Pepper corns.

Image Credit: John Loo / Flickr. This image has been modified.

Why Pepper Boosts Turmeric Blood Levels

Herbs as Medicine

“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.

How Pepper Works With Turmeric

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.

Other Ways to Boost Turmeric’s Benefits

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!

For all our videos on the latest research on turmeric, visit our Turmeric topic page.

-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.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

119 responses to “Why Pepper Boosts Turmeric Blood Levels

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  1. 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?

    1. 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.

    2. Just from a few years of casual study on the issue I think the problem with “sweet spots” is that they could be different for everyone. We’re just now beginning to understand (in western medicine) something that many cultures have known for a thousand years and that is that not everyone’s metabolism and chemistry is the same. The Chinese actually have names for the different metabolisms and adjust their treatment for that particular type. I find it a fascinating subject myself, instead of trying to reinvent the wheel, modern health care should be studying the old natural treatments but of course that generally does not leave big pharm with an overpriced pill that can be patented and sold for exhorbitant rates. Someone once said that nature has provided everything we need we just have to be smart enough to find it…I find truth in that statement.

  2. 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’.)

  3. 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!

  4. 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.

    1. 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).

    2. 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.

    3. 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.

      1. 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…

        1. 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.

          1. 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!

    4. 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.

    5. 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.

      1. 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:

        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:

        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.

    6. I believe a common [and medicinal] cooking oil in South Asia is stoneground mustard seed oil, if you want an alternative to ghee. The government in some places tried to get people to use soy oil instead, and people say their children were healthier on the mustard seed oil; probably kills parasites and other infections!

  5. 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?

  6. 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.

    1. 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.

      1. 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.

        1. 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.

          1. 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.

    2. 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 ?

  7. 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.

    1. 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.

      1. 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.

  8. 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?

  9. “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?

  10. 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.

  11. ‘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’…

  12. 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 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?

  13. 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?

  14. 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?

    1. There is research that supports the use of Maitake mushrooms. Also look at Inostiol and IP6). Look at research in China and also research using (the National Institute of Health). In Germany they use mistletoe to shrink tumors. Some clinics in the US may offer this treatment. It may be intervenous. Research also supports the use of tumeric.

  15. 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?

    1. 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.

  16. 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?

  17. 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? :) :)

    1. I have a suspicion tha the whole food has everything it needs to make the various substances more bio available. One case in point is raw broccoli. It has an enzyme that makes a great substance bio available but cooked or powdered has inactivated enzyme and one does not get the benefits from that substance ( I think it is NAD or something. Honestly, it seems that whenever we powder or liquefy anything, it doesn’t seem to work as well whether it be fruit juice or flour.

    2. I have a suspicion that the whole food has everything it needs to make the various substances more bio available. One case in point is raw broccoli. It has an enzyme that makes a great substance bio available but cooked or powdered has inactivated enzyme and one does not get the benefits from that substance ( I think it is NAD or something. Honestly, it seems that whenever we powder or liquefy anything, it doesn’t seem to work as well whether it be fruit juice or flour.

      1. Hi Margaret Scruggs,

        I am a volunteer for Dr. Greger. Thanks so much for your question.

        Dr. Greger recommends 1/4 of a teaspoon of turmeric. If you are consuming turmeric whole (rather than a curcumin supplement) the turmeric curcumin is absorbed much better. Even just small amounts of fats (a few nuts or seeds, or small amount of avocado) will help absorption. Regarding black pepper, even a pinch of black pepper (1/20th of a teaspoon) is enough to increase absorption.

        I hope that helps!

  18. 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?

  19. 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.

  20. 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.

    1. Jas: If you are interested in science, you are in the right place! There are lots of new myths about saturated fat, but not new science. You can learn more about the *science* of saturated fat, including how some studies are designed to mislead you, here on this site. (Check out these videos: ) Each video has a ‘sources cited’ button so you can check the science yourself.

      Another place to get started is the topic/summary page for saturated fat:

  21. “Though maybe it just tastes good, and it’s merely coincidence?”…don’t forget about the fact that the taste buds are designed to help the body determine what is healthy to eat and what is ailing the system.

  22. Actually, there’s no proof butter causes heart disease and ghee is really, really good for you; it’s a provider of at least three of the four fat-soluble vitamins in a bioavailable form not needing conversion. However, people in India are also known to use vegetable ghee, which is pretty much like our Crisco here. I’ve seen it offered in Asian groceries in my city and was just appalled. Plus people in India are largely vegetarian and eat a lot of grain and they probably go around inflamed as often as not. Their heart disease rates would be worse if they didn’t have their curry.

  23. thanks for sharing all this infos! I have been making golden milk with the purathrive curcuma extract : First of all it is absolutely delicious and so much more efficient than the regular curcuma powder I used to use! And I actually see improvement, my knees don´t hurt anymore. I am just so exited about this product. Good luck to all ;)

  24. i’m 66 and recovering from liver failure induced by Invokana to “help” my diabetes. I took it for 4 days and went jaundice and everything else that goes with liver failure. I was just st recovering from that when I had a heart attack leading me to triple bypass.
    I can’t take any pain medicine as I throw up. My cardiologist suggested Tumeric. After reading all the comments I’m not sure that this would be hard on my liver if I add pepper to the mix. I read if taken with a fat it by passes the liver. I was think if I took fish oil or Vitamin E this might help me recover and help with tumeric.
    Any suggestions?

    1. Hi Cherie, You have had a really rough time! I’m so sorry no one has addressed your question yet. We learned a lot about herbals and botanicals in my Integrative Medicine fellowship. Our professor for most of this portion is a wonderful, classically trained physician who had been and herbalist prior to going to med school, Dr. Tieraona Low Dog, MD. In the herbal world there have been lots and lots of published studies on the benefits of Milk Thistle to support the liver as it heals. You might want to start using that as the liver has so much to do with all our functions that having that working less than optimally will slow your recovery of your other problems.
      Turmeric is great for inflammation but so is ginger. You can get them in the powdered form but they are also roots that you can get from health food stores if you have one around. I like to put a few slices into my morning smoothie and get them incorporated that way. The great thing about the ginger is it will also settle your stomach and deal with any nausea you may have. Adding a little black pepper will enhance the absorption of the turmeric into your blood stream.
      I encourage you to look for books and websites by Dr. Low Dog and you can learn more about some alternative remedies. I hope this is helpful

    2. I am no expert in what would help, but I know that using turmetric at therapeutic doses requires taking it with a “buffer” to protect the stomack lining. That isanother reason why it is seldom used on its own in oriental countries.

    1. I was on the Turmeric 3D site which referred to the 2000X boost in turmeric effectiveness when coupled with some black pepper and clicked on the link to this page only because I wanted to get hold of citations. The link “Why pepper Boosts Turmeric Blood Levels” seemed promising in this regard.

  25. Great article but quite wrong about ghee. Ghee is not just butter fat there are multiple aspects to it – cow breed, cow feed, probiotics, non pasteurized, gold salts.

    Butter fat is a very narrow definition of ghee

  26. I take 2 teaspoons of turmeric with a sprinkle of black pepper some berries, kale,
    1 teaspoon ginger and 1 tablespoon flax power with water and sometime a little
    honey and 1/4 cup plain yogurt . Could I add milk instead of water? Thank you

    1. Hi Abigail, my name is Dr Renae Thomas and I am one of the moderators. The active compound from the black pepper, piperine, is not contained in cayenne, so that is not a substitute for this particular reason.

      Black pepper and white pepper are both made from the Piper nigrum plant. The piperine content for black pepper is about 5%-7.5 %. In white pepper the content is about 6%.

      So white pepper, but not cayenne, may be substituted for black pepper.

      Hope this helps!

  27. Very informative article. Have
    Been taking Tumeric with black pepper for over 6 month for a broken, healing leg. The pain and swelling disappeared over night. Dr. Said it coul probably take close to a year for complete healing, however after six month I started to walk again and there was no pain! It works!!

        1. Thank you, but your answer doesn’t say whether it is the powdered or fresh turmeric. I need to know about the fresh root as I grow a lot of it.

    1. I grow a lot of turmeric, how much of the fresh turmeric and pepper would I need to help the pain of osteoarthritis please?

  28. Nice,

    I guess its because Indians have a very ancient and wise culture which has seen them eat turmeric etc for thousands of years. Keep in mind, Buddha himself was Indian, so Indians do have a special relationship with this universal knowledge

    Turmeric in Indian diets may also explain why Indians have such a low cancer rate, despite still being a third world country. By contrast, America has an extremely high cancer rate despite being the worlds last superpower

  29. Since turmeric is fat soluble, (in addition to eating with black pepper) what’s the best way to reap the full benefits *without* mixing it with refined oil? Would sprinkling it on avocado, mixing with nuts / nut milk do the trick? Or does it need to “soak” in oil? Thanks!

    1. Unsweetened almond milk should do the trick. If dairy is well tolerated, then regular milk would be great. Golden milk gets its cult from this.

  30. Good article. But totally DISAGREE on the comment about ghee. First of all, the saturated fat fear is starting to get heavily debunked in recent times. Second, ghee is considered an elixir nutrient in ancient Ayurveda as a good that increases immunity (ojas). Third, India’s heart disease is most likely to be caused by the high consumption of simple carbohydrates like rice and flour. Not because of the ghee. Ghee is actually treated as a medicinal food if consumed in the right amounts and at the right times. The amount of ghee that India eats (a few TBSP per day) will never hurt at all.

  31. Dear Dr. Greger,

    I need to point out on the rising trend of heart problems even for young men who exercised frequently. This is due to imbalanced nutrition. The lack of folic acid is causing meat eaten to be stuck as work-in-progress in the arteries as homocysteine.

    Please refer related article:

    However, folic acid is too cheap at usd 5 cent per tablet. And this is not good for some businesses which focus on removing heart blockages

    I hope this is useful

  32. To quote you, Dr. Michael Greger, “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.”
    YES, it is amazing how we were able to do it – all starting from ANCIENT times. You are WRONG about GHEE. It is NOT ghee as such, that is responsible for heart diseases in India. It is the diet choice. Indian cuisine has as much sweets and fried foods as much as healthy foods. People always tend to consume more of sugar and fat (for the sake of taste) and end up with wrong things in their systems. And Turmeric cannot be blamed for not “absorbing” all the bad stuff you end up eating. GHEE is a good fat that has to be taken in moderation just like anything else. Since the late 90’s there has been a slow but STEADY surge towards Western junk foods. KFCs & McDonalds are becoming more common to find in any Indian city. This is also a reason because people are forgetting their roots when their system is simply NOT used to such foods and their ingredients.

  33. Hi I’m a health support volunteer. I don’t think any studies have been done comparing the two, but I think either would work fine.


  34. Hi, i’ve read several issued regarding piperine being harmful over time to your Liver. It is known that it inhibits the Liver from removing baddies from our body, so does NutritionFacts or Dr Greger have any infirmation on whether this is an issue? I take Turmeric with Black Pepper daily. Should i not be doing this?

  35. Hi Mark- Piperine does interact with certain liver enzymes. This can lead to certain substances being processed more rapidly by the liver. Alcohol toxicity, for example, is reduced by pipeline’s effects on liver enzymes. It also interacts with certain medications, and could lead to the liver clearing them so rapidly that they lose effect. I could not find reports of piperine causing liver toxicity. It’s safe to use pepper and turmeric in cooking. I can’t say if the same is true for supplements, which may provide very high amounts of the active compounds. -Dr Anderson, Health Support Volunteer

  36. I tried to contact in a non public forum, but it was either here or facebook. I was concerned about the statement about traditional medicine failing Indian people with ghee. I’m not an expert of Ayurveda which is the traditional medicine of India. But, I feel that comment comes off too strong for something that deserves much deeper attention and has many more factors. When the British colonized India it outlawed their traditional Medicine Ayurveda. If Indian Ayurvedic doctors were caught practicing they risked having their hands cut off. The system and wisdom was suppressed from the population and only now regaining its place. So the use of ghee today does not reflect the use prescribed by their traditional medicine. The work schedules, eating habits, stresses, attitudes etc. introduced by the West may not have taken the medicine away from India, but it has turned medicine into poison in many ways by way of practice and ignorance due to a violent suppression. I’m all for Science catching up, making new discoveries or old ones, and offering another perspective that is helpful when wisdom is applied to practice. I’m a supporter of using the best of multiple sciences allopathic and traditional and I believe there is a huge opportunity to find some highly effective practices. Thanks for what you do I otherwise found the article very informative.

  37. Ghee is butter fat which has been shown to decrease Flow Mediated Dilatation, which has been shown to correlate with premature death. If you have any peer-reviewed published unbiased clinical evidence that proves health benefits of ghee we’d all like to see it.

    Dr. Ben

  38. Hi,

    “Amazing how they could figure that out without double blind trials. (Though maybe it just tastes good, and it’s merely coincidence?)” Perhaps there are another way in universum than “double blind trials” and coincidence?? Another type of knowledge than natural scienticaly method??

    The knowledge about spices/herbs in India is mostly coming from Ayurveda which is a “science” because of Ayurveda has own teories about “everthing”: rules of the universe, the human body, the chemistry of the plants and more. I’ve tried and seen that they work.

    Everything is individual within Ayurveda but in general ghee is the most health fat (I think the medical science is going to “discover” that. We must not forget that all animal fats were very dangerous for health according to medical science not long ago!) and has a very special place in Ayurveda. .

    1. Yes I agree. There is more than one type of science, and more than one type of way to use food and medicine. Double Blind studies are not the only way to confirm the use of something as being beneficial. Also Western science completely negates energetics and spirituality. Which is a different practice. Then there is that science usually tests things in tubes and labs which can provide a great wealth of information, but the science tends to be slow at finding effective ways to implement their findings having people die until they get it right on one extreme, and later “discovering” why it was not an appropriate use of their previous findings or that they jumped the gun on a new wonder medicine because they would not look at the whole picture. I’m for science, I’m also for appropriate use and I feel in any field arrogance is a killer, even in holistic practices. You have your science other people have other sciences and there are ways to use them together, and appropriate applications and inappropriate applications of each. Now the Keto diet says all these fats from organic clean animals is great, and the whole low fat thing is dying finally. It about each persons metabolism, individual make-up, how much is used how often, and a myriad of other factors. Lets all be measured. Just because people learn to inappropriately use or eat something you want to make blanket statements without considering asking what would be appropriate.

  39. Yours was an interesting question and I reviewed many studies on Turmeric and pepper, but reviewing the Methods section of the studies could not find exact dosages, much less ratios, that were used or shown to be effective. I think my best advice is to encourage you to look at Dr. Greger’s video He advises: ” 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.”
    Some additional practical advice on how much pepper to use can be found here: Hope that’s helpful

    1. Thanks so much for your reply and the links provided.
      I’ve been mixing 1/4 tsp of turmeric, 1/8 tsp black pepper, 1/4 tsp cinnamon, 1/4 tsp ginger, 1/2 cup of berries and sliced kiwifruit into my cooked whole oats then topping it with a tbsp of ground linseed, a tbsp of sunflower seeds and a drizzle of unsulfured organic blackstrap molasses. Sounds weird but it’s actually really good!
      Think I’m ticking off a few of the daily dozen boxes in my first meal of the day!

  40. Do freshly ground peppercorns provide more piperine than the commercially ground (in a bottle) black pepper that may have been sitting in warehouses or store shelves for months if not years? If yes, how long does it take for the piperine to oxidize in the finely ground form if at all? Again, if we finely ground peppercorns how long does it keep its active ingredient piperine, and is there any loss during that time? I also read that we can freeze peppercorns and how long is that good for?

  41. Hi Tara, When stored in a cool, dry place, the shelf life of black pepper is up to two to three years. I could not find any article on freezing peppercorn or the pipeline content of fresh as apposed to commercially ground black pepper. However, they often Freeze-Dried Green Peppercorns before they reach maturity, and hence, have a lighter, fresher, more herbal flavor than black peppercorns, and a lighter green color than regular dried green peppercorns. Peppercorn is sensitive to humidity and one has to take that into consideration if you wanted to freeze it.

      1. Yes it does, thank you ! So for now, I’ll just use it w/ turmeric, I wouldn’t want it to reduce the bio-absorbability of any of the other spices !

  42. Hey there, You have done a fantastic job. Thanks for sharing such a nice information, The thing is that going perfectly here. That’s truly good, keep up writing…You get more succeed.

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