Also known by these names
Curcumin is the major constituent and the active component in turmeric, a seasoning used frequently in Indian and other South Asian cuisines and a main ingredient in curry powder.
Curcumin is not readily absorbed by the intestine,1 but consumption with either pepper or fats is noted to increase absorption.2 However, some sources advise taking turmeric supplements on an empty stomach. Some sources also advise caution in using piperine (the active ingredient in pepper) with certain prescription medications and/or long-term, as described below. Differing advice may derive from different formulations in supplements.3
Solutions are being developed to increase absorption. Consult your physician and the directions on a supplement for guidance. Examples:
- The Meriva formulation has greatly increased oral absorption in humans and metabolizes to a potent derivative.4
- Nanoformulations in colorectal cancer treatment have successfully enhanced water solubility, delivery and efficacy in preliminary studies.5
- A 2016 study found that a 40 percent guar gum and curcumin formulation showed better release of curcumin directly into the colon.6
- A liposomal form of curcumin—in which an extract of pure curcumin is placed into a small bubble made of at least one lipid (fatty) layer resembling the wall of a cell—is available. Studies of liposomal curcumin have shown greater effects inhibiting tumor growth and promoting apoptosis (programmed cell death) with cancer cells.7
- Other curcumin derivatives have been developed to increase absorption and show promising laboratory effects.8
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Preliminary findings from many small and uncontrolled studies indicate that curcumin is effective in treating cancer.9
- Clinical evidence of treatment effects is still very limited10 and available only with colorectal cancer.11
- In several small trials in humans, curcumin has shown anticancer effects with some—but not all—patients with several types of cancer.12
- Curcumin reduced disease markers in small studies:
- Cervical neoplasia13
- Colorectal cancer:
- Multiple myeloma16
- Pancreatic cancer17
- Prostate cancer (in combination with soy isoflavones)18
Lab and Animal Evidence
Some evidence indicates that curcumin is a tumor chemosensitizer and radiosensitizer—making tumor cells more sensitive to chemotherapy or radiation—while simultaneously protecting normal organs from these therapies.
- Curcumin has been shown to restore or promote certain gene expression or activity that suppresses cancer cell growth, survival and resistance to chemotherapy agents.42
- Curcumin has sensitized tumors to chemotherapeutic agents including these:
- Curcumin reduces multidrug resistance and dose-limiting cytotoxicity of 5-Fluorouracil (5-FU)..43
- Curcumin sensitizes pancreatic cancer cells to gemcitabine.44
- Curcumin potentiated the effect of bortezomib against human multiple myeloma.45
- Chemosensitization has been observed in cancers of the breast, colon, pancreas, stomach, liver, blood (leukemia, lymphoma and multiple myeloma), lung, prostate, bladder, cervix, ovary, head and neck, and brain..46
- Curcumin has enhanced the toxicity of oxaliplatin in malignant cells.47
- In cell lines, curcumin made pancreatic cancer cells more sensitive to the chemotherapy drug gemcitabine.48
- Curcumin induced toxic effects in paclitaxel-resistant cancer cells.49
- In rodent trials, curcumin has enhanced the effects of the chemotherapy drugs paclitaxel, docetaxel and etoposide.50
- Curcumin can sensitize a variety of tumors to gamma radiation: brain cancers (glioma and neuroblastoma), cervical carcinoma, epidermal carcinoma, prostate cancer, and colon cancer.51
- Curcumin sensitized prostate cancer cells to radiation.52
Protection against Chemotherapy and Radiotherapy
- Curcumin protects normal organs such as liver, kidney, oral mucosa, and heart from chemotherapy and radiotherapy-induced toxicity.53
- In rats, curcumin has made tumor cells more sensitive to the impacts of chemotherapy and radiotherapy while making non-cancerous cells less sensitive to these therapies.54
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Small trials show curumin is effective in promoting wellness, improving quality of life and reducing symptoms.55
- Curcumin attenuated several side effects of chemo- and radiotherapy, and was protective of the liver56
- Curcumin reduced the severity of radiation dermatitis in breast cancer patients, although not all studies have found a significant effect.57 A topical cream containing turmeric and sandalwood oil [Vicco(®) significantly reduced radiodermatitis in a pilot study.58
- A study of 160 cancer patients undergoing either chemotherapy or radiotherapy assessed whether a proprietary delivery system of curcumin (Meriva®) reduced treatment symptoms such as nausea, constipation, diarrhea, weight loss, soreness and ulceration. Those receiving the curcumin treatment reported a significant reduction in symptoms compared to a control group.59
- Much milder urinary symptoms were seen in prostate cancer patients undergoing external beam radiotherapy in a small pilot study.60
- Curcumin decreased depression among non-cancer patients with major depressive disorder.61
- Curcumin increased body weight in colorectal cancer patients after diagnosis and before surgery62 and in general.63
- Curcuminoids improved health-related quality of life scores in patients with solid tumors who were under standard chemotherapy regimens.64
- Curcumin lowered total cholesterol levels in patients at risk of cardiovascular disease,65
- Curcumin improved health-related quality of life,66 including in patients with solid tumors under standard chemotherapy regimens67
- Prevented cachexia (weakness and wasting) and increased body weight in colorectal cancer patients after diagnosis and before surgery68
Lab and Animal Evidence
Reducing the risk of developing cancer or the risk of recurrence
- Curcumin is a chemopreventive agent in colon, urinary bladder and pancreatic cancer, cervical neoplasia and other conditions.73
- Curcumin interfered with breast cancer proliferation in both preclinical and clinical studies74
- Effects seen in colorectal cancer:75
- Suppressed adenomas and polyp numbers and size in patients with familial adenomatous polyposis (FAP) when used with quercetin
- Reduced aberrant crypt foci (ACF) formation in smokers
- Curcumin treatment in West Bengal, India, was shown to have some protective role against the DNA damage caused by arsenic.76
Lab and Animal Evidence
Optimizing Your Terrain
Creating an environment within your body that does not support cancer development, growth or spread
- Curcuminoids showed anti-inflammatory effects in patients with solid tumors who were under standard chemotherapy regimens.85
- The Meriva formulation decreased oxidative stress and systemic inflammation in patients with solid tumors undergoing chemotherapy.86
- Curcumin decreased serum TNF-α level and enhanced the expression of p53 in tumor tissue in patients after diagnosis and before surgery87
- Curcumin can improve insulin signaling,88 and a clinical trial showed that it reduced the development of diabetes among prediabetic individuals.89
Lab and Animal Evidence
Foods containing curcumin—turmeric and curry powder—are widely available in grocery stores. Supplements containing cucumin or turmeric powder are also widely available.
Curcumin is generally regarded as safe by the US Food and Drug Administration (FDA). Epidemiological evidence and several clinical trials confirm the safety of curcumin up to 12 grams per day over several months.97 However, compounds in curcumin can bind to iron and reduce iron's availability, a concern to people with anemia or iron-storage problems. Iron levels may need to be monitored with curcumin supplement use.98
Preliminary clinical evidence shows that cucrumin may slightly reduce the effectiveness of tamoxifen. In a study of breast cancer patients, researchers in the Netherlands gave tamoxifen with or without curcumin 1200 mg three times a day. The group taking tamoxifen in combination with curcumin had about an 8 percent decrease in endoxifen levels. If the curcumin was compounded with piperine (often done to substantially improve curcumin absorption), endoxifen levels were further decreased by 12 percent.99 Read more about this study and implications for use during tamoxifen treatment in the Commentary section below.
Naturopathic oncologist and BCCT advisor Dr. Lise Alschuler cautions that curcumin should not be taken with some drugs (cyclophosphaide, anastrozole, exemestane, letrozole or erlotinib, or therapeutic doses of warfarin),100 and the TRC Natural Medicines database lists several interactions with chemotherapy drugs, diabetes medications and other drugs that lower blood sugar, estrogens, drugs that slow blood clotting, and other drugs. Medical supervision is recommended at doses higher than those typically found in foods.
Curcumin can interfere with certain liver detoxification enzymes and interact with substrates of drugs. It also has antiplatelet properties, possibly increasing the risk of bleeding in those on anti-clotting drugs. It can interact with chemotherapy drugs such as cyclophosphamide and doxorubicinc can interfere with CYP450 enzymes and may interact with substrate drugs.101
Side effects are mostly associated with doses higher than four grams per day:102
- Mild and self-resolving gastrointestinal disturbances such as loose stools, reflux, bloating and abdominal discomfort.
- Inhibited sperm motility in cell studies
- Inhibited synthesis of hepcidin (an iron -regulatory hormone), resulting in a dose-dependent drop in hematocrit, hemoglobin, serum iron and transferrin saturation especially in those with a subclinical anemia or iron deficiency. Curcumin should therefore be taken with caution among those with marginally low iron stores or other diseases associated with iron such as anemia of chronic disease. Similarly, curcumin may possibly contribute to iron chelation, with the potential to cause a clinical or subclinical iron deficiency anemia.
- Transient rise in liver enzymes
- Suppressed platelet aggregation
- Contact dermatitis, urticaria
- Don’t use turmeric if you have gallstones, bile duct dysfunction, hyperacidity, or stomach ulcers..
- Pregnant or lactating women shouldn’t use turmeric supplements without their doctors’ approval.
- In rare cases, extended use can cause stomach upset or heartburn.
- Piperine can slow the elimination of some prescription drugs including phenytoin (Dilantin), propranolol (Inderal), and theophylline. Some evidence also suggests that curcumin can interfere with certain chemotherapy drugs used to treat breast cancer, so if you’re being treated for this disease, be sure to discuss the advisability of taking curcumin with your physician.
BCCT does not recommend therapies or doses, but provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.
Dosage recommendations are available from these sources:
- Solutions 4 Health:
- Bladder Cancer Wellness Plan
- Breast Cancer Wellness Plan
- Colorectal Cancer Wellness Plan
- Leukemia Wellness Plan
- Lung Cancer Wellness Plan
- Lymphoma Wellness Plan
- Prostate Cancer Wellness Plan
- Thyroid Cancer Wellness Plan
- Natural Medicines Database (requires purchase)
- See also the protocols listed below.
Integrative Programs, Protocols and Medical Systems
|For more information about programs and protocols, see our Integrative Programs and Protocols page.|
- Programs and protocols
- Alschuler & Gazella complementary approaches104
- Bastyr University Integrative Oncology Research Center protocol for stage IV breast cancer105
- Block program106
- Anti-inflammatory terrain modifier
- Coagulation terrain modifier
- Surgical support program (wound healing)
- Radiation support program (mucositis)
- Post-treatment program (targeting cancer progression pathways)
- Rehabilitation program (reducing inflammatory response)
- Targeted molecular therapies
- Chemopreventive (breast, colon and pancreatic cancers, melanoma)
- As a targeted therapy when other treatment isn't working
- Lemole, Mehta & McKee protocols107
- MacDonald breast cancer program108
- Marsden Centre109
- McKinney protocols110
- General cancer
- Breast cancer
- Bladder cancer
- Brain/nerve cancer
- Carcinoid/neuroendocrine cancer
- Cervical cancer
- Colorectal cancer
- Esophageal cancer
- Gallbladder cancer
- Head and neck cancer
- Kidney cancer
- Liver cancer
- Lung cancer
- Myelodysplastic syndrome
- Ovarian cancer
- Stomach cancer
- Thyroid cancer
- Traditional systems
Based on safety and scientific evidence, most naturopathic physicians include curcumin/turmeric in their core protocol for reducing the risk of cancer relapse in patients who have received primary conventional treatment.111
BCCT advisor Dr. Andrew Weil advises: “Neither curcumin nor turmeric taken orally is well absorbed unless taken with black pepper or piperine, a constituent of black pepper responsible for its pungency. When shopping for supplements, make sure that the one you choose contains black pepper extract or piperine.”112 However, both Dr. Weil and naturopathic oncologist Lise Alschuler caution that use of piperine may interact with a wide range of prescription medications. Dr. Alschuler does not advise long-term use of piperine.113
Karen Collins, MS, RDN, CDN, FAND, January 23, 2018: The vast majority of studies on turmeric/curcumin have been in cell studies and rodent studies, and mostly with amounts that are unlikely to be consumed in humans who simply add turmeric as a culinary spice. Human studies are really limited.
I've seen one human study show reductions in TNF-alpha (the inflammatory signaling protein) with only 150 mg of curcumin/day—but I'm not sure how to translate the TNF-alpha change as to whether it was clinically significant. Other studies I've seen and as reviewed in the Natural Medicines Database tend to use 1000 to 4000 mg/day of curcumin (and some studies use much more).
Many are aware that tamoxifen is what we call a pro-drug. A pro-drug is ineffective until specific enzymes in your body activate it. Tamoxifen is metabolized to endoxifen, the effective drug that prevents ER+ breast cancer patients from relapse.
An enzyme called CYP2D6 is responsible for the magic that changes tamoxifen to endoxifen. The activity of this enzyme varies from individual to individual. Part of the variance is due to genetics—some people are born with hyperactive CYP2D6; others have an enzyme that is very sluggish. Many medications—antidepressants like fluoxetine (Prozac), paroxetine (Paxil) and citalopram (Celexa) amongst a host of others—as well as assorted foods and dietary supplements can either activate or slow down CYP2D6.
When this information first started causing a stir in the breast cancer world roughly 10 years ago, researchers hypothesized that taking tamoxifen with a CYP2D6 inhibitor would cause a increase in breast cancer relapse. As it turned out, further clinical research did not bolster this theory,114 leading to a new one: genetics, drugs and dietary intake have complex interactions with the body’s enzyme system. They activate some enzymes and inhibit others. This results in a variable net effect on the concentration of important drugs. In a 2016 study, the cause of low endoxifen levels could not be identified over 50 percent of the time.115
Non-cancer Uses of Curcumin
BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
Written by Nancy Hepp, MS, with review by Laura Pole, RN, MSN, OCNS; last updated on January 14, 2020.
- CAM-Cancer: Curcumin
- Memorial Sloan Kettering Cancer Center’s About Herbs: Turmeric
- Lone Star Medical Group Health Library: Turmeric
- Nelson KM, Dahlin JL et al. The essential medicinal chemistry of curcumin. Journal of Medicinal Chemistry. 2017 Mar 9;60(5):1620-1637.
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
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