Many patients with TGCT change components of their diet and/or take supplements to improve overall health, well-being, and systemic inflammation. While high anti-inflammatory diets and supplements can be used to aid in overall health, it is important to note that these changes may not impact the disease itself or symptoms associated with TGCT. Please Note: Dietary supplements are not approved by the FDA and cannot claim to treat any specific disease. It's important to consult with your healthcare provider prior to taking any supplements as they can impact other medicines you may be on and come with side effects.
One of the most common dietary supplements is turmeric. Turmeric is a spice that is part of the ginger family. Curcumin is the active ingredient within the spice that has anti-inflammatory, anti-microbial, anti-mutagenic, and anti-oxidant properties that has been used for thousands of years (1,2,3). Although turmeric has been around for a century, within the last two decades, it has been the subject of extensive research. Curcumin has been implicated in health benefits for the kidneys (4), pain (5), and anti-inflammatory conditions (6). Majority of the implicated health benefits can be attributed to the anti-inflammatory and anti-oxidant properties (7).
However, despite its benefit to overall health, a major challenge is the bioavailability. This means that when you consume turmeric or the curcumin extract, very little is able to get into your blood circulation and the majority is eliminated in your urine before it has a significant impact (8). Enhancing the influence of turmeric is of the utmost important to scientific research, therefore, studies have been underway to improve the circulating amounts of this supplement. According to the FDA, curcumin and turmeric is "Generally Recognized As Safe" (GRAS), making it commonly used amongst TGCT patients and patients with other diseases (7).
Mushrooms are considered a "superfood" with high anti-inflammatory components (9). Once metabolized, compounds within the mushroom have been implicated in antiviral, antibacterial, anti-tumor, and anti-inflammatory activities. Amino acids, such as leucine, tyrosine, arginine, and phenylalanine, found within the mushroom, particularly in oyster and enoki mushrooms, have been shown to decrease inflammation in cancer patients.
In a study done with breast cancer patients, arginine supplements showed a favorable immune system effect, body weight gain, and anticancer activities (10). Additional to the high quantity of beneficial amino acids found in mushrooms, other proteins that act as anti-oxidants have been found. For instance, lectin has been found in shiitake mushrooms and has shown anti-inflammatory properties in cancer (11). Other components of mushrooms have also been implicated in anti-inflammatory responses, such as polysaccharides.
A major challenge of using mushrooms as a treatment for inflammation or pain is that the quantity of these anti-oxidants and anti-inflammatory proteins vary drastically between mushroom and batches. It has been shown that season, weather, and environment can lead to variations in the expression of beneficial compounds (12).
Cruciferous vegetables are a family of vegetables that includes kale, brussel sprouts, broccoli, cabbage, bok choy, cauliflower, and other leafy greens. In animal studies, cruciferous vegetables and its metabolized compounds have been shown to lower inflammation (13). However, there is little data in human trials evaluating the clinical impact of these vegetables. The beneficial properties of vegetables are attributable to their anti-oxidant vitamins and phenolic compounds, such as sulforaphane.
Sulforaphane, a sulfur rich compound found in cruciferous veggies (especially broccoli) has been widely studied for its anti-inflammatory and anti-oxidant properties. It has been demonstrated that sulforaphane decreases oxidant and inflammatory proteins leading to protection against abberant cell growth and inflammation (14). This compound found in cruciferous veggies has been evaluated for strong protective effect against certain cancers (15). However, it has been shown that preparation of these veggies can influence the concentrations of sulforaphane. For instance, it has been shown that chopping and chewing of the vegetables promotes metabolism of sulforaphane by enzymes, while cooking these veggies on high heat can limit the systemically available sulforaphane and decrease metabolism (16).
This means that chopping and chewing the plant leads to higher concentrations that can be beneficial, while heating temperatures leads to a reduced benefit. It has also been found that refrigerating broccoli leads to a 16% decrease in the sulforaphane available, compared to a 79% reduction in sulforaphane in freshly harvested broccoli kept at room temperature (16). Therefore, the sale period, cooking technique, and storage of these cruciferous veggies could lead to significant loss in the beneficial sulforaphane.
References
1. Lestari MLAD, Indrayanto G. Chapter Three – Curcumin. In: Profiles of Drug Substances, Excipients and Related Methodology. ; 2014. 2. Wright L, Frye J, Gorti B, Timmermann B, Funk J. Bioactivity of Turmeric-derived Curcuminoids and Related Metabolites in Breast Cancer. Curr Pharm Des. 2013. doi:10.2174/1381612811319340013 3. Reddy RC, Vatsala PG, Keshamouni VG, Padmanaban G, Rangarajan PN. Curcumin for malaria therapy. Biochem Biophys Res Commun. 2005. doi:10.1016/j.bbrc.2004.11.051 4. Trujillo J, Chirino YI, Molina-Jijón E, Andérica-Romero AC, Tapia E, Pedraza-Chaverrí J. Renoprotective effect of the antioxidant curcumin: Recent findings. Redox Biol. 2013. doi:10.1016/j.redox.2013.09.003 5. Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study. Clin Interv Aging. 2014. doi:10.2147/cia.s58535 6. Aggarwal BB, Harikumar KB. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol. 2009. doi:10.1016/j.biocel.2008.06.010 7. Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: Lessons learned from clinical trials. AAPS J. 2013. doi:10.1208/s12248-012-9432-8 8. Anand P, Kunnumakkara AB, Newman RA, Aggarwal BB. Bioavailability of curcumin: Problems and promises. Mol Pharm. 2007. doi:10.1021/mp700113r 9. Muszyńska B, Grzywacz-Kisielewska A, Kała K, Gdula-Argasińska J. Anti-inflammatory properties of edible mushrooms: A review. Food Chem. 2018. doi:10.1016/j.foodchem.2017.09.149 10. Novaes MRCG, Valadares F, Reis MC, Gonçalves DR, Menezes M da C. The effects of dietary supplementation with Agaricales mushrooms and other medicinal fungi on breast cancer: Evidence-based medicine. Clinics. 2011. doi:10.1590/S1807-59322011001200021 11. Sarup Singh R, Preet Kaur H, Rakesh Kanwar J. Mushroom Lectins as Promising Anticancer Substances. Curr Protein Pept Sci. 2016. doi:10.2174/1389203717666160226144741 12. Elsayed EA, El Enshasy H, Wadaan MAM, Aziz R. Mushrooms: A potential natural source of anti-inflammatory compounds for medical applications. Mediators Inflamm. 2014. doi:10.1155/2014/805841 13. Jiang Y, Wu SH, Shu XO, et al. Cruciferous vegetable intake is inversely correlated with circulating levels of proinflammatory markers in women. J Acad Nutr Diet. 2014. doi:10.1016/j.jand.2013.12.019 14. Esteve M. Mechanisms Underlying Biological Effects of Cruciferous Glucosinolate-Derived Isothiocyanates/Indoles: A Focus on Metabolic Syndrome. Front Nutr. 2020. doi:10.3389/fnut.2020.00111 15. Bayat Mokhtari R, Baluch N, Homayouni TS, et al. The role of Sulforaphane in cancer chemoprevention and health benefits: a mini-review. J Cell Commun Signal. 2018. doi:10.1007/s12079-017-0401-y 16. Rungapamestry V, Duncan AJ, Fuller Z, Ratcliffe B. Effect of cooking brassica vegetables on the subsequent hydrolysis and metabolic fate of glucosinolates. In: Proceedings of the Nutrition Society. ; 2007. doi:10.1017/S0029665107005319
