Health Care Professional Information

Clinical Summary

Zyflamend is a formulation containing 10 different herbs. It is marketed as a dietary supplement for healthy inflammation response and normal cardiovascular and joint function (1).

Preliminary studies suggest that the ingredients in Zyflamend have anti-inflammatory, antiangiogenic, and antiproliferative properties (2). Zyflamend inhibits the proliferation of oral squamous carcinoma (3), pancreatic cancer (4), and melanoma cells in vitro (5). In an animal model, it inhibited the growth of both hormone-sensitive and hormone-insensitive prostate cancer, and reduced the expression of prostate specific antigen (PSA) (6). It can also suppress elevated levels of proinflammatory mediators and aromatase in obese models (7). In a phase I trial in men with prostatic intraepithelial neoplasia, Zyflamend did not cause any serious adverse events, and significant reductions in serum levels of C-reactive protein and nuclear factor-kappa B levels were observed (8). More studies are warranted.

Zyflamend may potentiate the cytotoxic effects of certain chemotherapeutic agents, including gemcitabine (4), taxol (2), doxorubicin (2), and bicalutamide (9).

Purported Uses
  • Antiaging
  • Cancer treatment
  • Inflammation
Constituents
Mechanism of Action

Holy basil, turmeric, ginger, green tea, rosemary, hu zhang, Chinese gold thread and Scutellaria inhibit cyclooxygenase-2 (COX-2) activity and thereby reduce inflammation. In vitro studies showed that Zyflamend inhibits inflammatory enzymes, decreases retinoblastoma (Rb) protein phosphorylation (10), and induces apoptosis in human prostate cancer cells (2) (3) (4) (11). It also reduced androgen receptor signaling and enhanced bicalutamide-induced apoptosis (9). In melanoma cells, it induces autophagy and apoptosis sequentially by activating the intrinsic caspase cascade. Cell migration and COX-2 expression were also suppressed (5). In myeloid leukemia cells and lung adenocarcinoma cells, it inhibits osteoclastogenesis and NF-kappa B activation (2). It also inhibits NF-kappa B activation and enhances gemcitabine-induced apoptosis in pancreatic cancer cells (4).

Both a cellular model of obesity-related inflammation and an obese animal model indicate that Zyflamend blocks proinflammatory mediators and aromatase induction as well as Akt and NF-kB activation. Increased aromatase mRNA levels and mammary gland activity were also partially inhibited (7).

In a murine xenograft model of prostate cancer, Zyflamend was shown to inhibit androgen-dependent tumor growth and histone deacetylase-5, biomarkers linked to prostate cancer progression (6). It also reduced the number of inflammatory cells, hyperplasia and dysplasia, and tumor incidence and number, and inhibited cell proliferation in an animal model of oral squamous cell carcinoma (3).

Contraindications

Hypersensitivity to any of the constituents

Adverse Reactions

Bad taste in the mouth, heartburn, and diarrhea (8)

Herb-Drug Interactions

Chemotherapy drugs (gemcitabine, taxol, doxorubicin, bicalutamide): Zyflamend may have additive effects (2) (4) (9).
Other prescriptions drugs: Because Zyflamend contains many herbal constituents, it can potentially interact with prescription drugs.

Dosage (Inside MSKCC Only)
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References
  1. New Chapter Inc. Zyflamend - Herbals from New Chapter. Available at: http://www.newchapter.com/zyflamend. 2012. Accessed October 29, 2013.
  2. Sandur SK, Ahn KS, Ichikawa H, et al. Zyflamend, a polyherbal preparation, inhibits invasion, suppresses osteoclastogenesis, and potentiates apoptosis through down-regulation of NF-kappa B activation and NF-kappa B-regulated gene products. Nutr Cancer. 2007;57(1):78-87.
  3. Yang P, Sun Z, Chan D, et al. Zyflamend reduces LTB4 formation and prevents oral carcinogenesis in a 7,12-dimethylbenz[alpha]anthracene (DMBA)-induced hamster cheek pouch model. Carcinogenesis. Nov 2008;29(11):2182-2189.
  4. Kunnumakkara AB, Sung B, Ravindran J, et al. Zyflamend suppresses growth and sensitizes human pancreatic tumors to gemcitabine in an orthotopic mouse model through modulation of multiple targets. Int J Cancer. Aug 1 2012;131(3):E292-303.
  5. Ekmekcioglu S, Chattopadhyay C, Akar U, et al. Zyflamend mediates therapeutic induction of autophagy to apoptosis in melanoma cells. Nutr Cancer. 2011;63(6):940-949.
  6. Huang EC, McEntee MF, Whelan J. Zyflamend, a combination of herbal extracts, attenuates tumor growth in murine xenograft models of prostate cancer. Nutr Cancer. 2012;64(5):749-760.
  7. Subbaramaiah K, Sue E, Bhardwaj P, et al. Dietary polyphenols suppress elevated levels of proinflammatory mediators and aromatase in the mammary gland of obese mice. Cancer Prev Res (Phila). Sep 2013;6(9):886-897.
  8. Capodice JL, Gorroochurn P, Cammack AS, et al. Zyflamend in men with high-grade prostatic intraepithelial neoplasia: results of a phase I clinical trial. J Soc Integr Oncol. Spring 2009;7(2):43-51.
  9. Yan J, Xie B, Capodice JL, et al. Zyflamend inhibits the expression and function of androgen receptor and acts synergistically with bicalutimide to inhibit prostate cancer cell growth. Prostate. Feb 2012;72(3):244-252.
  10. Yang P, Cartwright C, Chan D, et al. Zyflamend-mediated inhibition of human prostate cancer PC3 cell proliferation: effects on 12-LOX and Rb protein phosphorylation. Cancer Biol Ther. Feb 2007;6(2):228-236.
  11. Bemis DL, Capodice JL, Anastasiadis AG, et al. Zyflamend, a unique herbal preparation with nonselective COX inhibitory activity, induces apoptosis of prostate cancer cells that lack COX-2 expression. Nutr Cancer. 2005;52(2):202-212.

Consumer Information

How It Works

Bottom Line: Zyflamend has not been shown to treat cancer.

Zyflamend is an herbal supplement consisting of Holy basil, turmeric, ginger, green tea, rosemary, hu zhang, Chinese goldthread, barberry, oregano, and skullcap. Promoters of Zyflamend claim that it has anti-inflammatory and antiaging effects. In a few in lab studies, it has been shown to reduce inflammation and levels of certain enzymes that produce estrogen. It can also cause cell death. Results from a small study indicate it may help lower prostate specific antigen (PSA), a marker of prostate cancer. More research is needed.

Purported Uses
  • Cancer treatment
    A few lab studies show that Zyflamend can reduce the number of prostate cancer cells and also decrease some markers related to some types of breast cancer. Zyflamend did not cause serious adverse events in men with prostatic intraepithelial neoplasia and also decreased certain prostate disease-related markers. More research is needed.
  • Inflammation
    A few lab studies show that Zyflamend reduces inflammation but there are no data from clinical trials.
Do Not Take If
  • You have hypersensitivity to any of the constituents.
  • You are taking chemotherapy drugs. Zyflamend may increase the effects.
  • You are taking prescription medications. Because there are many botanicals in Zyflamend, there is a greater chance for herb-drug interactions.
Side Effects

Bad taste in the mouth, heartburn, and diarrhea.

E-mail your questions and comments to aboutherbs@mskcc.org.