Is it safe to take Resveratrol as a dietary supplement?

Resveratrol Supplementation: Safety and Recommendations

Resveratrol supplementation is not recommended for routine use due to insufficient evidence of benefit and potential safety concerns, including antiplatelet effects that may increase bleeding risk. 1

Safety Concerns

Bleeding Risk

• Resveratrol may have antiplatelet effects through inhibition of COX pathways or by inhibiting cellular calcium channels 1
• The Society for Perioperative Assessment and Quality Improvement (SPAQI) recommends holding resveratrol for 2 weeks before surgery due to potential bleeding risk 1
• Found in Japanese knotweed (Hu zhang) and may contribute to its antiplatelet effects 1

Drug Interactions

• Has potential for clinically relevant drug-drug interactions, especially at high doses 2
• May interact with various cytochrome P450 (CYP) isoenzymes 2
• Could reduce first-pass metabolism of medications, resulting in higher systemic exposure to certain drugs 2

Liver Effects

• In some studies, ALT and AST levels increased significantly in resveratrol supplementation groups 1
• Mixed results have been reported regarding effects on liver enzymes 1

Evidence for Potential Benefits

Metabolic Effects

• Some studies suggest resveratrol may improve insulin sensitivity and fasting glucose levels in patients with Type 2 Diabetes 3
• Limited evidence shows potential anti-inflammatory effects in human obesity 3
• In a small clinical trial of overweight older adults, resveratrol at doses of 300mg/day and 1000mg/day was well-tolerated over 90 days 4

Liver Disease

• ESPEN guidelines state that resveratrol cannot be recommended to treat non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) until further data regarding efficacy are available 1
• Conflicting results exist regarding resveratrol's effects on liver function in NAFLD patients 1

Current Recommendations

• The European Society for Clinical Nutrition and Metabolism (ESPEN) does not recommend resveratrol for treating NAFLD/NASH due to insufficient evidence 1
• The US Preventive Services Task Force (USPSTF) found insufficient evidence to recommend antioxidant supplements for prevention of cardiovascular disease or cancer 1
• No major medical guidelines currently recommend resveratrol supplementation for any specific condition

Practical Considerations

• Resveratrol is classified as a dietary supplement, not subject to the same regulatory standards as FDA-approved medications 1
• No requirement for premarket notification, proof of efficacy, or proof of safety 1
• Quality control may be variable; look for supplements with U.S. Pharmacopeia seal if choosing to take resveratrol 5
• Natural dietary sources of resveratrol (such as red wine, grapes, berries) are generally considered safe when consumed as part of a balanced diet 6

Conclusion

Based on current evidence and guidelines, resveratrol supplementation is not recommended for routine use. The potential risks, including bleeding complications and drug interactions, outweigh the uncertain benefits. If you're interested in the potential health benefits associated with resveratrol, consider obtaining it through dietary sources rather than supplements.