Herbal Medicine: Expanded Commission E

Latin Name: Saccharomyces cerevisiae, Candida utilis
Pharmacopeial Name: Faex medicinalis
Other Names: brewer's dried yeast, debittered brewer's dried yeast, primary dried yeast

• Overview
• Description
• Chemistry and Pharmacology
• Uses
• Contraindications
• Side Effects
• Use During Pregnancy and Lactation
• Interactions with Other Drugs
• Dosage and Administration
• References
• Additional Resources

Overview

Brewer's yeast is a fungus, classified under the genus Saccharomyces, meaning sugar (saccharo) fungus (myces). Medicinal brewer's yeast is the focus of ongoing scientific and medical study. The Hansen CBS strain binds to fibriated pathogenic bacteria. Medicinal applications relate to the treatment of acute diarrhea, the prevention of Candida proliferation, the treatment of acne, and the alleviation of premenstrual symptoms (PMS). Uses for disorders associated with specific diseases, such as recurrence of Clostridium difficile disease (CDD) and Candida proliferation in pediatric cystic fibrosis patients, are currently being investigated (Muller et al., 1995; McFarland et al., 1994).

Diarrhea prevention has been demonstrated through clinical studies. Tested in a multicenter, double-blind, controlled study of critically ill patients fed through tubes, Hansen CBS prevented diarrhea, even in patients for whom additional factors placed them at even higher risk than that presented by the feeding tubes alone (Bleichner et al., 1997). Beta-lactam antibiotics are also associated with causing diarrhea. In a double-blind, placebo-controlled study, high-risk patients were given either Hansen CBS or placebo within 72 hours of starting a beta-lactam antibiotic. The patients continued to take the yeast supplement for three days following the course of therapy. The resulting protection of Hansen CBS against antibiotic-induced diarrhea was 51%, with no accompanying adverse side effects (McFarland et al., 1995). Because antibiotic-induced diarrhea is common in the elderly, a placebo-controlled study was designed to determine whether or not older patients could benefit from the antidiarrheal effects of Hansen CBS as well; however, in this study the yeast supplement was not effective (Lewis et al., 1998).

A double-blind, placebo-controlled study was designed to demonstrate effects of yeast supplementation on varying types of acne in 139 subjects. According to their doctors, 74.3% of the patients were reported to have seen improvement. Over 80% of the patients felt their acne had completely healed (Weber et al., 1989).

A randomized, placebo-controlled, double-blind study of 40 patients with mild to moderate premenstral syndrome was conducted to test the effects of yeast supplementation versus placebo against PMS. At the end of the six-month study, brewer's yeast was determined more effective in reducing premenstrual symptoms than placebo (Facchinetti et al., 1997).

Yeast supplementation may also be effective in reducing preterm infant mortality in areas where nutritional deficiencies are endemic. In a recent trial, 28 preterm infants in Hungary were given a selenium-enriched yeast product. The product was found to be safe and to increase selenium levels effectively in preterm infants (Bogye et al., 1998).

Both brewer's yeast and Hansen CBS 5926 brewer's yeast are approved in Germany for the treatment of chronic acne and furunculosis (the occurrence of several boils at the same time) and loss of appetite. Hansen CBS 5926 is given in cases of acute and traveler's diarrhea and diarrhea associated with the use of a feeding tube.

Description

Medicinal yeast consists of fresh or dried cells of Saccharomyces cerevisiae Meyer [Fam. Saccharomycetaceae] or of Candida utilis (Hennenberg) Rodden et Kreyer Van Rey [Fam. Cryptococcaceae] and their preparations in effective dosage. Medicinal yeast contains vitamins, particularly B complex, glucans, and mannans.

Chemistry and Pharmacology

The main constituents include polysaccharides: long chain carbohydrates composed of glucans and mannans; not less than 40% proteins; B complex vitamins: not less than 0.012% thiamine hydrochloride, 0.004% riboflavin, and 0.025% nicotinic acid, and not more than 0.004% folic acid (Budavari, 1996; CFR 21, 1998; Tu, 1992).

The Commission E reported antibacterial activity and stimulation of phagocytosis.

The Chinese Pharmacopoeia reports its therapeutic category as vitamin (Tu, 1992). The Merck Index reports its therapeutic category as a source of protein and vitamin B complex (Budavari, 1996). Dry yeast is one of the highest natural sources of thiamin, an essential nutrient for normal metabolism of carbohydrates and fats (Taber, 1962).

Uses

The Commission E approved the use of brewer's yeast for loss of appetite and as a supplement for chronic forms of acne and furunculosis.

The Merck Index indicates its use as a source of vitamins (Budavari, 1996). The FDA permits the use of dried yeast as a food ingredient provided that its total folic acid content is not greater than 0.04 milligram per gram of yeast (approximately 0.008 milligram of pteroyglutamic acid per gram) (CFR 21, 1998). It has been used as a topical application to ulcers and also orally to treat putrid fevers (Nadkarni, 1976).

Contraindications

None known.

Side Effects

Migraine-like headaches may occur in sensitive individuals. The ingestion of fermentable yeast may cause flatulence.

Use During Pregnancy and Lactation

No restrictions known.

Interactions with Other Drugs

None known.

Note:Simultaneous intake of monoamine oxidase inhibitors may cause an increase in blood pressure.

Dosage and Administration

Unless otherwise prescribed: 6 g per day of medicinal yeast and galenical preparations for internal use.

Dried yeast: 2 g, three times daily.

Yeast tablets: Equivalent of 2 g dried yeast, three times daily.

References

Bleichner, G., H. Blehaut, H. Mentec, D. Moyse. 1997. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A multicenter, randomized, double-blind placebo-controlled trial. Intensive Care Med 23(5):517523.

Bogye, G., G. Alfthan, T. Machay. 1998. Randomized clinical trial of enteral yeast-selenium supplementation in preterm infants. Biofactors 8(12):139142.

Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12^th ed. Whitehouse Station, N.J.: Merck & Co, Inc. 1726.

CFR 21. See U.S.A. Dept. of Health and Human Services: Food and Drug Administration.

Facchinetti, F. et al. 1997. Effects of a yeast-based dietary supplementation on premenstrual syndrome. A double-blind placebo-controlled study. Gynecol Obstet Invest 43(2):120124.

Lewis, S.J., L.F. Potts, R.E. Barry. 1998. The lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhoea in elderly patients. J Infect 36(2):171174.

McFarland, L.V. et al. 1995. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol 90(3):439448.

McFarland, L.V. et al. 1994. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA 271(24):19131918.

Muller, J., N. Remus, K.H. Harms. 1995. Mycoserological study of the treatment of paediatric cystic fibrosis patients with Saccharomyces boulardii (Saccharomyces cerevisiae Hansen CBS 5926). Mycoses 38(34):119123.

Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan.

Taber, C.W. 1962. Taber's Cyclopedic Medical Dictionary, 9^th ed. Philadelphia: F.A. Davis Company. T22T23.

Tu, G. (ed.). 1992. Pharmacopoeia of the People's Republic of China (English Edition 1992). Beijing: Guangdong Science and Technology Press. 813.

U.S.A. Dept. of Health and Human Services: Food and Drug Administration. 1998. Code of Federal Regulations 21 (CFR 21). Parts 172.896 and 172.898. Washington, D.C.: Office of the Federal Register National Archives and Records Administration. 109110.

Weber, G., A. Adamczyk, S. Freytag. 1989. [Treatment of acne with a yeast preparation] [In German]. Fortschr Med 107(26):563566.

Additional Resources

Andre, F.E. and A. Safary. 1987. Summary of clinical findings on Engerix-B, a genetically engineered yeast derived hepatitis B vaccine. Postgrad Med J 63(2):169177.

Bizeau, C., P. Galzy, M. Bastide, J.M. Bastide. 1974. [Immunofluorescent study of morphologic mutants of Saccharomycescerevisiae Hansen] [In French]. C RAcad Sci Hebd Seances Acad Sci D 279(25):19551958.

Bckeler, W. and G. Thomas. 1989. In-vitro-Studien zur destabilisierenden Wirkung lyophilisierter Saccharomycescerevisiae Hansen CBS 5926-Zellen auf Engerobakterien. Lsst sich diese Eigenschaft biochemisch erklren? In: M ller, J., R. Ottenjann, J. Seifert (eds.). kosystem Darm. Heidelberg: Springer Verlag. 142153.

Chavanet, P. et al. 1994. Cross-sectional study of the susceptibility of Candida isolates to antifungal drugs and in vitro-in vivo correlation in HIV-infected patients. AIDS 8(7):945950.

Gedek, B. and G. Hagenhoff. 1989. Orale Verabreichung von lebensfhigen Zellen des Hefestammes Saccharomycescerevisiae Hansen CBS 5926 und deren Schicksal whrend der Magen-Darm-Passage. Therapiewoche (38):3340.

McCullough, M.J., K.V. Clemons, J.H. McCusker, D.A. Stevens. 1998. Species identification and virulence attributes of Saccharomyces boulardii (nom. inval.) J Clin Microbiol 36(9):26132617.

Oblack, D.L. et al. 1981. Clinical evaluation of the AutoMicrobic system Yeast Biochemical Card for rapid identification of medically important yeasts. J Clin Microbiol 13(2):351355.

Petzoldt, K. and E. Muller. 1986. [Animal experiment and cell biology study of Saccharomycescerevisiae Hansen CBS 5926 in the non-specific enhancement of resistance to infection] [In German]. Arzneimforsch 36(7):10851088.

Pfaller, M.A. et al. 1994. Selection of candidate quality control isolates and tentative quality control ranges for in vitro susceptibility testing of yeast isolates by National Committee for Clinical Laboratory Standards proposed standard methods. J Clin Microbiol 32(7):16501653.

Plein, K. and J. Hotz. 1993. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrheaa pilot study. Z Gastroenterol 31(2):129134.

Sinai, Y. et al. 1974. Enhancement of resistance to infectious disease by oral administration of brewer's yeast. Infection Immunol (9):781787.

Surawicz, C.M. et al. 1989. Die prophylaxe antibiotika-assoziierter diarrhoen mit Saccharomycesboulardii. eine prospektive studie [Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study]. Gastroenterol 96(4):981988.

This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

• Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
• Infusion: 2 g in 150 ml of water
• Fluidextract 1:1 (g/ml): 2 ml
• Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.