Turmeric Supplements May Harm Your Liver, Says Washington Post

The Risks and Benefits of Turmeric Supplements for Liver Health

The Popularity of Turmeric Supplements

Turmeric is a plant with anti-inflammatory, antimicrobial, and anti-cancer properties that have been touted to act against various conditions, such as arthritis, respiratory infections, and diabetes. Despite the fact that clinical trials have yet to provide rigorous evidence to support these broad claims, turmeric remains one of the top-selling herbal supplements in the United States. Unfortunately, an alarming trend has emerged: turmeric supplements have been linked to a rising number of cases of acute liver injury, with some even leading to liver transplant or death.

Turmeric-Induced Liver Injury

“Turmeric-induced liver injury is considered rare — one in 10,000 or even 100,000 people who take it might get sick — but now, millions of people are taking turmeric,” said Jay Hoofnagle, director of the Liver Disease Research Branch in the Division of Digestive Diseases and Nutrition at the National Institutes of Health (NIH). “Based on what we’re seeing in our data, it’s one of the most common causes of dietary supplement liver injury.”

The Impact of Supplements on Liver Health

The modern preparation of the turmeric plant involves combining it with a genetic susceptibility to certain patients that is most likely the cause of liver injury. Supplements contain high-dose purified extracts of curcumin, the main active ingredient of turmeric that typically only makes up between 1 and 7 percent of the root. Many supplements also contain additives such as black pepper to promote the absorption of curcumin, which is typically poorly absorbed by the digestive tract. A study that gave human subjects 2 grams of curcumin could barely detect it in blood samples. But after adding black pepper, the fraction of curcumin that reached the bloodstream shot up by 2,000 percent.

“People today are taking 100 times more curcumin than what was used in traditional medicine,” Hoofnagle said. “I go to Costco and see these big bottles of turmeric with black pepper, a gram per serving, and I think, ‘Oh my goodness.’ “

The DILIN Report

Hoofnagle supervises the Drug-Induced Liver Injury Network (DILIN), an NIH-sponsored initiative that collects and analyzes cases of severe liver injury caused by drugs and alternative medicines. In 2022, the DILIN reported 10 cases of liver injury associated with turmeric supplements. The most common symptoms were jaundice, nausea, and abdominal pain. Of the 10 cases, five patients were hospitalized, and one patient died of acute liver failure. The researchers concluded that liver injury because of turmeric appears to be rising in the United States, and the increasing popularity of turmeric over the last five years seems to mirror the rise in reported cases collected by the DILIN. Cases have also been reported elsewhere in the world.

Genetics and Drug-Induced Liver Injury

Drug-induced liver injury, which can be classified as either direct or idiosyncratic, is the most frequent cause of acute liver failure in most Western countries. Direct injury is predictable, dose-dependent, and caused by agents that are intrinsically toxic to the liver, such as acetaminophen. Idiosyncratic injury, on the other hand, only affects susceptible individuals, and the responsible agents have little to no intrinsic toxicity.

For example, women are more prone to drug-induced liver injury than men because of differences in hormonal status, body composition, metabolism, and other factors. African American patients may be prone to more severe liver injury and worse disease outcomes, such as liver transplant or death, after drug-related liver injury than White patients.

Genetics also play a part. Certain genes encode for enzymes involved in drug processing. After a drug is ingested, it gets absorbed by the gastrointestinal tract and taken up by the bloodstream. The first place it goes is the liver, whose job it is to remove toxins and metabolize drugs using specific enzymes.

The study by the DILIN also found that 7 of the 10 patients carried a genetic variant, found in only 10 percent of the U.S. general population, that may have increased their susceptibility to turmeric-associated liver injury.

Conclusion

Both health-care providers and consumers should be aware of the possible risks before taking turmeric as a supplement. Some experts believe taking turmeric as a supplement should be avoided altogether, since its purported benefits do not outweigh the risks. Other experts recommend informing doctors of its use so that monitoring can be done if needed, and physicians should regularly ask patients if they are taking any medications or supplements that can be purchased over-the-counter.

Originally Post From https://www.washingtonpost.com/wellness/2024/06/25/turmeric-supplements-may-harm-liver-some-people/