Cancer Nutrition Network for Texans
What is it?
This is an herb indigenous to Mexico and Central American. Plants derived from five species yield pungent fruits commonly called red pepper, cayenne pepper, chili pepper, or simply capsicum. Many enjoy the pungent flavor these plants give to the foods we eat. The fresh or dried fruit and/or seeds are prepared as capsules, creams or tinctures for medicinal use. Creams containing capsaicin have been used in treatment of intractable or constant pain such as that associated with shingles, phantom pain syndrome associated with postmastectomy and postamputation neuroma, arthritis, and diabetes neuropathy. Unproven uses include the combination of capsicum with other synergistic ingredients in general tonics, laxatives, sedatives, and hay fever remedies. In folk medicine it has been used internally for gastrointestinal disorders, seasickness, and as preventive therapy for cardiovascular diseases. Indian medicine uses this drug for the treatment of gout, coughs and hoarseness, alcoholism, loss of appetite, dyspepesia and diarrhea. Homeopathic uses include treatment of urinary tract infections as well as mouth, throat, and ear infections.
Preparations of cayenne have been approved exclusively for external use and it is recommended that the cream not be applied more than three to four times per day. Capsaicin-containing topical products are approved in over-the-counter and prescription drugs in the United States.
How does it work?
Capsicin is considered the most important active ingredient in this herb. Initially exposure to Capsicum can cause pain, inflammation, and hypersensitivity. Repeated applications cause a depletion of a neuropeptide chemical that mediates the transmission of pain impulses from the peripheral nerves in the legs and arms to the spinal cord. Eventually perception of pain stops because it fails to reach the brain. Creams must usually be applied three to four times daily for four weeks to achieve maximum pain relieve. The Food and Drug Administration has approved phytomedicines containing 0.075 percent capsaicin in a cream base. Users are cautioned to apply this cream with care to avoid contact with the eyes or mucous membranes. Anaphylaxis and rhinoconjunctivitis symptoms have been associated with this herb. Others have reported blisters and ulcers on the skin at points of contact with capsicum.
Internal use for digestive disturbances and supportive treatment of cardiovascular diseases has not been scientifically established. There are great individual variations in sensitivity to capsicum. Ingestion can cause diarrhea and intestinal colic. Likewise, limited studies indicate that medicinal doses of Capsicum alter the composition of human red blood cells via its effect on cellular enzyme activity. When Capsicum extract (100 mg/gm) was taken in combination with asprin it reduced the availability of this drug in the gastrointestinal tract. Thus if taken internally in large doses it could interfere with effectiveness of other drugs. Warnings suggesting limiting internal use to 2 days have been published in the PDR for Herbal Medicines.
Is it efficiacious?
There is a paucity of evidence to support the efficacy of capsicum beyond its role in topical application for selected forms of pain management Although this herb is a compound listed on the Food and Drug Administration GRAS(Generally Recognized As Safe) list, it has not undergone rigorous testing.
What is the state of the science?
The state of the science is limited to III – Expert opinion or testimonial.
It is unlikely that toxic doses of capsicum can be ingested from foods. There has been a substantial body of data testing both the cancer promoting effect as well as the anti-tumor promotional activity of capsicum. Early animal studies suggested that capsaicin promoted tumor activity. Recent studies support the role of capsaicn as an important dietary phytochermical with both antioxidant and anti-inflammatory effects. However, medicinal doses should be avoided until there is a substantial body of evidence to support it’s use.
Surh YJ, Lee E, Lee JM. Chemoprotective properties of some pungent ingredients present in red pepper and ginger. Mutation research. 402(1-2):259-267, 1998.
Tyler VE. Herbs of Choice. The Therapeutic Use of Phytomedicinals. New York: Pharmacerical Products Press, 1994.
Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used In Food, Drugs, and Cosmetics. 2nd ed. New York: John Wiley and Sons, Inc, 1996.
PDR for Herbal Medicine. 2nd ed., Montvale, NJ: Medical Economic Co, 2000.
Connie Mobley, Ph.D., R.D., is an Associate Professor of Nutrition at the University of Texas Health Science Center at San Antonio.