By Allana Akhtar
Liver damage from turmeric supplements in the US, though still rare, appears to have increased in recent years, according to a new report by the Drug Induced Liver Injury Network, a federally funded research group.
DILIN researchers identified 10 cases in which patients — who were mostly middle-age white women — developed a range of liver problems attributed to turmeric. Five of the patients were hospitalized, and one of them died.
The group had data on suspected drug-induced liver injury, including from supplements, from 2004 to 2022. But all the cases that showed turmeric as a highly probable cause for injury occurred after 2011. Six out of 10 cases occurred within the past five years, which the researchers interpreted as evidence of a possible increase in liver injury from turmeric in recent years.
In three cases of liver damage, patients took turmeric supplements containing piperine, or black pepper. Black pepper allows the body to better digest oral turmeric supplements, and some dietitians recommend taking the two together.
Dr. Paul Kwo, the director of hepatology at Stanford University School of Medicine, said little research existed on the interactions not just between supplements and prescription medicine but between the various ingredients in supplements, such as turmeric and black pepper. Pharmacists check for interactions between different drugs, like antibiotics and blood-pressure medicine, but clinicians typically don’t document which supplements people take, Kwo said.
“Because supplements are sold as ‘natural’ therapies, they are perceived as safe,” Kwo told Insider. “Combining supplements should be done with caution as the interactions are not well studied.”
Other studies have tied turmeric to liver damage. In 2019, Italian researchers identified seven cases of liver injury from turmeric within the country. Several case studies within the past two years have identified a handful of patients in the US who developed liver problems from turmeric, and DILIN’s work aims to better understand these cases.
The Food and Drug Administration doesn’t require supplement sellers to prove efficacy or establish standard, safe doses before products hit the market. Doctors told Insider that consumers needed to recognize that the lack of strict regulation meant supplements could pose as-yet-unidentified health risks.
“Where new information raises safety questions, the FDA may revoke food-additive approvals if the FDA is no longer able to conclude that there is a reasonable certainty of no harm from the authorized use,” the agency told Insider in a statement.
DILIN did not note the amount of turmeric each patient with liver damage consumed, and supplements contain varying levels of the spice. A teaspoon of turmeric contains about 5,000 milligrams and generally works for a dish containing four to six servings; the amount of turmeric in supplements can range from 500 mg or less to upwards of 8,000 mg.
But Dr. Cyriac Abby Philips, a liver-health specialist in India who studies herbal medicine’s effect on the body, said developing liver problems from turmeric isn’t entirely dose-dependent. Some people can have a more severe reaction to one large dose or prolonged use of turmeric than others, he said, because of a genetic predisposition to injury.
Philips said he was concerned about turmeric being marketed as a safe remedy for chronic and respiratory disease. Clinical evidence doesn’t support turmeric use to treat or prevent any disease, he said, adding a note of caution for patients who might nevertheless view it as a risk-free experiment.
Because of the lack of clinical evidence supporting turmeric’s health benefits, plus the potential for liver toxicity and blood thinning, Philips advises against the use of turmeric.
“This belief that turmeric is a safe, natural, herbal supplement pushes people to use it as an add-on therapy for many common conditions such as diabetes, cancers, and viral infections — when none of these diseases are benefited with the use of turmeric as standard of care or add-on therapy,” Philips said.
