In practice turmeric and the various curcuminoids are used in many forms and administered via various routes. This review will focus mostly on those methods of use that are commonly used and preparations that are available OTC, such as oral dose forms and topical applications. cancer
Epidemiological data suggest that curcumin reduces the rate of colorectal cancer (Hergenhahn et al 2002) and curcumin has wide-ranging chemopreventive activity in preclinical carcinogenic models (Plummer et al 2001), most notably for gastrointestinal cancers (Ireson et al 2001). To date, however, there are no controlled trials to attest to turmeric's efficacy in cancer treatment or prevention.
In a phase 1 study, curcumin taken orally for 3 months at a starting dose of 500 mg/day was found to produce histologic improvement in cases of bladder cancer, oral leucoplakia, intestinal metaplasia of the stomach, cervical intraepithelial neoplasm and Bowen's disease (Cheng et al 2001).
An ethanol extract of turmeric, as well as an ointment of curcumin, were found to produce remarkable symptomatic relief in patients with external cancerous lesions (Kuttan et al 1987) and there are clinical reports to suggest that curcumin could be safe and effective in the treatment of idiopathic inflammatory orbital pseudotumours (Lai et al 2000).
A randomised, controlled, double-blind prospective multicentre pilot study compared the effects of dried extracts of greater celandine and turmeric with placebo in 76 patients with colicky abdominal pain in the right upper quadrant due to biliary dyskinesia. Abdominal pain was reduced more quickly with active treatment;
however, other symptoms such as fullness, nausea and vomiting did not respond (Niederau & Gopfert 1999). Another randomised, placebo-controlled, double-blind study that investigated the efficacy of turmeric for treatment of dyspepsia and flatulence in 116 adult patients with acidic dyspepsia, flatulent dyspepsia or atonic dyspepsia found that 87% of patients receiving turmeric responded compared to 53% receiving placebo (Thamlikitkul et al 1989).
In a study of 24 patients with duodenal or gastric ulcers varying between 0.5 and 1.5 cm in diameter, 300 mg of turmeric given five times daily, 30-60 minutes before meals, at 1600 hours and at bedtime successfully healed 48% of ulcers after 4 weeks and 76% after 12 weeks. Of 20 patients who had erosion gastritis and dyspepsia, the same treatment produced a satisfactory reduction in abdominal pain and discomfort after the first and second week (Prucksunand et al 2001). Turmeric has also been positively compared to a liquid antacid for the treatment of gastric ulcer in a controlled clinical trial (Kositchaiwat et al 1993).
Turmeric may be associated with a decrease in the risk of cardiovascular disease and an intake of 200 mg of a hydro-ethanolic extract of turmeric may decrease total blood lipid peroxides and HDL- and LDL-lipid peroxidation, as well as normalise plasma fibrinogen levels and apolipoprotein B/apolipoprotein A ratio (Miquel et al 2002).
In an open trial, 10 healthy volunteers received 500 mg/day of curcumin for 7 days. A significant decrease in the level of serum lipid peroxides (33%), increase in HDL-cholesterol (29%), and a decrease in total serum cholesterol (11.63%) were noted. It also reduced serum lipid peroxides (Soni & Kuttan 1992). In a subsequent study, a 45-day intake (by healthy individuals 27-67 years of age) of a turmeric hydro-alcoholic extract at a daily dose equivalent to 20 mg of curcumin resulted in a significant decrease in serum lipid peroxides (Ramirez-Bosca et al 1995). A daily intake of turmeric equivalent to 20 mg of the phenolic antioxidant curcumin for 60 days also decreased peroxidation of both HDLand LDL in 30 healthy volunteers ranging in age from 40 to 90 years. The effect was quite striking in the persons with high baseline values of peroxidised compounds in these lipoproteins, although no apparent change took place in the persons having low baselinevalues (Ramirez et al 1997).
In a randomised, controlled double-blind study, curcumin 1200 mg/day was compared with phenylbutazone in subjects with RA. Curcumin was found to be effective Turmeric 1162
in improving morning stiffness, walking time and joint swelling; however, the effects of phenylbutazone were stronger (Deodhar et al 1980).
Curcumin combined with boswellia, withania and zinc produced a significant drop in pain and disability in OA of the knee in a randomised, double-blind, placebo-controlled crossover study of 42 patients (Kulkarni et al 1991); however, the contribution of cucurmin to these results is unknown.
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