DISCUSSION
sepsis, critically ill, dysmenorrhea
CRITICALLY ILL, PMS, NONALCOHOLIC FATTY LIVER DISEASE, DYSMENORRHEA, SEPSIS, INFLAMMATORY RESPONSE
To the best of our knowledge, this study is the first clinical trial that has investigated the effects of CUR intervention on inflammatory markers and iron profile in women with both PMS and dysmenorrhea. Our study demonstrated that 3 successive menstrual cycle administration of oral CUR had considerable effect on hsCRP levels which decreased significantly in the CUR group by within‐groups analyses. CUR had no significant effect on measures of iron homeostasis in healthy women with PMS and dysmenorrhea.In our study, CUR oral supplements significantly reduced serum hsCRP levels. The results of two randomized clinical trial disclosed that nano‐formulate of CUR significantly mitigated mean serum hsCRP levels in patients with nonalcoholic fatty liver disease (Jazayeri‐Tehrani et al., The anti‐inflammatory effects of CUR might be associated with its phytochemical compounds. The potential positive effect of CUR on inflammatory response may be because of the modulatory effect of CUR on inflammatory signaling paths. It prohibits myeloid differentiation protein 2‐Toll‐like receptor 4 co‐receptor axes, induces peroxisome proliferator activated receptor‐γ (PPAR‐γ), suppresses the induction and phosphorylation of JAK/STAT proteins, and blocks mitogen activated protein kinase (MAPKs) cascade (Aggarwal et al., Since hs‐CRP has a non‐normal distribution, most studies present it as median (25th, 75th percentile) or apply log transformation or divide it into quartiles or quintiles for comparison (Rogowski et al., CUR had no significant effect on inflammatory hemogram parameters in this trial. Results of recent randomized clinical trial on critically ill patients with sepsis failed to demonstrate the nano‐curcumin had beneficial effect on NLR and PLR compared to placebo (Naeini et al., Our results indicate that three menstrual cycle CUR administration did not alter iron status in healthy women with PMS and dysmenorrhea. We evaluated iron status by measuring serum iron, ferritin and TIBC levels in our cases because decreased iron status was reported post long‐time curcuminoid feeding in previous in vivo studies (Chin et al., CUR acts as a free radical scavenger because of the enol form being a hydrogen donor or acceptor and has been reported to neutralize the detrimental effects of iron‐induced ROS generation (Ferrari et al., This was a sub‐study of our previous triple‐blinded controlled trial on CUR's effects on menstrual‐associated manifestations in young women with PMS and dysmenorrhea (Bahrami et al., 