to the same meticulous regulations as drugs, the US nutraceutical market will still carry the same risks, benefits, and limitations as snake oil.
Nutraceuticals is regulated differently by the FDA; it has its own regulations apart from conventional food and drug products. It can lead to the misuse and abuse of supplements and functional food and drink in lieu of actual medications, or sometimes in conjunction with prescription medicines – which could result in unwanted drug interactions. As a pharmacy professional, you must know nutraceuticals and their role in your patient’s health.