Turmeric (Cumin, Curcumin) is a natural product and being increasingly used in various medical conditions. I researched the amazing health benefits of turmeric when I saw doctors prescribing turmeric pills for arthritis, diabetes, respiratory, and gastrointestinal conditions. Turmeric curcumin is used in Asia as a spice. People have been using it in different ways. Turmeric tea and turmeric coffee are among the favorite drinks of the obese individuals who try to lose weight. The first time I heard about the health benefits of turmeric curcumin was from a very senior pulmonologist. He was using turmeric curcumin as off-label medicine for patients who had thick phlegm as in patients with bronchiectasis. Specifically, he used it in patients with cystic fibrosis. Since patients with cystic fibrosis have both respiratory and gastrointestinal problems, these patients benefit the most from turmeric powder or tablets.

What is turmeric? 

Turmeric is a plant-derived spice mostly found in the Asian subcontinent. It belongs to the ginger family and the roots of the plant are primarily used as a spice. It is used as a flavoring and a coloring agent in curry, mustard, cheeses, and butter. Because of its brilliant color, it is also named as the golden spice and the “Indian saffron” relating to its use in religious activities. One of the states of Tamil Nadu is called the yellow city because of the production of large amounts of turmeric curcumin or Haldi. In India and Pakistan, it is called as “Haldi” and available as “Haldi powder”. The recently trending “golden milk turmeric coffee”, “paleo turmeric coffee”, and “paleo cinnamon turmeric coffee” are being used for weight loss, energizer, and as a liver tonic.

 Let's discuss the amazing health benefits of Turmeric Curcumin

Turmeric for stomach and indigestion – Effect of turmeric on the gastrointestinal system

Turmeric can be helpful for indigestion and gastritis. However, in higher doses, especially at doses greater than 50 mg/kg, it may cause gastrointestinal upset and maybe ulcerogenic. Curcumin and fish oil have also been shown to help digestion by increasing the lipase, maltase, and sucrose levels. These enzymes are responsible for the digestion of lipids and complex carbohydrates. Turmeric, by increasing the digestion of the fats and carbohydrates, results in relieving bloating, gas, and abdominal distension. It also increases the secretion of pancreatic enzymes trypsin, chymotrypsin, and lipases. It, therefore, helps the digestion of proteins and fats. Turmeric, because of its antioxidant properties is postulated to reduce the incidence of gastrointestinal cancers.

Bastaki et al studied the role of per rectal administration of turmeric extract in rats with inflammatory bowel disease.

With the use of intrarectal turmeric extract administration, a substantial decrease in the mean macroscopic score was detected.

Furthermore, a significant weight loss associated with IBD was reversed in these rats.

Turmeric for liver – is turmeric safe for liver disease? Can turmeric treat non-alcoholic fatty liver disease (NAFLD) patients?

Numerous studies have listed the health advantages of turmeric, particularly for people with liver disease. The excretion of bile, which might be harmful to the liver, is hypothesised to rise as a result.

Patients with NAFLD evidence on ultrasonography participated in a double-blind, randomised experiment.

For eight weeks, patients were given a choice between an amorphous dispersion curcumin formulation (500 mg/day, equivalent to 70 mg curcumin), or a matching placebo.

Transaminase levels, glycemic and lipid profiles, liver fat content, and anthropometric indices were examined at baseline and at the conclusion of the follow-up period.

Curcumin significantly decreased the amount of fat in the liver when compared to placebo (78.9% improvement in the curcumin group vs. 27.5% improvement in the placebo group).

In addition, compared to the placebo group, there were substantial reductions in body mass index and blood levels of glucose, glycated haemoglobin, aspartate aminotransferase, alanine aminotransferase, triglycerides, and low-density lipoprotein cholesterol.

Throughout the experiment, curcumin was secure and well-tolerated.

Like, Ursodeoxycholic acid (Ursodiol), turmeric may relieve some of the symptoms related to biliary stasis. It has also been shown to act as an anti-inflammatory and improvement in the liver enzymes (ALT and AST) has been seen in various studies. However, using excessive doses of curcumin has lately been linked to liver damage (turmeric tablets). Liver toxicity may occur if turmeric curcumin is ingested in excessive amounts.

Turmeric for heart and cardiovascular diseases:

Turmeric has antioxidant and anti-inflammatory properties. Inflammation is the primary culprit in most chronic diseases including cardiovascular diseases.

Curcumin turmeric may be able to reverse heart enlargement (cardiac hypertrophy), enhance the heart's capabilities, and lessen the creation of scar tissue, according to a study on animal models supported by the Heart and Stroke Foundation and the Canadian Institutes of Health Research. ref

Other studies have also pointed out the health benefits of turmeric in patients with heart failure. A study conducted in Thailand on the health benefits of turmeric in patients with Cardiac Bypass surgery concluded that it could prevent heart attacks in bypass patients.

Curcumin has significant beneficial effects on blood cholesterol levels. It is thought to reduce the blood cholesterol levels and improves the blood flow in clogged arteries. More specifically, it reduces the low density and the very low-density lipoprotein levels. It increases the bioavailability of vitamin E and improves alcohol-induced liver damage by reducing free fatty acids. Curcumin also improves calcium transport across the cardiac muscles and improves the pathological damage caused by myocardial infarction.

Turmeric for brain health and neurodegenerative diseases:

An imbalance of pro-inflammatory and anti-inflammatory proteins is assumed to be the root cause of neurodegenerative illnesses such as Alzheimer's disease, dementia, and Parkinson's disease. Some of the proinflammatory proteins include the beta-amyloids, interleukins and tumor necrosis factors. All of these have the potential to contribute to cellular damage brought on by free radicals, oxidative stress, and other conditions including Alzheimer's, dementia, and Parkinson's disease. Turmeric (curcumin) helps down-regulate these inflammatory mediators and reverses the cellular damage caused by these mediators. Curcumin also activates the macrophages and the neuroglial cells to clear the abnormal deposition of proteins.

Turmeric for depression and anxiety:

Various small human studies have been performed. Most studies included two groups of patients. One group received an SSRI (escitalopram or fluoxetine) or SNRI (venlafaxine) and the other group received the same medicines plus turmeric tablets. Turmeric in these studies was found to have favorable results and improvement in the various scales used to measure depression. The use of turmeric is linked to higher serotonin levels in the brain. Dopamine is little affected, whereas norepinephrine is unaffected. The increase in serotonin levels, the dominant neurotransmitter in the brain, is the primary mechanism by which it is used to treat patients with major depression and stress-induced anxiety.

Turmeric for arthritis (Osteoarthritis, Rheumatoid arthritis):

Turmeric curcumin is now available as tablets and is commonly used by pain doctors, rheumatologists, and orthopaedic surgeons. Curcumin downregulates inducible nitric oxide, cyclooxygenase, and tumor necrosis factor. All these chemicals are responsible for inducing and mounting an inflammatory response against the synovium of the joints. Curcumin is more effective at preventing inflammation in the joints than reducing joint inflammation. It is indicated for the treatment of bursitis, osteoarthritis, and rheumatoid arthritis.

Turmeric dosage in arthritis (Note: Curcumin makes up only 2 – 6% of turmeric)

For osteoarthritis: 400 mg - 600 mg capsules three times per day.

For Rheumatoid arthritis: 500 mg two times a day.

Studies have shown that 500 mg to 1000 mg of curcumin for 6- 12 weeks may be more effective and safe in reducing the pain in patients with osteoarthritis compared to ibuprofen and mefenamic acid.

Turmeric for Diabetes:

Since inflammation is among the important pathophysiologic processes in patients with diabetes mellitus type 2. Inflammatory processes result in pancreatic cellular damage along with oxidative stress. Curcumin has powerful anti-inflammatory and antioxidant properties. It also improves insulin resistance. Various studies have evaluated the role of turmeric as an adjunct to metformin.

In one trial, the addition of turmeric to metformin reduced indicators of inflammation and oxidative stress, dyslipidemia, and glycemic control in patients with type 2 diabetes.

Another study examined curcumin's impact on post-meal hyperglycemia. The dosage for the patients was 75 g of oral glucose. After the OGTT had begun, blood sugar and insulin levels were measured 15, 30, 45, 60, 90, and 120 minutes later.

The trial concluded that curcumin at a dose of 6 gms resulted in a much greater insulin release.

Turmeric has an essential role in the prevention of diabetes.

How to take turmeric for diabetes? How much turmeric should a diabetic take daily?

Experts recommend adding 3 – 5 gms of turmeric powder to a glass of boiling milk, mixing it thoroughly and keeping it for some time to let it cool down. Drink it before breakfast on an empty stomach. However, these atypical diet habits are not one of my favourites and I would prefer to add turmeric curcumin powder to soup, bone broth, oatmeal, rice, or a regular vegetable or meat dish.

Can turmeric and metformin be used concomitantly?

It is important to note that turmeric should be used as an adjunct to metformin and other antidiabetic medicines. It should not be used to replace metformin or other diabetes medications.

Turmeric for skin and hair:

I remember our elders used to apply turmeric (Haldi) powder over wounds especially those wounds which were not responsive to antibiotics and in chronic wounds. Turmeric has antiseptic, anti-inflammatory, and antioxidant properties. It is now used commonly in eczema, acne rosacea, and acne vulgaris. Skin conditions are among the most responsive to turmeric. It is occasionally used with bleaching agents to lighten the skin and remove dark spots and hyperpigmented areas. It also reduces skin exposure to ultraviolet light. However, patients sensitive to curcumin may develop stinging and burning sensations. Turmeric oil is used to remove unwanted hair as it arrests the growth of unwanted hair. Turmeric hair conditioner is being used for dry and itchy scalp. It is used as a treatment for dandruff in dark-skinned people with dark hair as it may give the hair an unwanted golden glow. Some people use it with henna powder to give the hair a golden yellow color. Because of the reduction in UV light exposure, it is postulated to reduce the incidence of skin cancer.

A study titled “Turmeric and Curcumin as Topical Agents in Cancer Therapy” concluded that topical application of turmeric resulted in symptomatic benefits. It reduced itching, pain, and the size of cancerous lesions.

Turmeric has antimicrobial and antifungal effects.

A study conducted on animals titled “Antifungal activity of turmeric oil extracted from Curcuma longa (Zingiberaceae)” concluded an improvement in the skin lesions caused by fungi in 3 – 5 days and disappearance of the lesions by the 7th day.

Turmeric for weight loss:

Obesity is a pro-inflammatory state. The role of turmeric has been studied in obese individuals. Turmeric tea, turmeric water, and turmeric coffee are all used to reduce belly fat and lose weight. Importantly, turmeric reduces the pro-inflammatory state associated with obesity. Thus, it helps reduce the comorbidities associated with obesity such as hypertension, diabetes, atherosclerosis, and dyslipidemias.

Turmeric weight loss studies:

Randomized controlled trials were the subject of a meta-analysis. More than 1600 patients were investigated throughout 18 different trials. The outcomes are as: 

• Curcumin intake was significantly reduced:

  • Waist circumference (WC) (SMD −0.25; 95% CI, −0.44, −0.05; P= 0.01)

  • Weight (SMD −0.23; 95% CI, −0.39, −0.06; P< 0.01)

  • Leptin levels (SMD −0.97; 95% CI, −1.18, −0.75; P< 0.001)

  • Body mass index (BMI) (SMD −0.37; 95% CI, −0.61, −0.13; P< 0.01)

  • Increased adiponectin levels (SMD 1.05; 95% CI, 0.23, 1.87; P= 0.01).
• The hip ratio (HR) was not significantly affected by curcumin consumption (SMD 0.17; 95% CI 0.42, 0.08; P = 0.18).

Another metaanlaysis titled “ The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials” The results indicated that the supplementation with ginger significantly decreased:

• Waist-to-hip ratio (WHR) (SMD −0.49; 95% CI, −0.82, −0.17; P = 0.003)

• Body weight (BW) (SMD −0.66; 95% CI, −1.31, −0.01; P = 0.04)

• Hip ratio (HR) (SMD −0.42; 95% CI, −0.77, −0.08; P = 0.01)

• Fasting glucose (SMD −0.68; 95% CI, −1.23, −0.05; P = 0.03)

• Insulin resistance index (HOMA-IR) (SMD −1.67; 95% CI, −2.86, −0.48; P = 0.006)

and greatly enhanced:

• HDL-cholesterol levels (SMD 0.40; 95% CI, 0.10, 0.70; P = 0.009).

Another meta-analysis found that consuming curcumin significantly reduced BMI, weight, waist circumference, leptin, and adiponectin levels while having no effect on the hip ratio. The Janus kinases and 11 beta-hydroxysteroid dehydrogenases, which activate cortisol in adipocytes, are downregulated by curcumin. The US FDA has designated curcuminoids as GRAS, or "generally recognised as safe," and several clinical investigations have shown that they have acceptable tolerance and a low toxicity profile even at large dosages.

Effect of turmeric on fertility:

Turmeric should generally be avoided especially in high doses by pregnant women as it is a mild uterine stimulant. Stimulation of the uterus may result in premature birth, miscarriages, or failure to conceive. It has the potential of a natural vaginal contraceptive. When turmeric is taken orally, it may reduce the serum testosterone levels in males and reduce sperm motility. Thus, couples who try to conceive should generally avoid turmeric especially the medicinal products and in high doses.

Turmeric for respiratory problems:

Curcumin has been studied for its potential health benefits in a number of lung ailments, including asthma, lung fibrosis, and bronchiectasis in cystic fibrosis patients. Most of the health benefits of turmeric in these conditions owing to its antioxidant and anti-inflammatory properties. Asthma, respiratory distress syndrome, acute lung damage, and chronic obstructive pulmonary disease are just a few of the acute and chronic lung problems that turmeric may be especially helpful in avoiding rather than curing.

Turmeric for cystic fibrosis:

When I first heard about the benefits of turmeric curcumin when a few of our colleagues went to Harvard Medical School for an internship. In their pulmonology rotation, the consultant asked one of our colleagues whether he knew curcumin. He then explained the benefits of curcumin in patients with cystic fibrosis. Curcumin reduces phlegm production and prevents disease exacerbations. In animal models, treatment with curcumin resulted in the correction of the defects associated with CFTR gene expression.

Turmeric dosage:

The usual dose of turmeric is 250 mg to 4 grams per day to a maximum dose of 10 gms per day. However, different regimens are used. In one treatment plan, 2 grammes of turmeric are given on consecutive days for 2–4 days until the situation improves, with approximately 1 gramme given on the initial day. It is taken as a soft gel with a glass of water and includes 500 milligrammes of turmeric. It should be taken with meals, especially with breakfast and lunch, in two separate dosages. Half of the typical adult dose of turmeric may be administered to children aged 12 to 16 years.. When initiating turmeric treatment, test the patient for allergy to the drug by ingesting a small quantity and looking for a rash, gastrointestinal side effects, and itching.

Turmeric tablets availability in Pakistan:

Turmeric tablets are available worldwide including in Pakistan. It is available as turmeric capsules at a dose of 450 mg - 500 mg. Turmeric tablets are taken by the patient as one or two capsules twice daily.

In conclusion:

The health benefits of turmeric curcumin are enormous. It is stomach-friendly in the usual doses. It is used to treat wounds, acne, gastrointestinal, liver, brain, heart, and respiratory problems. It is also used for weight loss and as an adjunct to metformin for the treatment of diabetes.