Eligibility Criteria For Studies Used In This Review
All prospective randomized clinical studies using turmeric and curcumin for the treatment of arthritis were included in this systematic review. Exclusion criteria included in vitro studies, in vivo studies in nonhuman species, studies that were only published in abstract form or included insufficient data to properly evaluate the outcomes, nonclinical trial studies, and studies in which arthritis was not the primary outcome measured, and then we eliminated the duplicates. A flow diagram of the article selection process is shown in Figure 1. Although no language barriers were imposed, all studies included in this review were written in English. Dissertations about randomized clinical studies were also included.
Flowchart of the selection process of the randomized clinical trials for systematic review.
Curcumin As A Cox Inhibitor
Typical non-steroidal anti-inflammatory drugs , such as ibuprofen and naproxen, work by blocking both COX-1 and COX-2 enzymes. COX-1 enzymes influence the clotting of blood and the health of the stomach, and COX-2 enzymes influence inflammation that can lead to pain. Researchers have found that curcumin has the chemical properties of a COX inhibitor17-20 and can provide modest pain relief. However, experts have not yet found a way to harness curcumins COX-inhibiting properties to reliably relieve moderate or significant arthritis pain.
Turmeric For Arthritis And Joint Pain: Does Curcumin Work
Throughout history, many herbs and spices have become famous for their medicinal uses. Perhaps none have reached the level of notoriety of turmeric, as it has been a principal healer of Ayurvedic medicine for thousands of years.
Turmeric contains a potent antioxidant and anti-inflammatory agent called curcumin. Derived from the Curcuma longa root, curcuminoids are the primary driver behind many of turmerics health benefits. But, can turmeric help relieve arthritis and joint pain?
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How To Take Turmeric Or Curcumin
To get turmeric, you take the stem, or the rhizome, of the plant, and boil, dry, and ground it into powder. There are many ways you can introduce turmeric or curcumin into your diet. Research has shown that curcumin is safe in high doses. This is great news because curcumin also has poor bioavailability, which means its poorly absorbed. It would need to be taken at large doses for an active effect.
What Should I Avoid While Taking Turmeric
Turmeric can make it harder for your body to absorb iron. Tell your doctor if you are taking an iron supplement.
Avoid using turmeric together with other herbal/health supplements that can also affect blood-clotting. This includes angelica , capsicum, clove, dandelion, danshen, evening primrose, garlic, ginger, ginkgo, horse chestnut, Panax ginseng, poplar, red clover, saw palmetto, and willow.
Avoid using turmeric together with other herbal/health supplements that can lower blood sugar, such as alpha-lipoic acid, chromium, damiana, devil’s claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
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Study : Curcumin Boosts The Action Of Steroids In Arthritis
Many a time we have received queries: whether it is safe to take turmeric with steroids and indeed it is safe to take turmeric in the diet when taking steroids as it helps in attenuating inflammation and pain.
And some individuals have benefited from this and discontinued steroid use.
This animal study published in the Journal of Pharmacy and Pharmacology, January 2014 shows that curcumin administered with steroid potentiates its anti-arthritic activity.
What happened in the study?
An animal model of arthritis was developed. Curcumin was administered along with low, moderate and high doses of steroid- prednisolone.
The efficacy and toxicity of the steroid were studied.
What were the results?
Induction of arthritis was marked by increased levels of inflammatory agents in the body such as tumor necrosis factor-alpha and interleukins etc.
Combination of curcumin and prednisolone had a beneficial effect on joint swelling, immune cell count and other biochemical parameters in arthritis.
Out of the different doses tested, low dose of prednisolone and curcumin worked the best.
This was demonstrated by increased inhibition of inflammatory enzymes, increase in antioxidant enzymes, body weight gain and reduced toxicity to organs.
How did this occur?
Quality Assessment Of The Articles
The Cochrane tool was used to assess quality of the RCT articles included in this systematic review by determining the risk of bias .28 This validated tool consists of the following eight categories: random sequence generation, allocation concealment, blinding of participants, assessor blinding, reporting drop out or withdrawal, intention to treat, selective outcome reporting, and other potential bias. Each category was scored as H, high ROB, U, uncertain ROB, or L, low ROB. Three independent reviewers performed the quality assessment, and disagreement on scores was resolved through discussion.
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Turmerics Skin Protective Properties Benefits In Psoriatic Arthritis
Around 30% of the individuals with psoriasis develop an inflammatory condition called psoriatic arthritis. Traditionally turmeric has been used to treat various skin disorders and research now proves the potential of curcumin to aid in various skin diseases.
Psoriasis is characterised by excessive cell death in skin cells compared to the growth rate of new skin cells. Curcumin is found to reverse such rate of cell death in psoriasis.
Animal study shows that curcumin can be taken safely with cyclosporine, an immune suppressing drug used to treat psoriasis.
What does this mean?Curcumins anti-inflammatory and skin protective properties can prevent inflammation occurring in skin in psoriasis to spread to joints in psoriatic arthritis.
Turmeric For Joint Pain Relief
Curcumin has also been shown to have a strong antioxidant capacity. In a randomized double-blind placebo-controlled trial, patients with mild-to-moderate knee osteoarthritis were given the curcuminoid and were compared to a group that received a placebo for 6 weeks. Researchers measured the levels of enzymes known to influence inflammation and malondialdehyde ). The treatment group showed significant changes in these enzymes suggesting that short-term supplementation with curcumin decreases oxidative stress.
Another randomized, double-blind, placebo-controlled trial of low or high dose bio-optimized Curcuma longa in 150 patients with knee osteoarthritis measured serum biomarkers of cartilage degradation . The high dose extract showed a transient but non-significant decrease in the cartilage degradation biomarkers. Moreover, pain improvement in the low- and high-dose extracts was better than in the placebo group after 90 days of treatment.
The effects of topical curcumin 5% ointment on osteoarthritis knee pain in patients older than 70 years was studied in a double-blind, randomized placebo-controlled trial. Subjects applied either the ointment or a placebo twice a day for 6 weeks. The pain intensity was significantly lower in the group receiving the curcumin ointment than in the placebo group suggesting that this treatment may be considered for older adults with knee osteoarthritis.
What Is Turmeric Curcumin
Turmeric powder is the primary spice in the Indian dish, curry. This powder derives from the ground-up roots of a species of ginger plant known as Curcuma longa. The curcumin content within turmeric provides the bright orange color as well as the majority of turmerics benefits.
The problem is that turmeric powder only contains about 3% curcumin, which is the potent antioxidant and anti-inflammatory agent. When youre buying a supplement, it should contain at least 150-250 mg of curcuminoids per serving to have any real positive effect.
Another issue with turmeric is the poor bioavailability into the bloodstream. The body struggles to make use of turmeric by itself without the help of bioavailability enhancers, such as piperine . Piperine, usually in the form of trademarked ingredient BioPerine, significantly increases the absorption of turmeric.
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Turmeric For Psoriatic Arthritis
Psoriatic arthritis is a chronic form of inflammatory arthritis which can develop in people suffering from psoriasis. As per National Psoriasis Foundation, the anti-inflammatory properties of turmeric have been effective in treating the psoriasis arthritis. You can add turmeric to your daily food or try any remedy mentioned above or consume turmeric capsules for relief.
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Turmeric Dosage What Experience Tells Us
Turmeric has been used in India for thousands of years. Millions of people take milk with turmeric on a daily basis and it is included in almost every curry / vegetable we make.
Thus, experience tells that taking even 1 tsp turmeric a day will not have any issues. Of course, if you are new to it, start small maybe 1/4 tsp and then increase.
So, 1 tsp good quality turmeric powder should not have any issues at all.
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Choosing The Right Product And Dosage
Turmeric is available as a capsule, tablet, or as an extract, the latter of which is more likely to be free of contaminants. The typical dose used to relieve pain due to inflammatory conditions such as osteoarthritis is between 400 and 600 mg, three times a day. It can also be prescribed at 500 mg, twice daily, but should not go above 2,000 mg a day.
Dr. Srinivas R. Nalamachu, founder and medical director of the Mid America PolyClinic and a PPM Editorial Advisor, says he recommends patients start out with just one dose of 500 mg a day to see if it is tolerated, and gradually increase the dosage from there. Some individuals experience mild nausea or stomach upset when using turmeric. In the absence of any undesired side effects, the supplement can be taken over a long period of time.
Individuals interested in trying turmeric should do their homework before purchasing the supplement to be sure that the product has enough curcumin in it. It may be sold as turmeric powder, turmeric root, turmeric curcumin, and other similar names. Curcumin only makes up about 3 to 5 percent of the turmeric plant and about 10 percent of most quality turmeric supplements on the market, according to Dr. Nalamachu. He suggests reading the labels of the product you are considering to be sure about how much curcumin youll be getting.
Studies suggest that combining the spice with piperine, found in black pepper, can increase the amount of curcumin that is absorbed by the body by up to 2,000%.
Options For Arthritis Pain Relief
Some studies concerning the use of turmeric supplements for osteoarthritis have been promising. Based on current research, the Natural Medicines Comprehensive Database classifies turmeric as “possibly effective” for alleviating arthritis symptoms. Turmeric supplements come in capsules and tablets that are easy to take with water. Be sure to follow the directions carefully. If you wish to try a turmeric health supplement, you may want to use it along with other products such as ointments and patches. You will also find a number of other solutions for arthritis pain at Walgreens. These include heating pads and over-the-counter pain relief products. If you have gallbladder disease, are pregnant or nursing or have acid reflux disease, do not take turmeric. Those who are on medications or herbs that thin the blood may be at an increased risk of bleeding when using turmeric. Consult your doctor before using any herbal or over-the-counter treatment for arthritis.
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How Should I Take Turmeric
When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.
If you choose to use turmeric, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.
Turmeric is thought to be possibly safe when used short time as a mouth rinse or as an enema.
Do not use different forms of turmeric at the same time or you could have an overdose.
If you need surgery, dental work, or a medical procedure, stop taking turmeric at least 2 weeks ahead of time.
Store as directed, or at room temperature away from moisture and heat.
How To Apply Turmeric Topically For Arthritis
Yes turmeric can be applied topically to affected joint to relieve arthritic pain.
Mix an adequate amount of turmeric powder in extra virgin olive or coconut oil to form a paste. You can slightly warm the oil prior to use.
Apply this paste to affected joint and massage gently Cover this with a gauze and let it be for as long as possible say 30 mins to an hour.
Cleanse with cool water.
You can do this procedure 2-3 times in a day. Effects should be visible in as a much as a week or twos time.
Turmeric can be included directly in the diet or can be used in any of the following ways to relieve arthritis.
- Take a small piece of turmeric and ginger and boil them together in water for about fifteen to thirty minutes. Now, remove the herbs and take the drink along with honey.
- Mix turmeric with ginger extract and make a paste. Apply the paste at the affected joints to obtain relief from stiff joints.
- Mix equal proportions of turmeric, ginger powder and fenugreek powder and store the mix in a tightly sealed container. Take one teaspoon of this mix twice a day.
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Precautions And Adverse Effects
The side effects of turmeric are quite rare and usually moderate. Keep the following in mind when deciding on whether or not curcumin is right for you.
- Turmeric is a blood thinner which can increase the risk of bruising or bleeding. Discontinue use of curcumin at least two weeks before any surgery or if you are using anticoagulants.
- Be extra careful if youre using turmeric for diabetes as it may cause blood sugar to drop too low.
- Turmeric may inhibit iron absorption. If you have an iron deficiency, you may want to avoid curcumin.
- If you are pregnant or breastfeeding, you should not use turmeric. There is not enough reliable evidence to confirm the safety of curcumin during pregnancy.
- Curcumin may also increase the risk of kidney stone formation and can worsen symptomology associated with gallbladder disease.
- In a small number of individuals using higher dosages, turmeric may cause stomach pain, nausea, vomiting, diarrhea, allergic reactions, or constipation.
What To Know Before Taking Turmeric
Curcumin and turmeric are generally safe. Talk to your doctor if you are interested in taking curcumin supplements. While there are no reports of severe effects from high doses of curcumin, its still possible for side effects to occur.
Curcumin may also interact with prescription drugs. This can make your medication less effective and impact your health if you have certain conditions. Check with your doctor before taking turmeric if you take medicine for:
- blood thinners
Some supplements may contain piperine, which also interferes with some medications, including phenytoin and propranolol .
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Turmeric And Lemon Grass
Lemongrass contains anti-inflammatory properties which suppress the activity of cyclooxygenase-2, an enzyme which is responsible for joint inflammation and pain.
- Pre-heat your oven to 150 degrees.
- Melt 2 cups of coconut oil and then pour it into a glass oven dish.
- Mix 5 tablespoons of turmeric powder, 5 tablespoons of cayenne pepper, and 1 ounce of dried lemon grass into it.
- Bake for 3-5 hours, then remove from oven and let cool.
- Strain with cheesecloth.
- Store the solution at room temperature in an airtight container.
- Apply this solution to painful joints whenever required.
Curcumin Vs Turmeric: Whats The Difference
Turmeric is comprised of 100 compounds. The one most talked about is curcumin, the active compound thats credited with most of turmerics health benefits. While turmeric gets its bright yellow hue from curcumin, this compound makes up only about 5 percent of the spice, according to an article published in January 2017 in the Journal of Medicinal Chemistry. Most of the benefits of turmeric are credited to curcumin .
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Turmeric And Lime Juice
Lime/lemon juice is a rich source of citric acid which helps to reduce inflammation and pain. This process is very effective for treating arthritis caused by uric acid deposits in the bones.
- Mix 2 tablespoons of turmeric with 1 tablespoon of lime juice.
- Add this to a small amount of boiling water to make a thick paste.
- Apply the mixture to sore joints.
- Leave it on for 15 minutes and rinse off with water.
- Repeat regularly to get relief from pain.
How Curcumin Actually Fights Inflammation In Arthritis
Arthritis means you have inflammation in a joint its chronic in RA, but also present OA. Your body makes inflammatory proteins , and a huge number of them are controlled by one molecule called NF-B, explains Randy Horwitz, MD, PhD, professor of medicine, University of Arizona College of Medicine. Think of it like an on/off switch for these genes, says Dr. Horwitz, who also serves as the medical director of the University of Arizona Center for Integrative Medicine. Treating arthritis with corticosteroids and anti-inflammatories inhibits NF-B research shows turmeric can have the same effect. Inhibit NF-B, and youre turning off a whole bunch of inflammatory molecules, says Dr. Horwitz.
Research suggests curcumin also targets specific inflammatory cells and blocks certain enzymes that lead to inflammation.
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