- Turmeric and black pepper
- Curcumin is amphiphilic
- Curcumin pairs well with antioxidants
- Why I avoid curcumin phospholipid products
- Curcumin supplement comparison
- Curcumin supplements on Amazon
Curcumin is all the rage in the supplement world, but Houston, we have a problem.
Curcumin is poorly absorbed and quickly metabolized, so supplement manufacturers are always looking for ways to increase absorption. In the U.S., bigger is seen as better. If a little turmeric is healthy for us, a mega-dose of turmeric’s primary antioxidant, curcumin must be even better, or so the thinking goes.
However, not all supplement experts agree that ultra bioavailable curcumin is always the best option.
For an interesting discussion on why you might want to skip curcumin altogether and simply start cooking with turmeric, take a look at this podcast interview I did with an industry insider in the supplement world.
The rest of the post will be devoted to the safest ways to increase curcumin absorption (since let’s be real, none of you are going to stop taking the stuff).
Turmeric and black pepper
For a few years now, the conventional wisdom has been that black pepper and curcumin should be taken side by side, as black pepper has been shown to increase curcumin’s bioavailability by 2,000% over curcumin alone.1
Pairing curcumin with black pepper will increase bioavailability, but black pepper has the potential to slow the metabolism of multiple drugs, potentially blunting the health benefits of curcumin by causing the unhealthy accumulation of OTC and pharmaceuticals in the body.2
New studies have introduced a fresh way of increasing curcumin’s bioavailability even further: pairing it with fat.
Curcumin is amphiphilic
Meaning it can dissolve into water or fat.
Just like carotenoids, curcumin is fat soluble, meaning it is better absorbed when paired with fat. For this reason, “curcumin phytosome” products, which dissolve curcumin in either phosphatidylcholine or lecithin, are all the rage right now, and some have data to back them up.
For example, this study examining Meriva, a curcumin phytosome product (View on Amazon), and its impact on ostearthritis, seems to justify the practice of blending curcumin with phospholipids. Meriva uses a phosphatidylcholine blend produced from sunflower.
To quote the study:
These results show that Meriva® is clinically effective in the management and treatment of osteoarthritis and suggest that the increased stability and better absorption of curcumin induced by complexation with phospholipids have clinical relevance, setting the stage for larger and more prolonged studies.
The Meriva study seems to corroborate others that have looked at ways of enhancing curcumin’s bioavailability. For his post evaluating curcumin’s health benefits, Aaron put together this chart which shows the various methods developed for adding curcumin to a phospholipid blend, as well as dissolving it in a water based solution:
CS = standardized curcumin mixture, CTR = curcumin with volatile oils to aid absorption, CP = curcumin with lipophilic phytosomes (lipid loving molecules to aid absorption), CHC = curcumin with PVP and natural antioxidants. Values are relative absorption of various curcuminoids into the blood, actual values are available in the paper. Red colored values are the worst performing for each type of curcuminoid, greens the best.
As you can clearly see in the table above, the CHC preparation (which features Polyvinylpyrrolidone (PVP) and vitamin C and E) significantly outperforms all other preparations, especially pure curcumin alone. So, while phospholipids elevate the bioavailability of curcumin, the water soluble formula plus antioxidants outperforms them all. Now, keep in kind that both the Meriva and PVP studies appear to have been conducted by interested parties, but I see the willingness to engage in actual clinical trials encouraging, and will take the absorption data at face value.
Bottom line is this is what we have to go on at the moment.
The bioavailability data cited above demonstrates that curcumin is amphiphilic, meaning it loves fat and it loves water.
Curcumin pairs well with antioxidants
The table above also suggests that curcumin bioavailability is enhanced when paired with antioxidants.
While phosphatidylcholine blends also increase the bioavailability of curcumin, I don’t use them because there is reason to believe they are not heart healthy for some people.
Let me explain.
Why I avoid curcumin phospholipid products
As consumers of supplements, we all hold our noses and swallow a litany of “other ingredients,” such as magensium stearate or soy lecithin, because they are included in very tiny amounts to facilitate delivery of nutrients we believe are good for us.
However, what happens when those ingredients become part of the main dish? In the world of curcumin supplementation, phospholipids are becoming a bigger part of the pie.
Some brands, like Gaia for example, are dissolving curcumin in phospholipid solutions that contain unknown amounts of soy lecithin. Others, like the Seeking Health Liposomal Curcumin product add curcumin to phosphatidylcholine in a similar fashion to Meriva.
Does the addition of these fats alter the health benefits of curcumin? Likely not in a significant way, but I would prefer top avoid the omega-6 fats the liposomal products are dissolved in.
Phosphatidylcholine and trimethylamine-N-oxide (TMAO)
TMAO is a metabolite of phosphatidylcholine and lecithin that has been linked to an increased risk of heart disease. How? Our gut bacteria break down these phospholipid fats into a substance (TMAO) that is thought to damage our arteries. I generally stay away from lecithin and liposomal supplements because of this TMAO data.
A New England Journal of Medicine study found that increased levels of TMAO were a significant independent risk factor for heart disease, even for people with otherwise normal markers.
To quote the NEJM study:
After adjustment for traditional risk factors and other baseline covariates, elevated plasma levels of TMAO remained a significant predictor of the risk of major adverse cardiovascular events.
The NEJM study calls out phosphatidylcholine directly as a causative agent in producing TMAO:
We recently described the potential role of a complex phosphatidylcholine–choline metabolic pathway involving gut microbiota in contributing to the pathogenesis of atherosclerotic coronary artery disease in animal models. We also reported an association between a history of cardiovascular disease and elevated fasting plasma levels of trimethylamine-N-oxide (TMAO), an intestinal microbiota-dependent metabolite of the choline head group of phosphatidylcholine that is excreted in the urine.
Some dismiss the NEJM study saying that eating fish, long thought to be heart protective, causes a spike in TMAO as well. As a result, they reason that we needn’t worry about TMAO. The NEJM study seems very sound to me. Its conclusions are reasonable and do not recommend avoiding phosphatidylcholine altogether.
It should also be noted that choline is a semi-essential nutrient and should not be completely eliminated from the diet, since this can result in a deficiency state. However, standard dietary recommendations, if adopted, will limit the intake of phosphatidylcholine- and choline-rich foods, since these foods are also typically high in fat and cholesterol content.
Limit phosphatidylcholine to keep TMAO levels in check, got it.
From where I’m sitting, I want to use my choline intake on foods I enjoy, like the occasional steak, or fried egg, not on sunflower oil goo unnecessarily added to a supplement.
As with many issues, including balancing dietary histamine, TMAO levels must be balanced. TMAO can be excreted in urine rendering it harmless. It is only when levels build that problems can arise. What better way to build TMAO levels than to take phosphatidylcholine on a daily basis in the form of a supplement? And the sad part is that most people have no clue what they are taking. We are trained to ignore the peripheral “other ingredients” on our supplement labels.
Ask someone taking Mariva what they are taking and they will answer curcumin, but they are also taking a daily dose of phosphatidylcholine. Daily ingestion of curcumin product like this could contribute to bad outcomes over time for some people.
Furthermore, TMAO isn’t the only issue with choline and lecithin supplements. Many of these fats can raise the body’s omega 6 levels, which is also inflammatory.
The irony for me is that some of the data points to an increase in bioavailability with water soluble, antioxidant solutions that exclude potentially unhealthy fats.
If phospholipids aren’t necessary for proper absorption of curcumin, why use them?
Below, I review some of the most popular curcumin brands on Amazon and give you an idea of what to look for on the labels, and how to choose a good quality product.
Curcumin supplement comparison
Ok, so you know my take on the various curcumin formulas that are out there. Other than for short-term use, say for pain management, I avoid the phospholipid and black pepper formulas because of concerns I have about spiking TMAO. When you factor in that antioxidant preparations have shown greater bioavailability, I opt for “fat free” curcumin, or add my own capsule to a spoonful of good-quality olive oil.
Curcumin supplements on Amazon
|CurcuWin Curcumin (View on Amazon)||N||N||60 capsules|
|Omega Curcumin by Nordic Naturals (View on Amazon)||N||Y||60 capsules|
|Seeking Health Liposomal Curcumin (View on Amazon)||Y||Y||8 ounces|
|Gaia Turmeric Supreme (View on Amazon)||Y||N||120 capsules|
|Jarrow Curcumin (View on Amazon)||N||N||120 capsules|
|Meriva Curcumin by Thorne (View on Amazon)||Y||N||120 capsules|
Although it has a terrible name, CurcuWin Curcumin (View on Amazon) was the type of curcumin that showed the greatest bioavailability in the study we cite above. Granted, that study was funded by the manufacturer of CurcuWin, Omni Active Health Technologies, Inc., but as we’ve discussed on this blog in the past, the willingness of a supplement manufacturer to engage in clinical trials at all is usually a good sign. That, and this blend contains no phospholipids or black pepper.
An overall great product from Nordic Naturals (View on Amazon) with an added small dose of NAC and glutathione plus good quality fish oil, but beware of the soy lecithin for long term use.
Seeking Health Liposomal Curcumin
Seeking Health is a reputable company that makes good quality products, and I like the addition of resveratrol to this blend. The issue with this liposomal curcumin formula (View on Amazon) is that it only has 200mg of curcumin (very low dose) and uses a phosphatidylcholine blend, which triggers TMAO concerns as well as concerns about inflammation. The goal for many people taking curcumin is to reduce levels of inflammation. Heavy doses of phospholipid fats can raise the levels of omega 6 fatty acids. When omega 6 ratios rise too far above omega 3 levels, inflammation can result.
Gaia Turmeric Supreme
Again, I have sampled this product (View on Amazon). If you were to break apart a capsule, you’d find a gooey liquid blend of curcumin, black pepper, and lecithin oozes out. This leads me to believe the product is heavy on the lecithin. For those taking medications, the black pepper could prevent proper metabolism, keeping the drugs in your system longer than is safe. Further, the product does not use 95% curcuminoid standardization.
This Jarrow formula (View on Amazon) is packed with good-quality curcumin at 95% standardization and is good for daily use. However, I have two problems with the blend. One, there are no antioxidants added to increase bioavailability. Two, the curcumin powder escapes the capsule such that when you touch it, your hands get yellow. If you touch a dress or a shirt after handling the Jarrow product, it will stain.
Meriva Curcumin by Thorne
The study we cited to above shows that Meriva (View on Amazon) is an effective supplement for relieving short-term inflammation, and this is undeniably a good product. My concern again is the phosphatidylcholine and that the marketing is way out in front of the science. We don’t know how heart healthy these types of products are for people over the long term. Short-term use, for example as an alternative to NSAIDs, could be considered.