Therapeutic Uses
On the basis of chitosan's supposed ability to bind fat in the intestines, it has been tried as a treatment for
high cholesterol. However, the evidence regarding whether it really works is generally more negative than positive.
31, 36,37,39,40, 42,43,45,48,49
At best, chitosan appears to offer no more than minimal benefit for high cholesterol.
Chitosan has also been proposed as a
weight loss
treatment on the same principle.
2,3
However, despite some mildly positive results, the current balance of evidence suggests chitosan does
not
in fact significantly aid weight loss.
4,5,37,41,44,46,49,50
Weak evidence hints that chitosan may be helpful in kidney failure.
15
When used for this purpose, it is thought to work by binding with toxins in the digestive tract and causing them to be excreted.
Studies in dogs have found that topically applied chitosan can help heal
wounds.
16
This effect might be due to stimulation of new tissue growth; in addition, topical chitosan appears to kill bacteria such as
Streptococcus
, which may also contribute to wound healing.
16
Chitosan may also have activity against
Candida albicans
, a form of yeast that causes
vaginal infections.
Highly preliminary evidence suggests that oral chitosan may inhibit the expected rise in
blood pressure
after a high-salt meal.
18
Other weak evidence hints that chitosan chewing gum might help prevent
cavities.
47
It has been suggested that chitosan can
stimulate the immune system
and
prevent cancer
,
16
but there is no reliable evidence as yet that it offers these benefits.
Animal studies suggest that some forms of chitosan may help to prevent bone loss;
20
however, because chitosan also interferes with mineral absorption, the net effect in humans might actually be to increase bone loss (see
Safety Issues
below).
References
1
Kanauchi O, Deuchi K, Imasato Y, et al. Increasing effect of a chitosan and ascorbic acid mixture on fecal dietary fat excretion
. Biosci Biotechnol Biochem. 1994;58:1617-1620.
2
Deuchi K, Kanauchi O, Imasato Y, et al. Decreasing effect of chitosan on the apparent fat digestibility by rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1994;58:1613-1616.
3
Deuchi K, Kanauchi O, Imasato Y, et al. Effect of the viscosity or deacetylation degree of chitosan on fecal fat excreted from rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1995;59:781-785.
4
Schiller RN, Barrager E, Schauss AG, et al. A randomized, double-blind, placebo-controlled study examining the effects of a rapidly soluble chitosan dietary supplement on weight loss and body composition in overweight and mildly obese individuals.
J Am Nutraceutical Assoc.
2001;4:42-49.
5
Pittler MH, Abbot NC, Harkness EF, et al. Randomized, double-blind trial of chitosan for body weight reduction.
Eur J Clin Nutr.
1999;53:379-381.
6
Ho SC, Tai ES, Eng PH, et al. In the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects.
Singapore Med J.
2001;42:6-10.
7
Maezaki Y, Tsuji K, Nakagawa Y, et al. Hypocholesterolemic effect of chitosan in adult males.
Biosci Biotechnol Biochem. 1993;57:1439-1444.
8
Jing SB, Li L, Ji D, et al. Effect of chitosan on renal function in patients with chronic renal failure.
J Pharm Pharmacol.
1997;49:721-723.
9
Ormrod D, Holmes CC, Miller TE. Dietary chitosan inhibits hypercholesterolaemia and atherogenesis in the apolipoprotein E-deficient mouse model of atherosclerosis.
Atherosclerosis.
1998;138:329-334.
12
Deuchi K, Kanauchi O, Shizukuishi M, et al. Continuous and massive intake of chitosan affects mineral and fat-soluble vitamin status in rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1995;59:1211-1216.
14
Kobayashi T, Otsuka S, Yugari Y. Effect of chitosan on serum and liver cholesterol levels in cholesterol-fed rats.
Nutr Rep Int. 1979;19:327-334.
15
Jing SB, Li L, Ji D, et al. Effect of chitosan on renal function in patients with chronic renal failure.
J Pharm Pharmacol.
1997;49:721-723.
16
Koide SS. Chitin-chitosan: properties, benefits and risks.
Nutr Res.
1998;18:1091-1101.
18
Kato H, Taguchi T, Okuda H, et al. Antihypertensive effect of chitosan in rats and humans.
J Tradit Med. 1994;11:198-205.
19
Koide SS. Chitin-chitosan: properties, benefits and risks.
Nutr Res.
1998;18:1091-1101.
20
Li H, Miyahara T, Tezuka Y, et al. The effect of low molecular weight chitosan on bone resorption
in vitro
and
in vivo.
Phytomedicine. 1999;6:305-310.
21
Schiller RN, Barrager E, Schauss AG, et al. A randomized, double-blind, placebo-controlled study examining the effects of a rapidly soluble chitosan dietary supplement on weight loss and body composition in overweight and mildly obese individuals.
J Am Nutraceutical Assoc.
2001;4:42-49.
22
Pittler MH, Abbot NC, Harkness EF, et al. Randomized, double-blind trial of chitosan for body weight reduction.
Eur J Clin Nutr.
1999;53:379-381.
23
Maezaki Y, Tsuji K, Nakagawa Y, et al. Hypocholesterolemic effect of chitosan in adult males.
Biosci Biotechnol Biochem. 1993;57:1439-1444.
24
Jing SB, Li L, Ji D, et al. Effect of chitosan on renal function in patients with chronic renal failure.
J Pharm Pharmacol.
1997;49:721-723.
25
Ormrod D, Holmes CC, Miller TE. Dietary chitosan inhibits hypercholesterolaemia and atherogenesis in the apolipoprotein E-deficient mouse model of atherosclerosis.
Atherosclerosis.
1998;138:329-334.
27
Deuchi K, Kanauchi O, Imasato Y, et al. Effect of the viscosity or deacetylation degree of chitosan on fecal fat excreted from rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1995;59:781-785.
28
Deuchi K, Kanauchi O, Shizukuishi M, et al. Continuous and massive intake of chitosan affects mineral and fat-soluble vitamin status in rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1995;59:1211-1216.
30
Kobayashi T, Otsuka S, Yugari Y. Effect of chitosan on serum and liver cholesterol levels in cholesterol-fed rats.
Nutr Rep Int. 1979;19:327-334.
31
Ho SC, Tai ES, Eng PH, et al. In the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects.
Singapore Med J.
2001;42:6-10.
32
Jing SB, Li L, Ji D, et al. Effect of chitosan on renal function in patients with chronic renal failure.
J Pharm Pharmacol.
1997;49:721-723.
34
Deuchi K, Kanauchi O, Shizukuishi M, et al. Continuous and massive intake of chitosan affects mineral and fat-soluble vitamin status in rats fed on a high-fat diet.
Biosci Biotechnol Biochem.
1995;59:1211-1216.
36
Tai TS, Sheu WH, Lee WJ, et al. Effect of chitosan on plasma lipoprotein concentrations in type 2 diabetic subjects with hypercholesterolemia [letter].
Diabetes Care.
2000;23:1703-1704.
37
Wuolijoki E, Hirvela T, Ylitalo P. Decrease in serum LDL cholesterol with microcrystalline chitosan.
Methods Find Exp Clin Pharmacol.
1999;21:357-361.
38
Caraccio, TR. Chronic arsenic (As) toxicity from ChitosanĀ® supplement [Abstract].
Clin Tox.
2002;644.
39
Bokura H, Kobayashi S. Chitosan decreases total cholesterol in women: a randomized, double-blind, placebo-controlled trial.
Eur J Clin Nutr.
2003:57:721-725.
40
Metso S, Ylitalo R, Nikkila M, et al. The effect of long-term microcrystalline chitosan therapy on plasma lipids and glucose concentrations in subjects with increased plasma total cholesterol: a randomised placebo-controlled double-blind crossover trial in healthy men and women.
Eur J Clin Pharmacol. 2003 Nov 7. [Epub ahead of print]
41
Mhurchu CN, Poppitt SD, McGill AT, et al. The effect of the dietary supplement, chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults.
Int J Obes Relat Metab Disord. 2004;28:1149-1156.
42
Guha S, Pal SK, Chatterjee N, et al. Effect of chitosan on lipid levels when administered concurrently with atorvastatin--a placebo controlled study.
J Indian Med Assoc. 2005;103:418,420.
43
Lehtimaki T, Metso S, Ylitalo R, et al. Microcrystalline chitosan is ineffective to decrease plasma lipids in both Apolipoprotein E epsilon4 carriers and non-carriers: a long-term placebo-controlled trial in hypercholesterolaemic volunteers.
Basic Clin Pharmacol Toxicol.
2005;97:98-103.
44
Mhurchu CN, Dunshea-Mooij C, Bennett D, et al. Effect of chitosan on weight loss in overweight and obese individuals: a systematic review of randomized controlled trials.
Obes Rev. 2005;6:35-42
45
Guha S, Pal SK, Chatterjee N, et al. Effect of chitosan on lipid levels when administered concurrently with atorvastatin--a placebo controlled study
. J Indian Med Assoc.
2005;103:418,420.
46
Kaats GR, Michalek JE, Preuss HG. Evaluating efficacy of a chitosan product using a double-blinded, placebo-controlled protocol.
J Am Coll Nutr. 2006;25:389-394.
47
Hayashi Y, Ohara N, Ganno T, et al. Chewing chitosan-containing gum effectively inhibits the growth of cariogenic bacteria.
Arch Oral Biol. 2006 Nov 15. [Epub ahead of print]
48
Tapola NS, Lyyra ML, Kolehmainen RM, et al. Safety aspects and cholesterol-lowering efficacy of chitosan tablets.
J Am Coll Nutr.
2008;27:22-30.
49
Jull AB, Ni Mhurchu C, Bennett DA, Dunshea-Mooij CA, Rodgers A. Chitosan for overweight or obesity.
Cochrane Database Syst Rev.
2008;CD003892.
50
Mhurchu CN, Dunshea-Mooij C, Bennett D, Rodgers A. Effect of chitosan on weight loss in overweight and obese individuals: a systematic review of randomized controlled trials.
Obes Rev.
2005;6:35-42.