March 4, 2015

Enhanced Curcumin Supplements Might Pack Too Hefty a Punch for Some

In yesterday's post, I mentioned recent warnings about dietary supplements. Today I'll take a closer look at curcumin, the supplement I've been touting for several years.

A recent article on (a subscription site that offers non-commercial, science-based reports on the latest nutrition research) raised the latest cautions about curcumin.

Click here for the five-minute video on the report. Here's the summary:

Curcumin is a natural plant product extracted from the turmeric root. It's commonly used as a food additive, popular for its pleasant mild aroma and exotic yellow color. It enlivens curries and other dishes popular in India and elsewhere in Southeast Asia, like Nepal -- for years, my home away from home. When curcumin is used for culinary purposes, it is very unlikely to cause side effects.

Traditional Indian diets may include as much as a teaspoon of turmeric a day. But the curcumin supplements I've been discussing (and using) could provide the equivalent of 29 CUPS of turmeric a day. That's a lot of turmeric.

Extensive research confirms curcumin's efficacy as an anti-inflammatory agent with the potential for treating many diseases. Typically, experts suggest combining high-dose curcumin with black pepper or other substances designed to boost the botanical's bioavailability as much as 2000%.

A Warning about Supplements in General
Before addressing the specifics of curcumin, NutritionFacts debunks the widely accepted notion that complementary, alternative medicines offer safer therapies than prescribed meds:
Just because something is natural doesn't mean it's not toxic. Strychnine is natural; cyanide is natural. Lead, mercury, and plutonium are all elements -- can't get more natural than that! But turmeric is just a plant. Surely plants can't be dangerous? Tell that to Socrates.
We must remind ourselves and our patients that a therapy that exerts a biologic effect is, by definition, a drug and can have toxicity. It cannot be assumed that diet-derived agents will be innocuous when administered as pharmaceutical formulations at doses likely to exceed those consumed in the diet.
Cautions about Curcumin
Following flax and wheatgrass, turmeric is the third bestselling botanical dietary supplement, racking up $12 million in sales. Currently, sales are increasing at a rate of 20% annually.

NutritionFacts notes that studies have yet to show clear serious side effects from turmeric/curcumin supplements in the short term. But it cautions that the elevated levels in the enhanced supplements could be dangerous.

One of the NIH scientific studies cited by NutritionFacts included this abstract:
Turmeric root has been used medicinally in China and India for thousands of years. The active components are thought to be the curcuminoids, primarily curcumin, which is commonly available worldwide as a standardized extract. This article reviews the pharmacology of curcuminoids, their use and efficacy, potential adverse effects, and dosage and standardization. Pre-clinical studies point to mechanisms of action that are predominantly anti-inflammatory and antineoplastic, while early human clinical trials suggest beneficial effects for dyspepsia, peptic ulcer, inflammatory bowel disease, rheumatoid arthritis, osteoarthritis, uveitis, orbital pseudotumor, and pancreatic cancer. Curcumin is well-tolerated; the most common side effects are nausea and diarrhea. Theoretical interactions exist due to purported effects on metabolic enzymes and transport proteins, but clinical reports do not support any meaningful interactions. Nonetheless, caution, especially with chemotherapy agents, is advised. Late-phase clinical trials are still needed to confirm most beneficial effects.
NutritionFacts notes that this study cautions pregnant women not to take curcumin supplements. The only other contraindication cited was the supplement's potential to trigger gallbladder pain in individuals with gallstones.

If anything, NutritionFacts adds, curcumin may help protect liver function and help prevent gallstones by acting as a cholecystokinetic agent. The report notes curcumin might even protect against gall bladder cancer.

It also cautions against the use of curcumin supplements by people troubled by kidney stones. On the other hand, the report suggests that curcumin supplements might help treat gout inflammation.

Buying Curcumin Supplements
If you're thinking about taking a supplement, how do you choose? NutritionFacts suggests purchasing from Western suppliers that follow recommended Good Manufacturing Practices to decrease the likelihood of receiving adulterated products.

My Take on Curcumin Supplements
I'm glad I had a chance to run this cautionary report. Enter "curcumin" in the search box at the upper right and you'll see links to many posts about  the positive clinical trials involving curcumin supplements.

At the same time, I want to be careful not to become one of the many miracle cure hucksters -- like Dr.Oz and Dr. Mary Newport (the cheerleader for coconut oil as an Alzheimer's treatment). Taking any pill -- even one prescribed by a doctor -- carries risks. And clearly, the more pills you take, the greater the risks.

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