Sulforaphane+ by Advanced Orthomolecular Research USA

POSSIBLY EFFECTIVE

• Colorectal cancer. Consumption of cruciferous vegetables, including broccoli, seems to reduce the risk of developing colorectal cancer. Details: Epidemiological research has found that the highest intakes of cruciferous vegetables, including broccoli, are associated with an 18% to 20% reduced risk of developing colorectal neoplasms when compared with the lowest intakes (14148,96187,96189).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Bladder cancer. It is unclear if consumption of broccoli reduces the risk of developing bladder cancer. Details: Epidemiologic research has found that eating about 1.75 cups daily of cruciferous vegetables, such as broccoli or cabbage, is associated with a 30% reduced risk of developing bladder cancer (14864).
• Breast cancer. It is unclear if consumption of broccoli reduces the risk of developing breast cancer. Details: Epidemiological research has found that consumption of broccoli is associated with a modestly reduced risk of developing breast cancer in premenopausal adults. However, broccoli consumption does not seem to be associated with breast cancer risk in postmenopausal adults (14146).
• Fibromyalgia. Broccoli has only been evaluated in combination with ascorbigen; its effect when used alone is unclear. Details: A small clinical study in females with fibromyalgia shows that taking one capsule containing ascorbigen 100 mg and broccoli powder 400 mg once daily for one month improves pain by 18% and reduces physical impairment by 20% when compared with baseline (19605). It is unclear if this effect is due to broccoli, ascorbigen, or the combination. The validity of these findings is limited by the lack of a comparator group.
• Gastric cancer. It is unclear if consumption of broccoli reduces the risk of developing gastric cancer. Details: A small epidemiological study has found that higher consumption of broccoli is associated with a reduced risk of developing gastric cancer when compared with lower consumption (14148).
• Hypercholesterolemia. Broccoli has only been evaluated in combination with cabbage; its effect when used alone is unclear. Details: A small clinical study in patients with mild to moderate hypercholesterolemia shows that consuming 160 grams of a beverage containing broccoli, cabbage, and fruit twice daily for 12 weeks reduces levels of low-density lipoprotein (LDL) cholesterol by 8.5% when compared with baseline. It is unclear if the improvement from baseline differed when compared with those consuming a similar beverage without broccoli and cabbage (19607). It is unclear if this effect is due to broccoli, cabbage, or the combination.
• Prostate cancer. It is unclear if consumption of broccoli reduces the risk of developing prostate cancer; the available research is conflicting. In patients with prostate cancer, broccoli has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Some epidemiological research has found that consumption of Brassica vegetables, such as broccoli, Brussels sprouts, cauliflower, and cabbage, is associated with a reduced risk of developing prostate cancer (14145). However, other epidemiological research has found no association (14147,15172). Clinical research in adults with prostate cancer shows that taking a whole food formulation containing broccoli powder 100 mg, turmeric powder 100 mg, pomegranate whole fruit powder 100 mg, and green tea extract 20 mg three times daily for 6 months prevents an increase in prostate specific antigen (PSA) levels. Mean PSA levels increased by 15% in the whole food formulation group, compared with 79% in the placebo group. Also, 46% of those taking the whole food formulation showed final PSA levels that were the same or lower than initial PSA levels, compared with 14% of those in the placebo group (89730). However, it is not yet known whether the whole food formulation reduces the risk of prostate cancer progression or recurrence. It is unclear if these effects are due to broccoli, other ingredients, or the combination. More evidence is needed to rate broccoli for these uses.

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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Cardiovascular disease (CVD). Although there has been interest in using oral wasabi to prevent CVD, there is insufficient reliable information about the clinical effects of wasabi for this purpose.
• Chronic fatigue syndrome (CFS). It is unclear if oral wasabi is beneficial for myalgic encephalomyelitis/chronic fatigue syndrome. Details: A very small open-label clinical study in adults with myalgic encephalomyelitis/chronic fatigue syndrome shows that taking a wasabi extract containing 3.2 mg of the 6-(methylsulfinyl) hexyl isothiocyanate constituent 3 times a day for 12 weeks modestly improves some scores related to fatigue and the frequency of myalgia and headache when compared to baseline (112845). However, the validity of this study is limited by the lack of a comparator group.
• Dyspepsia. Although there has been interest in using oral wasabi for dyspepsia, there is insufficient reliable information about the clinical effects of wasabi for this purpose.
• Fatigue. It is unclear if oral wasabi is beneficial for fatigue. Details: A small open-label clinical study in healthy adults experiencing fatigue shows that taking wasabi extract 600 mg (containing 4.8 mg of 6-(methylsulfinyl) hexyl isothiocyanate, a constituent of wasabi) daily for 4 weeks improves self-reported scores of fatigue and some factors related to mood when compared to baseline. Oral wasabi extract also improves self-reported scores regarding sleep (e.g., quality of sleep, sleepiness after rising) (112846). However, the validity of these findings is limited by the lack of a comparator group.
• Irritable bowel syndrome (IBS). Although there has been interest in using oral wasabi for IBS, there is insufficient reliable information about the clinical effects of wasabi for this purpose.
• Osteoporosis. Although there has been interest in using oral wasabi for osteoporosis, there is insufficient reliable information about the clinical effects of wasabi for this purpose. More evidence is needed to rate wasabi for these uses.

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LIKELY SAFE ...when used orally in food amounts (14145). There is insufficient reliable information available about the safety of broccoli when used in medicinal amounts.

PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in food amounts (14145). There is insufficient reliable information available about the safety of broccoli when used in medicinal amounts during pregnancy and lactation; avoid using.

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LIKELY SAFE ...when used orally in food amounts (29994). When used orally and appropriately in medicinal amounts, short-term, wasabi extract 600 mg once daily has been safely used for up to 4 weeks (112846).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.  Details Pharmacokinetic research in humans shows that eating 500 grams of fresh broccoli daily for 6-12 days can increase CYP1A2 activity by 10% to 200% (19608,95722). Induction of CYP1A2 activity by broccoli is attributed to its glucosinolate constituents (19608).

CYTOCHROME P450 2A6 (CYP2A6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP2A6.  Details Pharmacokinetic research in humans shows that eating 500 grams of broccoli daily for 6 days increases CYP2A6 activity by 135% to 550%. Induction of CYP2A6 activity is attributed to its glucosinolate constituents (19608).

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, wasabi might increase the risk of bleeding with anticoagulant or antiplatelet drugs.  Details In vitro research shows that 6-(methylsulfinyl) hexyl isothiocyanate, a constituent of wasabi, inhibits platelet aggregation (29143).

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General ...Broccoli is well tolerated when consumed as food. A thorough evaluation of safety outcomes when broccoli is taken as medicine has not been conducted.

Dermatologic ...Topically, allergic reactions to broccoli have caused contact dermatitis (14158).

Hepatic ...In one case report, a 56-year-old adult developed elevated transaminases, with alanine aminotransferase (ALT) 5. 8 times above normal, aspartate aminotransferase (AST) 2.4 times above normal, and gamma-glutamyl transpeptidase (GGT) 5.1 times above normal. This was thought to be related to the consumption of 800 mL of broccoli juice daily over a 4-week period. Values returned to normal 15 days after cessation of juice consumption (96191).

Immunologic ...Topically, allergic reactions to broccoli have caused contact dermatitis (14158).

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General ...Orally, wasabi seems to be well tolerated in medicinal amounts.

Endocrine ...A small clinical study in adults taking oral wasabi extract 2000 mg once daily for 4 weeks has found 1 case of ketone bodies in the urine (112846).

Hepatic ...A small clinical study in adults taking oral wasabi extract 1000 mg once daily for 4 weeks has found 1 case of mildly elevated alanine transaminase and aspartate transaminase levels (112846).

Musculoskeletal ...A small clinical study in adults taking oral wasabi extract 2000 mg once daily for 4 weeks has found 1 case of elevated creatine phosphokinase (112846).

Renal ...A small clinical study in adults taking oral wasabi extract 1000 mg once daily for 4 weeks has found 2 cases of proteinuria (112846).

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