Chlorophyll [Discontinued] by Swanson GreenFoods Formulas

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. It is unclear if topical chlorophyll is beneficial in patients with acne. Details: Preliminary clinical research in young adults with acne shows that applying facial sheets (VIRTA-Healer, Aseptica) containing chlorophyll to one side of the face for 30 minutes twice weekly, in combination with light-emitting diode (LED) irradiation, improves acne severity and reduces acne counts by 32% more than LED irradiation alone after 2 weeks of treatment (93893).
• Allergic rhinitis (hay fever). It is unclear if oral chlorophyll is beneficial in patients with allergic rhinitis (hay fever). Details: Preliminary clinical research in adults with allergic rhinitis shows that taking oral chlorophyll 0.7 mg daily for 12 weeks reduces the use of rescue medications after 8 weeks, but does not improve symptoms or quality of life, when compared with placebo (97934).
• Colostomy odor. Although there has been interest in using oral chlorophyll for colostomy odor, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Constipation. Although there has been interest in using oral chlorophyll for constipation, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Genital herpes. Although there has been interest in using topical chlorophyll for genital herpes, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Halitosis. Although there has been interest in using oral chlorophyll for halitosis, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Herpes zoster (shingles). Although there has been interest in using topical chlorophyll for herpes zoster (shingles), there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Nonmelanoma skin cancer. Although there has been interest in using topical or intravenous chlorophyll for nonmelanoma skin cancer, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Obesity. Although there has been interest in using oral chlorophyll for obesity, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose.
• Pancreatitis. It is unclear if oral chlorophyll is beneficial in patients with pancreatitis. Details: Preliminary observational research in patients with chronic relapsing pancreatitis suggests that administering chlorophyll 5-20 mg intravenously divided 1-2 times daily for 1-2 weeks modestly improves pain and other symptoms of pancreatitis when compared to baseline (1324). The validity of these findings is limited by the lack of a comparator group.
• Wound healing. Although there has been interest in using oral chlorophyll for wound healing, there is insufficient reliable information about the clinical effects of chlorophyll for this purpose. More evidence is needed to rate chlorophyll for these uses.

(Read more about CHLOROPHYLL)

LIKELY EFFECTIVE

• Copper deficiency. Oral or intravenous copper is beneficial for treatment of copper deficiency. Details: Taking copper orally or intravenously is effective for treating copper deficiency and anemia due to copper deficiency. Copper deficiency is rare. It is seen most commonly in people receiving prolonged parenteral nutrition (7135). Oral cupric sulfate has been used in doses up to 0.1 mg/kg daily (7135). Copper 1-2 mg per day in parenteral nutrition solution has also been used (505).

POSSIBLY INEFFECTIVE

• Alzheimer disease. Oral copper does not seem to be beneficial for Alzheimer disease. Details: Preliminary clinical research shows that taking copper orotate dihydrate, providing 8 mg of elemental copper, daily for 12 months does not improve scores on evaluation scales for Alzheimer disease when compared with placebo (45949). There is also some concern that copper could have detrimental effects. Observational research has found that people with Alzheimer disease have higher levels of copper in their blood than people without the disease (95917); the clinical significance of this finding is unclear.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. Oral copper has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that taking a specific combination product containing copper (NicAzel, Elorac Inc.) 1-4 tablets daily for 8 weeks reduces inflammatory lesions in patients with inflammatory acne when compared with baseline. Other ingredients in this product include nicotinamide, azelaic acid, zinc, pyridoxine, and folic acid; specific quantities are not known (90800). The validity of this finding is limited by the lack of a comparator group.
• Brain tumor. It is unclear if oral copper is beneficial for use in glioblastoma. Details: A moderate-sized open-label clinical study in adults with first recurrence of glioblastoma receiving alkylating chemotherapy shows that taking elemental copper 2.5 mg with disulfiram 400 mg daily for 6 months does not improve survival but does result in significantly more adverse effects (e.g., elevated liver enzymes) when compared with control. The trial was stopped early due to safety concerns (112376).
• Cardiovascular disease (CVD). Although there is interest in using oral copper for CVD prevention, there is insufficient reliable information about the clinical effects of copper for this purpose.
• Chemotherapy-induced acral erythema. Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months may reduce the incidence of grades 3 and 4 acral erythema (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Chemotherapy-induced anemia. Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months does not appear to reduce the incidence of grades 3 and 4 anemia (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Chemotherapy-induced diarrhea. Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months may reduce the incidence of grades 3 and 4 diarrhea (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Chemotherapy-induced leukopenia. Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months does not appear to reduce the incidence of grades 3 and 4 neutropenia or febrile neutropenia (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Chemotherapy-induced nausea and vomiting (CINV). Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months may reduce the incidence of grades 3 and 4 vomiting (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Chronic venous insufficiency (CVI). It is unclear if compression stockings containing copper are beneficial for lipodermatosclerosis in patients with CVI. Details: Preliminary clinical research shows that using compression stockings impregnated with copper for 8 weeks does not improve overall symptoms of lipodermatosclerosis secondary to chronic venous disease when compared with using a compression stocking without copper. However, the affected surface area may be reduced by approximately 16% by 2 weeks when copper-impregnated compression stockings are used (101809).
• Dental plaque. It is unclear if rinsing the mouth with copper is beneficial for reducing dental plaque. Details: Preliminary clinical research shows that rinsing the mouth with a solution of copper 1.1 mmol/L for 4 days decreases plaque accumulation when compared with a placebo solution (46006).
• Diarrhea. Oral copper has only been evaluated in combination with zinc; its effect when used alone is unclear. Details: Preliminary clinical research in children 6 months to 5 years of age presenting to a hospital in India with acute watery or bloody diarrhea shows that taking a solution providing zinc 2 mg/kg and copper 0.2 mg/kg orally daily for 2 weeks does not reduce the duration of diarrhea, the weight of stool, or the need for rehydration when compared with placebo (87166). It also does not seem to reduce the recurrence of diarrhea or improve weight gain over the next 3 months (95540).
• Oral mucositis. Oral copper has only been evaluated in combination with resveratrol; its effect when used alone is unclear. Details: A small clinical study in adults with advanced gastric cancers receiving docetaxel-based chemotherapy suggests that taking copper (Chelated Copper, JR Carlson Laboratories, LLC) with resveratrol three times daily for up to 6 months may reduce the incidence of grades 3 and 4 oral mucositis (112377). However, the interpretation of these findings is limited by the lack of a control group.
• Osteoarthritis. Although there is interest in using topical copper for osteoarthritis, there is insufficient reliable information about the clinical effects of copper for this condition.
• Osteoporosis. Oral copper has only been evaluated in combination with other minerals; its effect when used alone is unclear. Details: Preliminary clinical research in postmenopausal adults shows that taking copper 2.5 mg in combination with zinc 15 mg, manganese 5 mg, and calcium 1000 mg daily for 2 years can slow bone loss when compared with taking either calcium or the trace minerals alone (1994).
• Postoperative infection. It is unclear if copper-impregnated wound dressings are beneficial for the prevention of postoperative infection. Details: Preliminary clinical research shows that using a wound dressing impregnated with copper oxide 3% by weight reduces the incidence of a surgical site infection in the 30-day period following a caesarean section by 39%, but does not reduce length of hospital stay or readmission rate, when compared with a non-copper wound dressing. Eight patients would need to be treated with the copper-impregnated dressing to prevent one infection (105363). This study is limited by the use of a telephone questionnaire to assess the suspicion of infection.
• Systemic lupus erythematosus (SLE). It is unclear if oral copper is beneficial for improving symptoms of SLE. Details: Copper status does not appear to be associated with the risk of SLE (101810). Additionally, one small clinical study shows that taking copper 3 mg daily, alone or in combination with fish oil, for 24 weeks does not affect symptoms of SLE when compared with placebo (12953).
• Tinea pedis. Although there is interest in using topical copper for tinea pedis, there is insufficient reliable information about the clinical effects of copper for this condition.
• Wound healing. It is unclear if topical copper sulfate can improve the healing of umbilical granuloma. Details: A small clinical study in children 1-3 months of age with treatment-naïve umbilical granuloma shows that a single application of copper sulfate to the affected site results in complete resolution in 70% of patients, compared with 90% of patients receiving topical sodium chloride twice daily for 5 days. Some patients who received a second application of copper sulfate experienced full healing; however, it is unclear if this was due to the treatment or natural resolution (109403). More evidence is needed to rate copper for these uses.

(Read more about COPPER)

LIKELY SAFE ...when used orally and appropriately in amounts commonly found in foods. There is insufficient reliable information available about the safety of chlorophyll when used orally in medicinal amounts or when used topically or as an injection.

PREGNANCY AND LACTATION:
Insufficient reliable information available.

(Read more about CHLOROPHYLL)

LIKELY SAFE ...when used orally and appropriately. Copper is safe in amounts that do not exceed the tolerable upper intake level (UL) of 10 mg daily (7135).

POSSIBLY SAFE ...when copper oxide is used topically. A wound dressing impregnated with copper oxide in concentrations of 3% by weight has been used with apparent safety in one clinical trial (105363).

POSSIBLY UNSAFE ...when used orally in doses exceeding the UL of 10 mg daily. Higher intake can cause liver damage (7135,45865). Kidney failure and death can occur with ingestion of as little as 1 gram of copper sulfate (17).

CHILDREN: LIKELY SAFE
when used orally and appropriately. Copper is safe in amounts that do not exceed the tolerable upper intake level (UL) of 1 mg daily for 1-3 years of age, 3 mg daily for 4-8 years of age, 5 mg daily for 9-13 years of age, and 8 mg daily for 14-18 years of age (7135).

CHILDREN: POSSIBLY UNSAFE
when used orally in doses exceeding the UL (7135). Higher intake can cause liver damage (7135).

PREGNANCY: LIKELY SAFE
when used orally and appropriately. Copper is safe in amounts that do not exceed the tolerable upper intake level (UL) of 8 mg daily for those 14-18 years of age or 10 mg daily for those 19 years and older (7135).

PREGNANCY: POSSIBLY UNSAFE
when used orally in doses exceeding the UL. Higher intake can cause liver damage (7135).

LACTATION: LIKELY SAFE
when used orally and appropriately. Copper is safe in amounts that do not exceed the tolerable upper intake level (UL) of 8 mg daily for those 14-18 years of age or 10 mg daily for those 19 years and older (7135).

LACTATION: POSSIBLY UNSAFE
when used orally in doses exceeding the UL. Higher intake can cause liver damage (7135).

(Read more about COPPER)

METHOTREXATE (Trexall, others) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = B Theoretically, chlorophyll may reduce the clearance of methotrexate.  Details In one case report, a 54-year-old male developed delayed clearance of intravenous high-dose methotrexate with concomitant use of chlorophyll. When chlorophyll was stopped 2 days prior to methotrexate treatment, methotrexate clearance was unaffected (93891).

PHOTOSENSITIZING DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = B Theoretically, concomitant use of chlorophyll with photosensitizing drugs may have additive effects.  Details Chlorophyll has been reported to cause photosensitization. In two case reports, pseudoporphyria developed after oral intake of chlorophyll (93892). Theoretically, concomitant use with other photosensitizing drugs may exacerbate this effect (1326).

(Read more about CHLOROPHYLL)

CONTRACEPTIVE DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.  Details A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper (92395).

PENICILLAMINE (Cuprimine, Depen) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.  Details Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects (4412,4453,4531,4535,9630).

(Read more about COPPER)

General ...Orally, topically, or intravenously, significant adverse effects have not been reported. However, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Photosensitization.
Topically: Dermatitis, photosensitization.
Serious Adverse Effects (Rare):
Orally: Pseudoporphyria.

Dermatologic ...Topically, chlorophyll cream has been reported to cause dermatitis (41912). Orally, chlorophyll can cause photosensitization (1326). Certain carotenoids such as beta-carotene and canthaxanthin seem to prevent or lessen the photosensitivity that results from taking chlorophyll (1326). Oral consumption of chlorophyll has been associated with the development of pseudoporphyria in case reports. Two females developed easily traumatized blisters on their hands after consumption of a Swisse Chlorophyll drink (93892). In one case series, four males developed skin blisters and skin erosions after taking oral chlorophyll 100-1200 mg daily for 6.5 months up to 7 years. Resolution of symptoms was delayed for 2-8 months after chlorophyll discontinuation (97933).

(Read more about CHLOROPHYLL)

General ...Orally, copper is generally well tolerated when consumed in doses below the tolerable upper intake level (UL).

Dermatologic ...Contact dermatitis caused by copper has been reported rarely. A case report describes a 5-year-old male who developed recurrent fingertip dermatitis and a positive skin test to copper after playing with toy cars made with a copper-containing alloy (95538). Also, in a small clinical trial in children 1-3 months of age with umbilical granuloma, 3 of 33 children receiving a single topical application of copper sulfate developed superficial burns, whereas no superficial burns occurred in those receiving topical sodium chloride (109403).
In one case report, a 68-year-old male with type 2 diabetes and peripheral neuropathy developed second- and third-degree burns after wearing a copper-containing compression sock on the right leg for 3 hours while sitting in the sun. The patient received treatment with topical silver sulfadiazine and oral clindamycin. After 6 weeks, the patient was found to have multiple persistent wounds containing necrotic tissue which required debridement, daily dressing changes, and tubular compression. It is thought that the heat conductance of copper magnified the effects of sun exposure in this case (109402).

Endocrine ...There is evidence from observational studies that people with diabetes (type 1 or type 2) have higher copper levels in their blood than people without diabetes, although not all studies have shown this (95537). It is not known if elevated copper levels contribute to development or worsening of diabetes.

Hematologic ...A case report of copper overdose in a 28-year-old male resulted in hemolysis exacerbated by glucose-6-phosphate dehydrogenase deficiency. The patient was hospitalized, received D-penicillamine chelation, blood transfusion, and ultimately, 4 cycles of plasmapheresis which led to clinical recovery (112378).

(Read more about COPPER)