Seanol by Dr. Sinatra

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Dental plaque. It is unclear if oral Ascophyllum nodosum is beneficial in patients with dental plaque. Details: A small crossover study in adults with moderate to heavy calculus formation shows that taking a specific brand of Ascophyllum nodosum capsules (ProDen PlaqueOff, SDC Swedencar eAB) 500 mg daily for 6 months reduces the buildup of supragingival calculus by 52% when compared with placebo. The buildup of plaque was reduced by 19% in males, but was not reduced in females, when compared with placebo (94996).
• Gastroesophageal reflux disease (GERD). Although there has been interest in using oral Ascophyllum nodosum for GERD, there is insufficient reliable information about the clinical effects of Ascophyllum nodosum for this purpose.
• Gingivitis. It is unclear if oral Ascophyllum nodosum is beneficial in patients with dental plaque. Details: A small crossover study in adults with moderate to heavy calculus formation shows that taking a specific brand of Ascophyllum nodosum capsules (ProDen PlaqueOff, SDC Swedencar eAB) 500 mg daily for 6 months does not reduce gingivitis when compared with placebo (94996).
• Impaired glucose tolerance (prediabetes). Oral Ascophyllum nodosum has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in adults with prediabetes that are overweight or obese shows that taking a specific product (InSea2, InnoVactiv Inc.) containing 500 mg of Ascophyllum nodosum and Fucus vesiculosus extracts daily for 12 weeks reduces postprandial blood glucose but does not improve fasting blood glucose, glycated hemoglobin (HbA1c), body weight, lipids, or blood pressure when compared with placebo (110560).
• Inflammatory bowel disease (IBD). Although there has been interest in using oral Ascophyllum nodosum for IBD, there is insufficient reliable information about the clinical effects of Ascophyllum nodosum for this purpose.
• Iodine deficiency. It is unclear if oral Ascophyllum nodosum is beneficial in patients with iodine deficiency. Details: Ascophyllum nodosum contains iodine, and there is interest in its use for patients with iodine deficiency. A small clinical study in females with iodine insufficiency shows that taking a specific brand of Ascophyllum nodosum capsules (Napiers Hebridean Seagreens (NaHS), Seagreens Ltd) 500 mg daily for 14 days increases urinary iodine excretion by almost three-fold and increases thyroid stimulating hormone levels by 36% when compared with baseline (94997). The validity of these findings is limited by the lack of a control group.
• Metabolic syndrome. Oral Ascophyllum nodosum has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Observational research in adults with one or more components of metabolic syndrome has found that taking a specific combination product (Gdue, Aesculapius) containing extracts of Ascophyllum nodosum and Fucus vesiculosus in a 95:5 ratio along with chromium picolinate two to three times daily with meals for around 6 months is associated with reductions in body weight by 7.3 kg, waist circumference by 7.5 cm, fasting blood glucose by 16 mg/dL, glycated hemoglobin (HbA1c) by 0.55%, systolic blood pressure by 7 mmHg, diastolic blood pressure by 4 mmHg, low-density lipoprotein (LDL) cholesterol by 18 mg/dL, and 10-year cardiovascular risk scores by 1.8% when compared to baseline (110559). It is unclear if these effects are due to Ascophyllum nodosum, Fucus vesiculosus, or the combination. Further, the validity of these findings is limited by a lack of control group.
• Obesity. Oral Ascophyllum nodosum has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in adults with prediabetes that are overweight or obese shows that taking a specific product (InSea2, InnoVactiv Inc.) containing 500 mg of Ascophyllum nodosum and Fucus vesiculosus extracts daily for 12 weeks does not reduce body weight, body mass index (BMI), body fat, lipids, blood pressure, or measures of glycemic control when compared with placebo (110560).
• Peptic ulcers. Although there has been interest in using oral Ascophyllum nodosum for peptic ulcers, there is insufficient reliable information about the clinical effects of Ascophyllum nodosum for this purpose. More evidence is needed to rate Ascophyllum nodosum for these uses.

(Read more about ASCOPHYLLUM NODOSUM)

POSSIBLY EFFECTIVE

• Hypercholesterolemia. Oral Ecklonia cava seems to reduce levels of low-density lipoprotein (LDL) cholesterol. Details: Clinical research in patients with hypercholesterolemia shows that taking Ecklonia cava polyphenols (Botamedi Inc.) 200 mg twice daily for 12 weeks reduces LDL cholesterol by 11% when compared with taking placebo (106336). Also, preliminary clinical research in patients with hypercholesterolemia shows that taking a different Ecklonia cava polyphenol extract (Seapolynol, Livechem, Inc.) 400 mg once daily for 12 weeks reduces levels of LDL cholesterol by 9% when compared with baseline (106335). In overweight adults, many with hypercholesterolemia, clinical research shows that taking Ecklonia cava polyphenols 72 mg or 144 mg daily for 12 weeks reduces LDL cholesterol levels by 10% and 14%, respectively, when compared with placebo (96376). Taking Ecklonia cava does not seem to increase levels of high-density lipoprotein (HDL) cholesterol or reduce levels of triglycerides (96376,106335,106336).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Asthma. Although there is interest in using oral Ecklonia cava for asthma, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Athletic performance. It is unclear if oral Ecklonia cava is beneficial for improving athletic performance. Details: Preliminary clinical research in male college students shows that taking Ecklonia cava polyphenols 72 mg as part of 180 mL of a sport drink 30 minutes before exercise increases the time to exhaustion by approximately 2.4 minutes when compared with the sport drink alone (96377).
• Cancer. Although there is interest in using oral Ecklonia cava for cancer, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Cardiovascular disease (CVD). Although there is interest in using oral Ecklonia cava for CVD, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Diabetes. Although there is interest in using oral Ecklonia cava for diabetes, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Erectile dysfunction (ED). Although there is interest in using oral Ecklonia cava for ED, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Fatigue. Although there is interest in using oral Ecklonia cava for various causes of fatigue, there is insufficient reliable information about the clinical effects of Ecklonia cava for this use.
• Fibromyalgia. Although there is interest in using oral Ecklonia cava for fibromyalgia, there is insufficient reliable information about the clinical effects of Ecklonia cava for this use.
• Impaired glucose tolerance (prediabetes). It is unclear if oral Ecklonia cava is beneficial for prediabetes. Details: Preliminary clinical research in adults with prediabetes shows that taking a specific Ecklonia cava extract (AG-dieckol, Aqua Green Tech Co.) 500 mg three times daily for 12 weeks reduces postprandial glucose levels by 5.5%, compared with a small increase in those taking placebo. However, Ecklonia cava extract did not improve fasting blood glucose, insulin sensitivity, or glycated hemoglobin (HbA1c) when compared with placebo (96375).
• Insomnia. Although there is interest in using oral Ecklonia cava for insomnia, there is insufficient reliable information about the clinical effects of Ecklonia cava for this use.
• Male infertility. Although there is interest in using oral Ecklonia cava for male infertility, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Metabolic syndrome. Although there is interest in using oral Ecklonia cava for metabolic syndrome, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Neuropathic pain. Although there is interest in using oral Ecklonia cava for neuropathic pain, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Obesity. It is unclear if oral Ecklonia cava polyphenols improve weight loss or body composition; the available research is conflicting. Details: A small clinical trial in individuals with a body mass index (BMI) between 25 kg/m2 and 30 kg/m2 shows that taking Ecklonia cava polyphenols (Seapolynol, Botamedi Inc.) 180 mg twice daily for 12 weeks does not reduce body weight, BMI, body fat percentage, or low-density lipoprotein (LDL) cholesterol levels when compared with placebo. However, in a sub-group of patients with abdominal obesity, Ecklonia cava modestly reduced total adipose tissue levels and fat mass and increased skeletal muscle mass when compared with placebo. All patients in this study increased physical activity and consumed a diet with a mild caloric restriction (106334). Conversely, other clinical research in a similar population shows that taking Ecklonia cava polyphenols 144 mg daily for 12 weeks reduces body fat ratio by 7% and body weight, BMI, and waist circumference by 2%. These improvements were statistically significant when compared with placebo. Furthermore, taking Ecklonia cava polyphenols 72 mg or 144 mg daily reduces LDL cholesterol levels by 10% and 14%, respectively, when compared with placebo (96376). The reasons for these discrepant findings are unclear.
• Osteoarthritis. Although there is interest in using oral Ecklonia cava for osteoarthritis, there is insufficient reliable information about the clinical effects of Ecklonia cava for this condition.
• Radiation exposure. Although there is interest in using oral Ecklonia cava for radiation exposure due to its iodine content, there is insufficient reliable information about the clinical effects of Ecklonia cava for this use. More evidence is needed to rate Ecklonia cava for these uses.

(Read more about ECKLONIA CAVA)

POSSIBLY INEFFECTIVE

• Abortion. Despite traditional use for the induction of second trimester abortion, most research shows that intravaginal laminaria does not significantly reduce time to delivery or improve abortion rates, and it may actually worsen some outcomes when compared with standard of care. Details: One clinical study shows that intravaginal administration of laminaria along with misoprostol does not improve second trimester abortion rates at 24 and 48 hours after treatment initiation when compared with using only misoprostol. Also, using laminaria along with misoprostol does not shorten delivery time when compared with misoprostol alone (95688). Another small clinical study shows that adding intravaginal laminaria to misoprostol therapy significantly increases induction time and the need for opioid analgesics when compared with misoprostol alone (109576). Also, a small clinical study in patients undergoing second trimester abortions shows that intravaginal laminaria increases pain with cervical ripening and induction-to-delivery time when compared with mifepristone (109577). A retrospective study in 126 patients undergoing second trimester abortions has found that intravaginal administration of laminaria (Dilateria, Cooper Surgical) one day before using misoprostol might actually prolong delivery time by about 6 hours and does not improve abortion rates at 24 hours after induction when compared with misoprostol alone (105806). Some research shows that intravaginal administration of laminaria (Dilateria, Milex Products Inc.) one day before using prostaglandin E2 (PGE2) suppositories to induce second trimester abortions shortens the delivery time by about 3 hours when compared with PGE2 suppositories alone; however, the incidence of febrile episodes is about 2.3-fold higher for patients treated with laminaria (94045). Also, one small clinical study shows that intravaginal administration of laminaria the night before a scheduled abortion reduces procedure time by around 4 minutes, increases cervical dilation at the time of abortion, and reduces the need for additional dilation when compared with misoprostol treatment on the day of abortion. However, more patients preferred misoprostol over laminaria (109575). Laminaria has also been compared with a mechanical cervical dilation device, called Dilapan-S. A small clinical study in patients undergoing second trimester surgical abortion shows that intravaginal administration of laminaria for cervical preparation has no effect on pain scores or analgesic use following dilator placement or dilation and evacuation (D&E) when compared with Dilapan-S. The validity of these findings may be limited by the single-blinded nature of the study, as well as significant baseline differences between the treatment groups with respect to vaginal parity (105805).
• Parturition. Intravaginal administration of laminaria does not seem to be beneficial for cervical ripening. Details: While some research suggests that intravaginal laminaria might reduce the duration of induction, results are conflicting. Additionally, studies suggest that intravaginal laminaria does not seem to reduce the incidence of birth by caesarean section (8945,95689,102765). Also, a small observational study has found that intravaginal laminaria is associated with a greater risk of endometritis and fetal infectious complications when compared with a control group not receiving laminaria (8945).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acute radiation syndrome. Although there has been interest in using oral laminaria for acute radiation syndrome, there is insufficient reliable information about the clinical effects of laminaria for this purpose.
• Cancer. Although there has been interest in using oral laminaria for cancer prevention, there is insufficient reliable information about the clinical effects of laminaria for this purpose.
• Hypertension. Although there has been interest in using oral laminaria for hypertension, there is insufficient reliable information about the clinical effects of laminaria for this purpose.
• Obesity. It is unclear if oral laminaria is beneficial in patients with obesity. Details: A small clinical study in overweight Japanese adults shows that taking iodine-reduced laminaria powder 2 grams, providing 1 gram of alginate, three times daily for 8 weeks reduces body fat percentage in males, but not females, when compared with placebo. Laminaria does not affect body weight or body mass index when compared with placebo (109572).
• Radiation exposure. Although there has been interest in using oral laminaria to minimize environmental radiation exposure, there is insufficient reliable information about the clinical effects of laminaria for this purpose. More evidence is needed to rate laminaria for these uses.

(Read more about LAMINARIA)

POSSIBLY SAFE ...when used orally, short-term. Ascophyllum nodosum dried powder has been used with apparent safety at a dose of up to 500 mg daily for up to 6 months (94996,94997,103900). However, marine products such as Ascophyllum nodosum are known to accumulate heavy metals such as arsenic (94997,94999). Some supplement products are prospectively analyzed to confirm a lack of contaminants and that heavy metal levels are below threshold (94997).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using amounts greater than those found in food.

(Read more about ASCOPHYLLUM NODOSUM)

POSSIBLY SAFE ...when a specific Ecklonia cava phlorotannin extract (SeaPolynol) is used orally and appropriately. Doses of up to 400 mg daily have been used with apparent safety for 12 weeks (106334,106336). According to the European Food Safety Authority (EFSA), doses of up to 263 mg daily are considered safe based on extrapolation from animal toxicity research (106333). ...when other sources of Ecklonia cava polyphenols are used orally, short-term. Doses up to 144 mg daily have been used with apparent safety for up to 12 weeks (96376). ...when a specific Ecklonia cava polyphenol-rich extract (AG-dieckol, Aqua Green Tech Co.) is used orally and appropriately. Doses of up to 1500 mg daily have been used with apparent safety for up to 12 weeks (96375).

CHILDREN: POSSIBLY SAFE
when a specific Ecklonia cava phlorotannin extract (SeaPolynol) is used orally and appropriately in children 12 years and older. According to the EFSA, doses of up to 163 mg daily are considered safe in children aged 12-14 years, and 230 mg daily is considered safe in children aged 14 years and above, based on extrapolation from animal toxicity research (106333). There is insufficient reliable information available about the safety of Ecklonia cava in children under 12 years of age.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about ECKLONIA CAVA)

LIKELY SAFE ...when used in amounts found in foods. Laminaria has Generally Recognized as Safe (GRAS) status in the US (94048).

POSSIBLY SAFE ...when iodine-reduced laminaria supplements are used, short-term. Iodine-reduced laminaria powder has been safely used at doses up to 6 grams daily for up to 8 weeks (109572).

POSSIBLY UNSAFE ...when used orally in medicinal amounts. The average laminaria-based supplement might contain as much as 1000 mcg of iodine. Ingesting more than 1100 mcg iodine daily (the tolerable upper intake level) can cause hypothyroidism, hyperthyroidism, or exacerbate existing hyperthyroidism (9556,94046). In addition, some laminaria supplements may contain arsenic (645,10275,15588). There is insufficient reliable information available about the safety of laminaria for its other uses.

PREGNANCY: POSSIBLY UNSAFE
when used intravaginally for cervical ripening; there is an increased risk of parental and neonatal infection (8945).

PREGNANCY: LIKELY UNSAFE
when used intravaginally to induce labor; use has been associated with endometriosis, neonatal sepsis, fetal hypoxia, and intrauterine death (6).

PREGNANCY: UNSAFE
when used orally due to potential hormonal effects (19); avoid using.

LACTATION: LIKELY UNSAFE
when used orally because of potential toxicity (19).

(Read more about LAMINARIA)

AMIODARONE (Cordarone) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, combining Ascophyllum nodosum with amiodarone might cause excessively high iodine levels.  Details Ascophyllum nodosum contains iodine (94997,95000,95102), although the bioavailability of iodine from Ascophyllum nodosum is lower than that of potassium iodide (94997). Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use might increase the risk of having excessive iodine levels and adversely affecting thyroid function (7135,17574). Monitor thyroid function.

ANTITHYROID DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, Ascophyllum nodosum might alter the effects of antithyroid drugs.  Details Ascophyllum nodosum contains iodine (94997,95000,95102), although the bioavailability of iodine from Ascophyllum nodosum is lower than that of potassium iodide (94997). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Ascophyllum nodosum while using antithyroid drugs could alter the effects of the antithyroid drugs (17574).

THYROID HORMONE Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, Ascophyllum nodosum might alter the effects of thyroid hormone.  Details Ascophyllum nodosum contains iodine (94997,95000,95102), although the bioavailability of iodine from Ascophyllum nodosum is lower than that of potassium iodide (94997). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Ascophyllum nodosum while using thyroid hormone could alter the effects of thyroid hormone (17574).

(Read more about ASCOPHYLLUM NODOSUM)

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ACE INHIBITORS (ACEIs) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, laminaria might increase the risk of hyperkalemia when taken with ACEIs.  Details Laminaria contains potassium (19).

AMIODARONE (Cordarone) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, combining laminaria with amiodarone might cause excessively high iodine levels.  Details Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use with laminaria supplements, some of which may contain as much as 1000 mcg iodine, might increase the risk of adverse effects from iodine, including altered thyroid function (9556,94046).

ANTITHYROID DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, laminaria might alter the effects of antithyroid drugs.  Details Some laminaria supplements contain up to 1000 mcg of iodine (9556,94046). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking laminaria could theoretically alter the effects of antithyroid drugs.

DIGOXIN (Lanoxin) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, laminaria might increase the risk of hyperkalemia, which could increase the effects and adverse effects of digoxin.  Details Laminaria contains potassium (19).

POTASSIUM-SPARING DIURETICS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, laminaria might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.  Details Laminaria contains potassium (19).

THYROID HORMONE Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, laminaria might alter the effects of thyroid hormone.  Details Some laminaria supplements contain up to 1000 mcg of iodine (9556,94046). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking laminaria could theoretically alter the effects of thyroid hormone.

(Read more about LAMINARIA)

General ...Orally, Ascophyllum nodosum seems to be generally well-tolerated.

Endocrine ...Orally, taking Ascophyllum nodosum powder 500 mg daily for 14 days has been reported to cause elevated levels of thyroid stimulating hormone (TSH) in 2 of 22 women in a clinical trial. The powder contained 356 mcg iodine per 500 mg. Levels of free thyroxine (T4) were unaffected (94997).

Gastrointestinal ...Orally, Ascophyllum nodosum has been reported to cause stomach discomfort in one clinical trial (94996).

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General ...Orally, Ecklonia cava extract and Ecklonia cava polyphenols seem to be well tolerated.

Dermatologic ...Orally, alopecia has been reported by one person in a clinical trial (106335).

Gastrointestinal ...Orally, nausea, dyspepsia, and diarrhea have been reported by one person each in a clinical trial (106335).

(Read more about ECKLONIA CAVA)

General ...Orally, iodine-reduced laminaria seems to be well tolerated, while other laminaria formulations may contain excess amounts of iodine, as well as arsenic.
Most Common Adverse Effects:
Intravaginally: Cervical bleeding and pelvic cramps.
Serious Adverse Effects (Rare):
Orally: Arsenic poisoning.
Intravaginally: Rupture of cervical wall, fetal hypoxia, and fetal death. Anaphylaxis in sensitive individuals.

Dermatologic ...Orally, laminaria has been linked to a report of induced or exacerbated acne (9555).

Endocrine ...Orally, laminaria can affect levels of certain thyroid hormones, and might cause hypothyroidism or hyperthyroidism, or exacerbate existing hyperthyroidism (9556,94046).

Genitourinary ...Intravaginally, laminaria used for cervical ripening can cause pelvic cramps and cervical bleeding (8945). Uterine contractions associated with laminaria use have been implicated in fetal hypoxia and subsequent intrauterine death (6). Use of endocervical laminaria tents has been associated with possible rupture of the cervical wall and subsequent neonatal and parental infection (6,8945).

Immunologic ...There are case reports of anaphylactic reactions to laminaria when used intravaginally as a cervical dilator. In at least one case, ventilation was required (102766).

Other ...Laminaria concentrates arsenic from the ocean. In one case, use of an oral laminaria supplement for several months resulted in symptoms of arsenic poisoning including headache, weakness, fatigue, worsening memory loss, rash, nail damage, diarrhea, and vomiting. Urinary arsenic levels were elevated (15588). The concentration of arsenic in laminaria may vary between different batches, and also depends upon the part of the world where it was harvested (645,10275,15588). The concentration of arsenic has been reported to be higher in preparations from Australia than from Great Britain (645,10275).

(Read more about LAMINARIA)