Turmeric (curcumin) shown to improve 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. Why might that be?

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

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Bright JJ., Adv Exp Med Biol. 2007;595:425-51.

Curcumin and autoimmune disease

Summary of the abstract

A breakdown in the immune system often results in infection, cancer, and autoimmune diseases. Multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease, myocarditis, thyroiditis, uveitis, systemic lupus erythromatosis, and myasthenia gravis are organ-specific autoimmune diseases that afflict more than 5% of the population worldwide.

Although the etiology (cause) is not known and a cure is still wanting, the use of herbal and dietary supplements is on the rise in patients with autoimmune diseases, mainly because they are effective, inexpensive, and relatively safe.

Curcumin is a polyphenolic compound isolated from the rhizome of the plant Curcuma longa (turmeric) that has traditionally been used for pain and wound-healing. Recent studies have shown that curcumin ameliorates (improves, helps with) multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease in human or animal models.

Curcumin inhibits these autoimmune diseases by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways in immune cells.

Although the beneficial effects of nutraceuticals are traditionally achieved through dietary consumption at low levels for long periods of time, the use of purified active compounds such as curcumin at higher doses for therapeutic purposes needs extreme caution. A precise understanding of effective dose, safe regiment, and mechanism of action is required for the use of curcumin in the treatment of human autoimmune diseases.

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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 author’s 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 (e.g. as used in Banjo) is a better, more effective, safer alternative. I also don’t think that “higher doses” are required. But if you think they are, you can purchase essentially pure curcumin – today – in any health food store. Thousands use curcumin each day, and there are no significant side effects associated with its use.

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 require that the precise mechanism of action be known as a condition of new drug approval. They do require a showing of “safety and efficacy.”

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 many conditions for which it has been shown effective.

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

So it’s not just that you might 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 this might be the greatest new drug in the last 50 years (or ever?) 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 would not 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 its use. 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 would not be fair.