Turmeric

Background

• Turmeric, a plant in the ginger family, is grown commercially in Southeast Asia and India. Its rhizome (underground stem) has been used for culinary and cosmetic purposes, among others.
• Curcumin, a major component of turmeric, gives the spice its yellow color. The health activities of turmeric are commonly attributed to curcuminoids, which include curcumin.
• Historically, turmeric has been used in Chinese, Indian (e.g., Ayurvedic), Islamic, and Thai traditional medicine systems for conditions such as indigestion, the common cold, skin infections, arthritis, abdominal pain, and liver disease. Turmeric has also been used in some Indian religious ceremonies.
• Today, oral (taken by mouth) turmeric is promoted as a dietary supplement for a variety of conditions, including osteoarthritis, depression, allergies, itching, and high cholesterol. Topical (applied to the skin) turmeric is promoted for osteoarthritis.

How Much Do We Know?

• Many studies have been conducted on the safety and usefulness of turmeric or curcumin for nonalcoholic fatty liver disease (NAFLD), osteoarthritis, and high cholesterol or other lipid disorders. We don’t know enough to definitively conclude if turmeric or curcumin is beneficial for any health purposes.
• Highly bioavailable formulations of curcumin, which enhance the body’s ability to absorb the curcumin, may harm your liver.

What Have We Learned?

• It’s challenging to compare the available evidence on turmeric. Oral curcumin products vary in how much curcumin they actually contain, and they often contain substances from other plants, such as piperine from black pepper. Combining curcumin with piperine is one way to improve the bioavailability of curcumin. 
• Several meta-analyses have evaluated oral turmeric or curcumin for osteoarthritis measures related to relieving knee pain and stiffness, increasing the strength of the joints, improving joint mobility, and other functions. The initial evidence is positive; higher-quality evidence is needed to reach definitive conclusions, and more research is needed to understand the impact of bioavailability on curcumin’s effects.
• It’s unclear whether topical curcumin ointment has an effect on pain related to knee osteoarthritis. 
• Initial research suggests that oral turmeric or curcumin might improve some NAFLD measures, but it’s unclear which specific measures are consistently improved. 
• Initial research suggests that turmeric or curcumin in an oral or mouthwash formulation might improve symptoms of oral mucositis (tissue swelling and irritation in the mouth) related to cancer treatment. 
• There isn’t enough evidence to definitively conclude whether oral turmeric or curcumin has beneficial effects on other health conditions.

What Do We Know About Safety?

• Conventionally formulated oral turmeric or curcumin (not modified to enhance bioavailability) is likely safe in the recommended amounts for up to 2 or 3 months. 
• Oral turmeric can cause adverse effects such as nausea and vomiting, acid reflux, stomach upset, diarrhea, or constipation. Topical curcumin can cause hives or itching. 
• Many curcumin products with increased bioavailability are on the market, and liver damage has been reported in some people who have consumed these bioavailable formulations. If you notice any liver damage symptoms such as fatigue, nausea, poor appetite, dark urine, or jaundice, stop consuming turmeric or curcumin products immediately and talk with your health care provider. 
• The use of turmeric supplements during pregnancy may be unsafe. Little is known about whether it’s safe to use turmeric in amounts greater than those commonly found in food while breastfeeding.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
• If you take any type of medicine, talk with your health care provider before using any herbal product; some herbs and medicines interact in harmful ways.
• Federal Regulation of Herbal Products
  • Depending on what’s in them, how they’re intended to be used, and how they’re administered (orally or topically), herbal products are regulated in a variety of ways. Many herbal products intended for oral use are marketed as dietary supplements. The regulatory paths for dietary supplements are different than those for drugs.
  • Unlike drugs, dietary supplements are not approved by the U.S. Food and Drug Administration (FDA) before they are sold to the public. When public health concerns arise about the safety of a dietary supplement or an ingredient including an herb, the FDA can take action to protect the public. Manufacturers and distributors of supplements are responsible for evaluating the safety and labeling of their products before marketing to ensure that they meet all regulatory requirements. 

For More Information

• Using Dietary Supplements Wisely
• Know the Science: How Medications and Supplements Can Interact
• Know the Science: How To Make Sense of a Scientific Journal Article

Key References