Brussels sprouts instead of broccoli…(Part 2)

Today I would like to focus on the case study (see my March 28th post).

The first mention can be found in the abstract: The present study describes a case in which bronchitis developed upon turmeric intake for gastrointestinal complaints. Further on (page 266), the authors state that they feel the need to express a word of caution based on a case in which the use of moderate doses of turmeric induced some toxicity, possibly related to immunosuppression.

Well, before I begin growling (hehe, thanks, Sandy, you gave me a good chuckle with your comment…), let’s have a closer look at this part of the study.

The case: a 57-year-old man with an IgG1 deficiency and borderline hypogammaglobulinemia who had suffered from all sorts of ailments, poor dear!, from early childhood. These included middle ear infections (=otitis media), chronic rhinosinusitis (Stefano has the same thing, chronic rhinosinusitis I mean, so I know how nasty it can be…he frequently cannot breathe through his nose, and only when he is on cortisone does he regain his sense of smell, etc.…I am sure he is, er, really going to appreciate my having made all this public…oh, by the way, his regular use of a Neti pot has worked wonders…oh I digress…), and rarely bronchitis. This patient also suffered from chronic constipation that turned into post infectious irritable bowel syndrome (IBS) when he reached the age of 25.

We then learn that the patient himself suggested to his doctors that he take curcumin for this bothersome intestinal condition. CURCUMIN, mind you.

But no, the authors recommended that he take TURMERIC, yes turmeric the spice…a dose of one gram, twice a day…two grams total. Well, I must say that I was and still am completely bewildered as to why these doctors would have come up with a daily dose of turmeric, especially since they knew that Holt et al (the Australian MGUS-curcumin team) had used 99.5% pure curcumin...Very peculiar…

Let me pause here for a moment. If my haematologist had ever suggested that I take turmeric instead of curcumin, you can bet your fluorescent green socks that my reaction would have been a very strong one. At the very least, I would have pointed out the difference between turmeric and curcumin and insisted on taking the latter…more likely, I would have gone to a more knowledgeable specialist. I mean, what would you do if you asked your greengrocer for some broccoli, and he handed you a big bag of Brussels sprouts? Thought so…

Now, I am sure that the authors of this paper acted in good faith…but turmeric is NOT the same as curcumin. Turmeric the spice contains only a small percentage of curcumin, its active ingredient…8-9% at the most. But this is only the first of many problems…

Reading through the study, a million questions popped into my head but remained unanswered. Where did the patient get his turmeric? Was it a reliable source? You see, I have read that you have to be incredibly careful about where you buy turmeric and spices in general…for instance, spices bought in an open market may be contaminated with all sorts of nasty things: lead chromate, yellow earth, sand or even cheap talc (see: http://tinyurl.com/y8rf5d2).

I always buy organically certified spices in a health food store…and even then, I cook them, just in case there has been any bacterial contamination. I would never ingest a tablespoon of any spice without cooking it first. Did this patient cook the spice or simply take it raw? No details are provided in the study. This is a crucial bit of missing information…

Okay, it is one thing to swallow a daily dose of turmeric of unknown origin and in an unknown manner, quite another to take C3 Complex curcumin capsules/powder, the same curcumin that has been tested in the MD Anderson curcumin-myeloma clinical trial…the same curcumin made by a company that has received Good Manufacturing Practice awards…the same curcumin that has been tested in so many scientific studies. Blablabla…

But let’s set aside the curcumin-turmeric enigma for a minute and continue reading. Even on a daily one-gram dose of this mysterious turmeric, the patient confirmed the positive results found by Holt et al; within weeks the complaints related to the enteropathy became significantly milder and the patient experienced a subjective improvement in quality of life. (Enteropathy is any disease of the intestinal tract, by the way.)

But six weeks later, the authors report, their patient developed mild bronchitis with chronic cough and wheezing. This was surprising since traditional Indian medicine recommends the use of turmeric for a number of health problems, including sinusitis (see page 266 of the study for more details).

No kidding. I would like to highlight that this is the FIRST time I have EVER heard of a negative connection between turmeric and bronchitis…on the contrary, in traditional medicine, turmeric is given as a REMEDY for bronchitis (not just sinusitis) as well as many other ailments. So this just makes zero sense to me. Let’s keep reading…

The authors then tell us that Turmeric treatment was discontinued, and was re-initiated several weeks later after the bronchitis had totally cleared…after 4 weeks, the first signs of bronchitis returned, so turmeric treatment was stopped for 3 weeks, then re-initiated at a dose of 200 mg two times per day. This dose ended up being the correct amount for this particular patient, who has now, after two years, experienced a significant improvement of the intestinal problems without any further respiratory problems. That is wonderful, of course!

There are more details about this case, including an interesting discussion of vitamin B6 deficiency, but that isn’t what I would like to focus on right now.

I would instead like to offer a couple of examples of my own. Aside from having kept me stable for more than four years (in fact, my haematologist told me never to stop taking it…), curcumin has improved my quality of life in many ways, as we can see from the following…  

  1. Before January 2006, which is when I first began taking curcumin, I had recurrent and very (very!) bothersome yeast infections, which meant that I practically spent more time in my gynecologist’s office than at home. I was in pain/discomfort and on antibiotics almost constantly.
  2. I also had terrible bouts of bronchitis every single fall/winter. Wheezing was an everyday occurrence for me.

Points 1 and 2: I haven’t had a yeast infection since 2006. Not even the hint of one. I also haven’t had a serious illness in the past three plus years. These symptoms are a thing of the past, in spite of the fact that my immune system is extremely compromised. My IgAs and IgMs are hanging on a thread. My most recent tests show my IgA at 15 (normal range: 70-400 mg/dL) and my IgM at 10 (NR: 40-230). My haematologist is always amazed that I don’t have recurrent infections…she always asks me how I am doing and is always astounded to hear that I am in such good…health. My general good health must be due to my daily intake of curcumin. There is no other plausible explanation.

I don’t know what caused this patient’s bronchitis, but I would be very cautious about pointing my finger at his daily intake of…turmeric. Another question: was the turmeric analyzed for possible bacterial or mold contamination? I am not sure if mold can cause bronchitis, but it can certainly cause asthma…hmmm, if I were in this patient’s shoes, I would investigate this matter further…gather up my bag of turmeric and run to the nearest lab, I mean…Okay, I think my point is clear…

The authors end their discussion of the case study with the following: The development of bronchitis after the use of turmeric or curcumin has, to the best of our knowledge, never been reported in the literature. Thus, it cannot be ruled out that our patient may have been more susceptible to turmeric toxicity than other patients due to his mildly compromised immune system and/or the related tendency to develop vitamin B6 deficiency. While one case does not provide proof for turmeric toxicity, a review of the literature is warranted in order to find or dismiss a possible rationale for an immunosuppressive effect of turmeric.

Okay, I am always in favour of words of caution…I am also very much in favour of more research, just like these authors. I would, however, encourage authors of future papers on curcumin, turmeric and/or any other substance to present their data in a more open and logical manner. I would ask them, for instance, to provide a “Materials and Methods” section, which is sorely lacking in this study…leaving us with more questions than answers. Again, we do not know what type of turmeric was used…was it bought in an open market or in a health food store or…? Was it analyzed for purity? Sorry for all these repetitive questions, but I feel that these are extremely important points…points that the authors do not address, which is not good at all, in my opinion…

Oh dear, I have more to write about this study…but this post is already ridiculously long, so I will stop here for today…wow, there is a quite a thunderstorm going on out there…the cats are all freaked out…and now, the sun…weird!

A word of caution against…another word of caution. (Part 1)

In mid February I received a Google Alert that took me to a study published in January 2010: http://tinyurl.com/ygl775x The full text is available for free online…just click on the “Download PDF” button. At first, I admit, I was concerned (I mean, heckaroni, I don’t want to be taking anything that could possibly hurt me…or, horror!, hurt anyone else, for that matter!)…then I read the study again (and again…and again), did a bit of research, and my concern was put to rest.

Back then, I wrote a draft that I didn’t publish immediately but set aside, intending to return to it in a less “heated” moment. Well, I then got caught up in other things—my father-in-law’s health condition and so on—so I forgot about my draft…and many other things, come to think of it!…until a few days ago, when a blog reader left me a comment that included a link to a study written by three of the same authors who wrote the above-mentioned January paper and published this month (see: http://tinyurl.com/y8k73g4). Other blog readers have since brought that March study to my attention. Judging from the abstract, the content of the March study appears to be much the same as that of the January one, which I shall be discussing in this post (and at least one more). The study is fully available online, so you can read it, too.

Note: the January 2010 study mentions the Australian MGUS-curcumin pilot study that I posted about on my blog last year…here is a reminder of what that is all about: http://margaret.healthblogs.org/life-with-myeloma/discovery-of-curcumin/md-anderson-curcumin-myeloma-clinical-trial-results/another-curcumin-mm-clinical-trial/.

Before I begin, I would like to make it clear that I always enjoy reading serious, well-presented and well-argued studies, even if they are critical of something near and dear to me (in this case, curcumin). This particular study, however, does not fall into that category…no, I was not impressed with it. In Part 1, therefore, I would like to make a few points that I will develop further in Part 2…:

  1. if you look at the “References” section (p. 268), you will notice that the authors don’t list any of the curcumin studies co-authored by Prof. Aggarwal. Not one. Now, I am always interested in a study’s bibliography, and I must say that I was quite surprised and also puzzled not to find an Aggarwal study among the 12 curcumin studies listed here. Out of curiosity, I did a search for “Prof. Aggarwal” in PubMed, where I found that he has co-authored 495 studies, 69 of which are on curcumin. Now, in my opinion, writing a study on curcumin without referencing Aggarwal, the world’s authority on curcumin and cancer, is like writing an essay criticizing the theory of relativity without quoting Einstein…or writing about Harry Potter without mentioning J.K. Rowling. It just makes no sense…or…could there be more to this than just…forgetfulness? (Oh dear, perhaps I have watched too many seasons of “CSI Crime Scene” and have developed an overly suspicious nature…)
  2. here and there, the authors seem to use the words “turmeric” and “curcumin” interchangeably. But wait, there is a HUGE difference between the two. Turmeric is the spice…whereas curcumin is its active ingredient. Are the authors confused on this crucial point? We will discuss this more in depth, but not today…
  3. the choice of “case study” was a bit peculiar, and you can bet your purple socks that I have loads to say about it! Not now, though. I would like for you to read this study without too much interference on my part.

Oh phooey, I can’t resist. I will interfere…but just on one more point. It is hard not to be struck by a sentence written at the very beginning of the study (my emphasis): A recent pilot study found that curcumin, in certain patients with monoclonal gammopathy of undetermined significance (MGUS), decreases the paraprotein load and the urinary N-telopeptide of type 1 collagen bone turnover marker. While this result is encouraging, the easy availability of the food component turmeric, containing curcumin, may lead to intake by MGUS patients without medical supervision.

Now wait a sec…does this mean that—based only on ONE case study (as we will soon find out)—all MGUS folks and, even more so, SMM patients, should avoid cooking with a bit of turmeric without our doctor’s approval??? Even if we are not doing any chemo? Even if we do not have another health condition that requires us to take prescription medicine? Even if we don’t have a medical history similar to the case study discussed in this report? After a moment of surprise, then of irritation, this sentence almost made me laugh. Ridikkulus.

Sure, I agree with the authors that we should always inform and update our doctors on the supplements that we are taking…I have stated that over and over again in blog posts and private messages…that just boils down to common sense.

I am certain, however, that my haematologist would not be overly pleased, to put it mildly, if I phoned her every time I decided to cook something, asking her to check my list of ingredients. “Hello, Prof. S, may I add a bit of grated ginger to my vegetable soup?” C’mon, this is really going a bit too far…

Okay, that’s it for today. As I mentioned, I don’t want to make too many comments right now, but you can be sure that I have plenty to say…ah yes, plenty…stay tuned…

Planning our Easter holiday

I apologize for not having posted anything here in the past few days. I’ve been quite busy with work (students, translations, more students, more…) AND, most importantly!, planning our upcoming Easter trip to Rome. Yes, ROME! We decided that we needed a break (…), so…acting on an impulse last night, we got online and made a reservation at a really nice (we hope!) B&B that is a mere five-minute walk from the Vatican Museums. Perfect.

Stefano and I immediately made reservations (online, so as to skip the long queues, yaaay!) to visit the Vatican Museums and the Sistine Chapel, which we haven’t seen yet…shocking, eh? I mean, we live so close to Rome…well, better late than never. Of course, we have both been to Rome before…in fact, a few years ago we walked around the center of Rome nonstop for hours and hours and hours (by the late afternoon, my aching legs went on strike, so we got on one of those nifty “hop on, hop off” tourist buses that take you around to all the major attractions). We saw a lot, but obviously not everything…

Another thing I would really like to visit is the Caravaggio 400th anniversary exhibition, see: http://tinyurl.com/yetxqd8 and http://tinyurl.com/yd7g7ye Wow.

Anyway, back to us…I have a bunch of unfinished drafts sitting on my desktop but just don’t know when I will have the time to get to them. Plus, it’s the weekend, and we have some fun planned!

Okay, I had better get back to the garden now and help my indefatigable sweetie with our annual spring yard cleaning/pruning etc (oh, in case you were wondering, yard work is NOT part of the fun we have planned for the weekend…! Ah, if only we had a garden that would take care of itself…dream on…).

Have a great weekend, everyone! And don’t forget to laugh…ah wait a sec, speaking of which…here is something that a blog reader (thanks, D.!) sent to me…some Happy Easter wishes…but I warn you: click on this link ONLY if you have a wacky sense of humor: http://terrisfp1.com/holidays/chick.swf Hehe.

Curcumin in Italy…Curcumina in Italia

If you live in Italy, you can order your curcumin (or whatever) from a very friendly pharmacy (with a galenic lab) located in Calenzano, right outside of Florence: www.farmaciabalducci.it

And it gets better: if you live in Tuscany (well, unless you live too far from Florence), the pharmacy staff will deliver your order right to your door, otherwise they will mail it to you. Very highly recommended by yours truly…okay, now in Italian.

Per chi vive in Italia: potete ordinare la curcumina (e tante altre cose!) presso la Farmacia Balducci di Calenzano (provincia di Firenze) che ha al suo interno anche un laboratorio galenico (cliccate sul link di cui sopra). Se abitate nei dintorni di FI, il vostro ordine vi verrà recapitato direttamente a casa…altrimenti, verrà spedito per posta.

Nota bene 1: 1. il gentilissimo Dr. Balducci usa la curcumina C3 Complex, la stessa che è stata usata nello studio clinico mieloma-curcumina svoltosi alla MD Anderson Cancer Research Center, università del Texas. Meglio di così…! 🙂

Nota bene 2: Se volete arrivare a 8 grammi di curcumina al giorno, vi consiglio di non superare la dose di 15-20 mg di piperina (= di solito questa viene abbinata alla curcumina per favorirne l’assorbimento), per cui vi consiglio di parlate direttamente col Dr. Balducci per decidere la dose di piperina e curcumina per ogni capsula. Sono certa che vi saprà consigliare bene, anzi benissimo!

Smoldering myeloma with diabetes or Addison’s Disease?

Yesterday I received a message from a blog reader/curcumin-taker who was recently diagnosed with smoldering myeloma (SMM). She also has Addison’s Disease*. She asked me a very good question: do any of your blog readers have smoldering myeloma in addition to having Addison’s Disease or diabetes? I have no idea, and that is why I am asking this question today…

*A mini-quote from her message: “my adrenals have worn away and I take steroids (hydrocortisone) 3 times a day to replace the natural steroids my glands ought to be producing (very similar to a diabetic who takes insulin).”

*For more info on Addison’s Disease, a disorder of the adrenal glands, please see this Mayo Clinic overview: http://tinyurl.com/ynolcr 

If you would like to get in touch with her, please leave a comment here or fill out my blog’s Contact form (on the right)…or send me an e-mail. Thank you!

Amusing signs

A blog reader (thanks!) sent me most of these…I added a few…enjoy! 😀

Apartment laundry room sign: “Please be courteous and remove your clothes promptly.”

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Photographer’s studio: “Out to lunch: If not back by five, out for dinner also.”

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High school wall: “Fite Illiteracy.”

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Podiatrist’s office wall: “Time wounds all heels.”

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Proctologist’s  office door: “To expedite your visit, please back in.”

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Plumber’s truck: “We repair what your husband fixed.”

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Another plumber’s truck:”Don’t sleep with a drip. Call your plumber.”

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Pizza shop: “We offer pizza and quiet.”

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Repair shop door: “We can repair anything. (Please knock hard on the door – the bell doesn’t work)”

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Gynecologist’s office: “Dr. Jones, at your cervix.”

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Auto repair service station: “Try us once – you’ll never go anywhere else again.”

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Towing company: “We don’t charge an arm and a leg. We want tows.”

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Electrician’s truck: “Let us remove your shorts.”

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In a non-smoking area: “If we see smoke, we will assume you are on fire and take appropriate action.”

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Maternity room door: “Push. Push. Push.”

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Maternity ward (Florida): “No children allowed.”

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Optometrist’s office: “If you don’t see what you’re looking for, you’ve come to the right place.”

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Outside a muffler shop: “No appointment necessary. We hear you coming.”

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Package label: “Please notify us at once if this label fell off in transit.”

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Veterinarian’s waiting room: “Be back in 5 minutes. Sit! Stay!”

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Music teacher’s door: “OUT CHOPIN”

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Men’s restroom: “Toilet out of order. Please use floor below.”

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New British Town Hall (which was to be opened by the Queen): “The Town Hall is closed until opening. It will remain closed after being opened. Open tomorrow.”

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Restaurant window: “Don’t stand there and be hungry; come on in and get fed up.”

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Front yard of a funeral home: “Drive carefully. We’ll wait.”

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Chicago radiator shop: “Best place in town to take a leak.”

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Dry cleaner’s shop: “Anyone leaving their garments here for more than 30 days will be disposed of.”

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Billboard: “Keep your eyes on the road and stop reading these signs.”

Melanoma update…

If you have been following my blog for at least a month, you will know that my father-in-law was recently diagnosed with invasive melanoma (for a reminder, please see my Feb 6 and Feb 16 posts). In early February, we were told that the cancer had spread to his lungs (the nodules are small, which is positive…but they are there, which is not positive…).

Update: yesterday we received the results of the biopsy done on his cheek on Feb 11: no cancer cells…not even the shadow of a cancer cell. A bit of good news…

As you may remember, on Feb 16 Stefano and I accompanied my father-in-law to see his oncologist, Dr. P, who spoke with me very openly and amicably about curcumin (my Feb 16 post provides more details). Dr. P told my father-in-law to take at least three grams of curcumin per day. He also explained that the chemo “program” consisted of at least two cycles and then, provided that my father-in-law’s red/white cells and platelets didn’t decrease too much, perhaps a third one. This particular chemo drug tends to depress red and white cells and platelets, you see, so many patients are forced to stop at cycle number two (according to Dr. P).

Well, I am happy to report that my father-in-law was able to finish all three chemo cycles. His platelet and complete blood count remained stable during the first two cycles…indeed, they were “perfect,” according to a very pleased Dr. P.

I would also like to mention that my father-in-law did not experience any side effects from the chemo. None. On the contrary, he always reported that he felt as strong as a horse…

As you can imagine, I have been asking myself if such a positive reaction could have been a consequence of his curcumin intake…? Nobody can answer that question, obviously. But one thing I can and will say: every time he went to the hospital on “blood test day” or “chemo day,” my father-in-law reminded Dr. P that he was still taking curcumin. Dr. P always replied: “excellent, excellent, please continue to take it.”

I hope things continue to go well, of course. We should know a bit more next month, when my father-in-law undergoes more tests, another MRI and so on…

Dilemma…

Is this a little white kitty hanging out of a cat tree

OR a rare sighting (in Italy, anyway!) of a Hairy-legged or White-winged vampire bat…? I can’t decide…

A great day…

…It began with my reading a message from a MGUS blog reader who had contacted me last fall, after noticing that her markers, especially the freelite ones, were steadily worsening. After receiving my reply, she began the curcumin protocol. Today she received her test results: normal. No, I am not kidding: NORMAL. And her freelite chains are too small to be quantified. She is ecstatic, of course, and so am I! Ah yes!

I also had a very good day at work…and, when I got home, I found a message on Facebook from a childhood friend whom I had looked up and contacted yesterday evening. Enough to put a big grin on my face…but there is more. Another blog reader, who takes six grams of curcumin, informed me that he found out today that he is still stable. Stable…one of my favorite words in the dictionary…fantastico!

This evening I am having dinner with my girlfriends (we are playing cards after dinner, naturellement…)…which reminds me…oh no, where did the time go? It’s late, and I still have to ice my carrot cake…off I go! Well, I hope everyone has a great evening, wherever you are…!