Hoodia

Scientific Name(s): Hoodia gordonii (Masson) Sweet ex Decne.
Common Name(s): Bushman's hat, Hoodia, Queen of the Namib, Xhoba (San)

Medically reviewed by Drugs.com. Last updated on Mar 22, 2024.

Clinical Overview

Use

Hoodia products have been marketed worldwide for weight loss; however, there is little published clinical evidence to support this application, and concerns exist regarding adverse effects. Antiviral and antioxidant properties have been noted in vitro, and antidepressant activity has been demonstrated in rodents. Clinical trial data are lacking to recommend the use of hoodia for any indication.

Dosing

Information is lacking; neither an effective nor safe dose has been established.

Contraindications

No information is available. Caution is advised in patients with cardiovascular conditions or compromised hepatic function.

Pregnancy/Lactation

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

Interactions

None well documented.

Adverse Reactions

Moderately severe nausea, vomiting, and altered skin sensation have been reported. Cardiovascular and hepatic concerns also exist.

Toxicology

No data.

Scientific Family

• Apocynaceae (dogbane)

Botany

H. gordonii is a rare, succulent plant found in the Kalahari Desert of southern Africa. The leafless, swollen, spiny stem is similar to that of a columnar cactus and is topped by showy, saucer-shaped flowers. The flowers emit a carrion-like odor that attracts pollinating insects. H. gordonii is considered an endangered species because of the high potential for overexploitation and is listed in Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).CITES 2019 Commercial plantations have been established in South Africa to provide for anticipated demand for the plant, although the plant's slow growth makes commercial cultivation difficult. Hoodia was formerly categorized in the Asclepiadaceae (milkweed) family, but has been subsumed into the Apocynaceae (dogbane) family.Sennblad 2002 Other species in the genera Hoodia and Trichocaulon are said to have biological activity similar to that of H. gordonii. In Israel, Hoodia parviflora is cultivated and has been marketed for weight control.Landor 2015

History

Hoodia was not well known to the Western world until recently. Ethnobotanical reports date to 1796, but hoodia received little attention until a South African scientific project evaluated its appetite suppressant effects in 1963. In the 1980s, modern techniques in plant structure analysis revealed the bioactive oxypregnane steroidal glycoside P57AS3 (or P57). As a result, a patent was filed by the Council for Scientific and Industrial Research (CSIR) in 1995 in South Africavan Heerden 2002; the council further developed extraction and quality control procedures.Knight 2012, Vermaak 2011 At the same time, CSIR signed a licensing agreement with Phytopharm, a small British company specializing in the development of phytomedicines. A sublicense was granted to Pfizer for further clinical development of P57, which Pfizer relinquished in 2003. In 2003, CSIR responded to criticism of its appropriation of San (southern Africa's oldest human inhabitants) indigenous knowledge by signing a memorandum of understanding with the South African San Council; the memorandum provided benefit sharing of hoodia royalties.Wynberg 2004 As hoodia's popularity as a weight-loss product grew, a thriving, yet often illicit, worldwide market offering H. gordonii herbal products as dietary supplements emerged.Gathier 2013 The high demand for hoodia around 2011 to 2013 greatly surpassed supply (due to sparse geographical distribution, slow maturation rate, need for a permit to cultivate or export plant material), resulting in potential adulteration of a large amount of products.Vermaak 2011 Though demand has lessened, identification of the active ingredient and validation of quality of products remain a concern.

Chemistry

Pregnane steroidal glycosides, including gordonosides, pregnanone, and hoodigogenin, have been isolated from the aerial plant parts and described. However, information is limited due to plant protection and patent rights, as well as to poor yields (0.003% to 0.02%).Dall'Acqua 2007, Geoffroy 2011, Shukla 2009 H. gordonii ethanol and ethyl acetate extracts were observed to contain phenolic components, alkaloids, terpenes, steroids, and cardiac glycosides but, notably, not quinones and flavonoids.Kapewangolo 2016

A compound unique to H. gordonii and responsible for purported appetite suppression has not been confirmed; however, P57 is commonly accepted as the responsible metabolite.Ríos-Hoyo 2016 Adulteration of herbal preparations is common.Knight 2012, van Heerden 2007 High-performance liquid chromatography with ultraviolet and other chromatographic methods for quantification have been used.Rumalla 2008, Russell 2012, van Platerink 2011

Uses and Pharmacology

CNS effects

Animal data

Effects of H. gordonii extract in mice models of stress/depression included elevated levels of 5-hydroxytriptamine, norepinephrine, and dopamine.Citó 2015

HIV

In vitro data

In vitro antiviral activity against HIV was reported for H. gordonii crude ethanol and ethyl acetate extracts. Antioxidant properties were reported in the same study.Kapewangolo 2016

Obesity/Appetite suppression

Animal and in vitro data

Ex vivo studies in rats and in vitro studies in human cells suggest stimulation of cholecystokinin secretion by glycoside P57 as a possible mechanism of action.Le Nevé 2010, Ríos-Hoyo 2016 The patent application suggests that modulation of hypothalamic adenosine triphosphatase activity as well as antagonism of melanocortin-4 receptors play a role.MacLean 2004, Nargund 2006, van Heerden 2002 Experiments in rats have shown decreased body mass (adipose tissue and muscle) with supplemental H. gordonii extracts.Smith 2014, van Heerden 2008 Further experiments in rabbits suggest a dose-related response (reduction in feed intake), while limited effect was observed in chickens.Dent 2012, Mohlapo 2009

Clinical data

In a small clinical study of healthy overweight women (N=50), 1 g of H. gordonii extract twice daily for 15 days did not result in differences in food intake and body weight compared with placebo.Blom 2011 A single-blind study evaluated ingestion of hoodia (as an H. parviflora 3 g cube per day) among 204 normal weight, overweight, obese, and very obese volunteers, with 103 participants completing the 40-day study. Analysis suggests positive findings with respect to weight loss; however, methodological issues exist for this study.Landor 2015 A review of hoodia use for weight loss suggests the claimed effects on appetite and weight might be secondary symptoms of serious adverse effects associated with the high dose required to achieve therapeutic clinical effect.Ríos-Hoyo 2016, Smith 2014

Sympathomimetic activity

In vitro data

Studies using isolated rat uterine ring tissue revealed relaxant effects on smooth muscle and activity at beta-adrenergic receptors. This effect may be responsible for observed cardiovascular adverse effects.Roza 2013

Dosing

Information is lacking; neither an effective nor safe dose has been established.Robb-Nicholson 2008

A dosage of 1 g of H. gordonii extract twice daily before meals for 15 days was used in a clinical trial evaluating effects in overweight women.Blom 2011 Pharmacokinetic studies suggest that bioavailability is poor, possibly due to extensive gastric destruction of P57; therefore, high dosages of the extract are required for effect, increasing the potential for clinically significant adverse effects.Knight 2012, Ríos-Hoyo 2016

Pregnancy / Lactation

Avoid use. Information on safety is lacking. In rodent studies, higher doses of H. gordonii extract resulted in adverse effects, including ossification of fetal bones and reduced uterine weight.Dent 2012, Mohlapo 2009

Interactions

None well documented.

Adverse Reactions

Limited clinical data report moderately severe nausea, vomiting, and altered skin sensation. Increased blood pressure, pulse, electrocardiogram abnormalities (longer PR interval, higher ventricular heart rate, and lower QT interval), and blood chemistry abnormalities (increased total bilirubin and alkaline phosphatase, decreased serum urea nitrogen) were also noted in a clinical study.Blom 2011, Landor 2015, Posadzki 2013, Ríos-Hoyo 2016, Smith 2014

Data collected between 2004 and 2013 from 8 US centers in the Drug-induced Liver Injury Network revealed that 15.5% (130) of hepatotoxicity cases were caused by herbals and dietary supplements, whereas 85% (709) of cases were related to prescription medications. Of the 130 cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanics/Latinos compared with non-Hispanic whites and non-Hispanic blacks. Liver transplant was also more frequent with toxicity from non-bodybuilding supplements (13%) than with conventional medications (3%) (P<0.001). Overall, the proportion of severe liver injury cases was significantly higher for supplements than for conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, 175 had identifiable ingredients, of which hoodia was among the 32 (18%) single-ingredient products.Navarro 2014

Related/similar drugs

Toxicology

Information is limited; however, in a clinical study, increases in bilirubin and alkaline phosphatase levels were observed with H. gordonii purified extract.Blom 2011 H. gordonii extract has been shown to be nongenotoxic in 3 independent assays.Scott 2012 At higher doses only, adverse effects (eg, ossification of fetal bones, reduced uterine weight) have been observed in rodents.Dent 2012

Index Terms

• Hoodia parviflora
• Trichocaulon

References

Disclaimer

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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