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Clinical Update on Bergamot BPF for Non-Alcoholic Fatty Liver Disease (NAFLD)

by Dr. James Ehrlich(more info)

listed in heart, originally published in issue 239 - July 2017

Bergamot 37-47% Polyphenols (BPF) is a safe, highly concentrated polyphenolic extract of the Calabrian (Italy) citrus bergamot fruit that is available to both individuals and physicians without a prescription.

As a clinician familiar with the clinical research of bergamot polyphenols, I have been asked to answer questions about the general clinical role of the product and specifically, for people with non-alcoholic fatty liver disease.

Bergatone

What are the Clinical uses of Bergamot?

Bergamot 38-47% is a safe and well-established supplement that effectively addresses cardio-metabolic conditions including dyslipidemia, metabolic syndrome and NAFLD while improving vascular health.  A powerful anti-oxidant and natural statin, bergamot lowers cholesterol levels (while improving all atherogenic lipoproteins), promotes healthy metabolism (e.g., glucose) and addresses visceral adiposity while improving vascular health (endothelial function and arterial compliance). It is primarily used for people with dyslipidemia or metabolic syndrome, for those who are statin-intolerant and individuals who have hepatic steatosis.  It is commonly used in combination with statins to lower the dose of statins, decrease complications from statin usage and get a complementary improvement in HDL, triglycerides and blood sugar;

What are the Primary Mechanisms of Action?
There are numerous polyphenols in Bergamot, some of which are unique to the citrus bergamot fruit and others that are in higher concentrations than found elsewhere.  These active polyphenols contribute numerous mechanisms including HMG-CoA reductase (statin-like) activity, AMPKinase activity (improving metabolism like metformin), gut sterol inhibition (like ezetimibe) and PDE-3 inhibition;

Bergamot CT steatosis

What is the evidence that Bergamot may be helpful in NAFLD ?
Several clinical studies were performed on patients with clinical evidence of NAFLD and metabolic syndrome.  In a study presented at the 2014 annual meeting of the AGA involving 107 patients with NAFLD, 4 months of Bergamot 38-47% (1300 mg daily) resulted in a highly significant improvement in all relevant hepatic serum parameters (e.g. steato test) and a 50% improvement in echogenic visual fat measures (hepato-renal index).  In addition, as presented at the National Lipid Association in 2015, these people also demonstrated substantial improvement in all lipoprotein particle levels and characteristics;  

Does Bergamot improve cardiovascular health in patients with NAFLD?
A recent study examined advanced lipoprotein profiles including oxidized LDL, arterial stiffness and endothelial function changes after 16 weeks of BPF on188 patients with hyperlipemia and established NAFLD.  Significant improvements in all lipid and vascular  function parameters were demonstrated.  Separately, all  hepatic tests (biochemical, fibrosis indices, hepato-renal index, etc.) were favourably and significantly altered. This improvement in cardio-metabolic health is extremely promising because most people with NAFLD develop cardiovascular disease.

Further Information

Dr Ehrlich can be contacted in the first instance via Kevin Leivers MR Pharm S at the The Naked Pharmacy on Tel: 01483 685630; Mob: 07985 948353; kevin@thenakedpharmacy.com   www.thenakedpharmacy.com 

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About Dr. James Ehrlich

Dr. James Ehrlich is Clinical Associate Professor, University of Colorado (Endocrinology) and was Adjunct Assistant Professor, Department of Medicine, George Washington University Medical Centre, Washington DC from 1999-2012. Ehrlich established Early Detection Technologies, LLC - best practices with novel biomarkers, diagnostic testing and cardiovascular risk assessment, imaging technologies and radiation protection. Dr Ehrlich founded and was Medical Director, Colorado Heart and Body Imaging in Denver, diagnostic facilities for early detection of coronary and vascular disease, sleep apnea, osteoporosis and some cancers.

Dr Ehrlich is a founding member of the Society of Atherosclerosis Imaging and a co-founder of the Society of Cardiovascular CT. He is an active contributor to and task force member of SHAPE - the Society for Heart Attack Prevention and Eradication. In June 2013, Dr Ehrlich received the Ambassador of Bergamotto research award for clinical studies on bergamot and is studying the cardio-metabolic and hepatic effects of a proprietary extract of bergamot. Dr Ehrlich can be contacted in the first instance via Kevin Leivers MR Pharm S The Naked Pharmacy on Tel:  01483 685630;  Mob: 07985 948353; kevin@thenakedpharmacy.com  www.thenakedpharmacy.com 

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