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I found the following 2009 study below: TNF-alpha inhibitors may increase the risk of herpes zoster reactivation. In the last few months since I've started heavy supplementation, I've frequently felt a tingling in my lower lip, which is the prodromal symptom of a herpes eruption. I suspect some of the supplements I take are TNF-alpha inhibitors, and I opened this thread to pool together here the collective knowledge we have of which supplements are
TNF-alpha inhibitors. Please contribute. Here are some of my suspects. Is it the case that if something is a known anti-cancer agent, it likely is a TNF-a inhibitor? For some I've already detected leads through Google searches:
curcumin
"Now for the good news: An in vitro study just published in
Investigative Ophthalmology and Visual Science (IOVS) suggested that Curcumin has the ability to mediate transcription factor NF-kappa B (NFkB) production, which has the ability to block the inflammatory and apoptotic effect of TNF-a."
astragalus
echinacea
Cordyceps
Quercetin
Glucosamine
Pomegranate
Propolis
Oliveleaf
Bilberry
Resveratrol
NAD+
Ashwagandha
Rhodiola
Bacopa
Gotu Kola
EGcG/Green Tea
Grape Seed Extract
Cinnamon
Broccoli
Astaxanthin
Schizandra
Milk Thistle
Artichoke
NAC
Risk of Herpes Zoster in Patients With Rheumatoid
Arthritis Treated With Anti–TNF-alpha Agents
- Source: Journal of the American Medical Association, Feb 18, 2009by Anja Strangfeld, MD, et al.February 17, 2009
Context: The risk of bacterial infection is
increased in patients treated with drugs that inhibit tumor necrosis factor
a (TNF-alpha). Little is known about the reactivation of latent viral
infections during treatment with TNF-alpha inhibitors.
Objective: To investigate whether TNF-alpha inhibitors together as a class, or separately as either monoclonal anti–TNF-alpha antibodies (adalimumab,
infliximab) or a fusion protein (etanercept), are related to higher rates of
herpes zoster in patients with rheumatoid arthritis.
Design, Setting, and
Patients: Patients were enrolled in the German biologics register
RABBIT, a prospective cohort, between May 2001 and December 2006 at the
initiation of treatment with infliximab, etanercept, adalimumab, or
anakinra, or when they changed conventional disease-modifying antirheumatic
drug (DMARD). Treatment, clinical status, and adverse events were assessed
by rheumatologists at fixed points during follow-up. Main Outcome
Measures: Hazard ratio (HR) of herpes zoster episodes following
anti–TNF-alpha treatment. Study aims were to detect a clinically significant
difference (HR, 2.0) between TNF-alpha inhibitors as a class compared with
DMARDs and to detect an HR of at least 2.5 for each of 2 types of TNF-alpha
inhibitors, the monoclonal antibodies or the fusion protein, compared with
conventional DMARDs.
Results: Among 5,040 patients receiving TNF-alpha
inhibitors or conventional DMARDs, 86 episodes of herpes zoster occurred in
82 patients. Thirty-nine occurrences could be attributed to treatment with
anti–TNF-alpha antibodies, 23 to etanercept, and 24 to conventional
DMARDs.The crude incidence rate per 1000 patient-years was 11.1 (95%
confidence interval [CI], 7.9-15.1) for the monoclonal antibodies, 8.9 (95%
CI, 5.6-13.3) for etanercept, and 5.6 (95% CI, 3.6-8.3) for conventional
DMARDs.Adjusted for age, rheumatoid arthritis severity, and glucocorticoid
use, a significantly increased risk was observed for treatment with the
monoclonal antibodies (HR, 1.82 [95% CI, 1.05-3.15]), although this risk was
lower than the threshold for clinical significance. No significant
associations were found for etanercept use (HR, 1.36 [95% CI, 0.73-2.55]) or
for anti–TNF-alpha treatment (HR, 1.63 [95% CI, 0.97-2.74]) as a class.
Conclusion: Treatment with monoclonal anti–TNF-alpha antibodies may be
associated with increased risk of herpes zoster, but this requires further
study.
Source: Journal of the American Medical Association, Feb
18, 2009;301(7):737-744. PMID: 19132156, by Strangfeld A,
Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, Zink A. German Rheumatism Research Centre and Department of Rheumatology and Clinical
Immunology, Charite- University Medicine, Berlin.</H3>