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Bovine Colostrum

Common Name(s): BCC (bovine colostrum concentrate), Bovine colostrum, Cow milk colostrum, Early milk, Hyperimmune milk, Immune milk, Lactobin, Lactoferrin, LC2N

Clinical Overview

Use

Bovine colostrum may have a role in the management of HIV-associated diarrhea. There is increasing evidence of efficacy in boosting the immune system, preventing upper respiratory tract infection, reducing GI permeability, and enhancing athletic performance, although data are conflicting and are based on small sample sizes and studies of limited quality.

Dosing

Standardization of commercial bovine colostrum products is difficult because antibody content varies widely. Dosages up to 60 g/day for up to 12 weeks have been used in clinical trials evaluating use for athletic enhancement. In trials using bovine colostrum for exercise-induced GI permeability, dosages of 20 g/day for 14 days, or 1 g/day for 20 days have been used; in one trial, a dosage of 1.7 g/kg/day for 7 days prior to an exercise protocol was used.

Contraindications

Contraindications other than milk allergy have not been identified.

Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Bovine colostrum is well tolerated, with minor GI complaints (eg, nausea, flatulence, diarrhea), unpleasant taste, and skin rash occurring infrequently.

Toxicology

The US Food and Drug Administration (FDA) has accepted the safety of hyperimmune milks on the basis that no adverse health effects have been shown in clinical studies. Past concerns regarding transmission of bovine spongiform encephalopathy (BSE), a feed-borne infection in cattle, have been resolved.

Source

Bovine colostrum is the premilk fluid produced from mammary glands of a cow during the first 2 to 4 days after giving birth. It is a rich natural source of nutrients, antibodies, immunoglobulins, antimicrobial peptides, and growth factors for the newborn calf. Bovine colostrum is collected from dairy cows shortly after calving.Hurley 2011, Rathe 2014

History

The use of colostrum for both medicinal and spiritual purposes has been documented in traditional Ayurvedic medicine and among the ancient Hindu rishis (spiritual leaders) of India. At the turn of the 20th century, the use of colostrum was advocated to protect infants against both human and bovine infections. Prior to the advent of sulfa drugs and other antibiotics, colostrum was used to boost defense against immune diseases. Albert Sabin isolated antipolio antibodies in bovine colostrum in the 1950s; the first experiments with hyperimmune colostrum were conducted in the 1960s. Human lactoferrin is now produced via recombinant techniques and has been studied in preterm infants and neonates for the prevention and treatment of necrotizing enterocolitis.Struff 2007

Chemistry

Colostrum contains immunoglobulins (immunoglobulin G [IgG], IgA, and IgM), polypeptides and glycoproteins, lactoferrin, cytokines (including interleukins, interferon-gamma, and tumor necrosis factor alpha), lactoperoxidase, lysozyme, growth factors (including insulinlike, vascular endothelial, platelet-derived, and fibroblast growth factors), caseins, bioactive oligosaccharides, vitamins, fats, and minerals. Additionally, microRNA that may have immune-regulating activity is present in microvesicles.

Concentrations of immunoglobulins, which are dependent on the animal species, decline sharply in the first few days postpartum. Unlike humans, bovine maternal immunoglobulins do not cross the placenta and are retained in large quantities in the colostrum. In humans, the IgG component is transferred via the placenta before birth, whereas in bovine colostrum, it is the major immunoglobulin present (30 to 200 mg/mL vs 0.4 mg/mL in human colostrum). Immunoglobulins protect the gut mucosa from microbial invasion and offer passive immunity to the neonate until its own immune system is functioning optimally. IgG activates complement bacterial opsonization and agglutination and binds specifically to bacteria or their products. Hyperimmune bovine colostrum is produced by immunizing cows against specific microorganisms; studies using hyperimmune colostrum versus colostrum from nonimmunized cows should be interpreted cautiously.

Often, commercial producers attempt to differentiate their products on the basis of IgG content or by specifying the collection time for the colostrum; however, no specific standards exist. Processing of colostrum can lead to loss in IgG potency. Ultra–high temperature pasteurization (95°C [203°F]) destroys the majority of the immunoglobulin content; however, typical pasteurization (40°C [104°F]) results in less loss. The addition of stabilizers (sugars, glycerol) can further protect the IgG from thermal conformational changes. Many constituents of bovine colostrum, such as insulinlike growth factors, are resistant to dairy processing. However, compounds like cytokines are more labile. Techniques for analysis include gel and capillary electrophoresis and immunoassay techniques, including enzyme-linked immunosorbent assay.Gapper 2007, Hurley 2011, Korhonen 2007, Rathe 2014, Struff 2007

Uses and Pharmacology

Note: The lack of standardization of products reduces the external validity of clinical trial data; results indicating efficacy of a particular colostrum product cannot be generalized to apply to other products.

The relative safety of bovine colostrum, together with the lack of standardization of commercial products, makes animal studies largely irrelevant.

Athletic performance enhancement

Clinical data

The potential use of bovine colostrum for athletic enhancement is related to its growth factor content. Bovine IGF-I is structurally identical to human proteins, and short-term studies have been conducted in both high-performance (elite) athletes and other athletes by a limited pool of researchers.Kelly 2003, Shing 2013 Findings from these studies are inconsistent, with some, but not all, showing enhanced performance and changes in body composition. The studies are small, and it may be that a change in performance is more difficult to detect in elite athletes.Kelly 2003 Equivocal results regarding effects of bovine colostrum supplementation on immune function and intestinal permeability in athletes have also been demonstrated.Buckley 2009, Carol 2011, Crooks 2010, Marchbank 2011, Shing 2006 Equivocal results were reported in a systematic review of clinical use of oral bovine supplementation; a total of 14 studies related to athletic performance were identified (N=370 elite and recreational athletes, with study sizes ranging from 9 to 49 participants). Dosages ranged from 10 to 60 g/day for 2 to 12 weeks; the most commonly used dosage was 60 g/day for 4 to 9 weeks. Quality of the studies was considered adequate; however, extrapolating a consensus was difficult because end points were heterogeneous.Rathe 2014 In a double-blind, randomized, controlled study (N=40), use of bovine colostrum protein concentrate in elite male cyclists was associated with a significant increase in morning cortisol (P=0.004) and maintenance of testosterone (P≤0.05) compared with control (whey protein concentrate) throughout the duration of a 5-day stage race. The dose used in this small pilot study (N=10) was 10 g/day taken for 8 weeks prior to the race as well as during the 5-day race.Shing 2013 In adults older than 50 years performing resistance training, supplementation with 20 g of bovine colostrum 3 times daily for 8 weeks significantly improved muscle strength (P=0.026), leg press strength (P=0.045), and bone turnover (P=0.024) compared with those taking whey protein. Participants in both groups experienced improvements in cognitive function, lean tissue mass, and upper body strength. GI-related adverse events occurred in 5 patients. Two patients in the colostrum group experienced mild bloating, nausea, diarrhea, and unsettled stomach that were classified as "possibly" or "probably" related to bovine colostrum and led to 1 dose reduction. In the whey group, 2 patients experienced moderate gastroesophageal reflux that was classified as "definitely" related to whey protein and led to discontinuation of the supplement; 1 participant experienced mild nausea considered "possibly" related to whey.Duff 2014

GI effects

Clinical data

Limited small studies have evaluated the efficacy of bovine colostrum in immunodeficiency-related diarrhea (cryptosporidiosis). The studies are generally limited methodologically,Abubakar 2007, Florén 2006, Okhuysen 1998, Plettenberg 1993, Rump 1992 but at least 1 single-blind randomized trial has been conducted.Kaducu 2011 Reductions in stool frequency, weight loss, and self-reported fatigue, as well as increases in CD4+ count have been reported.Florén 2006, Kaducu 2011 A systematic review identified 5 studies (N=182, with study sizes ranging from 3 to 87 participants) that published data on the effects of bovine colostrum in patients with HIV-associated diarrhea and associated loss of gut mucosal CD4+ cells. Doses for most studies ranged from 10 to 32 g/day given for 10 days to 4 weeks. Collectively, the studies supported effectiveness of bovine colostrum, likely due to mechanisms involving direct antimicrobial effects, neutralization of endotoxins, suppression of gut inflammation, promotion of mucosal integrity, and tissue repair. However, the studies were of poor quality.Rathe 2014

Studies evaluating treatment of diarrhea from other bacterial causes (including Escherichia coli, Shigella, and Clostridium difficile) have also shown efficacy of bovine colostrum,Lissner 1996, Lissner 1998, Mattila 2008, Otto 2011, Tacket 1992 while no effect was observed in studies of patients infected with Vibrio cholerae.Kelly 2003

Immunoglobulin-enriched colostrum was reported to provide improved endotoxin-neutralizing capability against postsurgical translocation of microbes in patients undergoing intra-abdominal surgery, whereas no benefit was reported in coronary artery bypass patients who received a standard colostrum preparation.Rathe 2014

Efficacy against Helicobacter pylori and nonsteroidal anti-inflammatory drug (NSAID)–induced GI injury has been demonstrated in a few clinical studies; however, other studies have not produced positive results.Bitzan 1998, Buckley 2009, Kelly 2003 A systematic review of studies evaluating standard bovine colostrum oral supplementation identified 51 studies (N=2,326, with study sizes ranging from 3 to 605 patients); only 2 studies were of high quality. Data from the only 2 studies (n=7 and n=15) evaluating use in NSAID-induced GI injury showed evidence of possible benefit and protection of gut permeability; however, the studies were small and of short duration.Rathe 2014

A small, double-blind, randomized, placebo-controlled, 2-arm crossover trial investigated the effect of bovine colostrum and control (corn flour) on performance outcomes, GI permeability, and inflammatory markers during exercise in the heat in trained (n=7) as well as untrained (n=8) participants. The dose of bovine colostrum was 1.7 g/kg/day for 7 days prior to the exercise protocol. One performance measure (respiratory exchange ratio) and one measure of thermal strain were significantly improved in the colostrum group compared with controls (P<0.05 and P=0.004, respectively). No significant differences were found between groups for other measures, including cardiovascular strain, GI permeability, inflammatory cytokine response, and GI distress. No adverse effects or illnesses were reported.Morrison 2014 However, 2 small, double-blind, randomized, placebo-controlled crossover studies (N=18 and N=16) found that bovine colostrum dosed at either 20 g/day for 14 days or 1 g/day for 20 days blunted exercise-induced GI permeability in healthy young males who exercised regularly.Halasa 2017, March 2017

Clinical evidence does not support results demonstrated in animal studies for beneficial effects in short bowel syndrome. Additionally, limited data have shown no benefit in patients with irritable bowel syndrome.Rathe 2014

Immunomodulatory activity

Animal data

Various concentrations of bovine colostral constituents, including certain immunoglobulins, have been studied in calves fed colostrum or colostral supplement products.Garry 1996, Hopkins 1997, Mee 1996, Morin 1997, Quigley 1998

Clinical data

Due to its immune factor constituents (immunoglobulins, cytokines, lactoferrin, and lactoperoxidase), bovine colostrum is considered an immune system supplement.Kelly 2003, Shing 2007 However, clinical studies are sparse and diverse in the methodologies employed, products and dosages used, and in the conditions being evaluated.

Equivocal results have been reported regarding immune enhancement among athletes.Carol 2011, Crooks 2010, Jones 2017, Shing 2007 Both a lack of effect on CD4+ countsByakwaga 2011 and a positive effect have been reported. In one small study, exercise-induced immune dysfunction improved with bovine colostrum compared with placebo in healthy, recreationally active men. Concentrations of insulinlike growth factor 1 (IGF-1), which may influence antidoping tests, were not affected.Jones 2017

A systematic review of 10 studies found some support for the use of bovine colostrum for preventing upper respiratory tract infection (URTI); however, caution is warranted in interpreting the results because statistical significance was only found in pooled self-reported data. Additionally, heterogeneity was found in study populations, dosages, formulations, quality of methodologies, and results. The evidence did not support benefit for the increased susceptibility to URTI that results from exercise-induced immunosuppression.Kaducu 2011, Rathe 2014 In contrast, data from a double-blind, randomized, controlled trial (N=57) showed a significantly reduced proportion of days and episodes of URTI in male endurance athletes who consumed bovine colostrum (20 g/day) compared with controls. Also during the 12-week trial, a significantly lower proportion of athletes reported URTI in the colostrum group compared with placebo (12% vs 36%, respectively) at 5 to 8 weeks (P=0.044) but not at 1 to 4 weeks or 9 to 12 weeks.Jones 2014 The effect of colostrum on key mucosal immune parameters (ie, the salivary antimicrobial peptide lactoferrin, salivary IgA) and neutrophil cytotoxic activity in response to exercise was investigated in a double-blind, randomized, placebo-controlled trial in 20 healthy males. Bovine colostrum supplementation (10 g twice daily for 4 weeks) significantly improved neutrophil functional activity compared with controls (P<0.05) but not any of the other parameters tested.Jones 2015

Other uses

Bovine colostrum has been studied in oral hygiene products, as a tear substitute, as an enema in distal colitis, and in very limited clinical studies in type 2 diabetes, juvenile idiopathic arthritis, multiple sclerosis, and chronic pain syndrome, and for presurgical use.Hurley 2011, Kelly 2003, Kim 2009, Langmead 2006, Rathe 2014

Dosing

Standardization of commercial bovine colostrum products is difficult because antibody content varies widely, making comparisons difficult. Additionally, hyperimmune preparations are available that are collected from cows previously immunized with specific organisms and that contain large amounts of specific antibodies.Kelly 2003 Studies have used the following dosages:

Athletic performance enhancement

10 to 60 g/day for up to 12 weeks.Buckley 2009, Carol 2011, Crooks 2010, Rathe 2014, Shing 2007

Exercise-induced GI permeability

Dosages of 20 g/day of bovine colostrum for 14 days,March 2017, Marchbank 2011 or 1 g/day for 20 days have been usedHalasa 2017; in one trial, 1.7 g/kg/day for 7 days prior to an exercise protocol was used.Morrison 2014

Immune deficiency–related diarrhea

10 to 50 g/day for 10 days to 4 weeks.Florén 2006, Kaducu 2011, Rathe 2014

Infectious disease

10 g/day as a supplement has been evaluated as treatment and prophylaxis.Kelly 2003, Shing 2007

Intra-abdominal surgery

56 g 3 days prior to surgery for prevention of postsurgical microbial translocation.Rathe 2014

NSAID–associated GI effects

Two small trials used 125 mL 3 times daily for 7 days.Rathe 2014

Prevention of upper respiratory tract infection

10 g twice daily for 4 or 12 weeks has been used in athletes.Jones 2014, Jones 2015

Pregnancy / Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

In most clinical trials, bovine colostrum has been well tolerated, with only infrequent reports of minor GI complaints (eg, nausea, flatulence, diarrhea), unpleasant taste, and skin rash.Kelly 2003, Rathe 2014 Intolerance to lactose and sensitivity to milk proteins most likely contributed to these effects.Struff 2008

Toxicology

The FDA has accepted the safety of hyperimmune milks on the basis that no adverse health effects have been shown in clinical studies.Gapper 2007

Previously specific commercial colostrum products were theoretically associated with a risk of BSE; therefore, lactobin LC1 was withdrawn from the market in the 1990s. Newer versions (LC2N) are derived from animals in countries with strict veterinary controls and without incidence of BSE, and where pasteurization is conducted at 72°C (167°F) for 15 seconds. The BSE risk for milk and milk products was determined to be negligible by the Committee for Proprietary Medicinal Products of the European Commission and by the World Health Organization, provided the milk is obtained from healthy animals and is prepared under suitable conditions.Struff 2007, Vetrugno 2004

References

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Buckley JD, Butler RN, Southcott E, Brinkworth GD. Bovine colostrum supplementation during running training increases intestinal permeability. Nutrients. 2009;1(2):224-234.22253980
Byakwaga H, Kelly M, Purcell DF, et al; CORAL Study Group. Intensification of antiretroviral therapy with raltegravir or addition of hyperimmune bovine colostrum in HIV-infected patients with suboptimal CD4+ T-cell response: a randomized controlled trial. J Infect Dis. 2011;204(10):1532-1540.21930607
Carol A, Witkamp RF, Wichers HJ, Mensink M. Bovine colostrum supplementation's lack of effect on immune variables during short-term intense exercise in well-trained athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):135-145.21558575
Crooks C, Cross ML, Wall C, Ali A. Effect of bovine colostrum supplementation on respiratory tract mucosal defenses in swimmers. Int J Sport Nutr Exerc Metab. 2010;20(3):224-235.20601740
Duff WR, Chilibeck PD, Rooke JJ, Kaviani M, Krentz JR, Haines DM. The effect of bovine colostrum supplementation in older adults during resistance training. Int J Sport Nutr Exerc Metab. 2014;24(3):276-285.24281841
Florén CH, Chinenye S, Elfstrand L, Hagman C, Ihse I. ColoPlus, a new product based on bovine colostrum, alleviates HIV-associated diarrhoea. Scand J Gastroenterol. 2006;41(6):682-686.16716966
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This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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