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As of May 2021, there have been over a dozen cases of liver injuries caused by turmeric supplements reported to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. The number may be higher since some incidents may have gone unreported. Meanwhile, turmeric teas and supplements are popular, since they contain a compound called curcumin that has been shown to help ease inflammatory conditions in small studies.
However, some people experienced liver damage and jaundice after taking these supplements. Fortunately, all patients recovered with proper treatment. However, five particular cases were presented at the annual scientific meeting of the American College of Gastroenterology in October to give better insight into this phenomenon.
5 Cases of Turmeric Supplements Calling Liver Injury
One case involved a 49-year-old woman who was overall healthy. However, she began to experience nausea and vomiting after taking a turmeric supplement every day for three months. She was following the packaging’s recommendation of one dose per day. Her symptoms ceased when she stopped taking the doses and returned when she restarted.
Her skin began to yellow, along with the whites of her eyes. Medical tests indicated she had a severe liver injury. The yellowing occurred because her liver couldn’t function properly. It stopped being able to process bilirubin, a yellow substance created naturally as red blood cells break down. This led to jaundice. Fortunately, she recovered after getting steroids and the medicine N-acetylcysteine and left the hospital after three weeks.
Similar cases also include people taking the recommended dose printed on the supplement. For instance, a 62-year-old woman developed nausea, abdominal pain, and jaundice after ingesting a daily turmeric tea for three weeks. She became diagnosed with a liver injury and recovered with proper treatment.
Most people who take turmeric supplements don’t experience any liver damage. Therefore, Ken Liu at Royal Prince Alfred Hospital in Sydney, Australia, theorizes that genetic factors could cause these reactions for some people. “When you take a herbal supplement, it gets digested and absorbed into your bloodstream, then enters the liver to be metabolized before going to the rest of your body,” he says. “That metabolism is done by enzymes in the liver that are genetically different from one person to the next, so some people process it into something that is inert and harmless, while others process it into something toxic.” 
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Curcumin in Food vs. Supplements
Keep in mind, supplements present more of a potential risk than eating turmeric in food. This is because supplements often have additives to enhance the absorption of curcumin in the body. For example, many of these supplements and teas contain black pepper, which increases the absorption of turmeric by 30-fold. Although this combination appears in cooking, the other food ingredients often limit the absorption and reduce the effect of curcumin in the body.
On the flip side, it’s hard to attain the benefits of curcumin from eating turmeric since the curcumin content isn’t that high, nor is it well absorbed. Supplements provide a concentrated form of curcumin, often with ingredients like black pepper to enhance absorption.  Remember, these cases aren’t an inherent reason to avoid turmeric supplements, which can be taken for legitimate reasons. However, these cases should encourage some caution.
It’s important to pick quality products and consult with your doctor before taking them, as well as monitor your symptoms throughout. Although there are studies underway that continue to examine the effects of curcumin, there are some benefits that we know of so far. Multiple preclinical studies found that curcumin has antioxidant and anti-inflammatory properties, which is why some people turn to them to help with inflammatory conditions like arthritis or oxidative stress-related diseases. Some studies even indicate anti-cancer and neuroprotective effects.
Because of this, research is investigating curcumin’s potential uses for arthritis, heart disease, cancer, Alzheimer’s, and major depression; however, more human studies need to confirm its effectiveness.  But in general, many people take supplements believing they are completely risk-free and don’t think to mention supplements when medical professionals ask if they are on any medications, which can make it difficult to diagnose an issue caused by herbal supplements. This does not only refer to turmeric.
For instance, a 19-year-old developed jaundice, severe itches, and dark urine after taking ashwagandha supplements. Moreover, a 55-year-old woman experienced loss of appetite, dark urine, and itchiness after ingesting a tea with rhubarb root, skullcap root, and gardenia fruit. In both cases, the liver injuries healed after they stopped using the tea and supplements.
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How to Find High Quality Dietary Supplements
In any case, it’s important to choose quality dietary supplements. With a lack of regulation, quality supplements can be hard to come by, however, there are a few easy ways to find them. First, look for a third-party certification backing the claims on the label, this means what is on the label is in the product at the dose listed. Look for a company that routinely does batch testing on their raw materials either in-house or preferably by a reputable third party. Batch testing will look for contaminants like heavy metals — including mercury, lead, cadmium, and arsenic — pesticides, toxins, and dioxins.
As of now, in the United States, the Dietary Supplement Health and Education Act of 1994 allows manufacturers to sell supplements without running them by the FDA. Instead, the FDA has to prove an item is unsafe to take it off the market, which allows somewhat questionable products to stay on store shelves. Since there’s no FDA approval on any of these supplements, look for a certification from independent laboratories like United States Pharmacopeia, NSF International, and ConsumerLabs.com. Try to find certifications from an established and reliable laboratory instead of an unknown one that may not have high standards for their testing.  In Canada, all supplements need to have a Natural Product Number (NPN), which is similar to a Drug Identification Number (DIN), but for natural products. This approach does add some regulation but does nothing to guarantee ingredient label claims or test for adulterants.
Turmeric Supplement Recommendation
For example, take this turmeric supplement: Natural Factors Theracurmin® CurcuminRich™. It claims to give optimal curcumin absorption, as well as benefits like supporting “a healthy inflammation response,” exerting “antioxidant activity,” and helping to “relieve joint pain associated with osteoarthritis of the knee.” The company, Natural Factors,” is partnered with ISURA, who tests and certifies all of their products. ISURA is an independent, not-for-profit organization that verifies supplements and food products. Their label indicates the product is contaminant-free, authenticated, and accurately and inclusively labeled.  This is just one example. Note that this is a Canadian company, and therefore the product has an NPN number.
Fortunately, there are many high-quality and certified products available from many different companies. Once you know what to look for, the more you’ll find. Before starting any new supplement, talk to your doctor to ensure they are right for you and won’t interfere with any medications or worsen any current health issues.
Keep Reading: 9 Foods That Support Liver Function
- “Turmeric supplements have been linked to liver damage in five people.” New Scientist.Alice Klein. October 25, 2022.
- “Curcumin.” Examine. Antonis Damianou MSc. September 28, 2022
- “10 Proven Health Benefits of Turmeric and Curcumin.” Healthline. Kris Gunnars, BSc. May 10, 2021
- “Analysis: Some natural supplements can be dangerously contaminated.” PBS. C. Michael White. February 19, 2020
- “Natural Factors and ISURA® – A Partnership with a Common Mission.” Natural Factors. April 1, 2022.