Colorectal adenoma
Supplements studied for colorectal adenoma.
Overview
Colorectal adenoma prevention trials highlight mixed folate and B-vitamin findings versus clearer recurrence data for berberine. Folate and combined Vitamin B9 (Folate), Vitamin B6, and Vitamin B12 regimens have not consistently lowered adenoma incidence in large long-term studies of at-risk women.
Berberine 0.3 g twice daily for two years reduced adenoma recurrence by about 22% after polypectomy in Chinese trials. Green Tea extract and Selenium show mixed or subgroup-specific effects depending on sex and prior polyp history. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Berberine | ★★★★★ | Low |
| Vitamin B9 (Folate) | ★★★★★ | Very Low / None |
| Vitamin A | ★★★★★ | Low |
| Selenium | ★★★★★ | Low |
| Reishi | ★★★★★ | Low |
| Vitamin B6 | ★★★★★ | Very Low / None |
| Green Tea | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
7 supplements for and rated at least stars. All purchase bands. No minimum star filter.
BerberineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking berberine supplements may help prevent colorectal adenomas (precancerous growths) from coming back after they have been removed.
- Studies in Chinese patients found that taking berberine 0.3 grams twice daily for 2 years lowered the chance of adenomas returning by about 22% compared to a placebo.
- Follow-up research up to 6 years after stopping berberine showed continued benefit in reducing adenoma and colorectal growth recurrence.
- Berberine was safe and caused few side effects.
Browse 2 studies·1 meta-analysis
MetaEfficacy and safety of berberine in preventing recurrence of colorectal adenomas: A systematic review and meta-analysis2022n=1,076
A meta-analysis of 3 RCTs in 1,076 patients found 1–2 years of berberine lowered colorectal adenoma recurrence (RR 0.69 at 1 year; 0.75 at 2 years) with mostly mild constipation adverse events.
- Effect
- Benefit
- Duration
- 2 years
- Population
- Colorectal adenoma patients
- Participants
- 1,076
- Ages
- 1–2
RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma: a multicentre, double-blinded, randomised controlled study2020n=553
A multicenter RCT of 882 post-polypectomy adults found berberine 0.3 g twice daily for up to 2 years reduced adenoma recurrence 23% versus 36% on placebo (RR 0.77).
- Effect
- Benefit
- Dose
- 0.6 g/day
- Population
- Adults
- Participants
- 553
- Ages
- 18–75
SeleniumView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking selenium supplements for about 3 years does not seem to lower the risk of new colon or rectal polyps in most people.
- But selenium might help reduce polyp risk in people who had more serious polyps before.
- Some research shows that selenium combined with other vitamins and minerals may lower polyp risk, but it's not clear if selenium alone helps.
Browse 2 studies
RCTSelenium Supplementation for Prevention of Colorectal Adenomas and Risk of Associated Type 2 Diabetes2016n=1,621
In 1374 participants from the Sel/Cel trial, selenium 200 mcg/day for up to 33 months did not reduce colorectal adenoma recurrence versus placebo.
- Effect
- No Benefit
- Duration
- 33 months
- Dose
- 200 mcg/day
- Population
- Adults
- Participants
- 1,621
- Ages
- 40–80
RCTAntioxidant supplement and long-term reduction of recurrent adenomas of the large bowel. A double-blind randomized trial2013n=411
In 330 post-polypectomy patients over median 4 years, an antioxidant mix including 200 mcg selenium reduced adenoma recurrence risk by 39% versus placebo.
- Effect
- Benefit
- Duration
- 5 years
- Dose
- 30 mg
- Population
- Post-polypectomy patients
- Participants
- 411
- Ages
- 1–15
Vitamin AView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Vitamin A has only been tested together with other nutrients to prevent colon polyps.
- One study found that taking a daily supplement with vitamin A, selenium, zinc, vitamin C, and vitamin E for up to five years lowered the chance of colon polyps coming back by about 40%.
- It’s not clear exactly how much only taking vitamin A helps.
Browse 1 study
RCTAntioxidant supplement and long-term reduction of recurrent adenomas of the large bowel. A double-blind randomized trial2013n=411
In 330 post-polypectomy patients over median 4 years, an antioxidant mix including 200 mcg selenium reduced adenoma recurrence risk by 39% versus placebo.
- Effect
- Benefit
- Duration
- 5 years
- Dose
- 30 mg
- Population
- Post-polypectomy patients
- Participants
- 411
- Ages
- 1–15
Vitamin B9 (Folate)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Some research suggests that getting more folate might lower the risk of colon growths called adenomas, but most large studies do not support this.
- Taking folic acid supplements—either alone or with vitamins B6 and B12—for many years does not seem to reduce the risk of developing these growths.
- Using folic acid for more than 3 years may slightly increase the chance of more serious growths forming.
- Based on current evidence, folic acid supplements do not appear to help prevent colon adenomas.
Browse 12 studies·4 meta-analyses
RCTFolic acid prevents the initial occurrence of sporadic colorectal adenoma in Chinese older than 50 years of age: a randomized clinical trial2013
A randomized trial in adults found that 1 mg/day cRA occurred in 64 (14.88%) participants in the folic acid group and 132 (30.70%) in the control group [unadjusted risk ratio (RR), 0.49; 95% confidence interval (CI), 0.37-0.63; P < 0.01]; left-sided adenoma (unadjusted RR, 0.54; 95% CI, 0.38-0.76; P = 0.001) and advanced.
- Effect
- Benefit
- Dose
- 1 mg/day
- Population
- Adults
- Ages
- 50+
Meta[Folic acid supplementation and colorectal adenoma recurrence: systematic review]2012
A meta-analysis found that observational studies show that folate levels may be associated with the development of adenomas and colorectal cancer, suggesting that folic acid supplementation may have a preventive effect.
- Effect
- No Benefit
RCTEffect of combined folic acid, vitamin B(6), and vitamin B(12) on colorectal adenoma2012n=1,470
A randomized trial of 1470 women found that 2.5 mg the risk of colorectal adenoma was similar among participants receiving treatment (24.3%, 180 of 741 participants) vs placebo (24.0%, 175 of 729 participants) (multivariable adjusted relative risk = 1.00, 95% confidence interval = 0.83 to 1.20).
- Effect
- No Benefit
- Dose
- 2.5 mg
- Population
- Women
- Participants
- 1,470
ObservationalFolic acid and prevention of colorectal adenomas: a combined analysis of randomized clinical trials2011n=2,632
An observational study of 2632 adults found that 1.0 mg/day for 6–42 months the RR comparing folic acid versus placebo was 0.98 (95% CI = 0.82-1.17) for all adenomas and 1.06 (95% CI = 0.81-1.39) for advanced lesions.
- Effect
- No Benefit
- Duration
- 6–42 months
- Dose
- 1.0 mg/day
- Population
- Adults
- Participants
- 2,632
MetaFolic acid supplementation and colorectal cancer risk: a meta-analysis2011
A meta-analysis found that the risk associated with treatment was the highest for the occurrence of an advanced lesion (odds ratio 1.50, 95% confidence interval 1.06-2.10).
- Effect
- No Benefit
- Duration
- 3 years
MetaChemoprevention of colorectal cancer: systematic review and economic evaluation2010n=6,406
A UK systematic review of chemoprevention trials concluded calcium can reduce adenomatous polyps but noted limited direct CRC endpoint data and mixed evidence across micronutrients.
- Population
- Adults
- Participants
- 6,406
- Ages
- 50–60
MetaFolic acid supplementation for the prevention of recurrence of colorectal adenomas: metaanalysis of interventional trials2010n=775
A meta-analysis of 775 participants found that 1 mg/day however, the overall effect for all included studies was not significant [odds ratio = 0.78 (95% CI; 0.49, 1.24; P = 0.30)].
- Effect
- No Benefit
- Dose
- 1 mg/day
- Population
- Patients with history of colorectal adenomas
- Participants
- 775
MetaMeta-analysis: folic acid in the chemoprevention of colorectal adenomas and colorectal cancer2010
A meta-analysis found that there is no evidence that folic acid is effective in the chemoprevention of colorectal adenomas or colorectal cancer for any population.
- Effect
- No Benefit
RCTAspirin and folic acid for the prevention of recurrent colorectal adenomas2008n=945
A randomized trial of 945 patients with prior polyps found that 300 mg/day folate supplementation was found to have no effect on adenoma recurrence (relative risk, 1.07; 95% CI, 0.85-1.34).
- Effect
- No Benefit
- Duration
- 3 years
- Dose
- 300 mg/day
- Population
- Patients With Prior Polyps
- Participants
- 945
RCTFolic acid for the prevention of colorectal adenomas: a randomized clinical trial2007n=516
A randomized trial of 516 adults found that 1 mg/day during the first 3 years, 987 participants (96.7%) underwent colonoscopic follow-up, and the incidence of at least 1 colorectal adenoma was 44.1% for folic acid (n = 221) and 42.4% for placebo (n = 206) (unadjusted risk ratio [RR], 1.04; 95% confidence interval [CI],.
- Effect
- No Benefit
- Dose
- 1 mg/day
- Population
- Adults
- Participants
- 516
Folate intake, alcohol consumption, cigarette smoking, and risk of colorectal adenomas1998
A study in patients with at least one recent large-bowel adenoma found that alcohol intake (seven or more drinks/week) was associated with increased risk (odds ratio = 2.04; 95% confidence interval = 1.28-3.26).
- Effect
- No Benefit
- Population
- Patients With At Least One Recent Large-Bowel Adenoma
ObservationalMicronutrients and the risk of colorectal adenomas1996
An observational study of 236 found that folate appeared to be most protective, with women in the highest quartile only 40% as likely to develop adenomas compared with women in the lowest (odds ratio = 0.39, 95% confidence interval 0.15-1.01).
- Effect
- Benefit
- Population
- Adults
ReishiView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research indicates that taking reishi mushroom extract twice daily for a year may help reduce the number and size of colorectal adenomas compared to no treatment.
Browse 1 study
Controlled trialA water-soluble extract from culture medium of Ganoderma lucidum mycelia suppresses the development of colorectal adenomas2010n=123
In 123 adults with colorectal adenomas over 12 months, Ganoderma lucidum mycelia extract 1.5 g/day reduced adenoma recurrence versus no-treatment controls.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 1.5 g/day
- Population
- Patients with colorectal adenomas
- Participants
- 123
Green TeaView supplement →
Do not purchase·★★★★★
How we scored this▸
- Studies on green tea extract for preventing new colorectal adenomas after polyp removal show mixed results.
- One large trial found no clear overall benefit, but men might lower their risk by about 10% when taking green tea extract daily for several years.
- Smaller studies, especially in Asia, suggest green tea extract might reduce adenoma recurrence.
- Overall, green tea may help lower the chance of new polyps, but more research is needed to be sure.
Browse 2 studies
RCTGreen Tea Extract to Prevent Colorectal Adenomas, Results of a Randomized, Placebo-Controlled Clinical Trial2022n=879
In a 3-year RCT of 879 adults with prior colorectal adenomas, green tea extract 300 mg/day (150 mg EGCG twice daily) did not reduce recurrent adenoma rate versus placebo.
- Effect
- No Benefit
- Duration
- 3 years
- Dose
- 300 mg/day
- Population
- Adults
- Participants
- 879
RCTGreen tea extracts for the prevention of metachronous colorectal adenomas: a pilot study2008n=136
In a 12-month pilot RCT of 136 patients with prior colorectal adenomas, green tea extract 1.5 g/day did not reduce metachronous adenoma recurrence versus control.
- Effect
- No Benefit
- Duration
- 12 months
- Dose
- 1.5 g/day
- Population
- Adults
- Participants
- 136
Vitamin B6View supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking vitamin B6 by mouth does not seem to lower the chance of developing colorectal adenomas, which are precancerous growths in the colon.
- In a study of women with heart disease or higher risk, taking daily folic acid (2.5 mg), vitamin B6 (50 mg), and vitamin B12 (1 mg) for up to 9 years did not reduce their risk compared to taking a placebo.
Browse 1 study
RCTEffect of combined folic acid, vitamin B(6), and vitamin B(12) on colorectal adenoma2012n=1,470
A randomized trial of 1470 women found that 2.5 mg the risk of colorectal adenoma was similar among participants receiving treatment (24.3%, 180 of 741 participants) vs placebo (24.0%, 175 of 729 participants) (multivariable adjusted relative risk = 1.00, 95% confidence interval = 0.83 to 1.20).
- Effect
- No Benefit
- Dose
- 2.5 mg
- Population
- Women
- Participants
- 1,470
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Vitamin B9 (Folate) | ★★★★★44% | 12 | 4 | 57% |
| Berberine | ★★★★★48% | 2 | 1 | 10% |
| Green Tea | ★★★★★32% | 2 | 0 | 10% |
| Selenium | ★★★★★44% | 2 | 0 | 10% |
| Reishi | ★★★★★40% | 1 | 0 | 5% |
| Vitamin A | ★★★★★44% | 1 | 0 | 5% |
| Vitamin B6 | ★★★★★32% | 1 | 0 | 5% |