"Who Shouldn't Consume Curcumin or Turmeric"
Following flax and wheatgrass,
turmeric is the third best-selling
botanical dietary supplement,
racking up $12 million in sales,
increasing at rate of about 20%.
Curcumin is a natural plant product
extracted from the turmeric root,
used commonly as a food additive
popular for its pleasant mild aroma and exotic yellow color,
considered unlikely to cause side effects.
Just because something is natural, though,
doesn't necessarily 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.
Plants can't be dangerous. Tell that to Socrates.
In considering the validity of the widely accepted notion
that complementary and alternative medicine
is a safer approach to therapy,
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.
Traditional Indian diets may include
as much as a teaspoon of turmeric a day,
which is the equivalent of about
this much fresh turmeric root.
If you look at the doses of turmeric
that have been used in human studies,
they range from less then a 16th of a teaspoon a day
up to about 2 tablespoons a day for over a month.
Whereas the curcumin trials have used up to
the amount found in cups of the spice,
around 100 times more
than what curry lovers have been eating for centuries.
Still, without overt serious side effects in the short-term, at least,
but if you combine both high dose curcumin
with black pepper for that 2000% bioavailability boost,
that could be like consuming
the equivalent of 29 cups of turmeric a day.
That kind of intake could bring peak blood levels
up around here, where you start seeing
some significant DNA damage in vitro, at least.
So just incorporating turmeric into our cooking
may be better than taking curcumin supplements,
particularly during pregnancy.
The only other contraindication cited
in the most recent review was the potential
to trigger gallbladder pain in people with gallstones.
If anything curcumin may help protect liver function
and help prevent gallstones
by acting as a cholecystokinetic agent,
meaning it facilitates the pumping action of the gallbaldder
to keep the bile from stagnating.
In this study they gave people a small dose of curcumin,
about the amount found in like a quarter teaspoon of turmuric
and using ultrasound, were able to visualize the gallbladder
squeezing down in response,
with an average change in volume of about 29%.
Optimally, though, you'd want to like squeeze it in half.
So they repeated the experiment with different doses.
And it took about 40 milligrams to get a 50% contraction.
That's about a third of a teaspoon of turmeric every day.
On one hand that's great— totally doable,
but on the other hand I'm thinking
Wow! That's some incredibly powerful stuff.
What if you had a gallbladder obstruction?
If you had a stone blocking your bile duct,
and you eat something like that,
that makes your gallbladder squeeze down that hard
that could hurt!
So patients with biliary tract obstruction
should be careful about consuming curcumin,
but for everyone else, these results suggest
that curcumin can effectively induce the gallbladder
to empty and thereby reduce the risk of gallstone formation in the first place
and ultimately perhaps even gall bladder cancer.
Too much turmeric, though,
may increase the risk of kidney stones.
As I mentioned in a previous video,
turmeric is high in soluble oxalates,
which can bind to calcium and form insoluble calcium oxalate
which is responsible for approximately 3/4 of all kidney stones,
so the consumption of even moderate amounts of turmeric
would not be recommended
for people with a tendency to form kidney stones.
Such folks should restrict the consumption
of total dietary oxalate to less than 40 to 50 mg/day,
which means no more than at most, a teaspoon of turmeric.
So for example those with gout are by definition,
it appears, at high risk for kidney stones,
and so if their doctor wanted to treat gout inflammation
with high dose turmeric,
then that's where curcumin supplements
might come into play,
because to reach high levels of curcumin in turmuric form
would incur too much of an oxalate load.
If one is prescribed a supplement, how do you choose?
The latest review recommends purchasing
from Western suppliers that follow recommended
Good Manufacturing Practices,
which may decrease the likelihood of our buying
an adulterated product.