One of the more popular herbal products in the last few years has been turmeric. Used as a spice in cooking, this herb has also been used for the usual wide range of unrelated conditions in traditional folk medicine, particularly in Ayurvedic and Chinese medicine. Turmeric is sometimes suggested for use in the treatment of cancers and inflammatory conditions, such as arthritis, in veterinary patients. A recent question from a reader prompted me to have a look at the evidence concerning the use of this herb.
What Is It?
Turmeric is a root cultivated as a spice and herbal medicine throughout Asia and parts of Africa. It contains a plethora of compounds, however the most studied in terms of medical applications are the curcuminoids.
What’s the Evidence?
There are abundant in vitro studies examining the chemical and biological properties of compounds found in turmeric. These studies suggest antioxidant, anti-inflammatory, and anti-cancer activity for curcumin and other constituents of turmeric. Such in vitro studies can never, of course, prove a clinical benefit for patients. Bleach kills cancer cells in a petri dish, but it is hardly a cure for cancer. However, these studies are important for identifying possible uses to be investigated and for building a plausible foundation for conducting clinical studies. The in vitro research certainly does suggest a number of potential medical uses for turmeric.
The actual clinical research, however, is sparse. As the National Center for Complementary an Alternative Medicine (NCCAM) puts it, “There is little reliable evidence to support the use of turmeric for any health condition because few clinical trials have been conducted.” Many of the studies that have been done in humans have focused on curcumin and have found that it is poorly absorbed when taken orally. Large quantities must be taken to achieve detectable levels of curcumin in the blood.
There has been one systematic review of the research concerning the use of turmeric for a wide range of conditions:
Ulbricht C, Basch E, Barrette EP, et al. Turmeric (Curcuma longa): An Evidence-Based Systematic Review by the Natural Standard Research Collaboration. Alternative and Complementary Therapies. August 2011, 17(4): 225-236.
The summary conclusions of the review have been posted here. All potential uses were given the evidence grade of C, meaning the evidence is unclear, conflicting, or insufficient to draw any conclusions. Overall, there is no compelling clinical evidence in humans supporting any use of curcumin or other turmeric compounds.
As usual, there is less evidence in companion animals. One study comparing a turmeric compound to placebo in dogs with arthritis found not significant effects in an objective measure of weight bearing or in subjective owner assessment, though there was a small difference according to the subjective assessment of investigators. There are no other controlled clinical trials. A few experimental studies have been done on potential topical applications for ringworm and bacterial infections, and one research group in Brazil has published several papers looking at specific physiologic effects of turmeric compounds in dogs intentionally injected with snake venom. These studies have little relevance to the clinical use of turmeric for treatment of arthritis, cancer, and other clinical problems.
Is It Safe?
As I emphasize frequently, any therapy that has meaningful benefits will also have potential side effects. The body is simply too complex to expect to tinker with one element and not have wide-ranging effects on other elements. Therefore, it is actually a bad sign when a treatment is promoted as having no side effects since it likely suggests that treatment doesn’t actually do anything.
Potential adverse effects have been reported for turemric, including gastrointestinal upset, possible effects on blood clotting, possible increase in the risk for some kinds of bladder and kidney stones, and interactions with other herbs and pharmaceuticals. The limited clinical research so far suggests these risks are small. However, there is far less research available than is typical for a new drug before it is put on the market, and it is not unusual for unanticipated side effects to show up after a medicine is used and studied in a much larger and more diverse population. Therefore, the best we can say about the safety of turmeric for medical use (which, of course, means doses dramatically greater than its use as a spice in cooking) is that there is no obvious evidence of great risk but that the safety profile is no more clearly established than the efficacy profile.
Bottom Line
Turmeric contains a number of potentially useful chemical compounds, of which the most studied is curcumin. There is sufficient in vitro research to establish biological effects which might have clinical benefits, so the concept that these compounds could have therapeutic value is plausible. There is very little clinical research in humans, and there is not yet any convincing evidence to support the use of turmeric for any condition. There is virtually no clinical research in companion animals, and what there is does not support claims of benefit from turmeric compounds. Finally, the limited research to date suggests a few potential risks but the significance of these is unclear.
And sadly, none of this means anything to sCAM and CAVM practitioners, since they don’t care about the quality of research, unless they can cite whatever low-quality studies to exaggerate their bogus claims.
Turmeric is a good source of iron and manganese. Moreover, research found that it is also a potential source for vitamin B6. According to Indian and Asian research on humans the benefits of turmeric are quite well known especially for protecting the liver from damaging effects of toxins, pharmaceutical drugs and alcohol. It has certain properties which regenerate damaged liver cells. From a veterinarian perspective the herb may have not proved most of its benefits with the limited research performed so far.
As a food, it may provide some essential nutrients, however that doesn’t necessarily imply a therapeutic benefit. Remember, supplemental vitamins for individuals without dietary deficiencies have rarely been shown to have medical benefits, and sometimes supplementation is actually harmful. So the presence of such nutrients in turmeric isn’t really relevant to whether it is useful as a supplement for pets.
As for the research in humans, I reviewed this in the article, and it is suggestive in a number of areas but not conclusive in any, so “benefits of turmeric are quite well known” is overstating the case considerably.
@JO
you lost me at “according to Indian and Asian research…” but then piqued my interest when you noted that turmeric not only protects the liver but also has properties that regenerate damaged liver cells. why would you want to regenerate damaged cells?
Thanks for doing an article on turmeric, Skeptvet; this is something that I had been hearing good things about for both people and pets so it’s great to have this evaluation.
I really wish there was oversight of the supplement industry and reliable research being done. But I believe that in some situations it’s reasonable to try untested modalities when the alternatives are unacceptable (or there are no alternatives). And the “early adopters” seem to be what stimulate mainstream science to investigate further, so that is a good thing.
Many years ago my mom was diagnosed with terminal cancer and was told she had a few weeks. She consulted oncologists all over the country in an effort to find someone who could help her, but they all told her the same thing. Until she found a guy in Chicago who was willing to try a combination of mainstream treatments and alternative medicine. She felt she had nothing to lose (we felt she should spend her remaining time differently, but to her it was worth trying to fight and it was her decision). So she started a regime of some seemingly crazy things, based on unlikely theories, and she went into complete remission for two and a half years. Body scans that had previously shown cancer in every major bone in her body came back clean. Her previous oncologists became interested in the things she was doing. And many years later I started seeing articles about research studies on some of the things she had tried, suggesting possible value to them.
Of course we don’t know what was responsible for my mom’s improvement, but the lessons I took away from this experience were 1) You shouldn’t just blindly believe what doctors tell you, and 2) Just because something is unproven doesn’t mean it doesn’t work–it just means we don’t know yet. That isn’t to say that any idiotic thing is worth trying, and it is especially incumbent on humans to do their due diligence when making decisions on behalf of animals who have no choice in the matter. But I do believe that under certain circumstances it is reasonable to try unproven therapies, as long as they don’t cause suffering.
Diane,
I think your lessons from this one anecdote (albeit one of particular emotional significance for you) are quite reaosonable. If the urgency of a situation is great enough, taking the risk of trying therapies with poor supporting evidence may be justified. And the lack of evidence doesn’t mean we can say with certainty that something is ineffective.
Of course, I would also point out that the lack of knowledge means there is a significant chance of harm with such treatments. Stories such as your mother’s were often told about the Gonzalez Regime, a cancer treatment involving extreme diets, coffee enemas, and many supplements. Howeve,r when this therapy was tested scientifically, it was found that pateints receiving it not only didn’t live as long as patients not getting the therapy, they had more suffering and lower uality of life while dying of their cancer. Such treatments may not only be ineffective, they may actually make things worse.
Also, it is well established that ost new ideas, whether conventional or alternative in origin, turn out not to be true. So when something is untested, and particularly when it is justified theoretically by arguments that contradict established scientific knowledge, the odds are in favor of it not being effective. So we can say that such therapies are long shots in some cases even without specific clinical trials to prove it.
Thanks for your thoughtful comment.
That is very interesting information. I didn’t realize (though it’s pretty obvious when I think about it) that most new ideas turn out to not be of any value.
That info on Nicholas Gonzales’s treatment is especially interesting to me because he’s one of the people my mom consulted. And she used at least one of his ideas: the coffee enemas, which seemed particularly crazy, but she claimed they relieved her pain. In any case, her quality of life was certainly terrible while she was doing all this stuff–consistent with that study’s finding.
Luckily for whatever reason she did have an extra couple years that were good quality. I’ve always suspected the reasons were mostly psychological, but that may be my own bias since I’m very interested in psychology. 🙂
Diane, if your mom had chemo or radiation as one of those “mainstream” treatments, there is also the chance that it took time for the treatment to produce a noticeable effect, including on those scans. Good examples of this effect (and other explanations) are described in several articles on Respectful Insolence (linked on skeptvet’s sidebar), with particular emphasis on a certain cancer clinic (Burzynski). Also, you can see this effect in those patients’ stories on theotherburzynskipatientgroup.wordpress.com
I’m not saying that some of the alt treatments your mom might have taken were not at all helpful. But, I’d be willing to bet they had little to nothing to do with her remission. JMHO.
V.T., you may be right. My mom did have a round of an experimental chemo during this time. It could have been anything, or any combination of things, I realize. It just was eye-opening/humbling to me to find that years later some research started coming out supporting some things that I had completely dismissed as ridiculous. (Of course, I also don’t know how good the research was; I don’t remember specifics and also had not been exposed to this whole evidence-based-medicine approach to thinking.)
I think I recall a particularly funny James Herriot chapter illustrating the very issue you’re referring to, and I’m sure you and all vets have experienced it many times. I’m sure I’ve done it myself many times but it’s so second-nature I couldn’t even identify it in most cases. That is what’s so fascinating and challenging to me about skeptvet’s blog, and the discussions in the comments. I am also enjoying some of the links, but haven’t checked out Respectful Insolence yet.
Diane,
RI, sciencebasedmedicine.org and skeptvet are my daily reads. If you start, fair warning – they are addicting 🙂 Just when you thought you’d heard it all, in no way have you heard it all!
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It amazes me that we still need scientific evidence when Turmeric has been used successfully in many treatments of many ailments for thousands of years in Ayurveda and chinese medicine! Science is still so incomplete!
Yes, well prayer, and bloodletting, and astrology, and ritual sacrifice have all been used for thousands of years too, yet oddly enough science hasn’t shown any of them to be safe and effective. The idea that belief is evidence or that the fact people have used something means it works is a dangerous myth.
But just who is going to put up the money for those clinical trials–the pharmaceutical industry? If big money isn’t going to be made, forget any supporting data. Not in the US, anyway. Just not enough Bill Gates around.
Whoever sells the product and makes money from it has a responsibility to provide evidence their claims are true. Supplements are a multi-billion dollar industry, and the big pharmaceutical companies are jumping right into that. Yet far less of the profits from supplements go back into research than is true for pharmaceuticals because no one regulates these produst or requires proof they work.
And regardless of the source of funding, if we don’t know it’s safe and effective, we don’t know. Is it really ok to sell as medicine things we know nearly nothing about? Is that how you want to stay healthy and treat your diseae, by guessing? How is that better. I’m not ready to give up on actually knowing what the healthcare products I use are doing to me.
In Vivo study of curcumin: http://www.ncbi.nlm.nih.gov/pubmed/23042094
Yet more in vivo publication:
http://headandnecksurgery.ucla.edu/body.cfm?id=69
We have found that curcumin treatment of HNSCC both in vitro and in vivo results in significant suppression of tumor growth. In addition, a liposomal curcumin formulation can be given intravenously in vivo to inhibit xenograft HNSCC tumor growth, without toxicity to the animal.
In vitro and lab animal model studies prove the potential for a clinically useful effect, which I’ve already acknowledged exists for turmeric and most herbal remedies. It does not, however, prove benefits will actually exist or outweigh risks in real patients. Well over 90% of medicine that look good in the test tube or in mice fail to reach the doctor’s office because of problems discovered in clinical trials, so until then the verdict is still undecided.
In vitro and lab animal model studies prove the potential for a clinically useful effect, which I’ve already acknowledged exists for turmeric and most herbal remedies. It does not, however, prove benefits will actually exist or outweigh risks in real patients. Well over 90% of medicine that look good in the test tube or in mice fail to reach the doctor’s office because of problems discovered in clinical trials, so until then the verdict is still undecided.
We rescued a Boxer @ 5 weeks old, she was in pretty bad shape. She is now 5 years old & weighs 70lbs. She started having what we thought were back spazims, took her to the vet to find out that her spine X-rays looked like a 13 year old dog. So, I did some research & decided to try her on Turmeric, 720 mg once a day, within 2 weeks she was urinating blood. Her urinalysis showed a UTI & the starting of kidney stones. I thought I looked into this herb very thoroughly before giving it to her But, now that this has happened, I did a little more research & found that this is one of the side affects. Please be Very careful when giving this to your pets.
I was doing research and stumbled across this blog by accident. Just have to say- I think there have been lots of valid studies that do show turmeric works as a anti-inflammatory. They also now have curcumin that is treated in such a way that it when blood samples are tested it does make it into the bloodstream. I usually don’t believe in herbal remedies and am skeptical but I tried turmeric because I was having pain in the bend of my intestine right under my left rib- a lot of information I read said that part of the intestine is prone to inflammation. I can’t take aspirin, so when I read turmeric was anti-inflammatory and people where taking it for inflammatory bowel disease I decided to take it myself– I just put a heaping tablespoon in 3/4 cup of yoghurt and it really did help. It is the first herbal remedy I have ever tried that seems to work for me. Now every time I get that pain under my left rib I just take some turmeric and it works to alleviate the discomfort every time.
Your information on curcumin is a little incomplete and out of date so I just want to add a few points –
– In general, I tend to think alternative medicine is full of quacks and unproven hocus pocus. However it would be great folly to include curcumin with ineffective treatments like homeopathy (yes, believe it or not, near where I live, there is a homeopathic vet! Pity dogs are unable to benefit from the placebo effect…!)
– Our university recently conducted a double-blind, placebo controlled on curcumin for depression with encouraging results (sorry, trial data still embargoed but will be published in the near future).
– Curcumin acts as a mild monoamine oxidase inhibitor, providing a mood boost and anxiolytic effect in test subjects.
– Curcumin reduces circulating CRP in vivo – indicating potent anti-inflammatory effect
– Curcumin boosts levels of glutathione, increasing global endogenous antioxidant activity and improving liver function
– The comment regarding bioavailability is also incomplete. Yes, standard curcumin extracted from turmeric has extremely low bioavailability. However recently several companies have released patented forms with dramatically increased bioavailability. One form called BCM-95 has 2000% improved bioavailability. You can also increase bioavailability by administering piperine concurrently with curcumin.
A quick search of Pubmed will show you that there is a lot of research energy going into curcumin at the moment as it has shown promise in such a wide array of areas.
Based on the research to date and my own anecdotal experience, I have plenty of confidence in curcumin (particularly as an anti-inflammatory) for humans. I have less confidence regarding its use in dogs. However I should point out that based on a dog’s metabolism I can think of no theoretical reason why curcumin should pose any risk. Nevertheless we should proceed with caution.
I have my 12 year old dogs on the following concoction – high dose omega 3 (via fish oil and krill oil), probiotics and small doses of alpha lipoic acid and milk thistle. I am still considering whether to add curcumin (which is why I landed on this blog).
Personally, I take curcumin 3x per day and find it gives a definite mood boost and improvement in joint pain I get in certain spots.
The best summary of the research on Curcumin I have read is a little book on Amazon called “Curcumin – A Therepeutic Overview” by James Lee. Alternatively, there are also pages and pages of research on Pubmed that people can check out if they are particularly interested.
Hope this helps in some way.
It is definatley an area of active research. Promising, is the right word, but so is unproven. I appreciate the comments, but I would also love to see citations to published literature to support the specifics. Thanks!
US pharma companies would not have tried to patent the ancient and well known anti inflammatory Tumeric (haldi as it is called in India) if they had not realized the benefits and potential $$$ to be made – http://www.hindustantimes.com/india-news/newdelhi/india-foils-us-firm-bid-to-patent-turmeric/article1-1002749.aspx.
I referred a friend of mine living in the US who was told he had to have steroid injections in his eye for Uveitis to an ayurvedic doctor in India who consulted with him over skype – and told him to take tumeric in a certain proportion (I wont give out the details)….he was cured 5 days later. So yes tumeric has been shown in studies to be a powerful anti inflammatory and is commonly used/ prescribed in the rest of the first world nations which have a better healthcare system than the US (and we all know that the healthcare system in the US ranks the lowest in the first world). Here is the study on uveitis and tumeric :http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964958/
On the contrary, pharmaceutical companies will try to take control of anything they believe they can make a profict from. The unregulated dietary supplement industry, which pharmaceutical companies are significantly involved in, produces billions of dollars annually in profits selling many products with no proven benefits and even some risks of harm. Just as it is erroneous to characterize Big Pharma as the root of all evil, it is a mistake to assume they only sell products that there is good scientific evidence supporting safety and efficacy. I am aware, as you can see from my article, of the preclinical evidence suggestion turmeric has properties in the lab that might be beneficial in actual patietns, but prior to clinical trials showing such benefits in the real world, the value of this spice is only hoped-for, not established.
Skeptvet,
While I applaud your determination to hold on to your reservations regarding curcumin until proven beyond any possible doubt, I think you need to put it in perspective.
I think you are demanding a level of proof of curcumin that exceeds many commonly used drugs and other medicines today.
Let’s use SSRI antidepressants as an example. So, what do we know? We know that if you analyse all the published data there is a mildly statistically significant benefit. However, as many have shown (for example – Ben Goldacre in his book Bad Pharma), when you include all the unpublished and buried trials (the ones that didn’t show a statistically significant benefit or those that showed too many unacceptable side-effects and were therefore buried by the drug company), this statistical significance either lessens or disappears. This is not a criticism of SSRIs by the way. Depression is caused by many factors, only some of which respond to SSRIs.
However, where SSRIs and curcumin show commonality is the huge body of anecdotal information that suggests efficacy. I think the trials for SSRIs are borderline at best. Yet I know a range of people who have been helped immensely by SSRIs. Similarly, the anecdotal body of evidence for curcumin is irrefutable.
So, what do we know about curcumin?
1. It has very strong in vitro evidence
2. It has very strong in vivo (rodent, animal) evidence
3. It has very strong anecdotal evidence
Based on above, what do you think would be the most appropriate view of curcumin as an effective treatment for a range of illnesses (for which is has demonstrated such in trials)?
By disregarding all of the above until it proves itself in properly designed human trials, I think you are demanding more of curcumin than for a range of commonly used drugs (as you would know, many commonly used medicines have questionable human trial results).
By the way, please don’t take this to mean that I think the issue is black and white. Some people demand more evidence that something works before they will back its use. Others (like homeopathy proponents, for example) will believe something simply because they read it on the internet or a naturopath told them so. Neither is right or wrong.
My only point is, that when you look at the body of evidence supporting curcumin, I think it deserves a greater level of support. To use its anti-inflammatory properties as an example. It has shown itself to be a powerful anti-inflammatory in-vitro. It reduces inflammation in rodents (based on c-reactive protein and various other inflammatory biomarkers) and many people report dramatic improvement in conditions involving inflammation. I don’t know about you, but I find that darn convincing.
Irrespective of your view, I think this blog article and the subsequent discussion is immensely helpful for shedding light on curcumin. It turns up at number 1 when you type “curcumin and “dogs” into Google!!
I think you may misinterpret my stance a bit. I don’t disregard in vitro and animal model evidence, I simply place it in context, with an awareness of its strengths and weaknesses. It proves the potential for clinical benefits greater than risks, not the actuality of this. I do largely disregard anecdotal evidence, which is useful only in suggesting hypotheses to test, not as probative evidence for or against any hypothesis.
What I am saying about curcumin is that it is not yet proven to be safe and effective for any indication, and as such use of it is essentially experimental. You are correct that there is similar uncertainty for many therapies that are in widespread use, but that is an example of how we fail to use the tools we have to validate therapies properly, not a reason to move ahead without using them. Dr. Goldacre’s point is not that we should use any therapy, conventional or otherwise, without adequate evidence but simply that we are sometimes misled about the evidence we have for pharmaceuticals and we deserve more and better evidence.
I am also not saying such a therapy should never be used. It is necessary to balance the urgency of intervening with the uncertainty about the outcome for any therapy. If there is a specific case in which the preclinical evidence suggests curcumin might be useful and for which there is no more thoroughly tested alternative and if the patient/client understands the uncertainty and risk involved, it may be perfectly appropriate to try it. What I object to is the practice of claiming it probably works and is almost certainly safe and so should be tried before other therapies about which we have a more complete understanding of the risks and benefits.
Thanks for a great article.
I have heard for many years about the benefits of turmeric as an anti inflammatory and have added it to my cooking a lot.
Today I decided to read up on it more and found many sites that promote many wonderful things that it can do. That’s when the alarm bells went off.
As a registered nurse I have been involved in a lot of clinical trials, so I know what goes into the testing of drugs for use in Australia at least.
If turmeric can do all that they say it can, I am sure that ‘Big Pharma’ would have made it into a pill with a patent by now.
So for me I will just stick to adding it to my cooking for a bit of spice in life until more study is done.
This skeptical vet utilizes turmeric. I found this free full-text article interesting, but commonly surf pubmed for new studies.
Curr Neuropharmacol. Jul 2013; 11(4): 338–378.
Curcumin and its Derivatives: Their Application in Neuropharmacology and Neuroscience in the 21st Centuryhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744901/
The article you refer to is simply a review of some of the in vitro and lab animal work on curcumin. It is consistent with my conclusions in this article:
Further, the primary argument in this paper for the potential value of curcumin is its antioxidant properties. I have written several times about the growing evidence that anti-oxidants may not have the benefits we had hoped, and not surprisingly they have some risks. (e.g. HERE and HERE) So the rationale for using them is pretty weak.
What motivates you to use turmeric given the lack of any compelling evidence that it is of benefit dogs and cats for any particular disease?
Came here after reading this:
http://www.dogsnaturallymagazine.com/turmeric-proven-more-effective-than-ibuprofen-for-joint-pain/
Here’s the paper:
http://www.dovepress.com/articles.php?article_id=16170
Promising. But of course says nothing about its use in dogs and love that the Dogs Naturally article makes the point of saying that studies show that ibuprofen can be bad for dogs despite being good for humans, without allowing for the possibility of the reverse for turmeric.
But then that magazine doesn’t exactly have the reputation for caution in its claims.
Yes, it is a nicely done study. There are, as always, a few methodological issues. The dropout rate was moderate to high (7.5% in the curcumin group, 12% in the ibuprofen group), which raises the possibility of uncontrolled bias (if those who dropped out differed in response or side effects from those who didn’t, the real results might be different from the apparent results). It also looks like the adverse event data was calculated on an intent-to-treat basis, but it isn’t clear if the effect data were or not. But overall, the reporting and methods appear very good.
If consistent in other studies, these results would suggest curcumin is as effective as ibuprofen for treating knee arthritis. There is no reason in these data to think it would be any better. And, of course, there were no statistically significant differences in side effects, which means there is no reason in these data to suggest curcumin is any safer than ibuprofen. This is no surprise since any medicine which has beneficial effects is going to have unwanted effects as well, so any herbal remedy which works will have risks just like any other medicine. So if these results hold up, curcumin could be another option for osteoarthritis therapy in people, no better nor worse than current medications.
As you say, this tells us little about the safety or efficacy of this medication in dogs. Certainly, ibuprofen is very risky to use in dogs, so the fact that it is safe and effective in people doesn’t necessarily mean we should use it for our pts. The same, of course, is true of curcumin.
Thanks for pointing out this study!
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Love this discussion – I subscribe to Consumer Labs – an independent group that tests supplements for content (does it actually have what it says it has!), and provides seemingly unbiased summaries of ongoing research; they don’t hesitate to tell you when the data is lacking or unsupportive. Their latest updates on curcumin research indicate improvement in function and significant reduction in symptoms of osteoarthritis of the knee (Curcuminoid Treatment for Knee Osteoarthritis: A Randomized Double-Blind Placebo-Controlled Trial http://onlinelibrary.wiley.com/doi/10.1002/ptr.5174/abstract). I have not actually read the paper This study used a complex of curcuminoids and a bioavailability enhancer. I’m about to try it for my dog – who’s 12+ with bi-lateral hip dysplasia, and arthritis. I am looking for Anything to ease her pain – had to take her off meds (rimadyl and tramadol) due to seizure activity. Vets have no other options for us! Next option just might be cannabis for pups! Will keep you posted if you’re interested.
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I love this site and find it very informative.
However, there are a few real, if small studies, which show curcumin to be benefitial for certain conditions, in people at least:
A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis.
Chandran B1, Goel A.
…
Abstract
Curcumin is known to possess potent antiinflammatory and antiarthritic properties. This pilot clinical study evaluated the safety and effectiveness of curcumin alone, and in combination with diclofenac sodium in patients with active rheumatoid arthritis (RA). Forty-five patients diagnosed with RA were randomized into three groups with patients receiving curcumin (500?mg) and diclofenac sodium (50?mg) alone or their combination. The primary endpoints were reduction in Disease Activity Score (DAS) 28. The secondary endpoints included American College of Rheumatology (ACR) criteria for reduction in tenderness and swelling of joint scores. Patients in all three treatment groups showed statistically significant changes in their DAS scores. Interestingly, the curcumin group showed the highest percentage of improvement in overall DAS and ACR scores (ACR 20, 50 and 70) and these scores were significantly better than the patients in the diclofenac sodium group. More importantly, curcumin treatment was found to be safe and did not relate with any adverse events. Our study provides the first evidence for the safety and superiority of curcumin treatment in patients with active RA, and highlights the need for future large-scale trials to validate these findings in patients with RA and other arthritic conditions.
http://www.ncbi.nlm.nih.gov/pubmed/22407780
I agree there are some studies which suggest a benefit. However, as the authors of this study themselves point out, these small, limited studies “highlight the need for future large-scale trials to validate these findings.” In this study, the sample size was tiny, which makes the results tenuous. Glucosamine appeared to work until data collected on thousands of people revealed it really didn’t. I’m hopeful that some chemicals from herbal remedies will turn out to have real value, and curcumin may very well be one. Time and more reach will tell.
Thanks for the link, and the support.
Given the numerous commercials that advertise law suits for drugs that did go through human trials and were approved by the official government agency assigned to investigate the claims of said trials, I will take something made directly by my mother earth over what is manufactured in a lab for profit any day. Yes, some drugs are based on natural substances but with additives and no matter which you choose, there are risks. However, medicine has become nothing more than big business with no REAL concern for any thing other than how much money can be made and the law suits are nothing in comparison to the profit so if it works or it doesn’t, somebody got richer. Diseases have been on the increase for years and the one thing we ALL have in common is that we need to eat and that is where it all begins. Just look at the ingredients in our food and then look them up. Found out what I now wish I did not know while researching for a healthy and completely nutritionally correct diet for my four legged loves. I am still blown away by what people will do to ANY being, for money. Do some research on that Skept. Just saying. ????LOVE!
You have a very distorted sense of not only the agenda of people working to develop drug therapies but also of the effects of such therapies. No doubt, profit motives lead to bad behavior, but it is foolish to ignore the overwhelming evidence of benefits, in terms of suffering relieved and lives saved, by medicines and consider all of it to be crap just because of some cases of bad behavior and unexpected negative effects. “Straight from mother earth” was how we lived for millennia, and most of us were dead before we were, by today’s standards, even adults. Only a terrifying ignorance of history allows otherwise reasonable people to believe the kinds of things you are claiming here.
Interesting. As a former pathology lab supervisor and current biology teacher, I appreciate the value of scientific research. However, I also value safe natural alternatives. I have a seven year old gsd with severe hip diplasia that has had tumeric added to her food daily for years. She runs and plays pain free every day even though our vet diagnosed her with arthritis. I found Dr. Karen Becker’s advice on this topic very helpful.
Wow, I just looked over some of your blogs and your credentials. You really don’t like Dr. Karen Becker. Her credentials and experience impress me. Recall in my first post, I mentioned that I worked at a pathology lab? Well, the pathologists at that lab were all veterinarians with a doctorate in pathology. We did studies using rodents. The pathologists at the lab were all for natural alternatives. Why? Because we did studies for NIH on chemicals in foods, medicines, pesticides, drinking water, etc. at our lab. We saw the results after necropsies.
Of course, the key is what constitutes evidence for “safe and effective” and what, if any meaning does “natural” have. There are a lot of assumptions in that simple phrase which don’t hold up well when looked at closely.
I have no personal feelings towards Dr. Becker, so to say I don’t “like” her is misleading. I do often feel she is far to accepting of alternative medical claims without evidence. And, of course, her husband and his website are vehemently anti-vaccine and consistently promote pseudoscience, so I often disagree with her recommendations.
Again, “natural” is a largely meaningless word. And a generalized fear of “chemicals” is not a sound basis for deciding the safety and efficacy of specific therapies. Many “natural” substances are harmful (botulism, ebola, arsenic, uranium, rattlesnake venom, polio are all “natural”), and many “artificial” things are beneficial (vaccines, antibiotics, blood transfusions, chemotherapy, etc.), so you are making an unsound distinction.
I don’t promote pseudoscience nor am I anti vaccine or anti medication, but I don’t have a problem with the use of “natural” supplements like turmeric. After all, many of our current medications come from plant matter. Also, I would not classify a bacterium like C. botulinum or the Ebola virus as a “substance” ( http://www.merriam-webster.com/dictionary/substance). In addition, antibiotics aren’t really “artificial” (penicillin is derived from the fungus Penicillium) nor would I categorize a blood transfusion or vaccines as artificial. “Chemicals” have often harmed plants, animals and humans (DDT, Thalidomide, Asbestos). Just look at the drug recalls: http://www.fda.gov/Drugs/drugsafety/DrugRecalls/default.htm.
Have you ever taken a prescription medication on a long term basis? There can be harmful side effects. Turmeric is rendered safe in comparison:http://www.webmd.com/vitamins-supplements/ingredientmono-662-turmeric.aspx?activeingredientid=662&activeingredientname=turmeric. My vet encourages natural supplements in addition to prescription medication, just like my physician. Making use of all available resources, whether “natural” or “artificial” in an intelligent manner is using common sense. “Common sense is genius dressed In its working clothes.” Ralph Waldo Emerson
The problem is with the assumption that something is safe because e choose to label it “natural.” Turmeric may have beneficial physiologic effects, but if it does than it has risks as well. As you say, many medicine are derived from plants, and yet proponents of “natural” therapies constantly claim that such “drugs” are dangerous while “natural” plant products are not. This is a specious and dangerously misleading distinction, and the category “natural” really has no utility in terms of deciding whether something is safe and effective or not. That is only possible to determine through appropriate research, regardless of the origin of the therapy or the ideological labels we attach to it. You can die from too much water and oxygen, and yet synthetic compounds used as medicines can be life-saving. The “natural” vs “artificial” distinction is just meaningless.
The same is true for “chemicals.” Water is a chemical, as are most medicinal compounds regardless of whether we get them by chewing leaves or synthesizing them in a lab. Calling something a “chemical” is just a way to imply risk just like calling it “natural” is intended to imply safety, yet neither term provides any actual information, they simply reflect the speaker’s prejudices.
“Common sense is the collection of prejudices acquired by the age of eighteen.” Albert Einstein
Everything in life has risks…since when did someone die as a side effect of turmeric? Develop cancer from it? We could make a long list of synthetic and naturally occurring chemicals that have caused cancer or death. However, I doubt turmeric would be on it. I never indicated that “natural” meant safe. Yet, many natural products are very safe just like many synthetic products are safe. Turmeric has been consumed for thousands of years. I think we would know by now if it posed a health hazard.
Actually, that’s not accurate. Certainly, the use of turmeric in cooking does not represent a significant direct disease risk or, as you say, this would be obvious. It is not poisonous at levels used in cooking, obviously. However, that is entirely different from its use as a medicine, often at much higher doses, or with specific compounds extracted and concentrated, used over extended periods, and mixed with other medicines. We do not know if this use is safe because it has not been studied, and it differs significantly from ordinary culinary use. Now, for what it’s worth I think the existing evidence suggests very little risk, as I indicated in my article. However, the real risk is in the notion that haphazard observations of unsystematic use of such products constitutes adequate evidence of the safety of medicinal use.
Thousands of people are often studied in trials leading to the licensing of new medicine, yet unexpected risks are frequently found when these medicines are approved for use in tens of thousands or millions of people. Assessing the true risks of any medicinal product regardless of its origin requires careful, systematic, scientific study. Unfortunately, in the U.S. the law (DSHEA) exempts so-called “natural” products like this from such study, despite the numerous examples of people being harmed by some of them. Yes, everything in life has risk.
Yet you seem to think we already know the safety of at least some of these products, which again I think reflects your own assumptions rather than objective reality.
Studies on turmeric are listed under references in this article: http://www.nlm.nih.gov/medlineplus/druginfo/natural/662.html . Just click on “view abstract.”
NIH conducts studies on chemicals that humans are exposed to, including food additives like spices. Here is one such study: http://www.ncbi.nlm.nih.gov/pubmed/12676044.
And, yet another: http://www.ncbi.nlm.nih.gov/pubmed/12680238.
You seem to be under the impression I am not familiar with the research on turmeric. This is odd since I cited several thorough reviews of that research in the very article we are discussing. Studies do exist suggesting some benefits as well as some side-effects, but the evidence is not yet sufficient to justify any specific medical use or the safety of such use. If you wish to review the research, you need to look at the entire body of work and critically appraise each study for risk of bias, confounding, power, and all the other details of methodology that are relevant to evaluate the reliability of research evidence. Simply finding a study that makes a positive claim isn’t sufficient, since that can be found for virtually anything.
You assume I did not read your blog or earlier posts…wrong. You wrote: “we do not know if this use is safe because it has not been studied…” The NIH studies were for medicinal purposes. I get the impression that there would never be enough studies for people like you, even though the scientists who conducted those studies are experts in their field.