Lycium

• How It Works

  The safety and efficacy of lycium products for cancer prevention and treatment have not been established.

  The berries of Lycium barbarum are used in traditional medicine to treat inflammation, skin irritation, nose bleeds, aches, and pains and as a sedative. Lycium is also commonly used with other botanicals in Chinese medicine for poor vision, anemia, and cough. Polysaccharides isolated from the plant have been shown to improve immune response, improve the effects of radiation therapy, and inhibit growth of some cancer cells in laboratory and animal studies. An observational study showed that lycium may improve the effects of some cancer treatments. However, well-designed clinical trials are needed to determine the anticancer potential of lycium.

• Purported Uses
  • To treat aches and pains
    Evidence is lacking to support this claim.
  • To prevent and to treat cancers
    Clinical studies have not been conducted to evaluate the anticancer potential of lycium.
  • To improve the effects of a specific cancer therapy
    A small observational study showed benefits, but further well designed trials are necessary.
  • As a sedative
    Evidence is lacking to support this claim.
  • To reduce nose bleeds
    Evidence is lacking to support this claim.
• Do Not Take If

  You are taking warfarin or other anticoagulants: A few cases of elevated INR were reported in patients on anticoagulant therapy following consumption of concentrated Chinese herbal tea made from lycium.

  A 65-year-old man on warfarin experienced elevated INR with associated bleeding after drinking goji berry wine. His INR values returned to normal after discontinuing the wine.

  You are taking drugs that are substrates of cytochrome P450 (CYP) 3A4, 2C9 and 2C19: Lycium extract may influence how these drugs are metabolized.

• Side Effects
  • Allergic reactions have been reported after eating Lycium berries in people with food allergies.
• Scientific Name

  Lycium barbarum, Lycium chinense, Lycium europeaum

• Clinical Summary

  The berries of Lycium barbarum are used in traditional medicine in several Asian countries to treat inflammation, skin irritation, nose bleeds, aches, and pains and as a sedative ⁽¹⁾. Lycium is also commonly used with other botanicals for poor vision, anemia, and cough ⁽⁹⁾. Preclinical studies indicate that a polysaccharide isolated from lycium (LBP) has antitumor ^(2) (10), immune-enhancing ⁽³⁾, neuroprotective ^(11) (26), radiosensitizing ⁽⁴⁾, hepato- ⁽⁶⁾ and photoprotective ⁽¹²⁾ effects. Small clinical studies of lycium reported subjective improvement in well-being in healthy subjects ^{(14) (15) (16)}; for exerting hypoglycemic effects in type-2 diabetic patients ⁽²⁷⁾, and protective effects on macula in elderly subjects by preventing hypo-pigmentation ⁽¹⁹⁾. A systematic review and meta analysis suggest that lycium may have a role in managing liver disease, hyperlipidemia, and diabetes ^(28) (29).

  Additional findings indicate that lycium inhibits growth of ER-positive breast cancer cells ⁽¹³⁾, and reduces cardiotoxicity associated with doxorubicin ⁽¹⁷⁾. Data from an observational study suggest that when used with certain cancer treatments, lycium polysaccharides exert beneficial effects ⁽⁵⁾.

  However, despite marketing claims of cancer preventive potential, the efficacy and safety of lycium products for cancer treatment have yet to be established.

• Purported Uses
  • Anemia
  • Burns
  • Cough
  • Inflammation
  • Pain
  • Sedation
  • Skin infections
  • Visual acuity
• Mechanism of Action

  Lycium bark and berries contain betasitosterol, which can prevent cholesterol absorption in the gastrointestinal tract ⁽⁷⁾. The hepatoprotective effects of lycium polysaccharide (LBP) are in part via modulation of transcription factor NF-κB and MAPK pathways and autophagy ⁽⁶⁾. In another study, LBP was shown to act as a novel antioxidant against insulin resistance induced by a high-fat diet through activation of phosphatidylinositol 3-kinase/nuclear factor-E2-related factor 2, (PI3K/AKT/Nrf2) pathway ⁽²⁴⁾. It also exerts protective effects against focal cerebral ischemic injury by attenuating the mitochondrial apoptosis pathway ⁽²⁵⁾. In murine models of cerulein-induced acute pancreatitis LBP reduced inflammation by upregulating NRF2 and HO-1 ⁽³⁰⁾; and had protective effects on diabetic peripheral neuropathy, which is thought to be mediated via the induction of autophagy ⁽³¹⁾.

  In addition, LBP was shown to inhibit the growth of leukemia HL-60 cells ⁽²⁾, and increase expression of interleukin-2 and tumor necrosis factor alpha ⁽³⁾. The antiproliferative effects of LBP are via activation of extracellular signal-regulated protein kinase (ERK) ⁽²⁰⁾. It was also shown to induce systemic and local immune responses in H22 tumor-bearing mice via alleviating immunosuppression and by maintaining antitumor immune responses ⁽³²⁾.

• Adverse Reactions
  • Allergic reactions have been reported following consumption of lycium berries in individuals with allergies to food and to pollen ^(22) (33).
• Herb-Drug Interactions

  Warfarin: A few cases of elevated INR in patients on anticoagulant therapy were reported following consumption of concentrated Chinese herbal tea made from lycium ^{(8) (18) (21)}.
  A 65-year-old man on warfarin experienced elevated INR with associated bleeding after drinking goji berry wine. His INR values returned to normal after discontinuing the wine ⁽³⁴⁾.
  Cytochrome P450 (CYP) 3A4 substrates: Lycium extract induces CYP3A4 by activating pregnane X receptor (PXR). This may increase the clearance of substrate drugs when used concomitantly ⁽²³⁾.
  Cytochrome P450 2C9 and 2C19 substrates: Lycium juice, water and ethanol extracts inhibit CYP 2C9 and 2C19 enyzmes, and can affect the metabolism of certain prescription drugs ⁽³⁵⁾. The clinical relevance needs to be determined.

• References

  1. Dafni A,.Yaniv Z. Solanaceae as medicinal plants in Israel. J Ethnopharmacol. 1994;44:11-8.

  2. Gan L, Wang J, Zhang S. [Inhibition the growth of human leukemia cells by Lycium barbarum polysaccharide]. Wei Sheng Yan.Jiu. 2001;30:333-5.

  3. Gan L, Zhang SH, Liu Q, Xu HB. A polysaccharide-protein complex from Lycium barbarum upregulates cytokine expression in human peripheral blood mononuclear cells. Eur J Pharmacol. 2003;471:217-22.

  4. Lu CX,.Cheng BQ. [Radiosensitizing effects of Lycium barbarum polysaccharide for Lewis lung cancer]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1991;11:611-2, 582.

  5. Cao GW, Yang WG, Du P. [Observation of the effects of LAK/IL-2 therapy combining with Lycium barbarum polysaccharides in the treatment of 75 cancer patients]. Zhonghua Zhong.Liu Za Zhi. 1994;16:428-31.

  6. Xiao J, Xing F, Huo J, et al. Lycium barbarum polysaccharides therapeutically improve hepatic functions in non-alcoholic steatohepatitis rats and cellular steatosis model. Sci Rep. 2014 Jul 7;4:5587

  7. Law M. Plant sterol and stanol margarines and health. BMJ 2000;320:861-4.

  8. Lam AY, Elmer GW, Mohutsky MA. Possible interaction between warfarin and Lycium barbarum L. Ann.Pharmacother. 2001;35:1199-201.

  9. Bensky D, Gamble A. Chinese Herbal Medicine, Materia Medica, Revised Edition. Seattle (WA): Eastland Press; 1993.

  10. Zhang Z, Liu X, Wu T, et al. Selective suppression of cervical cancer Hela cells by 2-O-beta-D: -glucopyranosyl-L: -ascorbic acid isolated from the fruit of Lycium barbarum L. Cell Biol Toxicol. 2011 Apr;27(2):107-21.

  11. Ho YS, Yu MS, Yang XF, et al. Neuroprotective effects of polysaccharides from wolfberry, the fruits of Lycium barbarum, against homocysteine-induced toxicity in rat cortical neurons. J Alzheimers Dis. 2010;19(3):813-27.

  12. Reeve VE, Allanson M, Arun SJ, Domanski D, Painter N. Mice drinking goji berry juice (Lycium barbarum) are protected from UV radiation-induced skin damage via antioxidant pathways. Photochem Photobiol Sci. 2010 Apr;9(4):601-7.

  13. Li G, Sepkovic DW, Bradlow HL, Telang NT, Wong GY. Lycium barbarum inhibits growth of estrogen receptor positive human breast cancer cells by favorably altering estradiol metabolism. Nutr Cancer. 2009;61(3):408-14.

  14. Amagase H, Nance DM. A randomized, double-blind, placebo-controlled, clinical study of the general effects of a standardized Lycium barbarum (Goji) Juice, GoChi. J Altern Complement Med. 2008 May;14(4):403-12.

  15. Amagase H, Sun B, Borek C. Lycium barbarum (goji) juice improves in vivo antioxidant biomarkers in serum of healthy adults. Nutr Res. 2009 Jan;29(1):19-25.

  16. Amagase H, Sun B, Nance DM. Immunomodulatory effects of a standardized Lycium barbarum fruit juice in Chinese older healthy human subjects. J Med Food. 2009 Oct;12(5):1159-65.

  17. Xin YF, Zhou GL, Deng ZY, et al. Protective effect of Lycium barbarum on doxorubicin-induced cardiotoxicity. Phytother Res. 2007 Nov;21(11):1020-4.

  18. Leung H, Hung A, Hui AC, Chan TY. Warfarin overdose due to the possible effects of Lycium barbarum L. Food Chem Toxicol. 2008 May;46(5):1860-2.

  19. Bucheli P, Vidal K, Shen L, et al. Goji berry effects on macular characteristics and plasma antioxidant levels. Optom Vis Sci. 2011 Feb;88(2):257-62.

  20. Shen L, Du G. Lycium barbarum polysaccharide stimulates proliferation of MCF-7 cells by the ERK pathway. Life Sci. 2012 Sep 24;91(9-10):353-7.

  21. Rivera CA, Ferro CL, Bursua AJ, Gerber BS. Probable interaction between Lycium barbarum (goji) and warfarin.Pharmacotherapy. 2012 Mar;32(3):e50-3.

  22. Larramendi CH, García-Abujeta JL, Vicario S, et al. Goji berries Lycium barbarum: risk of allergic reactions in individuals with food allergy. J Investig Allergol Clin Immunol. 2012;22(5):345-50.

  23. Xu Y, Zhang Y, Zhou F, et al. Human pregnane X receptor-mediated transcriptional regulation of CYP3A4 by extracts of 7 traditional Chinese medicines. Zhongguo Zhong Yao Za Zhi. 2011 Jun;36(11):1524-7.

  24. Yang Y, Li W, Li Y, Wang Q, Gao L, Zhao J. Dietary Lycium barbarum polysaccharide induces Nrf2/ARE pathway and ameliorates insulin resistance induced by high-fat via activation of PI3K/AKT signaling. Oxid Med Cell Longev. 2014;2014:145641.

  25. Wang T, Li Y, Wang Y, et al. Lycium barbarum polysaccharide prevents focal cerebral ischemic injury by inhibiting neuronal apoptosis in mice. PLoS One. 2014 Mar 3;9(3):e90780.

  26. Shi Z, Zhu L, Li T, et al. Neuroprotective Mechanisms of Lycium barbarum Polysaccharides Against Ischemic Insults by Regulating NR2B and NR2A Containing NMDA Receptor Signaling Pathways. Front Cell Neurosci. 2017 Sep 27;11:288.

  27. Cai H, Liu F, Zuo P, et al. Practical Application of Antidiabetic Efficacy of Lycium barbarum Polysaccharide in Patients with Type 2 Diabetes. Med Chem. 2015;11(4):383-90.

  28. Guo XF, Li ZH, Cai H, Li D. The effects of Lycium barbarum L. (L. barbarum) on cardiometabolic risk factors: a meta-analysis of randomized controlled trials. Food Funct. 2017 May 24;8(5):1741-1748.

  29. Kwok SS, Bu Y, Lo AC, et al. A Systematic Review of Potential Therapeutic Use of Lycium Barbarum Polysaccharides in Disease. Biomed Res Int. 2019 Feb 12;2019:4615745.

  30. Xiong GF, Li DW, Zheng MB, Liu SC. The Effects of Lycium Barbarum Polysaccharide (LBP) in a Mouse Model of Cerulein-Induced Acute Pancreatitis. Med Sci Monit. 2019 May 25;25:3880-3886.

  31. Liu SY, Chen L, Li XC, Hu QK, He LJ. Lycium barbarum polysaccharide protects diabetic peripheral neuropathy by enhancing autophagy via mTOR/p70S6K inhibition in Streptozotocin-induced diabetic rats. J Chem Neuroanat. 2018 Apr;89:37-42.

  32. Deng X, Luo S, Luo X, et al. Polysaccharides from Chinese Herbal Lycium barbarum Induced Systemic and Local Immune Responses in H22 Tumor-Bearing Mice. J Immunol Res. 2018 Jun 3;2018:3431782.

  33. Zauli D, Mirarchi MG. Anaphylaxis induced by Goji berries. Ann Allergy Asthma Immunol. 2015 Jun;114(6):535-6.

  34. Zhang J, Tian L, Xie B. Bleeding due to a probable interaction between warfarin and Gouqizi (Lycium Barbarum L.). Toxicol Rep. 2015 Aug 29;2:1209-1212.

  35. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. J Complement Integr Med. 2016 Sep 1;13(3):257-265.