Turmeric anyone?

Have you noticed, whenever a new spice or herb or natural substance pops up in the news, suddenly you begin to see countless commercials, videos and news articles claiming a million health benefits? YouTube and other video posting sites get inundated with people claiming cures for everything from a mild itch to stage IV cancer? Well, it looks as if it is turmeric’s turn now…and I will attempt to look at the clinical basis for those claims.

The basics: Turmeric is a rhizome that belongs to the ginger family. As you can see from the picture below, it looks a lot like ginger…Turmeric has been used in Asian cultures, especially India, for millennia for its nutritional, medicinal (based on ayurveda), and cosmetic properties. I am not going to go into all of these, as I want to focus on the latest clinically known information, especially as it relates to osteoarthritis. The active ingredient in turmeric is called curcumin, is a cute little molecule whose chemical name is diferuloylmethane (see below). You can visit the Wikipedia page on turmeric for more background information.

Turmeric root. Photo: Sesha Reddigari.
Turmeric powder (with an aspirin pill shown for white balance). Photo: Sesha Reddigari.
Diferuloylmethane (curcumin)
https://www.researchgate.net/figure/Curcumin-diferuloylmethane-structure_fig1_264613777


First of all, let’s address the elephant in the room – is ‘curcumin’ currently officially ‘approved’ as treatment for any illness? The answer from the FDA Drug Appovals site, as of today (01/14/2020), is an emphatic NO.

It’s hard to know how many, if any, new drug applications are awaiting approval by the FDA, as that information may be confidential. However, we can look at how many clinical studies of curcumin have been completed in the past few years or how many are ongoing…This exercise can be useful because, by law, whenever a drug company (study sponsor) starts a new clinical study, it has to register the study with the government AND then submit high level results within a fixed time frame after study completion. Since we can’t find out the application status, we can at least look at the recently completed studies registered in the US. This is an indirect way to look at who might have applied or may apply in the future.

A search of this database revealed, again as of today, over 250 registered clinical trials where ‘turmeric’ OR ‘curcumin’ OR ‘curcuma’ was used as test treatment. Of these studies, approximately 60 were completed and the others were listed as either ongoing or terminated, etc. Again, of the 60 completed trials, a little over 10 were Phase III studies and only two of these 10 had available study results. However, neither study was conducted in participants with arthritis.

I did find, however, one completed Phase III arthritis study registered from Thailand (Mahidol University), but this one had no results although it was completed over seven years ago. This study would have provided a great opportunity for all knee osteoarthritis patients to know more about efficacy of turmeric in arthritis. This doozy of a randomized study was conducted in a whopping 360 plus patients! It directly compared turmeric extracts against the one of the current standard treatments, ibuprofen. Too bad there were no results!

You see, sponsors of totally foreign-based studies may not be legally required to post the results on the above-mentioned site. So, I went to the National Library of Medicine database next. This is a great resource for published results of almost all medical research conducted in the world. I was hoping to find that Thailand study results on this site, but sadly I was disappointed here as well.

So, moving on, I continued to search for other ‘published’ clinical information on turmeric and arthritis at this NLM site. A search with the words ‘turmeric‘ OR ‘curcumin‘ AND ‘osteoarthritis‘ AND ‘randomized‘ appearing in the titles revealed 4 articles (15 January 2020). We will look at those now…For obvious reasons, I will keep the information quite general and high level and will not go into a lot of scientific details.

The first article describes a study in which 139 osteoarthritis patients received either curcumin capsules or the non-steroidal anti-inflammatory agent diclofenac over four weeks and the two groups were then compared…the results showed the two treatments were similar with respect to knee pain, meaning that curcumin worked just as much as diclofenac did but the turmeric group had fewer side effects…that I think is a plus! Note that they used a brand of curcumin called BCM-95.

The second article describes a randomized study in which 201 osteoarthritis patients were treated over 12 weeks with curcuminoids (Curamed®) OR curcumin plus Indian frankincense (Curamin®) OR placebo, in three groups. Results were positive with respect to pain in the two treatment groups compared to placebo! This could be a good thing for osteoarthritis patients! The group that received curcumin plus frankincense fared a little better than the curcumin group, but still! I love this result.

The third study was not really a test of curcumin or turmeric, but it did suggest that it might be helpful when combined with exercise and a combination of glucosamine and chondroitin sulfate…the number of patients in the study was only around 50 overall…

The fourth study was a smallish study of 50 patients with knee osteoarthritis. Half the patients in the study were given a specialized formulation of curcumin (Theracumin®) and the other half a placebo over 8 weeks. The results were positive for the curcumin group who experienced significantly less pain than the other group! Yeay!!

In the same NLM search, dropping the word ‘randomized’, four additional articles popped up. I am not describing them as I did the others since these studies probably weren’t randomized, they do look very promising, in my opinion, for osteoarthritis patients considering turmeric and curcumin!

To sum it up, the whole point of my blog is to emphasize the importance of sticking to the tried and tested and reliable scientific information databases only and not trust charlatans and unproven claims on the net…

Free image from Clipart. [URL=https://www.clipart.email/download/2015489.html]