Happy to be Hurting:  Curcumin evaluations

Jacob Schor ND

June 19, 2009

Luckily I’ve got one messed up shoulder that pretty much hurts me all the time.  I take that view because this shoulder is going to provide me the solution to one painfully frustrating intellectual dilemma that has been troubling me for months.

It’s got to do with curcumin, the concentrate of the spice root turmeric.  I’ve been reading and writing about the health benefits of curcumin for years.  If even half of what I’ve written and a quarter of what I read is true, curcumin is the panacea of our time.  It prevents and cures cancer, Alzheimer’s disease, cardiovascular disease and just about anything else you care to name.

The problem with curcumin though is it never works as well in people as it does in test tubes.  That’s because it is barely absorbed from the human intestine into the blood.  It is difficult if not impossible to reach the same tissue saturation levels as used in the experiments. 

A number of approaches have been taken to overcome these absorption challenges.  The simplest is to use bigger and bigger doses.  MD Anderson’s pancreatic cancer trial published last year had patients consuming 8 grams a day of curcumin.  Another approach is to blend curcumin with fat that supposedly aids absorption.  Thus we have recipes for coconut cream curcumin, curcumin guacamole, and peanut butter curcumin.

In the last year nutritional supplement companies have launched several new curcumin based products.  Each through some proprietary trick in processing is supposed to be far superior to all prior products because it is much better absorbed.  This is great news.  The problem for me has been which to offer our patients.

I have spent the last several months gathering and reading the ‘data’ from the various sellers in the hope of comparing these ‘new’ curcumins and determining which will be most effective.  This is the source of my frustration.

Most product advertisements have relied on data from what are known as ‘in house’ studies that have not been published in journals.  Only two of the new products have data published in peer reviewed journals that support the claims of greatly enhanced absorption.  They are a product from India referred to as BCM-95 and a product developed UCLA by researchers Sally Frautschy and Greg Cole.  There are other products though that may be equally promising; winning the race to publication does not guarantee the superior product. 

Even is we give credibility to the unpublished studies the various companies are using to bolster their advertising claims, they do little to help us determine which is the better product.  Comparing the data from the studies is near impossible.  There seems to be no accepted methodology for testing or reporting curcumin absorption.  UCLA in their study are the most forthcoming reporting nanomolar quantities in serum, plasma and red blood cell levels in both animal and human subjects.  Additionally they report the amounts of curcumin found within the brain, in this case animal subjects only.  Reports on other products are in nanograms per milliter (ng/ml) and some report being plasma levels or whole blood levels.  For those of you curious, the conversion is 1 micro mole  curcumin = 370 ng/ml.  If this wasn’t frustrating enough, the data reported for absorption of even  the ‘control,’ that is the plain old-fashioned curcumin was all over the place.  UCLA reports achieving plasma levels of 0.023 micromole (8.61 ng/ml) for their ‘control’ curcumin.  Thorne Research reports their control product tested at only about 3 ng/ml.  Albi a company in British Columbia that imports the Indian BCM-95 reported a level of 200 ng/ml.  This is testing the same control version of curcumin.  With this sort of discrepancy on the known products, how do we interpret the data on the ‘new products?’

One way that I toyed with was to look at each study in isolation and simply ask how much better absorbed it the new product compared to the old product?  This provided grounds for comparison.  For example the data on BCM-95 suggests it is 6-7 times more absorbable and data on the UCLA product suggests it may be as much as 48 times more absorbable.  In the end I decided that we could not accurately compare data, at least until such a time when we have a published study comparing these different products under the same circumstances using the same methodology.

So where does that leave us, besides confused and frustrated?  I sat through a sales presentation last week by Alan Miller, ND, a technical sales guy from one of our big suppliers, Thorne Research.  He waxed poetical about his company’s new curcumin product that perhaps has the prettiest name of any of these new products.  They call it Meriva and tout a proprietary technique they use that marries molecules of curcumin to molecules of phophatidylcholine.  This is their ‘trick’ to greatly enhancing absorption.  I’d already read this information on the company’s website.  What Alan told me that perked my attention were a series of case histories of patients he had treated with Meriva. 

Dr. Miller related cases of three different patients with histories of long standing and chronic pain.  In each case, the patient’s response to taking fairly large doses of Meriva for two days was outstanding.  I was excited hearing about this.  Not just because these stories made Meriva sound like promising but because this offered a simple way for us to judge which might be the best product to use.

We need some way to discriminate between products to see which might be best absorbed.  Many of the conditions for which we use curcumin are not easily assessed over the short term.  Pain relief gives us a simple way to judge.  That’s where my painful shoulder comes into this story.

Following Dr. Miller’s suggested protocol I tried taking 12 capsules of Meriva per day for two days.  Yesterday, I had to admit that my shoulder bothered me less than usual, probably the I experienced less pain than any day in the last 6 or 7 months.  That made me happy, but more so, the idea that we might be able to compare these products without fancy studies and worrying about nanogram to micromole conversions has made me very happy.

Here’s the plan.  We’re going to order in a number of these different products.  We’re going to try them out for pain relief.  We’re going to encourage patients to keep track of how effective each product is by having them fill out a short questionnaire after taking the product.  In order to encourage patients to try out different products we will offer a  discount on the next bottle of curcumin they purchase when the give us a completed questionnaire.  The discount will be 5% for another bottle of the same product and 10% to try a different curcumin product.