Curcumin is the principal curcuminoid in turmeric and is responsible for turmeric’s yellow colour. It is a lipophilic (fat-loving) phenolic substance with a characteristic yellow colour derived from the rhizome of the plant turmeric (Curcuma longa). Curcumin is the most biologically active constituent of turmeric and has attracted a lot of attention due to the large number of scientific studies that have been carried out which suggest it may have numerous health benefits.
Applications
Anti-inflammatory Activity
A primary mechanism of curcumin relates to its actions as an anti-inflammatory agent.2 Rather than just influencing one anti-inflammatory pathway, it appears that curcumin has several modes of action, allowing it to deliver broad-spectrum protection against inflammation. Many anti-inflammatory agents inhibit either Cyclooxygenase (COX) or Lipoxygenase (LOX) enzymes, whereas curcumin blocks both, which subsequently inhibits both prostaglandin and leukotriene signaling molecules.3
Curcumin also reduces inflammation via the inhibition of inducible nitric oxide (iNOS),2 a pro-inflammatory enzyme. Additionally, studies indicate that curcumin exerts anti-inflammatory properties by suppressing the transcription of pro-inflammatory cytokine genes through the NF-kappaB signalling pathway.4
Studies show that curcumin blocks arachidonic acid from converting to pro-inflammatory Prostaglandin E2 (PGE2) and Leukotriene B4 (LTB4).2
According to studies, these broader anti-inflammatory actions provide a better therapeutic profile with no side effects when compared to NSAIDs.2,5
Curcumin has potent antioxidant activity which is contributory to its role as an anti-inflammatory agent.6 Pro-oxidants such as superoxide and hydroxyl radicals are scavenged by curcumin’s antioxidant activity and lipid peroxidation (one initiator of inflammation) is also reduced.2
There is a growing consensus among nutritional scientists that low-grade inflammation is a major contributory factor in many common ailments. As such, curcumin’s multi-faceted actions in reducing inflammation means that it has great potential for use in a wide range of health disorders.
Joint Inflammation
By simultaneously working on multiple inflammatory pathways, curcumin’s role in the management of both osteo and rheumatoid arthritis shows promise. Several studies have shown curcumin can offer relief for patients complaining of joint pain, inflammation and tenderness.7 In one study, the anti-inflammatory and analgesic effects of curcumin were superior to the NSAID diclofenac sodium in patients with active rheumatoid arthritis.8 Another study even suggests that curcumin may inhibit cartilage breakdown by the body, a benefit for osteoporosis patients.9
Blood markers of inflammation were noted at the end of the studies observing curcumin’s role in the management of osteo and rheumatoid arthritis. Research studies on joint inflammation have
Curcumin has several modes of action, allowing it to deliver broad-spectrum protection against inflammation.
Curcumin has been found to have potent anti-inflammatory properties and blocks numerous pro-inflammatory pathways including the COX, 5-Lx, TNF-a, iNOS and NFkB.
Oral administration of curcumin in instances of acute inflammation was found to be as effective as cortisone or phenylbutazone, and one-half as effective in cases of chronic inflammation.10
Gastrointestinal Health
Because of its propensity to accumulate in the tissues of the digestive tract, the therapeutic potential of curcumin has been investigated in several studies of digestive diseases.
The German Commission E, has approved turmeric for digestive problems. One double-blind, placebo-controlled study found that turmeric reduced symptoms of bloating and gas in people suffering from indigestion. This double-blind, placebo-controlled study compared the effects of 500 mg of curcumin 4 times daily against placebo (as well as against an over-the-counter treatment). After 7 days, 87% percent of the curcumin group experienced full or partial symptom relief from dyspepsia as compared to 53% of the placebo group.11
Current scientific literature documents curcumin’s potential role in the management of inflammatory bowel disease (IBD).12-14 IBD is the umbrella term used for ulcerative colitis (UC) and Crohn’s disease (CD). These are serious conditions affecting the small and large bowel. Inflammatory cytokynes that have been associated with IBD include interleukin-1beta (IL-1ß), and interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Curcumin has been found to inhibit the activation of these various transcription factors that are involved in inflammation, cell survival and proliferation and angiogenesis (the process through which new blood vessels form from pre-existing vessels).
In clinics, IBD is treated using various drugs including antibiotics, steroids and immunomodulators. Since these medications are associated with side effects when used long term, there is a need for a safe, non-toxic alternative for these patients.
In a small pilot study involving patients with IBD (ulcerative colitis/proctitis or Crohn’s disease), the administration of curcumin resulted in a reduction in markers of inflammation such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Patients also reported a lessening of symptoms.15
Cardiovascular Health
Inflammation plays a key role in the development of cardiovascular disease, a leading cause of death in the UK. The anti-inflammatory and antioxidant properties of curcumin have created an interest amongst scientists studying cardiovascular disease. As a result, there is now evidence suggesting that curcumin may indeed have protective effects against cardiovascular pathologies, which include atherosclerosis and elevated cholesterol, vascular dysfunction and cardiac hypertrophy.
Atherosclerosis, a serious and progressive condition, refers to the build-up of fatty deposits (plaques) in the walls of the arteries. Amongst the many causative factors for this condition are inflammation and oxidative stress within the vessel wall. Curcumin’s anti-atherosclerotic actions are wide-ranging, but include anti-inflammatory and antioxidant properties.16, 17 In addition studies show that curcumin plays a role in the modulation of cholesterol homeostasis and the inhibition of platelet aggregation.18
In a human study (using volunteers), 500mg of curcumin administered daily for 7 days, resulted in a 29% increase in HDL cholesterol, a 12% decrease on LDL cholesterol and a 33% decrease in serum lipid peroxidases.19
More recently a study carried out on patients with metabolic syndrome found that 630 mg three times a day significantly increased HDL cholesterol and significantly reduced LDL cholesterol. Triglycerides were also reduced.20
In patients with coronary heart disease, the administration of curcumin resulted in a reduction of total and LDL cholesterol. Another study reported that 10mg of curcumin given twice daily for 2 weeks significantly lowered plasma fibrinogen (a blood clotting factor) levels in humans with atherosclerosis.21
Recent preliminary (animal) studies suggest that curcumin may play a role in reducing hypertension and in the management of diabetic cardiomyopathy.22, 23 However further studies are needed in these areas before firm conclusions can be drawn.
Brain Health
In a six week study on 60 patients with depressive disorder, curcumin was found to be an effective and safe modality for treatment for patients and worked as well as the prescription drug fluoxetine in terms of the measurable changes in the HAM-D(17) score (Hamilton Depression Rating Scale – a standard diagnostic tool used for
There is now evidence suggesting that curcumin may indeed have protective effects against cardiovascular pathologies, which include atherosclerosis and elevated cholesterol.
interviewing and screening patients with possible depression).24 It has been suggested that it may support mood by playing a role in the production of serotonin, dopamine and norepinephrine.25
Curcumin has also shown promise for those suffering with dementia/Alzheimer’s disease although at present more research is needed to evaluate whether it may be of benefit.26, 27
General Inflammatory Conditions and Wellbeing
The emerging role of chronic inflammation in the major degenerative diseases of modern society (including dementia, diabetes and obesity) has stimulated research into the influence of nutrition on inflammatory indicators. This interest has extended to the exploration of phytochemicals and their effects on inflammation and their potential applications in the management of modern diseases. With the development of enhanced delivery forms of curcumin (offering better bioavailability), the considerable potential for further uses increases.
Other areas of research interest for curcumin
– Gum disease (gingivitis)
– Stomach ulcers caused by Helicobacter pylori (H pylori) infection
– Skin rash (Lichen planus)
– Stomach ulcers (peptic ulcer disease)
– Itchy skin (pruritus)
– Bypass surgery (coronary artery bypass graft surgery)
– Recovery from surgery
– Diarrhoea
– Fibromyalgia
– Liver and gallbladder problems
– Headache
– Menstrual problems
Safety
Clinical trials have demonstrated the safety of curcumin even at high doses (12 g/day) in humans. Turmeric is likely safe when taken by mouth or applied to the skin appropriately for up to 8 months.
Special precaution and warnings
Surgery: Curcumin might increase bleeding if used preoperatively. Patients should discontinue use two weeks prior to elective surgery.
If you are pregnant, nursing, taking any medications or have any medical conditions, please consult your healthcare practitioner before taking.
Food supplements should not be used instead of a varied balanced diet and a healthy lifestyle.
Known contraindications
Concomitant use of curcumin with herbs or medications that may affect platelet aggregation (blood-thinners) could theoretically increase the risk of bleeding in some people. If an individual is pregnant, nursing, taking medication or has a health condition they should consult with their healthcare practitioner before taking supplements.
References
1. Schiborr C, Kocher A, Behnam D, Jandasek J, Toelstede S, Frank J. The oral bioavailability of curcumin from micronized powder and liquid micelles is significantly increased in healthy humans and differs between sexes. Mol Nutr Food Res. 2014 Mar;58(3):516-27
2. Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). Journal of alternative and complementary medicine (New York, NY). 2003;9(1):161-8.
3. Rao CV. Regulation of COX and LOX by curcumin. Advances in experimental medicine and biology. 2007;595:213-26.
4. Singh S, Aggarwal BB. Activation of transcription factor NF-kappa B is suppressed by curcumin (diferuloylmethane) [corrected]. The Journal of biological chemistry. 1995;270(42):24995-5000.
5. Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpoontawee M, Lukkanapichonchut P, Chootip C, et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clinical interventions in aging. 2014;9:451-8.
6. Bengmark S. Curcumin, an atoxic antioxidant and natural NFkappaB, cyclooxygenase-2, lipooxygenase, and inducible nitric oxide synthase inhibitor: a shield against acute and chronic diseases. JPEN Journal of parenteral and enteral nutrition. 2006;30(1):45-51.
7. Henrotin Y, Priem F, Mobasheri A. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. SpringerPlus. 2013;2(1):56.
8. Chandran B, Goel A. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytotherapy research : PTR. 2012;26(11):1719-25.
For professional use only
9. Henrotin Y, Clutterbuck AL, Allaway D, Lodwig EM, Harris P, Mathy-Hartert M, et al. Biological actions of curcumin on articular chondrocytes. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2010;18(2):141-9.
10. Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sci Biol Med. 2013 Jan;4(1):3-7. doi: 10.4103/0976-9668.107253.
11. Thamlikitkul V BN, Dechatiwongse T, et al. Randomized double blind study of Curcuma domestica Val. for dyspepsia.J Med Assoc Thai.72:613-20.
12. Dulbecco P, Savarino V. Therapeutic potential of curcumin in digestive diseases. World journal of gastroenterology : WJG. 2013;19(48):9256-70.
13. Taylor RA, Leonard MC. Curcumin for inflammatory bowel disease: a review of human studies. Alternative medicine review : a journal of clinical therapeutic. 2011;16(2):152-6.
14. Hanai H, Sugimoto K. Curcumin has bright prospects for the treatment of inflammatory bowel disease. Current pharmaceutical design. 2009;15(18):2087-94.
15. Holt PR, Katz S, Kirshoff R. Curcumin therapy in inflammatory bowel disease: a pilot study. Digestive diseases and sciences. 2005;50(11):2191-3.
16. Olszanecki R, Jawien J, Gajda M, Mateuszuk L, Gebska A, Korabiowska M, et al. Effect of curcumin on atherosclerosis in apoE/LDLR-double knockout mice. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society. 2005;56(4):627-35.
17. Sahebkar A. Dual effect of curcumin in preventing atherosclerosis: the potential role of pro-oxidant-antioxidant mechanisms. Natural product research. 2015;29(6):491-2.
18. Srivastava R, Dikshit M, Srimal RC, Dhawan BN. Anti-thrombotic effect of curcumin. Thrombosis research. 1985;40(3):413-7.
19. Soni KB, Kuttan R. Effect of oral curcumin administration on serum peroxides and cholesterol levels in human volunteers. Indian J Physiol Pharmacol. 1992 Oct;36(4):273-5.
20. Yang YS et al. Lipid-lowering effects of curcumin in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled trial. Phytother Res. 2014 Dec;28(12):1770-7.
21.Ramirez-Bosca A, Soler A, Carrion MA, Diaz-Alperi J, Bernd A, Quintanilla C, et al. An hydroalcoholic extract of curcuma longa lowers the apo B/apo A ratio. Implications for atherogenesis prevention. Mechanisms of ageing and development. 2000;119(1-2):41-7.
22. Nakmareong S, Kukongviriyapan U, Pakdeechote P, Donpunha W, Kukongviriyapan V, Kongyingyoes B, et al. Antioxidant and vascular protective effects of curcumin and tetrahydrocurcumin in rats with L-NAME-induced hypertension. Naunyn-Schmiedeberg’s archives of pharmacology. 2011;383(5):519-29.
23. Ren J, Sowers JR. Application of a novel curcumin analog in the management of diabetic cardiomyopathy. Diabetes. 2014;63(10):3166-8.
24. Sanmukhani J, Satodia V, Trivedi J, Patel T, Tiwari D, Panchal B, Goel A, Tripathi CB. Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial. Phytother Res. 2013 Jul 6. doi: 10.1002/ptr.5025.
For professional use only
25. Jithendra ChimakurthyI, II; Murthy Talasila Effects of curcumin on pentylenetetrazole-induced anxiety-like behaviors and associated changes in cognition and monoamine levels. Psychol. Neurosci. (Online) vol.3 no.2 Rio de Janeiro July/Dec. 2010
26. Mishra S, Palanivelu K. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008 Jan;11(1):13-9.
27. S. Hagl, M. Heinrich, A. Kocher, C. Schiborr, J. Frank, G.P. Eckert. Curcumin micelles improve mitochondrial function in a mouse model of alzheimer’s disease. J Prev Alz Dis 2014;1(2):80-83