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Cabbage Drug Information - Precautions to be kept in mind while using Cabbage

Taxonomic Class

Pabaceae

Common Trade Names

None known.

Common Forms

Available in preparations from chopped or pressed cabbage and juices.

Source

Active components are extracted from the leaves of Brassica oleracea. Cabbage is originally from the Mediterranean, but cultivated varieties are found in damp and temperate climates worldwide.

Chemical Components

Compounds isolated from B. oleracea include various mustard oils, allyl mustard oil, methyl sulfonyl alkyl isothiocyanates, and methyl sulfonyl alkyl isothiocyanates; 3-hydroxy-methyl indole; 5-vinyl-oxazolidine-2­thion (goitrin); rhodanides; alkyl nitriles; and amino acids.

Actions

Cruciferous vegetables such as cabbage have a high glucosinate content. These substances are precursors that are converted to isothiocyanates. Many isothiocyanates inhibit the neoplastic effects of various carcinogens.

Brassinin, a phytoalexin first identified as a constituent of cabbage, was synthesized and demonstrated a dose-dependent inhibition in mouse mammary and skin tumors . Similar studies have reinforced the efficacy of cabbage as a suppressor of cancer in animal models .

Hypoglycemic effects of Brassica vegetables have been noted in a limited number of studies .

Reported Uses

Cabbage has been promoted for its cancer-preventive effects, hypoglycemic activity, and use in relieving breast engorgement.

Numerous case-control and cohort studies have examined the association between the consumption of Brassica or cruciferous vegetables and cancer. Six cohort studies have demonstrated an inverse relation between the consumption of Brassica vegetables and the risk of lung cancer, stomach cancer, and all cancers taken together. Sixty-four percent of the case-control studies showed this inverse association. The association was most consistent for colorectal, lung, and stomach cancers and least consistent for endometrial, ovarian, and prostate cancers .

A prospective cohort study reported a weak association between total vegetable and fruit intake and bladder cancer risk. In this study, only the associations for broccoli and cabbage were statistically significant .

The effect of cabbage on breast engorgement has been studied using various forms, such as a cream containing cabbage extract and application of the actual leaf. In one small placebo-controlled study involving 21 lactating women, there was no difference between the cabbage ex­tract cream and placebo. Breast-feeding had a greater effect on relieving breast engorgement than either cream . Other studies have compared the efficacy of applying cabbage leaves, chilled or at room temperature, with using standard care with chilled gel packs. Although mothers who used the cabbage leaves preferred this method and generally breast-fed longer, there was no statistically significant difference between the groups with regard to relieving breast engorgement .

Dosage

Traditional uses suggest the following doses:

Oral: 1 tsp of cabbage juice t.i.d. for gastritis; 1 L of juice daily to supplement the diet.

Topical: Apply leaves to inflamed tissue or use as an extract in a cream.

Adverse Reactions

None reported.

Interactions

Acetaminophen, oxazepam, warfarin: May decrease efficacy of these drugs because of induced hepatic metabolism. Monitor the patient's PT and INR.

Contraindications And Precautions

Cabbage may exacerbate goiters and hypothyroidism by reducing iodine uptake by the thyroid gland. Ingesting large quantities of cabbage may elevate thyroid-stimulating hormone levels. In pregnant and breast-feeding patients, avoid using in amounts greater than those typically found in foods.

Special Considerations

Educate the patient regarding the use of cabbage as a cancer preventive.

Caution the patient that cabbage may decrease the effectiveness of other drugs he is taking.

Caution the patient not to self-treat symptoms of illness before seeking appropriate medical evaluation because this may delay diagnosis of a serious medical condition.

Advise the patient to consult a health care provider before using herbal preparations because a treatment that has been clinically researched and proved effective may be available.

Points of Interest

Besides cabbage, Brassica vegetables include broccoli, Brussels sprouts, cauliflower, and kale.

Commentary

Most of the evidence concerning the cancer-preventive effects of Brassica vegetables and their proposed active ingredients comes from animal studies. Human epidemiological evidence supports the association between high consumption of cruciferous vegetables such as cabbage and a decreased risk of certain cancers. Critics caution that this effect may be due to consumption of vegetables in general, not just Brassica vegetables. Further epidemiological research and controlled trials in humans are needed to define the role of Brassica vegetables in cancer prevention. Cabbage leaves do not appear to relieve breast engorgement but may provide a cooling effect. Cabbage is a savory vegetable and when consumed in a realistic quantity does not appear to produce adverse effects.

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