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Do Turmeric Supplements Have a Downside?

Many people take turmeric supplements for their anti-inflammatory benefits, but a recent case shows that such pills can also trigger autoimmune hepatitis.
Do Turmeric Supplements Have a Downside?
Top view turmeric capsules in plastic cup isolated on white background

The yellow spice turmeric is extremely popular both as a food ingredient and as a supplement. When it is used to flavor food like yellow mustard or curry, turmeric is considered safe. Some case reports demonstrate, however, that not everyone tolerates turmeric supplements well. One story comes from a reader of this column.

Turmeric Led to Severe Anemia:

Q. I’m a retired nurse practitioner who began taking turmeric supplements almost two years ago for chronic sciatica, after my friend (another NP) had great luck with it for the same condition.

The supplement I took gave me significant relief. Then suddenly, after taking it for about a year and a half, I experienced debilitating fatigue. I thought my hypothyroidism was acting up, but a CBC showed I was significantly anemic with a ferritin level of 6 and a hemoglobin (Hgb) of 10. The previous year my Hgb was 15.

I was quite surprised and worried. I stopped my 81mg aspirin and began taking iron supplements on my doctor’s advice. However, six months of daily supplementation only raised my ferritin level to 9.8. A complete workup, including endoscopy, was negative, and I was discouraged that I couldn’t get my ferritin level higher.

All this time, I continued to take turmeric. Then I discovered a case study of a patient who developed anemia on high dose turmeric. The authors note that turmeric binds iron in the gut.

I stopped the turmeric supplements as soon as I read the article but continue to take my iron supplements. We’ll recheck the labs in a few months. You may want to warn your readers.

The Science on the Side Effects:

A. Thanks for the alert. We found the case report that got your attention (Cureus, Jan. 9, 2019).  As a result, safety assessments of curcumin now look for anemia as well as changes in liver enzymes and renal function (Toxicology Reports, June 16, 2021).

Pros and Cons of Turmeric Supplements:

Many people like to take turmeric supplements because they appear to have anti-inflammatory activity. Others find turmeric or its active ingredient curcumin can ease psoriasis. Curcumin has been shown to deter colorectal cancer. It also seems to act against certain types of breast cancer (Bioimpacts, online March 5, 2018). Studies show that turmeric and curcumin lower cholesterol (Nutrition Journal, Oct. 11, 2017). Occasionally people suffer side effects from this botanical medicine, however.

Elevated Liver Enzymes:

The doctor of a 71-year-old woman referred her to a specialist because a blood test showed her liver enzyme levels were too high (BMJ Case Reports, online Sep. 10, 2018). She felt well and had been taking turmeric capsules to reduce her chance of having a stroke. She was also taking 20 other medicines and supplements, though, so her doctors were not sure at first what was causing the liver problem. They diagnosed it as autoimmune hepatitis.

Once the liver enzyme problem came to light, the patient herself found studies online suggesting that the turmeric might be responsible. She threw the supplements out and within a month her lab values had begun to normalize. As a result, though, the scientists could not analyze the discarded supplement for contamination. The doctors suspect that an interaction between the turmeric supplements and her other pills might have been responsible for the serious reaction.

The authors of the case note that

“turmeric use was not documented in the patient’s medical records.”

They suggest that doctors specifically ask patients with elevated liver enzymes whether they are taking turmeric or curcumin.

Allergies and Interactions:

Despite its possible benefits, turmeric can trigger allergic reactions, especially rash. We also worry about its potential for interacting with anticoagulants such as warfarin. The combination could cause hemorrhage. In addition, turmeric supplements could increase urinary oxalate. As a result, people taking these pills may be more susceptible to painful kidney stones.

Learn More:

People interested in the pros and cons of turmeric and its active ingredient curcumin may find our book, Spice Up Your Health, of value. You might also want to listen to Show 988: Spices for a Healthy Life.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
  • Smith TJ & Ashar BH, "Iron deficiency anemia due to high-dose turmeric." Cureus, Jan. 9, 2019. DOI: 10.7759/cureus.3858
  • Pancholi V et al, "Safety assessment of a highly bioavailable curcumin-galactomannoside complex (CurQfen) in healthy volunteers, with a special reference to the recent hepatotoxic reports of curcumin supplements: A 90-days prospective study." Toxicology Reports, June 16, 2021. DOI: 10.1016/j.toxrep.2021.06.008
  • Moghtaderi H et al, "Gallic acid and curcumin induce cytotoxicity and apoptosis in human breast cancer cell MDA-MB-231." Bioimpacts, online March 5, 2018. DOI: 10.15171/bi.2018.21
  • Qin S et al, "Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials." Nutrition Journal, Oct. 11, 2017. DOI: 10.1186/s12937-017-0293-y
  • Lukefahr AL et al, "Drug-induced autoimmune hepatitis associated with turmeric dietary supplement use." BMJ Case Reports, online Sep. 10, 2018. http://dx.doi.org/10.1136/bcr-2018-224611
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