Hibiscus sabdariffa increases hydroxocobalamin oral bioavailability and clinical efficacy in vitamin B₁₂ deficiency with neurological symptoms

Abstract

The aim of the study was to evaluate the bioavailability and clinical benefits of oral new formulation (HB ) of hydroxocobalamin (Hdrx) with Hibiscus sabdariffa (HS). First, in an observational study, a cohort of 30 vitamin B -deficient patients (vit B < 200 pg/mL) with neurological symptoms received oral fixed dose of Hdrx containing 15 mg Hdrx daily for 10 days followed by 15 mg monthly. Clinical benefits were evaluated on haematological and biochemical parameters, and neurological improvement at days 10 and 90 compared to day 0. To understand the mechanism, intestinal mucosa from mice were mounted in vitro in Ussing chambers to measure Hdrx Fluxes. In the clinical study, serum vitamin B level increased from 55.1 ± 36.9 to 1330 ± 335.5 pg/mL at day 10 and 431.0 ± 24.27 pg/mL at day 90, without overt adverse effects. In mice ileum, (i) intestinal bioavailability of Hdrx increased in dose-dependent manner with HB . The apparent permeability of Hdrx was P = 34.9 ± 4.6 × 10 cm/s in the presence of 3 mg/mL (HB B) compared to the control P = 6.2 ± 0.7 × 10 cm/s. (ii) Total transepithelial electrical conductance (G ) increased in dose-dependent manner with HB , G = 161.5 ± 10.8 mS/cm² with HB B (Hdrx 1 mg + HS 3 mg) compared to the control Hdrx, G = 28.7 ± 4.0 mS/cm². In conclusion, the clinical study suggests that injections are not required when Hdrx is given orally. Intestinal bioavailability of Hdrx increased in vitro when it was used concomitantly with HS.

Effect of Roselle Flower Extract (Hibiscus sabdariffa Linn.) on Reducing Steatosis and Steatohepatitis in Vitamin B12 Deficiency Rat Model

“…Pathophysiological occurrences arising from intracellular homocysteine molecules are one of the factors that can cause NAFLD [ 20 ]. Increased homocysteine can be caused by a vitamin B12 deficiency; vitamin B12 acts as an enzyme cofactor for methionine synthase [ 21 ]. Increased plasma homocysteine levels cause oxidative stress, a lack of methyl donors, misfolded proteins and hepatic reticulum stress [ 5 ].…”

Herb–Drug Interactions: Worlds Intersect with the Patient at the Center

“…Two case reports hinted at the possibility of benefit from interaction, one interaction checker reported two interactions as beneficial (albeit in opposition to case report findings), and two clinical studies reported benefit from interaction. Perhaps the ability of botanical constituents to decrease pharmaceutical drug clearance could be harnessed to reduce drug costs through reduction in dose requirements, lower the burden of drug excretion into the water supply, or enhance bioavailability of nutrients [ 53 , 54 ]. Further exploration could conceivably improve patient quality of life through reduction in side effects [ 53 ].…”

Studies on intestinal passage of flumequine and oxytetracycline-loaded MIL-100 (Fe) in the presence of divalent ions

“…Jejunum samples were excised, rinsed in isotonic Ringer's solution, and cut flat open through the mesenteric axis. The jejunum slices were then mounted in Ussing chambers in line with established procedure [9,10].…”