The FAP Gene Support Group

(Familial Adenomatous Polyposis)

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FAP Polyps Management

 

Yellow Curcumin C3 Complex

&

White Curcumin C3 Reduct
(Tetrahydrocurcumin)

A family trial starting with three teenagers since 2008

December 2017 update

 

A family of three teenagers with Familial Adenomatous Polyposis (FAP) managed to keep colonic polyp numbers down to a safe level for nearly ten years (March 2018).

In March 2008 our eldest son, at aged 14 years with 150 polyps started taking curcumin to stabilise his polyp count. December 2017 at age 23 his polyp count is 200 small polyps.
In August 2010 our second son then aged 15 years had a 100 polyp count and with a continued variable dose of curcumin and now, December 2017, at age 22 has a polyp count of 200 polyps or more.
August 2010 our daughter at age 13 years had a count of 60 polyps and now in December 2017 at age 20 years she has a polyp count of 150.

Their point mutation in the APC gene on chromosome 5 is in the ‘hotspot’ to disable the tumour suppressor gene, whereas in AFAP the tumour suppressor gene is partially disabled for polyps numbers to manifest a little later in life. They have inherited their mutation from myself the father of which I am the first case in the family line. At age 31 my bowel cancer had entered all but the last layer of the colon with cancerous polyps breaking away to become a pool of blood on the floor. It was at this stage in 1988 I discovered I had colon cancer and I was told I was lucky to still be alive for it was a matter of months before the cancer would have travel via the lymphatic system. FAP was not diagnosed until I had children later when my eldest son showing blood from his rectum. My surgeon of the time back in 1988 had only seen one other case of so many polyps in the colon and suspected a genetic cause. In his opinion the polyps found would have been in their thousands by age 22 for the colon to be so consumed at age 31 with such an advanced state of cancer. With this in mind, I am pleased with the dampening effect the curcumin is having in my own children for the polyp count to be into the lower hundreds and for there to be no pedunculated polyp type (polyps on stalks).

Over the years the curcumin dose has been raised from a low dose of 1-2g in 2008, to doses of up to 12g a day in adjustment to an age related polyp increase. We have noted that from age 16 the polyps expression seem to increase dramatically needing a higher dose of curcumin of 8g a day by the age of 18years.
Over nearly ten years of our curcumin use we have not only explored different dose amounts, but also have tried a combination of curcumin with EPA fish oil and a shift from yellow curcumin to the white tetrahydrocurcumin, (this being a more potent and in a smaller tablet form and it doesn’t stain) yet they can cause some discomfort in the belly with a rapid gas build up and much looser stools due to its potent nature. The curcumin and tetrahydrocurcumin we use is produced by Sabinsa.corp in their 'Sami Labs', Bangalore, India. To produce tetrahydrocurcumin the yellow curcumin goes through a longer process for the compound to enter the market as 'C3 Reduct' via supplement companies under their own label.

In our younger son we tried combining curcumin with highly concentrated EPA fish oil called 'Alfa capsules' supplied by SLA Pharma from 2012 to 2015. The results had shown some promise, yet unfortunately the supply of Alfa Capsules became limited in supply preventing a fair evaluation of results.
Our daughter was introduced to curcumin for FAP at 11 years old and 10 months at 1g a day did with neglible adverse effects. Her polyp count has remained stable at around 40-60 from 2010 to 2012, but under the spray dye colonoscopy in 2013 the numbers seem to have doubled. Yet we now realise this was due to the spray dye used which reveal microadenomas (small polyp hives) which are normally unseen with the naked eye without the dye. The spray dye allows consultants to gain insight of polyp development into the next 3 years or so, but for our yearly polyp comparison it became a little alarming at first when the polyp numbers apeer to double in 2013 when the dye revealed micro polyp bumps to be included into the count previously unseen in other colonoscopies.


A good example of curcumin efficacy can be seen in the 'Male 1' listing for 2012, whereby 300 polyps developed of which 200 had progressed into pedunculated type due to remaining on an earlier successful low dose of 2g a day between the years 2010 - 2012. This shows that between the ages 16 to 18 years the polyps elevated to an alarming level without being observed as the scope stretched to every 24 months. Following the alarming result, we increased the dose to 8g a day with a second colonoscopy scope taking place 6 months later. Remarkably the polyp count dropped by 200 down to 100 in total and of which 50 remained pedunculated. With polyps now back at a safe level, any previous discussions of surgery were dropped for our son to continue with his curcumin for a further 12 months. The experience gained from this alarming scenario gave us a clear indication that curcumin can actually reverse polyp numbers, the size and the type of polyps.

I hope the chart is helpful, and although polyp numbers seem to fluctuate a little due to different consultant's estimation, the polyp estimation is stable if the number increase is no more than a hundred. The key area to observe is the polyp type (pedunculated) and size. Pedunculated are when the polyps have stalks (like mushrooms) for these type have the potentially to becoming cancerous quickly. Any polyp size over 1cm is viewed with concern for these to be removed.

In December 2017 only the younger son has been viewed with concern for a few of his polyp size have increased to 9-12mm with 8 being removed. It just goes to show each individual can have a different rate of expression in a sibling group for this son has been the most regular in dose regime and yet produces a faster expression, whereas the other two have missed many doses, even for days and yet the polyp expression is far less alarming.


FAP Gene would like to thank Peter and his family for the information in this update

 Male 1
Eldest Son

Year Polyp Numbers Age Dose used to gain result

2008

100-150

x1 Removed

14

Yellow curcumin

2g –3g a day

(divided into four doses)

2008

(9months later)

150

x7 biopsied

14

Yellow curcumin

2grammes a day.

(500mg four times a day)

2010

50

all below 2mm

 

16

Yellow curcumin

2g a day

(500mg four times a day)

2012

250-300

x200 pedunculated

x 1 removed

 

18

Yellow curcumin

2g a day

(500mg four times a day)

2012

(6 months later)

100 (numbers drop due to increase of curcumin dose over 6 months)

x50 pedunculated

 

18

Yellow curcumin

8g a day

(Divided 3g ; 2g ; 3g )

Spray-dye used from 2013

Spray-dye is used to reveal microadenomas that would otherwise not be seen in previous colonoscopies.

The new comparison starts here.

 

 

 

 

2013

200-300 (numbers increase under dye )

zero pedunculated

 

19

Yellow curcumin

8g a day (3g; 2g; 3g)

2014

200+

zero pedunculated

x4 removed

20

white curcumin ‘C3 Reduct’

(Tetrahydrocurcumoid THC)

 

x5 400mg Reduct tablet

equal potency of

7.5g of Yellow curcumin)

2015

100+

zero pedunculated

few 5mm removed

21

White curcumin ‘C3 Reduct’

8 Reduct tablets (3200mg)

Equivalent potency of 12g of yellow curcumin

Plus tried Alfa capsules 2g (x4 capsules) for 6 months

2016

200 +

Small adenomas

none larger than 8mm

non removed

zero pedunculated

22

White curcumin ‘C3 Reduct’

8 Reduct tablets a day

Equivalent potency of 12g of yellow curcumin

1 tablet = 400mg

Zero Alfa

 

2017

200+
All 2mm - 3mm
Non removed

23

White curcumin ‘C3 Reduct’
(Tetrahydrocurcumin)
8 Reduct tablets a day.
(two tablets four times a day)

  Male 2

Youngest Son

Year Polyp Numbers Age Dose used to gain result

2010

80-100

x1 pedunculated

x 1 removed

15

1.5g a day (500mg three times a day)

2011

100

Biopsies taken

16

1.5g a day(500mg three times a day)

2012

100

x1 pedunculated removed

17

3g a day first 6 months then

6g a day

Spray-dye used from 2013

Spray-dye is used to reveal microadenomas that would otherwise not be seen in previous colonoscopies.

The new comparison starts here.

 

 

2013

200-300 (numbers increase under dye)

x 7 removed over 5mm

 

18

6g curcumin ( 2g three times a day)

 

Plus 1g Alfa capsules (x1 twice a day)

2014

150

x 2 removed over 5mm

19

8g curcumin ( 2g four times a day)

 

Plus 2g Alfa capsules (x1 four times a day for 10 months)

2015

150+

x5 reaching 1cm

Increasing numbers of

pedunculated up to 7mm

20

12g a day ( 3g four times a day)

 

Plus 1g / 2g Alfa capsules (for a 8 month duration)

2016

No estimated numbers given

Predominantly small flat polyps up to 6mm

A few up to 8mm

No pedunculated

21

White curcumin ‘C3 Reduct’

10 x tablets a day

Dose 2; 3; 3; 2 a day

Potentially potency 15g of yellow curcumin

1 tablet = 400mg

 

Zero Alfa

2017

200 +
Mostly small but an increasing number
of polyps 9mm – 12mm in size
8 removed.

22

White curcumin ‘C3 Reduct’
And
Yellow Curcumin C3 complex


10 white 400mg tablets a day
&
4 x Yellow 1000mg tablets a day

 

Female
Eldest Daughter

Year Polyp Numbers Age Dose used to gain result

2010

50-60

Several biopsies taken

13

1g a day (500mg twice a day)

2011

50-55

x16 pedunculated removed

14

1g a day (500mg twice a day)

2012

40 4 biopsies taken

Zero pedunculated

 

15

3-6g a day (1.5g- 3g twice aday)

Spray-dye used from 2013

Spray-dye is used to reveal microadenomas that would otherwise not be seen in previous colonoscopies. The new comparison starts here .

 

 

2013

100 (numbers double due to dye)

x 5 removed for biopsies

x2 semi-pedunculated

16

6ga day (3g twice a day)

2014

150

x6 removed over 5mm

Zero pedunculated

17

6g a day (3g twice a day)

2015

150+

x15 removed for the

Radcliffe Bio Bank (research )

Zero 1cm

Zero pedunculated

18

6g a day (2g three times a day)

 

Tried Alfa capsules x2 a day

1g for 6 months

 

2016

150+

The largest 8mm

 

Zero pedunculated

10-15 removed

 

19

10g a day (10 tablets)

doses

2g; 3g; 3g; 2g

 

(I tablet = 1g)

2017

200 +

The largest polyp size is 5mm
Non removed

 

20

first 6 months
8g a day of yellow
&
three 400mg white reduct
next 9 months of
10g – 12g yellow ( 10 – 12 tablets)

Non steroid anti-inflammatory drugs ‘NSAIDs’

Below I have included an image as a guide to sequence stages from an APC mutation to full colon carcinoma.

A non Steroid anti-inflammatory drug (NSAIDs) is a label that can cover many medicines or compounds. Examples of NSAID’s used in FAP research are sulindac, celecobix , asprin, Epa oil (alfa caps), and curcumin. There are research papers available which show how NSAID’s affect the development of polyps in FAP if you wish to explore more technical understanding, but for simplicity I have marked on the image various stages the NSAIDs have been reported to have efficacy.

You will find my illustration is compatible to many scientific research images used.

Link examples

http://syscol-project.eu/wp-content

http://www.scielo.br/img/revistas/ag/v42n2/a07fig02.gif/uploads/2011/11/abstor.gif

http://www.bu.edu/synapse/files/2011/01/cancerprogression.png

Curcumin Chart

 


There is no doubt curcumin has worked in suppressing polyp advance in our three children with FAP. A clear example of effective reversing of polyps is in our eldest son back in 2010. Due to a stable condition in 2008 on curcumin low dose he did not have his next surveillance until 2 years later. In this time his polyps elevated from 150 to 300 with 200 being pedunculated. This was a critical situation with so many pedunculated polyps (on stalks) Yet after raising the curcumin to 8g a day for 6months his polyp count reversed to only 100 with 50 pedunculated. This clearly confirmed curcumin had a leading effect on polyp expression, not only to hold back, but also reverse the polyp expression.

From our observation there is no fixed family inherited expression with each individual producing their own level of accelerated polyp development making it impossible to predict a fixed base dose per age. The FAP condition is relevant to the persons own metabolic expression as we have discovered between our two sons. One will miss many doses due to night shift work yet his polyps seem to be very stable, whereas our second son is more careful with his dose taking and even takes more per day yet has the most concerning expression of sizes (2017)

The yellow curcumin has given us some good results over the years to bring polyps down in size and numbers without health risks. The Tetrahydrocurcumin (white curcumin) has shown an equal effective method of management but more convenient in size and non-staining.

Alfa capsules we had hoped to take for a minimum of 3 years in combination of taking curcumin, but with supplies becoming a problem the experiment had to be terminated before we could get a clear picture.

Regarding curcumin side effects, in our experience, if a curcumin dose is introduced slowly at first, young teenagers can tolerate curcumin very well, even at high doses of 8g a day. The worst side effects are the looser stools, which may be resolved by eating an egg in the morning, and mild nausea or even stomach ache if taken on empty stomach - especially first thing in the morning.

White curcumin can be a little more difficult to tolerate due to its potency, but by introducing it very slowly over a longer period of time than yellow curcumin the dose can be acceptable, but unfortunately far more expensive to buy. It’s an excellent method if prescribed by a consultant.

Alfa capsules (concentrated EPA fish oil) have not caused any negative reactions, but once again avoid them on an empty stomach as they can cause some nausea. Also if you decide to bite the capsule, the epa oil can have a hot effect on the tongue due to the concentrated fish oil. In the UK these can be prescribed by a consultant.

Curcumin
The yellow curcumin we use is 'curcumin C3 complex' produced by Sabinsa.corp.
Sabinsa's Curcumin is sold under many known brand names with the links listed on this site:

Tetrahydrocurcumin
Tertahydrocurcumoid (THC) we use is called 'C3 Reduct' and visually differs from standard curcumin by appearing white.
In human consumption within the digestive system, the standard curcumin whilst in the human intestine it is converted into tetrahydrocurcumin by E. Coli. Curcumin, also metabolized by other reductive enzymes in human body to become a tetrahydrocurcumin, and the resulting tetrahydrocurcumin is responsible for various activities associated with curcumin in the body. For example THC is far more bio-available, easier to be absorbed, and potent. Sabinsa.corp takes the standard curcumin through a further process to produce the THC as if in the human digestive system.
The potency of THC can make it more upsetting to the stomach. We have found taking two tablets (800mg) comfortable, but taking three in one dose (1,200mg) can evoke a feeling of needing to go to the toilet after 90 minutes, either due to just gas bloating, or a genuine need to go to the toilet.
We can only recommend the use of the Sabinsa product as it is produced to a high standard, absent of microbes,and delivering 95% active curcumoids from processed Asian spice tumeric. Standard turmeric on the shelf only delivers approximately 5-10 % active curcumoids.
It is worth a note; UK human clinical trials in Leicester use the Sabinsa product due to its many years of proven high quality.

Contact Sabinsa.corp http://www.sabinsa.com/contact/contact-sabinsa-usa.aspx

Website Link http://www.sabinsa.com/products/standardized-phytoextracts/c3/

Website Link http://www.c3reduct.com/

Website Link http://www.sabinsa.com/products/faq/c3reduct

Alfa Capsules

Alfa capsules are a concentration of EPA fish oil produced at a high standard and supplied by SLA Pharma, available on prescription through a consultant.

Website Link http://www.slapharma.com/

More info of the clinical trial of Alfa EPA oil:

http://www.clinicaltrials.gov/ct2/show/NCT00432913?term=S.L.A%2BPharma&rank=4

We would like to thank the Oxford Genetic department for all their support and expertise in working with us to maintain a safe working practice in our personal exploration of curcumin& Alfa Capsules

An update will be in 12 months.

If anyone wishes to know more details, please contact Mick Mason who will forward my contact e mail

mickmason@fapgene.com

Mick Mason

Secretary

The FAP Gene Support Group