Physicians Desk Reference Information - Health Research Library

As listed in the 2016 Physicians’ Desk Reference (PDR)

Immunocal®

NUTRACEUTICAL
Glutathione precursor (Bonded cysteine™ supplement)
Powder Sachets

DESCRIPTION and CLINICAL PHARMACOLOGY

IMMUNOCAL® is a specially formulated undenatured whey protein isolate. It holds several patents in the USA and worldwide and is listed by the FDA in the category of GRAS (generally recognized as safe). It assists the body in maintaining optimal concentrations of glutathione (GSH) by supplying the precursors required for intracellular glutathione synthesis. It is clinically proven to raise glutathione values.
Glutathione is a tripeptide made intracellularly from its constituent amino acids L-glutamate, L-cysteine and glycine. The sulfhydryl (thiol) group (SH) of cysteine is responsible for the biological activity of glutathione. Provision of this amino acid is the rate-limiting factor in glutathione synthesis by the cells since bioavailable cysteine is relatively rare in foodstuffs.
Immunocal® is a bovine whey protein isolate specially prepared so as to provide a rich source of bioavailable cysteine. Immunocal® can thus be viewed as a cysteine delivery system.
The disulphide bond in cystine is pepsin and trypsin resistant but may be split by heat, low pH or mechanical stress releasing free cysteine. When subject to heat or shearing forces (inherent in most extraction processes), the fragile disulfide bonds within the peptides are broken and the bioavailability of cysteine is greatly diminished.
Glutathione is a tightly regulated intracellular constituent and is limited in its production by negative feedback inhibition of its own synthesis through the enzyme gamma-glutamylcysteine synthetase, thus greatly minimizing any possibility of overdosage.
Glutathione has multiple functions:
1. It is the major endogenous antioxidant produced by the cells, participating directly in the
neutralization of free radicals and reactive oxygen compounds, as well as maintaining
exogenous antioxidants such as vitamins C and E in their reduced (active) forms.
2. Through direct conjugation, it detoxifies many xenobiotics (foreign compounds) and
carcinogens, both organic and inorganic.
3. It is essential for the immune system to exert its full potential, e.g. (1) modulating antigen
presentation to lymphocytes, thereby influencing cytokine production and type of response
(cellular or humoral) that develops, (2) enhancing proliferation of lymphocytes thereby
increasing magnitude of response, (3) enhancing killing activity of cytotoxic T cells and NK cells,
and (4) regulating apoptosis, thereby maintaining control of the immune response.
4. It plays a fundamental role in numerous metabolic and biochemical reactions such as DNA
synthesis and repair, protein synthesis, prostaglandin synthesis, amino acid transport and
enzyme activation. Thus, most systems in the body can be affected by the state of the
glutathione system, especially the immune system, the nervous system, the gastrointestinal
system and the lungs.

INDICATIONS AND USAGE

IMMUNOCAL® is a natural food supplement and as such is limited from stating medical claims
per se. Statements have not been evaluated by the FDA. As such, this product is thus not
intended to diagnose, cure, prevent or treat any disease.
Glutathione augmentation is a strategy developed to address states of glutathione deficiency, high
oxidative stress, immune deficiency, and xenobiotic overload in which glutathione plays a part in the
detoxification of the xenobiotic in question. Glutathione deficiency states include, but are not limited to:
HIV/AIDS, infectious hepatitis, certain types of cancers, cataracts, Alzheimer’s Disease, Parkinsons,
chronic obstructive pulmonary disease, asthma, radiation, poisoning by acetominophen and related
agents, malnutritive states, arduous physical stress, aging, and has been associated with sub-optimal
immune response. Many clinical pathologies are associated with oxidative stress and are elaborated
upon in numerous medical references.
Low glutathione is also strongly implicated in wasting and negative nitrogen balance, notably as seen in
cancer, AIDS, sepsis, trauma, burns and even athletic overtraining. Cysteine supplementation can
oppose this process and in AIDS, for example, result in improved survival rates.

CONTRAINDICATIONS

IMMUNOCAL® is contraindicated in individuals who develop or have known hypersensitivity to specific
milk proteins.

PRECAUTIONS

Each sachet of IMMUNOCAL® contains nine grams of protein. Patients on a protein-restricted diet need
to take this into account when calculating their daily protein load. Although a bovine milk derivative,
IMMUNOCAL® contains less than 1% lactose and therefore is generally well tolerated by lactoseintolerant
individuals.

WARNINGS

Patients undergoing immunosuppressive therapy should discuss the use of this product with
their health professional. Individuals with the autosomal-recessive metabolic disorder
cystinuria, are at higher risk of developing cysteine nephrolithiasis (1-2% of renal calculi).

ADVERSE REACTIONS

Gastrointestinal bloating and cramps if not sufficiently rehydrated. Transient urticarial-like rash
in rare individuals undergoing severe detoxification reaction. Rash abates when product intake
stopped or reduced.

OVERDOSAGE

Overdosing on IMMUNOCAL® has not been reported.

DOSAGE AND ADMINISTRATION

For mild to moderate health challenges, 20 grams per day is recommended. Clinical trials in
patients with AIDS, COPD, cancer and chronic fatigue syndrome have used 30-40 grams per day
without ill effect. IMMUNOCAL® is best administered on an empty stomach or with a light meal.
Concomitant intake of another high protein load may adversely affect absorption.

RECONSTITUTION

IMMUNOCAL® is a dehydrated powdered protein isolate. It must be appropriately rehydrated
before use. Ideally consumed after mixing. If it is premixed for later consumption, it should be
refrigerated and consumed shortly after mixing. DO NOT heat or use a hot liquid to rehydrate
the product. DO NOT use a high-speed blender for reconstitution. These methods will decrease
the activity of the product.
Proper mixing is imperative. Consult instructions included in packaging.

HOW SUPPLIED

10 grams of bovine milk protein isolate powder per sachet.
30 sachets per box.

STORAGE

Store in a cool dry environment. Refrigeration is not necessary.

REFERENCES

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Dekker Inc. New York, 447-461, 1998
2. Bounous G, Kongshavn P. Influence of protein type in nutritionally adequate diets on the
development of immunity. In Absorption and Utilization of Amino Acids Vol.II. Ed. M. Friedman.
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