Health Care Professional Information
Scientific Name
Sutherlandia frutescens, Lessertia frutescens
Clinical Summary
Sutherlandia frutescens is a shrub native to South Africa and the coast of West Africa. This plant and related species have been used by the locals as medicine to treat diabetes, chicken pox, and external wounds. Although Sutherlandia is not generally consumed as a dietary supplement in the West, some use the raw herb as an adaptogen. Constituents in Sutherlandia have antiviral, antibacterial, antifungal and anticancer properties (2). Sutherlandia is also known as “Cancer bush” for its purported use as a cancer treatment. There are case reports of Sutherlandia's ability to reduce fatigue in cancer patients (3).
In recent years, there is a growing effort in Africa to promote the use of local herbs to treat AIDS due to the lack of pharmaceuticals but easy access to traditional medicines. Based on reports that Sutherlandia is effective against HIV virus (4), it has been proposed as a treatment for AIDS (5). A study is currently underway to test the safety and efficacy of this herb in HIV-infected adults (6).
Adverse effects are rare but Sutherlandia may inhibit P-glycoprotein and cytochrome P450 3A4 and can interact with other substrate drugs, particularly those used to treat AIDS (7) (8).
Food Sources
- Sutherlandia frutescens is generally consumed as a tea.
Purported Uses
- Prevent infection
- As tonic
- Stomach and blood ailments
- Cancer
- AIDS
Constituents
- L-canavanine, L-arginine, Pinitol, GABA and Triterpenoid Glucoside
Mechanism of Action
Sutherlandia was shown to have antioxidant and anti-inflammatory effects in vitro (9). The active components of the plant are L-canavanine, Pinitol, GABA, and novel triterpenoid glucoside. Pinitol demonstrates antidiabetic effects by increasing the availability of glucose for cell metabolism (2). GABA found in dry leaves of Sutherlandia can slow down nerve cell activity (2).
The ethanolic extract of Sutherlandia inhibits growth of MCF-7 breast adenocarcinoma cell line by inducing apoptosis (10) (11). Sutherlandia downregulates metalloproteinases (MMP) that control cell migration, proliferation, apoptosis, and regulate tumor expansion, angiogenesis and dissemination (10).
Contraindications
- Pregnant women should not take Sutherlandia frutescens.
Adverse Reactions
Common: Diarrhea, dry mouth, dizziness.
Rare: Drinking or swallowing high doses of Sutherlandia may cause sweating and vomiting (2).
Herb-Drug Interactions
- Cytochrome P450 substrates: Sutherlandia inhibits CYP3A4 and can affect the intracellular concentration of drugs including antiretroviral treatments metabolized by this enzyme (7).
- P-Glycoprotein substrates: Sutherlandia was shown to inhibit P-Gp activity and can interfere with the metabolism of drugs including antiretroviral treatments (8).
Literature Summary and Critique
Dosage (Inside MSKCC Only)
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References
- Sutherlandia. http://www.sutherlandia.org/literature.html. Accessed September 10, 2011.
- van Wyk BE, Albrecht C. A review of the taxonomy, ethnobotany, chemistry and pharmacology of Sutherlandia frutescens (Fabaceae).J Ethnopharmacol. Oct 28 2008;119(3):620-629.
- Grandi M RL, Vernay M. Lessertia (Sutherlandia frutescens) and fatigue during cancer treatment. Phytotherapie. 2005;3:110.
- Harnett SM, Oosthuizen V, van de Venter M. Anti-HIV activities of organic and aqueous extracts of Sutherlandia frutescens and Lobostemon trigonus. J Ethnopharmacol. Jan 4 2005;96(1-2):113-119.
- Morris K. Treating HIV in South Africa—a tale of two systems. Lancet. Apr 14 2001;357(9263):1190.
- A Controlled Study of the Safety and Efficacy of Lessertia Frutescens in HIV-infected South African Adults. http://www.clinicaltrials.gov. Accessed September 10, 2011.
- Mills E, Foster BC, van Heeswijk R, et al. Impact of African herbal medicines on antiretroviral metabolism. AIDS. Jan 3 2005;19(1):95-97.
- Brown L, Heyneke O, Brown D, van Wyk JP, Hamman JH. Impact of traditional medicinal plant extracts on antiretroviral drug absorption. J Ethnopharmacol. Oct 28 2008;119(3):588-592.
- Fernandes AC, Cromarty AD, Albrecht C, van Rensburg CE. The antioxidant potential of Sutherlandia frutescens. J Ethnopharmacol. Nov 2004;95(1):1-5.
- Stander BA, Marais S, Steynberg TJ, et al. Influence of Sutherlandia frutescens extracts on cell numbers, morphology and gene expression in MCF-7 cells. J Ethnopharmacol. Jun 13 2007;112(2):312-318.
- Stander A, Marais S, Stivaktas V, et al. In vitro effects of Sutherlandia frutescens water extracts on cell numbers, morphology, cell cycle progression and cell death in a tumorigenic and a non-tumorigenic epithelial breast cell line. J Ethnopharmacol. Jul 6 2009;124(1):45-60.
- Chinkwo KA. Sutherlandia frutescens extracts can induce apoptosis in cultured carcinoma cells. J Ethnopharmacol. Apr 8 2005;98(1-2):163-170.
- Johnson Q, Syce J, Nell H, Rudeen K, Folk WR. A randomized, double-blind, placebo-controlled trial of Lessertia frutescens in healthy adults. PLoS Clin Trials. 2007;2(4):e16.
Consumer Information
How It Works
Bottom line: Laboratory studies indicate anticancer effects of Sutherlandia frutescens, but it has not been shown to treat or prevent cancer in humans.
Sutherlandia frutescens is a shrub native to Southern Africa and along the coast of West Africa. It is used in traditional medicine to treat diabetes, chicken pox, and external wounds, and also as a cancer treatment. Laboratory studies show that Sutherlandia can fight off viruses, bacteria, fungi, and also has anticancer properties. A few case reports show that it can decrease fatigue in cancer patients.
Because Sutherlandia can fight HIV virus, it is being proposed as an AIDS treatment in Africa. Clinical trials are needed to determine Sutherlandia's safety and efficacy.
Purported Uses
- Prevent infections
Laboratory studies show that Sutherlandia has antibacterial, antiviral, and antifungal effects. Human studies are needed.
- Stomach and blood ailments
There is no scientific evidence to support this claim.
- Cancer
Sutherlandia showed anticancer effects in lab studies, but it has not been studied in cancer patients.
- AIDS
Laboratory studies indicate that Sutherlandia has antiviral properties, but human data are needed.
Do Not Take If
- You are pregnant.
- You are taking drugs that are substrates of Cytochrome P450 3A4 (Sutherlandia may increase the risk of side effects of these drugs).
- You are taking drugs that are substrates of P-Glycoprotein (Sutherlandia may increase the risk of side effects of these drugs).
Side Effects
Common: Diarrhea, dry mouth, dizziness.
Rare: Drinking or swallowing high doses of Sutherlandia may cause sweating and vomiting.
Last updated: March 26, 2012
adenocarcinoma (A-deh-noh-KAR-sih-NOH-muh)
Cancer that begins in cells that line certain internal organs and that have gland-like (secretory) properties.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)AIDS
A disease caused by the human immunodeficiency virus (HIV). People with AIDS are at an increased risk for developing certain cancers and for infections that usually occur only in individuals with a weak immune system. Also called acquired immunodeficiency syndrome.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)angiogenesis (AN-jee-oh-JEH-neh-sis)
Blood vessel formation. Tumor angiogenesis is the growth of new blood vessels that tumors need to grow. This is caused by the release of chemicals by the tumor.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)antibacterial (AN-tee-bak-TEER-ee-ul)
A substance that kills bacteria or stops them from growing and causing disease.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)antifungal (AN-tee-FUN-gul)
A drug that treats infections caused by fungi.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)antiviral (AN-tee-VY-rul)
A drug used to treat infections caused by viruses.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)apoptosis (A-pop-TOH-sis)
A type of cell death in which a series of molecular steps in a cell leads to its death. This is the body’s normal way of getting rid of unneeded or abnormal cells. The process of apoptosis may be blocked in cancer cells. Also called programmed cell death.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)appetite (A-peh-tite)
A desire to satisfy a physical or mental need, such as for food, sex, or adventure.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)clinical (KLIH-nih-kul)
Having to do with the examination and treatment of patients.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)concentration (KON-sen-TRAY-shun)
In science, the amount of a substance, such as a salt, that is in a certain amount of tissue or liquid, such as blood. A substance becomes more concentrated when less water is present. For example, the salt in urine may become more concentrated when a person doesn’t drink enough water.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)diabetes (dy-uh-BEE-teez)
Any of several diseases in which the kidneys make a large amount of urine. Diabetes usually refers to diabetes mellitus in which there is also a high level of glucose (a type of sugar) in the blood because the body does not make enough insulin or use it the way it should.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)diarrhea (dy-uh-REE-uh)
Frequent and watery bowel movements.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)efficacy (EH-fih-kuh-see)
Effectiveness. In medicine, the ability of an intervention (for example, a drug or surgery) to produce the desired beneficial effect.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)enzyme (EN-zime)
A protein that speeds up chemical reactions in the body.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)extract (EK-strakt)
In medicine, a preparation of a substance obtained from plants, animals, or bacteria and used as a drug or in drugs.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)fatigue (fuh-TEEG)
A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)glucose (GLOO-kose)
A type of sugar; the chief source of energy for living organisms.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)HIV
The cause of acquired immunodeficiency syndrome (AIDS). Also called human immunodeficiency virus.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)intracellular (IN-truh-SEL-yoo-ler)
Inside a cell.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)L-arginine (… AR-jih-neen)
One of the twenty common amino acids (building blocks of proteins). L-arginine is being studied as a nutritional supplement in the treatment and prevention of cancer and other conditions. Also called arginine.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)M
In chemistry, M is the amount of a substance that has 6.023 x 10(23) atoms or molecules of that substance. Also called mole (chemical).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)medicine (MEH-dih-sin)
Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)metabolism (meh-TA-buh-lih-zum)
The chemical changes that take place in a cell or an organism. These changes make energy and the materials cells and organisms need to grow, reproduce, and stay healthy. Metabolism also helps get rid of toxic substances.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)nerve (nerv)
A bundle of fibers that receives and sends messages between the body and the brain. The messages are sent by chemical and electrical changes in the cells that make up the nerves.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)p-glycoprotein (… GLY-koh-PROH-teen)
A protein that pumps substances out of cells. Cancer cells that have too much p-glycoprotein may not be killed by anticancer drugs.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)placebo (pluh-SEE-boh)
An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)placebo-controlled (pluh-SEE-boh-kun-TROLD)
Refers to a clinical study in which the control patients receive a placebo.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)randomized
Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments.
(http://www.cancer.gov/dictionary)significant (sig-NIH-fih-kunt)
In statistics, describes a mathematical measure of difference between groups. The difference is said to be significant if it is greater than what might be expected to happen by chance alone. Also called statistically significant.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)stomach (STUH-muk)
An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)toxicity (tok-SIH-sih-tee)
The extent to which something is poisonous or harmful.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)virus (VY-rus)
In medicine, a very simple microorganism that infects cells and may cause disease. Because viruses can multiply only inside infected cells, they are not considered to be alive.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)
