CURCUMIN: FROM TRADITION TO TREATMENT

One of the most traded spices in Asia throughout the millennia has been Turmeric. Today, it enjoys status as being one of the most traded spices throughout the globe. So much so has turmeric been a staple of medicine and culture, that it is utilized in ceremonies for weddings, births, and deathsⁱ. The profound reverence for the plant, indicated by its utilization throughout the life cycle as both medicine and ceremonial plant, is exceptionally well deserved. Turmeric, and its chief constituents, the curcuminoids, have been utilized, studied, and their use refined throughout generations. Today much research exists supporting curcumin’s utility as an antioxidant, anti-inflammatory, immunomodulator, antidepressant, and anti- hyperlipidemic to name a few. It can be said that when dealing with curcumin, you are dealing with a molecule that the body readily utilizes to heal the body, mind, and spirit.

Curcuminoids are a mixed class of polyphenols that are metabolized by the liver and excreted in the urine, as well as partially in fecesⁱⁱ. The primary molecules that make up the curcuminoid class are curcumin itself along with demethoxycurcumin, and bidemethoxycurcumin. Within the root of turmeric, these curcuminoids make up anywhere from 2.5% to 6% of the biochemical content of the turmeric rhizomeⁱⁱⁱ. While this is still a robust amount of real estate to take up in a plant’s total biochemical content, it is still fairly low overall. In attempting to understand the medical applications of the curcuminoids, the most common criticism is their low absorption and thus bioavailability. Once again, researchers had to look back at cultures with whom turmeric is revered for its medicinal properties and found two major points: it is used regularly as both food and medicine, and it is virtually always co- administered with fats and spices including black pepper and long pepper. This led to the discovery that piperine increases curcuminoid absorption in the body^iv. It should be noted here that this is a slight oversight in this tale regarding black pepper. It was not actually just black pepper that turmeric is commonly co-administered with, rather a group of varying pepper plant species, ginger (a direct botanical relative of turmeric), and often other spices along with a fat which holds these molecules in solution since curcuminoids are lipophilic^v. In Indian culture, turmeric is often given with the components of Trikatu, a trusted and relied upon blend of black pepper (Piper nigrum), long pepper (Piper longum), and dried ginger (Zinigiber officinalis). While studies comparing single use black pepper versus Trikatu are lacking, it stands as an interesting juxtaposition of ethnobotanical data being reduced to fit the current research model paradigm.  That said, it is important to consider that the average person utilizing a Western diet will likely not consume enough turmeric to reach a therapeutic threshold of curcuminoids. This stands in contrast to Indian and East Asian cultures where turmeric is used more consistently within the diet^vi, thus increasing the likelihood of its tonic effects without supplementation, yet still not necessarily guaranteeing them.

With the addition of piperine, and even without it, the research around curcumin and its effects on human health are robust to say the least. Curcuminoids have been shown to be supportive in the wide-range categories of inflammatory conditions, mental health concerns, joint pains, metabolic conditions such as blood sugar dysregulation, cardiovascular support, and dyslipidemia. It is worth mentioning that this list omitted many additional claims made about curcuminoids that did not have ample retrievable evidence or had conflicting results.

When it comes to curcuminoids and their ability to support the body through an inflammatory episode, this is likely achieved by curcumin’s ability to up-regulate our body’s endogenous antioxidants and their associated enzymes: super oxide dismutase, glutathione, and catalase^vii. Similarly, nitric oxide is also found to be more abundant when curcumin is being regularly administered, which points at the blood pressure and vascular support claims that are often associated with curcumin. By increasing nitric oxide (NO) availability, the body increases its ability to vasodilate at the local level, allowing for enhanced blood flow, decreased peripheral resistance, which in turn decreases blood pressure^viii. The effect of one study found as much as a 40% increase in plasma NO in healthy individuals. Additionally, plasma soluble intercellular adhesion molecule-1 (sICAM), a marker for atherosclerosis risk, decreased.^ix

Another unique aspect of curcumin research is its use in mental health support. One study found depression scores for those with major depression improved with 500mg of curcuminoids administered daily^x. The mechanism for this is not well understood from a Western medical model, but in Ayurvedic practices, the utilization of both turmeric and Trikatu to stoke the digestive fire known as Agni, which in the Ayurvedic model has a direct impact on the clarity of mental faculties and strengthens one’s own fire for living. This once again gives evidence to the intricate and well-researched nature of the ancient healing arts that modern medical theory continues to learn from and incorporate as research continues to validate this body of knowledge.

As discussed, curcumin and its related molecules exert a measurable effect on our antioxidant system as well as on yield supportive improvements in cognition. It comes as no surprise that overall pain, as well as specifically joint pain, have been studied as well. In a randomized, double-blind, placebo-controlled trial, 53 people with knee osteoarthritis were assigned to take 1,500 mg of a curcuminoid complex (95% curcuminoids) with 15 mg of piperine or placebo daily for 6 weeks and showed improved pain and stiffness scores^xi. Another study found that curcumin, black pepper, and ginger combined created equal pain reduction to a group taking naproxen sodium for knee pain^xii.

One thing is for certain, there isn’t any one specific molecule that is exerting effect, it is the mixture are various sub-types of curcumin and piperine that are what is creating a symphony effect on the body and is reliant on a fat-matrix for best emulsion and absorption. This food, medicine, and ally of over 5,000 years is working to improve the fires of digestion as well as of the mind while also tending to oxidative stress on the body, thus bringing vitality and easing the pains of everyday life. Moreover, as science continues to unfold and validate the secrets of Ayurvedic medicine, it is likely we will continue to see the body of evidence for curcuminoids, Trikatu, and other Ayurvedic medicines continue to flourish just as they have for thousands of years.

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References

i Prasad, S., & Aggarwal, B. B. (2011). Turmeric, the Golden Spice: From Traditional Medicine to Modern Medicine. In I. Benzie (Eds.) et. al., Herbal Medicine: Biomolecular and Clinical Aspects. (2nd ed.). CRC Press/Taylor & Francis.

ii Tsuda T., (2018). Curcumin as a functional food-derived factor: degradation products, metabolites, bioactivity, and future perspectives. Food & function, 9(2), 705–714. https://doi.org/10.1039/c7fo01242j ⁱⁱⁱ Lee W-H, Loo C-Y, Bebawy M, et al. Curcumin and its derivatives: their application in neuropharmacology and neuroscience in the 21st century. Current neuropharmacology. 2013;11(4):338-78.

iv Chen, Z., Sun, D., Bi, X., Zeng, X., Luo, W., Cai, D., Zeng, Q., & Xu, A. (2017). Pharmacokinetic based study on "lagged stimulation" of Curcumae Longae Rhizoma - Piper nigrum couplet in their main active components' metabolism using UPLC-MS-MS. Phytomedicine : international journal of phytotherapy and phytopharmacology, 27, 15–22.

v Kotha, R. R., & Luthria, D. L. (2019). Curcumin: Biological, Pharmaceutical, Nutraceutical, and Analytical Aspects. Molecules (Basel, Switzerland), 24(16), 2930. https://doi.org/10.3390/molecules24162930

^vi Tze-Pin Ng, Peak-Chiang Chiam, Theresa Lee, Hong-Choon Chua, Leslie Lim, Ee-Heok Kua, Curry Consumption and Cognitive Function in the Elderly, American Journal of Epidemiology, Volume 164, Issue 9, 1 November 2006, Pages 898–906,

vii DiSilvestro RA, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79.

^viii Larsen F.J., Lundberg J.O., Ekblom B., Sahlin K., Weitzberg E. Effects of Dietary Nitrate on Blood Pressure in Healthy Volunteers. N. Engl. J. Med. 2006;355:2792–2793.

ix DiSilvestro RA, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79.

x Lopresti AL, Maes M, Maker GL, Hood SD, Drummond PD. Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study. J Affect Disord. 2014;167:368-75. xi Panahi, Y., Rahimnia, A. R., Sharafi, M., Alishiri, G., Saburi, A., & Sahebkar, A. (2014). Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytotherapy research : PTR, 28(11), 1625–1631.

xii Heidari-Beni M, Moravejolahkami AR, Gorgian P, Askari G, Tarrahi MJ, Bahreini-Esfahani N. Herbal formulation "turmeric extract, black pepper, and ginger" versus Naproxen for chronic knee osteoarthritis: A randomized, double-blind, controlled clinical trial. Phytother Res. 2020 Aug;34(8):2067-2073.