Medically reviewed by Drugs.com. Last updated on Dec 12, 2019.
Scientific Name(s): Hoodia gordonii (Masson) Sweet ex Decne.
Common Name(s): Bushman's hat, Queen of the Namib, Xhoba (San)
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.
Information is lacking; neither an effective nor safe dose has been established.
No information is available. Caution is advised in patients with cardiovascular conditions or compromised hepatic function.
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented.
Moderately severe nausea, vomiting, and altered skin sensation have been reported. Cardiovascular and hepatic concerns also exist.
Limited data suggest H. gordonii extracts are not genotoxic.
- Apocynaceae (dogbane)
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 over-exploitation and is listed in Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).1 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 it has been subsumed into the Apocynaceae (dogbane) family.2 Other species in the genera Hoodia and Trichocaulon are said to have biological activity similar to that of H. gordonii.
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 P57. As a result, a patent was filed by the Council for Scientific and Industrial Research (CSIR) in 1995 in South Africa3; the council further developed extraction and quality control procedures.4, 5 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.6 In the meantime, a thriving, yet illicit, worldwide market has emerged that offers Hoodia herbal products as dietary supplements.7
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%).8, 9, 10 A compound unique to H. gordonii and responsible for purported appetite suppression has not been defined, and adulteration of herbal preparations is common.5, 11 High-performance liquid chromatography with ultraviolet and other chromatographic methods for quantification have been used.12, 13, 14
Uses and Pharmacology
Ex vivo studies in rats and in vitro human cells suggest stimulation of cholecystokinin secretion as a possible mechanism of action.15 The patent application suggests that modulation of hypothalamic adenosine triphosphatase activity as well as antagonism of melanocortin-4 receptors play a role.3, 16, 17 Experiments in rats have shown decreased body mass (adipose tissue and muscle) with supplemental H. gordonii extracts.18, 19 Further experiments in rabbits suggest a dose-related response, while limited effect was observed in chickens.20, 21
In a small clinical study (N = 50), no difference was found in food intake and body weight between placebo and 1 g of H. gordonii extract twice daily for 15 days.22 A review of the topic suggests the claimed effects on appetite and weight loss might be secondary symptoms of the serious adverse effects associated with the high-dose consumption required to achieve therapeutic clinical effect.23
Studies with 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.24
There are no clinical studies to support claims of gastric acid secretion control and management of diabetes.
Information is lacking; neither an effective nor safe dose has been established.25
Pregnancy / Lactation
None well documented.
Data collected between 2004 and 2013 among 8 US centers in the Drug-induced Liver Injury Network revealed 15.5% (130) of hepatotoxicity cases was caused by herbals and dietary supplements whereas 85% (709) were related to medications. Of the 130 related cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanic/Latinos compared to 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 number of severe liver injury cases was significantly higher from supplements than conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, H. gordonii was among the 22% (116) of the single-ingredient products.29
Information is limited; however, a clinical study found increases in bilirubin and alkaline phosphatase levels.22 H. gordonii extract has been shown to be nongenotoxic in 3 independent assays.28 At higher doses only, adverse effects, including ossification of fetal bones and reduced uterine weight, have been seen in rodents.20, 26
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