Curcumin: benefits, dosage, contraindications
Family or group:
Phytochemicals
Indications
Scoring methodology
EFSA approval.
Depression ✪✪✪✪✪
Analysis of data from six clinical trials shows that daily curcumin taken with an antidepressant moderately improves depressive symptoms compared with placebo in patients with major depressive disorder. The effect of curcumin appears to be greater in middle-aged patients than in older patients, and when it is taken at a dose of 1 g per day for at least 6 weeks, compared with lower doses and shorter durations. Turmeric was used at a dose of 500 mg twice daily, alone or with fluoxetine, for 6-8 weeks.
Posologie
Oral
1000 mg
The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials.
Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.
Fatty liver ✪✪✪✪✪
Clinical research shows that daily intake of curcumin reduces the severity of non-alcoholic fatty liver disease. Indeed, curcumin lowers liver enzyme levels and reduces the severity of steatosis in 75% to 78.9% of patients, compared with 4.7% to 27.5% of patients receiving a placebo. Curcumin also reduces additional fat deposits in the liver from 0% to 4.5%, compared with 17.5% to 25.6% in those taking the placebo. Curcumin also reduces body mass index (BMI), blood glucose, HbA1c, total cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides in adults with non-alcoholic fatty liver disease, compared with placebo. A dose of 70 mg of curcumin per day for 8 weeks was used.
Posologie
Oral
70 mg
Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial.
Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? A systematic review and meta-analysis of randomized controlled trials.
Osteoarthritis ✪✪✪✪✪
Curcumin supplementation has led to a notable and consistent reduction in osteoarthritis symptoms in numerous studies. Among osteoarthritis symptoms, turmeric appears to be more effective at reducing pain and improving function, but less effective at improving stiffness. In most clinical studies, 500 mg of turmeric extract was taken orally once daily for 1 to 3 months. In some studies, lower doses of turmeric extract (90 mg twice daily for 8 weeks) were used.
Posologie
Orally
200 mg
Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study.
Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis.
Product-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis.
Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients.
Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study.
Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study.
Arthritis ✪✪✪✪✪
Compared to conventional anti-inflammatory drugs, curcumin (1,200 mg per day) has been shown to be as effective as phenylbutazone in the treatment of rheumatoid arthritis. As for turmeric, doses of 2 g per day for 6 weeks produced effects comparable to ibuprofen (800 mg per day) in people suffering from osteoarthritis. Good results were also obtained with curcumin (200 mg per day for 8 months) combined with phosphatidylcholine to improve its absorption by the body.
Posologie
Orally
200 mg
Dyslipidemia ✪✪✪✪✪
A clinical trial showed that taking 0.7 g of turmeric extract twice daily for 3 months reduced total cholesterol, LDL cholesterol, VLDL cholesterol, and triglycerides compared with a placebo group in people aged 15 to 45 years. However, the results of other clinical studies show inconsistent and conflicting findings. Indeed, a pooled analysis of data from 7 clinical trials shows that taking turmeric, curcumin, or curcuminoids moderately reduces LDL cholesterol and triglyceride levels, but does not improve total cholesterol or high-density lipoprotein (HDL) cholesterol compared with placebo. Another pooled analysis of data from 20 clinical trials found that taking turmeric or curcuminoids reduces triglycerides and increases HDL cholesterol compared with placebo; however, there is no significant effect on LDL cholesterol or total cholesterol. Overall, most research indicates that turmeric or curcuminoids may reduce triglycerides, but the effects on other lipid parameters are inconclusive. The reasons for the contradictory conclusions may be related to the turmeric formulation, the duration of treatment, and/or patients' baseline cholesterol levels.
Posologie
Orally
500 mg
Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials.
Effect of turmeric (Curcuma longa) on overweight hyperlipidemic subjects: Double blind study.
The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials.
Aging well ✪✪✪✪✪
Turmeric has demonstrated its effectiveness in reducing inflammatory phenomena and has shown promise in combating oxidative stress and as a neuroprotectant.
Posologie
Orally
100 mg
Oxidative stress ✪✪✪✪✪
Curcumin may play an antioxidant role by reducing circulating concentrations of malondialdehyde (malondialdehyde is naturally present in tissues, where it is a manifestation of oxidative stress) and by increasing SOD activity.
Posologie
Orally
100 mg
Cognitive decline ✪✪✪✪✪
A meta-analysis of three small clinical trials shows that curcumin modestly improves cognition in older adults. One of these clinical trials shows that taking curcumin at a dose of 90 mg twice daily for 18 months improves long-term memory and attention compared with placebo in middle-aged and older adults with or without mild cognitive impairment.
Posologie
Orally
180 mg
Irritable bowel syndrome ✪✪✪✪✪
Clinical studies have shown that taking a turmeric extract of 72 to 144 mg per day for 8 weeks can reduce symptoms by approximately 40% to 60% compared with baseline symptoms in otherwise healthy patients with irritable bowel syndrome (IBS). Other studies in adults with IBS have shown that taking two capsules containing 42 mg of curcumin per capsule and 25 mg of fennel essential oil per capsule twice daily for 30 days improves abdominal pain, abdominal bloating, and quality of life by 24% compared with placebo.
Posologie
Oral
100 mg
Premenstrual syndrome ✪✪✪✪✪
A clinical study showed that taking 100 mg of curcumin twice daily for 7 days before menstruation and 3 days after menstruation, for 3 consecutive cycles, produces a clinically significant improvement in physical, behavioral, and mood symptoms compared with placebo.
Posologie
Oral
100 mg
Type 2 diabetes ✪✪✪✪✪
Clinical studies have shown that taking a turmeric extract containing 750 mg of curcumin twice daily for 9 months reduced the percentage of patients in the prediabetes stage and at risk of developing type 2 diabetes, compared with placebo.
Posologie
Orally
750 mg
Digestive disorders ✪✪✪✪✪
Some clinical research shows that taking 500 mg of turmeric orally four times a day for 7 days may relieve dyspepsia symptoms in an additional 64% of patients compared with placebo.nn
Posologie
Orally
100 mg
Metabolic syndrome ✪✪✪✪✪
Preliminary clinical research in patients with metabolic syndrome shows that taking turmeric in the form of curcumin extract at 1.9 to 2.4 grams per day for 2 to 3 months decreases low-density lipoprotein (LDL) cholesterol compared with placebo. However, taking turmeric does not appear to affect weight, blood pressure, glucose, triglycerides, or high-density lipoprotein cholesterol (HDL-C) in these patients.nn
Posologie
Orally
2000 mg
Gastritis ✪✪✪✪✪
In vitro and animal studies indicate that turmeric has protective effects on the gastric mucosa and that it can destroy or inhibit the bacterium Helicobacter pylori, which is responsible for most gastric and duodenal ulcers. From a clinical standpoint, studies are few and their results still inconclusive. However, in one of them, conducted without a placebo, the healing rate was 75% with doses of 3 g of turmeric per day for 12 weeks.
Posologie
Oral administration
3000 mg
Comparative Antiulcer Effect of Bisdemethoxycurcumin and Curcumin in a Gastric Ulcer Model System
Curcuma Longa Linn. In the Treatment of Gastric Ulcer Comparison to Liquid Antacid: A Controlled Clinical Trial
Antimicrobial Activity of Curcumin Against Helicobacter Pylori Isolates From India and During Infections in Mice
Phase II Clinical Trial on Effect of the Long Turmeric (Curcuma Longa Linn) on Healing of Peptic Ulcer
Allergic rhinitis ✪✪✪✪✪
Clinical research indicates that taking a specific curcumin-based product at a dose of 500 mg/day for 2 months significantly reduces nasal symptoms including sneezing, itching, nasal discharge, and congestion, compared with a placebo group composed of people suffering from allergic rhinitis.
Posologie
Oral administration
500 mg
Rheumatoid arthritis ✪✪✪✪✪
Clinical research has shown that turmeric can reduce certain symptoms of rheumatoid arthritis (RA), including pain, morning stiffness, walking time, and joint swelling compared with baseline values. nnTurmeric has been used at 250 to 500 mg twice daily for 8 weeks to 3 months, or at 400 mg three times daily for 2 weeks.nn
Posologie
By mouth
200 mg
Crohn's disease ✪✪✪✪✪
Some clinical studies show that taking curcumin at a dose of 1.08 grams per day for one month, then 1.44 grams per day for a second month, can reduce stool frequency, diarrhea, and abdominal pain in patients with Crohn's disease.nn
Posologie
By mouth
360 mg
Properties
Anti-inflammatory
Many compounds in turmeric have anti-inflammatory effects, mainly via volatile compounds such as germacrone (a sesquiterpene isolated from volatile oils). These beneficial effects have been shown both in vitro and in vivo, in response to acute or chronic inflammation. During acute infections, the mechanism most frequently invoked is the one involving prostaglandins, whose secretion is significantly decreased. The active compounds in turmeric also inhibit, during inflammations, trypsin and hyaluronidase, which are essential to the development of certain inflammations, notably joint inflammations. In chronic inflammation, a number of anti-inflammatory properties have been proposed following studies in animals and humans: inhibition of phospholipases, lipoxygenases, leukotrienes, thromboxanes, prostaglandins, collagenase, elastase, hyaluronidase… as well as an action on the generation of nitric oxide (NO). Regarding NO, curcuminoids inhibit the conversion of NO into peroxynitrite and nitrite, thus avoiding the deleterious effects of these metabolites on the vasculature and on cellular DNA. In addition, curcuminoids inhibit platelet aggregation and slow the production of platelet thromboxane.gg
Antibacterial
Turmeric has antimicrobial properties. Indeed, turmeric or its curcuminoid constituents appear to have activity against certain bacteria, including E. coli, Yersinia enterocolitica, Staphylococcus aureus, Bacillus subtilis, Bacillus cereus, Helicobacter pylori, Mycobacterium tuberculosis and Neisseria gonorrhoeae.
Antioxidant
Curcuminoids are electron donors, thereby neutralizing free radicals and reactive oxygen species (ROS). Curcuminoids notably provide protection against lipid peroxidation. Furthermore, curcuminoids have an indirect effect on ROS that operates at various levels: - Activation of protein kinase C and regulation of intracellular calcium, resulting in inhibition of ROS production. - Inhibition of 5-lipoxygenase, preventing the incorporation of ROS into polyunsaturated fatty acids. - Inhibition of the conversion of xanthine dehydrogenase/xanthine oxidase, thereby inhibiting the production of the superoxide anion. - Modulation of superoxide dismutase expression, associated with the regulation of oxidative stress in the heart and kidneys.
Antidepressant
In humans, the antidepressant effects of curcumin were associated with a decrease in inflammatory cytokine levels and an increase in brain-derived neurotrophic factor (BDNF) (a protein that acts on certain neurons of the central and peripheral nervous systems. BDNF is involved in the survival of existing neurons and promotes the growth and differentiation of new neurons and synapses). The antidepressant effect of curcumin is also due to a decrease in cortisol levels and the role of the hypothalamic-pituitary axis. Moreover, in vitro and animal studies suggest that the antidepressant effects of turmeric extract stem from its ability to inhibit monoamine oxidase (MAO) A and possibly MAO B, resulting in increased levels of serotonin, dopamine, and norepinephrine. Curcumin, a component of turmeric, also appears to increase adenylyl cyclase activity and cyclic adenosine monophosphate (cAMP) concentration, which has been associated with antidepressant effects.
Cardiovascular
Turmeric slows the atheromatous process in the arterial system by reducing aortic lipid deposits and blood levels of peroxidized lipids in vivo. In vitro, turmeric may protect against myocardial infarction by reducing inflammatory cytokines and extracellular matrix proteases. Furthermore, curcumin may have antithrombotic effects. Research suggests it could inhibit platelet aggregation, platelet-activating factor, and arachidonic acid, possibly by interfering with thromboxane synthesis. Other cardiovascular effects induced by turmeric in vitro include reduction of blood pressure, vasorelaxation, and improved endothelial function.
Hepatoprotective
In the case of liver injury, curcumin has a major protective role by activating the liver's antioxidant enzymatic systems: superoxide dismutase, catalase, glutathione peroxidase and transferase. Moreover, curcumin limits iron-induced oxidation.
Analgesic
It has been shown that turmeric and its constituents, administered orally, reduce pain, but the exact mechanism of action is not yet clear.
Digestive effect
With daily administration, turmeric produces: • In the stomach: - An increase in gastrin secretion. - An inhibition of ulcer formation induced by various stress factors: alcohol, indomethacin... • In the gallbladder: A choleretic, cholagogue action and prevention of gallstone formation. • In the pancreas: An increase in the activity of pancreatic lipases and amylases, trypsin and chymotrypsin. • In the gastrointestinal tract: An antispasmodic action.
Antiparasitic
Animal models have shown that curcumin may have activity against the protozoa Leishmania amazonensis, Toxoplasma gondii, Schistosoma mansoni, Giardia lamblia and Plasmodium. In vitro evidence suggests that curcumin has antiparasitic activity against Cryptosporidium parvum.
Hypolipidemic
Through its antioxidant action, turmeric reduces lipid peroxidation induced by chemical agents (carbon tetrachloride, paraquat and cyclophosphamide). In humans, ingestion of an alcoholic extract of turmeric for 30 days: - lowers LDL cholesterol (Low Density Lipoprotein) levels by 62% and ApoB (Apolipoprotein B) by 83%. - increases HDL cholesterol (High Density Lipoprotein) levels by 72% and ApoA by 25%.
Hypoglycemic
Curcumin has been found to increase insulin sensitivity and insulin secretion in insulin-resistant individuals. However, several clinical studies have shown that the reduction in blood glucose is small and inconsistent overall. The decrease in blood glucose is probably significant in people with type 2 diabetes.
Safe dosage
Adults 18 years and older: 100 mg - 300 mg
Interactions
Médicaments
Antiplatelet agents/Anticoagulants: moderate interaction
In vitro, turmeric has antiplatelet effects. However, results from human studies are contradictory. Indeed, an increase in the INR (international normalized ratio, which describes the effectiveness of anticoagulant treatment in the vitamin K antagonist class) has been reported. On the other hand, another study showed that the use of a comprehensive dietary supplement containing broccoli powder, turmeric powder, whole pomegranate fruit powder and green tea extract for 6 months did not affect INR in patients taking warfarin. Similarly, combining 500 mg of curcumin with 100 mg of aspirin does not appear to increase antiplatelet effects.
Anticancer agents: moderate interaction
Research findings are contradictory. Indeed, an in vitro study showed that curcumin inhibits up to 71% of camptothecin-induced apoptosis in breast cancer cells, and up to 65% of doxorubicin-induced apoptosis in breast cancer cells. However, other in vitro research shows that curcumin can increase the cytotoxic effects of camptothecin and doxorubicin. This discrepancy may be related to the dose of curcumin administered and the exposure time. In humans, the effect of curcumin on the cytotoxicity of camptothecin and doxorubicin is not known. On the other hand, using an in vivo model of human breast cancer, dietary supplementation with curcumin was found to significantly inhibit cyclophosphamide-induced tumor regression. However, other research has shown that curcumin can increase the cytotoxicity of cyclophosphamide.
Antidiabetic: weak interaction
Some animal research suggests that curcumin may lower blood glucose and hemoglobin A1c in diabetic patients. Separately, pharmacokinetic research showed that taking 475 mg of curcumin per day for 10 days and then taking 5 mg of glyburide resulted in a 12% increase in blood glyburide concentration 2 hours after dosing, but the peak blood concentration did not change. In addition, the combination of curcumin and glyburide slightly decreased postprandial blood glucose for up to 24 hours compared with glyburide alone. Antidiabetic drugs include: glimepiride (Amaryl*), glyburide (DiaBeta*, Glynase PresTab*, Micronase*), insulin, pioglitazone (Actos*), rosiglitazone (Avandia*), chlorpropamide (Diabinese*), glipizide (Glucotrol*), tolbutamide (Orinase*), and others.
Cytochrome P450 substrates: moderate interaction
In vitro and in animals, turmeric inhibits cytochrome P450 3A4. A case has been reported in the literature of a patient who underwent a transplant and was taking tacrolimus (an immunosuppressive treatment used orally and by injection mainly in organ transplants), who developed acute nephrotoxicity with an increased tacrolimus level of 29 mg/L (even though she had levels within the therapeutic range), and this followed taking turmeric powder at 15 tablespoons or more per day. It was believed that turmeric increased the tacrolimus level by inhibiting cytochrome P450 3A4. Theoretically, turmeric can increase the levels of other drugs that are metabolized by cytochrome P450 3A4. Drugs metabolized by CYP3A4 include calcium channel blockers (diltiazem, nicardipine, verapamil), anticancer agents (etoposide, paclitaxel, vinblastine, vindesine), antifungals (ketoconazole, itraconazole), fentanyl (Sublimaze), lidocaine (Xylocaine), losartan (Cozaar), fexofenadine (Allegra), midazolam (Versed), and others.
Estrogens: weak interaction
In vitro studies have shown that curcumin competitively displaces estrogen binding to its receptors. Thus, in theory, using large amounts of curcumin may affect hormone replacement therapy.
P-glycoprotein substrates: weak interaction
In vitro and animal studies have shown that curcuminoids and other constituents of turmeric can inhibit P-glycoprotein activity (it is a protein that functions as a pump, using energy from ATP to expel specific substrates that may be endogenous molecules or exogenous xenobiotic substances), thereby promoting the absorption of P-glycoprotein substrates. These substrates include certain chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir) and calcium channel blockers (diltiazem, verapamil), digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, etc.
Talinolol: moderate interaction
Preliminary human studies show that taking curcumin for 6 days before a single 50 mg dose of talinolol may reduce talinolol's bioavailability.
Sulfasalazine: moderate interaction
Clinical evidence has shown that curcumin taken at therapeutic doses in humans can increase blood levels of sulfasalazine by 3.2-fold.
Plantes ou autres actifs
Curcumin: weak interaction
In vitro and animal studies suggest that curcumin or turmeric can bind to iron and prevent its absorption. This does not appear to occur in humans when turmeric is used at doses commonly found in the diet. However, in theory, high doses of curcumin or turmeric may reduce iron absorption.
Precautions
Breastfeeding women: avoid
Data are insufficient to assess the safety of turmeric during breastfeeding, so avoid its use.nn
Gallstones: use with caution
Turmeric causes contraction of the gallbladder. Use with caution in patients with gallstones.nn
Bleeding disorder: use with caution
Turmeric may increase the risk of bleeding and bruising due to its antiplatelet effect. Use with caution in patients with a bleeding disorder.nn
Iron deficiency: use with caution
The use of turmeric at doses commonly found in the diet does not appear to reduce iron absorption. However, animal and in vitro studies show that high levels of curcumin can chelate iron and reduce its absorption. Use with caution in cases of iron deficiency anemia.
Contraindications
Surgical intervention: contraindicated
Turmeric can slow blood clotting. This effect may cause increased bleeding during and after surgery. Stop taking turmeric at least two weeks before the operation.
Pregnancy: contraindicated
When used orally at medicinal doses during pregnancy, turmeric could trigger menstruation or stimulate the uterus, thereby compromising the pregnancy.
