Turmeric
Curcuma longa
TL;DR
Turmeric's activity comes from curcuminoids, which make up only about 3% of the root and absorb poorly on their own. Enhanced-bioavailability curcumin extracts at 500-2000 mg/day have solid evidence for osteoarthritis pain, comparable to NSAIDs in several head-to-head trials. Plain culinary turmeric will not reproduce that.
Ideal For
- Adults with knee or hand osteoarthritis wanting an NSAID alternative
- People with elevated inflammatory markers or metabolic syndrome
- Those with inflammatory bowel disease, as an adjunct to standard therapy
- Anyone who cannot tolerate NSAIDs gastrointestinally
Avoid If
- You take warfarin or other anticoagulants
- You have gallstones or bile duct obstruction
- You have surgery scheduled within two weeks
- You have iron deficiency — curcumin chelates iron
- You take medications metabolised by CYP3A4 and choose a piperine formula
- You are pregnant, at therapeutic supplement doses
- You have significant reflux, which curcumin can aggravate
Frequently Asked Questions
Overview
Turmeric is the rhizome of Curcuma longa, and almost everything studied about it concerns curcuminoids — curcumin, demethoxycurcumin and bisdemethoxycurcumin — which together constitute roughly 2-5% of the dried root. This distinction is the single most important practical fact about the supplement: a 500 mg capsule of turmeric powder contains perhaps 15 mg of curcuminoids, while the trials that show benefit used 500-2000 mg of curcuminoids in formulations designed to overcome their notoriously poor absorption.
Where curcumin has been properly tested with a bioavailable formulation, results are good. In knee osteoarthritis, multiple randomised trials and meta-analyses show pain and function improvements comparable to ibuprofen and diclofenac, with markedly fewer gastrointestinal adverse events — one of the better botanical-versus-drug comparisons in the literature. Trials in ulcerative colitis maintenance, non-alcoholic fatty liver disease, metabolic markers and depression as an SSRI adjunct are smaller but broadly positive. It works by inhibiting NF-kB, COX-2, 5-LOX and JAK-STAT signalling, and by activating Nrf2 antioxidant pathways.
The formulation question is unavoidable. Free curcumin has bioavailability under 1%, is rapidly glucuronidated, and needs help: piperine raises absorption roughly twentyfold, while phytosome, micellar, nanoparticle and gamma-cyclodextrin systems achieve larger increases without piperine's drug-interaction problems. Piperine is not benign — it inhibits CYP3A4 and P-glycoprotein and can raise levels of many medications. Also note that curcumin has genuine antiplatelet activity, may worsen reflux and gallbladder disease, and rare cases of hepatotoxicity have been reported with high-bioavailability formulations.
How It Works
- Inhibits NF-kB, reducing transcription of inflammatory cytokines
- Suppresses COX-2 and 5-lipoxygenase, lowering prostaglandin and leukotriene production
- Activates Nrf2, upregulating glutathione and phase II antioxidant enzymes
- Inhibits JAK-STAT signalling in immune cells
- Reduces TNF-alpha, IL-1beta and IL-6 concentrations
- Modulates the gut microbiome and strengthens intestinal barrier function
- Inhibits platelet aggregation via thromboxane pathways
Quick Facts
- Contains curcumin, a potent anti-inflammatory compound
- Used in traditional medicine for thousands of years
- Powerful antioxidant with multiple health benefits
- May support joint health and cognitive function
- Bioavailability enhanced when combined with black pepper
Supporting Research23 studies
Oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis: a randomized and placebo-controlled study
Khajehdehi P, et al
Short-term turmeric supplementation can decrease proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis.
Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study
Haroyan A, Mukuchyan V, Mkrtchyan N +5 more
In 201 adults aged 40-70 with knee osteoarthritis, 12 weeks of curcuminoid complex with turmeric volatile oil (500 mg three times daily) significantly reduced WOMAC pain and improved physical performance versus placebo; the curcumin plus boswellic acid combination produced larger improvements than curcumin alone.
Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review
Paultre K, Cade W, Hernandez D +3 more
Most trials reported significant improvement in pain and function with turmeric/curcumin versus placebo, and non-inferiority versus NSAIDs, with fewer gastrointestinal adverse events.
Antioxidant and anti-inflammatory effects of curcumin/turmeric supplementation in adults: A GRADE-assessed systematic review and dose-response meta-analysis
Turmeric/curcumin supplementation might be used as a viable intervention for improving inflammatory/oxidative status.
Efficacy and safety of curcumin therapy for knee osteoarthritis: a Bayesian network meta-analysis
Zhao J, Liang G, Zhou G +2 more
Curcumin, a polyphenolic compound extracted from turmeric (Curcuma longa L.), is widely used in traditional Chinese medicine to treat osteoarthritis and rheumatoid arthritis.
Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Daily JW, Yang M, Park S
Turmeric extracts and curcumin reduced arthritis symptoms, particularly WOMAC and VAS pain scores
Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysis
Panahi Y, Hosseini MS, Khalili N
Curcuminoid therapy significantly reduced circulating concentrations of C-reactive protein.
The effect of turmeric-boswellia formulation (Rhuleave-K) in posture-related low back soreness and discomfort: a randomized double blinded placebo controlled trial
Gupta A, Agarwal A
Posture-related low back soreness and discomfort was significantly reduced by Rhuleave-K at 500 mg dose.
Effect of a herbal extract containing curcumin and piperine on midazolam, flurbiprofen and paracetamol (acetaminophen) pharmacokinetics in healthy volunteers
Volak LP, Hanley MJ, Masse G +1 more
Turmeric extract derived curcuminoids (curcumin, demethoxycurcumin and bisdemethoxycurcumin) are currently being evaluated for the treatment of cancer and Alzheimer's dementia.
Complementary and alternative medicine therapies for uremic pruritus - A systematic review of randomized controlled trials
Yeam CT, et al.
Other therapies such as evening primrose oil, turmeric, vitamin B3, vitamin D and thermal therapy were not effective for treatment of UP.
Phase I clinical trial of oral curcumin: biomarkers of systemic activity and compliance
Sharma RA, Euden SA, Platton SL +1 more
Curcumin, a polyphenolic antioxidant derived from a dietary spice, exhibits anticancer activity in rodents and in humans.
Effects of curcumin supplementation on delayed onset muscle soreness: a systematic review and meta-analysis
Fang W, Nasir Y
Curcumin from turmeric reduced post-exercise soreness and muscle damage markers.
Impact of Supplementation with Curcuminoids on Systemic Inflammation in Patients with Knee Osteoarthritis: Findings from a Randomized Double-Blind Placebo-Controlled Trial
Rahimnia AR, et al
Significant improvement in clinical symptoms of OA in curcuminoid-treated subjects cannot be attributed to the systemic anti-inflammatory effects of these phytochemicals.
Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial
Small GW, Siddarth P, Li Z
Bioavailable curcumin improved verbal and visual memory and attention over 18 months
Curcumin and proton pump inhibitors for functional dyspepsia: a randomised, double blind controlled trial
Kongkam P, Khongkha W, Lopimpisuth C +1 more
Significant improvements were
The effect of curcumin supplementation on delayed-onset muscle soreness, inflammation, muscle strength, and joint flexibility: A systematic review and dose-response meta-analysis of randomized controlled trials
The effect of curcumin supplementation on delayed-onset muscle soreness, inflammation, muscle strength, and joint flexibility
Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study
Lopresti AL, Hood SD, Drummond PD
Curcumin produced significantly greater mood improvement than placebo after week four, especially in atypical depression
Curcumin: A Review of Its Effects on Human Health
Hewlings SJ, Kalman DS
Curcumin shows anti-inflammatory and antioxidant activity with bioavailability limiting clinical effect
Curcumin: A Review of Its' Effects on Human Health
Hewlings SJ, Kalman DS
Curcumin shows anti-inflammatory and antioxidant activity with bioavailability limiting clinical effect
Curcumin and inflammation: a systematic review
Hewlings, S.J., Kalman, D.S.
Curcumin shows anti-inflammatory and antioxidant activity with bioavailability limiting clinical effect
Oral curcumin for Alzheimer's disease: tolerability and efficacy in a 24-week randomized, double blind, placebo-controlled study
Ringman JM, Frautschy SA, Teng E +16 more
Oral curcumin was tolerable but produced no significant cognitive or biomarker benefit in Alzheimer disease
The Essential Medicinal Chemistry of Curcumin
Nelson KM, Dahlin JL, Bisson J +3 more
Curcumin is an unstable, reactive compound with poor bioavailability that has never yielded a successful drug candidate
Investigation of the anti-inflammatory effect of Curcuma longa in Helicobacter pylori-infected patients.
Koosirirat C, Linpisarn S, Changsom D +1 more
The eradication rate of H. pylori in patients that received OAM treatment was significantly higher than the patients that received curcumin (78.9% versus 5.9%).
Safety Information
Potential Side Effects
Generally safe when used as directed. May cause stomach upset, nausea, or diarrhea at high doses. Can increase bleeding risk when combined with anticoagulant medications. May interact with chemotherapy drugs and diabetes medications.
Contraindications
Anticoagulant therapy, gallstones or biliary obstruction, imminent surgery, and pregnancy at therapeutic doses. Caution in iron deficiency and active reflux disease.
Drug Interactions
- Warfarin and antiplatelet drugs — additive bleeding risk
- CYP3A4 substrates — piperine formulations markedly raise drug levels
- Tacrolimus and other narrow-therapeutic-index drugs — significant risk with piperine
- Iron supplements — curcumin chelates iron and reduces absorption
- Chemotherapy agents — variable interactions, requires oncology advice
- Diabetes medication — possible additive glucose lowering
Pregnancy & Breastfeeding
Pregnancy: likely_unsafe
Breastfeeding: insufficient_data
Dosage Guidelines
Dosage Used in Studies
500-2000 mg
Best Time to Take
Twice daily with fat-containing meals
Best Form
An enhanced-bioavailability curcumin extract — phytosome, micellar or cyclodextrin — delivering 500-1000 mg curcuminoids
Bioavailability
Unformulated curcumin has oral bioavailability below 1% due to poor solubility, rapid intestinal and hepatic glucuronidation and sulfation, and fast elimination. Formulation increases exposure by 20-185 fold depending on the delivery system.
Forms Compared
Curcumin phytosome (Meriva)
Curcumin with piperine (BCM-95, Bio-Perine)
Micellar or liquid curcumin (NovaSOL)
Gamma-cyclodextrin curcumin (CAVACURMIN)
Plain turmeric powder
Food & Timing
With a meal containing fat — curcuminoids are lipophilic and absorption drops sharply when fasted
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.