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Bergamot for Hypercholesterolemia: Patient Compliance Made Easy

Huntington College of Health Sciences

By Prof. Gene Bruno, MS, MHS, RH(AHG)
Huntington College of Health Sciences

When it comes to nutraceutical choices for the treatment of hypercholesterolemia, the sky seems to be the limit. That being said, many of the nutraceutical choices are fraught with problems such as limited efficacy and the requirement for relatively large doses that have to be taken two or three times daily. As a health care professional, you know that this latter problem can interfere with patient compliance. That’s why I find bergamot—and a specific material called Bergavit 40—to be such an interesting option for the treatment of hypercholesterolemia.

Bergamot is the common name of the fruit Citrus bergamia Risso (family Rutaceae) which differs from other citrus fruits in the composition and content of several distinct flavonoids, such as neoeriocitrin, neohesperidin and naringin. Preclinical and clinical studies indicated a hypocholesterolemic property of C. bergamia flavonoids. However, doses ranging between 1,000 and 1,500 mg per day were used in the clinical studies on bergamot extracts, sometimes requiring a twice daily dosing schedule.1,2 

However, a newer, six-month Bergamot study3 was published in 2016, in the journal Frontiers in Pharmacology. This study used a specific bergamot extract called Bergavit 40, which was standardized to provide 150 mg of the flavonoids neoeriocitrin, neohesperidin and naringin in a 400 mg dose—which is the daily dose used in the study by 80 subjects (42 men and 30 women, mean age: 55 ± 13 years). All subjects had moderate hypercholesterolemia (e.g. plasma LDL-C concentrations between 160 and 190 mg/dl).

At baseline and after six months of Bergavit 40 supplementation, total cholesterol (TC), triglycerides (TG), and high density lipoprotein cholesterol (HDL-C) were measured by routine laboratory methods, while LDL-C was calculated. In addition, color Doppler ultrasound of carotid arteries was performed at baseline and after 6 months.

The results showed that plasma lipids significantly improved with a 12 and 20 percent decrease in TC, LDL-C (p < 0.0001 for both), respectively, a 17 percent decrease in TG (p = 0.0020), while HDL-C increased 8% (p = 0.0007). A stronger reduction in plasma LDL-C level was achieved in subjects with higher baseline LDL-C levels (p = 0.004). Furthermore, carotid ultrasound revealed that carotid intima-media thickness (IMT), as a marker of subclinical atherosclerosis, decreased after six months of Bergavit 40 supplementation from 1.2 ± 0.4 to 0.9 ± 0.1 mm (25 percent; p < 0.0001).

Given the positive results of this studies, and the 400 mg/day dose, I propose that Bergavit 40 is a worthwhile nutraceutical to consider for your hypercholesterolemic patients, especially those for whom compliance may be an issue.

References:
1 Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. Third ed. New York, NY: Oxford University Press; 1999.
2 Krinsky NI, Landrum JT, Bone RA. Biologic mechanisms of the protective role of lutein and zeaxanthin in the eye. Annu Rev Nutr. 2003;23:171-201.
3 Vishwanathan R, Kuchan MJ, Johnson EJ. Lutein is the predominant carotenoid in the infant brain. Poster #1.23. 16th International Symposium on Carotenoids. Acta Biologica Cracoviensia series Botanica.2011;53(suppl.1):29.
4 Johnson EJ et al., Brain levels of lutein and zeaxanthin are related to cognitive function in centenarians (Abstract) FASEB J. 2011;25:975.
5 Lindbergh CA, Mewborn CM, Hammond BR, Renzi-Hammond LM, Curran-Celentano JM, Miller LS.
6 Relationship of Lutein and Zeaxanthin Levels to Neurocognitive Functioning: An fMRI Study of Older Adults. J Int Neuropsychol Soc. 2016 Oct 25:1-12. [Epub ahead of print].
7 Vishwanathan R, Iannaccone A, Scott TM, Kritchevsky SB, Jennings BJ, Carboni G, Forma G, Satterfield S, Harris T, Johnson KC, Schalch W, Renzi LM, Rosano C, Johnson EJ. Macular pigment optical density is related to cognitive function in older people. Age Ageing. 2014 Mar;43(2):271-5.

Gene Bruno

Professor Gene Bruno, MS, MHS, the Provost for Huntington College of Health Sciences, is a nutritionist, herbalist, writer and educator. For more than 37 years he has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines and peer-reviewed publications.
He can be reached at gbruno@hchs.edu.