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Can Turmeric Help with Inflammatory Bowel Disease?
Taking turmeric, either in food or supplement form, is definitely a popular trend these days. This post looks at the evidence supporting its use in ulcerative colitis and Crohn’s disease. Turmeric has been used for centuries in traditional Ayurvedic and Chinese medicine to treat inflammatory disorders. Curcumin is the active substance in the spice turmeric (curuma longa) and is what gives it its bright yellow colour. While curcumin has been shown to have anti-inflammatory, antioxidant and immunosuppressive properties, most of the studies to date have been in vitro or in animals.
Research on curcumin in IBD
There are some human studies that have evaluated the use of curcumin in humans with ulcerative colitis and Crohn’s disease.
- One study looked at 89 patients with ulcerative colitis in remission. The patients were randomized to take either 1 g of curcumin twice per day or placebo pills for six months. The group taking curcumin had a significantly lower relapse rate than the placebo group.
- Another study looked at the effects of curcumin in patients with active mild-to-moderate ulcerative colitis. Of the 26 patients who received 1.5 g of curcumin twice per day for one month, 53.8% achieved clinical remission and 36.3% achieved endoscopic remission. This was compared to the placebo group, where none of the evaluated patients achieved clinical or endoscopic remission.
- A pilot study that looked at the effects of curcumin enemas in patients with active mild-to-moderate ulcerative colitis showed improved rates of clinical remission and improved endoscopic disease activity after two months of enema use. A study with a larger sample size should be conducted to further test the effects of curcumin enemas.
- A very small pilot study evaluated the effects of curcumin in five patients with Crohn’s disease. The patients were given 360 mg of curcumin three times per day for one month followed by 360 mg of curcumin four times per day for another month. Of the four that completed the study, all showed improvement in clinical symptoms (less frequent bowel movements, more formed stools, less abdominal pain and cramping) and lower Crohn’s Disease Activity Index scores.
It should be noted that in all the studies mentioned above, patients continued to take their baseline medications throughout the study.
Some studies have looked at the effectiveness of curcumin in preventing colorectal cancer, which patients with ulcerative colitis or Crohn’s colitis are at increased risk for. In one human study, participants took either 2 g or 4 g of curcumin for 30 days. Reduction of aberrant crypt foci (a potential marker for development of colorectal cancer) was reduced in the group taking 4 g but not 2 g.
Is it safe to take high doses of curcumin?
Studies using high doses of curcumin (up to 12 g per day) have shown minimal adverse side effects. A small subset of people in studies experienced mild gastrointestinal symptoms, such as stomach pain, nausea and diarrhea. It should be noted that the studies evaluating the safety of curcumin have been relatively short studies; long-term studies are lacking. Curcumin supplements may interfere with iron metabolism and should not be taken if you are on blood thinners, such as warfarin. If you are thinking about taking curcumin supplements, it’s recommended that you speak with a doctor or pharmacist to ensure they do not interact with any medications you are taking. It is not recommended to take curcumin supplements while pregnant or breastfeeding.
Curcumin in food versus supplement form
Getting curcumin in the form of turmeric is another option and may be safer to take long term. However, given that curcumin is not well absorbed and that 1 teaspoon of turmeric only has about 200 mg of curcumin, you would have to consume a lot of turmeric to reach the levels that have been used in studies. It is not clear yet, though, what the optimal dose of curcumin is, so consuming turmeric may still provide some benefit. Having turmeric with black pepper and a source of fat can enhance the absorption of curcumin.
If you’re looking for a curcumin supplement, it is important to know how to interpret the label. When a supplement lists how much turmeric (curcuma longa) it has, only around 2-8% of that is curcumin. When a supplement lists how much turmeric root extract it has, that is usually standardized to contain 95% curcumin. Most supplements contain <500 mg curcumin overall.
Take-Away Points
- Curcumin supplements may provide benefit for some patients with IBD.
- Taking curcumin in food form as turmeric may be safer than taking concentrated curcumin supplements but may not be as beneficial in improving inflammation.
- More studies are needed to confirm the optimal dosage, route of administration, and long-term safety.
References
- Carroll, R. E., Benya, R. V., Turgeon, D. K., Vareed, S., Neuman, M., Kakarala, M., … & Brenner, D.E. (2011). Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia. Cancer prevention research (Philadelphia, Pa.), 4(3), 354–364. doi: 10.1158/1940-6207
- Duvoix, A., Blasius, R., Delhalle, S., Schnekenburger, M., Morceau, F., Henry, E., … & Diederich, M. (2005). Chemopreventive and therapeutic effects of curcumin. Cancer Lett, 223(2):181-190. doi: 1016/j.canlet.2004.09.041
- Hanai, H., Iida, T., Takeuchi, K., Watanabe, F., Maruyama, Y., Andoh, A., . . .& Koide, Y. (2006). Curcumin Maintenance Therapy for Ulcerative Colitis: Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial. Clinical Gastroenterology and Hepatology, 4(12), 1502-1506. doi:10.1016/j.cgh.2006.08.008
- Holt PR, Katz S, Kirshoff R. Curcumin therapy in inflammatory bowel disease: a pilot study. Dig Dis Sci. 2005;50(11):2191-2193.
- Jobin C., Bradham C.A., Russo MP., Juma, B., Narula, A.S., Brenner. D.A., … & Sartor, R. B. (1999). Curcumin blocks cytokinemediated NF-kappa B activation and proinflammatory gene expression by inhibiting inhibitory factor I-kappa B kinase activity. J Immunol, 163(6):3474-3483.
- Lang, A., Salomon, N., Wu, J. C., Kopylov, U., Lahat, A., Har-Noy, O., . . . & Ben-Horin, S. (2015). Curcumin in Combination With Mesalamine Induces Remission in Patients With Mild-to-Moderate Ulcerative Colitis in a Randomized Controlled Trial. Clinical Gastroenterology and Hepatology, 13(8). doi:10.1016/j.cgh.2015.02.019
- Lao, C. D., Ruffin, M. T., Normolle, D., Heath, D. D., Murray, S. I., Bailey, J. M., . . . & Brenner, D. E. (2006). Dose escalation of a curcuminoid formulation. BMC Complementary and Alternative Medicine, 6(1). doi:10.1186/1472-6882-6-10
- Perkins S., Verschoyle R.D., Hill K., Parveen, l., Threadgill, M.D., Sharma, R.A., … & Gescher, A.J. (2002). Chemopreventive efficacy and pharmacokinetics of curcumin in the min/+ mouse, a model of familial adenomatous polyposis. Cancer Epidemiol Biomarkers Prev, 11(6):535-540
- Singla, V., Mouli, V. P., Garg, S. K., Rai, T., Choudhury, B. N., Verma, P., . . . Ahuja, V. (2014). Induction with NCB-02 (curcumin) enema for mild-to-moderate distal ulcerative colitis — A randomized, placebo-controlled, pilot study. Journal of Crohn’s and Colitis, 8(3), 208-214. doi:10.1016/j.crohns.2013.08.006