Calcium D-Glucarate [Discontinued] by Tyler Encapsulations

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Breast cancer. Although there has been interest in using oral calcium D-glucarate for preventing breast cancer, there is insufficient reliable information about the clinical effects of calcium D-glucarate for this purpose.
• Colorectal cancer. Although there has been interest in using oral calcium D-glucarate for preventing colorectal cancer, there is insufficient reliable information about the clinical effects of calcium D-glucarate for this purpose.
• Prostate cancer. Although there has been interest in using oral calcium D-glucarate for preventing prostate cancer, there is insufficient reliable information about the clinical effects of calcium D-glucarate for this purpose. More evidence is needed to rate calcium D-glucarate for these uses.

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POSSIBLY INEFFECTIVE

• Diarrhea. Oral gelatin tannate does not seem to be beneficial for diarrhea treatment in infants and young children. Details: A pooled analysis of three clinical trials shows that taking gelatin tannate 250-500 mg four times daily for 5 days does not reduce the duration of diarrhea or stool frequency in infants and young children with acute diarrhea and gastroenteritis when compared with placebo (103296).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging skin. Although there has been interest in using oral gelatin for aging skin, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Beta-thalassemia. It is unclear if oral gelatin is beneficial for beta-thalassemia. Details: Preliminary clinical research in pregnant adults with minor or intermediate beta-thalassemia and mild iron-deficiency anemia shows that taking a specific form of gelatin made from donkey hide, colla corii asini, 15 grams daily for 4 weeks, increases hemoglobin by 11%, compared with a 5% reduction in those receiving no treatment (97634).
• Brittle nails. Although there has been interest in using oral gelatin for brittle nails, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Exercise-induced muscle soreness. Although there has been interest in using oral gelatin for exercise-induced muscle soreness and damage, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Joint pain. Although there has been interest in using oral gelatin for general joint pain, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Obesity. Although there has been interest in using oral gelatin for weight loss, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Osteoarthritis. Although there has been interest in using oral gelatin for osteoarthritis, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Osteoporosis. Although there has been interest in using oral gelatin for osteoporosis, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Rheumatoid arthritis (RA). Although there has been interest in using oral gelatin for RA, there is insufficient reliable information about the clinical effects of gelatin for this purpose.
• Ulcerative colitis. Rectal gelatin has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in adults admitted to the hospital in China with mild to moderate ulcerative colitis lesions shows that administering a 1-gram suppository containing a specific form of gelatin made from donkey hide, colla corii asini, and multiple other ingredients rectally for 3 months improves diarrhea and bloody stool symptom scores when compared with an 0.8-gram suppository containing the same ingredients. Recurrence at 12 months occurred in approximately 10% of the patients who received the higher-dose combination product compared with 47% of patients who received the lower dose. Patients in each group received 2 suppositories twice daily for the first month, 1 suppository twice daily for the second month, and 1 suppository once daily for the third month (109673). The interpretation of these results is limited by the lack of comparison to placebo or active control with known effectiveness for ulcerative colitis.
• Uterine fibroids. Oral gelatin has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Meta-analyses of a small number of preliminary clinical trials show that taking traditional Chinese medicines containing multiple ingredients including ejiao, a gelatin made from donkey hide, modestly reduces the volume of uterine fibroids and fibroid-related symptoms more effectively than mifepristone. When used in combination with mifepristone, benefits exceed those of mifepristone alone (106850). It is unclear whether any benefits are related to gelatin, one or more of the other ingredients, or their combination.
• Wrinkled skin. Although there has been interest in using oral gelatin for wrinkled skin, there is insufficient reliable information about the clinical effects of gelatin for this purpose. More evidence is needed to rate gelatin for these uses.

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There is insufficient reliable information available about the safety of calcium D-glucarate.

PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of calcium D-glucarate during pregnancy and lactation; avoid using.

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LIKELY SAFE ...when used orally in amounts commonly found in foods. Gelatin has Generally Recognized as Safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts, short-term . A specific type of gelatin from donkey hide, called colla corii asini, has been safely used in doses of 6-10 grams orally daily for 6-8 weeks. Higher doses of 15 grams daily have been associated with an increased risk of inflammatory adverse effects, including sore throat, swollen gums, local eczema, and oral ulcers (97634,107011). Since gelatin is often derived from bovine bones and skin, there is some concern about contamination with diseased animal parts (1825). So far, there are no reports of disease transmission to humans due to use of contaminated gelatin preparations.

CHILDREN: POSSIBLY SAFE
when gelatin tannate is used orally and appropriately in medicinal amounts, short-term. In children under 15 kg or under 3 years of age, gelatin tannate has been used with apparent safety at doses up to 250 mg four times daily for up to 5 days. In children over 15 kg or over 3 years of age, it has been used with apparent safety at doses up to 500 mg four times daily for up to 5 days (103296). There is insufficient reliable information available about the safety of other forms of gelatin in children.

PREGNANCY: LIKELY SAFE
when used orally in the amounts commonly found in foods.

PREGNANCY: POSSIBLY SAFE
when a specific type of gelatin from donkey hide, called colla corii asini, is used orally in doses of 10 grams daily for 6 weeks. Higher doses of 15 grams daily have been associated with an increased risk of inflammatory adverse effects, including sore throat, swollen gums, local eczema, and ulcers in the oral cavity (97634). There is insufficient reliable information available about the safety of other types of gelatin when used during pregnancy in medicinal amounts.

LACTATION: LIKELY SAFE
when used orally in the amounts commonly found in foods. There is insufficient reliable information available about the safety of using larger amounts of gelatin during lactation; avoid using.

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ALCOHOL (Ethanol) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, concomitant use with alcohol might decrease calcium D-glucarate activity.  Details There is some evidence that urinary excretion of calcium D-glucarate metabolites increases in people consuming alcohol (779).

GLUCURONIDATED DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, calcium D-glucarate might increase the clearance of drugs that undergo glucuronidation.  Details The calcium D-glucarate metabolite, D-glucaro-1,4-lactone, inhibits the enzyme beta-glucuronidase, reducing deconjugation of glucuronides in the intestine and thereby reducing reabsorption of the drugs (772,3952,107377).

KANAMYCIN Interaction Rating = Minor Be watchful with this combination. Severity = Insignificant •  Occurrence = Possible •  Level of Evidence = D Theoretically, calcium D-glucarate may reduce plasma levels of kanamycin.  Details Calcium D-glucarate may increase the rate of kanamycin elimination, which may decrease its clinical and adverse effects (777).

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General ...No adverse effects have been reported; however, a thorough evaluation of safety outcomes has not been conducted.

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General ...Orally, gelatin seems to be well tolerated.
Most Common Adverse Effects:
Oral: Belching, bloating, and dyspepsia.
Serious Adverse Effects (Rare):
Injection: IgE-mediated allergic reactions, Kounis syndrome.

Gastrointestinal ...Orally, gelatin can cause unpleasant taste, sensation of heaviness in the stomach, bloating, dyspepsia, and belching (7704).

Immunologic ...Gelatin can cause allergic reactions. Gelatin in foods can cause initial sensitization (7703). Gelatin-containing medicines including oral medications, suppositories, vaccines, and injectable products can cause IgE-mediated allergic reactions, including urticaria, angioedema, wheezing, hypotension, and anaphylaxis (7708,7709,7710,97633,111345). In the US, gelatin is used as a stabilizer in some vaccines such as measles, mumps, and rubella (MMR), and diphtheria, pertussis, tetanus (DPT) (7711). In one case report, a 73-year-old male experienced anaphylactic symptoms within 10 minutes of receiving gelatin lysate as a plasma expander during a routine surgery. The patient proceeded to develop heart, respiratory, and kidney failure and died 76 days after receiving the gelatin infusion (97633). At least 12 case reports describe life-threatening anaphylaxis after administration of gelatin-containing hemostatic agents during surgery. In these cases, hypotension, tachycardia, and increased airway pressure occurred shortly after injection of the agent into the pedicle tract (111345).
There are at least two cases of Kounis syndrome, an acute coronary syndrome related to a massive mast cell activation, after the use of a gelatin infusion during general anesthesia. In one case, immediate symptoms included bradycardia and hypotension, followed by myocardial ischemia and coronary vasospasm (97631).

Other ...Since gelatin is sometimes produced from bovine bones and skin, there is some concern about the potential risk of contamination with diseased animals and transmission of bovine spongiform encephalopathy (BSE, mad cow disease) and other diseases (1825). So far, there are no reports of BSE or other disease transmission to humans from gelatin products.

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