Curcumin stands as a giant among supplements because both the breadth and the strength of the mechanisms by which it alters health for the better seem staggering. In its repertoire, it boasts anti-oxidant benefit, pain control benefits, general anti-inflammatory benefits, detoxification capabilities, brain protection capabilities, and even anti-Lyme benefits.
Anti-oxidant and anti-inflammatory: With greater than 60 molecular targets, curcumin lowers the oxidative stress produced by normal metabolic functioning as well as addressing external triggers of oxidative stress. The Aggarwal article lists the following benefits in this category: down regulation of NF kB, COX2, LOX, Cell Proliferation, MMP9, iNOS, TNF and up regulation of Nrf2, apoptosis, HER2 (acronym key below). Curcumin’s reach extends far and wide. The review in Foods 2017 also notes many of these same benefits.
Arthritis & Pain: Beyond general anti-inflammatory benefit, curcumin helps many patients with osteoarthritis. Often it is more effective at pain relief than ibuprofen.
Detoxification: Curcumin touts the ability to protect heavy metal exposed individuals and protect the brain from organophosphates. It also up regulates phase 3 detox systems to remove toxins and their metabolites from the body. At Sanctuary we use curcumin in the detoxification process for mold toxicity given its potent anti-inflammatory effects and Nrf2 upregulation for detoxification systems.
Cancer: Studies are ongoing concerning its use in the prevention of colon cancer.
Anti-Viral: 2020 brought a newly recognized benefit of curcumin. The immune modulation mechanisms listed above appear to keep immune systems fighting coronaviruses in line sufficient for anti-viral effects, but avoiding cytokine storms.
How to Get the Benefits of Curcumin: Curcumin is a chemical derived from turmeric, a spice used in cooking. There remains much controversy over its poor bio-availability (absorption) which is why at Sanctuary we only use liposomal curcumin products. These greatly improved absorption. We also consider using bioperine to increase curcumin’s duration of action in the body.
How to take curcumin:
- Again, the absorption of liposomal curcumin is likely 10 to 20 times stronger than from dietary turmeric or non-liposomal supplemental curcumin. This comes from research studies. Patients who have used both forms frequently attest to the improved benefits from the liposomal form.
- Preventive: For those with chronic pain in terms of arthritis, headaches, etc. dosing one to three times a day on an ongoing basis will often keep the chronic pain at a lower level, preventing the need for higher doses or other pain medications.
- Short term, as needed: Many patients experience intermittent pain interspersed with asymptomatic periods. Ingesting liposomal curcumin upon onset of symptoms often provides significant pain relief.
- Prolonged therapy: For many conditions, weeks or months of dosing 2 to 3 times a day is necessary. When used alone or in combination for leaky gut, allergic, or autoimmune conditions, such dosing brings both tangible symptom improvement and reversal of the underlying processes causing the symptoms.
- For use in Mold Detox or Lyme Therapy, 2 to 3 times daily dosing is usually required at higher doses with occasional additional as needed dosages for breakthrough symptoms. For such patients, curcumin often treats or alleviates random inflammatory or neurologic pain symptoms. These include joint pain, nerve pain, migraines, and sometimes address brain fog.
- For use in Alzheimers prevention/therapy, months and years of daily dosages are necessary and ongoing.
- Taking liposomal forms with food, especially fatty food, may improve absorption, but the high absorption rate allows dosing without food as well. Those with bile acid / gallbladder deficiencies may have lower absorption rates if they have fat malabsorption in their GI tract.
Potential Side Effects of Curcumin usage:
- Allergic reactions: As with nearly any therapy, any one can develop allergies to any chemical we give them. Severe reactions are extremely rare with curcumin, but low grade subtle effects may occur. Blood tests can reveal these sensitivities.
- In mold toxic patients, nearly all bets are off in terms of reacting to chemicals or therapies. Mold patients are possibly the most sensitive patients we see. In such patients, the normally allergy-decreasing quercetin may trigger very unusual reactions. With detox of mold, these usually resolve but at times we are not able to use curcumin in normal dosages.
- Liposomal forms may use soy lecithin as the fatty carrier. Patients with true soy allergies may want to avoid these forms and look for sunflower lecithin options. Given the soy portion is primarily fatty, most others can still tolerate these liposomal products.
- GI symptoms: Again, even when taken alone, many patients have sensitive stomachs and find curcumin to cause a little nausea. Usually this can be prevented with simultaneous food ingestion.
- Neuro-psychiatric: Curcumin modulates the production and metabolism of some neurotransmitters. Usually this leads to benefits for emotional health, but if addition of curcumin produces unexpected changes in mental health, discuss with your provider.
Acronym Key
NF kappa B – Nuclear Factor kappa B. This protein plays a central role in promoting inflammation. A wide variety of triggers set off a cascade of downstream processes that all begin with NF kappa B. Once NK kappa B is triggered, these downstream processes carry out the metabolic pathways which produce what we perceive as inflammation.
COX-2: Cyclo-oxygenase 2 enzyme. This enzyme plays an important role in the inflammatory pathway. By converting arachidonic acid, an omega 6 fatty acid associated with inflammation, into prostaglandins, COX-2 sets off a cascade of processes leading to prostaglandins which cause inflammation. While a similar enzyme called COX-1 is always working at a relatively consistent low level, COX-2 is activated with inflammation.
LOX: Lipo-oxygenase. This enzyme family catalyzes arachidonic acid derivatives (see COX-2 for arachidonic acid explanation) along pathways to produce inflammatory mediators. The resulting chemicals produce what we perceive as inflammation.
MMP-9: Matrix Metalloproteinase 9. “Matrix metalloproteinase-9 (MMP-9) belongs to a family of zinc- and calcium-dependent metalloproteinases which are involved in the breakdown of extracellular matrix during tissue remodeling. Along with other metalloproteinases, MMP-9 plays a key role in physiological processes such as development, wound healing, angiogenesis, and also in pathological processes such as inflammation, tumor invasion and metastasis (reviewed by Parks and Mecham, 1998).” (Xiong 2001)
iNOS: inducible Nitric Oxide Synthase. This is one of the three enzymes responsible for producing nitric oxide in the body. NOS2 is the gene which produces this enzyme. This form is found in immune cells that are used to attack invaders like bacteria with oxidation. It is inducible because it is turned on when a need for immune defense is identified but turned down when the perceived threat is over.
TNF: Tumor Necrosis Factor. This is a cytokine (immune hormone) secreted by various tissues involved with the immune system. It functions to modulate inflammation.
NrF2: Nuclear receptor factor 2. As a counterpart to the central role of NFkB, NrF2 plays a central role in lowering inflammation and oxidative stress. When it is activated, NrF2 sets off a series of downstream process lowering inflammation. It counters the inflammatory effects of NFkB. Upregulating NrF2 and downregulating NFkB go hand in hand in combating the effects of inflammation.
Apoptosis. Our cells in a sense are born, live, and die. Their life cycle is controlled by countless process both known and yet to be discovered. At the end of their functioning life, they must turn off and be recycled. Various disease states including cancer result when this does not happen. Apoptosis is the process by which a cell carries out this process of turning the lights out and making room for newer cells.
HER2: Without getting too complex, HER2 is a cell surface receptor that modulates cell proliferation and growth. It is involved in development of breast cancer and treatment.
Directly quoted:
Multiple signaling pathways involved in activation of matrix metalloproteinase-9 (MMP-9) by heregulin-β1 in human breast cancer cells. Jun Yao, Shunbin Xiong, Kristine Klos, Nina Nguyen, Rebecca Grijalva, Ping Li & Dihua Yu. Oncogene volume 20, pages 8066–8074 (06 December 2001)
Anti-oxidant and anti-inflammatory:
Aggarwal B et al. 2003 Anticancer Research 23:363-98
Jurenka, J. S. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Alternative Medicine Reviews 2009;14(2):141-153.
Aggarwal, B. B. and Harikumar, K. B. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic,
autoimmune and neoplastic diseases. International Journal of Biochemical Cell Biology. 2009;41(1):40-59.
Satoskar, R. R., Shah, S. J., and Shenoy, S. G. Evaluation of anti-inflammatory property of
curcumin (diferuloyl methane) in patients with postoperative inflammation. International Journal of Clinical Pharmacology and Therapeutic Toxicology. 1986;24(12):651-654.
Hewlings, Susan J and Douglas S Kalman. “Curcumin: A Review of Its’ Effects on Human Health” Foods (Basel, Switzerland) vol. 6,10 92. 22 Oct. 2017, doi:10.3390/foods6100092
Arthritis & Pain:
Kulkarni, R. R., Patki, P. S., Jog, V. P., Gandage, S. G., and Patwardhan, B. Treatment of
osteoarthritis with a herbomineral formulation: a double- blind, placebo-controlled, crossover
study. Journal of Ethnopharmacology. 1991;33(1-2):91-95.
Deodhar, S. D., Sethi, R., and Srimal, R. C. Preliminary study on antirheumatic activity of
curcumin (diferuloyl methane). Indian Journal of Medical Research. 1980;71:632-634.
Chopra, A., Lavin, P., Patwardhan, B., and Chitre, D. A 32-week randomized, placebo controlled
clinical evaluation of RA-11, an Ayurvedic drug, on osteoarthritis of the knees. Journal of
Clinical Rheumatology. 2004;10(5):236-245.
Antony B, Kizhakedath R Benny M Kuruvilla BT. Clinical Evaluation of a herbal product
(Rhulief™) in the management of knee osteoarthritis. Abstract 316. Osteoarthritis Cartilage
2011;19(S1):S145-S146.
Detoxification:
Daniel S Journal of Inorganic Biochemistry 2004 Feb; 98(2): 266-75
Canales-Aguirre AA et al. Nutrition Neuroscience. 2012 Mar;15(2):62-9.
Asher GN et al. Alternative Therapies Mar/April 2013; 19 (2): 20-22
Cancer Prevention:
Carroll RE et al. Cancer Prevention Research (Phila).2011 Mar;4(3):354-64. doi: 10.1158/1940-6207.CAPR-10-0098. Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia.
Other:
Aggarwal, B. B. and Sung, B. Pharmacological basis for the role of curcumin in chronic
diseases: an age-old spice with modern targets. Trends in Pharmacology Science. 2009;30(2):85-94.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.