Rarely reported cases of hepatotoxicity associated with turmeric- and curcuminoid-containing dietary supplements: a comprehensive review by USP.
Hepatotoxicity from turmeric and curcuminoids is rare, but caution is advised, especially for those with liver issues. Users should consult healthcare practitioners if symptoms arise.
Where it sits
this study against the rest of the semaglutide corpusSummary and findings
This review assessed the safety of turmeric and curcuminoids, particularly focusing on hepatotoxicity reports. The evaluation was conducted by the USP DSAEL EC following multiple hepatotoxicity cases associated with these supplements. The findings suggest that while hepatotoxicity has been observed in rodent studies, clinical trials have not reported significant organ toxicity.
Abstract
<h4>Background</h4>The United States Pharmacopeia (USP) Dietary Supplement Admission Evaluation and Labeling Expert Committee (DSAEL EC) routinely monitors safety‑related literature for dietary ingredients covered by USP monographs. Following multiple reports of hepatotoxicity associated with turmeric- or curcuminoid-containing products, the DSAEL EC conducted a comprehensive evaluation.<h4>Objective</h4>To assess the safety of turmeric and curcuminoids and determine whether cautionary labeling should be added to the USP monographs for these ingredients.<h4>Methods</h4>Following USP Guidelines, the DSAEL EC reviewed safety and toxicological information.<h4>Results and discussion</h4>Hepatotoxicity has been observed with high-dose turmeric rhizome powder or extract in a few rodent toxicology studies. Numerous clinical trials involving turmeric- or curcuminoid-containing supplements have not reported organ toxicity or serious adverse events. Published case reports of clinically apparent liver injury often involve concomitant medications or supplements. Reported hepatotoxicity typically occurs after 1 to 4 months of use and generally resolves upon discontinuation; cases of acute liver failure have been reported albeit rarely. Proposed mechanisms include idiosyncratic, immune-mediated injury, and emerging evidence suggests possible genetic susceptibility.<h4>Conclusions</h4>The USP DSAEL EC recommends adding the following cautionary statement to its turmeric and curcuminoids monographs: <i>Liver problems have been reported very rarely in people taking supplements containing turmeric and/or curcuminoids. Consult your health-care practitioner before using this product if you have a history of liver problems. Stop using this product if you develop symptoms such as abdominal pain, dark urine, or jaundice (yellowing of the skin or eyes), and seek medical advice.</i>
Background
This paper addresses the safety concerns regarding turmeric and curcuminoids, particularly their association with hepatotoxicity. Prior reports indicated rare cases of liver injury linked to these dietary supplements, prompting the USP to evaluate the safety data. Understanding the potential risks associated with these widely used supplements is crucial for consumer safety and regulatory practices.
Methods
The study involved a comprehensive review of safety and toxicological information regarding turmeric and curcuminoids, following USP guidelines. The evaluation included both rodent toxicology studies and clinical trials. Specific details on the number of studies reviewed or the exact methodologies employed were not reported in the abstract.
Results
Hepatotoxicity has been observed in rodent studies involving high doses of turmeric, but clinical trials have not reported significant adverse events related to organ toxicity. The review notes that liver problems associated with turmeric supplements typically arise after 1 to 4 months of use and often resolve upon discontinuation. Acute liver failure cases were noted but are described as rare.
Interpretation
The findings suggest that while there is some evidence of hepatotoxicity in animal models, the lack of significant adverse events in clinical trials indicates that turmeric and curcuminoids may be safe for most users. However, the potential for idiosyncratic reactions and the influence of genetic factors complicate the interpretation of these results. The review highlights the need for caution, particularly for individuals with pre-existing liver conditions.
Key findings
- Hepatotoxicity observed with high-dose turmeric rhizome powder or extract in a few rodent toxicology studies.
- Numerous clinical trials involving turmeric- or curcuminoid-containing supplements have not reported organ toxicity or serious adverse events.
- Reported hepatotoxicity typically occurs after 1 to 4 months of use.
- Cases of acute liver failure have been reported albeit rarely.
Limitations
- Review based on rodent studies and case reports, which may not fully represent human outcomes.
- No specific n reported for the studies reviewed.
- Potential confounding factors in case reports, such as concomitant medications.