Turmeric is a powerful herb that's been used in South and Southeast Asia and Iran for thousands of years and it's used to treat several chronic diseases. It seems like every month we hear about a potential new benefit mostly centered around its anti-inflammatory effects like arthritis or autoimmune conditions. But it's also known for its antioxidant, anti-diabetic, anti-cancer, and even neuroprotective effects.
Some use it in the treatment of metabolic syndrome and related conditions like PCOS and fatty liver. Well, in this post, I'll tell you which of these indications or properties have the strongest evidence behind them. I'll also talk about the best ways to take turmeric and I'll review important things you need to consider when choosing the right supplement or formulation. Lastly, I want to review turmeric's latest safety profile and will let you know who should and who should not take the supplement.
The strongest evidence for the use of turmeric is in the treatment of joint pain and osteoarthritis. I want to highlight a systematic review and meta-analysis of 16 randomized controlled trials that looked at over 1,800 adults with knee osteoarthritis and found that turmeric extracts significantly reduced knee pain and improved physical function. The effects of turmeric were similar to NSAIDs or medications like ibuprofen or Advil.
What makes this exciting is turmeric extract had 12% fewer adverse effects when compared to NSAIDs. So this makes it a potentially better option for pain and inflammation control, especially for those that cannot take NSAIDs due to kidney disease, heart disease, or due to stomach or small intestine bleeding.
To follow that up, there was another systematic review and meta-analysis published in December of 2021. They looked at 11 randomized controlled trials with a total of 1,200 participants with knee osteoarthritis that noted that curcumin, the active ingredient in turmeric, was more effective in achieving pain relief than NSAIDs. But studies analyzed only looked at short-term use, so we'll need more high-quality randomized controlled trials of different doses to assess its long-term use.
Another exciting area with promising new evidence for the use of turmeric or curcumin is metabolic health, and more specifically, insulin resistance and glucose control and the way it works is curcumin stimulates glucose uptake through GLUT4 transporters in adipocytes or fat cells and in skeletal muscles. It also works in reducing glucose secretion from the liver by regulating the AMPK pathway. So it works for the same pathway as a common diabetes medication called metformin.
It also regulates gene expression of pancreatic glucose transporters, and by doing so, it stimulates natural insulin secretion. A recent meta-analysis of 17 randomized controlled trials showed that turmeric lowered fasting blood glucose, and it also lowered hemoglobin A1c (HBA1C) and HOMA-IR, which is a measure of insulin resistance.
It's no surprise that we are now seeing the benefits of turmeric in the treatment of PCOS, or polycystic ovarian syndrome, which is associated with insulin resistance and metabolic syndrome. A recent randomized double-blind placebo-controlled trial looked at 60 women with PCOS and found that turmeric administration for 12 weeks shows significant reduction in weight, fasting glucose, insulin resistance, and improvement in insulin sensitivity.
Another randomized controlled study showed that taking turmeric with metformin shows synergistic effects in improvement of insulin resistance and cholesterol in patients with PCOS, and when it comes to fatty liver, or non-alcoholic fatty liver disease, or now known as metabolic dysfunction-associated fatty liver disease, there was a recent meta-analysis of nine randomized controlled trials published in 2019 that show that curcumin supplementation produced a significant decrease in liver markers like ALT and AST., and it also showed beneficial effect on metabolic parameters in patients with fatty liver.
Best Way to Take Turmeric
Now, let's talk about the best way to take turmeric, as there's many products out there, and they all have different formulations. First, the proper dose depends on whether you're taking turmeric or curcumin. Turmeric is a root that's often used in spices or as a food additive, and curcumin is an extract that we get from turmeric. Most of the benefits we discussed actually come from curcumin, or the active compound in turmeric.
Now, since most of curcumin we take gets metabolized before it can be absorbed, the easiest way to take it is in a supplement form. There are important considerations you need to make when picking the right supplement. First, since absorption is so tricky when it comes to curcumin, it's important to take it with piperine, which is a natural alkaloid of black pepper.
Piperine protects curcumin from our digestive enzymes, and it can increase the bioavailability of curcumin by up to 2000%. Some supplements may advertise bioperine, which is a manufactured extract of piperine. Another important consideration you need to keep in mind is that curcumin is lipophilic, meaning it can only be dissolved in oils and fats. So the best way to take the supplement is to take it with meals that contain at least 15 grams of fats or oils.
Lastly, when picking your supplement, make sure it's third-party tested, and it's either USP, FDA or NSF verified. That verification lets you know that the supplement actually contains the ingredients listed on the label at the declared dosage. It also lets you know that it's not contaminated by toxins or metals, and that it's been made according to the FDA good manufacturing practices.
Safety of Turmeric or its Active Ingredient Curcumin
Now let's talk about the safety of curcumin or turmeric and discuss who should and who should not be taking the supplement. First, curcumin's been declared safe as generally regarded as safe by the FDA, with some studies showing curcumin to be safe even at high doses of up to 8 grams per day.
The actual dosage of curcumin you need to take depends on the indication or what you're taking it for, and you should talk to your doctor about the right dose for you. When it comes to side effects, curcumin can cause GI issues like abdominal pain, nausea, diarrhea, which should get better if you take it with meals. Curcumin also has several important interactions, and you have to be careful if you're taking it with blood thinners and antiplatelet medications like aspirin and Plavix.
You also have to be careful when taking it with warfarin or other blood thinners like Eliquis or Xarelto, as it may increase your risk of bleeding. Curcumin can also interact with certain diabetes medications and cause hypoglycemia or low blood sugars, and since curcumin has a lowering effect on blood pressure, you have to be careful if you're taking it with other blood pressure medications.
Finally, curcumin can increase your stomach acids and it can worsen your gastroesophageal reflux and peptic ulcer. Curcumin is not recommended in people suffering from kidney stones or gallstones, and I would try to avoid it in pregnancy or breastfeeding, as there's no reliable studies on the effects of curcumin in that population.
So based on the limited research we have, curcumin is a very powerful supplement with incredible health benefits that is supported by a growing body of evidence, and we have only scratched the surface of all the benefits of curcumin, and we haven't even talked about the benefits when it comes to inflammatory bowel disease, like ulcerative colitis, Alzheimer's, heart disease, and cancer prevention. But I will review those benefits in my future posts.
Also, if you are taking curcumin, let me know which brand you prefer and why, so we can all learn from each other. I hope this was helpful, and I'll see you in the next post.