Why Pepper Boosts Turmeric Blood Levels

Why You Should Always Eat Pepper with Your Turmeric

“Historians from all around the world have produced evidence to show that apparently all primitive peoples used herbs-often in a sophisticated way. Quinine from Cinchona bark was used to treat the symptoms of malaria long before the disease was identified, and the raw ingredients of a common aspirin tablet have been a popular painkiller for far longer than we have had access to tablet-making machinery. Indeed, today many pharmacological classes of drugs include a natural product prototype that we originally discovered through the study of traditional cures and folk knowledge of indigenous people.”

There’s a plant in South Asia called Adhatoda (from adu meaning “goat,” and thoda meaning “not touch” because it’s so bitter even the goats won’t eat it). It has compounds that help open one’s airways and as such, Adhatoda tea has been used traditionally to treat asthma, where the leaves are steeped with black peppercorns. Leaves steeped with black peppercorns? That sounds gross to me—why would they do that? Because they’re smart. Back in 1928, scientists discovered what the people evidently already knew, that adding pepper increased the anti-asthmatic properties of the leaves. Black pepper alone didn’t work: it was the combination. And now we know why.

Just like approximately 5% of the spice turmeric is composed of an active compound called curcumin, about 5% of black pepper by weight is comprised of this compound called piperine. Curcumin is responsible for the yellow color of turmeric and piperine for the pungent flavor of pepper. Piperine is a potent inhibitor of drug metabolism. One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.

And it doesn’t take much. If people are given a bunch of turmeric curcumin, within an hour there’s a little bump in the level in their blood stream. We don’t see a large increase because our liver is actively trying to get rid of it. But what if the process is suppressed by taking just a quarter teaspoon’s worth of black pepper? Then you see curcumin levels skyrocket (See Boosting the Bioavailability of Curcumin). The same amount of curcumin consumed, but the bioavailability shoots up 2000%. Even just a little pinch of pepper—1/20th of a teaspoon—can significantly boost levels. And guess what a common ingredient in curry powder is besides turmeric? Black pepper.

Another way to boost the absorption of curcumin is to consume it in the whole food, turmeric root (fresh or dried as a powder) because natural oils found in turmeric root and turmeric powder can enhance the bioavailability of curcumin seven to eight fold. When eaten with fat, curcumin can be directly absorbed into the bloodstream through the lymphatic system thereby in part bypassing the liver.

How is it prepared in India? With fat and black pepper. Amazing how they could figure that out without double blind trials. (Though maybe it just tastes good, and it’s merely coincidence?) Their traditional knowledge certainly failed them with ghee, however, which is practically pure butter fat, which may explain India’s relatively high rates of heart disease despite all their turmeric.

Why would we care about boosting curcumin levels? Learn why in my videos Which Spices Fight Inflammation? and Spicing Up DNA Protection, Turmeric Curcumin and Rheumatoid Arthritis, and Turmeric Curcumin and Osteoarthritis. It’s also good to know Who Shouldn’t Consume Curcumin or Turmeric.

I’ve previously covered this topic of food synergy in videos such as Apples and Oranges: Dietary Diversity and Garden Variety Anti-Inflammation that emphasize the importance of eating a variety of plant foods to take advantage of some of these interactions.

The black pepper mechanism reminds me of the grapefruit (Tell Your Doctor If You Eat Grapefruit) and broccoli (The Best Detox) stories. A testament to the power of plants.

The painkilling properties of aspirin mentioned in the video are actually found throughout the plant kingdom: Aspirin Levels in Plant Foods.

In some circumstances, traditional medicine wisdom seems incredible (Tomato Effect); in others, dangerous (Get the Lead Out). But that’s what we now have science for!

-Michael Greger, M.D

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: John Loo / Flickr

  • Arjan den Hollander.

    What about grapefruit?
    And does blocking it every day pose a risk, by disabling detoxification of other substances?
    Would by that line of thought taking in pepper or grapefruit a few days a week be safer than every single day?

    • Good questions Athan. I look forward to the replies.

      Awesome info as always Dr G

    • stevebillig

      Exactly my thought. We dump on many medical drugs because their method of action is often throwing a monkey wrench in a normal metabolic process, ignoring the fact that nature put that process there for a reason. I hope we get more NutritionFacts information on this broader, interesting matter.

    • Eric Harper

      Grapefruit can intensify the strength of whatever drugs you may be on

  • Jane’s Addiction

    People don’t believe me but I love pepper in my smoothies. This is my flavor of the month:
    1/2 Hass avocado
    3/4 c wild blueberries
    1/4 t freshly ground black pepper
    1 t turmeric
    1 t ginger
    1 t Ceylon cinnamon
    1/4 t cardamom
    1/4 t cloves
    I’ll admit that I prefer mango to blueberries, but I go with the blueberries because they pack an even greater nutritional punch than mango. But, if you prefer mango, substitute 1/2 c mango for the blueberries, or maybe 1/4 c mango and 1/4 c pineapple.
    Now, if you’re off sugar like I am, then this will be plenty sweet for you. If not, you may want to add something like erythritol. (I personally couldn’t get behind the erythritol—I think it has a ‘taste’.)

    • Tom

      Jane,

      In your ingredient list you have 1 t turmeric and 1 t ginger. Is that teaspoon?

      Thanks,

      Tom

      • jtercyak

        Small t always means teaspoon in recipes.Large T means Tablespoon.

      • Jane’s Addiction

        Yep, that’s one teaspoon turmeric and one teaspoon ginger. Enjoy!

    • Loretta Davis

      thanks for the recipe, Jane, it will be my smoothie tomorrow:-) it has all the essential spices in it. Wonderful!

    • Val

      Jane’s…what other liquid do you put in that smoothie? Do you use a bunch of ice or just water? Thanks!

      • Jane’s Addiction

        Just water. The wild blueberries are frozen, so they act as the ice.

  • justme

    I love spicy food Indian food. Right by our office is a vegetarian/vegan Indian restaurant that serves dal with a severe kick. I may go there today for my turmeric fix and will add extra pepper. Dr. Gregor, I wonder if I can use Pabla Indian Buffet as a medical tax write off? Maybe if you write me a prescription!

  • Sandy

    I have a question. In the transcript Dr. Gregor mentions that the nutrients in Turmeric is more absorbed with the addition of fat. Do we need to add fat to our dishes or does the amount of fat that naturally occurs in vegetables suffice. I cook by water sauteing my vegetables, so I do not add any other fat other than what naturally occurs in whole plant foods. I was wondering if perhaps I would absorb more nutrients by adding a little olive oil or something.

    • stevebillig

      Most fruits and vegetables have scant amounts of fat (olives and avocado are the exceptions). Grains don’t have much either. The best sources of whole plant-based fats are nuts, seeds and selected legumes (soy/tofu in particular).

    • KWD

      Sandy, I often use the water saute method for my vegetables too. A recent Dr. Greger post (sorry I cannot recall at the moment which one) suggests adding whole plant-based sources of fats, rather than extracted oils, to increase absorption of fat-soluble phytonutrients. Ideas, as stevebillig mentions below are nuts and seeds, or a tahini (made from sesame seeds) dressing and olives would work too.

    • sf_jeff

      Great question! I have been adding some oil-based salad dressing to my raw spinach, arugala, and kale leaves at Dr. Gregor’s suggestion. Now I can see the need for adding butter to my steamed broccoli as well.

      • Marlon

        wrong. dr.g doesn’t recommend butter or oil.
        stick to whole food plant sources of fats. nuts, seeds, avocados, olives.
        for example, avocado with your mexican food. olives with your pasta… seeds in your salad…

        • sf_jeff

          lol. But butter tastes better. Actually, I don’t use cow’s milk butter, but rather smart balance margarine. Is using canola or walnut oil on broccoli better for you than butter? Certainly. The point was rather to compare trying to get the nutrition of vegetables in a dietarily insignificant amount of oil vs trying to get the nutrition of vegetables with no oil at all.

          • Val

            If you MUST put something on your steamed broccoli or baked potato, try hummus! There IS a brand called World’s Healthy Gourmet that has only tahini in it….no extracted oils! Whole Foods carries it and some independent health food stores! Salsa is equally nice on them!

    • Pete

      Add 1 – 2 tablespoons of ground flax seed. I always add this to my smoothies as recommend by my plant based dietitian. I have a Vitamix but the dietitian still recommended using a coffee grinder for the flax seeds.

    • LaraH

      I would certainly use olive oil, but also why not try to get to the bottom of the ghee issue? It has been shown that ghee would boost the bioavailability of curcumin, and also have other health benefits, there has been some studies showing benefits of ghee for instance that it does not increase bad cholesterol levels, then why not consider it? Or at least discuss it, I would love it if Dr Greger would go through all these studies done on ghee, and make somekind of a logical conclusion.
      Now we must also remember that there are great differences between ghee products, low quality ghee is vegetable based loaded (up to 40%!) with transfats, this type of ghee is the reason why CVD is going up in countries like India.

      • Thea

        LaraH:

        You mention olive oil at the beginning of your post. Dr. Greger has addressed olive oil in a few videos and the oil does not come out looking good. Here are two:
        http://nutritionfacts.org/video/olive-oil-and-artery-function/
        http://nutritionfacts.org/video/extra-virgin-olive-oil-vs-nuts/

        I can’t think of any reason that ghee would come out any better than olive oil once the science is carefully reviewed. I expect ghee to come out worse, because it is my understanding that ghee is still high in saturated fat and cholesterol. NutritionFacts addresses both of these topics and their affect on heart disease. Here’s an overview of saturated fat:
        http://nutritionfacts.org/topics/saturated-fat/

        You write: “It has been shown that ghee would boost the bioavailability of curcumin” That’s because ghee is a fat and any fat might boost the bioavailability. But that doesn’t mean that ghee is a healthy way to get the most out of curcumin. (Just like drinking Coke is not a healthy way to get water even though Coke has a lot of water in it…) As the second video I linked to above about olive oil suggests, you would be better off with a whole nut instead of oil to get the most out of curcumin.

        Just something to think about.

  • rob

    I take a capsule of Turmeric, 400 mg.
    . Sounds like I should take black pepper about same time. Is I still effective to just use pepper at lunch/dinner?

  • Metrov

    Wow, just the other day, Dr. G confirmed for me that pepper is required to increase the bio-availability of Curcumin (when taken alone), but is not necessary to add to Turmeric. That seems to be confirmed in the body of the article, but the title threw me off: “Why Pepper Boosts Turmeric Blood Levels.” I just hope I’m getting it right because I just bought a pound of Turmeric and love adding it to my smoothies… but I haven’t been adding the pepper.

  • Loretta Davis

    well, in that case black pepper is going in my smoothie tomorrow:-)

  • Alice

    But what about this recent study?
    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113993
    “Piperine, a natural bioenhancer, nullifies the antidiabetic and antioxidant activities of curcumin in streptozotocin-diabetic rats”
    Addition of piperine to curcumin treatment seemed to lower the effect of curcumin alone on both markers for diabetes and antioxidant activity. How can this be?

    • Darryl

      20 mg/kg piperine didn’t adversely effect the curcumin effects. The higher dose of 40 mg/kg did, and elevated ALT & AST indicates some liver toxicity. 40 mg/kg in a mouse, using FDA conversion factors, scales to 225 mg piperine for a 70kg human, the amount in 2.2 tsp of ground black pepper.

      • Arjan den Hollander.

        And you were doing so great!
        mg/kg, mg/kg, mg/kg, mg, kg and then it all went south….
        2.2 tsp = voodoo science, even though your American beverage industry doesn’t think so :)
        http://youtu.be/MepXBJjsNxs?t=8m48s

      • Alice

        Thanks for replying. I was surprised to see this. The subjects were rats. All of the dosages were pretty large weren’t they. The figures for blood sugar seem to show that curcumin alone was the most effective, followed by piperine; the combinations were less effective, with the high dose piperine combination the worst. Surprising.

        Thanks for the link to Indian cooking fats. India contains so many different food cultures. There are areas where ghee is the primary cooking fat; others which use sesame or coconut oil. The area I know best is Bengal where mustardy flavors are loved, and mustard oil is the traditional cooking fat. Lots of modern Bengalis, worried about erucic acid, cook with peanut oil and add mustard oil at the end for flavor. Mustard oil is dark gold, a little thick, and amazingly aromatic. It’s the one oil that still tempts me occasionally.
        I don’t think black pepper is commonly used in Indian food any more; tho it was the original peppery spice used in everything, it’s mostly been supplanted by the new world chilies, used whole or as chili powders.

        • Darryl

          I’ve altered my prior post (I had 3 tabs open on mouse studies). 3.7 tsp is a lot of black pepper.

          I love mustard oil, which at the local Indian grocery is imported in the same bottles as sold in India, but labeled for massage use, For anyone on a low-fat plant based diet, aromatic oils like sesame and mustard are a great finishing touch.

          • Charzie

            You nailed it Darryl! The only free oils I EVER use, and only rarely, are toasted sesame, a few drops upon serving, and a gift from my sister of truffle oil, used the same way. Either can totally change the character of a dish, and take it out of the realm of the ordinary for special occasions.

    • Atlantisarch

      I’d like Dr Greger to clarify some point : is curcumin the active molecule in our cells or is the liver modified version ? Put it an other way : by making it hydrosoluble, does the liver aim ONLY to enhance excretion or is this step required for later use in the body.

      1/ If (hydrophobic) curcumin is active mocule then what about the question above of the long term toxicity of piperin by blocking the cleaning enzyme ?
      2/ If hydrophilic curcumin is the active molecule, then what other factors are limiting its use by our cells and what are the factors lowering its excretion ?

  • Darryl

    Their traditional knowledge certainly failed them with ghee

    Ghee is mostly for restaurant fare. Many more Indians cook at home with less expensive sunflower, peanut, or mustard oil. While sunflower and peanut oil didsn’t fare any better than ghee in this case control study, those who cooked with mustard oil appeared to have half the cardiovascular risk, and those who fried with mustard oil only a quarter of the risk, as the reference group which cooked with sunflower oil. As rats and pigs (unlike humans) accumulate erucic acid in their hearts, since the 1970s mustard oil has been labeled “external use only” in the US. Canola oil is similar, replacing nearly all the erucic with oleic acid, though with a poorer ω-3/ω-6 ratio.

    • Timar

      Canola oil still has an ω-3/ω-6 ratio of 1:2, which is decent enough. It is probably close the overall optimum intake ratio (which might be anywhere between 1:1 and 4:1). While I’m at it, let me dispel the common myth that canola oil is made from some genetically modified “Frankenstein crop”. The rape cultivars used for the production of canola oil have been conventionally bred to substitute oleic acid for the (probably benign) erucic acid and to greatly reduce the content of glucosinolates (no, not the toxic substances some tinfoil hat wearing conspiracy theorists make out of them, but the same beneficial, pungent-tasting anti-cancer compounds found in cruciferous vegetables). They are very popular in Europe, where genetically modified cultivars are not even allowed. In Northern America, most rape cultivars grown for human consumption have been genetically modified only subsequently to make them resistant to Monsanto’s herbicide Roundup – like many other crops. If you don’t shy away from oil in general I think that unrefined, expeller-pressed canola oil (which has a nice nutty flavor and still some glucosinolates) makes a great complement to virgin olive oil.

      • Thea

        Timar: re: “…dispel the common myth…” Great post! I have a hard time explaining to people that canola oil is not something to feared. I try to stay away from all oils myself. But if I’m going to have an oil, I think that canola oil is a very good choice.

  • BeachTime

    Dr. Gregor, Does it matter what type of fat when combining turmeric and fat to enhance absorbtion? Will olive oil or coconut oil yield the same result as dairy or animal fat?

  • sf_jeff

    “One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.”

    So does this mean that pepper is actually very bad for you when put on seared beef or chicken?

  • Rick

    Dr. Greger:

    THANK YOU for the wonderful, life-changing and life-saving information you provide.
    My comment on your statement:
    “One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.”

    In my case, I don’t want to inhibit this process! Who knows how such inhibition affects us?
    Potent curcumin effects can be obtained in multiple ways, including via the UCLA formulation that does not contain oil or piperine and has been shown to remove amyloid plaques, as well as the Japanese formulation Theracurmin.

  • dj

    ‘How is it prepared in India?…Amazing how they could figure that out without double blind trials.’

    In fact, Dr.G, they had something much better [from Wikipedia]’ Ayurvedic (Medicine) practices include the use of herbal medicines, mineral or metal supplementation (rasa shastra), surgical techniques, opium, and application of oil by massages.(as well as dietary protocols)
    Originated in prehistoric times, some of the concepts of Ayurveda have been discovered since the times of Indus Valley Civilization and earlier.[(3300–1300 BCE; mature period 2600–1900 BCE)’ Yup, these guys were like people of ancient Iraq (who invented mathematics,architecture,hydraulics,medicine, &much more), but now are called ‘savages’…

  • Daniel K Morris

    This is a fantastic article on so many levels. It is yet another example of the powerful health benefits of turmeric as can be seen on all the other NutritionFacts videos http://nutritionfacts.org/topics/turmeric/ but also powerful effect of the consumption of combinations of whole foods and many interactions that can occur from meals high in a variety of phytochemicals from different plant foods. Should we be focusing on getting small amounts of turmeric each day combined with other spices, vegetables and whole starches such as legumes combined with a source of fat from whole foods such as ground flaxseed or small amounts of walnuts rather than focusing on how much of the active ingredient of turmeric we should be taking in capsule form each day? Is this not what traditional Indians or Okinawa Japanese did through out their lives, who had very low rates of cancer compared to Western countries?

  • Arleen T

    I am a cancer patient and I am interested in boosting my immunity. What is your opinion on the vitamin C drip as a treatment for cancer?

  • www.carcinoid-cancer.com

    Hi Doc,
    I have stage 4 carcinoid cancer. It is supposed to be a chronic disease but, I still have hope. The only thing that has shrunk my tumors so far is everolimus…and not much. Do you have any suggestions as far as tumeric/curcumin or anything else that you think might help?
    Thanks,
    Ed

  • Stevie Jay

    Will whole peppercorns break down if I take them along with my turmeric pills? Thanks.

  • Sarah

    It is clear that eating lots of vegetables is better for you no matter what your diet. I think the whole butter argument is lopsided. In fact there is evidence all around that as the use of butter fat has gone down (low fat, no fat, trans fat), the incidence of heart failure has way gone up. The brain and lungs are both composed largely of saturated fats. Can what we are really be bad for us?

    • Thea

      Sarah: re: “Can what we are really be bad for us?” Think of it this way: Our bodies are also made up of a lot of water. Yet we know that drinking too much water can kill us. Or think of this: mammal herbivore bodies (say cows and gorillas) are made up of the same basic stuff as human bodies. And yes, eating animals is bad for those animals. Biology is a lot more complicated than your question implies. Your earlier arguments are equally flawed. If you are interested in the science, there is plenty of it to be found here on NutritionFacts. I would invite you to spend some time enjoying the informative and entertaining videos on this site.

  • Brian Richards

    I read years ago that ground dry turmeric root is not that bio available. I was told to boil it in water for 10 minutes, or saute in oil to make it more bio available. Does anyone know one way or the other?

  • AmirG

    Thank you for this great article!
    Got a question for you:
    Does ginger have the same effect as pepper on the absorption process of curcumin in the body? :) :)

  • AmirG

    Thanks for this awesome article!!
    got a question though:
    Does ginger effects the curcumin intake as well???

  • Sarah

    I am curious, why would the liver be trying to get rid of tumeric if it is supposedly good for us?

  • Savannah

    Hello, I recently spoke with someone who was dealing with some inflammatory reactions and lots of allergies..doctors had no answers for her as to why she was dealing with eyelid swelling. I encouraged her to search into an anti inflammatory diet and spoke about the benefits of including turmeric and turmeric paste. However, she is allergic to black pepper..and was wondering if white pepper would also enhance the absorption of turmeric?

  • Barnett Weiss

    Your comment about Ghee being in some way responsible for heart disease has little if any scientific basis. Saturated fats such as those in ghee are heart protective as shown in hundreds of articles speaking out against the food industries huge promotion of low fat milk and other products. Many vital ingredients need good saturated fat for transport in our systems let alone the protective aspect of saturated fats. It is the simple carbohydrates that are the main culprits as well as Poly unsaturated oils invluding the huge hype about omega 3 which is oxidized rapidly in our bodies leaving toxic residues. Omega 3’s importance was supposedly originally based on supplying cell membrane replenishment. The cutting edge of cell chemistry has shown for nearly 40 years that it is the property of the 4th phase of water that creates the barrier between cells like tiny jello blocks not membranes with all the constant need for inventing newer ion channels and simply not addressing the enormous energy needs if cells did in fact have anything like the transport ideas of membrane pumps. . See Gilbert Ling’s work, Gerald Pollack, Mae-Wan Ho and many others regarding this.

    • Rob Williams

      Making sure the ghee was from cows that ate grass is a good idea.

  • Jas

    You may want to check your facts about fat causing heart disease. Fat, especially sources like ghee, are what lower the small sharp ldl cholesteral that gets stuck in the inflamatian of the heart (not caused by cholesteral) and aggravates heart disease. There is new science out there. Maybe go read it. Saturated fat is healthy and should be in everyone’s diet.