Chitosan

USAGE AND EFFECTIVENESS

Usage	Effectiveness
High Blood Pressure	Effective (Decrease blood pressure) • Shown in two clinical studies that chitosan may reduce blood pressure when added to salt (3% by proportion/ not more than 3 gramme of salt in total); as compared to those who have consumed salt alone, subjects who have taken salt with chitosan may be more likely to achieve healthy blood pressure or healthy systolic blood pressure (pressure when the heart contract). In one of the studies, 76.2% of subjects who have taken salt with chitosan achieved normal blood pressure (less than 140/ 90 mm mercury) as compared to 36.8% among those who consumed salt alone. Source: 1, 2
Obesity	Mild Effectiveness (Reduce weight and improve health) • According to analysis of clinical studies, taking 1 to 3 gramme of chitosan may reduce weight ranging from 1 to 3 kilogramme. Source: 1, 2, 3 • It should be noted that chitosan needs to be use with dietary restriction; usage of chitosan alone may not bring the intended benefit. Source • Usage of chitosan may also manage risk factors of heart diseases (such as blood pressure (reduction by about 2mm mercury ( Source ) , total cholesterol (by about 0.2 mmol/L ( Source )).
Postoperative Recovery	Mild Effectiveness (Reduce risk of post-surgical complication after sinus surgery) • Two clinical studies showing that gel containing chitosan may reduce risk of adhesion of nasal tissue and bleeding in patients after sinus surgery; however, it does not reduce swelling, crusting or infections. Source 1, 2 • More evidence is needed to support the widespread use of chitosan for post-surgical recovery.
Crohn's Disease	Mild Effectiveness (Increase fat removal) • In a clinical study, chitosan was shown to increase removal of fats via stool; however, there was no improvement of symptoms or relapse rate. Source • The study was not robust enough (small sample size, no comparator to eliminate psychological effect); more evidence is needed to support the widespread use of chitosan in Crohn’s disease.
Tooth Decay	Mild Effectiveness (Suppress oral bacteria) • Two clinical studies showed that mouth rinse or gum containing chitosan may reduce oral bacteria. Source 1, 2 • Given that the sample sizes of these studies were small and short in duration, there was no evidence of prevention of tooth decay; more evidence is needed to support widespread use of chitosan to prevent tooth decay.
Dental Plaque	Mild Effectiveness (Reduce dental plaque) • 2 clinical studies showed that chitosan supplemented mouthwash may reduce dental plaque with similar effect as chlorhexidine mouthwash. Source: 1, 2 • As the clinical studies did not have enough sample size, more evidence is needed to support the widespread use of chitosan to reduce dental plaque.
Dry Eye	Mild Effectiveness (Improves symptoms of dry eye) • One clinical study showed that eye drop containing chitosan and acetylcysteine may reduce symptoms (such as redness and feeling of discomfort) and corneal damage by 60%. Source • It is unclear if chitosan alone is useful and the sample size of the clinical study was too small for the study result to be conclusive; more evidence is needed.
Periodontitis	Mild Effectiveness (Help in treatment for periodontitis) • One clinical study showed that chitosan gel (with vitamin C) may provide favorable structure for healing and help to reduce movement of tooth and the gap between the teeth and gum, aiding post treatment recovery. Source • However, the study was too small and do not have suitable comparator (such as gel that does not have any active ingredient); more evidence is needed.
Kidney Dialysis	Mild Effectiveness (Manage issues due to kidney failure) • In a small clinical study on patients with kidney failure receiving dialysis, chitosan was shown to better reduce cholesterol, alleviate anaemia, increase muscle strength, appetite & sleep. Source • As the study has very small sample size; more evidence is needed to support the widespread use of chitosan.
Wounds	Mild effectiveness (Facilitate wound healing) • Several clinical studies showed that wound dressing containing chitosan may be perform better than not having treatment, aiding wound healing. When compared to standard treatment, wound dressing containing chitosan may be either comparable (e.g. Alginate based dressing) or have better healing (e.g. wound dressing with liquid paraffin). Source: 1 2 3 4 • The conclusiveness of the clinical studies is hampered by their small sample size; in situation where the wound dressing containing chitosan and other ingredients, it may be unclear whether chitosan alone may be effective; more evidence is needed.
Minor Bleeding	Mild Effectiveness (Slow down bleeding) • An analysis of clinical studies showed that wound dressing containing chitosan may arrest bleeding 70% faster than using salt water or no wound dressing at all. Source • In a study, a combination product containing chitosan may stop bleeding five times faster as compared to no treatment. Source ; Effect of using chitosan may be comparable to standard dressing. Source • Given that most of the studies had small sample size, more evidence may be needed.
High Cholesterol	Unclear Effectiveness • An analysis of small clinical studies showed that as compared to pills without active ingredients, taking chitosan may reduce total cholesterol slightly by 7.8 milligram per decilitre. Source • In some other studies, chitosan may not be able to demonstrate ability to lower cholesterol. Source 1, 2, 3 • More evidence is needed.
Anaemia	Unknown Effectiveness • More evidence is needed.

General Safety

• Generally safe when used orally for a short term; side effects are generally mild

Pregnant/Breastfeeding

• Little data to show it is safe or otherwise; avoid if possible

Children

• Little data to show it is safe or otherwise; avoid if possible

Elderly

• Little data to show it is safe or otherwise; avoid if possible

Special to Note

• Unknown

Contraindications

• May cause allergy reactions in individuals with shellfish allergy

Side Effects

• Generally safe; side effects may include:
  Skin:One case of itching was reported
  Digestive System:May cause epigastric discomfort, constipation, gas, diarrhoea, nausea, and dryness of throat, excessive discharge of fat in stools, interfere fats digestibility, bile acid metabolism and lead to growth of resistant pathogens
  Muscle/Skeletal:May cause swollen heals and wrists
  Brain/CNS:May cause headaches
  Ear/Eye:May cause itching and irritation of the eyes

• Medicines
  Medium severity interactions with medicines for viral infections and blood thinners
• Supplements
  Medium to High severity interactions with supplements such as calcium, magnesium, selenium, vitamin A, vitamin D, vitamin E, and vitamin K
• Food
  None known
• Lab Tests
  Interactions with lab tests for hemoglobin, and urea/creatinine

• High Blood Pressure (Adults)
  Consume specific product containing sodium chloride with 3% chitosan, at a maximum daily dose of 3 grams for 8 weeks as a replacement for table salt at the table and in cooking
• Obesity (Adults)
  Consume 1 gram chitosan 2-4 times daily with calorie-restricted diet; Consume additional 4 tablets of a combination fiber supplement containing chitosan, guar meal, ascorbic acid, and other micronutrients twice daily for 4 weeks
• Postoperative Recovery (Adults)
  Apply 5mL chitosan gel in the nasal cavity following endoscopic sinus surgery for 10 minutes or until bleeding stopped
• Crohn's Disease (Adults)
  Consume 7 tablets daily of a combination containing 150mg chitosan per tablet and ascorbic acid for 8 weeks
• Kidney Failure (Adults)
  Consume 450mg chitosan three times daily for up to 12 weeks
• Minor Bleeding (Adults)
  Apply 5mL chitosan gel in the nasal cavity following endoscopic sinus surgery for 10 minutes or until bleeding stopped
• Dental Caries (Adults)
  Chew 8 pieces of xylitol-based gum, supplemented with chitosan 2% (w/v) over the course of 80 minutes; Rinse 0.5% chitosan mouth wash twice daily for 14 days
• Dry Eye (Adults)
  Apply specific eye drop containing 1% chitosan-N-acetylcysteine in the eye once or twice daily for 5 days
• High Phosphate Levels (Adults)
  Chew 20mg chitosan-containing gum twice daily for 2 weeks
• Periodontitis (Adults)
  Apply chitosan ascorbate topically
• Wound Healing (Adults)
  Apply dressing skin grafts with chitosan for up to six months; Apply specific topical gel containing chitosan, allantoin, dexpanthenol, and 0.2% chlorhexidine as 10mL three times daily for ten days after extraction of an impacted mandibular third molar
• High Cholesterol (Adults)
  Consume 1.2-1.35 grams chitosan daily for 8 weeks; Consume 1.2 grams chitosan and 1.2 grams glucomannan daily for one month; Consume specific combination supplement containing 240mg chitosan, 55mg garcina, 19mg chromium once or twice daily for 4 weeks; Consume specific product containing 300mg berberine, red yeast extract providing monacolin K 3mg, 10mg coenzyme Q10, and 10mg chitosan daily for 12 weeks; Consume additional 4 tablets combination fiber supplement containing chitosan, guar meal, ascorbic acid, and other micronutrients twice daily for 4 weeks

• General Information
  • Chitosan is used by consumers for postoperative recovery, tooth decay, dental plaque, periodontitis, wound healing and others
• How does it work?
  • Contains chemicals that have reduces bacterial, fungal, infections, have antioxidant effects, prevent tumour growth, enhance adsorption activity in the digestive system, minimise bleeding, reduce blood pressure, lipid levels, weight, aids wound healing, periodontal treatment, improves insulin sensitivity, and kidney function