Curcumin

Curcumin is a polyphenolic compound found in turmeric, a flowering plant of the ginger family. Both Ayurveda and traditional Chinese medicine have used turmeric as medicine for hundreds of years. Turmeric is also used as spice and as a coloring agent. Historically used for skin issues, upper respiratory tract, digestion and joint health, nowadays curcumin is prized for its antioxidant, hepatoprotective, anti-tumor and anti-inflammatory properties. A meta-analysis from Bhat et al (2019) shows that curcumin has also beneficial effects on brain health and neurodegenerative disorders. Clinical trials have shown curcumin to be useful in rheumatoid arthritis, osteoarthritis, precancerous lesions, irritable bowel syndrome, depression, and other internal and external conditions. Turmeric can be taken as the dried root, capsules, or a liquid extract (Bone & Mills, 2013).

Because of the nature of my practice, I am very interested in curcumin’s anti-inflammatory effect and especially its effects on osteoarthritis and rheumatoid arthritis. The anti-inflammatory effect of curcumin is due to its ability to inhibit the inflammatory compounds like cyclooxygenase, lipoxygenase, and inducible nitric oxide synthase (Menon & Sudheer, 2007). Curcumin inhibits the pathways that are responsible for rheumatoid arthritis, as well as the proinflammatory cytokines associated with osteoarthritis (Dai et al, 2018). In vivo animal studies showed that curcumin reduces join swelling in rats and slows down progression of histopathology. In vitro, curcumin also demonstrated significant reduction of inflammatory response in macrophages (Wang et al., 2019). Curcumin is not only anti-inflammatory, it has also pain relieving properties, making especially powerful herbal remedy for the treatment of arthritis, ostheoarthritis and rheumatoid arthritis (Uddin et al., 2020).

Studies show that curcumin is as effective as ibuprofen in managing pain in subjects suffering from osteoarthritis of the knee, without the side effects linked to use of NSAIDs (Kuptniratsaikul et al., 2014).

Clinical trials have shown that while curcumin is safe even at high doses, bioavailability is poor. For this reason, various pharmaceutical strategies have been adopted to overcome this limitation (Dei Cas & Ghidoni, 2019). Combining curcumin with fenugreek has shown to greatly increase its bioavailability. Fenugreek contains a fiber called galactomannan, which protects curcumin from gut activity and allows curcumin to be absorbed into the bloodstream, hence increasing its bioavailability (T Krishnareddy et al., 2018).

References

Bone, K. & Mills, S. (2013). Herbal therapeutic systems. Principles and Practice of Phytotherapy. https://doi.org/10.1016/b978-0-443-06992-5.00001-3

Kuptniratsaikul, V., Dajpratham, P., Taechaarpornkul, W., Buntragulpoontawee, M., Lukkanapichonchut, P., Chootip, C., Saengsuwan, J., Tantayakom, K., & Laongpech, S. (2014). Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clinical interventions in aging, 9, 451–458. https://doi.org/10.2147/CIA.S58535

Menon, V. P., & Sudheer, A. R. (2007). Antioxidant and anti-inflammatory properties of curcumin. In Advances in Experimental Medicine and Biology (Vol. 595, pp. 105–125). Springer New York. https://doi.org/10.1007/978-0-387-46401-5_3

T Krishnareddy, N., Thomas, J. V., Nair, S. S., N Mulakal, J., Maliakel, B. P., & Krishnakumar, I. M. (2018). A Novel Curcumin-Galactomannoside Complex Delivery System Improves Hepatic Function Markers in Chronic Alcoholics: A Double-Blinded, randomized, Placebo-Controlled Study. BioMed research international, 2018, 9159281. https://doi.org/10.1155/2018/9159281

Uddin, S. J., Hasan, M. F., Afroz, M., Sarker, D. K., Rouf, R., Islam, M. T., Shilpi, J. A., & Mubarak, M. S. (2020). Curcumin and its Multi-target Function Against Pain and Inflammation: An Update of Pre-clinical Data. Current drug targets, 10.2174/1389450121666200925150022. Advance online publication. https://doi.org/10.2174/1389450121666200925150022