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Who Shouldn’t Consume Curcumin or Turmeric?

Just because something is natural and plant-based doesn’t mean it’s necessarily safe. Those who are pregnant, have gallstones, or are susceptible to kidney stones may want to moderate their turmeric consumption.

January 22, 2014 |
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Supplementary Info

Sources Cited

H. M. Kramer, G. Curhan. The association between gout and nephrolithiasis: The National Health and Nutrition Examination Survey III, 1988-1994. Am. J. Kidney Dis. 2002 40(1):37 - 42.

A. Goel, A. B. Kunnumakkara, B. B. Aggarwal. Curcumin as Curecumin: From kitchen to clinic. Biochem. Pharmacol. 2008 75(4):787 - 809.

R. A. Sharma, A. J. Gescher, W. P. Steward. Curcumin: The story so far. Eur. J. Cancer. 2005 41(13):1955 - 1968.

S. C. Gupta, G. Kismali, B. B. Aggarwal. Curcumin, a component of turmeric: From farm to pharmacy. Biofactors. 2013 39(1):2 - 13.

S. C. Gupta, B. Sung, J. H. Kim, S. Prasad, S. Li, B. B. Aggarwal. Multitargeting by turmeric, the golden spice: From kitchen to clinic. Mol Nutr Food Res. 2013 57(9):1510 - 1528.

H. Hanai, T. Iida, K. Takeuchi, F. Watanabe, Y. Maruyama, A. Andoh, T. Tsujikawa, Y. Fujiyama, K. Mitsuyama, M. Sata, M. Yamada, Y. Iwaoka, K. Kanke, H. Hiraishi, K. Hirayama, H. Arai, S. Yoshii, M. Uchijima, T. Nagata, Y. Koide. Curcumin maintenance therapy for ulcerative colitis: Randomized, multicenter, double-blind, placebo-controlled trial. Clin. Gastroenterol. Hepatol. 2006 4(12):1502 - 1506.

T. Ahmed, A.-H. Gilani. Therapeutic Potential of Turmeric in Alzheimer's Disease: Curcumin or Curcuminoids? Phytother Res. 2013.

S. G. Das, G. P. Savage. Total and soluble oxalate content of some Indian spices. Plant Foods Hum Nutr. 2012 67(2):186 - 190.

J. Cao, L. Jia, H.-M. Zhou, Y. Liu, L.-F. Zhong. Mitochondrial and nuclear DNA damage induced by curcumin in human hepatoma G2 cells. Toxicol. Sci. 2006 91(2):476 - 483.

G. N. Asher, K. Spelman. Clinical utility of curcumin extract. Altern Ther Health Med. 2013 19(2):20 - 22.

S. Bengmark, M. D. Mesa, A. Gil. Plant-derived health: The effects of turmeric and curcuminoids. Nutr Hosp. 2009 24(3):273 - 281.

S. M. Devlin. Curry for the cure? Inflamm. Bowel Dis. 2007 13(12):1576 - 1577.

R. A. DiSilvestro, E. Joseph, S. Zhao, J. Bomser. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 11:79.

A. Rasyid, A. Lelo. The effect of curcumin and placebo on human gall-bladder function: An ultrasound study. Aliment. Pharmacol. Ther. 1999 13(2):245 - 249.

A. Rasyid, A. R. A. Rahman, K. Jaalam, A. Lelo. Effect of different curcumin dosages on human gall bladder. Asia Pac J Clin Nutr. 2002 11(4):314 - 318.

Acknowledgements

Images thanks to Savagecats, Viosplatter, Wallyg, h-bomb and Cizauskas via Flickr and Andy king50 via Wikimedia Commons. Thanks to Ellen Reid for her image-finding expertise and Jeff Thomas for his Keynote help.

Transcript

Following flax and wheatgrass, turmeric is the third best-selling botanical dietary supplement, racking up $12 million in sales, and sales are increasing at rate of 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 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 just a 16th of a teaspoon a day up two 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, but if one combined 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.

So just incorporating turmeric into your cooking may be better than taking curcumin supplements, especially during pregnancy. The only other contraindication cited in the most recent review was the potential to trigger gallbladder pain in individuals 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 turmeric 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 that makes your gallbladder squeeze that could hurt like heck! 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 and ultimately 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 75% 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 turmeric form would incur too much of an oxalate load.

If you are going to take 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 you're buying an adulterated product.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org.

Dr. Michael Greger

Doctor's Note

This is the last installment of a 6-part video series on the power of spices in general and turmeric in particular. I started out discussing the role spices play in squelching inflammation and free radicals in Which Spices Fight Inflammation? and Spicing Up DNA Protection. Then out of the lab into the clinic with attempts to test the ability of turmeric extracts to treat joint inflammation with Turmeric Curcumin and Rheumatoid Arthritis and Turmeric Curcumin and Osteoarthritis. My last video, Boosting the Bioavailability of Curcumin, discussed ways to improve the absorption of these anti-inflammatory and antioxidant compounds.

I wish there was more science on wheatgrass. I just had that one unhelpful anecdote in my video How Much Broccoli Is Too Much? There is good science on flax though. See:

More on gallbladder health can be found in my video Cholesterol Gallstones. And those who are susceptible to kidney stones should try to alkalinize their urine by eating lots of dark green leafy vegetables (but then shouldn’t we all :). See Testing Your Diet with Pee & Purple Cabbage.

Based on this new science on turmeric (lots more to come!), I now try to include it in my family’s daily diet.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • guest

    Thank you for alerting the masses to this.

    Same goes for LUPUS patients and garlic. Just because it is natural does not mean it is wise to ingest. John Hopkins Lupus Center, from what I am told, advises those with LUPUS to avoid garlic in all shapes and forms. Makes one wonder what else that is natural and used in the diet to spice up food that might actually be causing issues, not just in LUPUS, but in those with other autoimmune diseases/disorders. Potatoes and tomatoes cause me far more joint pain and arthritus then many meat based products. Not a free pass to eat meat and eggs and milk and all, but that little tomato and baked potato are natural, and they seem to naturally cause a lot of people intense pain.

  • Chessie

    Now he tells me, right after I ate cheez grits with turmeric and lots of black pepper! :-) I wasn’t aware of the oxalic acid in turmeric (sorry, kidneys). I promise I won’t do this every day.

    • Paddycakes

      I am sure you did no harm, unless you have a propensity for kidney stones, if no, then you do your kidneys no damage, unless of course, you OVERLOAD.

  • Tobias Brown

    Should someone who consumes cinnamon in an oats mix in the morning and turmeric in dal for lunch ought to be concerned here? The both are high oxalate. Thanks.

    • Brandon Klinedinst

      What Dr Gregor should have mentioned is that calcium oxalate only tend to be problematic in individuals with high consumption of the oxalate and relative low consumption of dietary vitamin C. If you’re eating a whole foods plant diet, you’re likely getting at least 300-400mg of vitamin C daily. This is a strong preventative for the buildup of any calcium oxalate stones.

  • Susan Eisner

    Dr. Greger: Having heard that turmeric can prevent memory problems, I eat a lot of turmeric powder in my meals, maybe .25 to .5 teaspoon a day most days each week. I don’t usually cook it. I sprinkle it on after the food is heated up, with ground black peppercorns and cumin. I have no gall or kidney stone issues. You mentioned turmeric is high in oxalates which bind with calcium. I have osteopenia and have been told to limit consumption of foods high in oxalates, such as spinach, as they bind to calcium and prevent absorption of calcium into the blood. Does eating lots of turmeric therefore also contribute to bone loss? After a recent bone density test 2 years after the last one (of 3 over several years), my rate of bone loss significantly accelerated much more than usual. During those 2 years I upped my turmeric intake, and I was also on Lexapro and thought the high rate of bone loss was due to the Lexapro (there are studies that indicate SSRI’s can cause bone loss). But now I wonder if too much turmeric could have caused it. What do you know about turmeric and its oxalates and bone loss? Should I reduce the amount of it that I eat, and if so, to how much? Should I reduce or stop the black peppercorns with the turmeric? And does it matter if the turmeric powder is cooked or not? Thank you!

    • Brandon Klinedinst

      It should probably be mentioned that the oxalate is often times already bound to calcium in the food. This is why spinach is considered a “poor” source of calcium despite being high in calcium… it’s all bound to oxalate already. It’s not really leaching it out of your bones or anything.

  • justme

    After all these videos on turmeric, I wondered if we would find out that it was bad for us. Remember cinnamon and excessive bleeding? I’m glad you covered this topic. Thankfully, I can continue eating curry as often as I want. Thank you for your help.

  • Paddycakes

    What if one does NOT have a gallbladder, what effect will turmeric/curcumin have, if any?

  • Shelly Young

    Thank you so much. I was overdosing a little bit on turmeric (maybe close to a tablespoon a day) for a couple of weeks. I developed loose stools that even woke me up one night and a very itchy rash on different areas of my body. Luckily I spoke to a health conscious friend and then read you writings on Tumeric. Everything cleared up when I let go of the Turmeric.

  • Susan Eisner

    Dr. Greger: Having heard that turmeric can prevent memory problems, I eat a lot of turmeric powder in my meals, maybe .25 to .5 teaspoon a day most days each week. I don’t usually cook it. I sprinkle it on after the food is heated up, with ground black peppercorns and cumin. I have no gall or kidney stone issues. You mentioned turmeric is high in oxalates which bind with calcium. I have osteopenia and have been told to limit consumption of foods high in oxalates, such as spinach, as they bind to calcium and prevent absorption of calcium into the blood. Does eating lots of turmeric therefore also contribute to bone loss? After a recent bone density test 2 years after the last one (of 3 over several years), my rate of bone loss significantly accelerated much more than usual. During those 2 years I upped my turmeric intake, and I was also on Lexapro and thought the high rate of bone loss was due to the Lexapro (there are studies that indicate SSRI’s can cause bone loss). But now I wonder if too much turmeric could have caused it. What do you know about turmeric and its oxalates and bone loss? Should I reduce the amount of it that I eat, and if so, to how much? Should I reduce or stop the black peppercorns with the turmeric? And does it matter if the turmeric powder is cooked or not? Thank you!

    • Erin Polaschek

      Hi,

      So according to various indian specialists on the subject turmeric should actually help prevent osteoporosis. A quick google search revealed that many seem to be reporting this.

      I guess check it out.

  • Coacervate

    The list of things that contain oxalate is long. One possible solution is to ensure plenty of calcium (green leafies) with every meal. Chew well. The dietary calcium will bind up the oxalate and pass through you, not into you. Of course this means compensating for the the calcium loss by eating a bit more calcium-rich foods.

  • Vegamaniac

    Glad you covered this. People who consume a plant-based diet and who are prone to kidney stones need to be especially careful because much of our diet is high in oxalates. Kale, collards, nuts, beans, chocolate, beets, spinach, strawberries, blueberries, black tea, cherries, all the good stuff. Need to offset it with lots of water with lemon added.

    QUESTION- did the video state that for those prone to kidney stones (or gout), supplementation with curcumin is fine but dietary consumption of tumeric needs to be watched? That’s confusing to me. Did I miss something?

    • Aquifer

      I think that is because the oxalates are present in the turmeric, not the curcumin ….

  • tedster

    I have a propensity for kidney stones. The first one that I had (or at least
    realized that it was a kidney stone) sent me to the ER. Fortunately it was done and over with within a few hours. (Yes, I did collect the stone,
    so I know that was the problem. It was determined to be of the calcium oxalatevariety.) That was about 12 years ago. Since then, I’ve experienced stoneson average about twice a year. Fortunately, they are way less intense than the “ER” stone event;however, they are longer in duration. Sometimes a day or two.

    At any rate, I started turmeric capsules (one a day) about nine months ago with the understanding that I could increase the frequency or intensity or both of my kidney stones; however, I wanted to see if it could
    help with some joint pain. I know my case is an “n” of one, but I’m happy to report I have had NO stone issues since I’ve started the turmeric. The flare-ups, so far, seem less frequent. I guess every body is different.

    • Liz

      Hi tedster,
      Your diet needs to be alkaline. We need to eat lots of acid
      foods for their many health benefits, but we also need to eat
      plenty of alkaline foods to offset the acid.
      See if you can find an acid/alkaline chart somewhere on the internet, or ask this site for a link.

      • tedster

        Hi Liz-
        I did drop out all processed treats and reduced the processed food in my
        diet about a year ago. In addition, I’ve been adding two big kale
        leaves or a green power to my smoothie every day. Finally, I’m always
        well hydrated. Maybe this tipped the balance toward reducing the kidney
        stones. Apparently enough so that I can tolerate 1 capsule/day of
        turmeric.

  • studio54

    Apparently curcumin can contribute to the oxidative stress in acute vitiligo and prevent repigmentation. Therefore, dermatologists and other doctors treating patients with this disease are aware of this possible problem. Turmeric is a widely used ingredient in curry, it can contribute to oxidative stress in asian people with vitiligo.

  • responsible D

    I’m a healthy person with no known kidney stone issues, and I’d like to put some turmeric in my smoothie every day to take advantage of its beneficial properties. Please tell me if I’ve gleaned the proper guidelines from the articles:
    - Try not to use more than one teaspoon per day of turmeric, to avoid getting too many soluble oxcylates that might promote kidney stones.
    - It’s ok to put in some black pepper in to increase the bioavailability of the curcumin, since doing so does not increase the potentially harmful effects of turmeric.
    Thanks!

    • nc54

      I do one teaspoon of turmeric with a little pepper in my fruit/veggie smoothie. But I heat treat it first. Heat it up in whatever liquid I am using, almond milk or water. Then just cool it down (I put it in the freezer for a few minutes) before putting it in the blender. I also use it as a dressing base in my salads. I add ground up flax and pumpkin seeds to it, mix it up, spread it over my salad.

  • DH

    Questions (sorry to be off-topic):
    1) Is it true that if one consumes horseradish on top of steamed broccoli, one gets all the benefits of raw broccoli, but without the goitrogens? (ie, the myrosinase in the horseradish will hydrolyze and release the glucosinolates). Or is this wrong?
    2) Is it better and more healthy to use balsamic vinegar on one’s salad or a small amount of oil?
    Many thanks,
    DH

  • prisha

    As a practitioner of Traditional Chinese Medicine I use turmeric but it is contraindicated in pregnancy. We put it in a formula. It is never given as a single herb.

  • Kathleen

    Is there less of a problem consuming curcumin supplement 500mg daily…versus the Tumeric? I have Wegeners granulomatosis and am taking for anti inflammatory purposes. No gallbladder and thus far no kidney stones…have had gout in the past prior to going plant based diet.

    • Darryl

      One advantage of the curcuminoid extracts that has gone unmentioned is that they will contain almost no oxalic acid (the turmeric compound with kidney stone concerns). The major disadvantage, as far as I can tell, is that there’s relatively little experience with the higher curcumin levels in humans.

      Very high curcumin doses are associated with liver pathologies in animal models (1, 2, 3), but I haven’t seen any case reports in humans. I suspect, like green tea extracts, it acts as a hormetin, so it probably isn’t wise to ingest handfuls of the extract.

  • Paul Spring

    Dementia, carbohydrates and fats – Very disturbing study

    read for free:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494735/

    This recent study shows a direct correlation between increased fiber, carbohydrate consumption and dementia. There is a reduction in dementia with increased fat intake. What the heck is going on!?

    • kayumochi

      Why is the reduction in dementia with increased fat intake disturbing?

  • drjembe

    Please let me know if I have missed the proportion of turmeric and black pepper to make my own supplement capsule. I believe this would be a more affordable option. I have read through the discussion and did not see this info. Perhaps I missed. If not, Dr. Greger, please answer. What amount (by teaspoon) per capsule and how many capsules a day for a healthy person? Thank you.

    • Tommasina

      Dr. Greger talks about just needing a pinch of black pepper (1/20th of a teaspoon) with the turmeric here: http://nutritionfacts.org/video/boosting-the-bioavailability-of-curcumin/
      I didn’t see a proportion but it seems like a normal Indian curry powder (which has both turmeric and black pepper in it) cooked with some sort of fat would give you the full benefits of curcumin.

  • Gabriel

    Thank you for your work of excellence.

    What about someone who only has one kidney? Is there any risks in consuming turmeric mainly through diet?

    Thank you.

  • R

    Dear Dr Greger
    Having seen all you videos on Turmeric, would you advice that I stop taking black pepper with Turmeric?
    Many thanks
    r

  • Kate McConaughy

    Turmeric eaten by itself and with pepper/olive oil makes my eyes red, which is usually a sign of liver toxicity?

  • Jon Sterngold

    Those sensitive to COX inhibitors (as with other NSAIDS) can have the same side effects from curcumin. Heartburn, esophageal spasm, etc.

    • Renee Schuhmacher

      Just learning about this. If I’m suffering from an ulcer I am assuming that turmeric supplements are off limits. Was using it for hip and finger pain. Am I correct in this assumption?

  • Jackie

    I would like to know if I should take turmeric,along with black pepper so it is digested?In your previous video you explain that black pepper suppresses the liver converting fat soluble substances into water soluble ones.,I have mercury poisoning and the suppression of liver function doesn’t sound good to me.Please advise.thank you

  • dharmarules

    Hello there ! First congratulations on your new hires and growth. I hope you get some more than deserved time off soon. My question is about “t-Curcuma extract (sp)”. For really bad knees/pain I read that “2g’s” daily should help. I am hoping you can give me a couple of names (not asking you to endorse any), just want to know they make the real thing. Any and all help is greatly appreciated, in peace, Lynda Whitney

  • Greg Blank

    Dr. Greger, isn’t the association of gout and kidney stones particular only to the case for uric acid stones (5% of stones), which are caused from too many purines and not the majority of stones that are a type due to too much oxalates? If true this would throw off any concern/connection of gout when considering oxalates – since gout like uric acid stones is also caused from too much uric acid production in the body. Or am I wrong? Thanks, Greg

  • Oren

    Dear Dr. Greger,

    https://www.youtube.com/watch?v=3voRIi88LtQ#t=2873

    According to the above Youtube video (which is in English of course), flax seed daily consumption causes in the long-term an allergic response, as the human body is not build to sustain such quantities of protein.
    Thus not giving the immune system a rest and developing significant allergies & autoimmune diseases.
    Please watch the attached lecture and revert back with your professional opinion.
    Thank you for your time and I hope to hear from you soon.

  • Roy

    Thank you for your work. It’s great. I have been drinking Golden Milk (1 tsp turmeric, 1 tsp cinnamon, 1/8 tsp black pepper, 1/4 tsp ginger and 1 tsp ashwaganda with soy milk, liquid stevia, olive oil and vanilla) daily for 8 months for arthritis. It has completely eliminated arthritic pain in my thumb which comes back only if I stop taking the drink. I had had this arthritic pain for years. Should I take a drug holiday from this mixture occasionally or is it ok to take everyday? I have no other health problems, no kidney or gall bladder stones at 63 years of age. I am vegan and take no meds.