Turmeric: Difference between revisions

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| parts_used = rhizome, the cured-and-dried form (the fresh rhizome is also used in Indian and southeast Asian cooking and traditional medicine); the leaves are used in some Indian cuisine but not medicinally

| cultivation = tropical herbaceous perennial; tuberous rhizome propagated vegetatively; nine to ten month growing season; rhizomes harvested at leaf senescence, boiled or steamed briefly to gelatinize the starch and inactivate the sprouting enzymes, then sun-dried and polished; the cured rhizome is what enters trade as "turmeric"

| preparations_summary = rhizome powder 1 to 4 g daily (culinary and traditional therapeutic dose); standardized curcuminoid extract 500 to 2000 mg daily (95 percent curcuminoid content typical); curcumin with piperine (Curcuma longa + Piper nigrum, the bioavailability-enhanced classical combination) at 500 to 2000 mg curcumin plus 5 to 20 mg piperine; phytosome formulations (Meriva, Theracurmin, BCM-95, others) at the manufacturer-specified dose, which deliver substantially higher systemic curcumin than plain powder; tincture 1:5 in 45 percent alcohol, 2 to 4 mL three times daily; the traditional topical Lepa (paste of turmeric, sandalwood, neem, and other powders) for skin complaint; the traditional infusion in milk (haridra dugdha, "golden milk") for respiratory and warming use

| preparations_summary = rhizome powder 1 to 4 g daily (culinary and traditional therapeutic dose); standardized curcuminoid extract 500 to 2000 mg daily (95 percent curcuminoid content typical); curcumin with piperine (''Curcuma longa'' + Piper nigrum, the bioavailability-enhanced classical combination) at 500 to 2000 mg curcumin plus 5 to 20 mg piperine; phytosome formulations (Meriva, Theracurmin, BCM-95, others) at the manufacturer-specified dose, which deliver substantially higher systemic curcumin than plain powder; tincture 1:5 in 45 percent alcohol, 2 to 4 mL three times daily; the traditional topical Lepa (paste of turmeric, sandalwood, neem, and other powders) for skin complaint; the traditional infusion in milk (haridra dugdha, "golden milk") for respiratory and warming use

| constituents_summary = curcuminoids 2 to 8 percent of dried rhizome by weight (curcumin approximately 70 percent of the curcuminoid fraction, demethoxycurcumin approximately 20 percent, bisdemethoxycurcumin approximately 10 percent); essential oil 3 to 5 percent (turmerones the principal volatile component: ar-turmerone, alpha-turmerone, beta-turmerone, with smaller amounts of zingiberene and curlone); starch 60 to 70 percent of dried rhizome (the bulk of the dry weight); polysaccharides; minor terpenoids and flavonoids

| mechanism = curcumin inhibition of nuclear factor kappa B (NF-kB) transcription, cyclooxygenase-2 (COX-2), and lipoxygenase (LOX), with downstream reduction of pro-inflammatory cytokines (TNF-alpha, IL-1, IL-6) is the principal mechanistic rationale for the anti-inflammatory effects; curcumin direct radical scavenging and glutathione-system upregulation account for the antioxidant activity; turmerones have separate pharmacological activity (immunomodulatory and aromatic carminative); the bioavailability problem (free curcumin oral absorption is approximately 1 percent and what is absorbed is rapidly glucuronidated and sulfated by UGT and SULT enzymes) constrains the in vivo effect substantially relative to in vitro and animal-model findings, and accounts for the limited clinical-trial effect sizes despite extensive preclinical evidence

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| legal = unscheduled; GRAS for culinary use; widely sold worldwide as culinary spice, traditional remedy, and dietary supplement

| interactionsummary = modest additive antiplatelet effect with antiplatelet medicines and anticoagulants at therapeutic-dose supplementation (theoretical and case-report supported; bleeding-risk caution in patients on warfarin or DOACs); modest CYP3A4 inhibition with high-bioavailability formulations or piperine-enhanced curcumin (potentially raising plasma concentrations of CYP3A4-substrate medicines); a growing case-report literature of hepatotoxicity associated with chronic high-dose curcumin supplementation, particularly with high-bioavailability formulations, represents a real safety signal at the supplement-capsule scale of use that is essentially absent at culinary scale

| intro = '''Turmeric''' is the dried, cured rhizome of Curcuma longa L., a tropical herbaceous perennial of the Zingiberaceae (the ginger family) native to the Indian subcontinent and cultivated continuously there for at least four thousand years as the principal food coloring, ritual aromatic, and anti-inflammatory medicine of the South Asian tradition. The Sanskrit name '''haridra''' (literally "yellow," from the same root as the Persian zard chub, "yellow wood") names the rhizome for the yellow color that has anchored its dual sacred-and-medicinal identity in Hindu, Buddhist, and Jain practice: turmeric paste is applied to the bride and groom in the Indian wedding [[wikipedia:Haldi ceremony|haldi]] ceremony, used as a ritual offering in temple worship, smeared on the forehead as a daily mark of auspicious blessing, and ground into the medicinal pastes (Lepa) of classical Ayurvedic external practice for thousands of years. The rhizome is documented in the Charaka Samhita and Sushruta Samhita (the foundational Ayurvedic texts compiled in the early centuries of the common era from older oral tradition) as a warming, drying, bitter, and pungent medicine indicated for indigestion, wound healing, skin disorders, blood-purification, diabetes, respiratory complaint, and inflammatory pain;<ref name="charaka-turmeric">Sharma PV (translator). ''Charaka Samhita: Text with English Translation''. Varanasi: Chaukhambha Orientalia; 1981.</ref> the bandwidth of classical indications is unusually broad even by Ayurvedic standards and matches the breadth of curcumin's in vitro pharmacology. Turmeric entered the Chinese materia medica as jiang huang ("yellow ginger") by the Tang dynasty, where it is classed as a blood-mover and qi-mover for amenorrhea, abdominal masses, and traumatic injury;<ref name="bensky-turmeric">Bensky D, Clavey S, Stoger E. ''Chinese Herbal Medicine: Materia Medica, 3rd ed''. Seattle: Eastland Press; 2004.</ref> the Persian and Islamic traditions received it as zard chub and kurkum but treated it as a secondary aromatic and dyestuff rather than as a central medicinal herb. The modern Western use of turmeric dates almost entirely from the late twentieth century, when the in vitro pharmacology of curcumin (the principal yellow pigment of the rhizome) attracted research attention in anti-inflammatory, antioxidant, and anticancer pharmacology, and turmeric and its standardized curcumin extracts became one of the most widely sold dietary supplements in the United States and Europe.

| intro = '''Turmeric''' is the dried, cured rhizome of ''Curcuma longa'' L., a tropical herbaceous perennial of the Zingiberaceae (the ginger family) native to the Indian subcontinent and cultivated continuously there for at least four thousand years as the principal food coloring, ritual aromatic, and anti-inflammatory medicine of the South Asian tradition. The Sanskrit name '''haridra''' (literally "yellow," from the same root as the Persian zard chub, "yellow wood") names the rhizome for the yellow color that has anchored its dual sacred-and-medicinal identity in Hindu, Buddhist, and Jain practice: turmeric paste is applied to the bride and groom in the Indian wedding [[wikipedia:Haldi ceremony|haldi]] ceremony, used as a ritual offering in temple worship, smeared on the forehead as a daily mark of auspicious blessing, and ground into the medicinal pastes (Lepa) of classical Ayurvedic external practice for thousands of years. The rhizome is documented in the Charaka Samhita and Sushruta Samhita (the foundational Ayurvedic texts compiled in the early centuries of the common era from older oral tradition) as a warming, drying, bitter, and pungent medicine indicated for indigestion, wound healing, skin disorders, blood-purification, diabetes, respiratory complaint, and inflammatory pain;<ref name="charaka-turmeric">Sharma PV (translator). ''Charaka Samhita: Text with English Translation''. Varanasi: Chaukhambha Orientalia; 1981.</ref> the bandwidth of classical indications is unusually broad even by Ayurvedic standards and matches the breadth of curcumin's in vitro pharmacology. Turmeric entered the Chinese materia medica as jiang huang ("yellow ginger") by the Tang dynasty, where it is classed as a blood-mover and qi-mover for amenorrhea, abdominal masses, and traumatic injury;<ref name="bensky-turmeric">Bensky D, Clavey S, Stoger E. ''Chinese Herbal Medicine: Materia Medica, 3rd ed''. Seattle: Eastland Press; 2004.</ref> the Persian and Islamic traditions received it as zard chub and kurkum but treated it as a secondary aromatic and dyestuff rather than as a central medicinal herb. The modern Western use of turmeric dates almost entirely from the late twentieth century, when the in vitro pharmacology of curcumin (the principal yellow pigment of the rhizome) attracted research attention in anti-inflammatory, antioxidant, and anticancer pharmacology, and turmeric and its standardized curcumin extracts became one of the most widely sold dietary supplements in the United States and Europe.

| traditional_uses = The Indian subcontinent is the historical centroid of turmeric, and the depth of Indian use is unusual even by the standards of widely-traded medicinal spices. Archaeological evidence from Indus Valley sites suggests turmeric was in cultivation in the Indian subcontinent by approximately 2500 BCE,<ref name="kashyap-weber-2010">Kashyap A, Weber SA. Harappan plant use revealed by starch grains from Farmana, India. ''Antiquity'' 2010;84(326), Project Gallery. Archaeobotanical starch-grain analysis identifying turmeric, ginger, and other Zingiberaceae in Harappan-period cooking residues.</ref> and the rhizome appears in the post-Vedic literary record as haridra (the Sanskrit name) from at least the first millennium BCE. The classical Ayurvedic texts the Charaka Samhita and Sushruta Samhita document turmeric extensively: Charaka classes haridra as warming (ushna virya), drying (ruksha), bitter-and-pungent (tikta-katu rasa), kapha-vata-shamaka (pacifying the cold-and-damp and the cold-and-windy doshas), and indicates it for indigestion (agnimandya), wound healing (vrana ropana), skin disorders broadly (kushta), blood-purification (raktashodhana), diabetes mellitus (madhumeha), respiratory complaint, and inflammatory joint pain.<ref name="williamson-haridra">Williamson EM. ''Major Herbs of Ayurveda''. Edinburgh: Churchill Livingstone; 2002.</ref> Sushruta's surgical text emphasizes the topical wound application of turmeric powder for its antiseptic and granulation-promoting effect, a use that has persisted in Indian folk and clinical practice to the present and that has substantial supporting in vitro evidence for cinnamaldehyde-equivalent antimicrobial activity. Classical Ayurvedic compound formulations including turmeric are numerous: Haridra Khanda (turmeric in a herbal-mineral compound for skin disorders), Mahasudarshana Churna (turmeric among many ingredients, for fever and detoxification), Yashtimadhukadi Ghrita, and many others.

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A growing case-report literature documents hepatotoxicity associated with chronic high-dose curcumin supplementation, particularly with high-bioavailability formulations and particularly in chronic supplementation extending beyond a few months. Case reports have accumulated since approximately 2018, with several published in 2020 to 2023 documenting acute hepatitis presentation in patients on multi-month high-dose curcumin or Meriva-type phytosome supplementation, generally with resolution on discontinuation.<ref name="lukefahr-2018">Lukefahr AL, McEvoy S, Alfafara C, Funk JL. Drug-induced autoimmune hepatitis associated with turmeric dietary supplement use. ''BMJ Case Reports''. 2018 Sep 10;2018:bcr-2018-224611. PMID 30206065.</ref> The NIH LiverTox database lists turmeric and curcumin as known hepatotoxicants at supplementation dose, with the bioavailability-enhanced formulations identified as the higher-risk preparations.<ref name="livertox-turmeric">National Institute of Diabetes and Digestive and Kidney Diseases. ''LiverTox: Clinical and Research Information on Drug-Induced Liver Injury'', Turmeric and Curcumin entry. Bethesda, MD: NIDDK; ongoing updates. Available at https://www.ncbi.nlm.nih.gov/books/NBK548561/</ref> The signal is real but rare in absolute terms relative to the magnitude of turmeric and curcumin supplementation worldwide; the clinical implication is that prescribers should counsel patients on chronic high-dose curcumin supplementation about the hepatotoxicity risk, monitor liver function in chronic users, and consider the dose-and-formulation choice (whether to use bioavailability-enhanced formulations or to accept lower bioavailability from plain turmeric powder) as a benefit-risk decision rather than a default. Culinary use of turmeric at the gram-per-day scale typical of Indian and southeast Asian cooking is essentially without hepatotoxicity risk.

| traditional_geography =

| botany = Curcuma longa is a tropical herbaceous perennial of the Zingiberaceae reaching 60 to 90 cm at flowering. The plant emerges annually from a tuberous rhizome, sending up large oblong leaves 30 to 50 cm long and 7 to 15 cm wide, glossy green with a prominent central midrib, arranged in a tight basal rosette. The inflorescence is a dense terminal spike of pale yellow flowers subtended by green and rosy-pink bracts (the bracts the more conspicuous floral feature). The medicinally used rhizome is the central tuberous body and its lateral branches: the central rhizome ("bulb") is rounded, 3 to 6 cm in diameter, with the lateral branches ("fingers") elongated and 1 to 2 cm in diameter, both intensely yellow-orange when cut, with a distinctive warm aromatic odor and pungent-bitter taste. Distinguished from the related Curcuma aromatica (Indian wild turmeric, the TCM yu jin) by smaller rhizome and more pungent aroma; from Curcuma zedoaria (white turmeric, the TCM e zhu) by deeper yellow rhizome color and less camphorous aroma; from Zingiber officinale (ginger, the most likely confusion in fresh-rhizome form) by deeper yellow color throughout and absence of ginger's distinctive zingerone-and-gingerol pungency. The dried-cured rhizome of commerce is hard, dense, intensely yellow, breaks with a clean crystalline fracture, and powders to the characteristic mustard-yellow color that has anchored turmeric's dual culinary-and-dye identity.

| botany = ''Curcuma longa'' is a tropical herbaceous perennial of the Zingiberaceae reaching 60 to 90 cm at flowering. The plant emerges annually from a tuberous rhizome, sending up large oblong leaves 30 to 50 cm long and 7 to 15 cm wide, glossy green with a prominent central midrib, arranged in a tight basal rosette. The inflorescence is a dense terminal spike of pale yellow flowers subtended by green and rosy-pink bracts (the bracts the more conspicuous floral feature). The medicinally used rhizome is the central tuberous body and its lateral branches: the central rhizome ("bulb") is rounded, 3 to 6 cm in diameter, with the lateral branches ("fingers") elongated and 1 to 2 cm in diameter, both intensely yellow-orange when cut, with a distinctive warm aromatic odor and pungent-bitter taste. Distinguished from the related Curcuma aromatica (Indian wild turmeric, the TCM yu jin) by smaller rhizome and more pungent aroma; from Curcuma zedoaria (white turmeric, the TCM e zhu) by deeper yellow rhizome color and less camphorous aroma; from ''Zingiber officinale'' (ginger, the most likely confusion in fresh-rhizome form) by deeper yellow color throughout and absence of ginger's distinctive zingerone-and-gingerol pungency. The dried-cured rhizome of commerce is hard, dense, intensely yellow, breaks with a clean crystalline fracture, and powders to the characteristic mustard-yellow color that has anchored turmeric's dual culinary-and-dye identity.

| constituents = The principal medicinally active constituents of turmeric are the '''curcuminoids''' (polyphenolic pigments of the diarylheptanoid class) and the '''essential oil''' (rich in sesquiterpene ketones called turmerones).

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