Thyroid node reduction with Spirulina, Curcumin and Boswellia? Perhaps.

reference

Stancioiu f, Mihai D, Papadakis GZ, Speidos da, Badiu C. Treatment of benign thyroid nodes with a combination of natural extracts. mol med rep. 2019; 20 (3): 2332-2338.

Study goal

to determine whether a combination of spirulina, curcumin and boswellia reduces the size of benign thyroid nodes

draft

prospective, double-blind, placebo-controlled clinical cross-over study with a period of 12 weeks

Intervention

placebo or a combination of spirulina (400 mg)/curcumin (50 mg)/ boswellia (50 mg) per capsule. No further information on the extract form/strength is listed in the study. The dose was 2 capsules twice a day about 30 minutes before breakfast and lunch.

participant

There were 34 participants; Half (17) of the participants received active ingredients (AI) and half (17) placebo (p).

inclusion criteria

Adult patients aged more than 18 years; Euthyreoter condition (within normal limits: thyrotropine [TSH] and free thyroxine 4 [ft _{4 ]); no active dysfunctional thyroid disease; individual benign thyroid node (between 2-5 cm), confirmed by fine needle aspiration biopsy (FNAB); No prior thyroid surgery, thyroid cancellation treatment or substitution treatment with thyroid hormones; no treatment with steroids or beta blockers; Presence of 1 or more thyroid nodes, documented by ultrasound.}

exclusion criteria

age under the age of 18, diagnosis suspicion of malignancy, Wilson's disease, hypo/hyperthyroidism, contraception with an intrauterine pessary (IUP), acute infection or well -known allergy to Spirulina, Curcumin or boswellia .

study parameters evaluated

The following parameters were assessed at 3 times:

• Baseline (V1): thyroid ultrasound (U/s) and TSH, ft 4 and serum copper mirror from the blood recording.
• Week 6 (V2): 17 patients who were previously treated with P received AI; 12 of the 17 patients who had previously received AI received P; and 5 randomly selected AI patients remained with AI. U/s and laboratories repeated.
• Week 12 (V3), that was the last visit with a final U/s and blood acceptance: 17 patients had received P-Ai, 12 patients had received AI-P and 5 patients had received AI-AI. U/s and laboratories repeated.

Primary result measurements

Primary result: Change the size of the participant's thyroid node, measurement of both the largest and the smallest diameter each time in the same angle of incidence and multiplication, in order to achieve an estimate of the surface (size = d x d).

Secondary result: Serum mirror of TSH, FT 4 and serum copper to see if a change occurred.

important knowledge

Primary result: The comparison of the node area at any time resulted in a total acceptance; V1 was 4.38 ± 3.14 cm2; V2 3.87 ± 2.79 cm2; and V3 3.53 ± 2.84 cm2 ( p <0.04).

of the total of 34 included subjects had 29 (85.29 %) a decrease in the thyroid node size of 5 % or more at the end of the study; In 22 patients, 10 % or more occurred after 3 months. A patient had an insignificant decrease in the size of the nodul and 4 patients had an enlargement of their nodules.

In some scenarios it is important to reduce benign thyroid nodes to avoid surgery, but there are several parameters that prescribe this.

The statistical analysis showed that the patients with AI had a reduction of 0.611 cm2 ± 0.933 (SD), but the authors give n = 39, although only 34 people ended the study. The placebo debt (n = 29) had an average acceptance of 0.178 cm2 ± 0.515 (SD). The reason for the 5 randomly selected subjects who did not change from AI to P were not explained and possibly distorted the statistics and the comparison between the groups.

practice implications

In some scenarios, it is important to reduce benign thyroid nodes to avoid surgery, but there are several parameters that prescribe this. Most clinicians know that a knot is generally monitored until he reaches certain criteria for surgery. The guidelines of the American Association of Clinical Endocrinology (AACE).

• class 1 - thyroid lesion with little risk. Mostly cystic, isoechoic/spongeForme nodes, regular halo.
• class 2 - thyroid lesion with medium risk. Slightly echo -poor nodules or isoechoic nodules with edges that are egg -shaped, round and smooth or poorly defined; Vascularization; Rand calcification; and echo -rich spots.
• class 3-high-risk thyroid lesions. Pronounced hypoechogenicity, microcalcifications, larger than wide, uneven edges and indications of extrathyroidal growth/adenopathy.

fnab is recommended for thyroid lesions with high U/s risk> 10 mm; Medium US risk> 20 mm; Low US risk> 20 mm and increasing size.

This study suggests that the use of a Spirulina/Curcumin/ boswellia extract for 3 months can reduce the size of benign thyroid nodes. Unfortunately, the study was financed by a company that will result in this in a combination product in the future. Although no researchers were apparently related to the company, the study was financed by this company; Therefore, there can be a certain distortion for positive results.

The exact formulation of natural active ingredients in the capsule was not clear in this study. Although it is assumed that Spirulina is a dried powder of the entire algae, there are many different types of curcumin and boswellia . The low dose used in this special formula can be explained or not by the extraction process, the amount of active ingredients (e.g. boswellic acids). This study is difficult to repeat and validate without the special features of the extractions used.

If the reduction of thyroid nodes is a helpful, advantageous result, this study seems to indicate that the study was effective.