Curcumin as an Alzheimer’s Treatment

Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. This disease, is due, in part, to the accumulation of amyloid, a protein, in the brain. Oxidative damage and inflammation are also associated with the progression of Alzheimer’s disease (AD).

Curcumin

A plant cultivated mostly in Asia, turmeric is a member of the ginger family. Curcumin (diferuloylmethane) is the yellow pigment in the spice turmeric. Curcumin is one of 3 curcuminoids of turmeric. The other two curcuminoids are bisdemethoxycurcumin and demethoxycurcumin.

Curcumin and Alzheimer’s Disease

Despite India being one of the most populated countries in the world, it has one of the lowest occurrences of Alzheimer’s disease. Epidemiological studies have shown that prevalence of Alzheimer’s disease is 4.4 less amongst Indian Asians as compared to people of western origin. It is thought for this reason that India, a region in which the consumption of curcumin is particularly high, has some of the lowest Alzheimer’s disease rates in the world. Researchs suggests that turmeric (curcumin) may afford protection against neurodegenerative diseases. Curcumin as an anti-inflammatory, antioxidant, and lipophilic action improves the cognitive functions in people with Alzheimer’s disease.

Amyloid protein plaque buildup is one of the primary factors that characterizes Alzheimer’s disease. Curcumin reduced plasma contents of beta-amyloid protein, a marker of brain aging, particularly in relation to AD. A study reported in the Nov 2001 edition of the “Journal of  Neuroscience” found, that curcumin, reduces brain cell damage and inhibits the formation of protein plaques. Curcumin, decreases the harmful effects of protein plaques in the brains of Alzheimer’s patients according to a research reported in the Sep 2010 Journal of  Biological Chemistry. The levels of beta-amyloid in Curcuma longaAlzheimer’s disease mice that were given low doses of curcumin were reduced by 40 percent in comparison to those that were not treated with curcumin. Also, low doses of curcumin caused a 43 percent reduction in the so-called “plaque burden” that these beta-amyloid have on the brains of AD mice. A study reported in the Feb 2005 edition of  The Journal of  Biological Chemistry demonstrated that curcumin inhibits the formation of neurofibrillary tangles, which are collections of beta-amyloid protein, in both tissue culture and in animal models of AD. In one study, scientists compared the effects of rosmarinic acid and curcumin on the formation, extension, and destabilization of beta amyloid fibrils. They found that both rosmarinic acid and curcumin inhibited the formation and extension of beta amyloid fibrils, and destabilized beta amyloid plaques that had already formed.

Alzheimer’s begins as an inflammatory process in the brain. Curcumin has a strong anti-inflammatory activity. Through its different anti-inflammatory properties, it may have a role in the treatment of Alzheimer’s disease. In a 2001 study, UCLA scientists fed groups of mice one of 2 different doses of curcumin as part of their normal diet. The scientists wanted to determine how each dose affect inflammation, oxidative damage, and cerebral plaque levels. After 6 months, brain biopsies were performed to evaluate any changes in the architecture of the tissue. Both doses of the curcumin were effective. The findings demonstrated that, compared with mice fed the normal diet, had a decreased in 2 markers of inflammation in the brain.

Researches demonstrated that metals can induce A-beta aggregation and toxicity and are concentrated on Alzheimer’s brain. A study at “Capital University Beijing” showed the toxicity of copper on neurons. Curcumin, by interaction with heavy metals such as lead and cadmium prevents neurotoxicity caused by these metals. A study at “Chinese University of Hong Kong” demonstrated that by using spectrophotometry, the curcumin effectively binds to copper, iron and zinc. Also, curcumin binds more effectively with redox-active metals such as copper and iron than the redox-inactive zinc.  The intraperitoneal injection of lead acetate in rats in the presence of curcumin was investigated microscopically. The research findings show lead-induced damage to neurons was significantly decreased in rats injected with curcumin.

Curcumin and Vitamin D3

Vitamin D3 together with curcumin, may stimulate the body’s immune system to clear amyloid beta from the brain. A study conducted at UCLA found that curcumin may help the macrophages to clear the amyloid plaques found in Alzheimer’s disease. When paired with vitamin D, curcumin may help protect against Alzheimer’s disease.  Like curcumin, vitamin D may also exert some of its beneficial effects on Alzheimer’s through its anti-inflammatory and immune-boosting properties. A study, revealed that vitamin D3 together with curcumin may help stimulate your immune system to clear your brain of amyloid beta, thereby helping to prevent Alzheimer’s.

Curcumin and Anticancer Effects

Curcumin is a biologically active component of turmeric (Curcuma longa). This spice has been part of  traditional Indian and Chinese medicine for thousands of years. Curcumin is the most important biologically active phytochemical compound of  Turmeric. Curcumin is one of 3 curcuminoids of turmeric. The other two curcuminoids are bisdemethoxycurcumin and demethoxycurcumin. Curcuminoids comprise about 2-9% of turmeric.

Dosage

The available findings show that doses of at least 3.6 to 4 g per day are essential in order for curcumin to accumulate to detectable levels in the blood.  Doses of turmeric less than 3.6 g per day do not appear to significantly alter blood levels of curcumin. Clinical trials  indicate that the systemic bioavailability of orally administered curcumin is relatively low. Some capsules of curcumin contain piperine, a compound found in pepper which aids absorption of curcumin into the blood stream. Nanoparticle or liposomal formulations can also increase absorption.

Cancer Prevention Properties and Research Findings

Curcumin (diferuloylmethane) has been shown to exhibit antioxidant, anti-inflammatory and anticancer activities. Curcumin may help prevent and treat cancer by different mechanisms. Evidence from test tube and animal studies suggests that turmeric may help prevent or treat several types of cancers, including breast, prostate colon and  skin cancer. Curcumin has been shown in recent years to be a strong immunomodulatory agent that can modulate the activation of  T cells, B cells, macrophages, neutrophils, natural killer cells, and dendritic cells. Pre-clinical trials in a variety of cancer cell lines including prostate,cervical, breast, hepatic, colon, gastric, pancreatic, and  leukemia have consistently shown that curcumin possesses anti-cancer effects in vitro and in pre-clinical animal models.

Curcumin, is a strong antioxidant. In laboratory experiments, curcumin does prove effective as an antioxidant that provides protection against cell-damaging free radicals. Reactive oxygen species (ROS) attach to amino acids in DNA and cause cell injury or death. Animal-based research showed curcumin provides antioxidant activity by protecting against damage caused by reactive oxygen species. Curcumin also appears to reduce the risk of lung cancer associated with smoking. Experimental studies on curcumin and nicotine, cancer-causing chemical, showed that curcumin reduced the effects of nicotine as a carcinogen by 50 %.

Curcumin is an compound capable of inhibiting the activity of  inflammatory enzymes. Inflammation plays a role in the development of cancer and curcumin is useful for cancer prevention and cure. New findings that curcumin exhibits powerful antioxidant and anti-inflammatory activities and modulates the expression of transcription factors, cell cycle proteins, and signal transducing kinases has prompted the mechanism-based researches on the potential of curcumin to primarily prevent and treat cancer.

Various research findings indicates that curcumin might help protect against cancer and stop its progression. In lab and animal models, curcumin has been shown to induce cell death (apoptosis), in cancer cells. Curcumin also inhibits several pathways involved in cell growth. Findings from some studies done by scientists at “Oregon State University” demonstrate that curcumin inhibits cancer cell proliferation by inducing cell cycle arrest and apoptosis.

CurcuminResults from an animal-based study reported in the Nov 2009 edition of  Carcinogenesis found that turmeric (curcumin) might inhibit lung cancer progression. Scientists at the China Medical University discovered curcumin’s mechanisms of action in regards to lung cancer. The researchers, concluded that curcumin is effective in stopping the spread of cancer cells through apoptosis, or cell death. A study using human saliva at UCLA’s Jonsson Comprehensive Cancer Center, reported in the Sep, 2011, edition of  “Clinical Cancer Research“, found that curcumin seems to suppress a cell signaling pathway that drives head and neck cancer growth. In this pilot study, 21 head and neck cancer patients were given 1000 mg of curcumin, and an independent lab confirmed the findings on blind samples. Scientists at the “University of Michigan Comprehensive Cancer Center” found that a compound derived from curcumin, FLLL32, may help tumor cells overcome resistance to cancer therapies. This data may allow for lower and less toxic doses of cisplatin.

Curcumin, has shown biological activity in pancreatic cancer patients and there are ongoing research to test its effect as an addition to cancer therapy. In a Phase II clinical trial with curcumin, reported in “Clinical Cancer Research” in 2008, patients with advanced pancreatic cancer who took curcumin demonstrated some signs of improvement during therapy. Curcumin, temporarily stopped advanced pancreatic cancer growth in 2 patients and substantially reduced the size of a tumor in another patient, according to a small study reported July in the journal “Clinical Cancer Research”.

Scientists find curcumin may be beneficial in the prevention of prostate and breast cancers, which both are associated to inflammation and in reducing their metastatic risk. A study reported in the October 2005, edition of  Clinical Cancer Research found that curcumin prevents the progression of breast cancer cells. Triple negative breast cancer is a type of cancer that defies conventional treatment. A study from “Zheijian Provincial People’s Hospital” showed that curcumin is capable of inducing apoptosis within triple negative breast cancer cells. The nuclear receptor activators are important in other forms of cancer, including breast cancer. Scientists at the “Jefferson’s Kimmel Cancer Center” found that curcumin may aid in the slowing of  tumor growth in castration-resistant prostate cancer individuals who are receiving ADT (androgen deprivation therapy). The curcumin suppressed 2 known nuclear receptor activators that work against ADT (androgen deprivation therapy).

Curcumin might prevent recurrence of  colon cancer, according to a study reported in the Apr 2011 edition of the journal Pharmaceutical Research. Curcumin suppresses colon cancer when combined with other polyphenols such as resveratrol. In researches with curcumin and resveratrol these 2 compound seem to stop tumour cell growth and induce cancer cell death in neuroblastomas by activating the p53 gene pathway (Anticancer Research 2004 March). Scientists from the “Barbara Ann Karmanos Cancer Institute” presented evidences showing that adding resveratrol or curcumin to standard chemotherapy could be effective in preventing the growth of chemo-resistant colon cancer cells. Karmanos Cancer Institute scientists investigated whether the addition of resveratrol and curcumin to chemotherapy would decrease the survival of colon cancer cells. Researches confirmed that both are effective and inhibit the growth of new colon cancer cells, with curcumin appearing to be superior. Colon polyps are a risk factor for developing colon cancer. Patients with a genetic form of potentially cancerous polyps in the colon were given quercetin and curcumin, over a time period of six months. During this time the average number of polyps dropped by over 60 %, with the average polyp size decreasing by over 50 %.

Guanabana Anticancer Effects and Research Findings

Guanabana (Annona muricata), also known as soursop and graviola, is a tropical evergreen tree. The  fruit and the leaves of  the guanabana tree are used in traditional medicine. Guanabana possesses unique  phytochemicals known as Annonaceous acetogenins, which showed antitumor activities.

Guanabana Cancer Benefits and Experiments

Guanabana (graviola) contains chemicals called annonaceous acetogenins, which are thought to be the  active component. Annonaceous acetogenins are, powerful antioxidants that have been found to help avoid and treat illness. In lab experiments, guanabana selectively hunts down and kills 12 different types of  cancer cells including colon, breast, prostate, pancreatic, and lung cancer. However there haven’t been  any large scale studies in humans.

In 1997, researches at “Purdue University” proved that annonaceous acetogenins appeared especially  effective at destroying cellsGuanabana that had survived chemotherapy. A study conducted at “Purdue University”,  showed that the acetogenins can selectively inhibit the growth of cancer cells and furthermore inhibit  the growth of tumor cells resistant to doxorubicin, respecting the integrity of cells healthy tissue. Many of the annonaceous acetogenins have a cytotoxicity with ED50 values as low as 10-9 ug/ml. In other  study performed by experts at the “Purdue University”, it was demonstrated that the acetogenins of  graviola are very strong to have an ED50  of up to 10 to 9 micrograms per milliliter, resulting to have  about 10,000 times the power of adriamycin.

In a 2002 study performed by Taiwanese scientists and reported in the Journal of  Natural Products, the  guanabana extract showed the ability to kill liver cancer cells. Annonaceous acetogenins (guanabana extract) were influential against the growth of  Adriamycin – resistant human mammary adenocarcinoma by blocking access of cancer cells to ATP and by inhibiting the actions of plasma membrane glycoprotein. A research reported in the July 2011  edition of “Nutrition and Cancer” showed that guanabana extract inhibits EGF receptor production and slows the growth of  human breast cancer cells cultured in test tubes and grafted onto mice. According to a study reported in the Nov 2010 edition of  Molecules, the A. acetogenins in guanabana decreased the proliferation of lung cancer and laryngeal cells in the lab. The recent study, conducted by a research team at the “Department of  Biochemistry and Molecular Biology at the University of  Nebraska Medical Center“, shows that guanabana kills pancreatic cancer cells by inhibiting cellular metabolism.

Medical Effects of Cranberry Fruit

Cranberry (Vaccinium macrocarpon) is an evergreen shrub related to buckberry, blueberry, bilberry, and huckleberry. The reddish-black fruit appear in the months of June and July. Fruit contain compounds called proanthocyanidins, which give them their red color.

Cranberry Juice Benefits and Diseases

Cranberry are rich in antioxidants. The important type of polyphenolic compound found in cranberry is proanthocyanidins. Antioxidants are substances that protect cells from oxidative damage caused by molecules called free radicals. Free radicals are unstable molecules that attack normal cells and damage membranes. Cell death caused by free radicals contributes to a variety of diseases, including heart disease, some forms of cancer and nervous system disorders such as Alzheimer’s. Elevated antioxidant amounts in the body may protect against damage to cells and cellular components, thus helping to reduce the risk of many chronic degenerative diseases.

Various polyphenolic compounds such as flavonoids have been identified as having powerful antioxidant activities. Cranberry are one of the most rich sources of  flavonoids that have a potent antioxidant and anti-inflammatory effects. Therefore, consumption of cranberries could be of  importance not only in the maintenance of  health but also in preventing cardiovascular disease. Cranberry score high on the antioxidant scale at 1750 ORAC units per 100 g of fresh fruit. Cranberry have been shown to contain more antioxidant phenols than 19 commonly eaten fruits according to a research reported in the Nov, 2001 issue of  the Journal of Agriculture and Food Chemistry.

Urinary Tract Infections (UTIs)

Cranberries has a long history of use  primarily for treating urinary problems. New researches have shown it can reduce the ability of  Escherichia coli to adhere to the lining of the bladder and urethra, reducing the potential for urinary tract infections. Some lab experiments showed  that cranberry also prevent other microorganism known as Helicobacter pylori from adhering to cell walls.

Previously, scientists believed that the effect of cranberry juice to help prevent urinary tract infections was partly related to the potent acidity of the cranberry. However scientists don’t believe this explanation any more. No longer, researches show that cranberry juice may prevent bacteria from attaching to the walls of the urinary tract. Cranberry juice contain proanthocyanidins, which inhibit the fimbrial adhesion of bacteria, including E. coli, to the urinary tract epithelium and hence the subsequent reproduction required for infection. The proanthocyanidins in cranberry inhibit the adherence of  Escherichia coli fimbriae to uroepithelial cells in vitro. Adhesion of  Escherichia coli bacteria  to cells lining the urinary tract is the first step in the development of a urinary tract infections, and Escherichia coli is the cause of approximately 85 % of urinary tract infections.

Research shows that drinking cranberry juice can help prevent repeated urinary tract infections in older women. In one study of older women, cranberry juice decreased the amount of bacteria in the bladder compared to placebo. Other a study demonstrated that younger women with a history of  frequent urinary tract infections (UTIs) who took cranberry capsules had fewer UTIs compared to those who took placebo. A study reported in the Phytomedicine concluded that cranberry extract proved effective in preventing recurrent UTIs.

Benign Prostatic Hyperplasia and Chronic Prostatitis

Cranberry JuiceCranberry extract appears to be a  effective therapy to manage symptoms of  Benign prostatic hyperplasia (BPH) and chronic prostatitis. A 2011 study performed at the “Catholic University of  Korea College of Medicine “, demonstrated that cranberry extract reduced bacterial growth in the prostate tissue of animals with chronic bacterial prostatitis. During the 6-month a study, participants were given 1,500 mg of cranberry fruit powder per day. Compared with the control group, patients symptoms in the cranberry group significantly healed in a few areas by the end of the study, including quality of  life, rate and amount of urinary frequency, urine flow, urgency, and waking at night to urinate. In a study “Cancer Management and Research” reported that cranberry extract was effective in reducing the risk of urinary tract infections and lower urinary tract symptoms in men who were undergoing radiation treatment for prostate cancer. Particularly, of the 184 patient given cranberry extract, just 16 experienced a urinary tract infection associated with radiation treatment, compared with 45 of 186 men in the control group.

Peptic Ulcers

Some preliminary research findings demonstrate that cranberries may be useful in the prevention of peptic ulcers through the inhibition of  Helicobacter pylori adhesion to gastric mucus and stomach epithelium. Regular consumption of cranberry juice can suppress Helicobacter pylori infection, a important factor in peptic ulcer disease and gastric cancer. In the study which was reported in the Apr 2005 edition of  the journal Helicobacter, researchers proved that the usage of 250 ml of cranberry juice twice daily for 90 days suppressed H. pylori infection compared with a placebo.

Anticarcinogenic Activities

In 1996 lab experiments performed by University of  Illinois researchers and reported in “Planta Medica” showed the possible anticarcinogenic activities of cranberry. In studies of cancer prevention and cure, cranberries extracts showed  anti-proliferative activity against breast, prostate, colon, liver and oral cancer cell lines in vitro. In a study performed by scientists at the Department of  Physiology & Pharmacology, University of  Western Ontario, investigated the effect of cranberry extract on mice that had been injected with human breast tumor cells, prostate cancer cells and colon cancer cells. As a result, in all cases decrease the growth and metastasis of the cancer tumors.

Cardiovascular Disease

Cranberries may  help to protect against cardiovascular disease. Cranberries contain important levels of  flavonoids compounds that have been showed to inhibit low density lipoprotein oxidation. Flavonoids have been shown to function as strong antioxidants both in vitro and in vivo and may lessen the risk of atherosclerosis (hardening and narrowing of the arteries). Atherosclerosis can slowly narrow and harden the arteries throughout the body. This condition causes cardiovascular disease that lead to heart attacks and stroke.

Cranberries are especially important  source of phenolic phytochemicals, including phenolic acids and flavonoids. The cranberries flavonoids belong to 3 groups; anthocyanins, flavonols, and proanthocyanidins. Polyphenols and flavonoids improve the function of  platelets, irregularly shaped cells in the blood that help with clotting. Latest research findings demonstrate that polyphenols, including those found in cranberry, may contribute to reducing the risk of cardiovascular disease by increasing the resistance of  LDL to oxidation, inhibiting platelet aggregation, reducing blood pressure.

Dosage

The National Kidney Foundation suggests drinking 300 ml glass of cranberry juice cocktail a day may help prevent urinary tract infections. If you prefer in capsule form, the University of  Maryland Medical Center (UMM) suggests 300 to 400 mg daily in divided doses. For BPH; some researches shows that taking dried cranberry capsules, 3 times daily for 6 months, might improve urinary symptoms and lower blood levels of PSA.

Shark Cartilage Therapeutic Effects and Researches

Shark Cartilage is natural substance from the shark’s cartilaginous skeleton. The basic compounds in shark cartilage are proteoglycans and glycoproteins, as well as protein and calcium salts. Different types of extracts are made from shark cartilage including squalamine lactate, U-995 and AE-941 (Neovastat).

Shark Cartilage Medical Benefits

Shark cartilage is used as a dietary supplement to treat cancer, arthritis, psoriasis, macular degeneration, and inflammatory conditions.

Cancer

Cancer therapy designed to stop the growth of blood vessels is called anti angiogenesis. Investigators have been interested in cartilage as a possible therapy for cancer because cartilage doesn’t contain any blood vessels. Some lab and animal-based studies have shown that some components in shark cartilage have the effects to slow the growth of new blood vessels. However no study has shown that it can do this in humans. An extract from shark cartilage called Neovastat® (AE-941) has been developed and is being researched as a cancer cure.

Taking shark cartilage extract Neovastat by mouth seems to enhance survival in people with advanced kidney cancer. Neovastat was administered to 331 patients with advanced solid tumors in two phase I/II trials. The results of these trials, but, have not been fully reported. A retrospective analysis involving a subgroup of patients with advanced non-small cell lung cancer suggests that Neovastat is able to lengthen the survival of people with this disease. In 2003, the findings of a phase I/II trial of  Neovastat in 80 patients with advanced non-small cell lung cancer showed that there was a significant survival advantage for patients receiving the highest doses (2.6 mL/kg/day) of Neovastat.

In a study, from” MD Anderson Cancer Center“, found that shark cartilage failed to increase survival of patients with stage-3, non-small-cell lung cancer. Results from a study reported in the July, 2005 edition of the” journal Cancer” demonstrated that adding powdered shark cartilage to normal cancer treatment didn’t help patients with advanced colorectal or breast cancer. A extremely purified extract of shark cartilage named AE-941 (Neovastat) was tested in a clinical study and reported in 2010. AE-941 was given alongside chemotherapy and radiotherapy to patients with advanced lung cancer. The study demonstrated that AE-941 gave few adverse effects and was safe to take but did not help patients to live longer.

Arthritis

Shark Cartilage components, glucosamine, chondroitin sulphate and mucopolysaccharidess, are necessary building blocks for healthful joints, tendons, ligaments and bones. Shark Cartilage contains mucopolysaccharides, which stimulate immune response and are useful for inflammation; and an angiogenesis-inhibiting protein, which blocks the formation of new blood vessels. The mucopolysaccharides are known to decrease inflammation. When applied to the skin products containing shark cartilage in combination with glucosamine sulfate, chondroitin sulfate, and camphor, reportedly lessen arthritis symptoms.

Shark CartilageCanadian scientists, have discovered that when a therapeutic preparation using shark cartilage is applied to the skin, it demonstrated  anti-inflammatory effects. A study that was performed in the seventies found out that when shark cartilage injections were given to 28 people with severe pain, 19 patients reported that their relief lasted for almost an year while just 3 out of the 28 did not respond to the therapy. In a other study, 147 people were given either shark cartilage extract or a placebo. 5 years later, the cartilage group reported a drop of 85 % in pain scores, compared to a 5 % drop in the placebo group.

Psoriasis

Some preliminary clinical findings show that extracts of  shark cartilage may lessen inflammation and itching from psoriasis. Psoriasis is a skin problem that causes skin redness and irritation. Researches has found that the psoriasis-causing changes in the skin begin in the immune system when some immune cells (T cells) are triggered and become overactive. Psoriasis causes cells to build up rapidly on the surface of the skin, forming thick silvery scales and itchy, dry, red patches that are sometimes painful. Researches have shown that shark cartilage extract prevents the formation of  new blood vessels. The growth of new blood vessels is believed to play  role in the development and progression of  psoriasis lesions. Additionally, Shark cartilage is  known to have anti-inflammatory effects. Researchers extracted the active agent (Neovostat) from shark cartilage and test its antiangiogenesis effect using the embryonic vascularization test. The result showed that topical Neovostat had a positive effect in psoriasis.

In one study, a specially prepared extract of shark cartilage was found to inhibit both angiogenesis as well as the activity of a collagen digesting enzyme. Also, when the shark cartilage extract was applied to the forearms of test participants it was shown to have anti-inflammatory activities. This finding, demonstrate that shark cartilage has a positive effect in psoriasis. Oral preparation of  Neovastat containing water-soluble shark cartilage extract in a single-center, randomized, open-label, phase I/II trial found Neovastat to improve the Psoriasis Area and Severity Index (PASI) in 50%, 41.7%, and 30.8% of 49 participant with psoriasis receiving 240, 120, and 60 ml/day Neovastat respectively. In other study, 10 patient with psoriasis where given shark cartilage for 40  days. The findings were that participants complaining of itching noticed its disappearance on day 6.  Over the course of  the 40 days, additional indications of improvement were noticed, and seven participant were healed by the end of the study. The investigators concluded that shark cartilage seems to “be able to control the greater part of psoriasis pathogenetic mechanism.”

How to Use

Shark cartilage comes in different forms. Shark cartilage is generally taken by mouth as a powder, capsule or liquid extract. Also, in  trials, it has sometimes been given as an enema (into the back passage – rectum) or injected under the skin. Neovastat is a highly purified extract of  shark cartilage. Other shark cartilage supplements may not have similar effects.

Side Effects

Some studies have reported adverse  effects such as nausea, vomiting,stomach upset, constipation, low blood pressure and fatigue. A few patients who were administered with the injections were found to be at a risk of developing hypercalcemia. Children,  patients who have had a recent heart attack or surgery, women who are pregnant or breast feeding not use cartilage.