Who Shouldn’t Consume Curcumin or Turmeric?

Image Credit: sean dreilinger / Flickr. This image has been modified.

Who Should be Careful About Curcumin?

Following flax and wheatgrass, turmeric is the third best-selling botanical dietary supplement, racking up $12 million in sales. Currently, sales are increasing at a rate of 20%.

“Curcumin is a natural plant product extracted from the turmeric root and is used commonly as a food additive popular for its pleasant mild aroma and exotic yellow color.  It is widely considered unlikely to cause side effects.” However, just because something is natural 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. Surely 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. Doses of turmeric that have been used in human studies range from less than just a 16th of a teaspoon a day to two tablespoons a day for over a month. On the other hand, 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.

Studies have yet to show overt serious side effects in the short-term. However, if we combine high dose curcumin with black pepper, resulting in a 2000% boost in bioavailability (See Boosting the Bioavailability of Curcumin), it could be like consuming the equivalent of 29 cups of turmeric a day. That kind of intake could bring peak blood levels to the range 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 on curcumin 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 that it facilitates the pumping action of the gallbladder to keep the bile from stagnating. In one study, profiled in my video, Who Shouldn’t Consume Turmeric or Curcmin?, researchers gave people a small dose of curcumin, about the amount found in 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 we want to squeeze it in half. So the researchers repeated the experiment with different doses. It took about 40 milligrams to get a 50% contraction, or about a third of a teaspoon of turmeric every day.

On one hand that’s great—totally doable. On the other hand, that’s some incredibly powerful stuff! What if you had a gallbladder obstruction? What if you had a stone blocking your bile duct? If you eat something that makes your gallbladder squeeze so much, it could cause pain. So patients with biliary tract obstruction should be careful about consuming curcumin. 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 gallbladder cancer.”

Too much turmeric, though, may increase the risk of kidney stones. As I mentioned in Oxalates in Cinnamon, 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. “The consumption of even moderate amounts of turmeric would therefore 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. Those with gout, for example, 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, he or she might consider curcumin supplements, because to reach high levels of curcumin in turmeric form would incur too much of an oxalate load.

If we are going to take a supplement, how do we choose? The latest review recommends purchasing from Western suppliers that follow recommended Good Manufacturing Practices, which may decrease the likelihood of buying an adulterated product.

I previously discussed 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.

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. 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.

-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.

Discuss

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.


46 responses to “Who Should be Careful About Curcumin?

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  1. Today’s blog on oxalates was very helpful; I think I’ll cut back on the turmeric from 1 teaspoon to 1/2 a teaspoon or so, especially since I eat spinach every day too. Regarding the oxalates in cinnamon, are there any oxalate dangers in eating Ceylon cinnamon?




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  2. I love how you can take a boring vegetable or bean, add the right mix of spices, and suddenly it becomes a delicious dish that everyone gobbles down.




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  3. Very thought provoking research you’ve given us today. 2000% boost in bioavailability concerns as it
    might relate to how it effects other bodily functions in maybe a harmful way.

    I have a concern about the iodine that is added to regular salt. Does this synthetic form of iodine have
    any negative science behind it as far as not being healthy for humans? Does long term consumption of
    this food additive have negative consequences, even if ingested in sensible amounts (regardless of the sodium
    intake issue)?

    Basically, for those out there who don’t eat a lot of fish and would prefer not to eat anything out of the ocean,
    is this fortified salt as an iodine source safe? Thank you Dr. G. for any science on this.




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    1. Yes, it is safe. Keep in mind that salt in processed foods is not iodized, however. Anyone whose main source of salt is processed foods may still need a source of iodine.

      When iodine was first added to salt to help ppl avoid goiters, there was no massive processed food industry. Therefore, adding a little iodized salt to a WFPB diet is not a bad idea.




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        1. Got curious and checked the label. There’s not even a single calorie of glucose in a single 1/4 tsp (1.5g) of salt. There’s more glucose in a placebo sugar pill.

          BTW If I were ever in a life-threatening accident, I would HOPE I’d be administered dextrose/saline solution to keep my body from going into shock.




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  4. That seemingly never ending fascination trying to use a measurement of volume as a measurement of weight not helping the message. Tsp’s is like watching a toddler trying to cram a cube in the round hole, over and over and over again, if a kid keeps doing that after a certain amount of time the parents should start to worry a little bit. If a kid can learn……..




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    1. The research used weight, the Good Doctor has converted the weight of that component found in a given volume of turmeric so we can measure/visualize the amount. Dr. Greger does a great job of explaining the science to the whole audience.




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        1. The doctor is an American; in the lab he uses metric, in his kitchen and garage/shop he uses English units. Get over it, were Americans, we don’t use metric exclusively and we don’t drive on the wrong side of the road.




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        2. No that wasn’t so bad. It’s more so your tendency to be targeting Dr. G’s material for what you think is wrong. I see lots of good stuff!!




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    2. This is somewhat off topic but when I was in junior high, the late 1960’s, the US was going to switch to metric but it turned out that it was too expensive for the auto industry to retool. Now the auto industry has retooled for some time and the US is still on the English system that even the English don’t use. It is time we americans got out of our comfort zone and made an effort to join the rest of the world. Perhaps NF could display both measurements since they are being internationally read. I notice my measuring cups have both english and metric. When we divide 5/8 by 2/3 doesn’t one convert to decimal to solve the problem?




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      1. I too was in JH when the switch to metric fizzled. Unless there is profit in switching; it probably won’t happen quickly. Manufacturing and medical have been slowly changing to metric, even packaged foods usually have both systems. The latest cookbooks however are still old school.
        I only responded to Arjan to defend Dr. Greger’s delivery (not that he needs defending) as I find all his messages well composed and very understandable. I wouldn’t want to add additional work (displaying both measurements) to his plate. Indeed, when I read European articles no one bothers to include measurements other than metric for the American readers.




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        1. That’s because we don’t want to check the internet or books to get an estimated average density of a substance to help us guesstimate a certain weight of something.

          We get a scale instead of a spoon and we weigh off 5 grams.

          Metric is easier and unavoidable because it makes sense, and it only remains an issue if you avoid using it.
          And it would just be polite to settle for once on a the system 96% of all mankind has already agreed upon,
          and the system that doesn’t require books full of conversion tables but is as simple as:
          http://www.geek-jokes.com/sites/default/files/styles/image_detail/public/images-gallery/USvsEU.png?itok=5TOSh7Bo




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          1. So tell me, why is a measurement system based on the circumference of the earth better than a system based in the length of the king’s foot or size of his pint of beer? We have a lot of unique measurements such as acres and hectares and measurements used only to measure the diameters of atoms and others to express distance to the stars, to which no one can relate.

            BTW, English measurements evolved from practical application, like stepping off the foundation line of the cabin you are building. One of the complications of changing from English to Metric in fasteners, nuts, bolts, and washers. Turned out the depth and numbers of English threads had greater strength and thus clamping force of equivalent Metric hardware. So there was some engineering resistance which eventually lead to a bastardized metric hardware to incorporated English dimensions. It is inconsequential, unless you are not paying attention as to in which system you’re immersed and your rocket science software’s units are in a different scale than the hardware it’s manipulating. Which still happens when there is a misplacement of decimals.




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  5. So how does one know if one is prone to kidney or gall stones? In a normally healthy person is a gel cap filled with turmeric and a bit of black pepper a good thing or a risky thing? I feel like we’re getting mixed messages here.




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    1. The simplest way to apply this, in my nursing opinion, is to use 1/3 tsp turmeric daily for preventive benefit; but if we have undiagnosed aches and pains, we should partner with our doctor to get evaluated and discuss any nutritional treatments.




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          1. LDGourmet, FYI, I’ve been taking turmeric capsules of approx.1 tablespoon (12 “00” caps) ,with 1 tablespoon capsules of cardamon and 1/2 tablespoon of tellicherry black pepper daily for 4 months. Oh, I forgot, 2 cups of blueberries also. I do this for cancer prevention and muscle and joint flexibility. I drink 60 to 80 oz of water daily, lift weights and run. I feel great at 62. Every – body – is different. This is working well for me so far. I also have several others healthy eating habits. My blood work is excellent. No health issues and my very high risk genetic cancer propensity is being held in check. Best wishes to you.




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    2. You WILL know when you have one and it isn’t pretty! LOL. I’ve had both, excruciating! I no longer have a gallbladder, and had numerous recurrent bouts of kidney stones before going plant based and dropping 1/2 my body weight about 5 years ago. I hope I don’t jinx myself, but I haven’t had a problem since and eat way more of the supposed “offending” oxalic acid containing plant matter than I ever did before, so feel there is a lot more to the equation than meets the eye. I can’t be very specific or scientific, but I am quite sure it has everything to do with no longer consuming animal products, since other episodes of weight loss were of no help. Sure wish I knew about WFPB ages ago!!!




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  6. Hi Jane’s Addiction,

    One study (http://tinyurl.com/o546uzv) from 2008 suggested that because much of the oxalate in cinnamon is not water soluble, it isn’t as available for the body to absorb, and to end up in the urine for excretion (thus affecting risk of kidney stones). In this study, the percent of oxalate that was water soluble in cinnamon was 6% vs. 91% water soluble oxalate in turmeric. The authors concluded that supplemental doses of turmeric, but not cinnamon, could increase the risk of kidney stone formation in susceptible individuals.

    However, this study sample was very small (11 healthy adults). Further complicating the interpretation of the results is the fact that plants are, well, plants. They are living organisms, and their composition can vary greatly based on soil conditions, pest exposure, heat, light, moisture, fertilizer use, and other differences in growing conditions. So, just because the cinnamon used in this study didn’t contain a lot of water soluble oxalate, that doesn’t guarantee another cinnamon source wouldn’t have higher amounts.

    In the end, I think it’s wise to be cautious about loading up on cinnamon (beyond the usual culinary amounts), if you have any reason to believe you are at risk of kidney stones – hHave you ever had stones? Has anyone in your family ever had them? Have you ever had blood or urine lab results that suggest this is a problem for you?

    If you really want to take cinnamon in supplemental amounts, you may want to talk to your doctor or pharmacist about it first. When taken in typical culinary amounts, I don’t believe cinnamon will pose a risk of kidney stones.




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  7. I do running to keep fit and a couple of years ago I decided to try barefoot style running. I bought the shoes for barefoot style which have no absoprtion because one mainly runs with the front of the foot striking the ground. I found it ok but one day I caused swelling around the achilles tendon running for a bus barefoot style with a small rucksack on my back.
    I saw my local doctor and he said it was just a little inflamation and no serious injury had been caused. I did however sporadically get pain and swelling around my achilles tendon even after I had stopped running barefoot style.
    I decided a year ago to start consuming tumeric with my food, about a half teaspoon a day and I did notice after a couple of months this inflamation around the achilles achilles tendon cleared up. I also noticed that I ceased to have occasional pain around the joints that all runners experience after a hard run. I must admit it is difficult to confirm that it was the turmeric but before I started using it after strenuous workout I did feel quite sore but not anymore




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  8. . I can’t quite get passed the horrible photo. Is that the best you could come up with depicting a pregnant women.
    ( I do appreciate the information on kidney stones)




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  9. Ooops!! Good to know this info! I’ve just had a big glass of warm water with a squeezed lemon, tiny bit of Himalayan salt, and a tablespoon of curcumin, with some black pepper, because I was starting to feel fluey, with a sore throat and temperature. In just 30 minutes my symptoms disappeared, and I feel just fine! Amazing! But I guess it’s too much curcumin? Or maybe to have a big dose like this only when you feel something coming is ok?




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    1. The article just posted (discussed in my post just now) says curcumin actually suppresses the immune response. In the case of a cold, this may be a good thing since the symptoms are largely an OVERREACTION of your immune system, whereas if your immune system is finely tuned you will experience no symptoms even though the charge of the rhinovirus is at full rage.




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      1. Thanks very much for your response, Daniel! Wow, and all this time I have been thinking that curcumin actually boosts the immune system, as shown in quite a few studies. It is quite confusing to see how some studies say one thing and others say something completely different. Looking all over the internet, I find more sites where they praise the immune system boosting properties of curcumin than the opposite. How can we be sure? It happens with so many things. One example: Dr McDougall says that the potato is a fantastic food, and that we could live on potatoes alone. But Dr Greger says that potatoes are bad for us. I admire and respect both of them. What should I believe?




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  10. So often, following the culinary practices of our ancestors is shown to be a healthier option. Because of this, I was not surprised to read that use of turmeric in cooking is probably a safer route than taking a curcumin supplement.




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  11. The abstract of the new article posted on Facebook http://www.ncbi.nlm.nih.gov/pubmed/23701561 says, “colorants like curcumin exert significant suppressive effects on the T helper (h)1 immune activation cascade in freshly isolated human peripheral blood mononuclear cells.” Does this mean we should moderate our turmeric intake no matter what, or is this yet another case of the sum of the whole food works better than the sum of its deconstructed parts?




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  12. I am a healthy, fit (5’6″, 125 pound) 39 year old. After having 2 babies in 2 years, I had severe cholecystits and biliary colic while trying to nurse my newborn. I opted for cholecystectomy because it seemed the only way I could eat enough food to support myself and my baby. That was 7 years ago, and I still have less digestive comfort than I enjoyed prior to the surgery. I also experience intermittent alcohol and fat intolerance (holidays or birthdays may result in severe episodes of vomiting or diarrhea). I eat a plant based diet with ‘meat on the side’ several times per week. I suspect my liver becomes fatigued and am looking for a nutritional support for my liver. Curcumin has been suggested, but I only find evidence of it’s ability to support gall bladder function, which would not apply since I no longer have one. Any suggestions?




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    1. I suggest looking at Dr. Greger’s videos and resources on liver health. He has suggestions for liver support. The curcumin may have additional benefits. Check with your doctor about using it or adding turmeric to your diet.




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      1. First, I wish to say thank you Joseph and Dr. Greger for such a wonderful website.

        Now, as for the Turmeric supplement, I have started taking Turmeric Curcuma 450 mg one or two capsules per day a week ago. The reason I started taking Turmeric is for my osteoarthritis in my finger joints.

        I have developed number of side effects, just one week after taking it – some are really bad. So I did further research regarding Turmeric supplements. I came across an article called “The dark Side of curcumin”. After reading the article, and the fact that I have developed these side effects, I am not sure if I should continue to stay on this supplement. Here is the link to the article, just in case someone might be interested in reading it – http://onlinelibrary.wiley.com/store/10.1002/ijc.24967/asset/24967_ftp.pdf?v=1&t=ib9n9l6v&s=2f28030b10740c29731e314cd82821b8470dbfde

        Regards,
        Zora




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        1. Hi Zora. You are very welcome! I suggest if you started developing side effects to stop taking it. Does the same thing happen with straight turmeric powder? Although osteoarthritis is different from rheumatoid arthritis perhaps some of the same foods or treatments could be applied? Turmeric is not the only spice to help fight inflammation. Check with your doctor about alternative supplements and discuss the side effects from curcumin. Also the link you supplied doesn’t seem to be working for me.




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          1. Thank you Joseph. I will stop taking the Curcumin capsules for now. I did try Turmeric powder a year ago or so, just once or twice – I just was not fund of this spice. I may try it again. I will keep looking into other kinds of anti-inflammatory remedies. I prefer to keep the pain and inflammation via food and spices if possible, instead of resorting to NSADs. I have removed all nightshades vegetables, all dairy food, wheat and other grains that contain gluten. I don’t eat soy products either. I am curious Joseph, what is your opinion on nightshade vegetables and arthritis?
            As for the link I provided, you are right, it doesn’t open for me either – not sure why. Sorry about that. But if someone wishes to read the article, one can google “The dark Side of curcumin – Wiley Online Library”. It should appear at the top of the page.

            Regards,
            Zora




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            1. Thanks! I agree that if you can avoid taking NSAIDs (or minimizing) and instead find alternatives, than more power to you! Nightshades only affect so many people, but they can be more problematic for folks with arthritis. You could try introducing them back one at a time. You should know within a few days (at most) if the food is causing pain. I would hate to steer you in the wrong direction so please tread lightly and ask your doctor or a dietitian about an “elimination diet.” You can read the way we conducted the elimination phase of our dietary intervention for people with migraines. Nutrition intervention for migraine: a randomized crossover trial. That may help a bit.




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  14. This whole saturated fat phobia has long since called into question. The current consensus is that saturated fat is nothing to fear if you get even 15 minutes of exercise today. All you’re doing is saying “beef industry!! pork industry!!” without making a convincing enough case.




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  15. Many people hype about the health benefits of substances forgetting to look into potential negative factors that can arise. In moderation people!




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  16. If you really want to take curcumin as a supplement, you may want to talk to your doctor or pharmacist about it first. I don’t believe curcumin will pose a risk if you follow the instruction before taking it




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  17. I have been taking Curcumin for a number of years. Initially I started taking it for my sinus problems but the more you learn about Curcumin the more you realise that it helps with so many different things. I take a number of supplements but Curcumin is always at the top of the list.




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