Turmeric

A 2024 network meta-analysis of 23 trials in 2,175 people with diagnosed knee osteoarthritis found curcumin extract reduced pain and WOMAC scores versus placebo, with fewer adverse reactions than NSAIDs. Those were concentrated extracts in people with diagnosed joint disease, not spice-jar turmeric, and the findings say nothing about healthy joints.

In documented cases, yes. A 2024 pathology review identified 11 people with liver injury attributed to turmeric supplements, 10 of them women; all recovered after stopping. A separate case report involved 60 mg of curcumin with 10 mg of black pepper twice daily. It is uncommon relative to use, and the cases involve concentrated supplements, not cooking spice. Jaundice or dark urine warrants a call to a doctor.

Curcumin on its own is poorly absorbed. A 1998 study found 2 g of curcumin alone was barely detectable in blood, while adding 20 mg of piperine raised bioavailability by 2000%. That also means a piperine product delivers more curcumin than the same milligram count without it. Phospholipid, liposomal and nanoparticle formulas are other approaches to the same problem.

Trials ran from weeks to a few months, so daily use over that span has some evidence behind it. Multi-year daily use has not been tested. The reported liver injury cases involved daily use over weeks to months. A 2006 study of single doses up to 12,000 mg tested one dose, not repeated use.

Most combinations are untested. Curcumin shows antiplatelet activity in laboratory research, which is why blood thinners and upcoming surgery are commonly flagged. It lowered HbA1c in trials of people with type 2 diabetes, so diabetes medication is worth raising too. Piperine may also affect how the body processes some drugs. Ask a doctor first.