Should I take curcumin?

Paul Saladino advised twice against consuming high amounts of curcumin from supplements, powders, or golden milk due to the high oxalate load. He also stated that curcumin supplementation had no effect on serum total LDL cholesterol, triglycerides, and HDL-C levels in a 2013 study, and that curcumin has variable and extremely low systemic bioavailability when dosed orally, even at maximum tolerated doses. Paul Saladino cautioned twice that turmeric should not be used to address inflammation, as it may have negative side effects like lowering androgens. He also noted that curcumin showed no significant effect on psoriasis index in a prospective clinical trial that was not randomized, and that no double-blind, placebo-controlled clinical trial of curcumin has been successful, according to a 2017 paper. Andrew Huberman generally does not recommend high-dose curcumin supplements, though cooking with curcumin is acceptable. Paul Saladino pointed out that curcumin has activity against the hERG channel, which is associated with potential cardiac toxicity. Andrew Huberman stated three times that turmeric supplementation can significantly reduce DHT levels and negatively impact feelings of vitality, and twice that individuals with low DHT levels or androgen receptor insensitivity should avoid bioavailable curcuminoids and black pepper extract. Andrew Huberman also noted five times that curcumin is a potent inhibitor of dihydrotestosterone (DHT), which can lead to reductions in libido in sensitive individuals. Paul Saladino reported that curcumin doses ranging from 0.9 to 3.6 grams per day for one to four months can cause adverse effects including nausea, diarrhea, and an increase in serum alkaline phosphatase and lactate dehydrogenase. He also mentioned that a 2018 double-blind randomized placebo-controlled pilot study showed changes in the gut microbiota when turmeric was administered, but the clinical significance or benefit of these changes is unknown. Paul Saladino emphasized three times that turmeric's anti-inflammatory properties do not fix the underlying problem causing inflammation. Paul Saladino also noted twice that turmeric was found to cause dose and time-dependent induction of chromosomal aberrations in mammalian cell lines at concentrations of 10 micrograms/ml in 1976. He also stated that curcumin shows cytotoxicity against normal human lymphocytes in addition to cancer cells, and that curcumin concentrations of 2.5 and 5 micrograms/ml have been shown to induce DNA damage to both mitochondrial and nuclear genomes in cells. Paul Saladino described the chemical structure of curcumin, containing two alpha-beta unsaturated ketones, mediates a Michael addition reaction that can generate reactive oxygen species, irreversibly modify antioxidant enzyme thioredoxin reductase, induce topoisomerase II-mediated DNA damage, and inactivate the tumor suppressor gene p53. He also mentioned that large doses (8-12 grams/day) of curcumin can cause adverse events like diarrhea, rash, and headache in up to 30% of participants, while lower doses are likely benign. Andrew Huberman noted twice that curcumin can inhibit cytochrome P450, requiring caution for individuals taking anticoagulant medications, and twice that some individuals are sensitive to curcumin, experiencing a reduction in DHT which can negatively impact libido, drive, aggression, and mood. Andrew Huberman also stated that curcumin has potent anti-inflammatory properties that can potentially blunt adaptation responses to exercise. Paul Saladino questioned the benefit of plant compounds like curcumin for healthy individuals eating meat and organs, despite their potential anti-inflammatory effects.

The verdict could change with more successful double-blind, placebo-controlled clinical trials demonstrating curcumin's efficacy and safety, particularly for systemic effects. Further research clarifying the clinical significance of gut microbiota changes and the long-term impact on androgen levels would also be influential. Additionally, studies addressing the underlying causes of inflammation rather than just symptomatic relief would be valuable.