Ask the doctors: Overuse of curcumin or tumeric can cause GI distress
Q: I am a 67-year-old physically active man. I was taking turmeric three times a day for several weeks to reduce workout-related inflammation. I ended up in the hospital with an abscess and small intestine perforation. I have read excess turmeric may cause this. Please comment.
A: Turmeric is a flowering plant in the ginger family. This plant is native to India and has been used as a spice for more than 4,000 years. In addition to lending a sweet, earthy flavor to a wide range of dishes, turmeric contains a number of biologically active compounds. Perhaps best known of these is curcumin.
Curcumin has been shown to have anti-inflammatory, antioxidant and possibly antiviral properties. Historically, traditional Chinese, Indian and Thai medicine have used turmeric. More recently, it has become a go-to in alternative medicine in the U.S. Turmeric and curcumin are used for a number of health conditions. They can ease pain and inflammation and reduce stiffness. They can also help with the decreased movement from conditions such as osteoarthritis.
A body of research has found that curcumin can derail some biochemical pathways involved in inflammation. This includes blocking the activity of signaling molecules that contribute to joint pain and swelling. These mechanisms, along with the antioxidant qualities it has, have increased interest in curcumin. It may be an aid in managing the chronic low-grade inflammation and oxidative stress that are biomarkers of metabolic disease.
One problem researchers have bumped into is that, when taken by mouth, curcumin is poorly absorbed by the body. The ability for a substance to be absorbed is known as bioavailability. This is an important aspect of any kind of medication. When someone ingests turmeric, only small amounts of the curcumin it contains can enter the bloodstream. So dietary supplements add certain substances to improve absorption. This can include piperine, which is a black pepper extract, and dietary fat.
Although turmeric and curcumin can be beneficial, it is possible for overuse to cause gastrointestinal side effects. These can include stomach discomfort, indigestion, nausea, loose stools and diarrhea. That said, there is no credible evidence that this would lead to an intestinal perforation or abscess.
These are serious conditions that typically arise from infection, obstruction, reduced blood flow or underlying disease. Also, an abscess or an intestinal perforation would take far longer to develop than a few weeks of turmeric use.
When a serious medical event occurs with, or closely follows, a change in routine, like adding a supplement, it is understandable to infer a connection. Based on what we know about turmeric and curcumin and the timing in your case, this connection seems unlikely.
They are probably not the direct cause of your intestinal issues. However, because turmeric can affect bleeding risk and interact with certain medications, we urge you to let your medical care providers know you have been using it.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.
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