Hoodia gordonii is a cactus-like succulent plant, native to the Kalahari Desert in southern Africa.1 Due to over harvest and slow growth, Hoodia is now considered an endangered species. Hoodia grows in clumps of upright stems with tan flowers and thorns, and a strong, unpleasant odor.
Hoodia has received publicity in recent times for its natural appetite suppressant properties.
What is the most important information I should know about Hoodia?
Patients should not take Hoodia without first talking to their doctor if they
- have diabetes or are taking a medicine to control blood sugar levels,
- have any heart problems or take any heart medicines,
- have a bleeding or blood clotting disorder or are taking a medicine to increase or decrease the clotting of their blood such as aspirin, warfarin (Coumadin), or heparin,
- have anorexia, bulimia or any other eating disorder.
Patients may not be able to take Hoodia, or may require special monitoring during treatment if they have any of the conditions or are taking any of the medicines listed above.
Hoodia has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/ or advantages of Hoodia may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/ health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/ health supplements should be purchased from a reliable source to minimize the risk of contamination.
Hoodia is available for purchase in retail stores and online; however, clinical trials have not proven Hoodia effectiveness or safety. Actual amounts of hoodia in advertised products cannot always be confirmed, and products may be counterfeit or contaminated. Because many of these products are promoted for weight loss, but have not been clinically evaluated, the manufacturers are in violation of the Federal Food, Drug, and Cosmetic Act.
In October, 2011 the FDA notified consumers that the “P57 Hoodia” product marketed by Huikng Pharmaceutical was found to contain sibutramine, a controlled substance that was removed from the U.S. market in October 2010 for safety reasons. Sibutramine may substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmia, or stroke. This product may also interact in life threatening ways with other medications a consumer may be taking.2
How does Hoodia work?
The appetite suppressant effects of Hoodia were first observed in 1937 by a Dutch anthropologist studying the primitive San Bushmen of the Kalahari Desert.
It was noticed that the nomadic Bushmen, (who call it Xhoba) ate the stem of the Hoodia plant to stave off hunger during long hunting trips in the sparsely vegetated area.
The active ingredient in Hoodia is the appetite-suppressing molecule, P57, or oxypregnane steroidal glycoside P57AS3.3 In scarce clinical studies, P57 has been researched to evaluate its potential as an anti-obesity drug.
It is theorized that P57 acts on the brain in a manner similar to glucose. It tricks the brain into thinking one is full even when they have not eaten, reduces interest in food and delays the time before hunger sets in. It appears to work at the level of the hypothalamus to inhibit hunger signals.
Who should not take Hoodia?
Patients should not take Hoodia without first talking to their doctor if they have
Patients should talk to their doctor before taking Hoodia if they have any other medical conditions, allergies (especially to plants), or if they take other medicines or herbal/ health supplements.
Patients should not take Hoodia without first talking to their doctor if they are pregnant or could become pregnant.
Patients should not take Hoodia without first talking to their doctor if they are breast-feeding.
There is no information available regarding the use of Hoodia by children. Do not give any herbal/ health supplement to a child without first talking to the child"s doctor.
How should I take Hoodia?
The use of Hoodia in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/ health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.
Take Hoodia only as directed by a doctor, pharmacist, or other health care provider.
Store Hoodia as directed on the package.
What happens if I miss a dose?
No information is available regarding a missed dose of Hoodia. Consult with a doctor, pharmacist, or health care provider if additional information is required.
What happens if I overdose?
Seek emergency medical attention.
What should I avoid?
There are no known restrictions on food, beverages, or activity while taking Hoodia, unless otherwise directed by a health care provider.
What are the possible side effects of Hoodia?
Patients should talk to their doctor about any side effects they may develop.
What other drugs will affect Hoodia?
There is limited drug interaction information available between Hoodia and other medicines. It is recommended that patients talk to their doctor, pharmacist, or health care provider before taking any prescription or over-the-counter medicines or other herbal/ health supplements.
An in-vitro clinical trial has shown that intestinal transport of P57 was mediated by P-glycoprotein and multidrug resistance proteins MRP1/MRP2. P57 exhibited weak inhibition of the liver cytochrome P450 3A4 enzyme.3 The potential for clinically significant drug interactions is unknown.
What are the results of Hoodia clinical trials?
Published, peer-reviewed, randomized controlled clinical trials evaluating the efficacy of Hoodia gordonii are lacking.
A 15-day, randomized clinical trial published in 2011 evaluated Hoodia gordonii purified extract (HgPE) relative to placebo. Healthy, overweight women (n=64) received 1,110 milligram HgPE or placebo formulated in a yogurt drink one hour before breakfast and dinner. Menus otherwise were unchanged and portions were not controlled. HgPE was less well-tolerated than placebo due to episodes of nausea, vomiting, and skin sensations. Blood pressure, pulse, heart rate, bilirubin and alkaline phosphatase were significantly increased in the HgPE group. No significant effects on energy intakes or weight relative to placebo were demonstrated.
References
- van Heerden FR. Hoodia gordonii: a natural appetite suppressant. J Ethnopharmacol 2008:119;434-7.
- U.S. Department of Health and Human Services. U.S. Food and Drug Administration. Public Notification: “P57 Hoodia” Contains Undeclared Drug Ingredient. Accessed 01/28/2012. http: / / www.fda.gov / Drugs / ResourcesForYou / Consumers / BuyingUsingMedicineSafely / MedicationHealthFraud / ucm276074.htm
- Madgula VL. Avula B. Pawar RS, et al. In vitro metabolic stability and intestinal transport of P57AS3 (P57) from Hoodia gordonii and its interaction with drug metabolizing enzymes. Planta Med 2008:74:1269-75.
- Blom WA. Abrahamse SL. Bradford R, et al. Effects of 15-d repeated consumption of Hoodia gordonii purified extract on safety, ad libitum energy intake, and body weight in healthly, overweight women: a randomized controlled trial. Am J Clin Nutr. 2011:94;1171-81; Clinical trial available at http://clinicaltrials.gov/ct2/show/NCT01306422?term=hoodia&rank=1 Accessed 1/28/2012.
