Curcumin and Heart Health (SQ-106)
There has been a lot of buzz around curcumin and its health benefits lately. It is one of the bioactive compounds in turmeric, the quintessential yellow spice that lends color and flavour to most Indian curries.
In Ayurvedic medicine, the turmeric root is highly acknowledged as a powerful medicinal herb. Ayurvedic practitioners have used this golden herb for thousands of years to heal and repair the body from a wide range of conditions (such as joint pain, indigestion and poor liver function) and to support the function of many important body systems (such as circulatory, immunity and cardiovascular systems).
Turmeric also contains other active compounds, collectively known as curcuminoids. Out of these, curcumin is possibly the most widely-researched so far. A lot of studies have investigated its medicinal properties, with most of them attesting to its therapeutic role in many health conditions, especially those arising from chronic inflammation.
This brings us to the link between curcumin and heart heath. Many high-quality studies support its potential in controlling inflammation, the main reason why curcumin is being touted as a natural supplement to reduce your risk of heart disease and boost heart health.
The role of inflammation in heart disease
Research suggests that chronic inflammation plays a major role in the development of many diseases including cardiovascular disease.
In the short-term, acute inflammation is a critical part of how your body protects and repairs itself. It helps the body fight infections and heal injuries. When your immune system responds to outside triggers, you experience tell-tale signs of inflammation, such as pain, redness and swelling. It is because of the bio-chemical dance taking place between various chemicals, proteins and hormones secreted by your immune cells. Though uncomfortable, this immune response is what you need to destroy pathogens and to heal and repair the body from the damage.
As the name suggests, this kind of inflammation and its symptoms don’t stick around for long and disappear once your immune system is able to outperform the triggers. The problem occurs when inflammation gets out of hand.
Some triggers keep your immune system constantly active, releasing chemicals and activating pathways that increase inflammation in the body. This happens when your body is continuously coming into contact with agents that cause injury or damage to your cells and tissues.
Triggers such as stress, smoking, unhealthy diet, overuse of medications, lack of sleep, excessive alcohol consumption and continuous exposure to germs, pathogens, pesticides, heavy metals and chemicals damage the body by generating excessive amounts of free radicals in the body. These molecules cause oxidative damage to your cells and their lipids, DNA and mitochondria, compromising their structure, stability and function in the process. This chaos increases oxidative and inflammatory stress in the body – linked to many of the health problems we are facing today.
Oxidative damage to low-density lipoproteins (LDL cholesterol) in the arteries is considered as one of the key steps in the development of atherosclerosis – where plaque builds up in the arterial wall. This causes hardening and narrowing of the arteries, reducing the flow of blood to the organs and increasing one’s risk of heart attack, stroke and peripheral artery disease.
Unfortunately, our modern lifestyle is full of these triggers, gathering up a perfect storm for low-grade inflammation. But the good news is that mainstream doctors and nutritionists are realizing this missing link while treating heart disease – emphasizing dietary and lifestyle interventions that reduce inflammation in the body.
Changes in your diet also include taking antioxidant supplements that not only reduce inflammation and protect heart health but also reduce the risk of other conditions that negatively affect your cardiovascular health. This is where curcumin helps.
There is credible scientific evidence of curcumin’s “antioxidant, anti-inflammatory, antimicrobial and chemopreventive” properties.
Curcumin reduces oxidative damage and inflammation
Curcumin is a powerful anti-oxidant that scavenges free radicals and protects the body from oxidative damage. While it is a strong antioxidant in itself, curcumin also improves the levels of antioxidant enzymes in the body.
Curcumin is also a solid anti-inflammatory that works in various ways to reduce inflammation. It blocks various proteins, enzymes and molecules that encourage inflammation. For example, curcumin inhibits both the production and activity of cyclooxygenase enzymes. These enzymes produce chemicals like prostaglandins that cause inflammation, pain and fever.
Curcumin blocks NF-κB, a molecule that turns on genes that produce pro-inflammatory molecules. Research shows that curcumin might bring similar improvements in relieving arthritis symptoms (related to pain and inflammation) as NSAIDs such as ibuprofen and diclofenac sodium.  Conventional nonsteroidal anti-inflammatory drugs (NSAIDs) also block cyclooxygenase enzymes and the NF-κB signalling pathway to reduce pain and inflammation in the body, but NSAIDs have a serious and damaging impact on the gastrointestinal tract and cardiovascular system if taken for long periods.
The antioxidant and anti-inflammatory capabilities of Curcumin are the reason why it can be a helpful supplement to manage various health conditions that stem from chronic inflammation. Many clinical trials have found curcumin to be safe, well-tolerated and effective against many types of chronic ailments. Curcumin “has been shown to be active against various chronic diseases including various types of cancers, diabetes, obesity, cardiovascular, pulmonary, neurological and autoimmune diseases.” 
Curcumin improves endothelial functions
There is a strong link between endothelial dysfunction and heart disease. Endothelium is a thin membrane that lines the inside of the blood vessels. The cells of a healthy endothelium release enzymes and other molecules that regulate many critical functions such as:
- Contraction and relaxation of blood vessels, which determines blood flow to various tissues
- Protecting blood vessels from oxidized LDL particles and other toxic substances in the bloodstream
- Blood clotting
Studies show that curcumin improves endothelial functions. A 2017 review concluded that “Curcumin appears to improve endothelial function, but additional research is needed to determine the precise mechanism(s) and biomarkers involved in curcumin's therapeutic effects on endothelial dysfunction.” 
A randomized controlled double-blind parallel prospective study showed that curcumin supplementation improved endothelial function in healthy adults. In this study, 59 young, healthy adults were given either placebo, 50 mg or 200 mg of curcumin for 8 weeks. While a 50 mg dose improved endothelial functions, 200 mg dose resulted in better and more meaningful outcomes. 
Another study investigated the effects of curcumin on endothelial function in postmenopausal women. Endothelial health becomes compromised as you age, increasing the risk of cardiovascular disease in the elderly. The study found that both curcumin and aerobic exercise protected endothelial function from age-related decline. This indicates that curcumin is likely to be just as effective as exercise in improving endothelial function. 
Most studies suggest that curcumin improves endothelial function by supressing inflammation, reducing oxidative damage and increasing the bioavailability of NO (Nitric Oxide), an important signalling molecule released by endothelium. NO maintains vascular health though various properties such as regulation of the dilation in blood vessels and prevention of abnormal constriction of the arteries.
Curcumin improves insulin resistance and reduces type 2 diabetes risk
Factors like high blood sugar levels, insulin resistance and obesity independently increase your heart disease risk.
In type 2 diabetes, excessive sugar levels in the blood will damage large and small blood vessels – leading to cardiovascular disease and other complications.
Insulin resistance (IR) is a condition where your cells build resistance to the insulin. IR causes endothelium to function poorly. Endothelial dysfunction, as we know, causes atherosclerosis, high blood pressure and coronary artery disease. Insulin resistance also increases your odds of developing metabolic syndrome, pre-diabetes and type 2 diabetes – causing further damage and inflammation in the arteries. This is bad news for your heart.
Oxidative stress, inflammation, obesity and insulin resistance seem to play a concrete role in the onset and progression of type 2 diabetes. Curcumin reduces the risk of these underlying factors. 
In a study conducted in Thailand, curcumin was found to significantly reduce the risk of developing type 2 diabetes in prediabetic individuals. The study reported that curcumin appears to protect beta cells of pancreas from oxidative damage, thereby improving their functions. Beta cells release insulin that helps your cells to absorb glucose available in the blood circulation.
The study concluded, “A 9-month curcumin intervention in a prediabetic population significantly lowered the number of prediabetic individuals who eventually developed T2DM. In addition, the curcumin treatment appeared to improve overall function of β-cells. This study demonstrated that the curcumin intervention in a prediabetic population may be beneficial.” 
In a nutshell
Curcumin offers cardioprotective benefits as it:
- Scavenges free radicals and reduces oxidative damage
- Improves the level and activity of antioxidant enzymes, which then further builds your body’s antioxidant capabilities
- Reduces inflammation by blocking pathways and enzymes that promote an inflammatory environment in the body
- Improves endothelial function by reducing oxidative damage and stimulating the production of NO, a molecule that helps in blood vessel dilation and blood pressure regulation.
- Reduces the risk of type 2 diabetes by improving insulin sensitivity in cells, reducing blood sugar levels and protecting beta cells from oxidative damage
- Reducing pain and inflammation in arthritis (osteoarthritis and rheumatoid arthritis)
- Offering protection against radiation exposure
- Liver disorders
- Weight loss
- Alzheimer’s, depression and brain inflammation
- Improving the efficacy of chemotherapy
Can curcumin help cancer patients? Preliminary studies hint that curcumin may stop cancer cells from growing and spreading. One of the most helpful features is that curcumin lowers inflammation in the body, mostly by blocking many enzymes and signalling molecules that trigger pain and inflammation. Curcumin also supports your immune system’s natural capability to identify and destroy cancer cells.
Perhaps where it shines the most is in its ability to increase the success of some chemotherapy drugs.  Curcumin can reduce the side effects typically associated with these drugs and make cancer cells more vulnerable to chemotherapy.
In addition, it can reduce damage caused by radiation therapy. For example, a study showed that curcumin reduces skin damage caused by radiation therapy in breast cancer patients.  This is an important benefit, as the majority of patients who undergo radiation therapy will suffer from dryness and redness or peeling of skin.
This is called radiation dermatitis.
What kinds of curcumin supplements work best?
The problem with curcumin is that it is poorly soluble in water and poorly absorbed from the intestines. It is also very quickly metabolised and rapidly eliminated from the body. This means it doesn’t stay in the circulation for long, basically not reaching the intended tissues effectively. All these characteristics limit the usefulness of curcumin supplements.
Taking curcumin supplements with a fat-rich diet and piperine may help increase its absorption. Another way you can work around bioavailability issue is by taking a liposomal curcumin supplement. Liposomal supplements are very effective in improving the bioavailability of a nutrient or a compound like curcumin. This translates into better absorption by the cells.
Although many clinical trials have demonstrated its benefits in heart and overall health, we don’t recommend ditching your regular medication to reduce your cholesterol levels, manage diabetes or treat cancer. Curcumin is best used as an adjunct therapy, where it is used as a supplement along with your regular, traditional medicine. Make sure you are buying your supplement from a trusted source to avoid heavy metal contamination.
Taking a curcumin supplement may not be entirely without risk, especially if you are taking other medications such as blood thinners. Some medications may interact with curcumin. Curcumin is generally considered safe but may cause side effects such as nausea and skin rash. So, it is best to work with an expert health practitioner to determine the benefits of taking a curcumin supplement and what dose should be right for you.
- Daily et al. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016
- Kunnumakkara et al. Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases. Br J Pharmacol. 2017
- Karimian MS et al. Curcumin and Endothelial Function: Evidence and Mechanisms of Protective Effects. Curr Pharm Des. 2017
- Oliver et al. Novel Form of Curcumin Improves Endothelial Function in Young, Healthy Individuals: A Double-Blind Placebo Controlled Study. Journal of Nutrition and Metabolism. 2016.
- Akazawa et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutrition Research. 2012.
- Ghorbani et al. Anti-Hyperglycemic and Insulin Sensitizer Effects of Turmeric and Its Principle Constituent Curcumin. Int J Endocrinol Metab. 2014
- Chuengsamarn et al . Curcumin Extract for Prevention of Type 2 Diabetes. Diabetes Care. 2012.
- Kumar et al. Molecular mechanisms underlying chemopreventive potential of curcumin: current challenges and future perspectives. Life Sciences. 2016.
- Ryan et al. Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiation Research. 2013.