Turmeric (curcumin) shown to improve multiple autoimmune conditions: multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease

Let’s take a look at a recent publication that briefly reviews curcumin for autoimmune disease.

We’ll see that curcumin (an active ingredient in turmeric,) is recognized as safe, and that it has recently been shown to be effective against several serious conditions in human and/or animal studies.

That sounds promising. But your doctor will never have a chance to prescribe it for you – and will probably never tell you about it. Why might that be?

Let’s start by taking a look at the abstract.

The history and likely future of curcumin (turmeric)

The list of disease conditions associated with “a breakdown” of the immune system is sobering. That these very serious, often debilitating and sometimes life threatening conditions collectively effect 5% of the world population should emphasize the urgency with which this problem must be addressed.

The author next observes that dietary supplement use is on the rise. Hardly surprising given the assessment that they are “effective, inexpensive, and relatively safe.”

Next comes a list the conditions for which curcumin (a component of turmeric) seems to be effective, followed by a brief explanation of how curcumin generally affects the immune system – by regulating inflammation.

Given all this, we must be well on our way to a new, effective treatment for these devastating conditions. Very exciting.

But no. Using higher doses for therapeutic treatment requires “extreme caution.” (Not just caution, mind you – “extreme” caution.) We can’t do anything, it seems, until we first have a precise understanding of the effective dose, safe regiment, and mechanism of action. (Not just an understanding – a “precise” understanding.)

I don’t want to seem as if I’m picking on this author. I’m not. I very much appreciate the review.

And I don’t disagree regarding the need for caution, especially when one component of a plant (in this case curcumin) is given in concentrated form. I think the full-spectrum extract of turmeric (e.g. as used in Banjo) is a better, more effective, safer alternative. And I happen to believe “higher doses” of curcumin are not required. But if you want concentrated curcumin you can purchase it in any health food store. Thousands do every day, and no significant side effects have been reported – ever. In fact a recent trial showed that up to 8 grams (8,000 mg) of pure curcumin taken daily for 4 months was safe.

What I object to is that natural products are viewed with such suspicion. Rather than expressing excitement over what might be an effective treatment for conditions that currently devastate the lives of millions – and for which there are few if any good treatments – only “extreme caution” is recommended. Yes, let’s be cautious – always. But let’s also recognize that curcumin has been in a real world ‘clinical trial’ for thousands of years and that it has performed well. Let’s not throw up artificial, unrealistic barriers to its use, such as the need to “precisely understand” its mechanism of action.

Here are the number of prescription pharmaceuticals for which we “precisely understand” the mechanism of action: 0.

OK, there might be a few where our understanding could be called “precise” – but there are far more where the mechanism of action is entirely unknown. The FDA does not need to know the precise (or any) mechanism of action before approving a new drug. A new drug need only be shown “safe and effective.”

Curcumin (turmeric) has a long history of safe use and is reported by thousands (millions?) to be effective. Additionally, as the author notes, a number of recent studies in animals and humans have shown it to be effective.

Given all this, it seems not much additional work should be required to determine the best dose at which curcumin can be safely and effectively used – either for autoimmune disease or the other numerous conditions it helps with.

Not much work, relatively speaking – but there is a problem. No one is doing that work.

So it’s not just that you’ll have to wait a long time for your prescription for curcumin. It will never arrive.

That might be (should be) very distressing to you. But it should not lead you to believe what is not true. No, the drug companies do not want to keep you sick. No, there is not a conspiracy among doctors to hide the cure for cancer, or warts, or any other condition. Your doctor genuinely wants you to get well and the pharmaceutical companies genuinely want to offer new, effective drugs. Yes, the pharmaceutical company wants and needs profit – just like your doctor – just like me – just like you.

And that is the problem – or a large part of the problem. There is no economic model that supports development of prescription curcumin. The clinical trials required to satisfy the FDA would cost at least (I’m guessing) $30 million? $50 million? Far more, actually, because in addition to out of pocket expenses the FDA process would require substantial time and effort on the part of many pharmaceutical employees. Other projects would have to be deferred. And since curcumin cannot be patented, their investment would amount to a donation. Anyone could sell it. Walgreen’s would have it on the end cap in all their stores. Sales at GNC would be going gangbusters.

Given that curcumin might be the greatest new drug in the last 50 years, maybe you think some generous pharmaceutical company ‘should’ make this donation – just for the good of the world. But you cannot believe they are malicious for not doing so.  That just wouldn’t be fair.

So while it’s probably true that no pharmaceutical company is working on curcumin, it’s also true that many are probably working with curcumin – trying to alter it so it becomes patentable. Maybe they can do that without diminishing its efficacy – and without creating a product that has serious side effects. Or maybe they can’t.

I guess we’ll just have to wait and see.

While we’re waiting, there’s turmeric (or curcumin.)  Use it as you see fit – but realize you’re on your own.

Very few doctors are well-informed on turmeric (or any natural product) and fewer still will advocate using anything not approved by the FDA. You will not see television commercials for turmeric. Your insurance company will not pay for it.

You’re on your own. Is this a good thing? No, but it is what it is. You and I can rail against the system, or we can spend our efforts looking for what works – trying to get better.

Should you be cautious, educate yourself and act prudently? Of course. As much or more with this issue as with any other. And yes, there is some dangerous stuff out there. And yes, people do foolish things.

But don’t let anyone tell you that it’s wrong, or dangerous, or foolish to look for what works. Don’t let anyone tell you that you should suffer silently or that you should wait patiently for a drug that might never arrive – or might not arrive in time. That just wouldn’t be fair.

This is an important publication because it demonstrates that by combining different natural inhibitors of NF-kB, a greater anti-inflammatory effect may be achieved than is possible with either agent alone. The study further suggests that this might be especially true when the different agents act to inhibit NF-kB through different mechanisms.

By implication, the observed synergy will not be limited to the specific combination studied (curcumin + resveratrol.)

Banjo combines a number of different natural NF-kB inhibitors, each of which may act through a slightly different mechanism in the inhibition of NF-kB. While many of the individual agents might provide some benefit, Banjo is expected to provide a substantially greater benefit than any single agent. That possibility is confirmed by the study briefly summarized below.

The publication:

This is an important publication because it:

• Demonstrates one likely reason you can’t overdose on curcumin or any other natural NF-kB inhibitor;
• Suggests ‘cooperation’ between these natural NF-kB inhibitors and the immune system – a ‘vitamin like’ action; and,
• Provides one example of the importance of natural NF-kB inhibitors in shutting down inflammation.

Each of the above is consistent with the theory of inflammation advanced on this site.

Curcumin & IL-10

Curcumin (a major active component of turmeric) has been shown to exert substantial anti-inflammatory effects. Many studies suggest that it acts primarily by inhibiting NF-kB.

IL-10 is an important chemical messenger in the immune system and a regulator of inflammation. Like most such immune regulating molecules, it interacts with many other components of the immune system in a complex manner resulting in diverse effects. However, IL-10 acts primarily to inhibit/reduce inflammation, largely by inhibiting NF-kB.

IL-10 is especially important in the digestive tract and may play a role in the onset and progression of inflammatory bowel disease: Crohn’s and ulcerative colitis patients may suffer from a deficiency of IL-10.

NF-kB & inflammatory bowel disease

Inflammatory bowel disease is strongly associated with excess activation of NF-kB.

Ulcerative colitis patients and, to a lesser extent Crohn’s patients, have been found to benefit from administration of curcumin – presumably because of its ability to inhibit NF-kB.

Drugs frequently used as first-line therapy for inflammatory bowel disease, such as glucocorticoids or aminosalicylates (e.g. sulfasalazine) are also inhibitors of NF-kB.

NF-kB inhibition, at least in the treatment of inflammatory bowel disease, seems to be a good thing.

IL-10 & curcumin – synergy & dependence

The study briefly summarized below demonstrates a synergistic effect between IL-10 and curcumin. In other words, IL-10 was much more effective as an NF-kB inhibitor when curcumin was present.

That’s significant because a difficulty in shutting down inflammation is common to many of the inflammation related conditions. Much of autoimmune disease is, I believe, not so much a primary attack on the body by one’s own immune system as it is an immune system that can’t turn inflammation off, and so ends up attacking all sorts of things (organs, joints, skin, nerves, etc.)

Also, curcumin was unable to inhibit NF-kB when IL-10 was absent.

The latter fact is quite surprising. Curcumin is ‘supposed’ to inhibit NF-kB – but in this study it stopped doing so when IL-10 was absent.

So it seems that when your body is trying to shut down inflammation – when IL-10 is present – curcumin comes alongside and joins in the battle. Then, once that excess inflammation is relieved (IL-10 no longer present) curcumin simply stops acting.

Something unexpected is going on. Curcumin seems as if it is ‘cooperating’ with the immune system, or perhaps being actively and selectively used by the immune system as a ‘tool’ of assistance in shutting down inflammation. To some  extent, curcumin seems to be acting like a vitamin.

When the body requires a vitamin it grabs one from the circulation. When that same vitamin is not needed it simply washes away (the water soluble vitamins at least.) But the vitamin has to have been taken in (eaten.) If not – if there is no vitamin to grab – then a deficiency disease will soon develop. The body cannot function properly without the vitamin.

Perhaps the body requires some minimum level of these natural NF-kB inhibitors in order to function properly. Perhaps a shortage of natural NF-kB inhibitors results in a deficiency disease that we recognize as various forms of inflammation. No, I don’t think we need curcumin per se, but I do think we need a steady supply of natural NF-kB inhibitors. I think we need this ‘class’ of molecule – call it a “vita-class.”

We know very little of what really goes on

While it’s fair to note the above description of curcumin and IL-10 (or everything on this site) as a gross oversimplification – I think it’s also fair to say that everything written on the immune system is grossly simplified – because we still know so very little of what really goes on ‘in there.’

No one could have guessed that curcumin would be found powerless in the absence of IL-10. And tomorrow something new will be discovered, and the day after, and the day after….

Curcumin just happens to be one of the better studied molecules – so at least we know a little. But curcumin certainly isn’t the only molecule that will be found to act in surprising ways. The interaction of curcumin and IL-10 is no doubt only one of a great many yet undiscovered examples of such synergistic cooperation.

The publication:

Summary of key findings:

• Chronic fatigue syndrome appears related to inflammation – at least of white blood cells.

• NF-kappaB recognized as the master switch controlling the inflammation relevant to chronic fatigue syndrome.

• Those with chronic fatigue syndrome have higher levels of activated NF-kappaB.

• More activated NF-kappaB results in (correlates with) more severe disease symptoms.

• Inflammation in the white blood cells plays an important role in chronic fatigue syndrome.

• Chronic fatigue syndrome might be effectively treated with agents that reduce NF-kappaB activation, such as anti-oxidants like turmeric (curcumin)

The publication:

Curcumin, or turmeric, is believed to have many beneficial effects relative to inflammation and disease. It is an inhibitor of NF-kappaB, but also affects other pathways and mediators of inflammation.

The publication:

Comments:

The only ‘problem’ with curcumin seems to be its low level of bio-availability. That is, not enough curcumin gets into the blood, and to the cells where it can exert its  beneficial effects.

Banjo delivers turmeric (and curcumin, its major active ingredient) trans-mucosaly. That is, the active ingredients are absorbed through the mucous membranes of the mouth. This is believed to substantially increase the bio-availability of all active agents, resulting in a much more effective product.

That’s why Banjo is provided as a lozenge that is held in your mouth until dissolved. Active ingredients coat the mucous membrane lining your mouth, and are absorbed through that mucous membrane while the lozenge dissolves.

If you prefer, the Banjo lozenge can instead be dissolved in water to make a great tasting ‘tea.’ By slowly sipping the tea you achieve the same effect, as the tea coats the membranes of your mouth, allowing active ingredients to be absorbed.

This method of administration bypasses the harsh environment of the stomach and avoids immediate destruction of active ingredients by the liver.

Active ingredients are very rapidly absorbed – directly into the bloodstream. That’s one reason why banjo acts so quickly. Significant relief from pain and inflammation often results within minutes.

Patients taking up to 8 grams of pure curcumin daily for 4 months reported no significant side effects.

The publication:

Comments:

The only ‘problem’ with curcumin is solved by a novel route of administration

The only ‘problem’ with curcumin seems to be its low level of bio-availability. That is, not enough curcumin gets into the blood, and to the cells where it can exert its  beneficial effects.

Banjo delivers turmeric (and curcumin, its major active ingredient) trans-mucosaly. That is, the active ingredients are absorbed through the mucous membranes of the mouth. This is believed to substantially increase the bio-availability of all active agents, resulting in a much more effective product.

That’s why Banjo is provided as a lozenge that is held in your mouth until dissolved. Active ingredients coat the mucous membrane lining your mouth, and are absorbed through that mucous membrane while the lozenge dissolves.

If you prefer, the Banjo lozenge can instead be dissolved in water to make a great tasting ‘tea.’ By slowly sipping the tea you achieve the same effect, as the tea coats the membranes of your mouth, allowing active ingredients to be absorbed.

This method of administration bypasses the harsh environment of the stomach and avoids immediate destruction of active ingredients by the liver.

Active ingredients are very rapidly absorbed – directly into the bloodstream. That’s one reason why Banjo acts so quickly. Significant relief from pain and inflammation often results within minutes.

The synovium is normally a very thin, smooth layer of cells that is closely attached to the membrane that encloses the joint and its synovial (lubricating) fluid.

In rheumatoid arthritis the synovium becomes thickened and develops finger-like projections extending out into the joint space. This thickening process is called “hyperplasia,”and typically leads to pannus formation. Pannus means “flap” – and the pannus in rhuematoid arthritis contributes to the joint destruction characteristic of that disease.

One reason the synovium may thicken is that old cells do not die as they are supposed to. So as new cells continue to be made, cells accumulate.

While it might seem strange that cell death is required to maintain health, such is often the case. This “programmed cell death” is called “apoptosis.”

The classic example of cells that do not die as they are supposed to is cancer. In cancer cells, the gene that programs for cell death (apoptosis) has somehow been turned off. So cancer cells live, and proliferate, forever.

The synovial cells in rheumatoid arthritis act like cancer cells in certain ways. They continue to reproduce and live ‘forever.’ They invade and destroy nearby tissue. And what’s ‘nearby’ is the cartilage of the joint capsule.

This, in brief, is how synovial hyperplasia leads to joint destruction. Of course preventing this hyperplasia would be a very good thing.

The publication:

Comments:

Curcumin was found to stimulate apoptosis – the programmed cell death that is required if synovial cells are to remain as a nice smooth layer and not build up into a joint-destroying pannus.That is, it seemed to make the synovial cells behave properly.

As something of a ‘side benefit’ – curcumin was found to inhibit COX-2 without affecting levels of COX-1. COX-1 is required for stomach protection. By inhibiting only COX-2 one would obtain the analgesic and anti-inflammatory benefits without the stomach-related (and kidney related) side effects common to aspirin and other NSAIDs.

The publication:

Comments:

Excess bone resorption is a characteristic of rheumatoid arthritis

Excessive osteoclastogenesis or activation of mature osteoclasts causes bone destruction. Excessive osteoclastogenesis is implicated as contributing to the pathology of rheumatoid arthritis and osteoporosis.

Prevention of excess osteoclast activity can be protective, especially in conditions like rheumatoid arthritis, characterized by excess bone resorption.

The present study suggests that dandelion and turmeric exert a bone protective effect the inhibition of NF-kB.

Increased collagen production and decreased matrix metalloproteinase-9 production may have implications in arthritis

While this study used a topical application to promote skin healing, especially after the application of topical corticosteroids, it may have implications beyond wound healing.

Matrix metalloproteinase-9 (which was shown in this study to be decreased) has been implicated in the pathogenesis of cancer, autoimmune disease, including rheumatoid arthritis, Sjögren’s syndrome, idiopathic uveitis, and systemic lupus erythematosus, as well as diverse pathologic conditions characterized by excessive fibrosis.

Corticosteroids may inhibit healing, as demonstrated on skin in this study. It may be that those using systemic corticosteroids could benefit from a topical composition of ginger and curcumin, though further studies would be needed to confirm this speculation.

It is noteworthy that this study confirmed, at least when topically applied to the skin, that ginger and turmeric (curcumin is a major component of turmeric) result in greater benefits when used in combination than was observed when either was used separately.

Banjo is composed of ginger, turmeric and additional plant extracts. It is not yet available in topical form, but that application is anticipated.

The publication: