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Introduction
Several herbal remedies and other dietary supplements are
promoted as effective treatments for Alzheimer’s disease
and related disorders. Claims about the safety and effectiveness
of these products, however, are based largely on testimonials,
tradition, and a rather small body of scientific research.
The rigorous scientific research required by the U.S. Food
and Drug Administration for the approval of a prescription
drug is not required by law for the marketing of dietary supplements.
Concerns about alternative
therapies
Although many of these remedies may be valid candidates for
treatments, there are legitimate concerns about using these
drugs as an alternative or in addition to physician-prescribed
therapy:
-
Effectiveness and safety are unknown. The maker
of a dietary supplement is not required to provide the
U.S. Food and Drug Administration (FDA) with the evidence
on which it bases its claims for safety and effectiveness.
-
Purity is unknown. The FDA has no authority over
supplement production. It is a manufacturer’s responsibility
to develop and enforce its own guidelines for ensuring
that its products are safe and contain the ingredients
listed on the label in the specified amounts.
-
Bad reactions are not routinely monitored. Manufacturers
are not required to report to the FDA any problems that
consumers experience after taking their products. The
agency does provide voluntary reporting channels for manufacturers,
health care professionals, and consumers, and will issue
warnings about products when there is cause for concern.
- Dietary supplements can have serious interactions with
prescribed medications. No supplement should be taken without
first consulting a physician.
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Coenzyme Q10
Coenzyme Q10, or ubiquinone, is an antioxidant that occurs
naturally in the body and is needed for normal cell reactions
to occur. This compound has not been studied for its effectiveness
in treating Alzheimer’s.
A synthetic version of this compound, called idebenone, was
tested for Alzheimer’s disease but did not show favorable
results. Little is known about what dosage of coenzyme Q10
is considered safe, and there could be harmful effects if
too much is taken.
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Ginkgo biloba
Ginkgo biloba is a plant extract containing several
compounds that may have positive effects on cells within the
brain and the body. Ginkgo biloba is thought to have
both antioxidant and anti-inflammatory properties, to protect
cell membranes, and to regulate neurotransmitter function.
Ginkgo has been used for centuries in traditional Chinese
medicine and currently is being used in Europe to alleviate
cognitive symptoms associated with a number of neurological
conditions.
In a study published in the Journal of the American Medical
Association (October 22/29, 1997), Pierre L. Le Bars,
MD, PhD, of the New York Institute for Medical Research, and
his colleagues observed in some participants a modest improvement
in cognition, activities of daily living (such as eating and
dressing), and social behavior. The researchers found no measurable
difference in overall impairment.
Results from this study show that ginkgo may help some individuals
with Alzheimer’s disease, but further research is needed
to determine the exact mechanisms by which Ginkgo works
in the body. Also, results from this study are considered
preliminary because of the low number of participants, about
200 people.
Few side effects are associated with the use of Ginkgo,
but it is known to reduce the ability of blood to clot, potentially
leading to more serious conditions, such as internal bleeding.
This risk may increase if Ginkgo biloba is taken in
combination with other blood-thinning drugs, such as aspirin
and warfarin.
Currently, multicenter trial with about 3,000 participants
is investigating whether Ginkgo may help prevent or
delay the onset of Alzheimer’s disease or vascular dementia.
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Huperzine A
Huperzine A (pronounced HOOP-ur-zeen) is a moss extract
that has been used in traditional Chinese medicine for centuries.
Because
it
has
properties
similar to those of FDA-approved Alzheimer medications, it
is promoted as a treatment for Alzheimer’s disease.
Evidence from small studies shows that the effectiveness
of huperzine A may be comparable to that of the approved
drugs.
Large-scale trials are needed to better understand the effectiveness
of this supplement.
In Spring 2004, the National Institute on Aging (NIA) launched
the first U.S. clinical trial of huperzine A as a treatment
for mild to moderate Alzheimer’s disease.
Because huperzine A is a dietary supplement, it is unregulated
and manufactured with no uniform standards. If used in combination
with FDA-approved Alzheimer drugs, an individual could increase
the risks of serious side effects.
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Phosphatidylserine
Phosphatidylserine (pronounced FOS-fuh-TIE-dil-sair-een)
is a kind of lipid, or fat, that is the primary component
of cell membranes of neurons. In Alzheimer’s disease
and similar disorders, neurons degenerate for reasons that
are not yet understood. The strategy behind the possible treatment
with phosphatidylserine is to shore up the cell membrane and
possibly protect cells from degenerating.
The first clinical trials with phosphatidylserine were conducted
with a form derived from the brain cells of cows. Some of
these trials had promising results. However, most trials were
with small samples of participants.
This line of investigation came to an end in the 1990s
over concerns about mad cow disease. There have been some
animals studies since then to see whether phosphatidylserine
derived from soy may be a potential treatment. A report was
published in 2000 about a clinical trial with 18 participants
with age-associated memory impairment who were treated with
phosphatidylserine. The authors concluded that the results
were encouraging but that there would need to be large carefully
controlled trials to determine if this could be a viable treatment.
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Coral calcium
“Coral” calcium supplements have been heavily
marketed as a cure for Alzheimer’s disease, cancer,
and other serious illnesses. Coral calcium is a form of calcium
carbonate claimed to be derived from the shells of formerly
living organisms that once made up coral reefs.
In June 2003, the Federal Trade Commission (FTC) and the
Food and Drug Administration (FDA) filed a formal complaint
against the promoters and distributors of coral calcium. The
agencies state that they are aware of no competent and reliable
scientific evidence supporting the exaggerated health claims
and that such unsupported claims are unlawful.
Coral calcium differs from ordinary calcium supplements only
in that it contains traces of some additional minerals incorporated
into the shells by the metabolic processes of the animals
that formed them. It offers no extraordinary health benefits.
Most experts recommend that individuals who need to take a
calcium supplement for bone health take a purified preparation
marketed by a reputable manufacturer.
See also the FDA/FTC press
release on the coral calcium complaint
Related resources
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