Turmeric (Curcuma longa Linn.) and Curcumin

Background
Synonyms
Evidence
Dosing
Safety
References

Turmeric (Curcuma longa Linn.) and Curcumin

Background

The rhizome (root) of turmeric ( Curcuma longa Linn.) has long been used in traditional Asian medicine to treat gastrointestinal upset, arthritic pain, and "low energy." Laboratory and animal research has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties of turmeric and its constituent curcumin. Preliminary human evidence, albeit poor quality, suggests possible efficacy in the management of dyspepsia (heartburn), hyperlipidemia (high cholesterol), and scabies (when used on the skin). However, due to methodological weaknesses in the available studies, an evidence-based recommendation cannot be made regarding the use of turmeric or curcumin for any specific indication.

Synonyms

Amomoum curcuma, anlatone (constituent), Curcuma, Curcuma aromatica , Curcuma aromatica salisbury, Curcuma domestica , Curcuma domestica valet, Curcuma longa rhizoma, Curcuma oil, curcumin (I, II, III), curcumin, diferuloylmethane, E zhu, Gelbwurzel, gurkemeje, Haldi, Haridra, Indian saffron, Indian yellow root, Jiang huang, kunir, kunyit, Kurkumawurzelstock, Kyoo, Olena, Radix zedoaria longa, Rhizome de curcuma, safran des Indes, shati, turmeric root, tumerone (constituent), Ukon, yellowroot, Zedoary, Zingiberaceae (family) , zingiberene (constituent), Zitterwurzel.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*Cancer
Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Reliable human studies are lacking in this area. It remains unclear if turmeric or curcumin has a role in preventing or treating human cancers.

C

Dyspepsia (heartburn)
Turmeric has been traditionally used to treat stomach problems (like indigestion from a fatty meal). There is preliminary evidence that turmeric may offer some relief from these stomach problems. However, at high doses or with prolonged use, turmeric may actually irritate or upset the stomach. Reliable human research is necessary before a recommendation can be made.

C

Peptic ulcer disease (stomach ulcer)
Turmeric has been used historically to treat stomach and duodenal ulcers. However, at high doses or with prolonged use, turmeric may actually further irritate or upset the stomach. In animals, turmeric taken by mouth protects against ulcers caused by irritating drugs or chemicals, and increases protective mucus. Currently, there is not enough human evidence to make a firm recommendation, and well-designed studies comparing turmeric with standard medical therapies are needed. Notably, the bacteria H. pylori are a common cause of ulcers, and treatment for these bacteria should be considered by people with ulcers, in consultation with a qualified healthcare provider.

C

Gallstone prevention/bile flow stimulant
It has been said that there are fewer people with gallstones in India, which is sometimes credited to turmeric in the diet. Early animal studies report that curcumin, a chemical in turmeric, may decrease the occurrence of gallstones. Limited human research suggests that curcumin may stimulate squeezing (contraction) of the gallbladder and stimulate bile flow. However, reliable human studies are lacking in this area. The use of turmeric may be inadvisable in patients with active gallstones.

C

High cholesterol
Animal studies suggest that turmeric may lower levels of low-density lipoprotein ("bad cholesterol") and total cholesterol in the blood. Preliminary human research suggests a possible similar effect in people. Better human studies are needed before a recommendation can be made.

C

Inflammation
Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin. Reliable human research is lacking.

C

Osteoarthritis
Turmeric has been used historically to treat rheumatic conditions. Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin, which may be beneficial in people with osteoarthritis. Reliable human research is lacking.

C

Rheumatoid arthritis
Turmeric has been used historically to treat rheumatic conditions, and based on animal research may reduce inflammation. Reliable human studies are necessary before a recommendation can be made in this area.

C

Scabies
Historically, turmeric has been used on the skin to treat chronic skin ulcers and scabies. It has also been used in combination with the leaves of the herb Azadirachta indica ADR or "Neem." Preliminary research reports that this combination may help in treatment of scabies. It remains unclear if turmeric alone has beneficial effects. More research is necessary before a firm recommendation can be made.

C

HIV
Several laboratory studies suggest that curcumin, a component of turmeric, may have activity against HIV. However, reliable human studies are lacking in this area.

C

Uveitis (eye inflammation)
Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin. A poorly designed human study suggests a possible benefit of curcumin in the treatment of uveitis. Reliable human research is necessary before a firm conclusion can be drawn.

C

* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Alzheimer's disease, antifungal, antispasmodic, anti-venom, appetite stimulant, asthma, bleeding, bloating, boils, bruises, cataracts, colic, contraception, cough, diabetes, diarrhea, dizziness, increased sperm count/motility, epilepsy, gallstones, gas, gonorrhea, heart damage from doxorubicin (Adriamycin®, Doxil®), hepatitis, high blood pressure, insect bites, insect repellent, jaundice, kidney disease, leprosy, pain, parasites, ringworm, lactation stimulant, liver protection, menstrual pain, menstrual period problems/lack of menstrual period, liver damage from toxins/drugs.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Turmeric may be standardized to contain 95% curcuminoids per dose. The dried root of turmeric is reported to contain 3% to 5% curcumin.

Turmeric may be combined with bromelain, because it is believed that this will enhance absorption of turmeric into the body. A lipid base of lecithin, fish oils, or essential fatty acids may also be used to enhance absorption. Additional benefit from these special formulations is not proven.

Adults (18 years and older)

Oral (by mouth) : Traditional doses range from 1.5 to 3 grams of turmeric root daily, divided into several doses. Studies have used 750 milligrams to 1.5 grams of turmeric daily in three to four divided doses, with doses up to 8 grams daily used for the treatment of duodenal ulcer. As a tea, 1 to 1.5 grams of dried root may be steeped in 150 milliliters of water for 15 minutes, and taken twice daily. Average dietary intake of turmeric in the Indian population may range between 2 to 2.5 grams, corresponding to 60 to 200 milligrams of curcumin daily.

Topical (for treatment of scabies) : One reported method is to cover affected areas once daily with a paste consisting of a 4:1 mixture of Azadirachta indica ADR ("Neem") to turmeric, for up to 15 days. Scabies should be treated under the supervision of a qualified healthcare provider.

Children (younger than 18 years)

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Allergic reactions to turmeric may occur, including contact dermatitis (an itchy rash) after skin or scalp exposure. People with allergies to plants in the Curcuma family are more likely to have an allergic reaction to turmeric. Use cautiously in patients allergic to turmeric or any of its constituents (including curcumin), to yellow food colorings, or to plants in the Zingiberaceae (ginger) family.

Side Effects and Warnings

Turmeric may cause an upset stomach, especially in high doses or if given over a long period of time. Heartburn has been reported in patients being treated for stomach ulcers. Since turmeric is sometimes used for the treatment of heartburn or ulcers, caution may be necessary in some patients. Nausea and diarrhea have also been reported.

Based on laboratory and animal studies, turmeric may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Limited animal studies show that a component of turmeric, curcumin, may increase liver function tests. However, one human study reports that turmeric has no effect on these tests. Turmeric or curcumin may cause gallbladder squeezing (contraction) and may not be advised in patients with gallstones. In animal studies, hair loss (alopecia) and lowering of blood pressure have been reported. In theory, turmeric may weaken the immune system, and should be used cautiously in patients with immune system deficiencies.

Pregnancy and Breastfeeding

Historically, turmeric has been considered safe when used as a spice in foods during pregnancy and breastfeeding. However, turmeric has been found to cause uterine stimulation and to stimulate menstrual flow, and caution is therefore warranted during pregnancy. Animal studies have not found turmeric taken by mouth to cause abnormal fetal development.

References

1. Aggarwal BB, Kumar A, Bharti AC. Anticancer potential of curcumin: preclinical and clinical studies. Anticancer Res 2003;23 (1A) :363-398.

2. Braga ME, Leal PF, Carvalho JE, et al. Comparison of yield, composition, and antioxidant activity of turmeric (Curcuma longa L.) extracts obtained using various techniques. J Agric Food Chem 2003;51(22):6604-6611.

3. Chainani-Wu N. Safety and Anti-Inflammatory Activity of Curcumin: A Component of Tumeric (Curcuma longa). J Altern Complement Med 2003;9(1):161-168.

4. Deodhar SD, Sethi R, Srimal RC. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632-634.

5. Di GH, Li HC, Shen ZZ, et al. [Analysis of anti-proliferation of curcumin on human breast cancer cells and its mechanism]. Zhonghua Yi Xue Za Zhi 2003;83(20):1764-1768.

6. Gao C, Ding Z, Liang B, et al. [Study on the effects of curcumin on angiogenesis]. Zhong Yao Cai 2003;26(7):499-502.

7. Kositchaiwat C, Kositchaiwat S, Havanondha J. Curcuma longa Linn. in the treatment of gastric ulcer comparison to liquid antacid: a controlled clinical trial. J Med Assoc Thai 1993;76(11):601-605.

8. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double- blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33(1-2):91-95.

9. Leu TH, Su SL, Chuang YC, et al. Direct inhibitory effect of curcumin on Src and focal adhesion kinase activity. Biochem Pharmacol 2003;66(12):2323-2331.

10. Ohashi Y, Tsuchiya Y, Koizumi K, et al. Prevention of intrahepatic metastasis by curcumin in an orthotopic implantation model. Oncology 2003;65(3):250-258.

11. Rasyid A, Lelo A. The effect of curcumin and placebo on human gall-bladder function: an ultrasound study. Aliment Pharmacol Ther 1999;13(2):245-249.

12. Rithaporn T, Monga M, Rajasekaran M. Curcumin: a potential vaginal contraceptive. Contraception 2003;68(3):219-223.

13. Satoskar RR, Shah SJ, Shenoy SG. Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24(12):651-654.

14. Taher MM, Lammering G, Hershey C, et al. Curcumin inhibits ultraviolet light induced human immunodeficiency virus gene expression. Mol Cell Biochem 2003;254(1-2):289-297.

15. Thamlikitkul V, Bunyapraphatsara N, Dechatiwongse T, et al. Randomized double blind study of Curcuma domestica Val. for dyspepsia. J Med Assoc Thai 1989;72(11):613-620.

16. Van Dau N, Ngoc Ham N, Huy Khac D, et al. The effects of a traditional drug, turmeric (Curcuma longa), and placebo on the healing of duodenal ulcer. Phytomed 1998;5(1):29-34.

January 01, 2004