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Monograph: Cassia cinnamon - Cinnamomum aromaticum

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This monograph is intended to serve as a guide to industry for the preparation of Product Licence Applications (PLAs) and labels for natural health product market authorization. It is not intended to be a comprehensive review of the medicinal ingredient. Notes: (i) Text in parentheses is additional optional information which can be included on the PLA and product label at the applicant's discretion. (ii) The solidus (/) indicates that the terms and/or the statements are synonymous. Either term or statement may be selected by the applicant. (iii) A claim for a traditional use must include either the term "Herbal Medicine" or "Traditional Chinese Medicine".

Date: 2014-11-04

NHPID Name

Cinnamomum aromaticum (USDA 2008)

Proper Name(s)

Common Name(s)

Source Material


Route Of Administration

Oral

Dosage Form(s)

The acceptable pharmaceutical dosage forms include, but are not limited to capsules, chewables (e.g. gummies, tablets), liquids, powders, strips or tablets. This monograph is not intended to include foods or food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or Purpose(s)

Statement(s) to the effect of:

General


Trunk bark

Dose(s)

Adults:

Antioxidants
Preparation: Powdered

Dose(s): not to exceed 6 Grams per day, bark powder
Appetite loss
Preparation: Powdered

Dose(s):
1 - 6 Grams per day bark powder , not to exceed 4 Grams per single dose
 (Gruenwald et al. 2010, Al-Jamal 2009, Crawford 2009, Mang et al. 2006, Safdar et al. 2004, Khan et al. 2003)

Directions For Use: Take a half hour before meals

Digestive disturbances/ Dyspepsia
Preparation: Powdered

Dose(s):
1 - 6 Grams per day bark powder , not to exceed 4 Grams per single dose
 (Gruenwald et al. 2010, Al-Jamal 2009, Crawford 2009, Mang et al. 2006, Safdar et al. 2004, Khan et al. 2003)

Directions For Use: Take with food/meal (Crawford 2009)

Healthy glucose levels
Preparation: Powdered

Dose(s):
3 - 6 Grams per day bark powder , not to exceed 4 Grams per single dose
 (Davis and Yokoyama 2011, Gruenwald et al. 2010, Crawford 2009, Mang et al. 2006)

TCM - dispel cold, pain relief, open channels; TCM - dispel cold, warm spleen, pain relief; TCM - Qi and blood production; TCM - kidney yang and ming men
Preparation: Decoction

Dose(s): 2 - 5 Grams per day, trunk bark
Preparation: Powdered

Dose(s): 1 - 2 Grams per day, trunk bark

Duration of use

For products providing  4 - 6 Grams per day :
For use beyond 6 weeks, consult a health care practitioner  (Safdar et al. 2004, Khan et al. 2003)

Risk Information

Statement(s) to the effect of:

Caution(s) and Warning(s):
  • Digestive disturbances/ Dyspepsia; Appetite loss:
    If symptoms persist or worsen, consult a health care practitioner
  • Doses greater than or equal to 1 Grams per day:
    If breastfeeding, consult a health care practitioner prior to use  (Blumenthal et al. 2000, WHO 1999)
  • Doses greater than or equal to 1 Grams per day:
    If you have diabetes, consult a health care practitioner prior to use  (NS 2011, Brinker 2010)

Contraindication(s):

Known Adverse Reaction(s):
Hypersensitivity/allergy may occur; in which case, discontinue use  (Blumenthal et al. 2000, WHO 1999, Blumenthal 1998, McGuffin et al. 1997)

Non-medicinal ingredients

Must be chosen from the current Natural Health Products Ingredients Database and must meet the limitations outlined in the database.

Specifications

  • The finished product specifications must be established in accordance with the requirements described in the NHPD Quality of Natural Health Products Guide.
  • The medicinal ingredient must comply with the requirements outlined in the Natural Health Products Ingredient Database (NHPID).

References cited

  • Al-Jamal AR. Effects of cinnamon on blood glucose and lipid levels in diabetic patients (type 1). AJBR 2009;3(5):181-184.
  • Bensky D, Clavey S, Stoger E, Gamble A, editors. Chinese Herbal Medicine Materia Medica. 3rd edition. Scattle (WA): Eastland Press Inc; 2004.
  • BHC 2006: Bradley PR, editor. British Herbal Compendium Volume 2: A Handbook of Scientific Information on Widely Used Plant Drugs—Companion to the British Herbal Pharmacopoeia. Bournemouth (GB): British Herbal Medicine Association; 2006.
  • Blumenthal M, editor. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin (TX): American Botanical Council in cooperation with Integrative Medicine Communications; 1998.
  • Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Boston (MA): American Botanical Council. 2000.
  • Brinker 2010: Brinker F. Final updates and additions for Herb Contraindications and Drug Interactions, 3rd edition, including extensive Appendices addressing common problematic conditions, medications and nutritional supplements, and influences on Phase I, II & III metabolism with new appendix on botanicals as complementary adjuncts with drugs. [Internet]. Sandy (OR): Eclectic Medical Publications. [Updated July 13 2010; Accessed 2012 April 23]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html
  • Chen JK, Chen TT. Chinese Medical Herbology and Pharmacology. Crampton L, editor. City of Industry (CA): Art of Medicine Press Inc; 2004.
  • Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med. 2009; 22(5):507-512.
  • Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. Journal of Medicinal Food 2011;14(9):884-889.
  • Gruenwald J, Freder J, Armbruester N. Cinnamon and health. Critical Reviews in Food Science and Nutrition 2010;50(9):822-834.
  • Halvorsen BL, Carlsen MH, Phillips KM, Bohn SK, Holte K, Jacobs DR Jr, Blomhoff R. Content of redox-active compounds (ie, antioxidants) in foods consumed in the United States. American Journal of Clinical Nutrition 2006;84(1):95-135.
  • ITIS 2011: Cinnamomum aromaticum [2011] Integrated Taxonomic Information System (ITIS) [Internet]. Accessed 2012 May 23]. Available from: http://www.itis.gov
  • Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26(12):3215-3218.
  • Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA1C, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 2006;36(5):340-344.
  • McGuffin M, Hobbs C, Upton R, Goldberg A, editors. American Herbal Products Association's Botanical Safety Handbook. Boca Raton (FL): CRC Press LLC; 1997.
  • McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. 2000. Herbs of Commerce, 2nd edition. Silver Spring (MD): American Herbal Products Association.
  • NS 2011: Cinnamon (Cinnamomum spp.) Natural Standard Professional Monograph [Internet]. Natural Standard Inc; 2011 [Accessed 2012 May 23]. Available from http://www.naturalstandard.com/
  • PPRC 2010: Pharmacopoeia of the People's Republic of China. Volume 1, English edition 2010. Beijing (CN): The State Pharmacopoeia Commission of the People's Republic of China.
  • Roussel AM, Hininger I, Benaraba R, Ziegenfuss TN, Anderson RA. Antioxidant effects of a cinnamon extract in people with impaired fasting glucose that are overweight or obese. J Am Coll Nutr 2009; 28:16-21.
  • Safdar M, Khan A., Khan MMA, Siddique M. Effect of various doses of cinnamon on blood glucose in diabetic individuals. Pakistan Journal of Nutrition 2004;3:268-272.
  • Shan B, Cai YZ, Sun M, Corke H. Antioxidant capacity of 26 spice extracts and characterization of their phenolic constituents. Journal of Agricultural and Food Chemistry 2005;53(20):7749-7759.
  • USDA 2009: USDA, ARS, National Genetic Resources Program. Germplasm Resources Information Network (GRIN) [Internet]. National Germplasm Resources Laboratory, Beltsville (MD). [Cinnamomum aromaticum Nees (Lauraceae) Diels. Last updated: 05-Oct-2009; Accessed 2012 May 23]. Available from: http://www.ars-grin.gov/
  • WHO 1999: World Health Organization. WHO Monographs on Selected Medicinal Plants, Volume 1. Geneva (CH): World Health Organization; 1999.

References reviewed

  • Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM. The effects of cinnamon on A1C among adolescence with type 1 diabetes. Diabetes Care 30:813- 816, 2007
  • Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, et al. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem. 2004;52(1):65-70
  • ASHP 2005: American Society of Health-System Pharmacists. American Hospital Formulary Service (AHFS) Drug Information. Philadelphia (PA): Lippincott Williams and Wilkins; 2005.
  • Baker W, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008;31:41-43.
  • Bandara T, Uluwaduge I, Jansz ER. Bioactivity of cinnamon with special emphasis on diabetes mellitus: a review. International Journal of Food Sciences and Nutrition 2012;63(3):380-386.
  • Blevins SM, Leyva MJ, Brown J, Wright J, Scofield RH, Aston CE. Effect of cinnamon on glucose and lipid levels in non-insulin dependent type 2 diabetes mellitus. Diabetes Care 2007;30:2236-2237.
  • Brinker 2010: Brinker F. Final updates and additions for Herb Contraindications and Drug Interactions, 3rd edition, including extensive Appendices addressing common problematic conditions, medications and nutritional supplements, and influences on Phase I, II & III metabolism with new appendix on botanicals as complementary adjuncts with drugs. [Internet]. Sandy (OR): Eclectic Medical Publications. [Updated July 13 2010; Accessed 2012 April 23]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html
  • Brinker F. 2001. Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications.
  • Brinker F. The Toxicity of Botanical Medicines. Sandy (OR): Eclectic Medical Publications; 2000.
  • Broadhurst CL, Polansky MM, Anderson RA. Insulin like biological activity of culinary and medicinal plant aqueous extracts in vitro. J Agric Food Chem 2000;48:849-852.
  • Canada Vigilance Adverse Reaction Online Database. Ottawa (ON): Marketed Health Products Directorate, Health Canada; 2011. [Accessed 2011 October 27]. Available from: http://webprod3.hc-sc.gc.ca/arquery-rechercheei/index-eng.jsp
  • Canadian Nutrient File (CNF), 2012 [Internet]. Ottawa (ON): Food and Nutrition, Health Canada. [Date Modified 2012-02-10; Accessed 2012 Apr 12]. Available from: http://webprod3.hc-sc.gc.ca/cnf-fce/index-eng.jsp
  • Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med. 1996; 125(1): 221-232.
  • Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Canadian Journal of Diabetes 2008:32 (suppl 1).
  • Dugoua JJ, Seely D, Perri D, Cooley K, Forelli T, Mills E, Koren G. From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark. Can. J. Physiol. Pharmacol 2007; 85: 837-847.
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  • Hlebowicz J, Hlebowicz A, Lindstedt S, Björgell O, Höglund P, Holst JJ, et al. Effects of 1 and 3g cinnamon on gastric emptying, satiety, and postprandial blood glucose, insulin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and ghrelin concentrations in healthy subjects. Am J Clin Nutr 2009; 89: 815-821.
  • Imparl-Radosevich J, Deas S, Polansky MM et al. Regulation of PTP-1 and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signalling. Horm Res 1998;50:177-182.
  • Jarvill-Taylor KJ, Anderson RA, Graves DJ. A hydroxychalcone derived from cinnamon functions as a mimetic for insulin in 3T3-L1 adipocytes. J Am Coll Nutr. 2001; 20(4) : 327-236.
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  • Solomon TPJ, Blannin AK. Changes in glucose tolerance and insulin sensitivity following 2 weeks of daily cinnamon ingestion in healthy humans. Eur J Appl Physiol. 2009;105:969-976.
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  • Soni R, Bhatnagar V. Effect of cinnamon (Cinnamonum cassia) intervention on blood glucose of middle aged adult male with non insulin dependent diabetes mellitus (NIDDM). Ethno-Med 2009;3:141-144.
  • United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853.
  • USDA Nutrient Database 2011: United States Department of Agriculture (USDA), Agricultural Research Service. Nutrient Data Laboratory. Spices, cinnamon, ground. NDB. No: 02010. 2011. [Accessed 2011-10-31]. Available from http://www.nal.usda.gov/fnic/foodcomp/cgi-bin/measure.pl
  • Vanschoonbeek K, Thomassen BJW, Senden JM, Wodzig WKWH, van Loon LJC. Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetic patients. J Nutr 2006;136:977-980.
  • WHO 2010: World Health Organization. WHO Food Additives Series 14: Cinnamaldehyde. 2010. [Accessed 2011-10-31]. Available from http://www.inchem.org/documents/jecfa/jecmono/v14je07.htm
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  • Ziegenfuss TN, Hofheins JE, Mendel RW, Landis J., Anderson RA. Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women. J Int Soc Sports Nut. 2006; 3: 45-53