Turmeric: benefits, dosage, contraindications
Other name(s)
Indian saffron
Scientific name(s)
Curcuma longa
Family or group:
Plants, Superfood
Active ingredients:
Curcumin
Sesquiterpenes
Curcuminoids
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 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 500 mg twice daily, alone or with fluoxetine, for 6-8 weeks. More recently, the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce indicate that curcumin extract at doses of 500 to 1000 mg per day is provisionally recommended as monotherapy or as an adjunctive treatment in cases of mild to moderate depression.
Posologie
Oral: rhizome, root
1 g
8 weeks
Adults
standardized extract
Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial.
The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials.
The efficacy and acceptability of curcumin for the treatment of depression or depressive symptoms: A systematic review and meta-analysis
Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.
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 used orally once daily for 1 to 3 months. In some studies, lower doses of turmeric extract of 90 mg twice daily for 8 weeks were used. The dosage depends heavily on the formulation used. A recent meta-analysis of clinical research shows that the benefits are limited to bio-optimized forms of curcuminoids, and that the benefits associated with pure extracts remain very limited.
Posologie
Oral: rhizome, root
180 - 500 mg
3 months
Older adults
standardized extract
Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial.
Efficacy and safety of curcuminoids alone in alleviating pain and dysfunction for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials
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.
Fatty liver ✪✪✪✪✪
Clinical research shows that daily curcumin intake 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 excess fat deposits in the liver. 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: rhizome, root
70 mg
8 weeks
Adults
standardized extract
Efficacy and Safety of Phytosomal Curcumin in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial.
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.
Curcumin and Piperine Combination for the Treatment of Patients with Non-alcoholic Fatty Liver Disease: A Double-Blind Randomized Placebo-Controlled Trial
Digestive disorders ✪✪✪✪✪
Turmeric is indicated for dyspeptic disorders: bloating, difficult digestion... Some clinical research shows that taking 500 mg of turmeric orally four times a day for 7 days can relieve dyspepsia symptoms in an additional 64% of patients compared to placebo. Other studies have shown that for patients suffering from functional dyspepsia, curcumin appears to be as effective as omeprazole, a proton pump inhibitor.
Posologie
Oral use: rhizome, root
2 g
7 days
Adults
standardized extract
Randomized double blind study of Curcuma domestica Val. for dyspepsia.
Effect of Curcumin on Severity of Functional Dyspepsia: a Triple Blinded Clinical Trial
Curcuma longa Linn versus omeprazole in treatment of functional dyspepsia: A randomized, double-blind, placebo-controlled trial
Curcumin and proton pump inhibitors for functional dyspepsia: a randomized, double-blind controlled trial
Arthritis ✪✪✪✪✪
Compared with conventional anti-inflammatories, curcumin (1,200 mg per day) proved 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 with 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
Oral: rhizome, root
200 - 2000 mg
8 months
Adults
standardized extract
Efficacy and Safety of Curcuma Domestica Extracts in Patients With Knee Osteoarthritis
Preliminary Study on Antirheumatic Activity of Curcumin (Diferuloyl Methane)
Efficacy and Safety of Meriva®, a Curcumin-Phosphatidylcholine Complex, During Extended Administration in Osteoarthritis Patients
Dyslipidemia ✪✪✪✪✪
A clinical trial showed that taking 0.7 g of turmeric extract twice daily for 3 months reduced total cholesterol, LDL cholesterol, and triglycerides compared with a placebo group in people aged 15 to 45 years.rnrnHowever, the results of other clinical studies are inconsistent and contradictory. Indeed, a pooled analysis of data from 7 clinical trials found that taking turmeric, curcumin, or curcuminoids moderately reduced LDL cholesterol and triglyceride levels but did not improve total cholesterol or high-density lipoprotein (HDL) cholesterol compared with placebo.rnrnAnother analysis of data from 20 clinical trials found that taking turmeric or a curcuminoid reduced triglycerides and increased HDL cholesterol compared with placebo; however, there was no significant effect on LDL or total cholesterol.rnrnA more recent meta-analysis of ten clinical trials found that taking 2400 mg per day of curcumin or curcuminoids derived from turmeric for 12 weeks did not significantly improve triglyceride, LDL, HDL, or total cholesterol levels.rnrnOverall, most research suggests that turmeric or curcuminoids may reduce triglycerides, but effects on other lipid parameters are inconclusive. This disparity in results may be attributable to different formulations studied or to the baseline cholesterol levels of patients included in the research.rnrn
Posologie
Oral: rhizome, root
1.4 g
3 months
Adults
standardized extract
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.
Curcumin and blood lipid levels: an updated systematic review and meta-analysis of randomized clinical trials
The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials.
Oxidative stress ✪✪✪✪✪
Curcumin may play a significant antioxidant role by reducing signs of oxidative stress and increasing the body's native antioxidant activity. In addition, turmeric has shown effectiveness at countering inflammatory processes, has potential benefits in combating aging factors, and may act as a neuroprotective agent.
Posologie
Oral: rhizome, root
1.5 g
Adults
standardized extract
Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials
Meta-analysis of Randomized Controlled Trials of 4 Weeks or Longer Suggest That Curcumin May Afford Some Protection Against Oxidative Stress
Rheumatoid arthritis ✪✪✪✪✪
Clinical research has shown that turmeric may reduce certain symptoms of rheumatoid arthritis (RA), notably pain, morning stiffness, walking time, and joint swelling compared with baseline values. Turmeric was used at a dosage of 250 to 500 mg twice daily for 8 weeks to 3 months.
Posologie
Oral: rhizome, root
500 - 1200 mg
3 - months
Adults
standardized extract
Type 2 diabetes ✪✪✪✪✪
Overall, studies tend to show that turmeric and its components used for at least 8 weeks improve glycated hemoglobin (HbA1c), but do not significantly improve insulin resistance, compared with placebo or conventional treatment.rnrnA meta-analysis of clinical trials of low to moderate quality involving various patient populations shows that taking turmeric extracts, curcumin, or curcuminoids reduces fasting blood glucose by about and modestly improves HbA1c in patients with type 2 diabetes, compared with placebo. The studies evaluated in this meta-analysis are heterogeneous and provided curcuminoids at doses ranging from 46 to 1500 mg per day for 1 to 9 months.rnrn
Posologie
Oral: rhizome, root
1.5 g
9 - months
Adults
standardized extract
The Effects of Curcumin on Diabetes Mellitus: A Systematic Review
Turmeric and curcuminiods ameliorate disorders of glycometabolism among subjects with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials
Potential Therapeutic Effects of Curcumin on Glycemic and Lipid Profile in Uncomplicated Type 2 Diabetes-A Meta-Analysis of Randomized Controlled Trial
The Effects of Nano-curcumin on Metabolic Status in Patients With Diabetes on Hemodialysis, a Randomized, Double Blind, Placebo-controlled Trial
Curcumin extract for prevention of type 2 diabetes.
Effect of Curcumin on Diabetic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials
Chronic inflammatory bowel diseases ✪✪✪✪✪
Turmeric is indicated for gastrointestinal inflammations on the basis of long traditional use. Some clinical studies show that taking curcumin, at a dose of at least 1 g per day for two months, can reduce stools, diarrhea, and abdominal pain in patients with Crohn's disease. A recent meta-analysis of small clinical trials in patients with mild to moderate ulcerative colitis shows that adding oral curcumin, 0.5 to 3 g per day, to standard treatment for 1 to 6 months can improve clinical remission rates compared with placebo.
Posologie
Oral use: rhizome, root
1 - 3 g
3 - months
Adults
standardized extract
Irritable bowel syndrome ✪✪✪✪✪
Turmeric extract appears promising for the symptomatic treatment of irritable bowel syndrome (IBS), according to several studies. rnrnIn this study, 207 volunteers suffering from irritable bowel syndrome diagnosed according to the Rome II criteria were randomly given 72 mg or 144 mg of turmeric per day or a placebo for 8 weeks. The group receiving the lower dose (72 mg/day) experienced a significant 53% reduction in irritable bowel symptoms, while the higher dose (144 mg/day) resulted in a 60% reduction compared with placebo. rnrnAnother study in adults with IBS with a Rome III diagnosis showed that taking two capsules per day, each containing 42 mg of curcumin and 25 mg of fennel essential oil, for 30 days improved abdominal pain and quality of life compared with placebo.rnrnA systematic review of studies examining the treatment of IBS with turmeric or curcumin indicates that they may help treat digestive disorders, particularly irritable bowel syndrome. rnrn
Posologie
Oral: rhizome, root
72 - 500 mg
8 weeks
Adults
standardized extract
Synergies
Curcumin and Fennel Essential Oil Improve Symptoms and Quality of Life in Patients with Irritable Bowel Syndrome.
Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study.
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, results in a clinically significant improvement in physical, behavioral, and mood symptoms compared with placebo.rnrnHowever, other studies did not find significant improvements.rnrn
Posologie
Oral: rhizome, root
200 mg
3 - months
Women
standardized extract
Metabolic syndrome ✪✪✪✪✪
Preliminary clinical research in patients with metabolic syndrome shows that taking turmeric in the form of a curcumin extract at 1.9 to 2.4 g per day for 2 to 3 months lowers 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.rnrn
Posologie
Oral: rhizome, root
1.9 - 2.4 g
3 - months
Adults
standardized extract
Gastric ulcer ✪✪✪✪✪
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 scarce and their results remain 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. It is recommended to use turmeric as an adjunct to the treatment of Helicobacter pylori infection.
Posologie
By mouth: rhizome, root
3 g
12 - weeks
Adults
standardized extract
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
Cognitive decline ✪✪✪✪✪
As part of a 6-month double-blind, placebo-controlled trial conducted in people aged 50 and over with memory decline, 1 or 4 g of curcumin per day (versus placebo) was evaluated. According to MMSE (MINI MENTAL STATE EXAMINATION) measurements, a 1.3-point increase on the rating scale in the placebo group (indicating a decline in cognitive ability) appears to have been attenuated in the groups that took curcumin, although the decline was not reversed. A more recent meta-analysis of three small clinical trials shows that curcumin modestly improves cognition in older adults.
Posologie
Oral use: rhizome, root
1 - 4 g
6 months
Seniors
standardized extract
Curcumin intervention for cognitive function in different types of people: A systematic review and meta-analysis
Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer's disease.
Properties
Anti-inflammatory
Many compounds in turmeric exhibit anti-inflammatory effects mainly through 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. In acute infections, the mechanism most frequently invoked is the one involving prostaglandins, whose secretion is significantly decreased. The active compounds of turmeric also inhibit, during inflammation, trypsin and hyaluronidase, which are essential to the development of certain inflammations, particularly joint inflammations. In chronic inflammation, a number of anti-inflammatory properties have been proposed following studies conducted in animals and in humans: inhibition of phospholipases, lipoxygenases, leukotrienes, thromboxanes, prostaglandins, collagenase, elastase, hyaluronidase… as well as an effect on the generation of nitric oxide (NO). Regarding NO, curcuminoids inhibit the conversion of NO to peroxynitrite and nitrite, thus avoiding the deleterious effects of these metabolites at the vascular level and on cellular DNA. In addition, curcuminoids inhibit platelet aggregation and slow the production of platelet thromboxane.
Usages associés
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.rnrn
Usages associés
Antioxidant
Curcuminoids are electron donors, thereby neutralizing free radicals and reactive oxygen species (ROS). Curcuminoids notably provide protection against lipid peroxidation.rnrnFurthermore, curcuminoids have an indirect effect on ROSrnrnthat operates at various levels:rnrn- Activation of protein kinase C and regulation of intracellular calcium, resulting in inhibition of ROS production.rnrn- Inhibition of 5-lipoxygenase, preventing the incorporation of ROS into polyunsaturated fatty acids.rnrn- Inhibition of the conversion of xanthine dehydrogenase/xanthine oxidase, thereby inhibiting the production of the superoxide ion.rnrn- Modulation of superoxide dismutase expression, associated with regulation of oxidative stress in the heart and kidneys.rnrn
Usages associés
Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials
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 system. BDNF is involved in the survival of existing neurons and promotes the growth and differentiation of new neurons and synapses).rnrnThe antidepressant effect of curcumin is also due to a reduction in cortisol levels and the role of the hypothalamic-pituitary axis.rnrnFurthermore, in vitro and animal studies suggest that the antidepressant effects of turmeric extract arise from its ability to inhibit monoamine oxidase (MAO) A and possibly MAO B, leading to increased levels of serotonin, dopamine, and norepinephrine.rnrnCurcumin, a component of turmeric, also appears to increase adenylate cyclase activity and the concentration of cyclic adenosine monophosphate (cAMP), which has been associated with antidepressant effects.rnrn
Usages associés
Cardiovascular
Turmeric slows the process underlying atherosclerosis at the arterial system level by reducing aortic lipid deposits and blood levels of lipid peroxides in vivo. In vitro, turmeric can protect against myocardial infarction by reducing inflammatory cytokines and extracellular matrix proteases. Other cardiovascular effects induced by turmeric in vitro include reduction of blood pressure, vasorelaxation, antithrombotic effects, and improved endothelial function. On the other hand, curcumin may have antithrombotic effects. Research suggests that it may inhibit platelet aggregation, platelet-activating factor and arachidonic acid, possibly by interfering with thromboxane synthesis.
Hepatoprotective
In the event of hepatic injury, curcumin has a major protective role by activating antioxidant enzymatic systems in the liver: superoxide dismutase, catalase, glutathione peroxidase and transferase. In addition, curcumin limits iron-induced oxidation.
Usages associés
Analgesic
Turmeric and its constituents, when administered orally, have been shown to reduce pain, but the exact mechanism of action is not yet clear.
Digestive effect
With daily administration, turmeric causes 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 and choleagogue 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.
Usages associés
Antiparasitic
Animal models have shown that curcumin may have activity against the protozoa Leishmania amazonensis, Toxoplasma gondii, Schistosomiasis 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%. - raises HDL cholesterol (High Density Lipoprotein) levels by 72% and ApoA by 25%.
Usages associés
Hypoglycemic
It has been observed that curcumin can increase insulin sensitivity and secretion in insulin-resistant individuals. However, several clinical studies have shown that the reduction in blood glucose is small and inconsistent overall. The reduction in blood glucose is probably significant in subjects with type 2 diabetes.
Usages associés
Safe dosage
Adults aged 18 and over: 1500 mg - 3000 mg
Dosage depends heavily on the formulation used.rnrnBecause of its poor bioavailability, multiple approaches have been developed over the years. rnrnThree generations of formulations can be identifiedrnrn1. First Generation : these formulations use adjuvants such as piperine to improve absorption and reduce curcumin metabolism. However, there is a possibility of interactions with other drugs and side effects associated with piperine. Examples: curcumin-piperine, BCM-95, Cureit.rnrn2. Second Generation : these formulations employ emulsifiers (liposomes, nanoparticles...) to increase curcumin solubility and absorption. Examples: BioCurc, Cavacurcumin, CurcuWIN, Hydrocurc, Meriva, Nanocurcumin, Novasol, Theracurmin, Turmipure Gold.rnrn3. Third Generation : This generation focuses on the availability of free (unconjugated) forms of curcumin, improving bioavailability and cellular permeability without using artificial emulsifiers. Examples: Longvida, CurQfen.rnrnThird-generation formulations are potentially safer due to the absence of emulsifiers. They have demonstrated superior absorption, better blood-brain barrier permeability, improved cellular uptake, and better tissue distribution. Compared with pure curcumin, they have more than 100-fold higher bioavailability.rnrn
Interactions
Médicaments
Antiplatelet agents/Anticoagulants: moderate interaction
In vitro, turmeric has antiplatelet effects. However, research results in humans are contradictory. Indeed, an increase in the INR (international normalized ratio — a measure that describes the effectiveness of anticoagulant treatment from the vitamin K antagonist family) has been reported. On the other hand, another study showed that use of a full dietary supplement containing broccoli powder, turmeric powder, whole pomegranate fruit powder, and green tea extract for 6 months did not affect the INR in patients taking warfarin. Similarly, combining 500 mg of curcumin with 100 mg of aspirin does not appear to increase antiplatelet effects.
Anticancer drugs: moderate interaction
Research findings are contradictory. Indeed, one study showed that curcumin in vitro inhibits up to 71% of apoptosis of breast cancer cells induced by camptothecin, and up to 65% of apoptosis of breast cancer cells induced by doxorubicin. However, other in vitro research shows that curcumin can increase the cytotoxic effects of camptothecin and doxorubicin. This discrepancy may be related to the administered dose of curcumin 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 breast cancer in women, it was discovered that dietary supplementation with curcumin significantly inhibited 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. Additionally, pharmacokinetic studies have shown 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 the dose, but the maximum blood concentration did not change. Furthermore, the combination of curcumin and glyburide slightly reduced postprandial blood glucose for up to 24 hours compared with glyburide alone. Antidiabetic agents include: sulfonylureas (AMAREL, DAONIL, DIAMICRON, etc.), the glinides (NOVONORM, REPAGLINIDE), alpha-glucosidase inhibitors (such as acarbose) and drugs that act through incretins (dipeptidyl peptidase-4 inhibitors and GLP-1 analogs), insulin, and others.
Cytochrome P450 substrate: moderate interaction
In vitro and in animals, turmeric inhibits cytochrome P450 3A4. A case has been reported in the literature of a female patient who underwent transplantation 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 her levels had been within the therapeutic range), and this followed the intake of turmeric powder at 15 spoons or more per day. It was thought 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 research has shown that curcumin competitively displaces estrogen binding to its receptors. Thus, theoretically the use of large amounts of curcumin may affect hormone replacement therapy.
P-glycoprotein substrates: weak interaction
In vitro and animal research has shown that curcuminoids and other constituents of turmeric can inhibit the activity of P-glycoprotein (it is a protein that acts as a pump, using energy from ATP to expel specific substrates that may be endogenous molecules or exogenous xenobiotics), 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.
Norfloxacin: weak interaction
Animal studies show that curcumin may increase the blood level of orally administered norfloxacin as well as its adverse effects. However, this interaction has not been proven in humans.
Plantes ou autres actifs
Turmeric: 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 food. However, theoretically, high doses of curcumin or turmeric may decrease iron absorption.
Precautions
Breastfeeding: avoid
Data are insufficient to assess the safety of turmeric during breastfeeding.rnrn
Gallstones: use with caution
Turmeric causes contraction of the gallbladder. Use with caution in patients with gallstones. rnrn
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.
Iron deficiency: use with caution
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
Surgery: contraindicated
Turmeric may slow blood clotting. This effect can cause increased bleeding during and after surgery. Stop taking turmeric at least two weeks before the operation.
Pregnancy: contraindicated
When taken orally at medicinal doses during pregnancy, turmeric could induce menstruation or stimulate the uterus, thereby compromising the pregnancy.
