Turmeric or Cure-meric

Turmeric, the magical golden-yellow spice, has been used in Indian households, Ayurveda, and Chinese medicine since time immemorial. Commonly called ‘haldi’ or ‘haldar’ in India, turmeric was an important part of our household while I was growing up. Not only was it included in almost everything we ate, but it was also used as an antiseptic for cuts and bruises, face packs, treatment of sore throats, etc.

In this post we will explore why and how including turmeric and its components in your day may add value to your health. But before I proceed, I would like to dedicate this post to a beautiful human being who is currently giving cancer a hard time with her grit and determination to fight it!

Turmeric, Curcuminoids, Curcumin — same thing?

With the commercialization of turmeric in the nutraceutical industry, there has been a lot of chatter about its components. Here is a simplified version of what each of these indicates:

• Turmeric is the stem of the plant Curcuma longa.

• Curcuminoids are a group of compounds (bisdemethoxycurcumin, curcumin, and demethoxycurcumin - let’s just call them B, C, and D for now) that constitute 1 to 6% of raw turmeric by weight [1].

• Curcumin or Diferuloylmethane (let’s continue to call it C) in turn constitutes up to 80% of the curcuminoid content in turmeric and is responsible for its golden-yellow color [1].

Why are all these numbers important? Let’s find out in a few minutes.

Why include it in your day?

Recent research on the health benefits of turmeric and curcumin has been overwhelming. With a more than 4-time increase in the number of articles published in PubMed in the past decade, curcumin, due to its anticancer, anti-inflammatory, antibiotic, and antioxidant properties has been researched for almost every health condition under the sun. Here is just a glimpse of some credible research on curcumin available on PubMed:

• Cancer: Due to its anti-cancer effects, curcumin may improve the effect of chemotherapy and reduce its side effects in patients with various cancers such as breast, prostate, pancreatic, colon, etc [2].

• Heart disease: Through a reduction in plaque formation, reduction in cholesterol, and its anti-inflammatory effects, curcumin has a protective effect on the heart [3].

• Diabetes: Curcumin ingestion has been linked to the prevention of diabetes and the improvement of blood sugar levels in diabetics [3,4].

• Autoimmune disorders: There is evidence that curcumin may benefit patients suffering from autoimmune conditions such as rheumatoid arthritis, psoriasis, and ulcerative colitis [5].

• Infections: Curcumin may be protective against infections including COVID-19 [6].

• Wound healing: The application of curcumin formulations on the skin can improve wound healing [7].

• Brain, Liver, and Kidney protection: Through various complex mechanisms, curcumin may have a protective effect on all these vital organs [8,9,10].

What about use amongst healthy individuals?

If this wonderful spice can play a role in reversing so many illnesses, can it prevent the development of disease in healthy individuals?

In comparison to research on people with health conditions, there seem to be sparing amounts of research on the beneficial effect of curcumin among healthy people. This is probably because it could take decades of follow-up until an individual is diagnosed with an illness - making studies on healthy people impractical and expensive to conduct. Besides, varying amounts of curcumin in different types of raw turmeric and the plethora of formulations available in the market, make it difficult to standardize curcumin quantities ingested by healthy people.

Nevertheless, daily, small doses of curcumin over long durations (as observed in curry consumers) has revealed numerous health benefits [11]. Some of these include [12]:

• Reduction of cholesterol levels

• Reduction in the markers of stress

• Slowing brain aging

• Improved recovery from exercise, etc.

Is what you consume = what your body receives?

To be able to affect the body, every substance needs to enter the circulation once consumed, i.e., become available. This is called bioavailability. Curcumin, when ingested alone or in raw turmeric has very poor bioavailability - which means what you consume doesn't really reach your circulation and have the impact you hoped for. Fortunately, there are ways that one can improve the bioavailability of curcumin. These include:

• Addition of pepper: Piperine, the active ingredient of black pepper, slows the breakdown of curcumin by the liver and can increase its bioavailability up to 2000% [12,13].

• Simultaneous consumption of healthy oil: Since curcumin is hydrophobic (does not mix with water), its absorption in the intestine is poor when consumed in its natural state with water. However, simultaneous consumption of healthy oil or fat (my favorite is a few walnuts or an avocado) that can carry curcumin improves its absorption [11].

• Improved delivery systems: Various curcumin supplements with improved delivery systems aimed at enhancing their bioavailability are now available in the market. These include lecithinization of curcumin (curcumin + phosphatidylcholine), curcumin with a combination of hydrophilic carriers, and nano-particle colloidal dispersion. These are definitely worth looking into before choosing your curcumin supplement [13].

How much is okay to consume?

Curcumin has been studied in varying dosages ranging from 0.5 to 12 grams per day, with most of the recommended dosages between 0.5 and 2 grams [12]. While it is a nutraceutical, it is not free of side effects. Therefore, the right amount for you should be decided by your healthcare provider and warrants appropriate supervision.

Supplement versus the real thing?

Even though most of the research against ailments has been done using curcumin, the essential oils in turmeric are more bioavailable while possessing anti-cancer, antioxidant, and anti-inflammatory activity as well [15,16]. In fact, the addition of turmeric oil to curcumin (separate, only to reunite!) seems to be more effective in treating some conditions than using curcumin alone [17]. This indicates that the ingestion of isolated curcumin could mean losing out on the beneficial effects of turmeric oils, amongst other less-researched parts of the turmeric stem.

But now, does it mean that curcumin supplements have no role to play?

Lets quickly revisit the numbers we saw earlier:

• C is only up to 80% of curcuminoids, i.e., a mixture of B, C, and D. So, for example, if I need to get 2gm of curcumin, I will need to ingest 2.5gm of a curcuminoid combination (80/100).

AND

• The concentration of curcuminoids (B,C, and D) in turmeric is variable and only 1-6%. So, to get my 2.5gm of curcuminoids, I will need to have 41.67gm (6/100). That is more than 8 teaspoons of ground turmeric a day, assuming the turmeric is of the best quality!

Putting aside how impractical that kind of consumption would be, just imagine the color of your teeth after all that turmeric!

Bottom line, if you are someone seeking to use curcumin as a treatment for a medical condition or as an adjuvant to treatment, you are probably better off using a supplement under supervision. However, ensure that you read the supplement labels well and get one that has good bioavailability.

On the other hand, if you are interested in using turmeric/curcumin as a prophylactic and for the maintenance of good health, you may be okay with using whole turmeric powder or stem along with some pepper and a source of good fat.

So go ahead…add some yellow to stay in the pink of health!

References:

1. Nelson KM, Dahlin JL, Bisson J, Graham J, Pauli GF, Walters MA. The Essential Medicinal Chemistry of Curcumin. J Med Chem. 2017 Mar 9;60(5):1620-1637. doi: 10.1021/acs.jmedchem.6b00975. Epub 2017 Jan 11. PMID: 28074653; PMCID: PMC5346970.

2. Curcumin (Curcuma, Turmeric) and Cancer (PDQ®)–Health Professional Version. Available from https://www.cancer.gov/about-cancer/treatment/cam/hp/curcumin-pdq, January 2023

3. Zhang HA, Kitts DD. Turmeric and its bioactive constituents trigger cell signaling mechanisms that protect against diabetes and cardiovascular diseases. Mol Cell Biochem. 2021 Oct;476(10):3785-3814. doi: 10.1007/s11010-021-04201-6. Epub 2021 Jun 9. PMID: 34106380; PMCID: PMC8187459.

4. Pivari F, Mingione A, Brasacchio C, Soldati L. Curcumin and Type 2 Diabetes Mellitus: Prevention and Treatment. Nutrients. 2019 Aug 8;11(8):1837. doi: 10.3390/nu11081837. PMID: 31398884; PMCID: PMC6723242.

5. Zeng L, Yang T, Yang K, Yu G, Li J, Xiang W, Chen H. Curcumin and Curcuma longa Extract in the Treatment of 10 Types of Autoimmune Diseases: A Systematic Review and Meta-Analysis of 31 Randomized Controlled Trials. Front Immunol. 2022 Aug 1;13:896476. doi: 10.3389/fimmu.2022.896476. PMID: 35979355; PMCID: PMC9376628.

6. Zahedipour F, Hosseini SA, Sathyapalan T, Majeed M, Jamialahmadi T, Al-Rasadi K, Banach M, Sahebkar A. Potential effects of curcumin in the treatment of COVID-19 infection. Phytother Res. 2020 Nov;34(11):2911-2920. doi: 10.1002/ptr.6738. Epub 2020 Jun 23. PMID: 32430996; PMCID: PMC7276879.

7. Akbik D, Ghadiri M, Chrzanowski W, Rohanizadeh R. Curcumin as a wound healing agent. Life Sci. 2014 Oct 22;116(1):1-7. doi: 10.1016/j.lfs.2014.08.016. Epub 2014 Sep 6. PMID: 25200875.

8. Di Meo F, Margarucci S, Galderisi U, Crispi S, Peluso G. Curcumin, Gut Microbiota, and Neuroprotection. Nutrients. 2019 Oct 11;11(10):2426. doi: 10.3390/nu11102426. PMID: 31614630; PMCID: PMC6835970.

9. Farzaei MH, Zobeiri M, Parvizi F, El-Senduny FF, Marmouzi I, Coy-Barrera E, Naseri R, Nabavi SM, Rahimi R, Abdollahi M. Curcumin in Liver Diseases: A Systematic Review of the Cellular Mechanisms of Oxidative Stress and Clinical Perspective. Nutrients. 2018 Jul 1;10(7):855. doi: 10.3390/nu10070855. PMID: 29966389; PMCID: PMC6073929.

10. Cai Y, Huang C, Zhou M, Xu S, Xie Y, Gao S, Yang Y, Deng Z, Zhang L, Shu J, Yan T, Wan CC. Role of curcumin in the treatment of acute kidney injury: research challenges and opportunities. Phytomedicine. 2022 Sep;104:154306. doi: 10.1016/j.phymed.2022.154306. Epub 2022 Jul 3. PMID: 35809376.

11. Stohs SJ, Chen O, Ray SD, Ji J, Bucci LR, Preuss HG. Highly Bioavailable Forms of Curcumin and Promising Avenues for Curcumin-Based Research and Application: A Review. Molecules. 2020 Mar 19;25(6):1397. doi: 10.3390/molecules25061397. PMID: 32204372; PMCID: PMC7144558.

12. Hewlings SJ, Kalman DS. Curcumin: A Review of Its Effects on Human Health. Foods. 2017 Oct 22;6(10):92. doi: 10.3390/foods6100092. PMID: 29065496; PMCID: PMC5664031.

13. Kotha RR, Luthria DL. Curcumin: Biological, Pharmaceutical, Nutraceutical, and Analytical Aspects. Molecules. 2019 Aug 13;24(16):2930. doi: 10.3390/molecules24162930. PMID: 31412624; PMCID: PMC6720683.

14. Shobal G., Joseph T., Majeed M., Rajendran R., Srinivas P.S.S.R. Influence of Piperine on the Pharmacokinetics of Curcumin in Animals and Human Volunteers. Panta Medica. 2000;64:353–356. doi: 10.1055/s-2006-957450.

15. Toden S, Goel A. The Holy Grail of Curcumin and its Efficacy in Various Diseases: Is Bioavailability Truly a Big Concern? J Restor Med. 2017 Dec;6(1):27-36. doi: 10.14200/jrm.2017.6.0101. PMID: 30899605; PMCID: PMC6424351.

16. Orellana-Paucar AM, Machado-Orellana MG. Pharmacological Profile, Bioactivities, and Safety of Turmeric Oil. Molecules. 2022 Aug 9;27(16):5055. doi: 10.3390/molecules27165055. PMID: 36014301; PMCID: PMC9414992.

17. Toden S, Theiss AL, Wang X, Goel A. Essential turmeric oils enhance anti-inflammatory efficacy of curcumin in dextran sulfate sodium-induced colitis. Sci Rep. 2017 Apr 11;7(1):814. doi: 10.1038/s41598-017-00812-6. PMID: 28400554; PMCID: PMC5429743.

Disclaimer: The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. StyleUrLife/Dr. Sukhpreet Patel expressly disclaims responsibility and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site. By visiting this site you agree to these terms and conditions, which may from time to time be changed or supplemented. If you do not agree to the foregoing terms and conditions, you should not enter this site.