Turmeric and Black Pepper Supplements Linked to Liver Injury in Some People
Research shows turmeric supplements may have unwanted effects.
The spice turmeric, known for a molecule called curcumin, is a favored food supplement due to its powerful antioxidant properties. In fact, I’ve used it myself in the past.
It’s thought that it could also help treat or prevent inflammatory conditions. Over the past decade or two, turmeric’s popularity has surged. Folks use it hoping it will ease symptoms of various conditions or even ward off cancer.
However, doctors are raising safety concerns. They discovered that some patients suffered liver injury after using turmeric supplements.
Recent studies, especially one based in the United States, back this claim, and cases of liver injury linked to turmeric are on the rise.
Researchers from Italy and other published case studies have connected turmeric supplementation (or curcumin) with liver damage. The most recent research indicates an increase in these cases.
This new study, published in The American Journal of Medicine in 2023, examined cases recorded by the US Drug-Induced Liver Injury Network (DILIN) from 2004 to 2022.
They found 10 cases of liver injury associated with turmeric — all emerging after 2011. Remarkably, six cases surfaced after 2017. Five patients needed hospitalization & sadly one died due to acute liver failure. The study also points to risks when combining turmeric and black pepper supplements.
I must say this is rather alarming, as some of my colleagues have used turmeric for many years, although none have mentioned any adverse effects.
Jay Hoofnagle, MD, one of the study’s authors and director at NIDDK Division of Digestive Diseases and Nutrition overseeing DILIN, shared insights with Medical News Today:
“So why now? That’s an important question. Why suddenly?”
One reason could be its widespread use by millions these days.
Another reason could be that unlike spices such as pepper or curry, modern turmeric products are altered for better absorption into the body.
HLA Alleles in Turmeric Users
Seven out of ten individuals who experienced liver injury after taking turmeric supplements carried a specific human leukocyte antigen (HLA) allele — HLA-B*35:01 — which typically occurs in only about 6–7% of the population. These HLA alleles help the immune system recognize foreign cells & thus play a role in autoimmunity.
Hoofnagle mentioned they weren’t entirely sure if all identified cases were truly due to turmeric since many patients were on other drugs too. But it seemed those with HLA-B*35:01 needed further checking for risks associated with this allele.
“We could be wrong about several cases,” he noted. “It may be essential that this allele is involved.” He observed differences between those with & without this allele & is pursuing more research on it.
Herbal Phenols in Curcumin May Be a Culprit
Curcumin’s phenolic compound nature might explain why certain individuals experience liver trouble after taking it.
Past research indicated people with this genetic trait were likelier to suffer liver issues after using Polygonum multiflorum — an herb from China known for traditional medicine uses.
Hoofnagle pointed out green tea supplements (commonly used for weight loss) have also been tied to liver problems.
“It seems phenols affect carriers of B*35:01 causing reactions in the liver.”
Kristin Kirkpatrick at Cleveland Clinic advised considering overall factors impacting liver health:
“This study not only examined turmeric but also piperine which enhances bioavailability,” she noted & added that the body first processes everything through our ‘TSA agent’ — the liver before further digestion.
Why correct dosage matters
Hoofnagle stressed treating turmeric supplements like safe spices was a mistake. Traditional Indian medicine used them mostly for digestive purposes — not daily doses through capsules.
Western approaches often seek higher dosages believing them beneficial; but Hoofnagle explained “in biology correct dose matters.” Higher doses just lead to side effects complicating regulations as FDA doesn’t supervise herbal medicines properly.
“What we’re discussing isn’t traditional medicine anymore,” he said firmly. Instead focusing on high-dose purified components turns herbs into unregulated medicines leading to potential harm.”
Citations:
ACG Case Reports Journal 9(12):p e00941, December 2022. | DOI: 10.14309/crj.0000000000000941
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