Gugulu (Commiphora mukul) induces triiodothyronine production: possible involvement of lipid peroxidation

Rumex nervosus leaves meal improves body weight gain, duodenal morphology, serum thyroid hormones, and cecal microflora of broiler chickens during the starter period

A total of 192 one-day-old Ross 308 broiler chicks were assigned to 4 treatments with 8 replicate cages of 6 chicks (3♀ and 3♂) per cage according to a completely randomized block design. The dietary treatments were a basal diet (control) and a control diet supplemented with 1,000, 3,000, and 5,000 mg/kg Rumex nervosus leaves meal (RN). Gallic acid and some volatile compounds were detected in the RN extract. On day 10 of age, BW was improved (P = 0.016) with supplemental RN (1,000-5,000 mg/kg). On day 14 of age, dietary application of RN up to 3,000 mg/kg increased BWG (P = 0.003) compared with control, while a 1,000 mg/kg RN had the best feed conversion ratio (P = 0.016). On day 10 of age, samples were taken on a single female bird per replicate. The addition of RN (1,000-5,000 mg/kg) increased (P < 0.001) serum albumin and triiodothyronine levels and maximized the relative weight of breast meat (P = 0.003). Feeding a diet with 1,000 mg/kg RN resulted in greater duodenal villus height (P < 0.001) than control and the diet with 5,000 mg/kg RN. Broilers fed diet supplemented with 1,000 mg/kg RN had the best duodenal villus surface area (P < 0.001). Feeding a diet with 1,000 mg/kg RN decreased (P < 0.001) cecal Escherichia coli count compared with control and the diet with 5,000 mg/kg RN. Salmonella spp. count tended to increase with 5,000 mg/kg RN leaves meal (P = 0.069, linear P = 0.026). In conclusion, R. nervosus leaves meal could be considered as a phytogenic feed additive in broiler diets up to a 1,000-mg/kg inclusion rate because of its combined positive effects on BWG, feed conversion ratio, villus height, villus surface area, serum albumin and triiodothyronine hormone, and cecal E. coli during the starter period (day 10-14 of age). Further study is required to elucidate its molecular mechanism.

Herbal preparations in the management of hypothyroidism in Unani medicine

Hypothyroidism is the most common thyroid disorder, affects women more frequently, and incidence increases with age. The prevalence of hypothyroidism in developed countries is around 4-5%, whereas, in India, it is about 11%. The common symptoms of hypothyroidism in adults are weight gain, fatigue, lethargy, cold intolerance, constipation, change in voice, and dry skin. It can affect all systems of the body. Diagnosis is mainly based on clinical history and laboratory investigations. Untreated hypothyroidism increases morbidity and mortality. In conventional medicine, the treatment of choice is Levothyroxine, whereas in Unani System of Medicine, pharmacotherapy consists of single and compound drugs. Single drugs are selected as per the constitution (Mizaj) of drugs as opposed to the abnormal constitution (Su-e-Mizaj) of disease and its pathology. Some drugs increase the basal metabolic rate whereas some evacuate the morbid material from the body by the action of purgation. The drugs are used either in a single form or as a prescription of more than one drug in the form of decoction (Joshandah), infusion (Kheshandah), or powder (Safoof). This review aims at providing comprehensive information regarding various drugs used in Unani system of medicine that is used in the management of thyroid dysfunction.

Herbal preparations in the management of hypothyroidism in Unani medicine

Hypothyroidism is the most common thyroid disorder, affects women more frequently, and incidence increases with age. The prevalence of hypothyroidism in developed countries is around 4-5%, whereas, in India, it is about 11%. The common symptoms of hypothyroidism in adults are weight gain, fatigue, lethargy, cold intolerance, constipation, change in voice, and dry skin. It can affect all systems of the body. Diagnosis is mainly based on clinical history and laboratory investigations. Untreated hypothyroidism increases morbidity and mortality. In conventional medicine, the treatment of choice is Levothyroxine, whereas in Unani System of Medicine, pharmacotherapy consists of single and compound drugs. Single drugs are selected as per the constitution (Mizaj) of drugs as opposed to the abnormal constitution (Su-e-Mizaj) of disease and its pathology. Some drugs increase the basal metabolic rate whereas some evacuate the morbid material from the body by the action of purgation. The drugs are used either in a single form or as a prescription of more than one drug in the form of decoction (Joshandah), infusion (Kheshandah), or powder (Safoof). This review aims at providing comprehensive information regarding various drugs used in Unani system of medicine that is used in the management of thyroid dysfunction.

Potential Anti-obesity and Lipid Lowering Natural Products: A Review

Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese. In Ayurveda, obesity is called ‘medoroga’. The detailed features and treatments of the disease have been described in an old Ayurvedic text, Charak and Sushrut Samhita. There are some native plants that are commonly used for the treatment of obesity in Ayurveda. Unfortunately, only few medications are available in the market, with side effects and unacceptable efficacy. With the current view that botanical drugs can be developed faster and more cheaply than conventional single entity pharmaceuticals, the review mainly focuses on the rationality of their use with appropriate literature data support.

Pharmacology and Phytochemistry of Oleo-Gum Resin of Commiphora wightii (Guggulu)

Guggulu is an oleo-gum resin which exudes out as a result of injury from the bark of Commiphora wightii (Arnott) Bhandari [syn.  Commiphora mukul (Hook. Ex Stocks) Engl; Balsamodendron mukul (Hook. Ex Stocks); Family, Burseraceae]. It has been used in the Ayurveda since time immemorial for the treatment of variety of disorders such as inflammation, gout, rheumatism, obesity, and disorders of lipids metabolism. It is a mixture of phytoconstituents like volatile oil which contains terpenoidal constituents such as monoterpenoids, sesquiterpenoids, diterpenoids, and triterpenoids; steroids; flavonoids; guggultetrols; lignans; sugars; and amino acids. This review is an effort to compile all the information available on all of its chemical constituents which are responsible for its therapeutic potential. The wild occurrence of this species is restricted mainly to the dry regions of Rajasthan and Gujarat States of India, and the bordering regions of Pakistan. Oleo-gum resin, guggulu, tapped from the stems of this species, is consumed in high volumes by the Indian herbal industries. There has been a decline in its wild population over the last several decades, as a result of habitat loss and degradation, coupled with unregulated harvesting and tapping of oleo-gum resin. This species is consequently assessed as Critically Endangered and enlisted in the IUCN red list of threatened species.

Pharmacological properties of guggulsterones, the major active components of gum guggul

Oleo gum resin secreted by Commiphora mukul, also known as gum guggul, has been used widely as an ayurvedic drug. Commiphora mukul is a short thorny shrub that is native to the Indian subcontinent. Oleo gum resin extracted by incision of the bark is a very complex mixture of gum, minerals, essential oils, terpenes, sterols, ferrulates, flavanones and sterones. Its active constituents, the Z- and E-guggulsterones, have been demonstrated to exhibit their biological activities by binding to nuclear receptors and modulating the expression of proteins involved in carcinogenic activities. Guggulsterones have also been reported to regulate gene expression by exhibiting control over other molecular targets including transcription factors such as nuclear factor (NF)-κB, signal transducer and activator of transcription (STAT) and steroid receptors. Considerable scientific evidence indicates the use of gum guggul as a therapeutic agent in the treatment of inflammation, nervous disorders, hyperlipidaemia and associated cardiac disorders such as hypertension and ischaemia, skin disorders, cancer and urinary disorders. This review highlights the taxonomic details, phytochemical properties and pharmacological profile of gum guggul.

Growth inhibition of struvite crystals in the presence of herbal extract Commiphora wightii

Struvite is one of the components of urinary stone. Large number of people is suffering from urinary stones (calculi) problem all over the globe. These stones can grow rapidly forming "staghorn-calculi", which is more painful urological disorder. Therefore, it is of prime importance to study the growth and inhibition of Struvite crystals. This in vitro study has been carried out in the presence of herbal extract of Commiphora wightii by using single diffusion gel growth technique. Sodium metasilicate solution of specific gravity 1.05 and an aqueous solution of ammonium dihydrogen phosphate of 0.5 M concentration were mixed so that the pH value 7.0 could be set. After the gelation, equal amount of supernatant solutions comprising of pure 1.0 M magnesium acetate as well as the mixtures of magnesium acetate and the herbal extract solutions of 0.5 and 1% concentrations of C. wightii were gently poured on the set gels. From the study of growth and inhibition behavior of Struvite crystals, it was found that C. wightii inhibits the growth of the Struvite. This study incorporates multidisciplinary interests and may be used for formulating the strategy for prevention or dissolution of urinary stones.

Amelioration of L-thyroxine-induced hyperthyroidism by coumarin (1,2-benzopyrone) in female rats

1. The efficacy of coumarin (1,2-benzopyrone) was examined for the regulation of hyperthyroidism in female rats. 2. Coumarin was administered (10 mg/kg per day for 15 days) to l-thyroxine (L-T(4))-induced hyperthyroid as well as to euthyroid rats and changes in serum concentrations of thyroid hormones and in associated parameters, such as serum cholesterol, activity of hepatic 5'-monodeiodinase (5'DI) and glucose-6-phosphatase (G-6-Pase), glycogen content, bodyweight and daily food consumption, were analysed. Simultaneously, changes in hepatic lipid peroxidation (LPO), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) were also investigated. 3. Although L-T(4) administration increased serum levels of thyroid hormones, the activity of hepatic 5'DI, G-6-Pase and LPO and daily food consumption, it decreased the level of serum cholesterol, hepatic glycogen content and the activities of anti-oxidant enzymes, such as SOD, CAT and GSH. 4. However, simultaneous administration of coumarin for 15 days to a group of hyperthyroid animals reversed most of the aforementioned changes, indicating its potential to ameliorate hyperthyroidism. Moreover, the drug did not increase, but rather decreased, hepatic LPO, suggesting its safe nature. 5. The present findings reveal a positive role for coumarin in the regulation of hyperthyroidism without any hepatotoxicity. It also appears that the test compound inhibits thyroid function at both a glandular level and at the level of peripheral conversion of T(4) to tri-iodothyronine.

Guggul for hyperlipidemia: A review by the Natural Standard Research Collaboration

OBJECTIVE

To evaluate the scientific evidence on guggul for hyperlipidemia including expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

METHODS

Electronic searches were conducted in nine databases, 20 additional journals (not indexed in common databases), and bibliographies from 50 selected secondary references. No restrictions were placed on language or quality of publications. All literature collected pertained to efficacy in humans, dosing, precautions, adverse effects, use in pregnancy/lactation, interactions, alteration of laboratory assays, and mechanism of action. Standardized inclusion/exclusion criteria were utilized for selection.

RESULTS

Before 2003, most scientific evidence suggested that guggulipid elicits significant reductions in serum total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as elevations in high-density lipoprotein (HDL) [Kotiyal JP, Bisht DB, Singh DS. Double blind cross-over trial of gum guggulu (Commiphora mukul) Fraction A in hypercholesterolemia. J Res Indian Med Yoga Hom 1979;14(2):11-6; Kotiyal JP, Singh DS, Bisht DB. Gum guggulu (Commiphora mukul) fraction 'A' in obesity-a double-blind clinical trial. J Res Ayur Siddha 1985;6(1, 3, 4):20-35; Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids. Asia Pacif J Pharm 1997;12:65-9; Urizar NL, Liverman AB, Dodds DT, et al. A natural product that lowers cholesterol as an antagonist ligand for the FXR. Science 3 May 2002 [Science Express Reports]; Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India 1989;37(5):323-8; Kuppurajan K, Rajagopalan SS, Rao TK, et al. Effect of guggulu (Commiphora mukul-Engl.) on serum lipids in obese, hypercholesterolemic and hyperlipemic cases. J Assoc Physicians India 1978;26(5):367-73; Gopal K, Saran RK, Nityanand S, et al. Clinical trial of ethyl acetate extract of gum gugulu (gugulipid) in primary hyperlipidemia. J Assoc Physicians India 1986;34(4):249-51; Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid-a new hypolipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res 1986;84:626-34; Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res 1988;87:356-60; Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8(4):659-64; Ghorai M, Mandal SC, Pal M, et al. A comparative study on hypocholesterolaemic effect of allicin, whole germinated seeds of bengal gram and guggulipid of gum gugglu. Phytother Res 2000;14(3):200-02]. However, most published studies were small and methodologically flawed. In August 2003, a well-designed trial reported small significant increases in serum LDL levels associated with the use of guggul compared to placebo [Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290(6):765-72]. No significant changes in total cholesterol, high-density lipoprotein (HDL), or triglycerides were measured. These results are consistent with two prior published case reports [Das Gupta R. Gugulipid: pro-lipaemic effect. J Assoc Physicians India 1990;38(12):346].

CONCLUSION

The effects of guggulipid in patients with high cholesterol are not clear, with some studies finding cholesterol-lowering effects, and other research suggesting no benefits. At this time, there is not enough scientific evidence to support the use of guggul for any medical condition. Guggul may cause stomach discomfort or allergic rash as well as other serious side effects and interactions. It should be avoided in pregnant or breast-feeding women and in children. Safety of use beyond 4 months has not been well studied.

Guggulu (Commiphora mukul) potentially ameliorates hypothyroidism in female mice

The efficacy of guggulu, the gum resin of Commiphora mukul in regulating hypothyroidism was evaluated in female mice. In addition to estimating serum levels of thyroxine and triiodothyronine, hepatic 5' monodeiodinase, hepatic glucose-6-phospatase and lipid-peroxidation (LPO), the activities of the anti-oxidative enzymes, superoxide dismutase (SOD) and catalase (CAT), were investigated. While 6-n-propyl-2-thiouracil (PTU, 10.00 mg/kg/d for 30 days) induced hypothyroidism in mice, as evidenced by a decrease in thyroid hormone concentration and in hepatic 5'D-I activity, simultaneous administration of guggulu (200 mg/kg/d for 30 days) reversed this effect, indicating its potential to stimulate thyroid function. Although in PTU treated animals a marginal increase in hepatic LPO was observed, when simultaneously treated with guggulu, it was decreased. A parallel increase in the activity of endogenous antioxidants, SOD and CAT, in the latter group indicated the safe and antiperoxidative nature of the drug. These findings suggest the possible use of guggulu in the amelioration of hypothyroidism.

HPTLC method for guggulsterone

A sensitive, selective, precise and robust high-performance thin-layer chromatographic method of analysis of E and Z stereoisomers of guggulsterone (the hypolipidemic agent in the gum-resin exudates of Commiphora mukul) both as a bulk drug and in formulations was developed and validated. The method employed TLC aluminium plates precoated with silica gel 60F-254 as the stationary phase. The solvent system consisted of toluene-acetone (9:1, v/v). Densitometric analysis of guggulsterone was carried out in the absorbance mode at 250 nm. This system was found to give compact spots for E- and Z-guggulsterone (Rf value of 0.38 +/- 0.02 and 0.46 +/- 0.02, respectively) following double development of chromatoplates with the same mobile phase. The linear regression analysis data for the calibration plots for E- and Z-guggulsterone showed good linear relationship with r2 = 0.9977 +/- 0.054 and 0.9975 +/- 0.068, respectively, in the concentration range of 100-6000 ng/spot. The mean value of slope and intercept were 0.11 +/- 0.006 and 0.11 +/- 0.005, 14.26 +/- 0.56 and 10.92 +/- 0.76, respectively, for E- and Z-guggulsterone. The method was validated for precision, robustness and recovery. The limit of detection and quantitation were 12, 10 and 24, 20 ng/spot, respectively, for E- and Z-guggulsterone. Statistical analysis proves that the method is repeatable and selective for the estimation of the said drug. Since the proposed mobile phase effectively resolves the E- and Z-isomers of guggulsterone, this HPTLC method can be applied for identification and quantitation of these isomers in herbal extracts and pharmaceutical dosage form.

Rhabdomyolysis Caused by Commiphora mukul, a Natural Lipid-Lowering Agent

OBJECTIVE:

To report a case of rhabdomyolysis caused by Commiphora mukul, a natural lipid-lowering agent.

CASE SUMMARY:

A 55-year-old man was taking an extract of C. mukul 300 mg 3 times daily to lower his cholesterol level. He developed rhabdomyolysis with hemoglobinuria after 2 weeks of treatment. Laboratory tests showed creatine kinase 144 600 IU/L (reference range 24–195), myoglobin >3000 ng/mL (28–72), lactate dehydrogenase 7157 IU/L (230–460), aspartate aminotransferase 1115 IU/L (10–35), and alanine aminotransferase 205 IU/L (10–35). Analysis of a urine sample was 2+ positive for hemoglobin. All parameters returned to normal after the herbal preparation was discontinued.

DISCUSSION:

The Naranjo probability scale indicates C. mukul as the possible cause of rhabdomyolysis in our patient. Drug-induced rhabdomyolysis is an established but rare adverse effect of high doses of cholesterol-lowering agents (statins) or interactions between drugs (eg, statins and fibrates). As of May 28, 2004, to our knowledge, this is the first reported case of rhabdomyolysis following C. mukul ingestion.

CONCLUSIONS:

Our report describes a case of rhabdomyolysis possibly caused by C. mukul and underlines the need for active surveillance of natural products.

Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice

Relative importance of Bacopa monnieri (200 mg/kg), Aegle marmelos (1.00 g/kg) and Aloe vera (125 mg/kg) leaf extracts in the regulation of thyroid hormone concentrations in male mice was investigated. While serum levels of both T(3) and T(4) were inhibited by A. vera, A. marmelos extract could decrease only T(3) concentration. On the other hand, T(4) concentration was increased by B. monnieri extract suggesting its thyroid-stimulating role. When the relative potency of each plant extract was calculated in terms of percent increase or decrease in thyroid hormones, as compared to the control value, the decrease in T(3) concentration by A. marmelos was about 62% indicating its possible use in the regulation of hyperthyroidism. B. monnieri could increase T(4) concentration by 41% without enhancing hepatic lipid peroxidation (LPO) suggesting that it can be used as a thyroid-stimulating drug. In fact, hepatic LPO was decreased and superoxide dismutase (SOD) and catalase (CAT) activities were increased by B. monnieri and A. marmelos leaf extracts showing their antiperoxidative role. It is thus suggested that A. marmelos and A. vera may be used in the regulation of hyperthyroidism, while B. monnieri in hypothyroidism.

Achyranthes aspera elevates thyroid hormone levels and decreases hepatic lipid peroxidation in male rats

A study was made to evaluate the role of Achyranthes aspera on the changes in serum thyroid hormone concentrations and glucose levels in male rats. An attempt was also made to establish the relationship between hepatic lipid peroxidation and extract induced changes in thyroid hormone concentration, if any. Adult male Wistar rats were orally administered with the aqueous leaf extract of Achyranthes aspera at a dose of 200 mg/kg b. wt./day for 7 days. The effects of the extract on body weight, hepatic protein content, lipid peroxidation (LPO), superoxide dismutase (SOD) and catalase (CAT) activities and on serum triiodothyronine (T3), thyroxine (T4) and glucose levels were evaluated. The extract exhibited significant prothyroidic activity as it enhanced the levels of both the thyroid hormones along with an increase in serum glucose concentration, body weight and hepatic protein content. On the other hand, it decreased hepatic LPO without altering the activities of the two antioxidant enzymes, SOD and CAT significantly, suggesting a direct free radical scavenging activity of the extract. It appears that the Achyranthes aspera leaf extract is both prothyroidic and antiperoxidative in nature.

How safe is neem extract with respect to thyroid function in male mice?

In this investigation we attempted to find out the hitherto unstudied adverse effects of neem (Azardirachta indica) leaf extract on the thyroid function of male mice. Neem leaf extract was orally administered in two different doses (40 mg and 100 mg kg(-1)day(-1)for 20 days). The extract exhibited differential effects. While the higher dose decreased serum tri-iodothyonine (T(3)) and increased serum thyroxine (T(4)) concentrations, no significant alterations of levels were observed in the lower dose group, indicating that the high concentrations of neem extract can be inhibitory to thyroid function, particularly in the conversion of T(4)to T(3), the major source of T(3)generation. A concomitant increase in hepatic lipid peroxidation (LPO) and a decrease in glucose-6-phosphatase (G-6-Pase) activity in the higher dosed group also indicated the adverse effect of neem extract despite an enhancement in the activities of two defensive enzymes, superoxide dismutase (SOD) and catalase (CAT). Thus, it appears that the higher concentration of neem extract may not be safe with respect to thyroid function and lipid peroxidation.