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Food supplements

Question
Dear experts,

Our son is two years old, is very pancreatic insufficient however otherwise one does not notice anything (yet). We are very faithful in following the conventional medicine therapy, and we will pursue it in any case like recommended. Now we ask ourselves, if we could do probably additionally "even more":
What do you think about curcumin, krill oil and MSM (methylsulphonylmethan) as complementary therapy in case of CF?
Even if some studies do not show any effect - could these perparations harm if they indeed do not have any effect? Thus, more concrete: does anything speak against a trial with these preparations?
If it cannot harm: which preparations and which dosage could we try in case of our son?
Many thanks!
Answer
Dear questioner,
nothing speaks against the intake of curcumin, krill oil and MSM in addition to the therapeutic recommendations of your CF center. Please be aware of the fact, that the dosage recommendations for food supplements in case of toddlers/children are very vague, if present at all.

To the single substances:

Krill oil: it contains a high part of omega-3 fatty acids, whereof 18% belong to the DHA (docosahexaenoic acid). The study situation is quite unclear: few studies suggest a superiority of krill oil in comparison to fish oil, others however did not show significant differences in the parameters of oxidative stress and inflammatory reactions. At the age of two years an intake of omga-3 fatty acids of 0.5% of the whole energy intake is recommended. That would mean with an intake of 1265 kcal (115% of the DACH reference value for energy intake [translator’s comment: DACH stands for the three countries Germany, Austria and Switzerland whose nutritional societies published cooperatively reference values on the nutrient intake] ), 0.7 g of omega-3 fatty acids (EPA + DHA). There are no concerns against the intake of up to 3 g per day (for adults!! US Food and Drug Administration).

Curcumin: an increased intake can lead to stomach ache and increase the bile flow. This is very problematic in case of patients with gall stones or narrowing of the bile ducts. Otherwise there are no side effects. On the natural way it is absorbed with the fat of the food, so that it has to be paid attention to a sufficient pancreatic enzyme substitution. The bio-availability of the substance is rather small, as it is on the one hand not well water-soluble and on the other hand it is degraded fast and is excreted via the liver. On the market there are preparations by now that are water-soluble. The effect of these preparations is however quite controversial if compared to the natural curcumin.
The WHO recommends a maximum of 0.3mg curcumin per kg body weight (for adults!!).

MSM: there is no recommendation for the dosage administered to children, only the statement, to adjust the dosage accordingly. For adults the dosage orientates to the field of application and varies between 0.5 and 8 grams daily. There seem to be no interactions between other drugs.

Concerning your question about concrete preparations: get information at a pharmacy you trust. Probably some preparations are also available in health stores.
I hope to have helped you and stay with my best regards,

Suzanne van Dullemen
06.05.2015