Update on my favorite herb for managing inflammation

Turmeric, the root from which we get curcumin, is one of the most thoroughly researched plants used in herbal therapy.  Its therapeutic properties have been the subject of over 5600 peer reviewed studies. Turmeric has been used in cooking for millennia.  Remnants of turmeric powder have been found on cooking implements from Asia dated at over 4000 years old.  Turmeric is one of several herbs used to make curry, a dietary staple for hundreds of millions of Asian and Indian people.  Not to say millions of people could be wrong, witness American elections every four years…but the odds are that they’re onto something.

Over the years I have used both herbal and nutritional supplements as front line therapy for inflammation and I’d like to review for you one of my favorites, the turmeric root, with its active ingredient called curcumin. Identifying and reducing inflammation is one of the most important preventative measures one can take to reduce the risk of disease and the general process of aging. Inflammation can be both generalized, as well as specific to a situation such as injury or overuse. Generalized inflammation is typically aggravated by lifestyle choices, or genetically related-when we lack the ability to optimally clear damage and repair injured tissue. Situational inflammation is usually due to a recent and acute event.  An injury, intermediate-term stress, exposure to inflammatory foods or toxins and infections are examples.

The medical profession has a number of pharmaceutical agents we use to reduce inflammation, including the nonsteroidal anti-inflammatories (ibuprofen, naproxen, etc.) as well as steroid-based therapy like prednisone and the newer biologic agents.  All of these classes of medications have known side effects, some of which can be severe.

Unlike prescription drugs, where the focus is on one channel of action, herbs usually work multiple therapeutic pathways simultaneously.  Multiple animal and human studies have shown that curcumin, the active ingredient in turmeric, inhibits a broad range of inflammatory provoking molecules, including cyclooxygenase (COX-2), lipoxygenase (LOX), tumor necrosis factor-alpha (TNF-a) and the pro-inflammatory interleukin (IL) factors 1, 2, 6, 8, and 12.  By working across the range of these inflammation provoking pathways, curcumin doesn’t put all of its focus on just one healing mechanism.  This diversity of action is a major contributor to its excellent safety profile.

Let’s consider three individuals I’ve seen recently (names and occupations have been changed), and their response to curcumin as used for some common health problems:

Overuse sports injuries.

Jim is a 55-year-old guy who has been getting back in shape as he lost 45 lbs. over this last year.  I’m really proud of his progress.  Part of his success was having a moderate amount of male hormone replacement, which helped him to have the motivation to exercise, and the ability to respond better when he did.  One result of his increased workout routine, however, was the regular occurrence of inflammatory driven overuse injuries.  First it was plantar fasciitis, followed closely by an elbow tendinitis, and then a pulled muscle in his lower back with an associated sciatica.   While cutting back slightly on his workout intensity, we added curcumin at 2000 mg/day.  In the last 6 months he has been able to regain progress with his exercise without additional injuries. This did not surprise me, as studies using curcumin for muscle inflammation have shown that optimal doses can hasten muscle recovery by five times over that of untreated cases. 1  I advised him that ~1000 mg/day may be a good maintenance dose for the near future.

Fibromyalgia

Ginny is a 49-year-old lady with ~5 years of progressive diffuse muscle aches and associated fatigue.  She was diagnosed with fibromyalgia, and as it worsened, she had to take temporary disability from her teaching position.  She has been on several ‘fibro’ meds that gave incomplete reduction of pain.  Part of her subsequent recovery process this last 6 months has included supporting her low thyroid, adrenal and post-menopausal hormones, especially testosterone.  We also added curcumin at 1500 mg/day and found that this step allowed significant progress on her flexibility and in reducing the amount of “day-after-exertion fatigue”.  This allowed her to successfully restart a meaningful and continuous conditioning program.  She returned to the workplace this last month on a part time basis, and as curcumin can be taken long term, we plan to make this a part of her ongoing support therapy.

Brain aging disorders

Brian is a 65-year retired firefighter who was diagnosed two years ago with early Alzheimer’s.  He had been doing relatively well until six months ago when he went on a statin drug for his moderately elevated cholesterol.  His wife Alison noticed that within a month on the new medication that he was noticeably more forgetful.  He also had a lot more muscle aches, and was putting off his favorite springtime pastime of developing his ‘internationally famous here locally’ summertime garden.  On the other hand, his cholesterol and his c-reactive protein (CRP)-a marker for inflammation were both improved.  It is likely that the potential from benefit of statins is as much the reduction of inflammation as it is the excess ‘bad cholesterol’.  Both of these benefits have the potential to help with brain aging.  Unfortunately, a common statin side effect is the reduction of a key energy producing nutrient called CoQ10.  Energy intensive organs like the liver, kidney, heart and…and oh, yes, especially in Brian’s case…skeletal muscles and the brain all require high CoQ10 levels to function optimally.  We changed his regimen by choosing a much less potent statin, adding CoQ10 200 mg/day, and also adding 2500 mg of curcumin/day (Brian’s a big guy).  Within ten weeks his memory was back to baseline-if not a bit better, according to Alison; his muscle pain was gone, his cholesterol and CRP maintained their progress, and he was by the office to show off the juiciest Brandywine tomatoes I’d ever seen.  I believe we were able to trade off some loss of inflammatory benefit from the reduced statin with that provided by curcumin, while avoiding the energy draining statin side effects.  In the long term, we will be advising to Brian to continue the curcumin, given the strong evidence that besides reducing brain inflammation, turmeric and its derivatives can also enhance brain repair.  The aromatic turmerones found in turmeric have been shown to promote neural stem cells to become functioning adult neurons, and to cause these new neurons to move to areas of the brain that need assistance.2,3  While it will take time to prove out how this works long term in humans with brain aging disorders, it’s a very exciting prospect.

What to look for in buying curcumin

Turmeric is derived from the root of the plant Curcuma longa, a member of the ginger family.  It is also commonly known in the health food world as curcumin, which is one of the most important active ingredients in turmeric.  Since only ~3% of turmeric powder is curcumin, most products come in the form of a 90-95% curcuminoid extract.  This means that a capsule containing 500 mg of turmeric extract can provide ~450-475 mg of curcuminoids, while the same amount of turmeric powder (ground herb, just like the spice) might provide only about 15 mg. ConsumerLab.com found that a capsule of turmeric (herb, not extract) from a well-known supplement brand contained only 3 mg of curcuminoids.  Clearly, one should always read the label for details.

While I can’t make claims specific to your story, if inflammation is a part of your health problem, consider adding curcumin to your list of natural remedy options.

References:

1 Systemic administration of the NF-kappaB inhibitor curcumin stimulates muscle regeneration after traumatic injury.  Thaloor D1, Miller KJ, Gephart J, Mitchell PO, Pavlath GK.   Am J Physiol. 1999 Aug; 277(2 Pt 1):C320-9.

2 Aromatic-turmerone induces neural stem cell proliferation in vitro and in vivo. Hucklenbroich, Klein R, Neumaier B, Graf R, et al. Stem Cell Research & Therapy. 2014; 5:100.

3 Aromatic-turmerone’s anti-inflammatory effects in microglial cells are mediated by protein kinase A and heme oxygenase-1 signaling.  Park SY, Kim YH, Kim Y, Lee SJ.  Neurochem Int. 2012 Oct;61(5):767 – 77.

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