Enfermedad de Hashimoto

A 2020 Lancet Gastroenterology & Hepatology double-blind RCT (n=1,108) found berberine 0.3 g twice daily reduced colorectal adenoma recurrence from 47% to 36% (RR 0.77, p=0.001) over two years. A 6-year follow-up retrospective cohort confirmed persistent protective effects (34.7% vs. 52.1% recurrence). Berberine is also under active investigation for familial adenomatous polyposis.

A 2006 pilot clinical study in 5 FAP patients showed curcumin (480 mg) combined with quercetin (20 mg) three times daily for 6 months reduced polyp number by 60.4% and size by 50.9% (both p<0.05). A subsequent Johns Hopkins double-blind RCT (n=44, 3,000 mg/day, 12 months) found no significant difference in polyp number or size vs. placebo when curcumin was used alone. Evidence for curcumin is strongest in combination with quercetin for FAP.

A Korean randomized clinical trial found green tea extract (containing EGCG) reduced recurrent colorectal adenoma incidence from 31% to 15% at 1 year post-polypectomy. The MIRACLE trial (n=1,001, 41 German centres) examined 300 mg EGCG daily for 3 years after polypectomy. The J-FAPP Study I (2026, n=160 FAP patients) formally evaluated green tea extract (1.5 g/day, 2 years) for suppressing colorectal polyp development in FAP.

EPA (2 g/day as free fatty acid) demonstrated a significant 22.4% net decrease in rectal adenoma number and 29.8% cumulative reduction in adenoma size versus placebo in a Phase III double-blind RCT of FAP patients—comparable to celecoxib. The seAFOod Polyp Prevention trial (Lancet, 2018; n=709) found EPA reduced mean adenoma number per participant in sporadic high-risk post-polypectomy patients, though overall adenoma detection rate was not significantly reduced.

Green tea extract has been shown in a randomized clinical trial to reduce recurrence of colorectal adenomatous polyps from 31% to 15% at 1 year in post-polypectomy patients. Multiple large RCTs (MIRACLE, J-FAPP Study I) have formally investigated green tea extract for colorectal polyp prevention. The chemopreventive effect is attributed to EGCG.

I3C has direct human clinical evidence for reducing HPV-driven papillomas (polyp-like growths) of the respiratory tract. In RRP trials, approximately one-third of patients achieved full papilloma remission on I3C. For cervical polyp-like lesions (CIN II-III), a placebo-controlled trial showed complete regression in approximately 50% of I3C-treated patients versus 0% on placebo. Colonic adenoma/polyp evidence is preclinical and conflicting.

Omega-3 fatty acids, particularly EPA, demonstrated a 22.4% reduction in FAP rectal adenoma number and 29.8% in size in a Phase III RCT. Omega-3 fatty acids including DHA may also modulate nasal polyp inflammation by shifting eicosanoid production away from pro-inflammatory arachidonic acid-derived mediators. The seAFOod trial (n=709) confirmed EPA reduced mean colorectal adenoma number per participant in high-risk post-polypectomy patients.

In a 2006 pilot study of 5 FAP patients, the combination of curcumin (480 mg) and quercetin (20 mg) three times daily for 6 months reduced polyp number by 60.4% and polyp size by 50.9% (both p<0.05). Animal studies show quercetin reduces adenoma load in ApcMin/+ mice via IL-6/STAT3 pathway suppression. Quercetin is characterized as a chemopreventive candidate for colorectal polyps in multiple peer-reviewed reviews.

Preclinical studies show resveratrol significantly reduced polyp number in ApcMin/+ mice (15–30 mg/kg) and in azoxymethane-injected rats (10–100 mg/kg) via LEF1 downregulation in the Wnt/β-catenin pathway. In vitro screening of 1,309 FDA-approved compounds using colorectal adenoma patient-derived organoids identified resveratrol as the strongest inhibitor of adenoma growth. Resveratrol also synergizes with curcumin against colorectal cancer cells in vivo.

In ApcMin/+ mouse models, dietary sulforaphane (300–600 ppm/day) significantly reduced intestinal polyp number and size in a dose-dependent manner via apoptosis induction. Epidemiological evidence shows the protective effect of high cruciferous vegetable (sulforaphane-rich food) intake against colorectal adenomas is concentrated in individuals with GSTM1-null genotype. Laboratory studies consistently classify sulforaphane as a potent anti-cancer substance in colon cancer prevention.

Observational data show a protective association between vitamin D supplementation and high-risk colorectal adenoma (OR 0.57 in one study). A 2019 study confirmed 25-hydroxyvitamin D deficiency in nasal polyposis; 4,000 IU/day post-surgery has been associated with reduced nasal polyp recurrence. However, the Vitamin D/Calcium Polyp Prevention Study (n=2,259, 3–5 years) and the VITAL trial (n=25,871) both failed to show significant reduction in colorectal adenoma recurrence with vitamin D supplementation.