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Turmeric/Curcumin

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. Currently it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area. C
Dyspepsia (heartburn)

Date:   2/13/2006 9:52:21 PM   ( 15 y ) ... viewed 5803 times

Turmeric (Curcuma longa Linn.) and Curcumin

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.

SynonymsReturn to top

Amomoum curcuma, anlatone (constituent), CUR, Curcuma, Curcuma aromatica , Curcuma aromatica salisbury, Curcuma domestica , Curcuma domestica valet, Curcuma longa , 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 oil, turmeric root, tumerone (constituent), Ukon, yellowroot, Zedoary, Zingiberaceae (family), zingiberene (constituent), Zitterwurzel.

Selected combination products: Smoke Shield is a proprietary formulation containing extract of turmeric ( Curcuma longa ), obtained by supercritical carbon dioxide gas extraction and post-supercritical hydroethanolic extraction, together with extracts of green tea and other spices whose presence synergistically increases the activity of turmeric.

EvidenceReturn to top

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 evidence
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. Currently it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area. 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;
F: Strong scientific evidence against this use.

Grading rationale
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, antimicrobial, antispasmodic, anti-inflammatory, anti-venom, appetite stimulant, asthma, bleeding, bloating, boils, bruises, cataracts, cervical cancer, colic, contraception, cough, cystic fibrosis, diabetes, diarrhea, dizziness, increased sperm count/motility, epilepsy, gallstones, gas, gastric cancer, gonorrhea, heart damage from doxorubicin (Adriamycin®, Doxil®), Helicobacter pylori-infected epithelial cells, hepatitis, hepatoprotection, high blood pressure, human papillomavirus (HPV), insect bites, insect repellent, jaundice, kidney disease, lactation stimulant, leprosy, liver protection, menstrual pain, menstrual period problems/lack of menstrual period, liver damage from toxins/drugs, multidrug resistance, neurodegenerative disorders, ovary cancer, pain, prostate cancer, parasites, ringworm, scarring, scleroderma.

DosingReturn to top

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. Patients with colorectal cancer ingested curcumin capsules (3,600, 1,800, or 450 mg daily) for 7 days. For their chemoprotective effect against chemically-induced malignancies they were administered 0.6 milliliters of TO three times a day for 1 month and 1 milliliters in 3 divided doses for 2 months.

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)
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.

SafetyReturn to top

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 theCurcumafamily 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 theZingiberaceae(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.

InteractionsReturn to top

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. 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.
Interactions with Drugs
Based on laboratory and animal studies, turmeric may inhibit platelets in the blood and increase the risk of bleeding caused by other drugs. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve® ).

Based on animal studies, turmeric may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. If you are using any medications, check the package insert and speak with your healthcare provider or pharmacist about possible interactions.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering drugs such as lovastatin (Mevacor®) or atorvastatin (Lipitor®).

In animals, turmeric protects against stomach ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin®), and against heart damage caused by the chemotherapy drug doxorubicin (Adriamycin®).

Based on animal data, turmeric may lower blood sugar and therefore may have additive effects with diabetes medications.

Interactions with Herbs and Dietary Supplements
Based on animal studies, turmeric may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , some cases with garlic, and fewer cases with saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, evening primrose, fenugreek, feverfew, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

Based on animal studies, turmeric may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements to be too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system, such as bloodroot, cat's claw, chamomile, chaparral, chasteberry, damiana, Echinacea angustifolia , goldenseal, grapefruit juice, licorice, oregano, red clover, St. John's wort, wild cherry, and yucca.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering herbs or supplements such as fish oil, garlic, guggul, or niacin.Based on animal data, turmeric may lower blood sugar. Check with your health care professional before starting turmeric if you are taking other herbs or supplements or medications for diabetes.

Methodology Return to top

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Methodology details

Selected references Return to top

1. Aggarwal BB, Kumar A, Bharti AC. Anticancer potential of curcumin: preclinical and clinical studies. Anticancer Res 2003;23(1A):363-398.
2. 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.
3. Deodhar SD, Sethi R, Srimal RC. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632-634.
4. Egan, M. E., Pearson, M., Weiner, S. A., Rajendran, V., Rubin, D., Glockner-Pagel, J., Canny, S., Du, K., Lukacs, G. L., and Caplan, M. J. Curcumin, a major constituent of turmeric, corrects cystic fibrosis defects. Science 4-23-2004;304(5670):600-602.
5. Garcea, G., Berry, D. P., Jones, D. J., Singh, R., Dennison, A. R., Farmer, P. B., Sharma, R. A., Steward, W. P., and Gescher, A. J. Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences. Cancer Epidemiol.Biomarkers Prev. 2005;14(1):120-125.
6. Joshi, J., Ghaisas, S., Vaidya, A., Vaidya, R., Kamat, D. V., Bhagwat, A. N., and Bhide, S. Early human safety study of turmeric oil (Curcuma longa oil) administered orally in healthy volunteers. J Assoc.Physicians India 2003;51:1055-1060.
7. Khattak, S., Saeed, ur Rehman, Ullah, Shah H., Ahmad, W., and Ahmad, M. Biological effects of indigenous medicinal plants Curcuma longa and Alpinia galanga. Fitoterapia 2005;76(2):254-257.
8. 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.
9. 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.
10. 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.
11.
12. Limtrakul, P., Anuchapreeda, S., and Buddhasukh, D. Modulation of human multidrug-resistance MDR-1 gene by natural curcuminoids. BMC.Cancer 4-17-2004;4(1):13.
13. Nishiyama, T., Mae, T., Kishida, H., Tsukagawa, M., Mimaki, Y., Kuroda, M., Sashida, Y., Takahashi, K., Kawada, T., Nakagawa, K., and Kitahara, M. Curcuminoids and sesquiterpenoids in turmeric (Curcuma longa L.) suppress an increase in blood glucose level in type 2 diabetic KK-Ay mice. J Agric.Food Chem. 2-23-2005;53(4):959-963.
14. 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.
15. Pitasawat, B., Choochote, W., Tuetun, B., Tippawangkosol, P., Kanjanapothi, D., Jitpakdi, A., and Riyong, D. Repellency of aromatic turmeric Curcuma aromatica under laboratory and field conditions. J Vector.Ecol. 2003;28(2):234-240.
16. Polasa, K., Naidu, A. N., Ravindranath, I., and Krishnaswamy, K. Inhibition of B(a)P induced strand breaks in presence of curcumin. Mutat.Res 2-14-2004;557(2):203-213.
17. Prusty, B. K. and Das, B. C. Constitutive activation of transcription factor AP-1 in cervical cancer and suppression of human papillomavirus (HPV) transcription and AP-1 activity in HeLa cells by curcumin. Int J Cancer 3-1-2005;113(6):951-960.
18. 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.
19. Rithap 0 r n T, Monga M, Rajasekaran M. Curcumin: a potential vaginal contraceptive. Contraception 2003;68(3):219-223.
20. 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.
21. 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.
22. 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.
23. Tilak, J. C., Banerjee, M., Mohan, H., and Devasagayam, T. P. Antioxidant availability of turmeric in relation to its medicinal and culinary uses. Phytother.Res 2004;18(10):798-804.
24. Tourkina, E., Gooz, P., Oates, J. C., Ludwicka-Bradley, A., Silver, R. M., and Hoffman, S. Curcumin-induced apoptosis in scleroderma lung fibroblasts: role of protein kinase cepsilon. Am.J Respir.Cell Mol.Biol 2004;31(1):28-35.
25. 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.

August 01, 2005.

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-turmeric.html

http://www.arthritis.org/resources/arthritistoday/1999_archives/1999_05_06exp...

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