Curcumin (Turmeric) for Arthritis: 7 Side Effects

Thinking about taking curcumin supplements to manage your arthritis pain?

First, know the potential drawbacks, side effects and risks – especially for higher dosage curcumin supplements.

1. Best taken as a combination supplement

One of the primary challenges with curcumin supplements is absorption. Curcumin is rapidly metabolized by your liver and intestinal wall, and very little reaches your bloodstream in its active form.

This poor bioavailability significantly limits the anti-inflammatory and pain-relieving properties you seek to manage your arthritis pain.

See An Anti-Inflammatory Diet for Arthritis

Solution: Facilitate absorption through combination supplements

Research has identified ways to dramatically improve curcumin absorption.

The most well-studied approach combines curcumin with piperine, the active compound in black pepper. A significant study published in Planta Medica found that piperine increases curcumin bioavailability by 2000% (20-fold) in humans.

Additional combinations to improve curcumin absorption include:

• Curcumin is fat-soluble, so it is more effective when taken with healthy fats
• Nano-curcumin particles are better absorbed due to smaller size
• Curcumin phytosome complexes bound to phospholipids

When selecting a supplement, look for products that specifically address bioavailability through these methods.

See The Ins and Outs of an Anti-Inflammatory Diet

2. Gastrointestinal Side Effects Are Common

Curcumin supplements have the potential to cause digestive issues, particularly at higher doses or with long-term use.

Gastrointestinal symptoms include stomach upset, nausea, diarrhea, and gastroesophageal reflux disease (GERD).

These effects typically occur when people take doses exceeding 1000-1500mg daily or take supplements on an empty stomach.

Minimize digestive issues by:

• Start with a lower dose (500mg daily) and gradually increase
• Take curcumin supplements with meals containing healthy fats
• Divide your daily dose into smaller amounts taken two to three times each day
• Choose formulations designed for better tolerability

If you experience any concerning digestive issues, consult your healthcare provider about adjusting your dose or trying a different formulation.

3. Potentially serious drug interactions due to blood-thinning

Curcumin has natural anticoagulant (blood-thinning) properties, so the risk is that taking curcumin if you are also taking blood-thinning medications may lead to potential bleeding and/or bruising.

Examples of common medications that interact with curcumin include, but are not limited to, warfarin (Coumadin), clopidogrel (Plavix), and daily aspirin therapy.

Avoid curcumin or use extreme caution if you:

• Take prescription anticoagulants or antiplatelet drugs or aspirin therapy
• Are scheduled for surgery (discontinue curcumin at least 2 weeks before procedures)
• Have any type of bleeding disorders or clotting abnormalities

Always discuss any type of curcumin supplementation with your doctor before starting. Your physician may need to adjust dosages and/or monitor your blood clotting times, or may recommend against any type of supplementation.

4. Potentially serious drug interactions with arthritis medications 

Curcumin can interact with several medications commonly prescribed for arthritis and related conditions, including but not limited to:

Sulfasalazine: A disease-modifying antirheumatic drug (DMARD) prescribed for rheumatoid arthritis can interact with curcumin, potentially intensifying therapeutic and/or adverse effects.

NSAIDs: While some studies suggest curcumin might work synergistically with nonsteroidal anti-inflammatory drugs like ibuprofen (e.g. Advil) or naproxen (e.g. Aleve), it also increases the risk of gastrointestinal side effects.

Antacids and proton pump inhibitors: Turmeric / curcumin may increase stomach acid production when taken with medications like omeprazole (Prilosec), famotidine (Pepcid), or ranitidine (Zantac), potentially reducing their effectiveness.

Diabetes medications: Curcumin can enhance the blood sugar-lowering effects of diabetes medications, increasing the risk of hypoglycemia (dangerously low blood sugar).

Always consult your healthcare provider prior to taking curcumin supplements to avoid potentially dangerous interactions.

5. Curcumin may interfere with iron absorption

Curcumin can suppress iron absorption in your digestive tract, which may worsen existing iron deficiencies or contribute to anemia over time.

It does this by binding to iron and preventing your body from properly absorbing this essential mineral.

Anyone with potential iron deficiency, commonly called anemia, needs to work with a doctor prior to taking curcumin.

Women with rheumatoid arthritis are particularly at risk for anemia and should work closely with their health care team when considering curcumin supplementation.

See Dietary Supplements for Treating Arthritis

6. Supplement Quality Varies Dramatically Between Brands

Unlike prescription medications, dietary supplements are not regulated by the US Food and Drug Administration (FDA) for safety and efficacy before they reach the market.

This lack of regulation means that supplement potency, purity, and quality can vary significantly from brand to brand and even batch to batch.

Tips for choosing a high-quality curcumin supplement:

• Look for products certified by independent testing organizations like USP (United States Pharmacopeia), NSF International, or ConsumerLab.com
• Choose manufacturers that list Good Manufacturing Practice (GMP) certification on their labels
• Select brands that provide certificates of analysis showing third-party testing results
• Purchase directly from the company’s website, not from third-party online platforms as those tend to attract counterfeit supplements

See Top 4 Supplements to Treat Arthritis Pain

7. Long-Term Safety Data Remains Limited

While short-term studies (up to several months) suggest curcumin is generally safe at typical supplementation doses, comprehensive long-term safety data remains limited._^,  Most clinical trials studying curcumin for arthritis have lasted 8-12 weeks, leaving questions about what happens with years of continuous use.

Some healthcare providers have expressed concern over potential effects of excessive dosing and prolonged supplementation. Research investigating long-term safety, optimal dosing strategies, and potential cumulative effects is ongoing.

Current evidence gaps include:

• Effects of taking high-dose curcumin (>2000mg daily) for extended periods
• Long-term impact on liver function and kidney health
• Potential hormonal effects with prolonged use
• Interactions that may emerge only after months or years of supplementation

Until more comprehensive long-term studies are completed, a cautious approach with regular medical monitoring is advisable for anyone taking curcumin supplements continuously.

Cooking with Turmeric vs. Curcumin Supplements: An Important Distinction

It's crucial to understand that culinary turmeric used in cooking is very different from concentrated curcumin supplements.

Turmeric powder contains only about 2-5% curcumin by weight, meaning a teaspoon of turmeric contains approximately 100-200mg of curcumin.  Pure turmeric was found to have the highest concentration, and curry, which is the spice commonly used in cooking, had a relatively low concentration of curcumin.

The side effects and drug interactions discussed in this article primarily apply to concentrated curcumin supplements providing 500-2000mg or more of curcumin daily.

The key is finding the right balance between potential benefits and risks for your individual situation.

For more information, see How Turmeric Can Treat Arthritis Pain and Inflammation

Your healthcare provider can help you determine whether curcumin supplementation is appropriate for your specific medical condition, current medications, and overall health status.