Curcumin and Osteoarthritis

Curcumin and Osteoarthritis

Hi everyone, sorry it’s been so long since I have put a blog post up.  Feels like August and September flew by. I had a big deadline for a presentation I’m giving at the American Society of Health-System Pharmacists Meeting and the American Pharmacists Association meeting in December and March, but the majority of that is over and I’m caught up on teaching materials for the most part!

I’m teaching a diabetes elective on-line this semester and it’s been so fun to spend part of my week on Zoom discussing diabetes with my students. I am going to be adding some new diabetes content here soon. And I promise I’m still working on my probiotics posts, it’s such an overwhelming topic when it comes to the data and making any specific recommendations but I’m getting closer! For now though, I remembered I have this awesome post put together by Dr. Timothy Unger, DO who was on a clinical rotation with me earlier this year and is now graduated and a few months into residency training. Curcumin is possibly my favorite supplement for anyone with inflammation or pain. Hope you enjoy!
[drh]

 

I would first like to thank Dr. Hartzler for giving me the opportunity to write this post. My name is Timothy Unger and I am a 4th year medical student at Ohio University Heritage College of Osteopathic Medicine. As a young student doctor, I quickly learned that nothing in medicine is free of side effects and there is certainly no catch all medication. However, there is an age old remedy that has gained notoriety that contradicts this claim. Turmeric is a plant native to Southeastern Asia and is in the same family of plants, like ginger [1]. Turmeric has been used for centuries in these Asian countries as a herbal remedy. The active compound that can be extracted from the turmeric root is diferuloylmethane, more commonly known as curcumin [2][7]. This yellow pigmented spice was first identified in 1910 by Lampe and Milobedzka as the active compound of the turmeric root [3]. Researchers have found evidence of curcumin’s anti-oxidant, anti-inflammatory, anti-carcinogenic and anti-microbial properties [1]. This posting will focus primarily on the anti-inflammatory effects of curcumin in osteoarthritis.

Osteoarthritis (OA) is a very common condition worldwide. It is estimated that more than 20 million Americans have OA [4]. This number is projected to increase with the aging population of Baby Boomers. Osteoarthritis is commonly referred to wear and tear of cartilage in joints. There currently is not a cure for osteoarthritis, but there are treatments to treat the symptoms and slow the progression of the condition. The treatments available include pain relievers (like tylenol), steroids and non-steroidal anti-inflammatory drugs (NSAIDs, like advil, aleve, ibuprofen). These medications only manage the symptoms by reducing pain and inflammation [2]. These treatments carry with them their own set of risks. NSAIDs, for example, can cause gastric ulcers when taken long-term. Researchers are investigating novel therapies that eliminate these risks and maximize the benefits. Curcumin supplementation has caught the attention of researchers as this potentially novel agent that has anti-inflammatory properties and little to no side effects.

The chemical structure of curcumin gives it the property of not completely dissolving in water but it is stable in the acidic pH of the stomach [3]. The chemical structure also causes it to be metabolized by the body rapidly. This has led researchers to develop methods of increasing the absorption and the effect curcumin can have one the body [3][7]. Meriva is a form of curcumin developed to solve the problem of absorption [3][5][6]. With this delivery system, researchers measured levels of curcumin after patients were given Meriva and found that absorption was significantly increased compared to taking raw curcumin [3][5]. Other combination supplements are available, like the combination of curcumin and black pepper, or curcumin and sunflower lecithin [10][14]. These combinations have similar improvements on the absorption by the body.Curcumin is sold in formulations, like Meriva where the manufacturers suggests a daily dose of 1 to 2 tablets per day (1 tablet = 500mg) [11]. The manufacturer’s research found that 500mg of Meriva twice daily improved joint function and decreased achiness [12][13].

The pain and inflammation caused by OA can be very irritating and bothersome. Researchers have found that curcumin extracts are as effective as an NSAID, like ibuprofen for the treatment of pain and inflammation from OA [8][9]. These results are even more significant when you compare the side-effect profile of curcumin and NSAIDs. The side effects of curcumin are similar to NSAIDs but with fewer gastrointestinal effects [8][10]. The Food and Drug Administration (FDA) claims that curcumin is “generally regarded as safe” [10]. Several studies of curcumin on rats have shown the supplement to be safe at low to medium doses [10]. Studies have also shown, in mice, that curcumin blocks the effect of some chemotherapeutic agents, namely cyclophosphamide [10]. These reports of side effects state that curcumin is safe and further research is needed on the long-term effects in human patients.

Osteoarthritis affects millions of Americans and this amount is projected to increase over the coming years. There is no cure for this condition, only symptomatic treatment. The current treatment regimen includes NSAIDs, steroids and analgesics, which can have dangerous side effects. This has put alternatives, like Meriva (curcumin), on the main stage because taking it does not cause the dangerous side effects like conventional treatments. If suffer from osteoarthritis and are looking for a change, that can be as effective as other NSAIDS, then curcumin could be the answer. For those with Diabetes, curcumin has also been shown to decrease blood glucose levels, and increase plasma insulin levels [10].

You can find  high-quality curcumin supplements in over in Dr. Hartzler’s FullScript store or by clicking on a image below. Don’t hesitate to reach out with questions. Specifically Dr. Hartzler recommends the ones listed below for good absorption. Both the Protocol for Life Balance and CurcumaSorb have the Meriva formulation metentioned above. Curcum-Evail has the added ingredients to help with absorption!

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References

1. Monograph: Curcuma Longa (Turmeric). Alternative Medicine Review 2001; 6: S-62 – S-65.
2. Henrotin Y., Clutterbuck A.L., D. Allaway, et al. Biological Actions of Curcumin on Articular Chondrocytes. Osteoarthritis and Cartilage. 2010; 18: 141-149
3. Jurenka J. S. Anti-inflammatory Properties of Curcumin, a Major Constituent of Curcuma longa: A Review of Preclenical and Clinical Research. Alternative Medicine Review 2009; 14, 2: 141 – 153.
4. Osteoarthritis. (http://www.niams.nih.gov/). [Accessed March 16 2018]
5. Belcaro G, Hosoi M, Pellegrini L. A Controlled Study of a Lecithinized Delivery System of Curcumin (Meriva) to Alleviate the Adverse Effects of Cancer Treatment. Phytotherapy Research 2014; 28: 444-450.
6. Meriva: Curcumin Phytosome. Thorne Research: Clinical Research Report. 2016; 1-4; www.throne.com
7. Henrotin Y, Priem F, Mobasheri A. Curcumin: A New Paradigm and Therapeutic Opportunity for the Treatment of Osteoarthritis: Curcumin for Osteoarthritis Management. SpringerOpen Journal. 2013; 2:56 1-9.
8. Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W. et al. Efficacy and Safety of Curcuma domestica Extracts Compared with Ibuprofen in Patients with Knee Osteoarthritis: A Multicenter Study. Dove Press Journal. 2014; 9: 451-458.
9. Turmeric: Arthritis Foundation. https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/turmeric.php [Accessed March 16 2018]
10. Aggarwal B, and Harikumar K B. Potential Therapeutic Effects of Curcumin, the Anti-inflammatory Agent, Against Neurodegenerative, Cardiovascular, Pulmonary, Metabolic, Autoimmune and Neoplastic Diseases. International Journal Biochemistry Cellular Biology. 2009; 41: 40-59
11. Meriva-SF. https://www.thorne.com/products/detox-support/dp/meriva-sf [Accessed March 16 2018]
12. Meriva Scientific Support http://www.meriva.info/en/meriva-bioavailable-curcumin/scientific-support/ [Accessed March 16 2018]
13. Belcano G, Cesarone M, Dugall M, et al. product evaluation  of registry of Meriva, a curcumin-phosphatidylcholine complex. Panminerva Med 2010;52 (suppl 1):55-62
14. Curcum-Evail. http://catalog.designsforhealth.com/Curcum-Evail-60 [Accessed 03/20/18]