Curcumin that is Absorbable and Curcumin that is Not

I F YOU FOLLOW ADVERTISEMENTS FROM SUPPLEMENT COMPANIES, YOU MAY HAVE NO­TICED THAT IN RECENT YEARS, A NEW TYPE OF ABSORB ABLE CURCUMIN HAS BEEN MARKETED AS BEING SUPERIOR TO REGULAR CURCUMIN THAT IS LESS ABSORBABLE. THIS DIFFERENCE DOES NOT MEAN THAT ONE IS NECESSARILY SUPERIOR TO THE OTHER. Poorly absorbed curcumin Consider the dnigs sulfasalazinc and mcsalaminc. They arc both aspirin derivatives designed to be less absorbablc. which means they exert their anti-inflammatory in the gut. They arc used to treat ulccrativc colitis. However, they arc also used to treat rheumatoid arthritis, which means that reducing gut in­flammation also leads to less systemic inflammation. Similarly to these meds. up until recent years, the standard curcumin supplement exerted most of its anti-inflammatory activity in the gut. which would indirectly lead to peripheral inflammation reduction. Doses of up to 12 g of traditional curcumin per day for three months have been shown to be safe (1). My view is to use regular curcumin if the goal is to primar­ily "dcilamc" the gut. This is especially relevant to about 20% of the adult population, which are mostly females who suffer from irritable bowel syndrome (IBS). Supplementation with standard, less absorbablc. turmeric appears to be beneficial for IBS patients (2). These women suffer from gut pain, gut motility issues, and also back pain, widespread pain, and constitutional symptoms such as malaise, fatigue, depression, anxiety, and impaired cognition (3.4). Highly absorbed curcumin To reduce peripheral inflammation directly, a more absorb­ablc curcumin is emerging as the best choice. In the last decade, studies have demonstrated improved curcumin absorption when it is associated with a lipophilic or phospholipid matrix, called a liposomc orphytosomc (5). Mcriva is the most studied supplemental curcumin utilizing photosomc technology. "At a dose of 2 g (corresponding to 400 ing of curcumin), Mcriva showed clear analgesic activity, comparable with that of a standard dose (1 g) of acetaminophen." in patients with ostcoarthritis. back pain, headaches, and muscular pain (6). Mcriva has been demonstrated to be clinically beneficial for patients with ostcoarthritis (7.8). and recommended to consider for the long-term complementary management of ostcoarthritis (8). Mcriva also has been studied in the context of exercise-induced delay cd-onset muscle soreness. Subjects in the curcumin group had MRI evidence of muscle injury in the posterior or medial compartment of both thighs and increases in markers of muscle damage, and inflammation tended to be lower in the curcumin group (9). While chiropractors mostly primarily treat musculoskeletal conditions, many patients simultaneously suffer from various conditions for which highly absorbablc curcumin may be ben­eficial. For example. Mcriva supplementation provided thera­peutic value in the management of diabetic microangiopathy and rctinopathy (10). Benign prostatic hypertrophy is a condition that most men get. so it is likely to present in a chiropractic office on a regular basis. When Mcriva supplementation was included with the standard medical treatment, there was an additional reduction of signs and symptoms of the disease without causing any sig­nificant additional side effect (11). While yet to be studied, it is reasonable to consider using Mcriva as a preventive measure. Anterior uvcitis has also been studied. In just a few weeks. Meriva supplementation reduced eye discomfort in more than 80% of 106 subjects. The authors suggest that curcumin may be beneficial for other inflammation-promoted eye condi­tions, such as dry eye. maculopathy. glaucoma, and diabetic rctinopathy (12). Summary Each variety of curcumin is beneficial. One exerts most of its anti-inflammatory activity in the gut. while the other is more active systcmically. The key is to determine whether reducing inflammation in the gut or peripheralh is the needed goal. Since cureumin is beneficial for so mam diverse conditions, it should be viewed as one of the more eommonh used supplements in clinical practice. Because turmeric can be used in food on a daih basis, it can also be supplemented daih for those wishing to derive its anti-inflaniniatorv benefits. Dr. Seaman is a Professor of Clinical Sciences at the NUHS branch campus at St. Petersburg College in Florida. He is also a C linical C 'onsullant for Anabolic Laboratories. He has written numerous articles on the treatment options for chronic pain patients, with a focus on nutritional management. He can be reached at deflame adejlame.com. References: GoelA el al. C 'urciimin as "airecumin ": from kitchen to clinic. Biochem Pharmacol. 200H;75:787-809. Bundy R el al. Turmeric extract may improve irritable bowel syndrome symptomatology in otherwise healthy adults: a pilot study. JAll Comp Med. 2004:10:1015-18. Smith MD. Russell A, Hodges PW. How common is hack pain in women with gastrointestinal problems? Clin J Pain. 2008:24:199-203. Lin HC. Small intestinal bacterial overgrowth: a frame­ work for understanding irritable bowel syndrome. JAMA. 2004:292:852-58. Cuomo J el al. Comparative absorption of a standardized curcuminoid mixture and its lecithin formulation. J Nat Prod. 2011:74(41:664-9. Di Pierro F el al. Comparative evaluation of the pain- relieving properties of a lecithinized formulation of curcumin (Meriva('Sj), nimesulide, and acetaminophen. J Pain Res. 2013:6:201-5. Belcaro G el al. Product-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarlhrilis. Panminerva Med. 2010:52(2 Suppl l):55-62. Belcaro G et al. Efficacy and safety ofMeriva®, a curcumin- phosphatidylcholine complex, during extended administration in osteoarlhrilis patients. AllernMedRev. 2010:15(4):337-44. Drobnic Fel al. Reduction of delayed onset muscle soreness by a novel curcumin delivery system (MerivaR): a randomised, placebo-controlled trial. J Inl Soc Sports Nutr. 2014 Jim 18:11:31. Sleigerwall R el al. Meriva®, a lecithinized curcumin delivery system, in diabetic microangiopalhy and retinopalhy. Panmi­ nerva Med. 2012:54(1 Suppl 4): 11-6. Ledda A el al. Meriva®, a lecithinized curcumin delivery system, in the control of benign prostalic hyperplasia: a pilot, product evaluation registry study. Panminerva Med. 2012:54(1 Suppl 4): 17-22. Allegri P et al. Management of chronic anterior uveitis re­ lapses: efficacy of oral phospholipidic curcumin treatment. Long-term follow-up. Clin Opthalmol. 2010:4:1-6.