Medically reviewed on March 27, 2018
Scientific Name(s): Arthrospira platensis (Nordstedt) Gomont and Arthrospira maxima Setchell et Gardner. Family: Phormidiaceae
Common Name(s): Spirulina , dihe , tecuitlatl
Spirulina is sold in the United States as a health food or supplement. Diverse claims exist for its immunostimulatory, hypolipidemic, antiviral, and anticancer effects; however, there is limited evidence to support these indications.
Doses in clinical studies have ranged from 1 to 10 g/day.
Phenylketonuria; however, this has not been substantiated.
Information regarding safety and efficacy in pregnancy and lactation is lacking. Because of possible mercury and other heavy metal contamination, spirulina should be avoided during pregnancy.
None well documented.
Few reports of adverse reactions are available. However, spirulina-associated hepatotoxicity and reactions from heavy metal contamination are possible.
Spirulina is considered nontoxic to humans at usual levels of consumption; however, information is limited.
Spirulina, a blue-green algae (cyanophytes/cyanobacteria), grows as microscopic, corkscrew-shaped multicellular filaments and is now classified as a distinct genus, Arthrospora . A. plantensis is found in Africa and Asia, and A. maxima is found in Central America. 1 , 2 Free growing, spirulina exists only in high-salt alkaline water in subtropical and tropical areas, sometimes imparting a dark-green color to bodies of water. 3 Spirulina is noted for its characteristic behavior in carbonated water and energetic growth in laboratory cultures. 4 It is commercially grown in the United States and has been proposed as a primary foodstuff to be cultivated during long-term space missions because it withstands extreme conditions. 5 , 6 Due to its unique growth requirements, contamination of open pond cultures of spirulina by other microorganisms is usually slight, with the alga growing as a relatively pure culture.
Spirulina has been described in literature since the 16th century. Spanish explorers observed the Aztecs harvesting a blue mud that probably consisted of spirulina. 2 The mud, which was dried to form chips or flavored loaves, was obtained from Lake Texcoco near Mexico City. Spirulina was similarly harvested in the Sahara Desert from small lakes near Lake Chad, where it was called dihe . Thus, 2 cultures approximately 10,000 km apart, independently discovered and utilized the nutritional properties of spirulina. 2 Currently, spirulina is actively marketed by numerous companies as a nutritional supplement. 7
Spirulina is composed of approximately 65% crude protein, high levels of B-complex vitamins, 8 vitamin E, 9 beta-carotene, 10 and zeaxanthin. 4 , 11 The protein content includes 22 essential amino acids, 2 , 12 and the total protein is nutritionally superior to legume protein, but inferior to meat protein. 2 The proteins C-phycocyanin and allophycocyanin in spirulina have been the focus of much research. 13 , 14 High levels of gamma linolenic acid, a polyunsaturated fatty acid, are present. 15 An assay for spirulina lipids using high-pressure liquid chromatography-mass spectrometry has been developed. 16 Spirulina preparations contain 300 to 400 ppm iron (dry weight), and unlike many forms of plant iron, has high bioavailability when ingested by humans. A dosage of 10 g/day can contain 1.5 to 2 mg of absorbable iron, similar to that of standard ferrous sulfate. 17 , 18 Trace elements present at high levels include manganese, selenium, and zinc. Calcium, potassium, and magnesium are also concentrated in the organism. 19 Calcium spirulan, a sulfated polysaccharide, was characterized from A. platensis . 20
Uses and Pharmacology
Clinical trials have investigated spirulina's potential but have been too small to support its purported effects. 21Allergic rhinitis and asthma
Experimental data have suggested that C-phycocyanin can selectively inhibit release of histamine from mast cells and prevent increases in immunoglobulin E. A small study in patients with mild to moderate asthma suggested that spirulina supplementation (1 g/day) produced improvement in lung function parameters, 22 while a study evaluating spirulina in allergic rhinitis suggested a positive effect on laboratory values, but no clinical outcomes were reported. 23 A 6-month, double-blind, placebo-controlled study enrolling 150 patients with allergic rhinitis found efficacy for 2 g/day of spirulina over placebo using diary-based symptom scores of nasal discharge. 24Antimicrobial activity
A provocative suggestion has been made that human cultures in which large amounts of algae are consumed have lower levels of HIV infection. 25 Spirulina and its extracts have been evaluated for antiviral activity. One in vitro study found that the sulfated polysaccharide calcium spirulan interfered with the replication of several enveloped viruses, including herpes simplex, cytomegalovirus, mumps, measles, influenza A, and HIV-1, 20 while another study described a slightly different range of viruses susceptible to the extract. 26 HIV-1 adsorption and penetration were inhibited by an aqueous extract of spirulina, while a crude hot water extract reduced HIV-1 replication. 25 This type of in vitro activity is common to acidic polysaccharides from a variety of sources. Enterovirus is also susceptible to spirulina, and allophycocyanin was the active constituent. 27 Spirulina demonstrated some in vitro activity against common human bacterial pathogens but less than that of the standard comparator. 28 Immune stimulation by phycocyanin and polysaccharides of spirulina led to an antifungal and antibacterial effect in mice. 29Cancer
C-phycocyanin showed a dose-dependent inhibition of HeLa and human chronic myeloid leukemia cell growth and proliferation in vitro. 30 , 31 Induction of apoptosis was considered to be one of the mechanisms involved. 32 Doxorubicin-resistant HepG2 liver cancer cells were inhibited by spirulina C-phycocyanin through an apoptotic mechanism, 33 while water-soluble polysaccharides were implicated as the active agent against stomach cancer cells. 34 A combination of selenium and spirulina inhibited MCF-7 breast cancer cells via growth arrest and apoptosis. 35 Survival rates increased in mice with liver cancer treated with C-phycocyanin, and tumor regression has been reported in animals with oral cancer. 36 , 37 , 38 Activation of antitumor natural killer cells by spirulina enhanced antitumor efficacy in a B16 mouse melanoma model, and the effect was abolished in MyD88 null/null mice, indicating that NK cell activation was a key pathway. 39 In a hamster cheek pouch model of carcinogenesis, 10 mg/day of spirulina extract reduced dysplastic changes, 40 which was further confirmed by an immunohistochemical study. 41 Spirulina was chemopreventative in a dibutyl nitrosamine carcinogenesis model. 42 It also induced lesion regression in tobacco chewers with oral leukoplakia in a study conducted in India. 43Diabetes
A study in alloxan-induced diabetic rats revealed that spirulina at 10 mg/kg orally for 30 days lowered glucose levels, while slightly elevating insulin. 44 Two small clinical studies investigated the effects of spirulina supplementation in type 2 diabetes, with improvement noted in fasting blood sugar and lipid profiles. Suggested mechanisms of action include hypoglycemia caused by fiber content or possible insulin-stimulating action of peptides and polypeptides of spirulina proteins. The actions on lipids have been attributed to gamma linolenic acid content. 45 , 46Dietary supplement
Spirulina, considered a food item for centuries in many countries, is now popularly thought of as a dietary supplement. 5 Spirulina consumption was purported to aid in weight loss because of its high phenylalanine content, but a US Food and Drug Administration review found no evidence to support this claim. 47 , 48 Suggestions that spirulina is a valuable source of vitamin B 12 have been similarly disputed. 5 Skeletal muscle protein (myosin) was increased in young rats fed spirulina as the sole dietary protein source compared with casein. 49 A study of spirulina supplementation for 8 weeks demonstrated clinical improvement in weight gain and increased hemoglobin levels in malnourished children in the West African nation of Burkina Faso. 50 Similar results have been demonstrated among children who are HIV-positive. 51 In elderly Koreans, spirulina 8 g/day for 16 weeks had a variety of positive effects (cholesterol, antioxidant status, interleukin [IL]-2 and IL-6 levels) observed in a randomized, double-blind, placebo-controlled study. 52 In a study of athletic training, spirulina increased time to fatigue, decreased carbohydrate oxidation rate, and increased fat oxidation rate, leading to an increase in exercise performance. 53Hyperlipidemia
Experiments in rats suggest that C-phycocyanin exhibits hypercholesterolemic action. 54 In rabbits fed a high-cholesterol diet, spirulina (1% or 5% in diet) lowered serum triglycerides, total cholesterol, and low-density lipoprotein (LDL) at 8 weeks. High-density lipoprotein (HDL) was markedly increased. 55 Two small clinical studies examined the role of spirulina in hyperlipidemia secondary to nephrotic syndrome. Both populations showed an improved lipid profile with spirulina supplementation; however, the control group in 1 experiment also showed improvement. The gamma linolenic acid content of spirulina may have played a role in the mechanism of action. 56 , 57 A study in type 2 diabetes patients reported a reduction in triglycerides with 8 g/day of spirulina. 58 In normal volunteers, 4.5 g/day of spirulina for 6 weeks lowered blood pressure, total cholesterol, LDL, and increased HDL. 59 , 60Immune system effects
Most in vitro and animal experiments have suggested immunostimulatory effects; however, 1 study found a spirulina extract to be immunosuppressive. 61 Activation of monocytes and macrophages, 62 , 63 as well as augmentation of interleukin and interferon production, have been demonstrated. 64 Intestinal epithelial lymphocytes of aged mice treated with spirulina were increased compared with the control aged group. 65 A clinical study in healthy men found that oral administration of spirulina for 3 months resulted in enhanced interferon production and natural killer (NK) cell capacity. 25 An ex vivo study of NK cells from spirulina-treated healthy patients showed increased NK activity, which was confirmed by a second study in which NK cell and T-cell markers were increased by spirulina. 66 A clinical trial in elderly patients showed positive effects on anemia and immunosenescence after 6 and 12 weeks of supplementation. 67 The immunostimulatory effects appear to be largely mediated by spirulina polysaccharides. 62 , 63Prevention of toxicity due to metals or organic compounds
A 5% spirulina-supplemented diet prevented carbon tetrachloride-induced fatty liver in rats. 68 In a case series of 3 patients with nonalcoholic fatty liver disease, 4.5 g/day of spirulina for 3 months improved ALT values and lipid profiles. 69 Cadmium toxicity in rats was reduced by spirulina, as measured by liver histopathology. 70 Mercuric chloride-induced oxidative stress in mice was blocked by spirulina at 800 mg/kg orally for 40 days. 71 Lead acetate damage to rats was minimized by spirulina via normalizing plasma and liver lipid levels, as well as via its antioxidant effect. 72 A protein extract and purified phycocyanin protected neuroblastoma cells from iron-induced toxicity. 73 Spirulina pretreatment protected mice against acetaminophen and galactosamine-induced liver damage. 74 Liver and kidney enzyme markers of toxicity were reduced by spirulina following 4-nitroquinoline 1-oxide insult to rats. 75 Spirulina decreased cisplatin-induced nephrotoxicity in rats, an effect attributed to an antioxidant action. 76 Gentamicin-induced kidney damage in rats was reversed by intraperitoneal spirulina 1 g/kg daily. 77 In pregnant mice, teratogenicity due to cadmium was reduced by 125 to 500 mg/kg of spirulina by intragastric administration for 17 days of gestation. 78 Mutagenicity of cyclophosphamide in mice pretreated with spirulina was reduced. 79 In a small, randomized, placebo-controlled trial, spirulina plus zinc increased urinary excretion of arsenic and decreased arsenic hair-content in people with long-term exposure to arsenic. 80Antioxidant
The spirulina protein phycocyanin in pure form was active in 4 different cell-free radical-scavenging assays; however, phycocyanin-containing selenium was more effective. 81 In cellular assays of antioxidant activity, 4 commercial spirulina preparations were also active. 82 Spirulina supplementation of rats did not increase plasma or liver alpha-tocopherol levels 83 ; however, another study reported effective antioxidant activity using combinations of whey protein and spirulina. 84 C-phycocyanin from spirulina reduced oxidative stress in hamsters fed an atherogenic diet. 85 Similarly, rabbits fed a high-cholesterol diet were protected from oxidative stress by 4 to 8 weeks of spirulina in feed at 1% or 5%. 86 Other studies suggest spirulina as an antioxidant, 87 but clinical importance has not been demonstrated, 88 , 89 and 1 small clinical study showed spirulina to be without effect on plasma antioxidant status. 90Other uses
C-phycocyanin inhibited platelet aggregation in ex vivo experiments. 91 In mice with zymosan-induced arthritis, phycocyanin exerted a scavenging action against reactive oxygen species and anti-inflammatory activity. 92 Similar experiments with complete Freund's adjuvant-induced arthritis found 800 mg/kg of oral spirulina effective in reducing inflammation. 93 In rats, collagen-induced arthritis was inhibited by 400 mg/kg of spirulina. 94 Osteoporosis was inhibited in rosiglitazone-treated rats by 500 mg/kg/day of oral spirulina. 95 A rat study showed evidence that spirulina could protect neural stem cells and promote their growth 96 ; however, an amyotrophic lateral sclerosis (ALS) support network did not find the evidence compelling for use in ALS. 97 Spirulina supplementation (3 g/day) was ineffective against idiopathic chronic fatigue in a small study. 98 Pretreatment with spirulina 180 mg/kg orally in a rat cerebral ischemia-reperfusion injury model reduced neurologic deficits and histological changes. 99 A polysaccharide extract of spirulina was antiangiogenic in a mouse corneal model. 100 Spirulina also has been reported to protect mouse and human bone marrow cells against gamma radiation. 23 , 76 , 87 , 101 , 102 , 103
Information regarding safety and efficacy in pregnancy and lactation is lacking. Spirulina may contain more than 180 mcg of mercury per 20 g 19 and should be avoided.
None well documented. An antiplatelet effect has been demonstrated in vitro but was not clinically evaluated. 91
Few reports of adverse reactions are available. Case reports of immunoblistering 104 and rhabdomyolysis 105 linked to spirulina have been published. Cyanobacteria (blue-green algae) may contain the amino acid phenylalanine; therefore, people with phenylketonuria should avoid spirulina. 5 A case of spirulina-associated hepatotoxicity has been reported. 106 Hepatotoxic microcystins and neurotoxic anatoxin-a are produced by a number of cyanobacteria and have been reported as spirulina contaminants. 107 , 108 Other contaminants include the heavy metals mercury, cadmium, arsenic, and lead, as well as microbes cultivated on fermented animal waste. 19 , 109 Questions have been raised regarding the potential for adverse reactions in people with autoimmune disorders who consume immunostimulatory herbal preparations. 110
Spirulina is considered nontoxic to humans at usual amounts of consumption; however, information is limited.
Bibliography1. Kulshreshtha A, Zacharia AJ, Jarouliya U, Bhadauriya P, Prasad GB, Bisen PS. Spirulina in health care management. Curr Pharm Biotechnol . 2008;9(5):400-405.
2. Ciferri O . Spirulina, the edible microorganism . Microbiol Rev . 1983;47(4):551-578.
3. Ciferri O , Tiboni O . The biochemistry and industrial potential of Spirulina . Annu Rev Microbiol . 1985;39:503-526.
4. Dillon JC , Phuc AP , Dubacq JP . Nutritional value of the alga Spirulina . World Rev Nutr Diet . 1995;77:32-46.
5. Robb-Nicholson C . By the way, doctor. I read that spirulina is the next wonder vitamin. What can you tell me about it? Harv Womens Health Watch . 2006;14(3):8.
6. Godia F , Albiol J , Montesinos JL , et al. MELISSA: a loop of interconnected bioreactors to develop life support in space . J Biotechnol . 2002;99(3):319-330.
7. Khan Z, Bhadouria P, Bisen PS. Nutritional and therapeutic potential of Spirulina. Curr Pharm Biotechnol . 2005;6(5):373-379.
8. Lumsden J , Hall DO . Soluble & membrane-bound superoxide dismutases in a blue-green algae (Spirulina) and spinach . Biochem Biophys Res Commun . 1974;58(1):35-41.
9. Mitchell GV , Grundel E , Jenkins M , Blakely SR . Effects of graded dietary levels of Spirulina maxima on vitamins A and E in male rats . J Nutr . 1990;120(10):1235-1240.
10. Wang J, Wang Y, Wang Z, et al. Vitamin A equivalence of spirulina beta-carotene in Chinese adults as assessed by using a stable-isotope reference method. Am J Clin Nutr . 2008;87(6):1730-1737.
11. Kapoor R , Mehta U . Utilization of beta-carotene from Spirulina platensis by rats . Plant Foods Hum Nutr . 1993;43(1):1-7.
12. Maranesi M , Barzanti V , Carenini G , Gentili P . Nutritional studies on Spirulina maxima . Acta Vitaminol Enzymol . 1984;6(4):295-304.
13. Patil G, Chethana S, Madhusudhan MC, Raghavarao KS. Fractionation and purification of the phycobiliproteins from Spirulina platensis. Bioresour Technol . 2008;99(15):7393-7396.
14. Yoshikawa N, Belay A. Single-laboratory validation of a method for the determination of c-phycocyanin and allophycocyanin in Spirulina ( Arthrospira ) supplements and raw materials by spectrophotometry. J AOAC Int . 2008;91(3):524-529.
15. Otles S , Pire R . Fatty acid composition of chlorella and spirulina microalgae species . J AOAC Int . 2001;84(6):1708-1714.
16. Herrero M, Vicente MJ, Cifuentes A, Ibáñez E. Characterization by high-performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry of the lipid fraction of Spirulina platensis pressurized ethanol extract. Rapid Commun Mass Spectrom . 2007;21(11):1729-1738.
17. Kapoor R , Mehta U . Iron status and growth of rats fed different dietary iron sources . Plant Foods Hum Nutr . 1993;44(1):29-34.
18. Kapoor R , Mehta U . Effect of supplementation of blue green algae (Spirulina) on outcome of pregnancy in rats . Plant Foods Hum Nutr . 1993;43(1):29-35.
19. Johnson PE , Shubert LE . Availability of iron to rats from Spirulina, a blue-green alga . Nutr Res . 1986;6(1):85.
20. Hayashi T , Hayashi K , Maeda M , Kojima I . Calcium spirulan, an inhibitor of enveloped virus replication, from a blue-green alga, Spirulina platensis. J Nat Prod . 1996;59(1):83-87.
21. Karkos PD, Leong SC, Karkos CD, Sivaji N, Assimakopoulos DA. Spirulina in clinical practice: evidence-based human applications. Evid Based Complement Alternat Med . 2008 Sep 14 [Epub ahead of print].
22. Labhe RU , Mani UV , Iyer UM , Mishra M , Jani K , Bhattacharya A . The effect of spirulina in the treatment of bronchial asthma . J Nutraceutical Functional Med Foods . 2001;3(pt 4):53-62.
23. Mao TK , Van de Water J , Gershwin ME . Effects of a Spirulina-based dietary supplement on cytokine production from allergic rhinitis patients . J Med Food . 2005;8(1):27-30.
24. Cingi C, Conk-Dalay M, Cakli H, Bal C. The effects of spirulina on allergic rhinitis. Eur Arch Otorhinolaryngol . 2008;265(10):1219-1223.
25. Teas J , Hebert JR , Fitton JH , Zimba PV . Algae—a poor man's HAART? Med Hypotheses . 2004;62(4):507-510.
26. Hernández-Corona A , Nieves I , Meckes M , Chamorro G , Barron BL . Antiviral activity of Spirulina maxima against herpes simplex virus type 2 . Antiviral Res . 2002;56(3):279-285.
27. Shih SR , Tsai KN , Li YS , Chueh CC , Chan EC . Inhibition of enterovirus 71-induced apoptosis by allophycocyanin isolated from a blue-green alga Spirulina platensis . J Med Virol . 2003;70(1):119-125.
28. Ozdemir G , Karabay NU , Dalay MC , Pazarbasi B . Antibacterial activity of volatile component and various extracts of Spirulina platensis . Phytother Res . 2004;18(9):754-757.
29. El-Sheekh MM, Mahmoud YA, Abo-Shady AM, Hamza W. Efficacy of Rhodotorula glutinis and Spirulina platensis carotenoids in immunopotentiation of mice infected with Candida albicans SC5314 and Pseudomonas aeruginosa 35. Folia Microbiol (Praha) . 2010;55(1):61-67.
30. Subhashini J , Mahipal SV , Reddy MC , Mallikarjuna Reddy M , Rachamallu A , Reddanna P . Molecular mechanisms in C-Phycocyanin induced apoptosis in human chronic myeloid leukemia cell line-K562 . Biochem Pharmacol . 2004;68(3):453-462.
31. Li B , Gao MH , Zhang XC , Chu XM . Molecular immune mechanism of C-phycocyanin from Spirulina platensis induces apoptosis in HeLa cells in vitro . Biotechnol Appl Biochem . 2006;43(pt 3):155-164.
32. Li B , Zhang X , Gao M , Chu X . Effects of CD59 on antitumoral activities of phycocyanin from Spirulina platensis . Biomed Pharmacother . 2005;59(10):551-560.
33. Roy KR, Arunasree KM, Reddy NP, Dheeraj B, Reddy GV, Reddanna P. Alteration of mitochondrial membrane potential by Spirulina platensis C-phycocyanin induces apoptosis in the doxorubicinresistant human hepatocellular-carcinoma cell line HepG2. Biotechnol Appl Biochem . 2007;47(pt 3):159-167.
34. Oh SH, Ahn J, Kang DH, Lee HY. The Effect of ultrasonificated extracts of Spirulina maxima on the anticancer activity. Mar Biotechnol (NY) . 2011;13(2):205-214.
35. Chen T, Wong YS, Zheng W. Induction of G1 cell cycle arrest and mitochondria-mediated apoptosis in MCF-7 human breast carcinoma cells by selenium-enriched Spirulina extract. Biomed Pharmacother . 2009 Oct 27 [Epub ahead of print].
36. Schwartz J , Shklar G . Regression of experimental hamster cancer by beta carotene and algae extracts . J Oral Maxillofac Surg . 1987;45(6):510-515.
37. Schwartz J , Shklar G , Reid S , Trickler D . Prevention of experimental oral cancer by extracts of Spirulina-Dunaliella algae . Nutr Cancer . 1988;11(2):127-134.
38. Shklar G , Schwartz J . Tumor necrosis factor in experimental cancer regression with alphatocopherol, beta-carotene, canthaxanthin and algae extract . Eur J Cancer Clin Oncol . 1988;24(5):839-850.
39. Akao Y, Ebihara T, Masuda H, et al. Enhancement of antitumor natural killer cell activation by orally administered Spirulina extract in mice. Cancer Sci . 2009;100(8):1494-1501.
40. Grawish ME. Effects of Spirulina platensis extract on Syrian hamster cheek pouch mucosa painted with 7,12-dimethylbenz[a]anthracene. Oral Oncol . 2008;44(10):956-962.
41. Grawish ME, Zaher AR, Gaafar AI, Nasif WA. Long-term effect of Spirulina platensis extract on DMBA-induced hamster buccal pouch carcinogenesis (immunohistochemical study). Med Oncol . 2010;27(1):20-28.
42. Ismail MF, Ali DA, Fernando A, et al. Chemoprevention of rat liver toxicity and carcinogenesis by Spirulina. Int J Biol Sci . 2009;5(4):377-387.
43. Mathew B , Sankaranarayanan R , Nair PP , et al. Evaluation of chemoprevention of oral cancer with Spirulina fusiformis . Nutr Cancer . 1995;24(2):197-202.
44. Muthuraman P, Senthilkumar R, Srikumar K. Alterations in beta-islets of Langerhans in alloxan-induced diabetic rats by marine Spirulina platensis. J Enzyme Inhib Med Chem . 2009;24(6):1253-1256.
45. Mani UV , Desai S , Iyer I . Studies on the long-term effect of spirulina supplementation on serum lipid profile and glycated proteins in NIDDM patients . J Nutraceutical Funct Med Foods . 2000;2(3):25-32.
46. Parikh P , Mani U , Iyer U . Role of spirulina in the control of glycemia and lipidemia in type 2 diabetes mellitus . J Med Food . 2001;4(4):193-199.
47. ACSH News & Views . 1982;3(3):3.
48. FDA Consumer . 1981;15:3.
49. Voltarelli FA, de Mello MA. Spirulina enhanced the skeletal muscle protein in growing rats. Eur J Nutr . 2008;47(7):393-400.
50. Simpore J , Kabore F , Zongo F , et al. Nutrition rehabilitation of undernourished children utilizing Spiruline and Misola . Nutr J . 2006;5:3.
51. Simpore J , Zongo F , Kabore F , et al. Nutrition rehabilitation of HIV-infected and HIV-negative undernourished children utilizing spirulina . Ann Nutr Metab . 2005;49(6):373-380.
52. Park HJ, Lee YJ, Ryu HK, Kim MH, Chung HW, Kim WY. A randomized double-blind, placebo-controlled study to establish the effects of spirulina in elderly Koreans. Ann Nutr Metab . 2008;52(4):322-328.
53. Kalafati M, Jamurtas AZ, Nikolaidis MG, et al. Ergogenic and antioxidant effects of spirulina supplementation in humans. Med Sci Sports Exerc . 2010;42(1):142-151.
54. Nagaoka S , Shimizu K , Kaneko H , et al. A novel protein C-phycocyanin plays a crucial role in the hypocholesterolemic action of Spirulina platensis concentrate in rats . J Nutr . 2005;135(10):2425-2430.
55. Cheong SH, Kim MY, Sok DE, et al. Spirulina prevents atherosclerosis by reducing hypercholesterolemia in rabbits fed a high-cholesterol diet. J Nutr Sci Vitaminol (Tokyo) . 2010;56(1):34-40.
56. Khanam A , Rashid H . Effect of spirulina on lipid profile in patients with glomerulonephritis . Bangladesh Renal J . 2001;20:8-13.
57. Samuels R , Mani UV , Iyer UM , Nayak US . Hypocholesterolemic effect of spirulina in patients with hyperlipidemic nephrotic syndrome . J Med Food . 2002;5(2):91-96.
58. Lee EH, Park JE, Choi YJ, Huh KB, Kim WY. A randomized study to establish the effects of spirulina in type 2 diabetes mellitus patients. Nutr Res Pract . 2008;2(4):295-300.
59. Juárez-Oropeza MA, Mascher D, Torres-Durán PV, Farias JM, Paredes-Carbajal MC. Effects of dietary Spirulina on vascular reactivity. J Med Food . 2009;12(1):15-20.
60. Torres-Duran PV, Ferreira-Hermosillo A, Juarez-Oropeza MA. Antihyperlipemic and antihypertensive effects of Spirulina maxima in an open sample of Mexican population: a preliminary report. Lipids Health Dis . 2007;6:33.
61. Rasool M, Sabina EP. Appraisal of immunomodulatory potential of Spirulina fusiformis: an in vivo and in vitro study. J Nat Med . 2009;63(2):169-175.
62. Pugh N , Ross SA , ElSohly HN , ElSohly MA , Pasco DS . Isolation of three high molecular weight polysaccharide preparations with potent immunostimulatory activity from Spirulina platensis, Aphanizomen flos-aquae and Chlorella pyrenoidosa . Planta Med . 2001;67(8):737-742.
63. Balachandran P , Pugh ND , Ma G , Pasco DS . Toll-like receptor 2-dependent activation of monocytes by Spirulina polysaccharide and its immune enhancing action in mice . Int Immunopharmacol . 2006;6(12):1808-1814.
64. Mao TK , Van de Water J , Gershwin ME . Effect of spirulina on the secretion of cytokines from peripheral blood mononuclear cells . J Med Food . 2000;3(3):135-140.
65. Hayashi O, Katayanagi Y, Ishii K, Kato T. Flow cytometric analysis of age-related changes in intestine intraepithelial lymphocyte subsets and their functional preservation after feeding mice on spirulina. J Med Food . 2009;12(5):982-989.
66. Nielsen CH, Balachandran P, Christensen O, et al. Enhancement of natural killer cell activity in healthy subjects by Immulina , a Spirulina extract enriched for Braun-type lipoproteins. Planta Med . 2010;76(16):1802-1808.
67. Selmi C, Leung PS, Fischer L, et al. The effects of Spirulina on anemia and immune function in senior citizens. Cell Mol Immunol . 2011;8(3);248-254.
68. Torres-Durán PV , Miranda-Zamora R , Paredes-Carbajal MC , Mascher D , Díaz-Zagoya JC , Juárez-Oropeza MA . Spirulina maxima prevents induction of fatty liver by carbon tetrachloride in the rat . Biochem Mol Biol Int . 1998;44(4):787-793.
69. Ferreira-Hermosillo A, Torres-Duran PV, Juarez-Oropeza MA. Hepatoprotective effects of Spirulina maxima in patients with non-alcoholic fatty liver disease: a case series. J Med Case Reports . 2010;4(1):103.
70. Karadeniz A, Cemek M, Simsek N. The effects of Panax ginseng and Spirulina platensis on hepatotoxicity induced by cadmium in rats. Ecotoxicol Environ Saf . 2009;72(1):231-235.
71. Sharma MK, Sharma A, Kumar A, Kumar M. Spirulina fusiformis provides protection against mercuric chloride induced oxidative stress in Swiss albino mice. Food Chem Toxicol . 2007;45(12):2412-2419.
72. Ponce-Canchihuamán JC, Pérez-Méndez O, Hernández-Muñoz R, Torres-Durán PV, Juárez-Oropeza MA. Protective effects of Spirulina maxima on hyperlipidemia and oxidative-stress induced by lead acetate in the liver and kidney. Lipids Health Dis . 2010;9:35.
73. Bermejo-Bescós P, Piñero-Estrada E, Villar del Fresno AM. Neuroprotection by Spirulina platensis protean extract and phycocyanin against iron-induced toxicity in SH-SY5Y neuroblastoma cells. Toxicol In Vitro . 2008;22(6):1496-1502.
74. Lu J, Ren DF, Wang JZ, Sanada H, Egashira Y. Protection by dietary Spirulina platensis against D-galactosamine--and acetaminophen-induced liver injuries. Br J Nutr . 2010;103(11):1573-1576.
75. Viswanadha VP, Sivan S, Rajendra Shenoi R. Protective effect of Spirulina against 4-nitroquinoline-1-oxide induced toxicity. Mol Biol Rep . 2011;38(1):309-317.
76. Mohan IK , Khan M , Shobha JC , et al. Protection against cisplatin-induced nephrotoxicity by Spirulina in rats . Cancer Chemother Pharmacol . 2006;58(6):802-808.
77. Karadeniz A, Yildirim A, Simsek N, Kalkan Y, Celebi F. Spirulina platensis protects against gentamicin-induced nephrotoxicity in rats. Phytother Res . 2008;22(11):1506-1510.
78. Paniagua-Castro N, Escalona-Cardoso G, Hernández-Navarro D, Pérez-Pastén R, Chamorro-Cevallos G. Spirulina ( Arthrospira ) protects against cadmium-induced teratogenic damage in mice. J Med Food . 2011;14(4):398-404.
79. Chamorro-Cevallos G, Garduño-Siciliano L, Barrón BL, Madrigal-Bujaidar E, Cruz-Vega DE, Pages N. Chemoprotective effect of Spirulina ( Arthrospira ) against cyclophosphamide-induced mutagenicity in mice. Food Chem Toxicol . 2008;46(2):567-574.
80. Misbahuddin M , Islam AZ , Khandker S , Ifthaker-Al-Mahmud , Islam N , Anjumanara . Efficacy of spirulina extract plus zinc in patients of chronic arsenic poisoning: a randomized placebo-controlled study . Clin Toxicol (Phila) . 2006;44(2):135-141.
81. Chen T, Wong YS. In vitro antioxidant and antiproliferative activities of selenium-containing phycocyanin from selenium-enriched Spirulina platensis. J Agric Food Chem . 2008;56(12):4352-4358.
82. Dartsch PC. Antioxidant potential of selected Spirulina platensis preparations. Phytother Res . 2008;22(5):627-633.
83. García-Martínez D, Rupérez FJ, Ugarte P, Barbas C. Tocopherol fate in plasma and liver of streptozotocin-treated rats that orally received antioxidants and Spirulina extracts. Int J Vitam Nutr Res . 2007;77(4):263-271.
84. Gad AS, Khadrawy YA, El-Nekeety AA, Mohamed SR, Hassan NS, Abdel-Wahhab MA. Antioxidant activity and hepatoprotective effects of whey protein and Spirulina in rats. Nutrition . 2011;27(5):582-589.
85. Riss J, Décordé K, Sutra T, et al. Phycobiliprotein C-phycocyanin from Spirulina platensis is powerfully responsible for reducing oxidative stress and NADPH oxidase expression induced by an atherogenic diet in hamsters. J Agric Food Chem . 2007;55(19):7962-7967.
86. Kim MY, Cheong SH, Lee JH, Kim MJ, Sok DE, Kim MR. Spirulina improves antioxidant status by reducing oxidative stress in rabbits fed a high-cholesterol diet. J Med Food . 2010;13(2):420-426.
87. Wu LC , Ho JA , Shieh MC , Lu IW . Antioxidant and antiproliferative activities of Spirulina and Chlorella water extracts . J Agric Food Chem . 2005;53(10):4207-4212.
88. Deng R, Chow TJ. Hypolipidemic, antioxidant, and antiinflammatory activities of microalgae Spirulina. Cardiovasc Ther . 2010;28(4):e33-e45.
89. McCarty MF. Clinical potential of Spirulina as a source of phycocyanobilin. J Med Food . 2007;10(4):566-570.
90. Shyam R, Singh SN, Vats P, et al. Wheat grass supplementation decreases oxidative stress in healthy subjects: a comparative study with spirulina. J Altern Complement Med . 2007;13(8):789-791.
91. Hsiao G , Chou PH , Shen MY , Chou DS , Lin CH , Sheu JR . C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis . J Agric Food Chem . 2005;53(20):7734-7740.
92. Remirez D , González R , Merino N , Rodriguez S , Ancheta O . Inhibitory effects of Spirulina in zymosan-induced arthritis in mice . Mediators Inflamm . 2002;11(2):75-79.
93. Rasool M, Sabina EP, Lavanya B. Anti-inflammatory effect of Spirulina fusiformis on adjuvant-induced arthritis in mice. Biol Pharm Bull . 2006;29(12):2483-2487.
94. Kumar N, Singh S, Patro N, Patro I. Evaluation of protective efficacy of Spirulina platensis against collagen-induced arthritis in rats. Inflammopharmacology . 2009;17(3):181-190.
95. Gupta S, Hrishikeshvan HJ, Sehajpal PK. Spirulina protects against rosiglitazone induced osteoporosis in insulin resistance rats. Diabetes Res Clin Pract . 2010;87(1):38-43.
96. Bachstetter AD, Jernberg J, Schlunk A, et al. Spirulina promotes stem cell genesis and protects against LPS induced declines in neural stem cell proliferation. PLoS One . 2010;5(5):e10496.
97. ALSUntangled Group. ALSUntangled No. 9: Blue-green algae (Spirulina) as a treatment for ALS. Amyotroph Lateral Scler . 2011;12(2):153-155.
98. Baicus C, Baicus A. Spirulina did not ameliorate idiopathic chronic fatigue in four N-of-1 randomized controlled trials. Phytother Res . 2007;21(6):570-573.
99. Thaakur S, Sravanthi R. Neuroprotective effect of Spirulina in cerebral ischemia-reperfusion injury in rats. J Neural Transm . 2010;117(9):1083-1091.
100. Yang L, Wang Y, Zhou Q, et al. Inhibitory effects of polysaccharide extract from Spirulina platensis on corneal neovascularization. Mol Vis . 2009;15:1951-1961.
101. Lu HK , Hsieh CC , Hsu JJ , Yang YK , Chou HN . Preventive effects of Spirulina platensis on skeletal muscle damage under exercise-induced oxidative stress. Eur J Appl Physiol . 2006;98(2):220-226.
102. Qishen P , Guo BJ , Kolman A . Radioprotective effect of extract from Spirulina platensis in mouse bone marrow cells studied by using the micronucleus test . Toxicol Lett . 1989;48(2):165-169.
103. Klingler W , Kreja L , Nothdurft W , Selig C . Influence of different radioprotective compounds on radiotolerance and cell cycle distribution of human progenitor cells of granulocytopoiesis in vitro . Br J Haematol . 2002;119(1):244-254.
104. Kraigher O, Wohl Y, Gat A, Brenner S. A mixed immunoblistering disorder exhibiting features of bullous pemphigoid and pemphigus foliaceus associated with Spirulina algae intake. Int J Dermatol . 2008;47(1):61-63.
105. Mazokopakis EE, Karefilakis CM, Tsartsalis AN, Milkas AN, Ganotakis ES. Acute rhabdomyolysis caused by Spirulina ( Arthrospira platensis ). Phytomedicine . 2008;15(6-7):525-527.
106. Iwasa M , Yamamoto M , Tanaka Y , Kaito M , Adachi Y . Spirulina-associated hepatotoxicity . Am J Gastroenterol . 2002;97(12):3212-3213.
107. Rawn DF , Niedzwiadek B , Lau BP , Saker M . Anatoxin-a and its metabolites in blue-green algae food supplements from Canada and Portugal . J Food Prot . 2007;70(3):776-779.
108. Jiang Y, Xie P, Chen J, Liang G. Detection of the hepatotoxic microcystins in 36 kinds of cyanobacteria Spirulina food products in China. Food Addit Contam Part A Chem Anal Control Expo Risk Assess . 2008;25(7):885-894.
109. Wu JF , Pond WG . Amino acid composition and microbial contamination of Spirulina maxima, a blue-green alga, grown on the effluent of fermented animal wastes . Bull Environ Contam Toxicol . 1981;27(2):151-159.
110. Lee AN , Werth VP . Activation of autoimmunity following use of immunostimulatory herbal supplements . Arch Dermatol . 2004;140(6):723-727.
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