Inflammation is the defensive response of the body against cell damage or microbial infection to remove the cause of injury and repair the injured tissues.
Inflammation is characterized by redness, heat, pain and swelling.
Redness and heat are due to increased blood flow in the expanded blood capillaries of the affected area.
Swelling is caused by increased permeability of blood vessels that causes the outflow of plasma proteins and the fluid into damaged tissue allowing them to swell up. Some of these proteins increase the pain sensitivity.
Neutrophils (white blood cells) migrate from bloodstream to site of injury where they release the toxins and antimicrobial proteins to kill the pathogen.
Neutrophils stimulate pro-inflammatory cytokines to maintain inflammatory response and stimulate systemic inflammation in form of fever.
Some common disorders associated with inflammation are arthritis, allergies, gastrointestinal problems, muscle problems, asthma, autoimmune diseases, cancer, atherosclerosis, inflammatory eye disorders etc.
It is the common symptom associated with diseases such as arthritis, psoriasis, asthma, and bronchitis allergies, gastrointestinal problems, muscle problems, asthma, autoimmune diseases, cancer, atherosclerosis, inflammatory eye disorders etc..
It causes symptoms such as redness, stiff and aching joints, fever, headache, loss of appetite and fatigue.
What is Turmeric?
Turmeric is a yellow coloured powder obtained from the rhizomes of the plant, Curcuma longa belonging to the Zingiberaceae (ginger) family.
Ayurveda contains an age-long documented therapeutic use of turmeric as an anti-inflammatory agent.
Curcuminoids are the active compounds in turmeric which are responsible for its medicinal property.
There are mainly three curcuminoids: curcumin (diferuloylmethane), demethoxycurcumin, and bisdemethoxycurcumin. Curcumin gives a yellow colour to turmeric.
Use of turmeric for inflammation treats all of these symptoms efficiently in par with the anti-inflammatory drugs.
The active ingredient curcumin present in turmeric plays role in the treatment of various ailments and associated symptoms.
Please feel free to use the Table of Contents below to jump to the relevant section in the article.
Table of Contents
- What is Turmeric?
- How Turmeric Treats Inflammation?
- Why Turmeric better than Many anti-inflammatory drugs?
- Examples How turmeric Combats Inflammation in Various Disorders
- Turmeric Dosage
- In the end.
How Turmeric Treats Inflammation?
<The following section is slightly technical in natures as it elaborates how turmeric combats inflammation in the body>
Curcumin inhibits the action of different enzymes, transcription factors, cytokines and adhesion molecules involved in the inflammatory pathway.
These include phospholipase, lipoxygenase, cyclooxygenase 2, leukotrienes, tumour necrosis factor, thromboxane, prostaglandins, nitric oxide, interferon-inducible protein collagenase, monocyte chemoattractant protein-1, and interleukin-12.
Mode of protection provided by curcumin against different inflammatory molecules has been elaborated as follows:
Neutrophils are a kind of white blood cells which are activated as the first line of immune defence against the presence of foreign substances in the body such as pathogens.
Abnormality in the natural programmed death of these neutrophils is often associated with disorders like sepsis and acute lung injury.
The effect of Curcumin on neutrophil apoptosis (programmed cell death of neutrophils) was studied.
It suppressed the migration of neutrophils from lung endothelial (outer lining of the blood vessel) cells to the outer lining of lungs.
This migration was earlier responsible for the delay in death of neutrophils. Consequently, curcumin increased neutrophil apoptosis.
Neutrophils possess myeloperoxidase activity.
Myeloperoxidase is an enzyme that is responsible for the microbe-killing action of neutrophils. Curcumin treatment reduced the release of myeloperoxidase enzyme which is indicative of the decline in neutrophil activation.
The beneficial effect of curcumin is facilitated by the upregulation of peroxisome proliferator-activated receptor-γ (PPAR-γ) activation.
PPAR-γ regulate the expression of genes in fat tissues, large intestine and macrophages (immune cells that engulf the foreign substances in the body).
After sepsis (severe whole-body inflammation), PPAR-γ protein levels drastically decreases to half in the liver.
Pretreatment of septic rats with curcumin reversed the reduced levels of PPAR-γ to normal.
Arachidonic acid metabolic pathway
Arachidonic acid is released in the outer lining of the cell by enzyme, phospholipase A2 (PLA2). This acid can be metabolized through either COX or LOX pathway.
Cyclooxygenase is the chief enzyme in the COX pathway that converts arachidonic acid to prostaglandins (important in the expansion of blood vessels resulting in redness and heat) and thromboxanes (constrict blood vessels to allow clot formation).
In LOX pathway, lipoxygenases (LOX) convert arachidonic acid into leukotrienes (mediator of inflammation).
Curcumin acts against PLA2, COX-2, and 5-LOX activities to prevent inflammation.
Cytokines and other inflammatory molecular signals are responsible for activating COX-2 at sites of inflammation.
Overexpression of COX-2 gene has been found in various cancerous cells such as in colon, breast, head and neck, lung, pancreas etc.
In this way, inflammation and tumor formation are interrelated. Curcumin exerts its cancer preventive effect through its anti-inflammatory activity only.
Curcumin acts against inflammation through its ability to prevent cyclooxygenase-2 (COX-2), lipoxygenase (LOX), and inducible nitric oxide synthase (iNOS). COX-2, LOX, and iNOS are enzymes that play an important role in inflammation.
Pathophysiology of various types of human cancer and some inflammatory disorders is linked to inappropriate upregulation of COX-2 and iNOS.
In a mouse model of inflammation, curcumin blocked the pathway of arachidonic acid metabolism and inflammation by suppression of cyclooxygenase and lipoxygenase pathways.
Nuclear factor-kappa B (NF-kB) is a protein that binds to DNA and enhances the expression of pro-inflammatory genes such as COX-2 gene and inducible nitric oxide synthase (iNOS).
NF-κB plays an important role in upregulation of cytokines in many inflammatory diseases.
Curcumin suppresses activation of NF-κB by blocking activation of I-kappa B kinase (IKB) enzyme present upstream in a signal cascade that sends signals to NF-κB for propagating inflammation signals further by switching on all the inflammatory genes.
Nitric oxide is synthesized in inflammatory cells by the action of enzyme, intracellular nitric oxide synthase (INOS). Nitric oxide can form reactive oxygen species that damage DNA and other proteins.
Through animal studies in the laboratory, curcumin has shown its potential to inhibit both NF-kB as well as subsequent activation of COX-2 and iNOS.
Curcumin enhanced the anti-cancerous effect of gemcitabine in cancer patients by preventing: the proliferation of cancer cells, supply of blood as a nutrient to tumor cells and NF-κB-regulated genes. Upregulation of PPAR-γ may be linked to activation of NF-κB pathway.
Why Turmeric better than Many anti-inflammatory drugs?
Many non-steroidal anti-inflammatory drugs (NSAIDs) are present in the market for treatment of pain and inflammation. Some popular ones are aspirin, ibuprofen, naproxen, celecoxib, phenylbutazole, etc.
People often prefer natural remedies over chemical drugs due to side-effects associated with the long-term use of these chemical compounds.
Years of scientific study has proven that natural herbs like turmeric are safe and do not produce any toxicity in the body upon consumption.
In India, the pinch of turmeric is used on a regular basis in food which confirms that turmeric is safe if taken within edible limits.
NSAIDs are effective in their function but their prolonged use at higher concentrations can cause stomach problems such as ulcers and gastrointestinal bleeding and even increase the risk of developing stroke, cardiovascular disorders and kidney problems.
NSAIDs like Celecoxib act by inhibiting the inflammatory enzyme, COX-2 which is present in the stomach too. Stomach problems arise as these drugs block the COX pathway.
In case of steroidal drugs for inflammation, too many corticosteroids injection into joints can lead to joint damage.
Another reason of using turmeric for therapeutic purposes is its easy accessibility and cost-effectiveness as compared to the conventional NSAIDs being used.
It was found that anti-inflammatory activity of turmeric in decreasing inflammatory cytokine production exceeded that of NSAID by 10.2%.
Alzheimer’s disease (AD) is marked by high cytokines level leading to inflammation. NSAIDs are used in AD patients to suppress the inflammation but often lead to gastrointestinal, liver and kidney toxicity.
Hence, curcumin was studied as NSAID alternative in AD rat models where both low and high doses of curcumin were administered.
Both doses could significantly decrease interleukin-1β (proinflammatory cytokine) and the level of oxidized proteins in the brain of AD mice models. Curcumin was found to be effective and apparently less toxic relative to NSAIDs.
Examples How turmeric Combats Inflammation in Various Disorders
Curcumin, the most active ingredient of turmeric, has shown its therapeutic efficacy in a wide range of diseases where inflammation is directly or indirectly one of the major signs/causes.
The action of curcumin in some of these disorders has been elaborated below:
Inflammation is observed in the majority of cardiovascular diseases such as atherosclerosis and ischemia.
Use of curcumin protects the heart from ischemia and reperfusion by preventing a drop in the rate of heartbeat and blood pressure.
It also prevents the elevation of certain enzymes such as lactate dehydrogenase that rise following ischemia.
Curcumin reduces the risk of inflammation and heart failure by suppressing the expression of inflammatory genes.
It also shows hypocholesterolemic effect, free radical scavenging property, and antioxidant property that aid in controlling diabetes.
Orally taken curcumin corrects the metabolic processes and promotes glycemic control in people suffering from obesity and prevents diabetes.
By preventing oxidative stress and inflammation it also plays role in preventing diabetic retinopathy. The anti-nociceptive activity of turmeric along with insulin reduces diabetic neuropathic pain.
It also fastens the wound healing process that normally gets impaired in diabetics.
Read more about turmeric benefits for diabetes here>
Arthritis means chronic pain and inflammation in joints.
Antiarthritic effect of turmeric inhibits inflammation and destruction of joints by preventing activation of NF-κB and other genes regulating inflammation including chemokines and cyclooxygenase 2.
It also inhibits migration of inflammatory cells from plasma to damaged joint tissues and joint levels of prostaglandins.
Efficacy of curcumin was compared with phenylbutazone (an anti-inflammatory drug) in rheumatoid arthritis patients.
Curcumin could significantly improve swelling in joints, morning stiffness and walking time.
Anti-inflammatory action of curcumin has been studied in both acute and chronic animal models.
In acute model, curcumin was half as active in the chronic model. No toxic effect of curcumin was observed.
Meriva®, a curcumin-based drug exhibited therapeutic potential for management of osteoarthritis due to its long-term efficacy and safety when assessed on various inflammatory markers like interleukins and cell adhesion molecules.
What it means
Chronic joint inflammation and pain make life miserable for arthritis patients. Curcumin has the potential to treat it by acting directly on NF-κB which is responsible for regulating all the inflammatory genes.
Autoimmune diseases occur when the immune system of the host organism attacks its own body as it recognizes own tissues as foreign.
Severe inflammation is common in autoimmune diseases like multiple sclerosis, type 1 diabetes, rheumatoid arthritis, inflammatory bowel disease etc.
Overproduction of cytokines and chemokines leads to inflammation of body tissues.
Such condition becomes worse when chemokines attract other destructive components of the immune system such as macrophages, neutrophils etc. and magnify the inflammatory response.
Recent studies have shown that curcumin administration inhibits the autoimmune diseases by targeting all inflammatory cytokines and NF-κB signalling pathways leading to expression of inflammatory genes.
What it means
Autoimmune disorders are deadly as a person’s immune system becomes self-degrading as a result of which severe inflammation is bound to happen.
In such disorders, curcumin targets all the pro-inflammatory cytokines and chemokines to prevent amplification of inflammatory reaction.
Cancer is characterized by uncontrolled proliferation of cells due to an abnormality in their cell cycle. Some types of cancer arise from damaged tissues, inflammation and infection.
Inflammatory cells such as neutrophils help tumors to multiply and spread.
Tumors (a mass of abnormally growing cells) produce chemokines to attract neutrophils, nutrients and anchor systems towards themselves.
With the help of the support provided by cancer cells, tumors spread throughout the body and help propel the movement of neutrophils too.
Scientists have found a link between inflammation and cancer as anti-inflammatory medicines taken to treat inflammation showed prevention of certain kinds of cancer like colon and lung cancer.
Thus, curcumin’s anti-inflammatory property is anticipated to have chemopreventive activity too.
Anti-inflammatory action of curcumin involved in cancer treatment includes inactivation of NF-κB and COX-2 as COX-2 expression has been found in many types of cancers. Curcumin also causes inhibition of lipoxygenase pathway in arachidonic acid metabolism and scavenging of free radicals generated.
Curcumin also lowered expression of pro-inflammatory cytokines like interleukin-1ß, interleukin 6, and TNF-α causing growth suppression of cancer cell lines.
It also down-regulated inflammatory enzymes such as protein kinase C that is involved in the proliferation of tumors.
Nitric oxide (NO) plays an important role in inflammation and cancer.
Low dose curcumin inhibited NO synthesis by enzyme nitric oxide synthase(NOS). NOS activity was found to be lower in macrophages activated in presence of curcumin than that of macrophages activated in absence of curcumin.
What it means
Cancer and inflammation are interrelated. Hence, curcumin’s anti-inflammatory property comes into action in cancer prevention by inactivating C0X-2 gene often expressed in tumors and suppressing all the inflammatory mediators.
It also prevents nitric oxide formation during development of cancer.
Inflammatory bowel disease (IBD) is caused by inflammation in colon and small intestine. Various studies have shown curcumin to have a positive effect on patients with IBS due to its anti-inflammatory effect.
In many experimental models of IBD, curcumin administration has modulated elevated cytokine levels responsible for intestinal inflammation.
IBD carries a risk of cancer and causes a high rate of morbidity in adults and children.
Curcumin treatment of IBD children and adults effectively reduced activated p38 mitogen-activated protein kinase (p38-MAPK enzyme is activated by inflammatory cytokines) in the gut of children and adults, enhanced IL-10 (anti-inflammatory cytokine that inhibits synthesis of other human cytokines) and reduced IL-1β (cytokine involved in inflammation).
Ulcerative colitis (UC) and Crohn’s disease (CD) are two types of inflammatory bowel diseases. UC affects the colon and rectum parts of large intestine resulting in inflammation of the outer lining of the intestine.
CD can affect any part of the gastrointestinal tract and inflammation occur in the entire wall of the tract.
Pretreatment with curcumin in UC induced mice led to suppression of activated NF-κB in colon mucosal lining and reduced levels of all inflammation indicators i.e. nitric oxide, free radicals, neutrophil migration into intestinal tissues. Improvement in symptoms was also observed.
A preliminary study was conducted in 10 IBD patients (five with UC and five with CD).
Curcumin treatment was used in patients of both the groups. In UC group, curcumin led to improvement in inflammatory indicators: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
In CD group, Crohn’s Disease Activity Index (CDAI) scores decreased by almost half. It also led to the reduction in CRP and ESR in 4 out of 5 patients of CD.
ESR is usually increased in inflammation condition. CRP test is used to detect C-reactive protein in your blood that measures the general level of inflammation in the body.
Familial adenomatous polyposis (FAP) is a genetic disease marked by the formation of abnormal growth of tissues in colon.
In a clinical study, a decline in the number and size of polyps was found in the FAP patients receiving curcumin treatment.
Curcumin gave the similar level of output as received during treatment with NSAIDs (Non-steroidal anti-inflammatory drugs).
What it means
Inflammation in the intestine is the main cause of many inflammatory gastrointestinal disorders such as Ulcerative colitis, Crohn’s disease, Familial adenomatous polyposis etc.
Curcumin has the potential to reduce the high cytokine level in the gastrointestinal tract and behave as efficient as NSAIDs in the inflammation treatment.
Asthma is an allergic reaction that causes difficulty in breathing. It involves inflammation of the air passage caused by the action of inflammatory molecules such as histamine, leukotrienes, and various other cytokines.
These molecules make lungs extra responsive to different forms of stimulus, stimulate the production of mucus which obstructs airway to make breathing harder and changes the lining of the blood vessels in the air passage.
Usually, anti-inflammatory drugs are taken to inhibit leukotrienes production.
The effectiveness of curcumin was studied in animal models of asthma. Curcumin significantly reduced the allergic reaction.
Curcumin displays anti-allergic properties by inhibiting release of histamines (inflammatory mediator) from mast cells (immune cells playing role in allergy).
What it means
Histamines and leukotrienes play role in allergic reactions like asthma where the allergen stimulates mast cells to release histamines and leukotrienes as an immune response against hypersensitivity.
Turmeric exhibits its anti-allergic action by hindering the release of these inflammatory mediators during times of allergy.
Inflammatory eye diseases
Anterior uveitis is characterized by inflammation of the uveal tract (one of the layers of the eye) which if remains untreated can cause blurred vision and even blindness.
In a study, anterior uveitis patients received curcumin and showed 100 percent improvement in visual flair (ability to distinguish between shapes and details of objects) and aqueous flare (breakdown of eye and blood barrier).
Curcumin has also been used for idiopathic orbital inflammatory pseudotumors (IOIP). IOIP is marked by the formation of a hard, non-cancerous lump of cells in the eye and inflammation of the moist inner surface of eyelids.
Curcumin treatment led to complete recovery from the disease in 4 out of 8 patients, one did not show the symptoms of the disorder and remaining continued to have restricted eye movements.
What it means
Curcumin do not directly heal the eye problems but act against inflammation which is one of the causes behind such eye disorders.
Curcumin treatment in patients suffering from such problems has resulted in complete visual improvement.
Transplant rejection is quite common as the host body treats the transplant as a foreign substance and generates an immune response against it.
In a study, reduced transplant rejection was observed in all the kidney recipients who had taken curcumin for a month.
Transplant rejection occurs when antibodies of the host binds to the antigens on the graft and activates immune system.
As inflammation takes place as an immune response of the body, it prevents blood supply to the graft and graft is damaged due to lack of oxygen in it.
Delayed transplant rejection was completely prevented in a study where kidney transplant patients received a combination of curcumin and quercetin.
Since the amount of quercetin compound was very little in the combination, delayed rejection was attributed to anti-inflammatory and anti-oxidant function of curcumin only.
Curcumin could successfully induce improved early function of the transplanted kidneys by inhibiting NF-κB and proinflammatory cytokines and removing all the reactive oxygen species responsible for tissue damage.
What it means
Transplant is often rejected by the host’s immune system when it treats the transplant as a foreign object and damages it.
Curcumin prevents the damage of transplant by suppressing NF-κB that controls expression of all inflammatory genes and eliminating free radicals produced in the body that creates oxygen-deficient environment for transplanted organ.
Turmeric is very safe when used as a spice.
To know more details on how much turmeric you can use in a day check this detailed article on dosage. If you are wondering how to include turmeric in your diet here is my list of two awesome ways:
Also, there so several other recipes under recipe section of the website.
In the end.
Turmeric is one of the best natural anti-inflammatory agents. This is proven by research. It not only helps with inflammation but has no side effects as compared to drugs used to treat inflammation as pain in disorders such as arthritis.
If you have tried turmeric for inflammation, please do share your feedback through comments.