Summary
Turmeric is a member of the ginger family that can be used to treat or prevent ulcers and inflammation, and is helpful in repelling insects. It can also be used to cure digestive issues, bronchitis, colds, and conjunctivitis. Turmeric can be found in powder, capsule, solution, and tablet form.
Description
Medicinal Parts
The medicinal parts are the stewed and dried rhizome.
Flower and Fruit
The inflorescence is conelike, 10 to 15 cm long, and is attached to a stem enclosed in a sheathing petiole. The flower has 2 pale green bracts, which are 5 to 6 cm long. The covering bracts are whitish, often red-tinged. The individual flowers are yellowish-white or yellow. The flowers have a tubular, 3-lobed calyx, and funnel-shaped, 3-tipped corolla. The fruit is a gobular capsule.
Leaves, Stem, and Root
Curcuma domestica is a perennial, erect, leafy plant with very large, lilylike leaves up to 1.2 m long. The leaf blade is ovate-lanceolate, thin, entire-margined, and narrows to a long sheathlike petiole. The main rhizome is thickened to a tuber and has numerous roots. The roots in turn terminate in partially elliptical tubers. The secondary rhizomes are digit-shaped with no roots. All rhizomes are yellowish-brown with stipules and appear transversely ringed when they die.
Habitat
Turmeric is probably indigenous to India; it is cultivated today in India and other tropical regions of Southeast Asia.
Production
Turmeric root consists of the fingerlike scalded and dried rhizomes of Curcuma longa. It is harvested from February to April. The rhizomes are boiled in water for 5 to 10 minutes and then dried in the sun.
Adulterations
The synthetic color pigments azo and anilin are sometimes added to the herb.
Not to be Confused With
Curcuma xanthorrhiza, Curcuma aromatica, and Curcuma zedoaria
Actions & Pharmacology
Compounds
Volatile oil (3-5%): alpha- and beta-tumerone (aroma source), artumerone, alpha- and gamma-atlantone, curlone, zingiberene, curcumol
Curcuminoids (3-5%): including curcumin, demethoxy curcumin, bidemethoxy curcumin
1,5-diaryl-penta-1,4-dien-3-one derivatives
Starch (30-40%)
Effects
Turmeric has antihepatotoxic, antihyperlipidemic, antithrombotic, and anti-inflammatory effects. It is also antioxidative, antitumoral and antimicrobial (in particular, the sesquiterpene derivatives). It has insect repellent and antifertile effects. It also inhibits prostaglandin formation, in vitro.
Anti-Inflammatory Effects
The anti-inflammatory effects of turmeric are thought to be due to inhibition of leukotriene biosynthesis, and through this inhibition, a change in prostaglandin production. Alpha tumerone blocks the proliferation of human lymphocytes and decreases the activity of natural killer cells. Ukonan A (a polysaccharide) has phagocytic effects when tested in mice (Bisset, 1994).
Turmeric binds to estradiol and progesterone receptors and may have weak estrogenic activity in vivo. Turmeric had an estradiol binding capacity in vitro of 0.5 mcg of estradiol binding equivalent per 2 g of dried herb and 4 mcg of progesterone binding activity per 2 g of dried herb. After ingestion, saliva was used to obtain these phytoestrogens and phytoprogesterones. The substances isolated were used to detect bioavailability and bioactivity of phytoestrogens and phytoprogesterones in turmeric. Breast cancer cell lines were used to evaluate growth rate changes induced by this herb, but the differences were not significant (Zava et al, 1998).
Curcumin has antineoplastic effects through an antiproliferative mechanism. Part of this effect may be due to curcumin's effect on various kinases. Curcumin was found to be an inhibitor of highly purified protein kinase A (Ka), protein kinase C (Kc), protamine kinase (PK), phosphorylase kinase (PHK), autophosphorylation-activated protein kinase (AAPK), and pp60-tyrosine kinase (TK). The amount of inhibition varied, with phosphorylase kinase being the most effected at lower doses of curcumin. A dose of 0.1 mmol of curcumin produced the following reductions: PHK (98%), TK (40%), Kc (15%), Ka (10%), AAPK (1%), and PK (0.5%). PHK is a key regulatory enzyme in glycogen metabolism, which may result in antiproliferation effects if it is inhibited (Reddy & Aggarwal, 1994). Curcumin also inhibits the expression of several proto-oncogenes (c-jun, c-fos, c-myc) in mouse skin cells and transcription factor AP-1 (Sikora et al, 1997). The antiproliferative effect of curcumin on transformed and nontransformed cancer cells was measured in vitro. In all experiments, curcumin caused slight-to-moderate inhibition of the proliferation of leukemia hematopoietic cell types but not fibroblasts (Gautam et al, 1998).
Curcumin I and curcumin III are two antineoplastic chemicals found in curcumin. Curcumin I inhibited benzopyrene-induced forestomach and benzopyrene-initiated, tetradeconylphorbol-acetate-promoted skin tumors in Swiss mice. Curcumin II inhibited dimethylbenzathracene-induced skin tumors in Swiss bald mice. Both compounds demonstrated in vitro cytotoxicity against human chronic myeloid leukemia in a dose dependent manner. Using in vivo carcinogen metabolism enzyme studies and 3H-benzopyrene-DNA studies, curcumins were shown to inhibit cancer at the initiation, promotion, and progression stages of development. Altering of the activation and/or detoxification process of carcinogen metabolism was reported (Nagabhushan & Bhide, 1992).
Antioxidant Effects
Curcumin provides an antioxidant and anti-inflammatory effect by inhibiting the binding of transcription factor AP-1 to DNA and activation of NF-kappaB. These two substances control many endothelial genes such as plasminogen activator factor-1, tissue factor, endothelin-1, and interleukin 6 & 8. Via its AP-1 inhibitory activity, curcumin inhibits both cell growth and cell death (Bierhaus et al, 1997; Sikora et al, 1997; Singh & Aggarwal, 1995). Curcumin inhibits epidermal arachidonic acid metabolism by means of lipoxygenase and cyclooxygenase pathways and reduces the inflammatory effects of arachidonic acid and tetradeconylphorbol-acetate (TPA) (Stoner & Mukhtar, 1995).
Tumerone has anti-snake venom properties, blocking the hemorrhagic effects of Bothrops venom and reducing the lethality of Crotalus venoms (Bisset, 1994). Specific studies could not be found, but maybe due to an antithrombotic effect (Bierhaus et al, 1997; Sikora et al, 1997).
Clinical Trials
Turmeric is frequently cited as a mild and effective anti-inflammatory for such conditions as postoperative inflammation, osteoarthritis, and rheumatoid arthritis (Yarnell, 2006).
Ulcerative Colitis
A double-blind, multi-center placebo-controlled trial in 89 Japanese adults with ulcerative colitis in a period of relative quiet found that Curcumin was promising and relatively free of side-effects in maintaining remission. The Curcumin dosage of 2 grams daily in combination with the standard medicines sulfasalazine (SZ) or mesalamine was effective, with only 2 of 43 patients randomized to the Curcumin regimen relapsing during the 6 months of therapy, while eight of 39 patients receiving placebo with SZ or mesalamine did so. The regimen proved to be significantly superior in preventing relapse as compared with SZ and mesalamine alone, or placebo alone. Also, the Curcumin regimen resulted in significantly improved index designed to measure clinical activity (clinical activity index; P=.038) and endoscopic index (EI; P=.0001). The Curcumin was well tolerated, with none of the participants reporting serious side effects—a notable finding given the many unpleasant side effects such as rash, headache, fever, and increased risk of kidney inflammation typically associated with conventional medicines used to treat ulcerative colitis (Hanai, 2006).
Ulcers
One study demonstrated that turmeric was not better than controls in healing duodenal ulcers. The study was a double-blind, prospective, placebo-controlled, multicenter trial of 118 patients who received 6 g/d of turmeric. No H2-receptor antagonists, anticholinergics, or other antiulcer drugs were used during the study or for a week before the study began. The follow-up endoscopy and x-rays were done after 28 and 56 days. The ulcer healing rate of placebo was 29% and that of turmeric was 27% (Van Dau et al, 1998).
Chronic Anterior Uveitis
Marked improvement was seen in 32 patients with chronic anterior uveitis (CAU) who received 375 mg curcumin daily for 12 weeks. Patients were divided into 2 groups. Group A (n=18) received topical mydriatic agents, local hot fomentation and curcumin. Patients in group B (n=14) were treated with antitubercular drugs (rifampicin 10 mg/kg plus INH 5 mg/kg plus pyrazinamide 30 mg/kg daily), local mydriatics, hot fomentation, and curcumin. In Group B, curcumin was administered for 12 weeks but antitubercular medications were continued for one year. Symptomatic improvement was observed in both groups. Patients in group A experienced improved vision, pain relief, decreased redness and lacrimation, regression in circumciliary congestion, keratic precipitates, aqueous flare, and vitreous turbidity. Complete remission of CAU was observed in 12 of 14 patients in group B within 12 weeks of beginning therapy (Lal et al, 1999).
Indications & Usage
Approved by Commission E:
- Dyspeptic complaints
- Loss of appetite
Turmeric is used for dyspeptic disorders, particularly feelings of fullness after meals and regular abdominal distention due to gas.
Unproven Uses
The drug is also used for diarrhea, intermittent fever, edema, bronchitis, colds, worms, leprosy, kidney inflammation, and cystitis. Other uses include headaches, flatulence, upper abdominal pain, chest infections, colic, amenorrhea, and flushing. It is used externally for bruising, leech bites, festering eye infections, inflammation of the oral mucosa, inflammatory skin conditions, and infected wounds.
Chinese Medicine
Turmeric is used for pains in the chest, ribs, abdomen, liver and stomach; nosebleeds, vomiting with bleeding, and heat stroke.
Indian Medicine
Turmeric is used for inflammation, wounds and skin ulcers, itching, stomach complaints, flatulence, conjunctivitis, constipation, ringworm infestation, and colic.
Contraindications
Turmeric should not be used by people with gallstones or bile duct obstruction. It should also not be used by patients with hyperacidity or gastrointestinal ulcers.
Pregnancy
Not to be used during pregnancy. Turmeric has emmenagogic and abortifacient effects from its uterine stimulant activity.
Precautions & Adverse Reactions
Stomach complaints can occur following extended use or in the case of overdose. One case of acute contact dermatitis was reported following a 6-month occupational exposure to turmeric (Kiec-Swierczynska & Krecisz, 1998).
Drug Interactions
Moderate Risk
Anticoagulants, Antiplatelet Agents, Low Molecular Weight Heparins, and Thrombolytic Agents
Theoretically, curcumin may add to the effect of these medications and increase the risk of bleeding. Curcumin inhibited platelet aggregation in animals and in vitro (Srivastava et al, 1995; Srivastava et al, 1985), which may result in prolonged bleeding times if taken with drugs known to affect platelet function. Clinical Management: Caution is advised if curcumin and any of these agents are used concomitantly. Monitor bleeding time and signs and symptoms of excessive bleeding.
Dosage
Mode of Administration
Whole, cut and powdered drug available as capsules, solution, coated tablets, and compound preparations.
Preparation
To prepare a tea, scald 0.5 to 1 g drug in boiling water, cover, draw for 5 minutes and then strain. The tincture strength is 1:10.
Daily Dosage
The average dose is 1.5 to 3 g of drug. The powder should be taken 2 to 3 times daily after meals; the tea (2 to 3 cups) should be taken between meals. The tincture dose is 10 to 15 drops 2 to 3 times daily.
Storage
Turmeric should be protected from light.
