Will Turmeric Supplements Really Help People With MS?

Will Turmeric Supplements Really Help People With MS?

From a culinary standpoint yes!  In other words, turmeric very effectively adds flavor and color to foods! From a clinical standpoint, turmeric is a mixed bag. 

To make some sense of this tricky issue, a quick review of some research fundamentals might be helpful. There are several kinds of research studies. When someone is claiming that turmeric (or any other treatment) offers clinical benefit it is helpful to know what kind of study they are referring to. 

• In vitro (Latin for within the glass) refers to a procedure or study conducted in a controlled environment outside of a living organism— think test tube, petri dish).  In vitro experiments often fail to replicate the exact conditions of an organism, and may lead to results that do not translate to humans.
• In vivo (Latin for “within the living”) is experimentation using a whole, living organism. Animal studies and human clinical trials are two forms of in vivo research. Unfortunately, animal models are not always able to accurately predict human responses.

Bioavailability Enhancers For Turmeric Supplements:

Turmeric has poor bioavailability. Only a small percentage of turmeric will be absorbed into the blood. A variety of turmeric supplement formulations have been (and continue to be) developed to optimize bioavailability. A few examples include:

• Black pepper… well, not the black pepper in your kitchen. Bioperine is a patented black pepper extract that has been shown to increase bioavailability by 1.5 times and is found in some supplement formulations of Turmeric. 
• Nanoparticle Formulations in which the size of curcumin particles is greatly reduced and encapsulated in an emulsifying agent making it more dispersible in water. 
• Liposomal Encapsulation Liposomes are considered as effective drug carriers because of their ability to bypass the destructive elements of the gastric system and deliver the encapsulated nutrients to the cells and tissues.  

Which of these formulations is best? The jury is still out on that. Much of the evidence supporting the efficacy of each product was gathered in studies funded by supplement manufacturers.

ConsumerLab.com would be a great place to start if you are wanting to compare various products of check on the quality of a specific product. 

What the National Center for Complementary and Alternative Medicine (NCCAM) Says About Turmeric:

• There is little reliable evidence to support the use of turmeric for any health condition because few human clinical trials have been conducted.
• Preliminary findings from animal and other laboratory studies suggest that a chemical found in turmeric—called curcumin—may have anti-inflammatory, anticancer, and antioxidant properties, but these findings have not been confirmed in people.
• NCCIH-funded investigators have studied the active chemicals in turmeric and their effects—particularly anti-inflammatory effects—in human cells to better understand how turmeric might be used for health purposes. NCCIH is also funding basic research studies on the potential role of turmeric in preventing acute respiratory distress syndrome, liver cancer, and post-menopausal osteoporosis.

What the Natural Medicine Database Says About Turmeric:

The Natural Medicines Database has reviewed the available scientific studies and has concluded that it is “Likely Safe”. They have concluded that it is  “Possibly Effective” in treating:

• High cholesterol
• Osteoarthritis
• Itching (pruritus) related to kidney disease and some kinds of chemotherapy.

But it has also determined that there is “Insufficient Reliable Evidence” to rate effectiveness for other claims. The list of conditions/claims for which there is “insufficient reliable evidence” is long but includes:

• Alzheimers 
• Colorectal cancer
• Diabetes
• Irritable Bowel Syndrome (IBS)
• Lichen Planus
• Rheumatoid Arthritis
• Fibromyalgia
• Ulcerative Colitis
• Other conditions… Multiple Sclerosis is not specifically mentioned.

What Recent Research Says About How Turmeric Benefits People With MS:

A PubMed search results in several in vitro and in vivo (animal) studies that have shown Turmeric (Curcumin) offers improvements for experimental autoimmune encephalomyelitis (EAE) which is an animal model of multiple sclerosis. Currently, there are NO human clinical trials that indicate effectiveness for treating multiple sclerosis or symptoms or multiple sclerosis.

Does Turmeric (Curcumin) Have Any Precautions Or Side Effects?

Turmeric supplements are generally considered safe when taken by mouth and in amounts commonly found in food, but there are some precautions to consider:

• Pregnancy: If pregnant you should not take Turmeric at medicinal amounts due to risk of stimulating the uterus or endangering the pregnancy.
• Iron deficiency: Taking high amounts of turmeric might prevent the absorption of iron. Turmeric should be used with caution in people with iron deficiency.
• Gallbladder Problems: Turmeric can make gallbladder problems worse. Do not use turmeric if you have gallstones or a bile duct obstruction.
• Bleeding Problems and Surgery: Taking turmeric might slow blood clotting. This might increase the risk of bruising and bleeding in people with bleeding disorders or those having surgery.
• Diabetes: Curcumin, a chemical in turmeric, might decrease blood sugar in people with diabetes. Use with caution in people with diabetes as it might make blood sugar too low.
• Gastroesophageal Reflux Disease (GERD): Turmeric can cause stomach upset in some people. It might make stomach problems such as GERD worse.
• Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids:  Turmeric (Curcumin) might make hormone-sensitive conditions worse. Evidence is mixed on this but until more is known, use cautiously if you have a condition that might be made worse by exposure to hormones.
• Infertility:Turmeric should be used cautiously by people trying to have a baby.When taken by men, Turmeric might lower testosterone levels and decrease sperm movement. This might reduce fertility.

Interactions to be aware of:

• Diabetes Medications and herbal remedies that might lower blood sugar: Taking turmeric along with diabetes medications might cause your blood sugar to go too low.  Herbs that might lower blood sugar include devil’s claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
• Medications and herbal remedies that might slow blood clotting: Taking turmeric with medications that slow blood clotting might increase the risk of bleeding.Herbal remedies of concern include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, red clover, willow and others. 
• Sulfasalazine (used for ulcerative colitis and rheumatoid Arthritis): Taking turmeric might increase how much sulfasalazine the body absorbs.
• Talinolol: (a beta blocker): Taking turmeric might decrease how much talinolol the body absorbs.
• Iron: High doses of turmeric might prevent the body from absorbing iron. This does not seem to occur when consuming turmeric at levels found in food.
• Be aware that Bioperine has diuretic properties and may stimulate the production of stomach acid. And it may significantly increase the absorption of other compounds as well, so it would be best not to take if you are taking medications known to be metabolized by CYP enzymes such as phenytoin, rifampin, propranolol theophylline, felodipine, amlodipine, and nevirapine.

My Thoughts On Turmeric Supplements:

Turmeric provides a warm spicy quality to foods. I personally prefer to get my turmeric in the form of a great turmeric-rich curry or other tasty prepared meal. You may have other favorite foods or beverages that contain or even feature turmeric— and to this I say enjoy! But given the absence of evidence to support any benefit of turmeric supplements for multiple sclerosis combined with the lack of oversight of the supplement industry and then add in the expense of supplements I personally do not see turmeric supplements as a worthwhile investment. At least not for multiple sclerosis.

If you are living with high cholesterol, osteoarthritis or itching related to kidney disease or as a side effect from chemotherapy, I would encourage you to discuss it with your doctor or pharmacist to see if they think it will benefit you. In any case, make sure your healthcare team is aware of all herbal remedies that you take.  

And remember, turmeric has some great antioxidant properties but it is certainly not the only way to get antioxidants….if your turmeric rich meal is full of colorful vegetables you will be getting lots of antioxidants from those foods as well. Finish your meal with some fresh berries and you will add even more antioxidants!

??By consuming colorful plant foods every day and you will be eating a diverse plateful of tasty antioxidants, no supplements required! ??

References:

• ConsumerLab.com
• Natural Medicine Database
• NIH : National Center For Complimentary And Integrative Health : Turmeric
• Natarajan C, Bright JJ. Curcumin inhibits experimental allergic encephalomyelitis by blocking IL-12 signaling through Janus kinase-STAT pathway in T lymphocytes. J Immunol. 2002 Jun 15;168(12):6506-13.
• Kanakasabai S, Casalini E, Walline CC, Mo C, Chearwae W, Bright JJ. Differential regulation of CD4(+) T helper cell responses by curcumin in experimental autoimmune encephalomyelitis.  J Nutr Biochem. 2012 Nov;23(11):1498-507. doi: 10.1016/j.jnutbio.2011.10.002. Epub 2012 Mar 7
• Uhl, Elizabeth W, Warner,Natalie J. Mouse Models as Predictors of Human Responses: Evolutionary Medicine Curr Pathobiol Rep. 2015; 3(3): 219–223. Published online 2015 July doi:   10.1007/s40139-015-0086-y
• Xie L, Li XK, Funeshima-Fuji N, Kimura H, Matsumoto Y, Isaka Y, Takahara S. Amelioration of experimental autoimmune encephalomyelitis by curcumin treatment through inhibition of IL-17 production. Int Immunopharmacol. 2009 May;9(5):575-81. doi: 10.1016/j.intimp.2009.01.025. Epub 2009 Feb 3.