With kidney disease often being a disease that comes as a result of many of the big health conditions affecting our modern western world, I wanted to share some information on a supplement that has many great benefits not just for kidney disease but may also be useful in the diseases that cause or lead to kidney disease. Introducing chitosan.
What is Chitosan?
Chitosan is a biodegradable fibre that is obtained from chitin, the hard outer skeleton of a variety of shellfish, including crab, lobster, and shrimp. Medicinal uses include treating high cholesterol, obesity, anemia, insomnia, and Crohn’s disease. It can be applied directly to the gums to treat periodontal disease or given in chewing gum form to prevent cavities, it can also be applied to the skin to speed up and improve wound healing. There is also evidence chitosan is effective for treating complications related to kidney failure and dialysis treatment, as well as many of the medical issues related to kidney diseases, such as high cholesterol, anemia, and fatigue.
How does Chitosan work?
Chitosan is said to work by turning into a gel in the stomach. These large gel molecules then bind to toxins, fats and cholesterol in the gut. By binding to these substances in the gut they are then eliminated and removed from the body via the stool. This fat binding action is thought to be the action behind chitosans ability to reduce cholesterol and work as a weight-loss supplement.
Chitosan has also been shown to lower the action of several inflammatory compounds such as IL-1b while increasing the action of important anti-inflammatory cytokines, such as IL-10, that are important in facilitating the healing process.
There are only a few studies using chitosan to lower cholesterol in humans. One study found that dietary chitosan has been reported to reduce serum total cholesterol levels by 5.8-42.6% and low-density lipoprotein (LDL’s) levels by 15.1-35.1%. In short-term trials up to 12 weeks, no clinically significant side effects were observed with chitosan compared to placebo.
In another clinical trial of 84 women, chitosan worked to lower total cholesterol levels better than the placebo. In a subgroup of women over 60 years of age, it also reduced LDL and total cholesterol levels.
High Blood Pressure
Excess salt intake is known to contribute to elevated blood pressure in some genetically susceptible individuals. Researchers have found that chitosan may act as a binding agent for table salt and thus have the ability to reduce high blood pressure caused by excess salt intake.
In two trials of 81 patients with prehypertension or moderate hypertension, taking a specific product (Symbiosal- which includes 3% chitosan in a table salt blend, for 8 weeks decreased systolic blood pressure, compared with table salt alone.
Chitosan is thought to be effective in weight loss via its ability to form connective films, attaching to bile and fatty acids in the gut. The films then pass through the digestive system, potentially increasing the amount of fat removed in the stool.
In one clinical study, chitosan supplements reduced participants’ weight by up to 7 lbs over three months. But placebo alone helped people lose up to 4 lbs. In turn, chitosan’s realistic contribution was only about 3 lbs (1.36 kg), on average.
A Cochrane database review included 15 clinical trials of 1,219 total participants. Chitosan supplementation slightly improved weight loss (‐1.7 kg on average).
Overall chitosan would not be my supplement of choice for weight loss, but possible combined with healthy whole food and alkaline diet it may be slightly useful.
Inflammation is the major driver behind the autoimmune disease known as Chron’s disease, a disease that causes inflammation in the intestines and often results in gastrointestinal bleeding, weight loss, diarrhea, nausea, vomiting and fever.
Specific cytokines such as IL-1b and TNF – alpha have been associated with the onset and development of Crohn’s disease. High circulating levels of these cytokines may compromise the integrity of the gastrointestinal lining and may contribute to not only Crohn’s disease but also leaky gut syndrome.
Animal studies have shown that chitosan has the ability to improve symptoms of inflammatory bowel diseases such as Crohn’s disease and strengthen the gut barrier.
In one open study, researchers tested chitosan supplements in 80 people with kidney failure receiving ongoing hemodialysis treatment. Half the participants were given 45 mg tablets for a total of about 1,500 mg of chitosan daily for 12 weeks; the other half were not given a supplement. Those in the treatment group showed a significant decrease in urea and creatinine levels. Further, they had a rise in hemoglobin levels and reported improved overall strength, appetite, and sleep.
After 12 weeks of chitosan ingestion, the proportions of the patients with improved appetite and sleep pattern in the treatment and control groups were 68% and 43%, respectively, and the proportions of the patients with improved physical strength were 80% and 13%, respectively.
In one older trial, chitosan given to 40 people with kidney failure improved strength, appetite, and sleep after 12 weeks. It also increased hemoglobin and reduced blood creatinine and urea levels, which points to its potential to improve kidney function.
Clinical studies have indicated that chronic renal failure is not only a series of complex biochemical reactions but also a systemic chronic inflammatory response as we often talk about here at the Kidney Coach. It has been shown that proinflammatory cytokines, specifically Interleukin-1 Beta (IL-1β) and tumour necrosis factor-α (TNF-α) contribute to the progression of nephritis in animal models and patients. Therefore, proinflammatory cytokines play an important role in the development of renal inflammatory diseases and glomerular sclerosis. Chitosans anti-inflammatory mechanism that I mentioned earlier when I spoke about its effect in Crohn’s disease may also be the same mechanism in which chitosan has a protective and supportive role in CKD.
Acute Kidney Injury
Further to this, chitosan has been shown to have a renoprotective role in lithium-induced renal toxicity. Chitosan was shown to do this via its anti-inflammatory and antioxidant mechanisms. The study found that lithium was completely absent in the serum of the chitosan treated rats at the end of the experiment. It was revealed that there were no histopathological alterations in the kidney of the chitosan treated rats, the glomeruli and tubules were recorded at the cortex with normal histological structure.
Polycystic Kidney Disease
A study conducted in 2020 in rats, used chitosan to reduce the size of cysts in PKD. The results revealed that the cysts treated with chitosan at concentrations of 50 and 100 µg/mL were significantly smaller in size after treatment when compared with the control group.
When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow to make red blood cells. With less EPO, your body makes fewer red blood cells, and less oxygen is delivered to your organs and tissues. This intern results in a drop in blood haemoglobin levels.
The ingestion of chitosan resulted in a significant increase in the serum haemoglobin levels of patients in the treatment group after 4 weeks compared with patients in the control group. Serum haemoglobin levels for the treatment group increased from 58.2f 12.1 to 69.3f11.3 g L-‘ whereas the corresponding values for the control group were 59.2 f 8.4 and 58.4f9.3 g L-‘. The increased haemoglobin levels in the treatment group were maintained throughout the remainder of the test.
Toxicity and Contraindications
Taking excessive amounts of chitosan can cause certain vitamin deficiencies. According to the National Digestive Diseases Information Clearinghouse, fat-soluble vitamins such as vitamins A, D, E and K, are stored in the liver and fatty tissues may bind with chitosan. There’s a possibility for these vitamins to be depleted insignificantly.
Patients who are allergic to crustaceans and shellfish will develop hypersensitivity reactions when taking chitosan.
Overall clinical studies have found Chitosan to be very safe with minimal side effects.
Chitosan may reduce the effectiveness of some drugs. The following interactions are possible:
- Reduced absorption of fat-soluble drugs, including birth control pills.
- Reduced vitamin K levels and increased blood-thinning effects of warfarin (Coumadin), possibly causing excessive bruising and bleeding.
- Reduced absorption of antiviral drug acyclovir.
Overall chitosan is a safe addition to your daily routine. It is a supplement I would specifically think of if I was supporting a patient with kidney disease caused by heavy metal toxicity (due to its ability to bind toxins and metals) as well as those with fat assimilation issues indicated by obesity, or elevated cholesterol or if you have low energy levels caused by low haemoglobin levels.
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Until next time stay healthy!