Turmeric and Curcumin : Dosing and Safety

by MedlinePlus

(Page 2 of 2)

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Turmeric may be standardized to contain 95% curcuminoids per dose. The dried root of turmeric is reported to contain 3% to 5% curcumin.

Turmeric may be combined with bromelain, because it is believed that this will enhance absorption of turmeric into the body. A lipid base of lecithin, fish oils, or essential fatty acids may also be used to enhance absorption. Additional benefit from these special formulations is not proven.

Adults (18 years and older)

Oral (by mouth): Traditional doses range from 1.5 to 3 grams of turmeric root daily, divided into several doses. Studies have used 750 milligrams to 1.5 grams of turmeric daily in three to four divided doses, with doses up to 8 grams daily used for the treatment of duodenal ulcer. As a tea, 1 to 1.5 grams of dried root may be steeped in 150 milliliters of water for 15 minutes, and taken twice daily. Average dietary intake of turmeric in the Indian population may range between 2 to 2.5 grams, corresponding to 60 to 200 milligrams of curcumin daily. Patients with colorectal cancer ingested curcumin capsules (3,600, 1,800, or 450 mg daily) for 7 days. For their chemoprotective effect against chemically-induced malignancies they were administered 0.6 milliliters of TO three times a day for 1 month and 1 milliliters in 3 divided doses for 2 months.

Topical (for treatment of scabies): One reported method is to cover affected areas once daily with a paste consisting of a 4:1 mixture of Azadirachta indica ADR ("Neem") to turmeric, for up to 15 days. Scabies should be treated under the supervision of a qualified healthcare provider.

Children (younger than 18 years)

Topical (for treatment of scabies): One reported method is to cover affected areas once daily with a paste consisting of a 4:1 mixture of Azadirachta indica ADR ("Neem") to turmeric, for up to 15 days. Scabies should be treated under the supervision of a qualified healthcare provider.

Safety

Allergies

Allergic reactions to turmeric may occur, including contact dermatitis (an itchy rash) after skin or scalp exposure. People with allergies to plants in theCurcumafamily are more likely to have an allergic reaction to turmeric. Use cautiously in patients allergic to turmeric or any of its constituents (including curcumin), to yellow food colorings, or to plants in theZingiberaceae(ginger) family.

Side Effects and Warnings

Turmeric may cause an upset stomach, especially in high doses or if given over a long period of time. Heartburn has been reported in patients being treated for stomach ulcers. Since turmeric is sometimes used for the treatment of heartburn or ulcers, caution may be necessary in some patients. Nausea and diarrhea have also been reported.

Based on laboratory and animal studies, turmeric may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Limited animal studies show that a component of turmeric, curcumin, may increase liver function tests. However, one human study reports that turmeric has no effect on these tests. Turmeric or curcumin may cause gallbladder squeezing (contraction) and may not be advised in patients with gallstones. In animal studies, hair loss (alopecia) and lowering of blood pressure have been reported. In theory, turmeric may weaken the immune system, and should be used cautiously in patients with immune system deficiencies.

Pregnancy and Breastfeeding

Historically, turmeric has been considered safe when used as a spice in foods during pregnancy and breastfeeding. However, turmeric has been found to cause uterine stimulation and to stimulate menstrual flow, and caution is therefore warranted during pregnancy. Animal studies have not found turmeric taken by mouth to cause abnormal fetal development.

Interactions

Interactions with Drugs

Based on laboratory and animal studies, turmeric may inhibit platelets in the blood and increase the risk of bleeding caused by other drugs. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve® ).

Based on animal studies, turmeric may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. If you are using any medications, check the package insert and speak with your healthcare provider or pharmacist about possible interactions.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering drugs such as lovastatin (Mevacor®) or atorvastatin (Lipitor®).

In animals, turmeric protects against stomach ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin®), and against heart damage caused by the chemotherapy drug doxorubicin (Adriamycin®).

Based on animal data, turmeric may lower blood sugar and therefore may have additive effects with diabetes medications.

Interactions with Herbs and Dietary Supplements

Based on animal studies, turmeric may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , some cases with garlic, and fewer cases with saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, evening primrose, fenugreek, feverfew, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

Based on animal studies, turmeric may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements to be too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system, such as bloodroot, cat's claw, chamomile, chaparral, chasteberry, damiana, Echinacea angustifolia , goldenseal, grapefruit juice, licorice, oregano, red clover, St. John's wort, wild cherry, and yucca.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering herbs or supplements such as fish oil, garlic, guggul, or niacin.Based on animal data, turmeric may lower blood sugar. Check with your health care professional before starting turmeric if you are taking other herbs or supplements or medications for diabetes.

About the Author

medlineplus.gov
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.