Lauric Select by Moss Nutrition

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease). It is unclear if oral inosine is beneficial for ALS. Details: A small clinical trial in adults with ALS shows that supplementation with inosine 1000-3000 mg daily, either by mouth or via a feeding tube, for 20 weeks has no effect on survival, functional outcomes, or body weight compared with placebo (112395). The study may have been inadequately powered to detect a difference between groups.
• Athletic performance. It is unclear if oral inosine improves athletic performance in experienced athletes. Details: Two small crossover studies in cyclists and endurance runners show that taking inosine 5-6 grams daily for 2-5 days does not improve athletic performance when compared with placebo (2369,2370).
• Diabetic neuropathy. Oral inosine has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A large clinical trial in adults with type 2 diabetes and peripheral neuropathy shows that administration of a combination product (Cytoflavin, POLYSAN) containing inosine, nicotinamide, riboflavin, and succinic acid intravenously for 10 days and then taking the same combination orally for 75 days reduces total neuropathy symptom scores compared with placebo. Specifically, intensity of paresthesia, numbness, and burning are most improved (110503). The total daily dose of inosine provided by the intravenous solution and oral tablets was 400 mg and 200 mg, respectively. It is unclear if the effects are due to inosine, other ingredients, or the combination.
• Parkinson disease. It is unclear if oral inosine is beneficial in patients with Parkinson disease. Details: Preliminary clinical research in adults with Parkinson disease shows that taking inosine orally 1000-3000 mg daily for 2 years does not improve Parkinson disease functioning scores or prevent the need for additional drug therapy when compared with placebo. Inosine therapy was initiated as 1000 mg three times daily and titrated to a goal serum urate level of 7.1-8 mg/dL (106854). However, other preliminary clinical research in adults with Parkinson disease shows that taking inosine 500 mg orally twice daily in conjunction with febuxostat 20 mg twice daily for 57 days improves Parkinson disease motor scores by 12% when compared with baseline. The validity of this study is limited by the lack of a comparator group. In addition, it is unclear if this effect is due to inosine, febuxostat, or the combination (106852).
• Multiple sclerosis (MS). It is unclear if oral inosine is beneficial in patients with MS. Details: Low serum uric acid levels have been associated with an increased risk of developing MS (95290). Clinical research shows that taking inosine increases serum uric acid levels in adults with MS. However, this increase has not been consistently associated with clinical improvement (95288,95289,95290,95291). Taking inosine 3 grams daily for up to 24 months, in conjunction with interferon beta 1-alpha (IFN), does not seem to improve disability or clinical progression when compared with IFN alone (95288,95289). However, some preliminary clinical research shows that taking inosine 1-2 grams daily for 36 months as monotherapy might improve MS relapse rate, but not disability scores, when compared with no treatment (95291). This inconsistency in outcomes may be related to the severity of disease in the studied population and the other treatments used. More evidence is needed to rate inosine for these uses.

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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Bacterial vaginosis. Preliminary clinical research shows that applying a monolaurin 5% gel to the vagina twice daily for 3 days in premenopausal women does not improve clinical cure rates when compared with a placebo gel (103602).

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POSSIBLY SAFE ...when used orally and appropriately. Inosine has been used with apparent safety at doses of up to 3 grams daily for up to 24 months or at doses of up to 2 grams daily for 36 months (95287,95289,95290,95291,106854,106857,112396).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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LIKELY SAFE ...when used orally in amounts commonly found in foods. Monolaurin has Generally Recognized as Safe (GRAS) status in the US (7705). There is insufficient reliable information available about the safety of monolaurin when used orally or topically in medicinal amounts.

PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (7705). There is insufficient reliable information available about the safety of monolaurin when used in medicinal amounts during pregnancy or lactation.

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ANTIGOUT DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Inosine might reduce the effects of antigout medications.  Details Inosine increases uric acid levels in the serum and urine, potentially resulting in hyperuricemia and reducing the effects of medications used for the prevention and treatment of gout (95287,95288,95289,106852,106854).

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General ...Orally, inosine seems to be well tolerated.
Most Common Adverse Effects:
Orally: Hyperuricemia, nephrolithiasis, uric acid crystals, urinary tract stones.
Serious Adverse Effects (Rare):
Orally: Hypertension, kidney dysfunction.

Cardiovascular ...Orally, inosine was reported to cause mild elevation of blood pressure in 6% of patients in one clinical trial (95289).

Endocrine ...Orally, inosine increases serum uric acid levels in a dose-dependent manner, which can cause non-symptomatic hyperuricemia (95288,95289).

Gastrointestinal ...Orally, inosine has been reported to cause nausea (95289,106854).

Genitourinary ...Orally, inosine has been reported to cause uric acid crystals and symptomatic uric acid kidney stones. Uric acid kidney stones occurred more frequently when inosine was taken concurrently with calcium supplements (95287,95289,95290,106854,112395).

Renal ...Orally, inosine 1-2 grams daily has been reported to cause acute renal colic in patients with multiple sclerosis (95288). Inosine has also been reported to cause reversible reductions in kidney function (106854).

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General ...No adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.

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