Dietary Supplements Guide Spring 2022

Page 105

Hunter Swindle Student pharmacist Spring 2022

Pomegranate (Punica granatum) Background/Common Uses

Pomegranate, Punica granatum, is a fruit-bearing deciduous shrub that bears a round, reddishbrown fruit with a hard outer coating. The fruit has been eaten and used to make juices for thousands of years. The fruit itself can also be referred to as a seeded apple. The fruits, juice, and extracts have been shown to have possible benefits on the cardiovascular system, diabetes, and glucose metabolism, and smaller studies have shown other potential risk lowering benefits. Pomegranate juice provides an excellent source of fructose, sucrose, and glucose; however, the health benefits are believed to be due to the tannins and flavonoids that possess antioxidant and preservative activities.1 Animals studies have been conducted and shown that there may also be benefits in many different forms of cancer.

Pharmacology

Pomegranate exhibits its cardiovascular benefits by reducing oxidative stress, lipid peroxidation, and generation of foam cells. This influences endothelial cell function by increasing nitic oxide levels, lowering glucose levels, and attenuating platelet aggregation. Pomegranate has been shown to provide protection from chemicals and drugs, and therefore it is thought to improve outcomes with some cancers and the cancer drugs. 2 Pomegranate is metabolized by cytochrome P450 enzymes, with one being CYP2D6. This is likely to cause many drug interactions, and genetic testing may be warranted.

Dosing

Pomegranate can exhibit its effects in many different forms including the peel, juice, and leaves. Numerous different formulations of pomegranate have also been studied. Doses of 50 to 750 ml/ day of pomegranate juice has been shown to have potential benefits on cardiovascular disease. Doses of 750 mg/day of pomegranate extract have some potential benefits on exercise endurance performance. Doses of 1-3 grams/day of pomegranate extract have effects at lowering prostate-specific antigen levels.3

Effectiveness Although studies have been conducted to show the benefits of

pomegranate in many different disease states, there are currently no FDA approved indications for pomegranate.

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