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“Food is not just calories, it is information. It talks to your DNA and tells it what to do. The most powerful tool to change your health, environment and entire world is your fork.”

Dr Mark Hyman.

Curcumin is an incredible compound found in the bright yellow spice turmeric. Well known for adding depth of colour and flavour to Asian dishes, turmeric has also long been revered for its impressive array of potential health benefits. Here we dive into the many potential uses of curcumin; some familiar, others more surprising. Read on to find out more.

What is curcumin?

Turmeric contains curcumin and curcuminoids. Curcumin is the main natural polyphenol found in the rhizomes of the East Indian plant, turmeric (Curcuma longa L).  The other major curcuminoids present in turmeric are demethoxycurcumin, bisdemethoxycurcumin, and cyclocurcumin.

The widespread potential of curcumin…

Anti-inflammatory

Inflammation is a vitally important response to harmful stimuli or conditions – we need it; but we also need it to subside when the threat has passed. If inflammation stays switched on, it can start to work against us and it is now widely acknowledged that hidden inflammation is at the root of many common chronic health problems from heart disease, diabetes and obesity to depression, dementia and many more. Curcumin has significant potential as a natural anti-inflammatory agent because it is able to modulate the inflammatory response in several different ways. Curcumin exerts anti-inflammatory effects by regulating inflammatory signalling pathways and inhibiting the production of inflammatory mediators.1

Pain-relief

As an adjunct to curcumin’s potential as a natural anti-inflammatory compound, several studies support the use of curcumin as an effective pain-relieving agent. In one study, researchers investigated the efficacy of curcumin for relieving pain and discomfort caused by simple over-exertion. Results showed that a special curcumin extract delivered comparable benefits to standard pain relief medication in healthy rugby players who were experiencing pain due to excessive physical activity, minor injury or chronic pain.2 In a systematic review and meta-analysis of eight randomised controlled trials, curcumin was found to significantly reduce pain, and was also found to be safe and well tolerated.3

Antioxidant

Oxidative stress happens when there is an imbalance between free radical formation and the capacity of cells to clear them. Oxidative stress can cause significant damage to vital cellular structures such as membranes, lipids, proteins, lipoproteins, mitochondria and even deoxyribonucleic acid (DNA). It is also closely linked to inflammatory processes. As you can imagine, oxidative stress can cause considerable harm to health and sits right at the core of many disease states. Fortunately, we have in-built antioxidant systems that support cellular capacity to clear free radicals and oxidants. And we also consume antioxidant compounds through our diets. Curcumin has remarkable potential because it is able to act both as dietary antioxidant and support our in-built antioxidant systems too.4-10

Gut barrier support

The small intestinal epithelial lining is just one cell thick – cleverly designed this way so it can act as a highly selective barrier. The integrity of this barrier is vital for health. An unhealthy shift towards increased intestinal permeability involves a loss of integrity between the cells of the small intestine. This loss of integrity occurs when the tight junction proteins connecting epithelial cells break apart. Increased intestinal permeability has been associated with a wide range of symptoms and chronic diseases. Intestinal barrier integrity is about more than tight junctions however – in fact, there are many ‘layers’ of support that are needed. Intestinal alkaline phosphatase (IAP) is a crucially important part of the luminal first line of defence, and is especially important for reducing LPS (bacterial lipopolysaccharide). Maintaining IAP is thus a vitally important aspect of protecting the intestinal barrier. Oral supplementation with curcumin has been shown to increase IAP activity and reduce LPS thus demonstrating significant potential for curcumin as intestinal barrier support.11

Gut microbiota

Research into the gut microbiota has accelerated in the last decade and many scientists now believe this diverse ecosystem of microorganisms may even be as complex and influential as our genes when it comes to our overall health and happiness. There is an interesting relationship between curcumin and the gut microbiota which is not yet fully understood. High concentrations of curcumin are detected in the gastrointestinal tract following oral administration, yet curcumin has low systemic bioavailability. However, curcumin also has wide pharmacological activity - a seeming paradox. One hypothesis which could explain this paradox is this: perhaps curcumin exerts its regulatory effects on the gut microbiota which in turn influences systemic health? Both curcumin and its metabolites have been shown to influence the gut microbiota - curcuminoids are metabolised by gut bacteria to produce active colonic metabolites that may exert local or even systemic effects. In a 2020 review article on the ‘Interaction between gut microbiota and curcumin’, the researchers wrote, “it is worth noting that the interaction between curcumin and gut microbiota gives rise to two different phenomena: the first is the direct regulation of intestinal microflora by curcumin and the second is the biotransformation of curcumin by gut microbiota, yielding active metabolites; both these phenomena seem to be crucial for the activity of curcumin.”12

Anti-depressant

Growing evidence now suggests that at least some forms of depression may be linked to ongoing inflammation in the body. Edward Bullmore, professor of Psychiatry at The University of Cambridge has written a book on the subject entitled, The Inflamed Mind, in which he explores this intriguing relationship. He writes, “we could be on the cusp of a revolution, I might be wrong. But I think it has already begun.”13 There is certainly enough evidence to suggest that it is now prudent for clinicians to at least consider the use of therapeutic approaches that support inflammation balance in patients with depression. In a 2014 randomised, double-blind, placebo-controlled study, 56 individuals with major depressive disorder were treated with curcumin (500mg twice daily) or placebo for 8 weeks. Curcumin supplementation is well known for its anti-inflammatory properties and was found to be significantly more effective than placebo in improving several mood-related symptoms from weeks 4-8 of the study.14

Anti-cancer

In a 2020 systematic review on the ‘Clinical effects of curcumin in enhancing cancer therapy’ the researchers wrote, “curcumin is a multifaceted molecule and has many therapeutic effects. The multifaceted effects of curcumin are due to its capacity to interact with different molecules, and to regulate multiple molecular pathways and their targets.”15 There is widespread potential for curcumin in cancer prevention and in supporting cancer therapy too. And there are many possible mechanisms by which curcumin may exert these positive effects. These may include induction of apoptosis, anti-angiogenic effects, interrupting the cell proliferation cycle of tumour cells and preventing tumour invasion of healthy tissues. In addition, curcumin’s anti-inflammatory and antioxidant properties likely play a role in its potential anti-cancer effects. Since high concentrations of curcumin persist in the gastrointestinal tract following oral administration, it is crucial to consider the intestine as an important site of curcumin activity and this is reflected in encouraging early results of research into curcumin supplementation in colorectal cancer in particular.16

Neuro-Protection

The brain is lipid-rich and has a high oxygen consumption, both of which make it highly vulnerable to oxidative stress. Oxidative stress-induced damage to the brain has the potential to impact normal functioning of the central nervous system. There are also strong links between inflammation and neurodegenerative diseases such as Alzheimer’s and Parkinson’s and, as previously mentioned, neuropsychiatric problems such as depression. Curcumin’s anti-inflammatory and antioxidant properties likely deliver many of its critical neuroprotective effects. Curcumin is also increasingly being recognised as a potent epigenetic regulator – this means it has the potential to positively regulate gene expression; in simple terms this means curcumin has a remarkable ability to switch on or off processes that may benefit our health and lifespan.17,18

A remarkable compound with remarkable potential

The widespread activity and potential of curcumin is undoubtedly impressive, especially given that it extends even further beyond what has been covered here. Whilst it may seem like there’s nothing that curcumin can’t do, as always with functional medicine, it’s vital to consider the role of curcumin within a personalised approach. There is no ‘one size fits all’ solution in functional medicine, and this is as true for curcumin as with any other therapeutic intervention. As always, context is key. There’s no denying however that curcumin is a remarkable compound with remarkable potential for supporting vibrant health and longevity.

References:
1. Peng Y, Ao M, et al. Anti-inflammatory effects of curcumin in the inflammatory diseases: status, limitations and countermeasures. Drug Des Devel Ther. 2021; 15: 4503-4525.
2. Di Pierro F, Zacconi P et al. A naturally-inspired, curcumin-based lecithin formulation alleviates the osteo-muscular conditions in rugby players. European Review for Medical Pharmacological Sciences. 2017; 21: 4935-4940
3. Sahebkar A & Henrotin Y. Analgesic efficacy and safety of curcuminoids in clinical practice: a systematic review and meta-analysis of randomized controlled trials. Pain Med 2016 Jun; 17(6): 1192-202.
4. Alizadeh M & Kheirouri S. Curcumin reduces malondialdehyde and improves antioxidants in humans with diseased conditions: a comprehensive meta-analysis of randomised controlled trials. Biomedicine (Taipei). 2019 Dec; 9(4): 23
5. Sreejayan, Rao MN. Nitric oxide scavenging by curcuminoids. J Pharm Pharmacol. 1997;49(1):105-107
6. Sreejayan N, Rao MN. Free radical scavenging activity of curcuminoids. Arzneimittelforschung. 1996;46(2):169-171.
7. Garcea G, Jones DJ, Singh R, et al. Detection of curcumin and its metabolites in hepatic tissue and portal blood of patients following oral administration. Br J Cancer. 2004;90(5):1011-1015
8. Dickinson DA, Levonen AL, Moellering DR, et al. Human glutamate cysteine ligase gene regulation through the electrophile response element. Free Radic Biol Med. 2004;37(8):1152-1159.
9. Dickinson DA, Iles KE, Zhang H, Blank V, Forman HJ. Curcumin alters EpRE and AP-1 binding complexes and elevates glutamate- cysteine ligase gene expression. Faseb J. 2003;17(3):473-475.
10. Zheng S, Yumei F, Chen A. De novo synthesis of glutathione is a prerequisite for curcumin to inhibit hepatic stellate cell (HSC) activation. Free Radic Biol Med. 2007;43(3):444-453.
11. Ghosh SS, He H, et al. Curcumin-mediated regulation of intestinal barrier function: The mechanism underlying its beneficial effects. Tissue Barriers. 2018; 6(1): e1425085
12. Scazzocchio B, Minghetti L, et al. Interaction between Gut Microbiota and Curcumin: A new key of understanding for the health effects of curcumin. Nutrients 2020, 12(9), 2499.
13. Edward Bullmore – The Inflamed Mind
14. Lopresti AL, Maes M et al. Curcumin for the treatment of major depression: a randomised, double-blind, placebo-controlled study. J Affect Disord. 2014; 167: 368-75
15. Mansouri K, Rasoulpoor S, et al. Clinical effects of curcumin in enhancing cancer therapy: A systematic review. BMC Cancer 20, Article number: 791(2020).
16. Adeleke Ojo, O, Adeyemo, TR, et al. Anticancer properties of curcumin against colorectal cancer: A review. Front Oncol. 2022; 12: 881641.
17. Salim S. Oxidative stress and the Central Nervous System. J Pharmacol Exp Ther 2017 Jan; 360(1): 201-205.
18. Nebrisis E. Neuroprotective activities of curcumin in Parkinson’s Disease: A review of the literature. Int J Mol Sci. 2021, 22(20), 1148

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