The Effects of Spirulina Supplementation on Cardiometabolic Risk Factors: A Narrative Review

Figures & data

Table 1. Summary of human studies investigating the effect of spirulina supplementation on risk factors for cardiometabolic diseases.

Author, year	Study design, country	Participants	Spirulina dose	Obesity-related outcomes	Lipid-related outcomes	Diabetes-related outcomes	Inflammation-related outcomes
(Shariat et al. 2019)	RCT, Iran	56 obese patients	1 g daily for 12 wk	↓ appetite	–	–	↑ superoxide dismutase conc.
				↓ body weight
				↓ BMI
				↓ WC
(Koite et al. 2022)	DB-RCT, France	30 metabolic syndrome patients	0.02 g daily as liquid extract ‘Spirulysat®’ for 12 wk	–	↓ TG	↔ FBS	↓ urinary isoprostane
					↑ HDL-C	↔ insulin	↔ oxidized LDL/TC ratio
					↔ TC
					↔ LDL-C
(Karizi et al. 2023)	DB-RCT, Iran	60 patients with inadequately controlled diabetes	2 g daily for 12 wk	–	↓ TG	↓ FBS	–
					↓ LDL-C	↓ HbA1C
					↓ TC
					↑ HDL-C
(Rostami et al. 2022)	Clinical trial, Iran	30 new cases of types 2 diabetes	4 g daily for 8 wk	↔ BMI	↓ TC	↓ FBG	↓ Malondialdehyde
				↔ Weight	↓ LDL-C	↔ Serum insulin
					↓ TG
					↔ HDL-C
(Martínez-Sámano et al. 2018)	Clinical trial, Mexico	16 patients with systemic arterial hypertension	4.5 g daily for 12 wk	–	–	–	↑ glutathione peroxidase activity
							↑ oxidized glutathione levels
(Yousefi et al. 2018)	RCT, Iran	52 obese patients	2 g daily with RCD vs. RCD placebo	↓ body weight	↓ TG	–	↓ hsCRP
(Zeinalian et al. 2017)	DB-RCT, Iran	62 obese patients	1 g daily for 12 wk	↓ appetite	↑ HDL-C	–
				↓ BMI	↓ TC
				↓ body weight	↔ LDL-C
(Szulinska et al. 2017)	DB-RCT, Poland	50 obese patients with hypertension	2 g daily for 12 wk	↓ body weight	↓ LDL-C	Improved insulin sensitivity ratio	↓ IL-6
				↓ BMI			Improved total antioxidant status
				↓ WC
(Beihaghi et al. 2017)	RCT, Iran	50 diabetic patients	8 g daily for 12 wk	–	–	↓ FBS	–
						↔ HbA1C
(Miczke et al. 2016)	DB-RCT, Poland	40 patients with hypertension	2 g daily for 12 wk vs placebo	↓ BMI	–	–	–
				↓ body weight
(Alam et al. 2016)	RCT, India	40 diabetic patients	7 g daily for 45 days	–	–	↓ FBS	–
						↓ PPBS
						↔ HbA1C
(Lee et al. 2008)	RCT, South Korea	37 diabetic patients	8 g daily for 12 wk	–	↓ TG	–	↓ Malondialdehyde
					↓ LDL-C		↑ Adiponectin

Abbreviations: BMI, body mass index; DB-RCT, double-blind randomized controlled trial; FBS, fasting blood sugar; HbA1C, glycated hemoglobin A1C; HDL-C, high density lipoprotein cholesterol; hsCRP, high sensitivity c-reactive protein; IL-6, interleukin 6; LDL-C, low density lipoprotein cholesterol; PPBS, postprandial blood sugar; RCD, restricted calorie diet; RCT, randomized controlled trial; TC, total cholesterol; TG, triglycerides; WC, waist circumference. ↑; increased, ↓; decreased, ↔; no change

Figure 1. Theorized effect of spirulina supplementation on body weight loss, body inflammation, blood lipid profile, and glucose metabolism.

Shariat A, Farhangi MA, Zeinalian R. 2019. Spirulina platensis supplementation, macrophage inhibitory cytokine-1 (MIC-1), oxidative stress markers and anthropometric features in obese individuals: a randomized controlled trial. J Herbal Med. 17-18:100264. doi:10.1016/j.hermed.2019.100264.

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Koite NDLN, Sanogo NgI, Lépine O, Bard J-M, Ouguerram K. 2022. Antioxidant efficacy of a spirulina liquid extract on oxidative stress status and metabolic disturbances in subjects with metabolic syndrome. Mar Drugs. 20(7):441. doi:10.3390/md20070441.

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Karizi SR, Armanmehr F, Azadi HG, Zahroodi HS, Ghalibaf AM, Bazzaz BSF, Abbaspour M, Boskabadi J, Eslami S, Taherzadeh Z. 2023. A randomized, double-blind placebo-controlled add-on trial to assess the efficacy, safety, and anti-atherogenic effect of spirulina platensis in patients with inadequately controlled type 2 diabetes mellitus. Phytother Res. 37(4):1435–1448. doi:10.1002/ptr.7674.

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Rostami HAA, Marjani A, Mojerloo M, Rahimi B, Marjani M. 2022. Effect of spirulina on lipid Profile, glucose and malondialdehyde levels in type 2 diabetic patients. Braz J Pharm Sci. 58:106802. doi:10.1590/s2175-97902022e191140.

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Martínez-Sámano J, Torres-Montes de Oca A, Luqueño-Bocardo OI, Torres-Durán PV, Juárez-Oropeza MA. 2018. Spirulina maxima decreases endothelial damage and oxidative stress indicators in patients with systemic arterial hypertension: Results from exploratory controlled clinical trial. Mar Drugs. 16(12):496. doi:10.3390/md16120496.

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Yousefi R, Mottaghi A, Saidpour A. 2018. Spirulina platensis effectively ameliorates anthropometric measurements and obesity-related metabolic disorders in obese or overweight healthy individuals: a randomized controlled trial. Complement Ther Med. 40:106–112. doi:10.1016/j.ctim.2018.08.003.

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Zeinalian R, Farhangi MA, Shariat A, Saghafi-Asl M. 2017. The effects of Spirulina Platensis on anthropometric indices, appetite, lipid profile and serum vascular endothelial growth factor (VEGF) in obese individuals: a randomized double blinded placebo controlled trial. BMC Complement Altern Med. 17(1):225. doi:10.1186/s12906-017-1670-y.

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Szulinska M, Gibas-Dorna M, Miller-Kasprzak E, Suliburska J, Miczke A, Walczak-Gałezewska M, Stelmach-Mardas M, Walkowiak J, Bogdanski P. 2017. Spirulina maxima improves insulin sensitivity, lipid profile, and total antioxidant status in obese patients with well-treated hypertension: a randomized double-blind placebo-controlled study. Eur Rev Med Pharmacol Sci. 21(10):2473–2481.

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Beihaghi M, Ghodrati Azadi H, Taherzadeh Z, Bahrami H. r 2017. The effects of oral administration of spirulina platensis (cultured Iranian) on blood glucose and glycosylated hemoglobin blood in type ii diabetes mellitus patients. Iran J Diabetes Lipid Disord. 16(3):183–190. http://ijdld.tums.ac.ir/article-1-5520-en.html.

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Miczke A, Szulińska M, Hansdorfer-Korzon R, Kręgielska-Narożna M, Suliburska J, Walkowiak J, Bogdański P. 2016. Effects of spirulina consumption on body weight, blood pressure, and endothelial function in overweight hypertensive Caucasians: a double-blind, placebo-controlled, randomized trial. Eur Rev Med Pharmacol Sci. 20(1):150–156.

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Alam A, Siddiqui M, Quamri A, Fatima S, Roqaiya M, Ahmad Z. 2016. Efficacy of Spirulina (Tahlab) in patients of type 2 diabetes mellitus (Ziabetus Shakri): a randomized controlled trial. J Diabetes Metab. 7(10):1–5. doi:10.4172/2155-6156.1000710.

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Lee EH, Park J-E, Choi Y-J, Huh K-B, Kim W-Y. 2008. A randomized study to establish the effects of spirulina in type 2 diabetes mellitus patients. Nutr Res Pract. 2(4):295–300. doi:10.4162/nrp.2008.2.4.295.

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