Home Medicine The effect of Nigella sativa on oxidative stress and inflammatory biomarkers: a systematic review and meta-analysis
Article
Licensed
Unlicensed Requires Authentication

The effect of Nigella sativa on oxidative stress and inflammatory biomarkers: a systematic review and meta-analysis

  • Sanaz Malekian , Nafiseh Ghassab-Abdollahi , Mojgan Mirghafourvand and Azizeh Farshbaf-Khalili EMAIL logo
Published/Copyright: January 5, 2021

Abstract

Objectives

The present systematic review of literature was conducted to study the effect of Nigella sativa (N.S) on oxidative stress and inflammatory biomarkers.

Content

Different online databases such as Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Scopus, Web of Sciences, EMBASE, and Clininaltrial.gov for English articles and national databases of SID, Magiran, Irandoc, and Iranmedex for Persian articles, which were published until March; 2019 were scrutinized. All Randomised Controlled Trials (RCTs) and quasi-experimental studies that aimed to compare the impact of N.S along, with placebo or without supplementation, on inflammatory factors and oxidative stress were entered in the present study.

Summary

Finally, 11 RCTs covering 710 women and men, in total, were participated in the present meta-analysis. Significant differences were observed in Tumor Necrosis Factor alpha (TNF-α) (Weighted Mean Difference (WMD) =−2.15 pg/mL, 95% Confidence Interval (CI) =−3.22–−1.09, I2=32%; 5 trials with 262 participants) superoxide dismutase (WMD=63.79 µ/gHb, 95% CI=6.84–120.75, I2=0%; 2 trials, with 88 participants), and total antioxidant capacity (WMD=0.34 mmol/L, 95% CI=0.04 to 0.63, I2=94%; 5 trials with 232 participants). Nevertheless, there was no significant difference in high sensitivity C-reactive protein (WMD=−0.98 mg/L, 95% CI=−1.98–0.03, I2=78%; 5 trials with 267 participants), Interleukin 6 (IL-6) (WMD=−0.25 pg/mL, 95% CI=−0.65 to 0.16, I2=0%; 2 trials with 134 participants), and malondialdehyde (WMD=−0.95 nmol/mL, 95% CI=−1.97–0.08, I2=68%; 4 trials with 179 participants).

Outlook

Generally speaking, N.S probably results in the improvement of superoxide dismutase serum levels, TNF-α, and total antioxidant capacity. Thus, further studies are required to fully assess its impacts on all oxidative stress and inflammatory biomarkers.


Corresponding author: Azizeh Farshbaf-Khalili, Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran, Phone: 00989144023216, Fax: + 984134796969, E-mail:

Acknowledgments

This study was extracted from a master’s thesis (in progress) approved by the Ethics Committee of Tabriz University of Medical Sciences under No. IR. TBZMED. REC.139 7.733. We thank the Vice Chancellor for Research and Technology at Tabriz University of Medical Sciences for their financial support, also Mrs Bakhtiarai at physical medicine and rehabilitation research center of Tabriz University of Medical Sciences for their assistance with this study.

  1. Research funding: This article was financially supported by Tabriz University of Medical Sciences.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: The authors have no conflict to declare.

References

1. Namazi, N, Mahdavi, R, Alizadeh, M, Farajnia, S. Oxidative stress responses to Nigella sativa oil concurrent with a low‐calorie diet in obese women: a randomized, double‐blind controlled clinical trial. Phytother Res 2015;29:1722–8. https://doi.org/10.1002/ptr.5417.Search in Google Scholar

2. Ramadan, MF. Nutritional value, functional properties and nutraceutical applications of black cumin (Nigella sativa L.): an overview. Int J Food Sci Technol 2007;42:1208–18. https://doi.org/10.1111/j.1365-2621.2006.01417.x.Search in Google Scholar

3. Ghannadi, A, Hajhashemi, V, Jafarabadi, H. An investigation of the analgesic and anti-inflammatory effects of Nigella sativa seed polyphenols. J Med Food 2005;8:488–93. https://doi.org/10.1089/jmf.2005.8.488.Search in Google Scholar

4. Develi, S, Evran, B, Betul Kalaz, E, Kocak-Toker, N, Erata, GO. Protective effect of Nigella sativa oil against binge ethanol-induced oxidative stress and liver injury in rats. Chin J Nat Med 2014;12:495–9. https://doi.org/10.1016/s1875-5364(14)60077-7.Search in Google Scholar

5. Bourgou, S, Pichette, A, Marzouk, B, Legault, J. Antioxidant, anti‐inflammatory, anticancer and antibacterial activities of extracts from Nigella sativa (black cumin) plant parts. J Food Biochem 2012;36:539–46. https://doi.org/10.1111/j.1745-4514.2011.00567.x.Search in Google Scholar

6. Tolerability and safety of black cumin seed oil (Bcso) administration for 20 days in healthy subjects. Biomed Res 2017;28:4196–201.Search in Google Scholar

7. Ahmad, A, Husain, A, Mujeeb, M, Khan, SA, Najmi, AK, Siddique, NA, et al.. A review on therapeutic potential of Nigella sativa: a miracle herb. Asian Pac J Trop Biomed 2013;3:337–52. https://doi.org/10.1016/s2221-1691(13)60075-1.Search in Google Scholar

8. Houghton, PJ, Zarka, R, de las Heras, B, Hoult, J. Fixed oil of Nigella sativa and derived thymoquinone inhibit eicosanoid generation in leukocytes and membrane lipid peroxidation. Planta Med 1995;61:33–6. https://doi.org/10.1055/s-2006-957994.Search in Google Scholar

9. Al-Ghamdi, M. The anti-inflammatory, analgesic and antipyretic activity of Nigella sativa. J Ethnopharmacol 2001;76:45–8. https://doi.org/10.1016/s0378-8741(01)00216-1.Search in Google Scholar

10. Khan, N, Sultana, S. Inhibition of two stage renal carcinogenesis, oxidative damage and hyperproliferative response by Nigella sativa. Eur J Canc Prev 2005;14:159–68. https://doi.org/10.1097/00008469-200504000-00012.Search in Google Scholar PubMed

11. Dwita, LP, Yati, K, Gantini, SN. The anti-inflammatory activity of Nigella sativa balm sticks. Sci Pharm 2019;87:3. https://doi.org/10.3390/scipharm87010003.Search in Google Scholar

12. Valizdeh, N, Zakeri, HR, Shafiee, A, Sorkhil, P, Heshmat, R, Ardeshirlarijani, MB. Effect of blackberry extract on bone markers in postmenopausal women. Endocr Metabol Iran 2008;10:571–80.Search in Google Scholar

13. Kaatabi, H, Bamosa, AO, Badar, A, Al-Elq, A, Abou-Hozaifa, B, Lebda, F, et al.. Nigella sativa improves glycemic control and ameliorates oxidative stress in patients with type 2 diabetes mellitus: placebo controlled participant blinded clinical trial. PloS One 2015;10:e0113486. https://doi.org/10.1371/journal.pone.0113486.Search in Google Scholar PubMed PubMed Central

14. Yusof, HM, Ling, LP, Suzuri, M, Suhaimin, N. Effect of Nigella sativa and honey mixture (NSxH) on cardiovascular risk factors in healthy adults. Kuala Terengganu, Malaysia: Universiti Malaysia Terengganu; 2012:703–12 p.Search in Google Scholar

15. Leong, X-F, Rais Mustafa, M, Jaarin, K. Nigella sativa and its protective role in oxidative stress and hypertension. Evid base Compl Alternative Med 2013;2013:120732. https://doi.org/10.1155/2013/253479.Search in Google Scholar

16. Entok, E, Ustuner, MC, Ozbayer, C, Tekin, N, Akyuz, F, Yangi, B, et al.. Anti-inflammatuar and anti-oxidative effects of Nigella sativa L.: 18 FDG-PET imaging of inflammation. Mol Biol Rep 2014;41:2827–34. https://doi.org/10.1007/s11033-014-3137-2.Search in Google Scholar PubMed

17. Majdalawieh, AF, Fayyad, MW. Immunomodulatory and anti-inflammatory action of Nigella sativa and thymoquinone: a comprehensive review. Int Immunopharm 2015;28:295–304. https://doi.org/10.1016/j.intimp.2015.06.023.Search in Google Scholar PubMed

18. Hadi, V, Kheirouri, S, Alizadeh, M, Khabbazi, A, Hosseini, H. Effects of Nigella sativa oil extract on inflammatory cytokine response and oxidative stress status in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial. Avicenna J Phytomed 2016;6:34–43.Search in Google Scholar

19. Mohammadshahi, M, Rashidmyvan, MH, Seyedian, SS, Haghighizadeh, MH. The potential protective effect of Nigella sativa oil on patients with non-alcoholic fatty liver disease. Austin J Nutr Metab 2018;5.Search in Google Scholar

20. Sterne, JA, Hernan, MA, Reeves, BC, Savovic, J, Berkman, ND, Viswanathan, M, et al.. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ; 2016. https://pubmed.ncbi.nlm.nih.gov/27733354/.10.1136/bmj.i4919Search in Google Scholar PubMed PubMed Central

21. Higgins JP, SG, Green, S. Cochrane handbook for systematic reviews of interventions. John Wiley & Sons Ltd; 2008.10.1002/9780470712184Search in Google Scholar

22. Wan, X, Wang, W, Liu, J, Tong, T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014;14:135. https://doi.org/10.1186/1471-2288-14-135.Search in Google Scholar PubMed PubMed Central

23. Fu, R, Vandermeer, BW, Shamliyan, TA, O’Neil, ME, Yazdi, F, Fox, SH, et al.. Handling continuous outcomes in quantitative synthesis. Methods guide for effectiveness and comparative effectiveness reviews [Internet]. Agency for Healthcare Research and Quality (US); 2013. https://pubmed.ncbi.nlm.nih.gov/24006546/.Search in Google Scholar

24. Mahdavi, R, Namazi, N, Alizadeh, M, Farajnia, S. Nigella sativa oil with a calorie-restricted diet can improve biomarkers of systemic inflammation in obese women: a randomized double-blind, placebo-controlled clinical trial. J Clin Lipidol 2016;10:1203–11. https://doi.org/10.1016/j.jacl.2015.11.019.Search in Google Scholar PubMed

25. Kheirouri, S, Hadi, V, Alizadeh, M. Immunomodulatory effect of Nigella sativa oil on T lymphocytes in patients with rheumatoid arthritis. Immunol Invest 2016;45:271–83. https://doi.org/10.3109/08820139.2016.1153649.Search in Google Scholar PubMed

26. Datau, EA, Wardhana, Surachmanto, EE, Pandelaki, K, Langi, JA, Fias. Efficacy of Nigella sativa on serum free testosterone and metabolic disturbances in central obese male. Acta Med Indones 2010;42:130–4.Search in Google Scholar

27. Nikkhah-Bodaghi, M, Darabi, Z, Agah, S, Hekmatdoost, A. The effects of Nigella sativa on quality of life, disease activity index, and some of inflammatory and oxidative stress factors in patients with ulcerative colitis. Phytother Res: PTR 2019;33:1027–32. https://doi.org/10.1002/ptr.6296.Search in Google Scholar PubMed

28. Hadi, S, Mirmiran, P, Daryabeygi-Khotbesara, R, Hadi, V. Effect of Nigella sativa oil extract on inflammatory cytokine response and oxidative stress among people with type 2 diabetes mellitus: a randomized, double-blind, placebo controlled trial. Prog Nutr 2018;20(1 Suppl):127–33.Search in Google Scholar

29. Amin, F, Islam, N, Anila, N, Gilani, A. Clinical efficacy of the co-administration of Turmeric and Black seeds (Kalongi) in metabolic syndrome–A double blind randomized controlled trial–TAK-MetS trial. Compl Ther Med 2015;23:165–74. https://doi.org/10.1016/j.ctim.2015.01.008.Search in Google Scholar PubMed

30. Darand, M, Darabi, Z, Yari, Z, Saadati, S, Hedayati, M, Khoncheh, A, et al.. Nigella sativa and inflammatory biomarkers in patients with non-alcoholic fatty liver disease: results from a randomized, double-blind, placebo-controlled, clinical trial. Compl Ther Med 2019;44:204–9. https://doi.org/10.1016/j.ctim.2019.04.014.Search in Google Scholar PubMed

31. Sadeghpour, N, Khaki, AA, Najafpour, A, Dolatkhah, H, Montaseri, A. Study of Foeniculum vulgare (fennel) seed extract effects on serum level of estrogen, progesterone and prolactin in mouse. Crescent J Medical Biol Sci 2015;2.Search in Google Scholar

32. Gheita, TA, Kenawy, SA. Effectiveness of Nigella sativa oil in the management of rheumatoid arthritis patients: a placebo controlled study. Phytother Res 2012;26:1246–8. https://doi.org/10.1002/ptr.3679.Search in Google Scholar PubMed

33. DeBoer, MD. Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions. Nutrition 2013;29:379–86. https://doi.org/10.1016/j.nut.2012.07.003.Search in Google Scholar PubMed PubMed Central

34. Naghizadeh, H, Afzalpour, M, Zarban, A. The comparison of antioxidant status and lipid profile of karate athletes with non-athletes; 2009.Search in Google Scholar

35. Torkzahrani, S, Ataei, PJ, Hedayati, M, Khodakarim, S, Sheikhan, Z, Khoramabadi, M, et al.. Oxidative stress markers in early pregnancy loss: a case-control study. Int J Women’s Health Reprod Sci 2019;7:61–6.10.15296/ijwhr.2019.10Search in Google Scholar

36. Szczesny, B, Marcatti, M, Ahmad, A, Montalbano, M, Brunyánszki, A, Bibli, S-I, et al.. Mitochondrial DNA damage and subsequent activation of Z-DNA binding protein 1 links oxidative stress to inflammation in epithelial cells. Sci Rep 2018;8:914. https://doi.org/10.1038/s41598-018-19216-1.Search in Google Scholar PubMed PubMed Central

37. Ahmadian, F, Mozaffari-Khosravi, H, Azaraein, MH, Faraji, R, Zavar-Reza, J. The effect of consumption of garlic tablet on proteins oxidation biomarkers in postmenopausal osteoporotic women: a randomized clinical trial. Electron Physician 2017;9:5670. https://doi.org/10.19082/5670.Search in Google Scholar PubMed PubMed Central

38. Al-Gubory, KH, Fowler, PA, Garrel, C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. Int J Biochem Cell Biol 2010;42:1634–50. https://doi.org/10.1016/j.biocel.2010.06.001.Search in Google Scholar PubMed

39. Banerjee, J, Shaeib, F, Maitra, D, Saed, GM, Dai, J, Diamond, MP, et al.. Peroxynitrite affects the cumulus cell defense of metaphase II mouse oocytes leading to disruption of the spindle structure in vitro. Fertil Steril 2013;100:578–84.e1. https://doi.org/10.1016/j.fertnstert.2013.04.030.Search in Google Scholar PubMed

40. Najafi, T. Chemotherapy-induced oxidative stress and infertility. Iran: ARAS PART MEDICAL INT PRESS NO 1, S SHAREATI ST, 5138815941, TABRIZ, 00000; 2017.10.15296/ijwhr.2017.15Search in Google Scholar

41. Chakraborty, A, Chowdhury, S, Bhattacharyya, M. Effect of metformin on oxidative stress, nitrosative stress and inflammatory biomarkers in type 2 diabetes patients. Diabetes Res Clin Pract 2011;93:56–62. https://doi.org/10.1016/j.diabres.2010.11.030.Search in Google Scholar PubMed

42. Fernández-Sánchez, A, Madrigal-Santillán, E, Bautista, M, Esquivel-Soto, J, Morales-González Á, Esquivel-Chirino, C, et al.. Inflammation, oxidative stress, and obesity. Int J Mol Sci 2011;12:3117–32. https://doi.org/10.3390/ijms12053117.Search in Google Scholar PubMed PubMed Central

43. Roberts, CK, Sindhu, KK. Oxidative stress and metabolic syndrome. Life Sci 2009;84:705–12. https://doi.org/10.1016/j.lfs.2009.02.026.Search in Google Scholar PubMed

44. Quiñonez-Flores, CM, González-Chávez, SA, Del Río Nájera, D, Pacheco-Tena, C. Oxidative stress relevance in the pathogenesis of the rheumatoid arthritis: a systematic review. BioMed Res Int 2016;2016:6097417. https://doi.org/10.1155/2016/6097417.Search in Google Scholar PubMed PubMed Central

45. Faghihzadeh, F, Adibi, P, Rafiei, R, Hekmatdoost, A. Resveratrol supplementation improves inflammatory biomarkers in patients with nonalcoholic fatty liver disease. Nutr Res 2014;34:837–43. https://doi.org/10.1016/j.nutres.2014.09.005.Search in Google Scholar PubMed

46. Soltani, M, Moghimian, M, Abtahi, H, Shokoohi, M. The protective effect of Matricaria chamomilla extract on histological damage and oxidative stress induced by Torsion/Detorsion in adult rat ovary. Int J Women’s Health Reprod Sci 2017;5:187–92. https://doi.org/10.15296/ijwhr.2017.34.Search in Google Scholar

47. Sayed‐Ahmed, MM, Nagi, MN. Thymoquinone supplementation prevents the development of gentamicin‐induced acute renal toxicity in rats. Clin Exp Pharmacol Physiol 2007;34:399–405.10.1111/j.1440-1681.2007.04560.xSearch in Google Scholar PubMed

48. Umar, S, Hedaya, O, Singh, AK, Ahmed, S. Thymoquinone inhibits TNF-α-induced inflammation and cell adhesion in rheumatoid arthritis synovial fibroblasts by ASK1 regulation. Toxicol Appl Pharmacol 2015;287:299–305. https://doi.org/10.1016/j.taap.2015.06.017.Search in Google Scholar PubMed PubMed Central

49. Chehl, N, Chipitsyna, G, Gong, Q, Yeo, CJ, Arafat, HA. Anti-inflammatory effects of the Nigella sativa seed extract, thymoquinone, in pancreatic cancer cells. HPB 2009;11:373–81. https://doi.org/10.1111/j.1477-2574.2009.00059.x.Search in Google Scholar PubMed PubMed Central

50. El-Mageed, AE-DA, Ismaeil, R, Ali, HE-M. Nigella sativa modulates cytokines expression in mature bovine adipocytes. Asian J Biochem 2009;4:60–7.10.3923/ajb.2009.60.67Search in Google Scholar

51. Norouzi, F, Abareshi, A, Asgharzadeh, F, Beheshti, F, Hosseini, M, Farzadnia, M, et al.. The effect of Nigella sativa on inflammation-induced myocardial fibrosis in male rats. Res Pharmaceut Sci 2017;12:74. https://doi.org/10.4103/1735-5362.199050.Search in Google Scholar PubMed PubMed Central

52. Yildiz, A, Balikci, E. Antimicrobial, anti-inflammatory and antioxidant activity of Nigella sativa in clinically endometritic cows. J Appl Anim Res 2016;44:431–5. https://doi.org/10.1080/09712119.2015.1091341.Search in Google Scholar

53. Oskouei, Z, Akaberi, M, Hosseinzadeh, H. A glance at black cumin (Nigella sativa) and its active constituent, thymoquinone, in ischemia: a review. Iran J Basic Med Sci 2018;21:1200–9. https://doi.org/10.22038/ijbms.2018.31703.7630.Search in Google Scholar PubMed PubMed Central

54. Amin, B, Hosseinzadeh, H. Black cumin (Nigella sativa) and its active constituent, thymoquinone: an overview on the analgesic and anti-inflammatory effects. Planta Med 2016;82:8–16. https://doi.org/10.1055/s-0035-1557838.Search in Google Scholar PubMed

55. Ebru, U, Burak, U, Yusuf, S, Reyhan, B, Arif, K, Faruk, TH, et al.. Cardioprotective effects of Nigella sativa oil on cyclosporine A‐induced cardiotoxicity in rats. Basic Clin Pharmacol Toxicol 2008;103:574–80. https://doi.org/10.1111/j.1742-7843.2008.00313.x.Search in Google Scholar PubMed

56. Abdelmeguid, NE, Fakhoury, R, Kamal, SM, Al Wafai, RJ. Effects of Nigella sativa and thymoquinone on biochemical and subcellular changes in pancreatic β‐cells of streptozotocin‐induced diabetic rats. J Diabetes 2010;2:256–66. https://doi.org/10.1111/j.1753-0407.2010.00091.x.Search in Google Scholar PubMed

57. Bordoni, L, Fedeli, D, Nasuti, C, Maggi, F, Papa, F, Wabitsch, M, et al.. Antioxidant and anti-inflammatory properties of Nigella sativa oil in human pre-adipocytes. Antioxidants 2019;8:51. https://doi.org/10.3390/antiox8020051.Search in Google Scholar PubMed PubMed Central

Received: 2019-09-02
Accepted: 2020-08-11
Published Online: 2021-01-05

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. The effect of Nigella sativa on oxidative stress and inflammatory biomarkers: a systematic review and meta-analysis
  4. Effect of fennel on primary dysmenorrhea: a systematic review and meta-analysis
  5. Raising burden of non-communicable diseases: importance of integrating Yoga and Naturopathy at primary care level
  6. Research Articles Basic
  7. Marketing and legal status of phytomedicines and food supplements in Morocco
  8. Hydrogen sulfide as a mediator of endothelium-dependent relaxation evoked by Moringa oleifera leaf extract in mesenteric arterial beds isolated from L-NAME hypertensive rats
  9. Acute and sub-acute toxicity assessment of aqueous leaves extract of Crassocephalum crepidioides (Asteraceae) in Wistar rats
  10. Zingerone improves the immune responses in an animal model of breast cancer
  11. Evaluation of efficacy of Bombax ceiba extract and its major constituent, mangiferin in streptozotocin (STZ)-induced diabetic rats
  12. Bacterial endosymbiont inhabiting Leucaena leucocephala leaves and their antioxidant and antidiabetic potential
  13. Ameliorative effect of morin on dutasteride-tamsulosin-induced testicular oxidative stress in rat
  14. The potentiation of beta-lactam and anti-bacterial activities of lipophilic constituents from Mesua ferrae leaves against methicillin-resistant Staphylococcus aureus
  15. Influence of irisin on diet-induced metabolic syndrome in experimental rat model
  16. Modulatory effect of methanol extract of Annona muricata stem bark on mitochondrial membrane permeability transition pore in normal rat liver and monosodium glutamate-induced uterine hyperplasia
  17. Research Articles Clinical
  18. Functional status in adhesive capsulitis – yoga vs. physiotherapy: a quasi experimental study
  19. Okada Purifying Therapy in combination with duloxetine vs. duloxetine alone in patients with TMD and fibromyalgia: a randomized clinical study
  20. The FIFA 11+ does not alter performance in amateur female basketball players—a randomized control trial
  21. Body composition, phenotype and central obesity indices in Egyptian women with non-alcoholic fatty liver disease
  22. Immediate effect of interscapular cupping on blood pressure, oxygen saturation, pulse rate and chest expansion in sedentary smoker students
  23. The effects of an olive-oil massage on hemodialysis patients suffering from fatigue at a hemodialysis unit in southern India – a randomized controlled trial
  24. Effects of epigallocatechin-3-gallate of Camellia sinensis leaves on blood pressure, lipid profile, atherogenic index of plasma and some inflammatory and antioxidant markers in type 2 diabetes mellitus patients: a clinical trial
  25. The effect of practicing yoga during pregnancy on labor stages length, anxiety and pain: a randomized controlled trial
  26. Effect of lumbar stabilization exercises and thoracic mobilization with strengthening exercises on pain level, thoracic kyphosis, and functional disability in chronic low back pain
  27. A prospective controlled study on Ramadan fasting in the healthy young males in summer in Germany: effect on cytokines
  28. Tualang honey versus steroid impregnated nasal dressing following endoscopic sinus surgery: a randomized controlled trial
  29. Short Communications
  30. Improved anti-arthritic activity of ginger extract, a traditional medicine, using novel drug delivery approach
  31. Efficacy of fenugreek seed extract on men's psychological and physical health: a randomized placebo-controlled double-blind clinical trial
Downloaded on 2.2.2026 from https://www.degruyterbrill.com/document/doi/10.1515/jcim-2019-0198/html
Scroll to top button