Intestinal Distress

January 29, 2007 1:29 PM

Crohn's Disease and Mangosteen - snake oil or success?

I've in the process of beating a new diagnosed Crohn's disease flare-up into submission and have been reading a number of things about using mangosteen juice as a helper for prevention of future flare-ups.

After reading dozens of "articles" all of them raise my skeptic hackles as they appear to be thinly masked advertisements to sell product. I've found some research papers, but unfortunately my high school level understanding of organic chemistry and immunology makes critical assessment of these works near impossible for me.

The CCFA has no information at all and my gastroenterologist (who is pretty fly for a GI guy) knows nothing of it, which make me even more skeptical.

So what's the deal?

posted by plinth to health & fitness (12 comments total)

If it's not on Pubmed, it really doesn't exist in standard western medicine.
posted by NucleophilicAttack at 1:47 PM on January 29, 2007

I just checked Pubmed and there's nothing for colitis. There's some stuff about some of the compounds in mangosteen being investigated for antioxidant, anti-neoplasm, and anti-TB effects, but it's all still in the preliminary 'this works in the lab in a dish' stage.
posted by cobaltnine at 1:52 PM on January 29, 2007

Mangosteen is chock-full of antioxidants. Total antioxidant capacity is reduced in Crohn's disease. So eat mangosteen, or any number of other antioxidant-rich foods: antioxidant supplementation reduces oxidative stress. Mangosteen has a high xanthone content, but you need to make sure eat (or juice) the pericarp (fruit wall/rind) to get at it. As seen on Pubmed (search for mangosteen), they do seem to have anti-inflammatory benefits. Check out Noni^ juice as another potential selective COX-2 inhibitor.

There is the inflammatory component as well. Are you taking fish oil supplements yet? Costco has big 400-capsule bottles for a reasonable price (you should go through about a bottle a month!). But really, why not just fly to Cameroon and infest yourself with hookworm?
posted by chudder at 2:13 PM on January 29, 2007 [1 favorite has favorites]

mangosteen is a scam, no matter what it's being marketed as the cure-all for. These people are out to sell you overpriced juice, and nothing more. Avoid at all costs. The same goes for Tahitian Noni or any other "miracle supplement the medical establishment doesn't you to know about"!!11!1!11 eleventy.
posted by cosmicbandito at 2:14 PM on January 29, 2007

I'm a fellow Crohn's patient and biomedical researcher. I've combed the literature pretty extensively, and there is little clinical evidence that supports the use of most "alternative" treatments in CD. In fact, I've never even heard of the mangosteen claims until now, and am extremely skeptical. Do they have any clinical evidence? Any specifics about the mechanism for repression of CD symptoms? From what I saw, no. In summary, that site sets off my bullshit detector big-time.

The three "alternative" treatments that have some limited evidence to support their use are antibiotic treatment, probiotic supplements, and some types of dietary restriction. Again, evidence is very scanty and circumstantial at this point, and it's probably more likely than not that these treatments aren't going to work for you.

A good place to look for information is the wikipedia article on CD. It's actually very well-maintained, and reflects the current state of knowledge about the disease. The discussion page can actually be very informative too, as people talk about the differences between the proven therapies and the bullshit.
posted by chrisamiller at 2:44 PM on January 29, 2007 [1 favorite has favorites]

This treatment might be more effective, but hard to stomach.
posted by whimsicalnymph at 3:59 PM on January 29, 2007

While I appreciate the suggestions of worms and fish oil, that's really tangential to my question, and the fish oil, unfortunately is not a great idea for me since it is an activated protein C inhibitor and since I'm also on warfarin sodium (coumadin), is a generally bad idea without some careful monitoring.
posted by plinth at 4:52 PM on January 29, 2007

Mangosteen is not a bad fruit. It's pretty tasty, from what I hear. However, it's perfectly normal, and very pedestrian as far as fruits go: high in anti-oxidants, but not that incredible.

Mangosteen juice, however, has been the main product in one of the more popular and infamous multi-level marketing cons. It's been marketed by a company that calls it Xango.

There's some good info on the company here, but what you'll really want is this great article on why mangosteen juice isn't actually good at fighting any of the things they claim it does. Prognosis: "In my opinion, what we have here is simply an overpriced fruit drink."

Do not, for the love of God, pay $35 a bottle for this crap, as you might have been asked to.
posted by koeselitz at 6:32 PM on January 29, 2007 [1 favorite has favorites]

Not mangosteen-y, but related: my acupuncturist had very, VERY good results on a Crohn's patient who was not responding to the standard "Western" treatments. Have you tried acupuncture at all? She was using it combined with TCM (traditional Chinese medicine), if I remember right.

Mangosteen-y: Trader Joe's was selling freeze dried mangosteen for a while and it was really super tasty. I haven't seen it at mine lately -- have any of you?
posted by bitter-girl.com at 7:35 PM on January 29, 2007

I'm currently researching IBD, specifically the mechanism of action of various fruit extracts in the context of gut inflammation.

My quick pubmed search didn't show anything promising for mangosteen, and there are other fruits or plant extracts with a lot more evidence going for them. Many fruits are high in antioxidant activity and there isn't any reason to think this will directly help with IBD. Anti-inflammatory activity is more important and is often linked to anti-oxidant activity, and again many plant products do this. Mangosteen may be helpful but, based on current evidence, if you're going to try something like this you're probably better off with green tea extract, curcumin, blueberries, apples and kiwifruit (off the top of my head). All of which can be obtained without paying some MLM scheme or buying fancy products.

This article did look useful though, email me if you want a copy of the full text pdf. It's pretty brief and easy to understand, and seems balanced on quick skim through.

Diet is hugely important in IBD and these interactions are the basis of the whole research program I'm part of. But part of what we're looking at is how different dietary components work better or worse for different people, it's very individualised. We're trying to understand both the genetics of the disease and the biochemical interactions of the food so we can put them together and create diets that work. But we're a long way off that yet. In the meantime anything that claims to be a magical cure probably ... isn't.

What I do suggest is keeping a food diary. Write down both what you're eating and how you felt afterwards. Hopefully you can then link together good and bad foods for you specifically, and work out which foods are good for certain situations (e.g. kiwifruit often has a mild laxative effect which apparently many IBD patients find helpful).
posted by shelleycat at 8:12 PM on January 29, 2007 [1 favorite has favorites]

Oh. Maybe I should mention that Inflammatory Bowel Disease (IBD) has two subtypes, Crohn's Disease and ulcerative colitis. So when I said IBD above I was talking about Crohn's too. I'm currently studying both but hopefully the biochemistry will work out so that I can focus on CD because I find it's immunology more interesting.
posted by shelleycat at 8:19 PM on January 29, 2007

there isn't any reason to think this will directly help with IBD.

Arg, I should preview. Reading back over what I wrote that's a stronger statement than I intended. There aren't any big, obvious, strong reasons why general increase in anti-oxidants will directly affect the disease, although anti-oxidants may help less directly and/or there may be pathways involved that we aren't looking at yet. The biochemistry of these diseases is still unclear and more is being worked out all the time, so it's very difficult to say so far that something definitely won't work. Mangosteen, for example, certainly can't be ruled out, but it's far from proven as a good thing either.
posted by shelleycat at 8:25 PM on January 29, 2007