DRUGS AND SUPPLEMENTS

Modified citrus pectin

March 22, 2017

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Modified citrus pectin

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Citrus pectin, depolymerized pectin, fractioned pectin, MCP, modified pectin, PectaSol®, pH-modified pectin.

Background

  • Pectins are gel-forming polysaccharides from plant cell walls, especially apple and citrus fruits. Pectins are a type of viscous dietary fiber and vary in the length of their polysaccharide chains, from 300-1,000 monosaccharides. Although pectins are not digestible by humans, modified citrus pectin (MCP) is altered to increase their absorbability. Pectin from citrus rinds is depolymerized through a treatment with sodium hydroxide and hydrochloric acid. The resultant smaller molecule is comprised predominantly of D-polygalacturonates and may be more easily absorbed by the human digestive system.

  • Modified citrus pectin is most often used as an adjuvant to cancer therapy to prevent metastasis. Modified citrus pectin is still considered an experimental therapy for cancer and should be used as an adjuvant to standard cancer therapy under medical supervision. Pectins, including modified citrus pectin, have also been investigated for possible cardiovascular benefits, including lowering cholesterol and reducing atherosclerosis. Clinical studies are needed in these areas.

  • Some experts caution that citrus pectin and all "modified" citrus pectins may not have the same effects as modified citrus pectin. Citrus pectin does not have the same short polysaccharide chains as modified citrus pectin, and "modified" pectin could indicate that the pectin has been altered in some way, but not necessarily have the shorter polysaccharide chains.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

Detoxification (toxic excretion)

Modified citrus pectin may increase the excretion of metals, such as arsenic, cadmium, and lead. Additional study is needed in this area before a firm recommendation can be made.

C

Prostate cancer

Modified citrus pectin may reduce the metastasis of certain types of cancers, including lung, prostate, and breast. More research is needed in this area, especially with other types of cancer and with other criteria for prostate cancer progression.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Anti-thrombotic, atherosclerosis (hardening of the arteries), bulk laxative, chelating agent, diarrhea, hyperlipidemia (high cholesterol), immunostimulant, tonic (gastrointestinal).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • There is no proven safe or effective dose for modified citrus pectin. Although not well studied in human clinical trials, 6-30 grams daily in divided doses, dissolved in a small amount of water, and diluted with juice, has been used. For capsules, a dose of 800 milligrams three times a day with meals has also been used. For biopsy and cancer, a dose of 15 grams daily (5 grams three times a day) one week before procedure and two weeks after has been used. For toxic excretion, 15 grams of MCP PectaSol® (EcoNugenics® Inc.) daily for five days and 20 grams on day six has been used with some benefit.

Children (younger than 18 years)

  • There is no proven safe or effective dose for modified citrus pectin in children and use is not recommended.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in individuals with a known allergy or hypersensitivity to modified citrus pectin. Modified citrus pectin may cause gastrointestinal discomfort in patients allergic or sensitive to modified citrus pectin.

Side Effects and Warnings

  • Modified citrus pectin is Generally Regarded as Safe (GRAS) by the U.S. Food and Drug Administration (FDA) and few adverse effects have been reported in the available literature. Because it is a dietary fiber, modified citrus pectin may result in mild loose stools, but should not cause other gastrointestinal problems in healthy patients. Theoretically, modified citrus pectin may cause fluid or electrolyte loss, constipation, or fecal impaction in some patients, especially geriatric patients, because it is a fiber.

  • Use cautiously in patients taking chelating medications as modified citrus pectin may significantly increase the urinary excretion of metals. Also, use cautiously in patients under treatment for cancer as modified citrus pectin may inhibit tumor growth.

Pregnancy and Breastfeeding

  • Modified citrus pectin is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Modified citrus pectin may significantly increase the urinary excretion of metals. Caution is advised in patients taking chelating agents.

  • Although not well studied in humans, pectin may lower cholesterol levels. Consult with a qualified healthcare professional, including a pharmacist, before combining modified citrus pectin with cholesterol-lowering agents.

  • Based on animal study, modified citrus pectin may significantly inhibit carbohydrate-mediated tumor growth. Patients taking any agents for cancer should use modified citrus pectin with caution.

  • Modified citrus pectin may slow or reduce the absorption of oral drugs. Caution is advised when taking medications by mouth.

Interactions with Herbs and Dietary Supplements

  • Modified citrus pectin may significantly increase the urinary excretion of metals. Caution is advised in patients taking chelating agents.

  • Although not well studied in humans, pectin may lower cholesterol levels. Consult with a qualified healthcare professional, including a pharmacist, before combining modified citrus pectin with cholesterol-lowering agents.

  • Although not well studied in humans, modified citrus pectin may significantly inhibit carbohydrate-mediated tumor growth. Patients taking any herbs or supplements for cancer should use modified citrus pectin with caution.

  • Modified citrus pectin may slow or reduce the absorption of oral agents. Caution is advised when taking herbs and supplements by mouth.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Bresalier RS, Yan PS, Byrd JC, et al. Expression of the endogenous galactose- binding protein galectin-3 correlates with the malignant potential of tumors in the central nervous system. Cancer 8-15-1997;80(4):776-787.

  2. Eastwood M, Kritchevsky D. Dietary fiber: how did we get where we are? Annu Rev Nutr 2005;25:1-8. View Abstract

  3. Eliaz I, Hotchkiss AT, Fishman ML, et al. The effect of modified citrus pectin on urinary excretion of toxic elements. Phytother Res 2006;20(10):859-864. View Abstract

  4. Guess BW, Scholz MC, Strum SB, et al. Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study. Prostate Cancer Prostatic Dis 2003;6(4):301-304. View Abstract

  5. Hayashi A, Gillen AC, Lott JR. Effects of daily oral administration of quercetin chalcone and modified citrus pectin on implanted colon-25 tumor growth in Balb-c mice. Altern Med Rev 2000;5(6):546-552. View Abstract

  6. Hsieh TC, Wu JM. Changes in cell growth, cyclin/kinase, endogenous phosphoproteins and nm23 gene expression in human prostatic JCA-1 cells treated with modified citrus pectin. Biochem Mol Biol Int 1995;37(5):833-841. View Abstract

  7. Kidd P. A new approach to metastatic cancer prevention: modified citrus pectin (MCP), a unique pectin that blocks cell surface lectins. Altern Med Rev 1996;1:4-10.

  8. Marounek M, Volek Z, Synytsya A, et al. Effect of pectin and amidated pectin on cholesterol homeostasis and caecal metabolism in rats fed a high-cholesterol diet. Physiol Res 2007;56(4):433-42. View Abstract

  9. Modified citrus pectin-monograph. Altern Med Rev 2000;5(6):573-575. View Abstract

  10. Nangia-Makker P, Hogan V, Honjo Y, et al. Inhibition of human cancer cell growth and metastasis in nude mice by oral intake of modified citrus pectin. J Natl Cancer Inst 12-18-2002;94(24):1854-1862. View Abstract

  11. Pienta KJ, Naik H, Akhtar A, et al. Inhibition of spontaneous metastasis in a rat prostate cancer model by oral administration of modified citrus pectin. J Natl.Cancer Inst 3-1-1995;87(5):348-353. View Abstract

  12. Raz A, Loton R. Endogenous galactoside-binding lectins: a new class of functional cell surface molecules related to metastasis. Cancer Metastasis Rev 1987;6:433-452.

  13. Strum S, Scholz M, McDermed J, et al. Modified citrus pectin slows PSA doubling time: A pilot clinical trial. Presentation: International Conference on Diet and Prevention of Cancer. May 28, 1999 - June 2, 1999.

  14. Terpstra AH, Lapre JA, de Vries HT, et al. The hypocholesterolemic effect of lemon peels, lemon pectin, and the waste stream material of lemon peels in hybrid F1B hamsters. Eur J Nutr 2002;41(1):19-26. View Abstract

  15. Vergara-Jimenez M, Furr H, Fernandez ML. Pectin and psyllium decrease the susceptibility of LDL to oxidation in guinea pigs. J Nutr Biochem 1999;10(2):118-124. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017