Monthly Archives: July 2016

How Can I Motivate Myself to Eat More Turmeric?

I didn’t plan on writing another post on turmeric. But after getting some tips via facebook in response to my previous post, I thought I’d put up a quick update.

Jessica of Our Little Honey Bun shared a turmeric milk recipe with me involving honey and a cardamom pod – sounds delicious! And then one of my favorite teachers from high school, Dr. N of Dr N’s Blog told me about putting fresh turmeric root in smoothies with black pepper, coconut oil, and lots of fresh fruits & veggies. These, and a few other comments, inspired me to start collecting turmeric recipes on pinterest.

So far, I’ve pinned more than 40 recipes that incorporate turmeric.

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Some are desserts that I’d only make for special occasions, or tempting drinks with a per-cup sugar load that gets my spidey sense tingling. Others are savory dishes and veggie-filled soups that I’d like to try soon. The mouthwatering photos accompanying the recipes certainly motivate me to get in the kitchen.

I’ve never been much of cook, though. I aced my food science and food safety classes in grad school, but food prep has always appealed more in theory than in fact. I can boil and scramble eggs, make salads and stews, cover strawberries in chocolate, and even bake the (very) occasional cake. Yet other than boiling eggs, none of these are daily occurrences.

So the aspirational pinterest photos aren’t motivating enough, on their own, to get me to attempt a turmeric recipe. That’s where science comes in. I found a few studies specifically about using turmeric in cooking. A recent article published last spring in the International Journal of Food Sciences and Nutrition has a title that basically says it all: “Turmeric and black pepper spices decrease lipid peroxidation in meat patties during cooking.” Lipid peroxidation happens when free radicals react with lipids. Studies show that eating food with lipid peroxidation products poses health risks, and is associated with diseases such as atherosclerosis, cancer and myopathy.

This suggests that not only would I be getting the anti-cancer benefits of turmeric if I used it in cooking alongside black pepper, but I’d help to protect my food from health-damaging free radical damage to boot.

Food scientists also found that turmeric powder added to burgers at 3.5 grams per 100 grams of meat acted as a natural antioxidant, “increasing the quality and extending the shelf life of rabbit burgers.”

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I’m not sure why these scientists, who happen to be based in Italy and Hungary, were specifically interested in rabbit burgers. I have no plans to make rabbit burgers in the foreseeable future, but I’d assume that this study’s findings can apply to many types of meat and perhaps vegetarian dishes as well.

An earlier study with turmeric and fish lends support to this idea. Fish contain a high percentage of polyunsaturated fatty acids (PUFAs). That’s usually considered a good thing, but the high degree of PUFA unsaturation means that they are more vulnerable to oxidation by free radicals than other types of fatty acids. But, good news for fish lovers: researchers found that 75 mg of powdered turmeric root significantly inhibited lipid peroxidation in cooked mackerel.

These studies convince me that supplements, even if they do contain turmeric/curcumin in the amounts claimed on the labels, can’t offer me the full benefits that cooking with freshly ground turmeric root would. But I’m not ready to ditch the supplements, because I can’t see how I would ever get up to eating or drinking 3-4 grams of the spice each day. It has a distinct taste, which I don’t like except as a faint note in the background of louder flavors.

I decide to start slowly; I can keep my supplement regimen while experimenting with the turmeric recipes I’ve saved on my pinterest boards.

Just one recipe each week – that sounds like a reasonable goal.

you can do it emoji

And this blog is a handy tool to keep me accountable. Stay tuned to find out about my turmeric kitchen adventures.

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Dose & Type of Turmeric Supplement – What’s the Best Choice?

Note: this is my third in a series of posts about turmeric. To get the full story on why I decided to take the supplement and possible contraindications to supplementing, please see my first and second posts.


I’d intended to get this post up earlier, but my current chemo regimen makes me prone to long naps on the couch.naptime emoji

Though truth be told, this post was also harder for me to write. I’m still figuring out the dosing and which brand of supplement I should go with. I’ll share what I learned from my research, and perhaps you, dear readers, can make suggestions or tell me about your own experiences with different brands.

Once I made the decision to take a turmeric supplement, I looked to see what was available on Amazon. Pages and pages of options came up – I clicked through more than ten before realizing that I needed more pubmed.gov research time.     

I learned three main points:

1) Turmeric as a whole spice works better than isolated curcumin.

A study comparing turmeric to curcumin found:

…in breast cancer cells curcumin induced 33% growth inhibition, while 66% growth inhibition was observed by turmeric containing equivalent amount of curcumin. A similar trend was observed with other tumor cells. These observations indicate that components other than curcumin might contribute to the potency of turmeric. (emphasis mine)

Not surprising if you consider that turmeric has more than 300 components in total, though curcumin has been the one most thoroughly studied. A review article provides a good graphic of the most  promising compounds found in turmeric besides curcumin:

Noncurcumin_Compounds of turmeric

Some of these compounds, including turmerones, elemene, furanodiene, cyclocurcumin, calebin A and germacrone have inhibited growth or induced apoptosis (cell death) in many different types of human cancer cells.

I also found an article published late last year describing yet another turmeric-derived compound, β-sesquiphellandrene (SQP). The authors found SQP to be highly effective in suppressing cancer cell colony formation and inducing apoptosis. SQP is also synergistic with the chemotherapeutic agents velcade, thalidomide and capecitabine (Xeloda, the chemo regimen that I’m on right now!)

So I’d be missing out on all that synergy if I took a supplement containing curcumin alone.

Supplement FactsThe supplement with is label wouldn’t do, since it only contains 25mg of all the other compounds besides curcumin.

Instead, I was looking for ingredients like:

organic turmeric supplement facts
According to the label above, there’s about 95mg of curcumin per two capsules, but also 900mg of turmeric spice with its full spectrum of beneficial compounds. The 10mg of black pepper claimed on the label is also a plus.

Which brings me to my second point – another aspect of turmeric that challenges researchers:

2) Turmeric is not water-soluble and our bodies have trouble absorbing it. Fats and piperine from black pepper help make turmeric more bioavailable.

This insight allowed me to eliminate supplements that did not contain that black pepper extract. While there are also a few supplements on the market that package the turmeric and black pepper alongside oils to further improve bioavailability, I planned to take capsules with meals. I’m hoping that fats from the eggs I have for breakfast or the fish I have for dinner are enough to help at least some of the turmeric be absorbed.

I was still worried, however, that I wouldn’t be getting enough turmeric or curcumin to really make a difference with my tumors. Studies in humans showed that a curcumin dose as low as 1.8 grams per day produced a “measurable pharmacodynamic change,” but what does that actually mean? It’s unclear how much of the curcumin was actually absorbed into tissues. Other studies used doses of 4 – 8 g — it’s been administered safely at up to 12 g daily over 3 months in clinical trials.

I decided to aim for 3 – 4 grams per day to start with. Since most supplements have about 1 g of turmeric/curcumin per serving (which can be two or three capsules), I’d need to take capsules with every meal and maybe sometimes with snacks. That gets expensive!

Worse, such a regimen won’t necessarily ensure that I ingest those promised 3 – 4 grams. It’s a leap of faith on my part, since supplements are not reviewed by the FDA before they go to market. Third-party verification is, unfortunately, not widespread in the turmeric supplement industry, so I have little choice but to believe the bottle labels. Even the brands claiming organic turmeric don’t seem to have third-party verification to back up those statements.

But I could hedge my bets by taking capsules from a few different brands. The third major thing I learned about turmeric/curcumin:

3) Researchers are formulating more bioavailable forms of curcumin.

One such preparation, dubbed Theracurmin, achieved dramatically higher absorption rates in mice and humans by disbursing curcumin with colloidal nano-particles. I’ve come across other formulations using nano-particles, but Theracurmin was the only one I could find on Amazon.

I ended up ordering the Theracurmin and another supplement that included turmeric as well as curcumin. I also got a bottle of turmeric capsules from my local Whole Foods. Between the three, I might be getting something close to the intended dose. It adds up to a lot of money, but I feel like I have to give this experiment my best shot.  All In Emoji

I’ll have no idea what the supplements are doing, if anything, till I get scans and tests after this third cycle of chemo. I’ll post updates once I get those results.

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Could Turmeric Supplements Harm Me?

All the turmeric studies I read described the spice (and its derivative, curcumin) as generally safe for consumption. So I was surprised to see the full list of possible side effects on WebMD.CautionLayer

 

The first precaution was easy to dismiss – I was not pregnant or breast-feeding, though turmeric is deemed “likely safe” as long as women didn’t exceed amounts commonly found in food. So a plate of curry is probably fine, but not medicinal amounts of of turmeric.

The second contraindication is for people with gallbladder problems. I haven’t had issues with gallstones or bile duct obstructions – should be ok on that one.

The precaution on diabetes didn’t apply to me either, but those with diabetes should be aware that curcumin could decrease blood sugar. I’d count that as a positive side effect, unless of course your blood sugar gets too low.

People with stomach problems like gastroesophageal reflux disease (GERD) are also advised to proceed with caution, since turmeric can cause stomach upset and thus make GERD symptoms worse.

Two precautions concerned me the most: bleeding problems and interactions with hormone-sensitive conditions.

1) I’m taking warfarin (Coumadin) to prevent blood clots that I’m at a higher risk for as a cancer patient. The Xeloda chemo regimen that I’m on already interacts with warfarin to increase my risk of bleeding. Turmeric can slow blood clotting, so adding it into the mix with my meds might be risky, especially if I needed emergency surgery. However, I do get weekly monitoring through a lab test that measures my INR (international normalized ratio) to ensure that my blood clots within a specific time range. I told my oncologist that I would be taking a turmeric supplement, and she adjusts my warfarin dose as needed based on the INR results.

2) WebMD warns that curcumin supplementat

ion could make hormone-sensitive conditions — including breast, uterine and ovarian cancer — worse. This was the scariest contraindication for me, since my breast cancer is estrogen receptor positive.

Gulp emojiBut it was also contrary to most of the research I’d been reading. One study from 2010 did find a weak estrogenic effect, but their research only looked at curcumin’s behavior in a petri dish. Three of the study’s authors (including the lead author) published another article that same year in which they state:

…in vitro studies, ex vivo and first clinical investigations confirm the anti-tumor effects of Curcumin, either as an isolated chemoprevention substance or in combination with chemotherapeutic agents as supportive measure reducing pharmaceutical resistance of tumor cells to certain chemotherapeutics.

Besides, authors of the recent “Curcumin in Treating Breast Cancer: A Review” reference that 2010 study (which found the estrogenic effect), but come to a different conclusion than WebMD. They suggest that curcumin’s estrogenic effect actually help with breast cancer treatment:

…curcumin, acting as a phytoestrogen, competitively inhibited endogenous estrogen, which also contributed to the suppression of breast cancer cell growth.

I decided that enough research supported turmeric’s effectiveness against all types of breast cancer to justify dismissing WebMD’s warning, at least for now.

A few friends brought up two more concerns.

One woman’s oncologist told her not to take turmeric since she has liver mets and turmeric is metabolized by the liver. I have liver mets too, but my oncologist ok’d the turmeric supplementation. I didn’t come across any studies showing that turmeric could harm the liver – on the contrary, a 2016 review article described a few studies in which curcumin inhibited tumor growth in rats and mice with liver cancer. Maybe the liver mets keep me from processing turmeric as well as I otherwise would; I can only hope that I’m getting at least some of the benefits.

Finally, I looked into a concern brought up by another friend that wasn’t specific to turmeric, but questioned whether it was a good idea to supplement with any anti-oxidants at all while on chemo. Turmeric falls into this category since it demonstrates antioxidant activity. I hadn’t heard that before, but found a good summary of the issue from the Oncology Nutrition practice group of the Academy of Nutrition and Dietetics. My takeaway is that there’s no strong scientific evidence either for or against taking antioxidants during chemo, and it can depend on individual circumstances. Having read the studies that showed turmeric or curcumin working synergistically with Xeloda and other cancer treatments, I reaffirmed my decision to supplement with turmeric.

All that remained was to choose the brand of supplement and the dose. I’ll cover that decision-making process in my next post. I also resolved to eat more iron-rich foods like sardines and liver, since WebMD warns that turmeric can interfere with iron absorption. Still working on that part…

Should I Take a Turmeric Supplement for my Metastatic Breast Cancer?

I started investigating turmeric about half a year after my diagnosis of metastatic breast cancer. I’d just completed the second of a 2-week-on, 1-week off cycle of a new (to me) chemo med, Xeloda (capecitabine). I dutifully swallowed 4 pills in the morning and 4 pills in the evening for 14 days, imagining the tumors in my spine, lymph nodes, liver and brain dissolving away.

Not quite. My oncologist said that some of the tumors had shrunk a bit, and most showed no progression. Encouraging enough to continue taking Xeloda, but why wasn’t I responding quicker?

Turning to google for some infotherapy, I threw in all sorts of keywords – cancer, metastatic, chemo, supplement – as if fumbling around for the right chants with no spellbook to guide my spellcasting.

After clearing my head with episodes of the new season of Orange is the New Black, I switched over to pubmed.gov to probe into turmeric (Curcuma longa). It’s the spice that gives curry its yellow color, and has been used in Asian cooking as well as medicinally for thousands of years.

Of all the supplements that turned up in my google search, turmeric emerged as the clear winner in terms of the sheer amount of research and the benefits attributed to the spice. Numerous studies show that a compound isolated from turmeric, curcumin, has anti-inflammatory, anti-oxidative and antibacterial activity. Curcumin also shows promise in the treatment of type 2 diabetes, rheumatoid arthritis, psoraisis, non-alcoholic fatty liver disease (NAFLD), and Alzheimer’s (1). But I focused my investigation on research into curcumin’s anti-cancer properties.

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I was already familiar with turmeric from my graduate studies in nutrition, but I got cautiously excited when searching for “turmeric Xeloda” or “turmeric capecitabine” turned up three recent studies (2, 3, 4). They all suggested that turmeric sensitizes cancer cells to Xeloda. But while the chemo drug matched my case, only one of the studies used breast cancer cells in their experiments.

Still, I found many studies that reported curcumin’s effectiveness against various breast cancer cell lines both in both petri dishes and mouse/rat models. A review article published last fall, “Recent Advances of Curcumin and its Analogues in Breast Cancer Prevention and Treatment” does a nice job of summarizing all the research and explains the possible mechanisms by which curcumin fights cancer.

Another review article gives the Canadian perspective on curcumin. In Canada, curcumin supplements can claim two statements approved by Health Canada:

1) “Provides antioxidants for the maintenance of good health.”

2) “Used in herbal medicine to help relieve joint inflammation.”

Claims about curcumin’s anti-cancer properties are not yet allowed, however. The authors conclude that “more high-quality human clinical trials designed to study the effect of curcumin on cancer-specific markers are required to validate the benefits currently seen in animal models and cell culture studies.”

With no high-quality human clinical trials in sight, I decided to conduct my own n=1 experiment. But which supplement to take?

The amount of choices that I encountered on Amazon was overwhelming, so I looked back at the research to figure out what form and dose of turmeric is best. I’ll tackle that, as well as some health concerns with turmeric supplementation, in my next posts.