Bioflavonoids: Benefits, Dosage, Contraindications

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Bioflavonoids, also known as vitamin P, represent a group of compounds synthesized by plants with powerful antioxidant properties, found abundantly in a variety of fruits and vegetables, especially in citrus fruits like oranges, lemons, and grapefruits. These compounds include hesperidin, naringin, and rutin, mainly extracted from the peels and pulps of citrus fruits. Discovered in the 1930s by Hungarian scientist Albert Szent-Györgyi, bioflavonoids were initially recognized for their ability to strengthen blood vessel walls, hence their designation as "vitamin P" for their action on vascular permeability. Scientific research has since highlighted a multitude of benefits associated with these compounds, notably their role in the prevention of cardiovascular diseases, thanks to their antioxidant effect which contributes to protection against damage caused by free radicals. Bioflavonoids are also studied for their potential beneficial effects against various pathologies, such as cancer and inflammatory disorders, due to their anti-inflammatory and antimicrobial activity. Furthermore, clinical research has validated their ability to improve cardiovascular health by reducing LDL-cholesterol oxidation, a key factor in the development of atherosclerosis. This action is attributed to the molecular structure of bioflavonoids, which allows them to effectively neutralize free radicals and favorably modulate lipid metabolism.

Other name(s) 

Vitamin P, flavonoids

Scientific name(s)

Citrus flavonoids

Family or group: 

Phytosubstances

Active ingredients:

Hesperidin

Rutin

Naringin


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Atherosclerosis
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Citrus bioflavonoids such as hesperidin, naringin, and naringenin play a crucial role in the prevention of atherosclerosis, primarily due to their antioxidant capacity, contributing to protection against oxidative damage, which is a key factor in the development of atherosclerosis. Hesperidin, in particular, has shown significant beneficial effects in reducing triglycerides and LDL cholesterol in hyperlipidemic patients, which is crucial for reducing cardiovascular disease and atherosclerosis risks. Clinical studies have demonstrated that daily supplementation with hesperidin can improve endothelial function and reduce blood pressure, thereby decreasing atherosclerosis risk factors. A clinical trial investigated the efficacy of a polyphenol-enriched bergamot extract (BPE-C) in patients with metabolic syndrome. The double-blind study included obese patients with an atherogenic plasma index (AIP) above 0.34 and mild hyperglycemia. They were randomly assigned to receive two different dosages of BPE-C (650 mg and 1300 mg per day) or a placebo for 90 days. The results indicated that treatment with BPE-C at the highest dose led to a significant reduction in fasting blood glucose, triglycerides, and cholesterol parameters, with reductions up to 41.4% for LDL-C. This intervention also resulted in a notable reduction of the AIP, dropping well below the 0.2 threshold, indicating a decreased risk of atherosclerosis. The observed effects were dose-dependent and accompanied by improvements in insulin resistance and insulin levels.

Posologie

posologieOral route

posologie1300 mg


Venous insufficiency
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Bioflavonoids, particularly hesperidin, play a significant role in the treatment of venous insufficiency by reducing associated symptoms such as pain, edema, and thrombotic complications. In a randomized prospective study, the use of a combination of diosmin, troxerutin, and hesperidin was evaluated in patients suffering from acute hemorrhoidal attacks. The results showed significant improvement in symptoms, with reduced pain and edema, as well as decreased persistence of thromboses in treated patients compared to a placebo group. This study involved 134 patients, with a treatment period up to 12 days, followed by additional monitoring. The doses administered were 300 mg for each flavonoid, three times a day initially, then gradually reduced. Another research confirmed the effectiveness of micronized flavonoid fraction, composed of 90% diosmin and 10% hesperidin, in reducing edema and promoting the healing of venous ulcers. These clinical studies well illustrate the potential of bioflavonoids as a promising treatment to improve symptoms of chronic venous insufficiency. It is noteworthy that Daflon, a medication composed of bioflavonoids such as hesperidin, is frequently used in the treatment of venous insufficiency and hemorrhoids.

Posologie

posologieOral route

posologie500 - 1000 mg


Synergies


Metabolic syndrome
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Citrus bioflavonoids, particularly hesperidin, have shown significant beneficial effects on cardiovascular health through various clinical trials. Hesperidin, administered at a dose of 500 mg per day in capsule form for 12 weeks, demonstrated an ability to reduce fasting glucose levels in patients with metabolic syndrome, underscoring its potential in managing cardiovascular risk factors. Additionally, the daily consumption of 500 mL of hesperidin-enriched orange juice resulted in a notable reduction in insulin and HOMA-IR index, confirming its antidiabetic properties. A meta-analysis conducted by Khorasanian et al. highlighted the significant beneficial effects of hesperidin on key parameters such as triglyceridemia, total cholesterol, LDL cholesterol, tumor necrosis factor alpha, and systolic blood pressure. The results suggest that effective supplementation dosages are around 1,000 mg per day, with supplementation durations exceeding six weeks to favorably influence fasting glucose and more than eight weeks for insulin levels.

Posologie

posologieOral route

posologie500 - 1000 mg

duration12 - weeks


Properties


Antioxidant

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Citrus bioflavonoids, thanks to their exceptional antioxidant properties, play an important role in combating oxidative stress and cellular aging. These natural compounds act in multiple ways: they neutralize various free radicals such as hydroxyl and superoxide radicals, prevent lipid peroxidation, and chelate metals, thus preventing oxidation catalyzed by these metals. Their "free radical scavenger" activity is mainly due to their ability to donate hydrogen atoms through the phenolic groups they possess, allowing the stabilization of radicals on their molecular structure. Research shows that orange juices rich in flavonoids and other polyphenols offer significant antioxidant capacity, suggesting that daily intake of orange juice could provide additional protection against oxidation.


Anti-inflammatory

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Citrus bioflavonoids, notably hesperidin and nobiletin, have demonstrated a notable capacity to modulate immune and inflammatory responses. Their anti-inflammatory effects can be attributed to the inhibition of key regulatory enzymes such as protein kinase C, phosphodiesterase, phospholipase, lipoxygenase, and cyclooxygenase, which play a crucial role in the formation of biological mediators activating endothelial and other specialized cells in inflammation. For instance, hesperidin can reduce inflammation in cases of pleurisy (a medical condition characterized by inflammation of the pleura, a thin membrane surrounding the lungs and lining the inner wall of the thoracic cavity), decreasing fluid and the number of involved white blood cells. Nobiletin, on the other hand, has shown selective action in down-regulating the expression of cyclooxygenase-2 without affecting cyclooxygenase-1, and has reduced the production of prostaglandin E2 and the expression of pro-inflammatory cytokines.


Vein Tonic

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Bioflavonoids, including hesperidin, significantly improve venous health through several interdependent mechanisms that have been widely documented through clinical and experimental studies. These natural compounds mainly act by enhancing venous tone and reducing venous stasis, which is crucial for preventing and managing chronic venous insufficiency (CVI) symptoms. Hesperidin plays a vital role in modulating inflammation and protecting venous structures from damage. It inhibits the synthesis of prostaglandins and free radicals, reduces microvascular leaks induced by bradykinin (a vasodilator peptide that helps increase blood flow), and limits leukocyte activation and migration. These actions decrease leukocyte infiltration and tissue damage associated with CVI, facilitating the healing of venous ulcers and reducing edema. In clinical practice, the use of hesperidin has shown improvement in endothelial function, essential for maintaining the integrity of blood vessels and preventing vascular complications. Hesperidin supplementation could thus represent a promising therapeutic approach for treating venous insufficiency.

Usages associés

Venous Insufficiency

Anticancer

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Citrus bioflavonoids, by their antimutagenic effects, significantly inhibit tumor development and cell proliferation. They protect DNA from damage caused by UV rays and neutralize free radicals that can induce mutations near DNA. Furthermore, flavonoids such as naringin and nobiletin have shown their ability to inhibit enzymes involved in tumor promotion and reduce the expression of certain pro-inflammatory genes, thereby limiting the development and progression of cancer cells. Studies have revealed that citrus flavonoids can delay tumor development, notably by positively influencing cell metabolism and inhibiting key metabolic pathways in tumor cells. They also exert a direct cytotoxic effect on various types of cancer cells, inducing apoptosis (programmed cell death) without affecting surrounding healthy cells.


Cardiovascular

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Citrus flavonoids, including hesperidin, naringin, and nobiletin, have demonstrated a wide range of beneficial effects on cardiovascular and metabolic health, partly due to their powerful antioxidant activity, ability to improve glucose tolerance and insulin sensitivity, and modulatory effect on lipid metabolism and adipocyte differentiation. Additionally, they contribute to the suppression of inflammation and apoptosis and improve endothelial function, a critical factor in the prevention of cardiovascular diseases. Hesperidin, for instance, acts by inhibiting phosphodiesterase and increasing intracellular cAMP, resulting in a reduction in the production of inflammatory prostaglandins and thromboxane B2. This action is crucial for its anti-inflammatory effects and for reducing platelet aggregation, helping prevent thrombus formation. Preliminary clinical research has shown that daily intake of 500 mg of hesperidin increases flow-mediated dilation, indicating an improvement in endothelial function in patients with metabolic syndrome, in addition to reducing inflammatory biomarkers such as C-reactive protein.

Usages associés

Atherosclerosis, Metabolic Syndrome

Antimicrobial

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Studies have shown that bioflavonoids possess significant antimicrobial activity, particularly against various viruses and bacteria. This activity is primarily due to non-glycosylated compounds, and the presence of a hydroxyl group at position 3 is essential for antiviral activity. 40-hydroxy-3-methoxy flavones have demonstrated efficacy against rhino and polio viruses. The structure of these flavonoids, especially multiple substitutions in the A-ring, is crucial for their superior antiviral activity. For example, quercetin and hesperidin inhibit the replication of several viruses, including herpes simplex and poliovirus. However, not all flavonoids exert this activity; naringenin from grapefruit, for instance, has not shown this efficacy.


Neurological

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Bioflavonoids such as hesperidin demonstrate a notable neuroprotective potential, particularly relevant for neurodegenerative disorders like Parkinson's and Alzheimer's disease. Hesperidin protects against hydrogen peroxide-induced neurotoxicity in a laboratory model. It acts by attenuating behavioral alterations, oxidative stress, and mitochondrial enzyme complex dysfunctions, possibly through a mechanism related to nitric oxide. In the context of Parkinson's disease, hesperidin improves vascular tone and reduces stasis, contributing to the normalization of capillary permeability and lymphatic drainage, which is crucial for modulating inflammatory responses in the brain. It also inhibits phosphodiesterase, thus increasing intracellular cAMP, reducing the production of inflammatory prostaglandins and thromboxane, key molecules in inflammatory and coagulation processes associated with neurodegeneration. Moreover, hesperidin has shown positive effects on endothelial function, which is essential for preventing cardiovascular complications often associated with neurodegenerative diseases. It also helps modulate leukocyte gene expression, which could contribute to its anti-atherogenic and cardioprotective effects, thereby reducing the risks of progression of neurodegenerative diseases. By regulating Glutathione (GSH) levels, Glutathione Peroxidase (GPx) and Catalase activities, and preventing the formation of reactive oxygen species, hesperidin could help prevent the depletion of dopamine and its metabolites, essential in the context of diseases like Parkinson's.


Safety dosage

Adult: 500 mg - 1000 mg

Bioflavonoids are safely consumed up to 1300 mg, according to studies, for 3 months.


Interactions

Médicaments

Celiprolol: weak interaction

Animal research shows that the use of hesperidin might reduce the plasma area under the curve of celiprolol by up to 75%.

Diltiazem: weak interaction

Animal research suggests that hesperidin might improve diltiazem bioavailability.

Antihypertensive: weak interaction

Some clinical and animal research shows that hesperidin might decrease blood pressure.

Antiplatelet/Anticoagulant: weak interaction

Animal research suggests that bioflavonoids could have antiplatelet activity.

Plantes ou autres actifs

Bioflavonoids: moderate interaction

Some studies suggest that bioflavonoids improve vitamin C absorption.


Precautions

Pregnant woman: use with caution

Consumption during the third trimester of pregnancy of a combination of hesperidin and diosmin (100 mg) for 30 days does not appear to pose safety concerns for pregnant women.

Breastfeeding woman: use with caution

Consumption during breastfeeding of a combination of hesperidin and diosmin (100 mg) does not appear to affect the growth or feeding of the infant.