Bovine Colostrum

Brand names: BCC (bovine Colostrum Concentrate), Bovine Colostrum, Cow Milk Colostrum, Early Milk, Hyperimmune Milk, Immune Milk, Lactobin, Lactoferrin, LC2N

Usage of Bovine Colostrum

Note: The lack of standardization of products reduces the external validity of clinical trial data; results indicating efficacy of a particular colostrum product cannot be generalized to apply to other products.

The relative safety of bovine colostrum, together with the lack of standardization of commercial products, makes animal studies largely irrelevant.

Athletic performance enhancement

Clinical data

The potential use of bovine colostrum for athletic enhancement is related to its growth factor content. Bovine IGF-I is structurally identical to human proteins, and short-term studies have been conducted in both high-performance (elite) athletes and other athletes by a limited pool of researchers.(Kelly 2003, Shing 2013) Findings from these studies are inconsistent, with some, but not all, showing enhanced performance and changes in body composition. The studies are small, and it may be that a change in performance is more difficult to detect in elite athletes.(Kelly 2003) Equivocal results regarding effects of bovine colostrum supplementation on immune function and intestinal permeability in athletes have also been demonstrated.(Buckley 2009, Carol 2011, Crooks 2010, Marchbank 2011, Shing 2006) Equivocal results were reported in a systematic review of clinical use of oral bovine supplementation; a total of 14 studies related to athletic performance were identified (N=370 elite and recreational athletes, with study sizes ranging from 9 to 49 participants). Dosages ranged from 10 to 60 g/day for 2 to 12 weeks; the most commonly used dosage was 60 g/day for 4 to 9 weeks. Quality of the studies was considered adequate; however, extrapolating a consensus was difficult because end points were heterogeneous.(Rathe 2014) In a double-blind, randomized, controlled study (N=40), use of bovine colostrum protein concentrate in elite male cyclists was associated with a significant increase in morning cortisol (P=0.004) and maintenance of testosterone (P≤0.05) compared with control (whey protein concentrate) throughout the duration of a 5-day stage race. The dose used in this small pilot study (N=10) was 10 g/day taken for 8 weeks prior to the race as well as during the 5-day race.(Shing 2013) In adults older than 50 years performing resistance training, supplementation with 20 g of bovine colostrum 3 times daily for 8 weeks significantly improved muscle strength (P=0.026), leg press strength (P=0.045), and bone turnover (P=0.024) compared with those taking whey protein. Participants in both groups experienced improvements in cognitive function, lean tissue mass, and upper body strength. GI-related adverse events occurred in 5 patients. Two patients in the colostrum group experienced mild bloating, nausea, diarrhea, and unsettled stomach that were classified as "possibly" or "probably" related to bovine colostrum and led to 1 dose reduction. In the whey group, 2 patients experienced moderate gastroesophageal reflux that was classified as "definitely" related to whey protein and led to discontinuation of the supplement; 1 participant experienced mild nausea considered "possibly" related to whey.(Duff 2014)

GI effects

Clinical data

Limited small studies have evaluated the efficacy of bovine colostrum in immunodeficiency-related diarrhea (cryptosporidiosis). The studies are generally limited methodologically,(Abubakar 2007, Florén 2006, Okhuysen 1998, Plettenberg 1993, Rump 1992) but at least 1 single-blind randomized trial has been conducted.(Kaducu 2011) Reductions in stool frequency, weight loss, and self-reported fatigue, as well as increases in CD4+ count have been reported.(Florén 2006, Kaducu 2011) A systematic review identified 5 studies (N=182, with study sizes ranging from 3 to 87 participants) that published data on the effects of bovine colostrum in patients with HIV-associated diarrhea and associated loss of gut mucosal CD4+ cells. Doses for most studies ranged from 10 to 32 g/day given for 10 days to 4 weeks. Collectively, the studies supported effectiveness of bovine colostrum, likely due to mechanisms involving direct antimicrobial effects, neutralization of endotoxins, suppression of gut inflammation, promotion of mucosal integrity, and tissue repair. However, the studies were of poor quality.(Rathe 2014)

Studies evaluating treatment of diarrhea from other bacterial causes (including EscheriChia coli, Shigella, and Clostridium difficile) have also shown efficacy of bovine colostrum,(Lissner 1996, Lissner 1998, Mattila 2008, Otto 2011, Tacket 1992) while no effect was observed in studies of patients infected with Vibrio cholerae.(Kelly 2003)

Immunoglobulin-enriched colostrum was reported to provide improved endotoxin-neutralizing capability against postsurgical translocation of microbes in patients undergoing intra-abdominal surgery, whereas no benefit was reported in coronary artery bypass patients who received a standard colostrum preparation.(Rathe 2014)

Efficacy against Helicobacter pylori and nonsteroidal anti-inflammatory drug (NSAID)–induced GI injury has been demonstrated in a few clinical studies; however, other studies have not produced positive results.(Bitzan 1998, Buckley 2009, Kelly 2003) A systematic review of studies evaluating standard bovine colostrum oral supplementation identified 51 studies (N=2,326, with study sizes ranging from 3 to 605 patients); only 2 studies were of high quality. Data from the only 2 studies (n=7 and n=15) evaluating use in NSAID-induced GI injury showed evidence of possible benefit and protection of gut permeability; however, the studies were small and of short duration.(Rathe 2014)

A small, double-blind, randomized, placebo-controlled, 2-arm crossover trial investigated the effect of bovine colostrum and control (corn flour) on performance outcomes, GI permeability, and inflammatory markers during exercise in the heat in trained (n=7) as well as untrained (n=8) participants. The dose of bovine colostrum was 1.7 g/kg/day for 7 days prior to the exercise protocol. One performance measure (respiratory exchange ratio) and one measure of thermal strain were significantly improved in the colostrum group compared with controls (P<0.05 and P=0.004, respectively). No significant differences were found between groups for other measures, including cardiovascular strain, GI permeability, inflammatory cytokine response, and GI distress. No adverse effects or illnesses were reported.(Morrison 2014) However, 2 small, double-blind, randomized, placebo-controlled crossover studies (N=18 and N=16) found that bovine colostrum dosed at either 20 g/day for 14 days or 1 g/day for 20 days blunted exercise-induced GI permeability in healthy young males who exercised regularly.(Halasa 2017, March 2017)

Intestinal permeability in critically ill adults improved significantly in patients who received early enteral bovine colostrum supplementation (within 48 hours of ICU admission) compared to placebo in a double-blind, randomized, controlled study (N=70). The results were based on day 10 plasma zonulin (P<0.001) and endotoxin levels (P=0.007). Bovine colostrum was administered at 20 g/day for 10 days. The incidence of diarrhea was significantly lower in the colostrum group than controls (9% vs 33%; P=0.021).(Eslamian 2019)

In children with newly diagnosed acute lymphoblastic leukemia (ALL) who were starting the 29-day induction therapy based on the Nordic Society of Pediatric Hematology and Oncology ALL 2008 protocol, adjunctive supplementation with bovine colostrum significantly reduced the peak severity of chemotherapy-induced oral mucositis (P=0.02) compared to placebo in this double-blind, randomized trial but did not impact overall occurrence or severity. Additionally, no difference was found between groups in chemotherapy-induced intestinal mucositis or peak severity of abdominal pain or diarrhea. According to questionnaire scores, an improvement was reported in oral mucositis in the colostrum group compared to placebo only during week 1 (odds ratio, 0.19; 95% confidence interval, 0.04 to 0.88; P=0.03). The incidence of fever, inflammation (eg, plasma C-reactive protein levels), and infection as well as the proportion of patients given IV antibiotics was similar between treatment groups.(Rathe 2020)

Clinical evidence does not support results demonstrated in animal studies for beneficial effects in short bowel syndrome. Additionally, limited data have shown no benefit in patients with irritable bowel syndrome.(Rathe 2014)

Immunomodulatory activity

Animal data

Various concentrations of bovine colostral constituents, including certain immunoglobulins, have been studied in calves fed colostrum or colostral supplement products.(Garry 1996, Hopkins 1997, Mee 1996, Morin 1997, Quigley 1998)

Clinical data

Due to its immune factor constituents (immunoglobulins, cytokines, lactoferrin, and lactoperoxidase), bovine colostrum is considered an immune system supplement.(Kelly 2003, Shing 2007) However, clinical studies are sparse and diverse in the methodologies employed, products and dosages used, and in the conditions being evaluated.

Equivocal results have been reported regarding immune enhancement among athletes.(Carol 2011, Crooks 2010, Jones 2017, Shing 2007) Both a lack of effect on CD4+ counts(Byakwaga 2011) and a positive effect have been reported. In one small study, exercise-induced immune dysfunction improved with bovine colostrum compared with placebo in healthy, recreationally active men. Concentrations of insulinlike growth factor 1 (IGF-1), which may influence antidoping tests, were not affected.(Jones 2017)

A systematic review of 10 studies found some support for the use of bovine colostrum for preventing upper respiratory tract infection (URTI); however, caution is warranted in interpreting the results because statistical significance was only found in pooled self-reported data. Additionally, heterogeneity was found in study populations, dosages, formulations, quality of methodologies, and results. The evidence did not support benefit for the increased susceptibility to URTI that results from exercise-induced immunosuppression.(Kaducu 2011, Rathe 2014) In contrast, data from a double-blind, randomized, controlled trial (N=57) showed a significantly reduced proportion of days and episodes of URTI in male endurance athletes who consumed bovine colostrum (20 g/day) compared with controls. Also during the 12-week trial, a significantly lower proportion of athletes reported URTI in the colostrum group compared with placebo (12% vs 36%, respectively) at 5 to 8 weeks (P=0.044) but not at 1 to 4 weeks or 9 to 12 weeks.(Jones 2014) The effect of colostrum on key mucosal immune parameters (ie, the salivary antimicrobial peptide lactoferrin, salivary IgA) and neutrophil cytotoxic activity in response to exercise was investigated in a double-blind, randomized, placebo-controlled trial in 20 healthy males. Bovine colostrum supplementation (10 g twice daily for 4 weeks) significantly improved neutrophil functional activity compared with controls (P<0.05) but not any of the other parameters tested.(Jones 2015)

Other uses

Bovine colostrum has been studied in oral hygiene products, as a tear substitute, as an enema in distal colitis, and in very limited clinical studies in type 2 diabetes, juvenile idiopathic arthritis, multiple sclerosis, and chronic pain syndrome, and for presurgical use.(Hurley 2011, Kelly 2003, Kim 2009, Langmead 2006, Rathe 2014)

Bovine Colostrum side effects

In most clinical trials, bovine colostrum has been well tolerated, with only infrequent reports of minor GI complaints (eg, nausea, flatulence, diarrhea), unpleasant taste, and skin rash.Kelly 2003, Rathe 2014 Intolerance to lactose and sensitivity to milk proteins most likely contributed to these effects.Struff 2008

Before taking Bovine Colostrum

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

How to use Bovine Colostrum

Standardization of commercial bovine colostrum products is difficult because antibody content varies widely, making comparisons difficult. Additionally, hyperimmune preparations are available that are collected from cows previously immunized with specific organisms and that contain large amounts of specific antibodies.Kelly 2003 Studies have used the following dosages:

Athletic performance enhancement

10 to 60 g/day for up to 12 weeks.Buckley 2009, Carol 2011, Crooks 2010, Rathe 2014, Shing 2007

Exercise-induced GI permeability

Dosages of 20 g/day of bovine colostrum for 14 days,March 2017, Marchbank 2011 or 1 g/day for 20 days have been usedHalasa 2017; in one trial, 1.7 g/kg/day for 7 days prior to an exercise protocol was used.Morrison 2014

Immune deficiency–related diarrhea

10 to 50 g/day for 10 days to 4 weeks.Florén 2006, Kaducu 2011, Rathe 2014

Infectious disease

10 g/day as a supplement has been evaluated as treatment and prophylaxis.Kelly 2003, Shing 2007

Intra-abdominal surgery

56 g 3 days prior to surgery for prevention of postsurgical microbial translocation.Rathe 2014

NSAID–associated GI effects

Two small trials used 125 mL 3 times daily for 7 days.Rathe 2014

Prevention of upper respiratory tract infection

10 g twice daily for 4 or 12 weeks has been used in athletes.Jones 2014, Jones 2015

Warnings

The FDA has accepted the safety of hyperimmune milks on the basis that no adverse health effects have been shown in clinical studies.Gapper 2007

Previously specific commercial colostrum products were theoretically associated with a risk of BSE; therefore, lactobin LC1 was withdrawn from the market in the 1990s. Newer versions (LC2N) are derived from animals in countries with strict veterinary controls and without incidence of BSE, and where pasteurization is conducted at 72°C (167°F) for 15 seconds. The BSE risk for milk and milk products was determined to be negligible by the Committee for Proprietary Medicinal Products of the European Commission and by the World Health Organization, provided the milk is obtained from healthy animals and is prepared under suitable conditions.Struff 2007, Vetrugno 2004

What other drugs will affect Bovine Colostrum

None well documented.

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