Bio -available curcumin for rheumatoid arthritis

Unfortunately we have to weigh the advantages and costs for the various forms of curcumin available on the market in the long term.

Intervention

The patients were randomized and received either 250 mg curcumin extract for 90 days, 500 mg of curcumin extract twice a day or 500 mg in food quality than placebo twice a day. The turmeric product consisted of main components of the turmeric root. The dietary supplement used was reproduced by recombination of extracted curcuminoids (50 %), etheric turmeric oil (3.0 %), protein (2.0 %), Total carbohydrate (40.0 %) and fiber (5.0 %). The curcuminoids were extracted with ethanol, the essential oil was extracted by water vapor distillation and the carbohydrates, fiber and proteins were extracted with water.

The study was carried out at the Dhanwantri Ayurvedic College Hospital and Research Center, Siddapur, Karnataka, India. Three of the authors are employees of Aurea Biolabs LTD, the manufacturer of the nutritional supplements and a research subsidiary of Plant Lipids Ltd. The other authors do not report any conflicts.

study parameters evaluated

Total cholesterol, random serum glucose, creatine, sodium, potassium, urea, overall picture, overall protein, albumin, alkaline phosphatase, CRP, BSG, rheumatism (RF), disease activity score 28 (DAS28), visual analog scale (VAS), American College of Rheumatology 20 (ACR20), totally swollen joints and totally pain -sensitive joints.

important knowledge

There were no significant changes between the initial value and the end of the visit or between the 3 treatment groups for the following measurements: size, weight, BMI, total cholesterol, random glucose, creatine, sodium, potassium, urea, overall picture, overall protein, albumin, and alkaline phosphatase.

The statistically significant changes in the ratings are included compared to the starting value:

• VAS improved in every group: low dose, 62.5 %; high dosed 72.3 %; Placebo, 3.5 %
• Das-28 improved in the groups with lower (52.6 %) and high dose (66 %), but remained unchanged in the placebo group
• ESR fell in every group: low dose, 88.1 %; High dose, 88.6 %; Placebo, 29.6 %
• CRP fell in every group: low dose, 29.9 %; High dose 51.2 %; Placebo, 11.3 %
• RF fell in every group: low dose, 80.2 %; High dose 84.2 %; Placebo, 13.1 %
• The ACR20 scores fell in the low dose (70.3 %) and high-dose (75.7 %) group, but remained unchanged in the placebo graduate
• overall swollen joints fell in each group: low dose, 80.4 %; High dose, 84.8 %; Placebo, 3.7 %
• Total joint joints fell in each group: low dose, 78.1 %; High dose, 88.0 %; Placebo, 4.4 %

All improvements in the assessment and reduction of inflammatory markers were statistically significant compared to placebo in both the high dose and low dose treatment group ( p ≤ 0.001 for all except the low dose for overall pain-sensitive joints [ p ≤01]). Although the high dose group had major changes compared to the low dose group, they were not significantly larger.

No side effects have been observed or reported and both doses were well tolerated.

practice implications

It is known that curcumin has therapeutic effects in cardiovascular, neurodegenerative, psychiatric (depression), lung, metabolic, autoimmune and neoplastic diseases. ^{1,2 The main problem was the absorption and the finding of therapeutic dose that is handling and not nausea and diarrhea caused. 3 study doses were up to 12 g a day. The result was a strong increase in products that claim to be more bioavailable than their competitors. 4}

A review of 7 forms of curcumin available on the market showed that a hydrophilic carrier curcuminoids dispersed somewhat better than a curcuminoid-cyclodextrin complex with a 45.9- or 5 The product used in this study was not part of this review and does not claim to be bi. like the hydrophilic and cyclodextrin forms. One of the examined study products made a 65-time more bioavailable statement, but methodological anomalies make their purpose unclear.

In 2015, Gopi (one of the authors of the present study) led et. A single-dose-dose-bioequivalence study with 500 mg of the new study, 500 mg 95 % unformulated curcumin and placebo. ^{6 The participants were 12 healthy men between the ages of 18 and 45 with BMIs from 18.5 to 30.0. The newly formulated curcumin was 10 times more bioavailable than the unformulated 95 % curcumin.}

A systematic overview and meta -analysis published in 2016 identified 10,293 publications that were distilled in 8 randomized clinical studies on joint pain due to osteoarthritis and RA that were treated with curcumin. ^{7 The authors came to the conclusion that curcumin could be used as a dietary complement to conventional therapy, and supported the concept, and supported the concept, and supported the concept, and that a larger clinical study could lead to its acceptance as standard therapy for many forms of arthritis.}

One of the positive features of the present study are not only the 2-dose schemes, but also the 90-day test phase. It can take some time for pain to disappear, especially at RA, a state that can end and subsite due to a variety of circumstances. It is important to tell the patient about how long it can take to feel a persistent improvement. Three months are not inappropriate for a chronic illness such as RA, especially since the measured inflammatory markers showed a significant improvement at the end of this study. If the pain has decreased, would the patient maintain his profit if we prescribed half of the initial dose? Only the time or a clinical study will show it.

It is also important to know that the lower dose of statistically looked as effective as the higher dose. If a lower dose is effective, the financial effort for curcumin treatment should be lower. It can be frustrating for doctors and patients to have a treatment that works, but costs a lot more than the raw material because it is high -tech that is unaffordable for the patient's wallet. Unfortunately we have to weigh the advantages and costs for the various forms of curcumin available on the market in the long term.

summary

rheumatoid arthritis is an autoimmune disease that affects about 1 % of the world's population and more than 1.3 million Americans; RA is the third most common arthritis according to osteoarthritis and gout, ^{8 and studies indicate that 1 out of 28 women (3.6 %) and 1 out of 59 men (1.7 %) in the United States develop to RA in the course of their lives. widespread inflammation that extends beyond the joints and affects many organ systems.}

The curcumin extract used in this 90-day study was statistically significant compared to placebo, both at 250 mg twice a day, both daily and 500 mg twice a day. Significance was shown for VAS, DAS-28, ESR, CRP, RF, ACR20, totally swollen joints and totally sensitive to pain. There were no unwanted events. While this product is worth considering in your own practice, the larger questions remain: Which turmeric longa extract or new formulation is most effective? What costs do our patients incur? How long do you have to take it? Which dose is optimal for a persistent long -term benefit?