- The spice turmeric is a popular dietary supplement because of a molecule it contains called curcumin, which acts as a powerful antioxidant.
- It is also thought that it could be used to treat or prevent inflammatory diseases.
- The use of turmeric has grown in popularity over the past ten or twenty years, with people using it in hopes of improving the symptoms of different illnesses or preventing cancer.
- Doctors have expressed concerns about its safety after finding that a small group of patients suffered liver damage after taking turmeric supplements.
Turmeric supplements have been linked to a number of cases of liver damage, most recently in a study conducted in the United States.
Previous research from Italy and published case studies have linked supplementation with turmeric or curcumin, its active compound, to liver damage. This latest research shows that rates of turmeric-related liver damage may be increasing.
The latest study, published inThe American Journal of Medicine in 2023, examined cases of turmeric-associated liver injury recorded in the United States by the US Drug-Induced Liver Injury Network (DILIN) between 2004 and 2022.
Researchers found 10 cases of liver damage linked to turmeric, all occurring after 2011 and including six since 2017. Five patients were hospitalized and one patient died of acute liver failure. The authors identified a risk associated with taking turmeric and black pepper supplements simultaneously.
“The question we always get asked is: How come we are suddenly seeing this? And this is a very important question. For what ? One reason is that millions of people now use it. »
“But the other reason is that turmeric is a spice, right? It is not absorbed. You don’t absorb the pepper. Your body doesn’t absorb it. You don’t absorb the curry, the spice in turmeric. Okay, so how could this cause liver disease if it’s not absorbed? Well, the answer, in our opinion, is that these modern turmeric products have been modified in a way that they can be absorbed,” he said.
Seven of ten people identified as having suffered liver damage from turmeric supplementation carried a specific allele of human leukocyte antigen (HLA), known as HLA-B*35:01although this disease normally exists in the population at a frequency of approximately 6-7%. HLA alleles are genes that encode proteins that help the immune system recognize cells as part of the body or as foreign objects, meaning they play a role in immunity or autoimmunity.
Hoofnagle said they couldn’t say for sure that all the cases discovered were due to turmeric because many people with liver damage were taking other medications at the time. There appears to be a particular risk for people carrying the HLA allele HLA-B*35:01which requires further investigation.
“So out of our 10 cases, we could be wrong about several of them. So it could be that this allele is absolutely necessary. We don’t know that when we look at the cases that had the allele and compare it to the three that didn’t, the cases with the allele had this classic, look, you see, allele, whereas the ones that didn’t have the allele, they were a little bit different,” Hoofnagle said.
He and other authors are now planning to conduct additional research to better understand this allele and the mechanisms behind the increased risk of liver damage they observed.
One reason why liver damage occurs in some individuals could be that curcumin is a phenolic compound, making it a bioactive compound in the human body.
Previous research has shown that people with this genetic variant are more likely to experience liver damage after taking the drug.
Hoofnagle explained that the use of green tea supplements, primarily in the form of weight loss supplements, has also been linked to liver damage.
“These other medicinal plants that are involved also contain phenols. So we’re starting to understand that something about phenols is affecting (carriers of) B*35:01 and causes it to react in the liver,” he said.
Kristin Kirkpatrick, MS, a registered dietitian and dietitian at the Cleveland Clinic, said: Today’s Medical News that it was important to consider the bigger picture when analyzing these data and to consider other factors that can influence liver health:
“This study looked not only at turmeric in supplemental form, but also at the addition of piperine, which appeared to improve bioavailability. The liver is the body’s TSA agent. You cannot move forward in the body without first being filtered by this gatekeeper. Supplements make their first stop there and as a result the liver takes most of the energy needed for the body to break down, detoxify and allow entry or elimination.
— Kristin Kirkpatrick, MS
“When it comes to liver damage, it’s estimated that one in three people today have metabolic-associated fatty liver disease (MASLD), and the more advanced the disease, the harder it is for the liver to do its job properly. If it can’t detoxify effectively, it’s more susceptible to damage,” Kirkpatrick said.
Hoofnagle said treating turmeric supplements as if they were as safe as turmeric used in foods, which has been the case with the majority of regulations since the 1970s, was a mistake. While acknowledging that turmeric has been used in Indian medicine for thousands of years, he stressed that it was mainly for digestive problems and that there was a difference between using a spice in a meal and taking a gram whole in a capsule every day.
“It’s a typical Western approach to traditional medicine. You try to find out what the active ingredient is, and the more of it, the better, right? The higher the dose, the better. But that’s not true in biology. In biology, the right dose is the right dose. And if you increase the dose, you just get more side effects,” he explains.
He said this created regulatory complications because the
“What I’m saying is, no, we’re not talking about traditional medicine. We’re talking about a purified compound that’s being administered in much higher doses. It’s a medicine. So I know it’s being promoted as an herb, but I would say no, it’s a medicine. …(T)hat’s my attitude, that once you start messing with traditional medicines, you’re not dealing with them anymore… when you start chemically altering or extracting things, it’s not really traditional medicine anymore,” he said.