 Following flax and wheatgrass, turmeric is the third best-selling botanical dietary supplement, wrecking up $12 million in sales and increasing it a rate of about 20%. Curcumin is a natural plant product extracted from turmeric root, used commonly as a food add to popular forts. Pleasant mild aroma and exotic yellow color considered unlikely to cause side effects. Just because something is natural, though, doesn't necessarily mean it's not toxic. Strict 9 is natural, cyanide is natural, lead, mercury, and plutonium are all elements. Can't get more natural than that, but not. Turmeric is just a plant. Plants can't be dangerous. Tell that to Socrates. In considering the validity of the widely accepted notion that complementary and alternative medicines is a safer approach to therapy, we must remind ourselves and our patients that a therapy that exerts a biological effect is, by definition, a drug and can have toxicity. It cannot be assumed that diet-derived agents will be innocuous when administered as pharmaceutical formulations at doses likely to exceed those consumed in the diet. Traditional Indian diets may include as much as a teaspoon of turmeric a day, which is the equivalent of about this much fresh turmeric root. If you look at the doses of turmeric that have been used in human studies, they range from less than a sixteenth of a teaspoon a day up to about two tablespoons a day for over a month. Whereas the curcumin trials have used up to the amount found in cups of the spice around a hundred times more than what curry lovers have been eating for centuries. Still, without overt serious side effects in the short term at least, but if you combine both high-dose curcumin with black pepper for that 2,000% bio-availability boost, that could be like consuming the equivalent of 29 cups of turmeric a day. That kind of intake could bring peak blood levels up around here, where you start seeing some significant DNA damage in vitro at least. So just incorporating turmeric into our cooking may be better than taking curcumin supplements, particularly during pregnancy. The only other contraindication cited in the most recent review was the potential to trigger gallbladder pain in people with gallstones. If anything, curcumin may help protect liver function and help prevent gallstones by acting as a colocystokinetic agent, meaning it facilitates the pumping action of the gallbladder to keep the bile from stagnating. In this study they gave people a small dose of curcumin, about the amount found like a quarter teaspoon of turmeric. And using ultrasound, we're able to visualize the gallbladder squeezing down in response, with an average change in volume, about 29%. Optimally though, you'd want to like squeeze it in half, so they repeated the experiment with different doses. And it took about 40 milligrams to get a 50% contraction. That's about a third of a teaspoon of turmeric every day. On one hand, that's great, totally doable. But on the other hand, I'm thinking, wow, that's some incredibly powerful stuff. What if you had a gallbladder obstruction? If you had a stone blocking your bile duct, and you eat something like that that makes your gallbladder squeeze down that hard, it could hurt. So patients with biliary tract obstruction should be careful about consuming curcumin. But for everybody else, these results suggest that curcumin can effectively induce the gallbladder to empty, and thereby reduce the risk of gallstone formation in the first place, and ultimately, perhaps even gallbladder cancer. Too much turmeric though may increase the risk of kidney stones. As I mentioned in a previous video, turmeric is high in soluble oxalates, which combine to calcium form insoluble calcium oxalate, which is responsible for approximately three quarters of all kidney stones. So the consumption of even moderate amounts of turmeric would not be recommended for people with a tendency to form kidney stones. Such folks should restrict the consumption of total dietary oxalate to less than 40-50 milligrams a day, which means no more than at most a teaspoon of turmeric. So for example, those with gout are by definition it appears at high risk for kidney stones, and so if their doctor wanted to treat gout inflammation with high-dose turmeric, then that's where curcumin supplements might come into play, because to reach high levels of curcumin in turmeric form would incur too much of an oxalate load. If one is prescribed a supplement, how do you choose? The latest review recommends purchasing from Western suppliers that follow recommended good manufacturing practices, which may decrease the likelihood of our buying an adulterated product.