Clinical observationCitrus aurantium used for weight loss by an adolescent with anorexia nervosa
Section snippets
Case report
This 16-year-old otherwise healthy young woman presented to our hospital-based clinic for evaluation of a possible eating disorder in July 2003. At that time she weighed 51.1 kilograms, measured 163 centimeters, and had a body mass index (BMI) of 19.2. She had a significant bradycardia with a resting heart rate of 38 beats per minute (bpm) and orthostatic hypotension (standing blood pressure 78/58). She was hypothermic with a temperature of 35.4°C. She had developed secondary amenorrhea of 9
Discussion
A recent article in the Journal on nutritional supplement use by adolescents presented the findings of a cross-sectional Canadian survey showing that female respondents indicated they would be more likely than males to consume herbal weight loss products [2]. It mentioned the possibility that eating disorder patients might be even more likely than healthy adolescents to use weight control supplements.
Citrus aurantium, a dietary supplement extracted from the rind of the Seville (sour) orange
Acknowledgments
This work was supported by grant AT00538 from the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health, and project 5T71MC00009-13 from the Maternal and Child Health Bureau (Title 5, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. The views expressed in this paper are solely those of the authors, and do not necessarily reflect the views of either NCCAM or DHHS.
References (7)
- et al.
A look at nutritional supplement use in adolescents
J Adolesc Health
(2004) - et al.
Determination of adrenergic agonists from extracts and herbal products of Citrus aurantium L. var. amara by LC
J Pharmacol Biomed Anal
(2002) Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk
Fed Regist
(2004)
Cited by (16)
Whole-Cell Bioconversion of Citrus Flavonoids to Enhance Their Biological Properties
2018, Studies in Natural Products ChemistryEndothelium- and smooth muscle-dependent vasodilator effects of Citrus aurantium L. var. amara: Focus on Ca<sup>2+</sup> modulation
2016, Biomedicine and PharmacotherapyCitation Excerpt :A recent cardiovascular study also reported that neroli essential oil reduced blood pressure in humans [6]. Consistent with this, a case report showed that neroli causes bradycardia and hypotension in adolescent patients [7], and limonene, the major component of neroli essential oil, has been reported to decrease blood pressure and heart rate in rats fed a high-fat diet [8]. These observations predict that neroli acts by affecting the autonomic nervous system or cardiovascular system.
Investigating herb-drug interactions: The effect of Citrus aurantium fruit extract on the pharmacokinetics of amiodarone in rats
2013, Food and Chemical ToxicologyCitation Excerpt :Even so, the safety and efficacy of supplements containing C. aurantium have been questioned (Bent et al., 2004; Fugh-Berman and Myers, 2004). A large number of case reports have emerged over the last years associating the use of C. aurantium-containing products with serious clinical adverse events, most of them involving the cardiovascular system, such as syncope and prolongation of the QT interval (Nasir et al., 2004), myocardial infarction (Nykamp et al., 2004; Thomas et al., 2009), ischemic stroke (Bouchard et al., 2005), angina (Gange et al., 2006) and tachycardia (Firenzuoli et al., 2005), bradycardia and hypotension (Gray and Woolf, 2005), vasospasm and stroke (Holmes Jr. and Tavee, 2008), ventricular fibrillation (Stephensen and Sarlay Jr., 2009) and ischemic colitis (Sultan et al., 2006). Furthermore, a pharmacokinetic herb–drug interaction involving a decoction of C. aurantium and cyclosporine was also reported (Hou et al., 2000).
Physiological effects following administration of Citrus aurantium for 28days in rats
2012, Toxicology and Applied PharmacologyCitation Excerpt :Much of the concern regarding the safety of C. aurantium extracts involves potential adverse effects on the cardiovascular system. Several case reports have associated intake of C. aurantium-containing extracts with various adverse effects, such as syncope and QT prolongation (Nasir et al., 2004), myocardial infarction (Nykamp et al., 2004; Thomas et al., 2009) ischemic stroke (Bouchard et al., 2005), angina (Gange et al., 2006) and tachycardia (Firenzuoli et al., 2005), bradycardia and hypotension (Gray and Woolf, 2005), vasospasm and stroke (Holmes and Tavee, 2008), ventricular fibrillation (Stephensen and Sarlay, 2009) and ischemic colitis (Sultan et al., 2006). Since many of the adverse events associated with ephedra use involved the cardiovascular system, the purpose of this investigation was to evaluate effects of synephrine and a bitter orange extract on the cardiovascular system of rats.
Assessment of the adverse event reports associated with Citrus aurantium (bitter orange) from April 2004 to October 2009
2010, Journal of Functional FoodsReview of Case Reports on Adverse Events Related to Pre-workout Supplements Containing Synephrine
2023, Cardiovascular Toxicology