![]() JP is thought to reduce oxidative stress and DNA damage (2) (6) (10), and has been associated with a reduction in common cold symptoms (12). Other studies on cardiovascular effects such as changes in blood pressure and cholesterol levels were inconclusive (4) (5). Although JP appeared to decrease plasma homocysteine levels, a risk factor for cardiovascular disease (1) (9), the results were not reproducible (4). JP was comparable to standard vitamin C and E supplements (3), but it remains unclear if this product is nutritionally superior to fresh produce. Studies on bioavailability suggest that consumption of JP can increase serum levels of alpha-carotene, vitamin C, and folate (1) (2), but studies with other markers such as lutein and alpha-tocopherol yielded mixed results. It is marketed to complement the daily diet based on the notion that people do not consume enough fruits and vegetables. Juice Plus (JP) is a formulation derived from a variety of fruits and vegetables that contains additional vitamins. In using this website you agree that neither Memorial Sloan Kettering nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented at this website. You are hereby advised to consult with a physician or other professional health-care provider prior to making any decisions, or undertaking any actions or not undertaking any actions related to any health care problem or issue you might have at any time, now or in the future. Memorial Sloan Kettering does not record specific website user information and does not contact users of this website. Use of this Web site does not create an expressed or implied physician-patient relationship. Statements made about products have not been evaluated by the Food and Drug Administration. Health-related information changes frequently and therefore information contained on this Web site may be outdated, incomplete or incorrect. Memorial Sloan Kettering does not assume any risk whatsoever for your use of this website or the information contained herein. Memorial Sloan Kettering Cancer Center makes no warranties nor express or implied representations whatsoever regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced on this Web site. Any questions regarding your own health should be addressed to your own physician or other healthcare provider. Users of this Web site should not rely on information provided on this Web site for their own health problems. This Web site is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. Liver function test results peaked and improved, followed shortly by a second lesser peak, and then normalized over 4 weeks.This Web site - Information About Herbs, Botanicals and Other Products - is for general health information only. On the basis of the timing of her elevated liver function test results, the Juice Plus+ supplement was deemed the most likely causative agent of the patient's liver injury, and it was discontinued. Liver biopsy results showed no carcinoma, but focal hepatocellular degenerative changes and steatosis with mild sinusoidal dilatation against a background of mild cholestasis, minimal lobular, and portal acute and chronic inflammation were findings most consistent with a drug effect. Viral hepatitis serology, ceruloplasmin, anti-smooth muscle antibody, and antimitochondrial antibody test results were negative. She had started taking Juice Plus+ a few days before her initial visit to the MD Anderson Cancer Center. The patient's regular medications included ramipril, calcium/vitamin D, ciprofloxacin, hydrocodone/acetaminophen, and ibuprofen. Computed tomography and ultrasound showed no extrahepatic or intrahepatic biliary obstruction, hepatomegaly, or liver metastases. She had icteric sclera and mild tenderness on palpation of a lower abdominal/pelvic mass. The patient felt well with no fever or change in diet. Peak total bilirubin, aspartate aminotransferase, and alanine aminotransferase levels were 4.0 mg/dL, 302 IU/L, and 91 IU/L, respectively ( Figure). Initial assessment showed normal liver function test results, although aspartate aminotransferase, alanine aminotransferase, and bilirubin levels were elevated on repeat blood tests several days later. A 51-year-old woman with endometrial cancer whose condition progressed with prior treatments was referred to the MD Anderson Cancer Center Phase I Clinical Trials clinic for treatment with an investigational agent.
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