Turmeric Dosage: How much turmeric should I take daily?

INTRODUCTION

Turmeric is known for its vibrant yellow color and unbelievable health benefits. Interestingly, curcumin, the component of turmeric that gives turmeric its characteristic color, also happens to be the component credited for nearly all the health benefits of turmeric. Though estimates vary, it has been established that curcumin accounts for roughly 3-4% of the mass of turmeric. With curcumin in the spotlight, many supplement companies isolate and sell curcumin, ignoring the other components of the turmeric root. There is a bit of a problem, however. Curcumin is poorly absorbed and quickly metabolized. To combat this problem, many supplement producers also employ mechanisms to enhance the bioavailability of curcumin. The most common example is the addition of piperine, a component of black pepper that accounts for approximately 5% of black pepper’s mass. Research has demonstrated that the co-administration of 20 mg of piperine (or around 400 mg of black pepper) boosts the bioavailability of curcumin by 20X. However, this is merely the tip of the iceberg. Prasad et al. (2014) identified 46 different bioavailability-enhanced curcumin formulations. While bioavailability-enhancing mechanisms may represent a prime opportunity for supplement companies to establish a unique selling proposition, a good pharmacist would ask this question: Is it safe to take a spice like turmeric, known for its surprising health benefits, isolate the component credited for all the health benefits, administer that component in massive doses, and then boost that component’s availability in the bloodstream by 20X? Let’s try to find out.

HOW MUCH TURMERIC IS TOO MUCH?

According to Cao et al. (2006), curcumin possesses both pro-oxidative and antioxidative effects. The desirable antioxidative effects are enjoyed at low doses, whereas the potentially carcinogenic DNA-damaging pro-oxidative effects are seen at high doses. According to Cao et al. (2006), mitochondrial DNA damage was seen in vitro at curcumin concentrations of 5 µM. I’ll explain how that translates into a standard milligram-based dosage in a minute. However, given that DNA damage can give rise to cancer, it may be wise to ensure that our dose does not exceed a more conservative limit (e.g., a peak serum curcumin concentration of < 2.5 µM).

The concentrations cited above (e.g., 5 µM) are based on in vitro testing. How do we translate these numbers into oral dosages? In research conducted by Cheng et al. (2001), it was demonstrated that an 8-gram dose of curcumin produced an average peak serum concentration of 1.77 µM in human subjects. The highest serum concentration of curcumin produced by an 8-gram dose of curcumin in this study was 3.64 µM, which exceeds our conservative limit of 2.5 µM. Meanwhile, a 6-gram dose of curcumin yielded an average peak serum concentration of 0.63 µM (no single subject measured a peak greater than 0.69 µM on this dose). Based on currently available information, this dose (6 grams of curcumin) represents what is very likely to be at the upper limit of a non-damaging dose (with regard to mitochondrial DNA).

Since 1 gram of turmeric contains around 40 mg of curcumin, one would need to consume 150 grams of turmeric daily to achieve the equivalent of 6 grams of daily curcumin intake. Alternatively, consuming 7.5 grams of turmeric and 400 mg of black pepper could accomplish the same result. I am not recommending this.

HOW MUCH TURMERIC DO THE PEOPLE OF INDIA CONSUME?

The people of India have been consuming turmeric as a spice for thousands of years. India produces nearly all the world’s turmeric and consumes around 80% of it. So, a second logical reference point is the average daily amount of turmeric consumed per person in India. According to Amalraj et al. (2016), in India, the average person consumes 2-2.5 grams of turmeric daily. According to Uma et al. (1993), in India, the average person also consumes 330 mg of black pepper daily. It would probably be a stretch to assume that all this turmeric and black pepper consumption is occurring simultaneously. It’s more likely that some of this black pepper is consumed simultaneously with the turmeric, and some is consumed separately. However, assuming it was all consumed together, we would expect a nearly 20X boost in curcumin bioavailability from black pepper’s piperine content.

If each gram of turmeric contained 40 mg of curcumin, then 2.5 grams of turmeric would contain 100 mg of curcumin. When factoring in the potential 20X bioavailability boost provided by piperine, that would be equivalent to 2 grams of daily curcumin intake. It’s safe to assume that such a dose is, at the very least, not overtly harmful.

According to Cheng et al. (2001), “In humans receiving a dose of 2 grams of curcumin alone, serum levels of curcumin were either undetectable or very low.” I think that further supports the idea that 2 grams of daily curcumin intake alone (or its equivalent; for example, 100 mg of curcumin + 20 mg of piperine) may be safe long-term.

TURMERIC DOSES PROVEN TO BE THERAPEUTIC IN THE SHORT-TERM

Can you determine the “best dose” of turmeric (or curcumin) by reading published studies? Not easily because the formulation varies from one study to another. For instance, many of the studies are funded by companies attempting to produce evidence that their product is effective. Usually, these products are proprietary extracts of turmeric. Because the curcumin content can vary widely between these products, it is challenging to convert the doses given in the respective studies to a standard turmeric dose. Here are two examples of published studies designed to compare turmeric extracts to over-the-counter pain medications for arthritis pain. Kuptniratsaikul et al. (2014) found that, over a 4-week period, a total daily dose of 1.5 grams of a particular turmeric extract was at least as good as ibuprofen 1,200 mg/day for osteoarthritis of the knee. Another study by Singhal et al. (2021) found that, over a 6-week period, 1 gram of a bioavailability-enhanced turmeric extract was at least as good as acetaminophen 1.95 grams/day for osteoarthritis of the knee. Keep in mind that these are relatively short-term studies. Whether these products are safe and effective long-term remains an open question.

While it is prohibitively difficult to convert the above-referenced turmeric extract doses to “regular” turmeric doses, we can assume that any given bioavailability enhancement will boost curcumin levels somewhere in the ballpark of 2-40X (Zhongfa et al., 2012), which happens to be in the general vicinity of 20 mg of piperine (which has boosts curcumin absorption by 20X). That being the case, I find it interesting that the doses selected for these and other studies would be expected to produce serum curcumin levels very near or slightly below those achieved by the average person in India.

THE DANGER OF HIGH-BIOAVAILABILITY CURCUMIN SUPPLEMENTS

I think it has been established over the course of thousands of years that turmeric is perfectly safe as a spice in cooking. The question is: are bioavailability-enhanced curcumin formulations safe? There are certain formulations I think would pose a danger. The most obvious is the nano-emulsion curcumin (NEC) formulation detailed in the paper by Zhongfa et al. (2012). This formulation boosted the peak plasma concentration of curcumin by 40X in mice. Now, let’s assume there is an equivalent effect in human subjects. A typical dose for a curcumin supplement is 500 mg. Keep in mind already that 500 mg of curcumin is equivalent to approximately 12.5 grams of turmeric. That’s quite a lot. Now, take into account that the NEC formulation may boost peak levels of curcumin by 40X, and we’re looking at the equivalent of 20 grams of curcumin (or 500 grams of turmeric). Such a dose would produce peak serum concentrations well beyond the previously estimated safe upper limit of < 2.5 µM. Even a 500 mg dose of curcumin with 20 mg of piperine would be expected to exceed this level.

CONCLUSION

Avoid turmeric extracts and bioavailability-enhanced curcumin supplements. Instead, opt for fresh turmeric root or turmeric powder supplied by a trusted source. Consume about 1-2 grams (~1/4 teaspoonful) of turmeric per day, and consider adding up to ¼ teaspoonful of black pepper to boost curcumin absorption.

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REFERENCES

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Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J. 2013;15(1):195-218. doi:10.1208/s12248-012-9432-8

Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998;64(4):353-356.

Cheng AL, Hsu CH, Lin JK, et al. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001;21(4B):2895-2900.

Prasad S, Aggarwal BB. Turmeric, the Golden Spice: From Traditional Medicine to Modern Medicine. In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 13. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92752/

Amalraj A, Pius A, Gopi S, Gopi S. Biological activities of curcuminoids, other biomolecules from turmeric and their derivatives – A review. J Tradit Complement Med. 2016;7(2):205-233. Published 2016 Jun 15. doi:10.1016/j.jtcme.2016.05.005

Uma Pradeep K, Geervani P, Eggum BO. Common Indian spices: nutrient composition, consumption and contribution to dietary value. Plant Foods Hum Nutr. 1993;44(2):137-148. doi:10.1007/BF01088378

Prasad S, Tyagi AK, Aggarwal BB. Recent developments in delivery, bioavailability, absorption and metabolism of curcumin: the golden pigment from golden spice. Cancer Res Treat. 2014;46(1):2-18.

Zhongfa L, Chiu M, Wang J, et al. Enhancement of curcumin oral absorption and pharmacokinetics of curcuminoids and curcumin metabolites in mice. Cancer Chemother Pharmacol. 2012;69(3):679-689. doi:10.1007/s00280-011-1749-y

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. Clin Interv Aging. 2014;9:451-458. Published 2014 Mar 20. doi:10.2147/CIA.S58535

Singhal S, Hasan N, Nirmal K, et al. Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol. Trials. 2021;22(1):105. Published 2021 Jan 30. doi:10.1186/s13063-021-05053-7

Haq IU, Imran M, Nadeem M, Tufail T, Gondal TA, Mubarak MS. Piperine: A review of its biological effects. Phytother Res. 2021;35(2):680-700.

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