Talk:Curcumin

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Proposed Changes

goodness, this page is terrible-"the fresh root is so expensive?" this is not a message board, and much of this research is frought with epidemiological fallacies "people who ate yellow curry once in six months.." such a dose is useless, but also doesnt point out the far more likely factors (how about eating fish? pancakes? asprin? ect) broad misrepresentation-curcumin has terrible bioavailablity, but this page makes it seem like the perfect drug for anything and what little logic there is in the entry is muddled by pointless edits FIX OR DELETE!

Maybe we could start by dividing the Medicinal Uses section into categories, such as antioxidant, anti-inflammatory, cancer, neurodegenerative diseases, and so forth. We could start adding data to the different headings and the information would be more organized. I have done some research on curcumin, and I have a list of 19 physiological properties (with citations) that could be added as a table, and some other material that could be added to the content. I agree with the comment below - low bioavailability doesn't mean no bioavailability, and many physiological/therapeutic effects have been documented. I am a new editor as well.--Little Flower Eagle (talk) 20:42, 6 February 2009 (UTC)

This article needs a better structure. New to editing wikipedia, and not entirely sure of the protocol but I would recommend: 1. Creating a separate section regarding the bioavailability of curcumin. The review article is a good place to start looking. The article is not entirely misrepresentative of the therapeutic potential of curcumin. Despite having low bioavailability, curcumin has been documented to have therapeutic efficency against several diseases including cancer, diabetes, and arthritis. 2. Creating a proposed mechanisms of action section. 3. Removing "x group in year xxxx did ..." from sections. Those type of statements I believe sound more like press releases and less like an encyclopedia If there is consensus this is a good idea, I will make these changes.--Biophysik (talk) 06:47, 6 October 2008 (UTC)

—Preceding unsigned comment added by 130.219.235.232 (talk) 21:58, 19 August 2008 (UTC) 

also the supposed selectivity for mao-a isnt cited, the maoi article says that its non selective (and that isnt cited either). whats the deal? does anybody know? —Preceding unsigned comment added by 24.164.172.232 (talk) 02:16, 25 March 2010 (UTC)

I added a journal citation for curcumin being an MAOI affecting both MAO-A and MAO-B. There's a discussion on https://emediahealth.com/2012/01/17/curcumin-and-the-mao-inhibitor-cheese-effect-from-tyramine-triggered-hypertension/ regarding the question of whether it indeed affects both of those, and to the same degree. I have not added any discussion of selectivity to the article (the previous uncited claim discussed above had since been removed). --Dan Harkless (talk) 05:07, 29 March 2017 (UTC)

Alexbrn has reverted my changes. Please see the new #Curcumin found to be an MAOI (e.g. in mouse brain studies) section below for further discussion. --Dan Harkless (talk) 06:31, 29 March 2017 (UTC)

References

Misrepresentation of research (title added)

The research article mentioned in the Wikipedia definition of curcumin and its prooxidant effects on DNA (Kelly MR, Xu J, Alexander KE, Loo G. 2001. Disparate effects of similar phenolic phytochemicals as inhibitors of oxidative damage to cellular DNA. Mutat Res. May 10;485(4):309-18.) have not been accurately described.

The article clearly states "Therefore, it is concluded that NDGA has antioxidant activity but curcumin has prooxidant activity in cultured cells based on their opposite effects on DNA". The key terms in this sentence are "in cultured cells". Therefore, in the Wikipedia description of curcumin where this article is addressed, it should not state that this research "proves" curcumin's prooxidant affects. The data presented in the referenced article provides in vitro evidence of a prooxidant affect on cultured cells. It is clearly a stretch to say it proves this activity occurs in vivo, e.g. when humans consume curcumin. The paragraph describing this research is extremely misleading, especially to non-scientists, and should be removed from the web-description of curcumin. —The preceding unsigned comment was added by Ajourdan (talk • contribs) .

Well, Be bold - you've read the article, you seem to have understood it - go ahead and fix the article :) I think it is good that the article mentions that the antioxidant role of curcumin is not as clear as the rest of the article suggests. But I'm looking forward to seeing your corrected version ;) Iridos 21:01, 30 September 2006 (UTC)

It is fundamentally wrong to cite the Kelly article as showing anything about the effects of curcumin on healthy cells. In this study, the authors used Jurkat T-cells. Jurkat cells are cancer cells. Any effect of curcumin on these cells cannot be reliably extrapolated to healthy cells. As the work of Michael Karin has shown, cancer cells have high levels of NF-kappa B activity and depend on this for survival. Bharat Aggarwal, at M. D. Anderson Cancer Center, has shown that curcumin inhibits NF-kappa B activity. This effect will cause apoptosis (programmed cell death) in cancer cells.

I like your intelligent, well-written comment, but you probably will agree that, to conclude that curcumin inhibition of NF-kappa B is the prevalent process by which the Jurkat T-cells are affected. I'd sit on the fence on this one, till a better study is attempted and published. 213.243.137.56 (talk) 19:44, 20 August 2009 (UTC)

The benefit of the doubt is not more deserving for one side of the battle or the other. The fact that nothing scientific is never "proven" does not grant the other side the right to declare it "disproven" or invalid. Only those assertions which can be disproven should be removed from a Wikipedia article.Landroo (talk) 13:24, 16 September 2016 (UTC)

Contradictory statements need to be resolved

In Paragraph 5, the second sentence reads:

"Its anticancer effects stem from its ability to induce apoptosis in cancer cells without cytotoxic effects on healthy cells."

But in Paragraphs 9 and 10, the text states:

"However, as pointed out by Kawanishi et al. (2005) curcumin is a "double-edged sword" having both anti-cancer and carcinogenic effects.

"Curcumin has devastating effects on healthy human cells."

It seems to me that having "devastating effects on healthy human cells" would reasonably constitute a "cytotoxic effect[] on healthy cells," would it not? Either way, perhaps some clarification by someone knowledgeable might be in order?

Until the biovailability issue is addressed adequately, discussion of potential medical uses is ridiculous (except for benefits that might occur within the digestive tract.)```` —Preceding unsigned comment added by 68.127.229.103 (talk) 20:49, 28 October 2009 (UTC)

Psychotropic effects?

A friend of mine consistently gets in a better mood when eating some yellow-coloured foods and sweets, but not with others, and I found the common factor was curcumin being used as the colorant in those that had this effect. Is anyone aware of any such psychotropic effects, theoretical or otherwise? It would seem the low bioavailability should prevent any significant absorption. Zuiram 23:57, 13 April 2007 (UTC)

Unless he's eating a buncha Piperine with it. :0)192.249.47.11 18:04, 17 August 2007 (UTC)

I guess I'm confused - how is it that curcumin is shown to helping these diseases if it isn't bioavailable? Something has to be absorbing, right? Otherwise the improvements would be attributed to a placebo effect. Can someone please clarify for me? How much curcumin is in 1 teaspoon of turmeric anyway? —Preceding unsigned comment added by 75.36.219.59 (talk) 17:16, 7 September 2007 (UTC)

Maybe your friend is subconsciously associating yellow with smiley faces and sunshine! —Preceding unsigned comment added by 75.223.156.139 (talk) 14:13, 11 April 2008 (UTC)

Joking aside, turmeric is about 3-5% curcuminoids, of which curcumin is the major fraction. In theory, substances can have a system-wide effect even if poorly absorb, if in the unabsorbed state these compounds reach the large intestine and act as prebiotics - meaning not bacteria (i.e., probiotic) but affecting the nature of the myriad bacterial species that populate the large intestine, in turn affecting the host. And yes, placebo effect is huge for all mental state mediated symptoms. David notMD (talk) 00:54, 7 April 2017 (UTC)

Misc

Dr. Dennis Liotta is a chemistry professor at Emory University in Atlanta.

Along with Dr. Raymond F. Schinazi and Dr. Woo-Baeg Choi of Emory, he discovered Emtricitabine, which is a breakthrough HIV drug; it was sold to Gilead Sciences in July 2005 for $525 million and it is marketed under the name Emtriva. —The preceding unsigned comment was added by 68.19.17.2 (talk • contribs) .

What does that have to do with anything? —Keenan Pepper 23:54, 22 April 2006 (UTC)

Does dried, ground tumeric oxidize? The fresh root is so expensive. --63.24.85.190 06:14, 6 July 2006 (UTC)

Does anyone know what the excitation and emission fluorescence spectra of curcumin is? 129.43.47.159 18:25, 7 August 2006 (UTC)

Curcumin is essentially non-fluorescent (and unstable) in water. A weak broad emission can be detected at 550 nm using 420 excitation. In a non-polar environment such as a lipid membrane or after curcumin binds to serum albumin, the fluorescence is increased and blue-shifted with a 498 nm emission maximum using 420nm excitation.--Biophysik (talk) 06:47, 6 October 2008 (UTC)

Thank you for that! I promptly made a few experiments tonight with a number of nonpolar solvants and lipids, and the results are interesting. I'll check out the article you cite, tomorrow. Again, much obliged. 213.243.137.56 (talk) 20:56, 20 August 2009 (UTC)

Curcumin in isopropyl alcohol can also be used as a pH indicator...should this be included? It's an interesting fact, but I'm not sure how it would fit anywhere.

WikiProject Food and drink Tagging

This article talk page was automatically added with {{WikiProject Food and drink}} banner as it falls under Category:Food or one of its subcategories. If you find this addition an error, Kindly undo the changes and update the inappropriate categories if needed. The bot was instructed to tagg these articles upon consenus from WikiProject Food and drink. You can find the related request for tagging here . Maximum and careful attention was done to avoid any wrongly tagging any categories , but mistakes may happen... If you have concerns , please inform on the project talk page -- TinucherianBot (talk) 01:19, 4 July 2008 (UTC)

  Turmeric should be tagged, circumin should not be

Shjacks45 (talk) 06:34, 9 November 2009 (UTC)

Bioavailability and black pepper

Apparently, curcumin is not bioavailable. Yet, there are reports that brains of people who eat turmeric all their lives are stained yellow or orange. Observed on autopsy... (I confess, I don't know if these reports are reliable.)

Piperine seems to increase the bioavailability of curcumin.

When turmeric is used in cooking, in India and Pakistan, it is used in various combination with other spices. The combination of spices is called curry, as we know. As far as I know, black pepper is another common ingredient in curry. Black pepper is rich in piperine.

So, you've gotta wonder if the combination of black curry with turmeric in South Asia, represents some kind of indigenous folk medicine that increases the bioavailability of turmeric, by the addition of black pepper.

I don't know if there's been any research on this. I wouldn't know where to begin.

68.127.235.15 (talk) 04:44, 1 October 2009 (UTC)

Wording re piperine absorbtion study

The following wordig currently appears in the article (italics, mine):

"Co-supplementation with 20 mg of piperine (extracted from black pepper) significantly increased the absorption of curcumin by 2000% in a study funded by a prominent manufacturer of piperine.[30] However, the increase in absorption only occurred during the first hour, in which the difference between the piperine curcumin and the regular curcumin was almost the same as far as absorption."

Would whoever is familiar with / has read this study please take a look at the wording? The "in which" would seem to contradict the main point being made. I strongly suspect that what is really meant is "after which".--Ericjs (talk) 22:32, 27 December 2009 (UTC)

Infobox inconsistencies

The infobox shows an image of the enol form, yet the SMILES formula is of the ketone form. Is that OK? The correct SMILES for the given image is O=C(\C=C\c1ccc(O)c(OC)c1)CC(O)\C=C\c2cc(OC)c(O)cc2 --94.73.47.98 (talk) 09:49, 17 February 2011 (UTC)

Primary Sources in Medical Section

I see some big problems in the medical section of this article; namely, an over reliance on primary sources of dubious significance (test tube and animal studies, small scale uncontrolled clinical trials) and lack of consensus statements and reviews. The article vastly overstates the medical relevance of curcumin; it has elements of WP:OR and WP:SYNTH and would benefit from a much more balanced POV. See also WP:MEDRS and WP:PRIMARY. Rhode Island Red (talk) 00:34, 30 December 2011 (UTC)

Yes, I agree that this article could certainly use a good review with a critical eye with respect to WP:MEDRS. -- Ed (Edgar181) 20:35, 16 March 2012 (UTC)

Stylistically it needs a lot of work too. The goal should be to describe what curcumin does, not to chronicle the history of the research. Thus, the dates of publications and the organizations responsible for the research need not be mentioned; it just adds unnecessary noise. It doesn't tell a cohesive readily comprehensible story and it tends to oversell the significance of basic (non-clinical) research. Rhode Island Red (talk) 00:22, 18 March 2012 (UTC)

At least the date of a study helps to weed out dated sources and to focus on MEDRS sources, which are RECENT SECONDARY sources. Regarding reliance on primary sources, practically all articles dealing with herbal, alternative, traditional, naturopathic or ethnic medicine have that, even more if ever the word "cancer" or "HIV" was mentioned in the past 100 years. Even worse, these primary sources get mixed with "healthy living" pamphlets and advertisements for (sarcasm)"Olde-Buzzard vitaminized raven lard, according to ancient indigenous recipes, improves rheumatism and your golf scores"(/sarcasm) 70.137.144.94 (talk) 05:53, 18 March 2012 (UTC)

Agreed. We should focus on MEDRS secondary sources, but recency of sources is a bit more complicated. It matters in some cases, not in others. For example, if a preliminary finding from a study done in the 80s is never followed up on in subsequent research, then there's a good possibility that it's not a very noteworthy detail. But on the other hand, imagine a scenario where a study reported a result and a subsequent study reported opposing results, and a WP editor writes the following "a 2005 study found X but a study in 2012 reported Y". The more recent study isn't necessarily more valid than the older study. In this case, the detail that's important is that two studies reported conflicting findings, and hopefully it would also be evident why the results conflicted (and also how the reliability of the studies compared from an experimental design standpoint). It's not important that one was conducted in 2005 and one in 2012. Structuring the summary of research using dates also makes for a bit of clumsy, repetitive narrative IMO. Appropriate perhaps for an academic review article or textbook chapter where the focus is more on the chronological stages of R&D (and where there is a logical progression), but not so much for an encyclopedia.

The same applies for listing the affiliations of the authors in the article. It's not really relevant and it just weighs down the narrative. Is a study done at Texas Tech more or less valid than one conducted at Wake Forest U? It doesn't really matter right? Stylistically, this method of organizing the material is more akin to a magazine than an encyclopedia. There are sometimes exceptional reasons to list the affiliation though, like if the study was done at an obscure/tiny/sketchy institution or by a source with a clear biasing/partisan interest. So rather than using wording such as "In 2011, researchers at Wake Forest U conducted a study in rats which showed X....", it's more in keeping with encyclopedic style to phrase this simply as "A study in rats showed X....". Much more economical. Also, a study will often have multiple institutional affiliations, so then you would face the task of having to list them all in the article, in which case the details about the subject get buried by a jumble of dates and affiliations. It's a signal-to-noise ratio issue. Rhode Island Red (talk) 20:35, 18 March 2012 (UTC)

Agree. I believe the focus on recent secondary sources makes more sense in fields with intense activity, where a systematic progress is achieved over time, and with common medications, where the developing statistical evidence may lead to changes of prescription guidance etc. by medical and government organizations over time. In these cases old reviews may really be outdated by the accumulated experience over time, as much may have changed in say 10 years. In other cases 50 year old articles may still be as good as new.(and sometimes fun to read, I love historical sources) In all these alternative / ethnic / naturopathic / traditional medicine articles the historical part may be interesting and should be included for the historical value, but set apart from "medical" information, clearly marked as "historical". This is even true for the lotion of vitaminized "Olde Buzzard" raven lard.(which improves the golf scores) Or for the interesting "galvanic" apparatus and radioactive quack medicines which were in fashion 100 years ago, until the patients teeth fell out. There is interesting material about this and old X-ray machines at the ORAU website. All looking like from Dr. Frankensteins laboratory, with humpback assistant "Igor" adjusting the voltage on the "Rumkorff Inductor". 70.137.130.84 (talk) 21:02, 18 March 2012 (UTC) 70.137.130.84 (talk) 21:02, 18 March 2012 (UTC)

We're on the same page amigo. Rhode Island Red (talk) 22:41, 18 March 2012 (UTC)

So I imagine that we have Medical Sections, from (preferably recent) review articles, reflecting contemporary state of encyclopedic and widely agreed information. Then "Research Section" with interesting primary research cited as "A (year) study on (species) (material) found (short findings)". e.g. "A 1990 study on rat tumor cell line XYZ found that X suppressed Y at a concentration of Z nmol/ml" (Single case reports are useless here, as almost everything has once been observed on some patient)

This may not be carried too far, as otherwise immediately zealots come in who cherry-pick primaries to prove that Aspirin immediately causes cancer and impotence, which can be prevented by co-administration of curcuma with raven-lard according to olde voodo recipe. Also to prove that it is a cure-all panacea even against cancer and HIV etc. etc. etc.

Then if applicable Section "History" may contain references like the 1850 Pharmacists Handbook etc. if the history looks interesting. "has already been recommended in 1850 for the tumbness of horses in a dosis of 30 drachms in strong brandy..." etc. (I make these up of course) 70.137.155.252 (talk) 06:08, 19 March 2012 (UTC)

Preliminary research for potential health effects

I made this addition of a comprehensive secondary source - a journal review - only for User:Zefr to remove it on grounds of WP:MEDRS, however re: WP:MEDRS: the journal "Molecules" is indeed listed in MEDLINE see here: http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v1=1&ti=1,1&Search_Arg=100964009&Search_Code=0359&CNT=1&SID=1 , and has been established for nearly 20 years https://en.wikipedia.org/wiki/Molecules_%28journal%29 (impact factor 2.095 is not amazing, but not disastrous either). Unlike the examples given in WP:MEDS this is not a case of e.g. a review on oncogenesis appearing in a psychology journal. "Molecules" includes "natural product chemistry" in its remit, and the review concerns itself with the biochemistry of curcumin - I would argue there is sufficient overlap of fields to justify inclusion.

Opinions of other editors please, as to the quality of this review / author reputation / quality & relevance of journal, and whether or not the following should be included on the Curcumin page:

Sethi et al published an in depth 2015 review of the scientific literature re: curcumin's interaction with molecules implicated in oncogenesis, in the peer-reviewed open access journal Molecules, in which they concluded: "A plethora of in vitro and in vivo research together with clinical trials conducted over the past few decades substantiate the potential of curcumin as an anti-cancer agent. At the molecular level, curcumin targets numerous pathways, highlighting its ability to inhibit carcinogenesis at multiple levels and thus, potentially circumventing the development of resistance. However, there is a paucity of data to explain the underlying mechanism of its activity. Clinical trials with curcumin indicate safety, tolerability, non-toxicity (even up to doses of 8000 mg/day), and efficacy. These studies provide a solid foundation for more well-controlled studies in larger cohorts as well as open avenues for future drug development. However, curcumin activity is limited by its poor bioavailability and some possible adverse effects. The development of formulations of curcumin in the form of nanoparticles, liposomes, micelles or phospholipid complexes to enhance its bioavailability and efficacy are still in its early stages. Nonetheless, curcumin has established itself as a safe and promising molecule for the prevention and therapy of not only cancer but also other inflammation-driven diseases." ~~User:Dukeredwulf~~ (unsigned comment by Dukeredwulf 02:57, 13 April 2015‎)

References

Virtually every scientific journal is listed in Medline, so being listed in that database confers no particular authority or reliability. Molecules is a low-tier open source journal, so in other words, nothing impressive about the journal itself. The proposed text contains too much fluff for my taste and it gives WP:UNDUE to this one particular article, and the article greatly oversells curcumin as a potential therapy. The proposed text is also an overly long quote that borders on plagiarism. Rhode Island Red (talk) 20:46, 13 April 2015 (UTC)

I am with RIR on this one. The quality of human research on curcumin is so inconsistent, and heavily tied to dueling claims from improving absorption from companies with patented products, that it is premature to attribute any health benefits to curcumin. The science may improve in the future. The website www.clinicaltrials.gov lists at least 50 trials that are ongoing or recently completed and not yet published.David notMD (talk) 18:15, 20 March 2016 (UTC)

Unclear Statement

From the article: "More recently, curcumin was found to alter iron metabolism by chelating iron and suppressing the protein hepcidin, potentially causing iron deficiency in susceptible patients."

Wait. Chelating iron might cause iron deficiency but suppressing hepcidin will increase iron transport by enterocytes. https://en.wikipedia.org/wiki/Hepcidin#Tissues — Preceding unsigned comment added by 184.158.8.37 (talk) 03:53, 6 February 2016 (UTC)

As the study was on mice and contained much speculation far from proof in humans per WP:MEDANIMAL, I removed the paragraph and source.--Zefr (talk) 05:40, 6 February 2016 (UTC)

Note for consideration by topic experts: recent retractions of research articles on curcumin

In February 2016, the publisher of Biochemical Pharmacology issued retraction notices for seven (7) articles originally published in that journal during the period 2007-2011, at least five of which involve research on curcumin; links to sites providing further details are below. Fortunately none of the retracted research articles are cited in this Wikipedia article. But given the nature of the retractions, I felt I should bring it to the attention of any experts on curcumin who check in here, even though the retractions do not appear to affect this Wikipedia article in any direct way. (Although I am a research chemist, I am not a biochemist, and certainly not an expert on curcumin.) For further information on the retractions, see the bottom seven items of this Table-of-Contents listing. Further discussion of these retractions was also posted in the blog Retraction Watch; the link is here. Because none of the retracted articles were cited in this article, and because of my limited knowledge of this topic, I did not edit the article content (I only made a couple minor edits to External Links). I am providing this information under Talk, so that anyone with appropriate expertise will be made aware of this situation, and can assess the information and determine whether changes to this Wikipedia article are in fact warranted based on those retractions.Sharl928 (talk) 08:21, 24 February 2016 (UTC)

It's an excellent vindication of WP:MEDRS's guidance only to use high-quality secondary sources for medical content. Alexbrn (talk) 08:23, 24 February 2016 (UTC)

Business

I've added some basic business-related information. It might be interesting to expand this to say that it's mostly produced in India, and mostly sold in Canada and the U.S.

I've seen predictions for sales approximately quintupling during the next decade, but I thought that was probably too speculative to be included. As far as I can tell, that market-growth estimate all goes back to a single consulting firm. It's been repeated everywhere, but it seems to be just one source behind that number. WhatamIdoing (talk) 20:06, 29 February 2016 (UTC)

Recent lit to incorporate

A few meta-analyses and systemic reviews worth incorporating into the Article. Al-Karawi/Phytother Res reported improvement for depression. Sahebkar/Pain Med concluded benefit for pain relief. Sahebkar/Clin Nutr concluded that curcumin did not affect circulating lipids. Sahebkar/Phytother concluded that curcumin lowered CRP (C-reactive protein, a questionable biomarker for risk of cardiovascular disease), but the results hinged on which product and duration of study. Brondino/ScientificWorld reported no benefit for dementia, based on inclusion of three human trials. Zhang is an all-purpose review.

Al-Karawi D, Al Mamoori DA, Tayyar Y. The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials. Phytother Res. 2016 Feb;30(2):175-83.

Sahebkar A, Henrotin Y. Analgesic Efficacy and Safety of Curcuminoids in Clinical Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Med.(in press).

Sahebkar A. A systematic review and meta-analysis of randomized controlled trials investigating the effects of curcumin on blood lipid levels. Clin Nutr. 2014 Jun;33(3):406-14.

Sahebkar A. Are curcuminoids effective C-reactive protein-lowering agents in clinical practice? Evidence from a meta-analysis. Phytother Res. 2014 May;28(5):633-42.

Brondino N, Re S, Boldrini A, Cuccomarino A, Lanati N, Barale F, Politi P. Curcumin as a therapeutic agent in dementia: a mini systematic review of human studies. ScientificWorldJournal. 2014 Jan 22;2014:174282. Zhang DW, et al. Curcumin and diabetes: a systematic review. Evid Based Complement Alternat Med. 2013;2013:636053.

The last journal is junk, wouldn't touch it with a barge pole. Don't know about the others, any of repute? Alexbrn (talk) 19:09, 20 March 2016 (UTC)

None of them are great. Clinical Nutrition would be the best of the lot; OK for a nutrition journal anyway. The rest are dregs. Never even heard of Scientific World Journal, and I've heard of most. Incidentally, an article in press would not be a WP:RS unless the journal's website has a pre-publication version posted. Rhode Island Red (talk) 01:32, 21 March 2016 (UTC)

BTW it should be pointed out that (a) there is no specific text proposal here, and (b) the meta-analyses are going to be worthless if they included data from Aggarwal's studies. Rhode Island Red (talk) 01:39, 21 March 2016 (UTC)

Sahebkar is a mass-producer of meta-analyses (43 since 2013). Not a disqualification per se, but a concern.David notMD (talk) 21:53, 21 March 2017 (UTC)

Revert

I cited material from Wilken, Reason; Veena, Mysore S.; Wang, Marilene B.; Srivatsan, Eri S. (2011-01-01). "Curcumin: A review of anti-cancer properties and therapeutic activity in head and neck squamous cell carcinoma". Molecular Cancer. 10: 12. doi:10.1186/1476-4598-10-12. ISSN 1476-4598. PMC 3055228. PMID 21299897.{{cite journal}}: CS1 maint: unflagged free DOI (link), which was immediately reverted without discussion. I claim that this is a reliable, secondary source. I make no other claim about its contents. Thus, I don't see the basis for the revert. Lfstevens (talk) 02:26, 16 June 2016 (UTC)

You need to read WP:MEDRS, especially WP:MEDASSESS. The Wilken source is a review of lab experiments and is not reliable for biomedical content, as explained in MEDRS. --Zefr (talk) 02:29, 16 June 2016 (UTC)

Moved from my Talk:

There is no accepted clinical evidence of curcumin having any role as a therapeutic. Evidence would require sources that satisfy WP:MEDRS. Please understand this guideline before editing an article for medicinal effects. You have a Cure Award, so should be standing behind MEDRS sourcing. Thanks. --Zefr (talk) 22:55, 15 June 2016 (UTC)

Can't speak to the quality of the evidence. I only know that I was citing a reliable, secondary source, almost verbatim. Lfstevens (talk) 02:20, 16 June 2016 (UTC)

It's not MEDRS quality as you'll see when you read WP:MEDRS, especially WP:MEDASSESS. A review of primary lab or in vitro studies is not a reliable source for biomedical information per MEDRS. --Zefr (talk) 02:26, 16 June 2016 (UTC)

Huh? It says "editors should rely on high-quality evidence, such as systematic reviews", which is what I did. What it doesn't say is that only reviews of RCTs qualify. Please clarify your criticism. Lfstevens (talk) 02:43, 16 June 2016 (UTC)

All of the work cited in the Wilken article on curcumin and cancer is from lab studies, i.e., WP:PRIMARY, much of it more than 10 years old. MEDRS states: Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials, described further under WP:MEDASSESS in "Assess evidence quality". If you're not satisfied, post a request for comment at the Talk for WikiProject Medicine. --Zefr (talk) 03:41, 16 June 2016 (UTC)

Not getting this at all. Reviews summarize/filter primary studies. So no primary sources were used. Instead I relied on a review. Lfstevens (talk) 03:51, 16 June 2016 (UTC)

Yes, Wilken was a review, but nowhere in the review is there any mention of human trials.David notMD (talk) 22:00, 21 March 2017 (UTC)

Effect in ulcerative colitis?

Although the statement and source below are from a Cochrane collaboration analysis, I think this result is too weak to deserve even mentioning it. The source is weak MEDRS at best. --Zefr (talk) 17:59, 13 January 2017 (UTC)

Reverted statement and source... for discussion

A Cochrane review found that curcumin may be an effective adjunct for ulcerative colitis, when given with standard therapy, however more trials are needed to confirm this.

Main finding, quoted: "Only one trial (89 patients) fulfilled the inclusion criteria. This trial randomized 45 patients to curcumin and 44 patients to placebo. All patients received treatment with sulfasalazine or mesalamine. The study was rated as low risk of bias. Curcumin was administered orally in a dose of 2 g/day for six months. Fewer patients relapsed in the curcumin group than the placebo group at six months. Four per cent of patients in the curcumin group relapsed at six months compared to 18% of patients in the placebo group (RR 0.24, 95% CI 0.05 to 1.09; P = 0.06)."

References

I was going of the conclusion, and I think the source is def MEDRS(it's a cochrane review), but if you think it isn't worth mentioning then that is fine. Also, I want to expand the section on the cancer scandal, what sources are good enough for that?Petergstrom (talk) 18:23, 13 January 2017 (UTC)

My opinion is that we don't have to tacitly accept any Cochrane review, especially one whose conclusion is based on only one weak study is not worth being in the article. By "the cancer scandal", I'm assuming you mean the studies of Bharat Aggarwal who has been extensively discredited, so his studies should not be used. There are no MEDRS-quality studies giving credibility of curcumin to anticancer effects. The report entered yesterday under Research here indicates a widespread scientific view that curcumin is too disparate under study to yield any conclusive insight to effects it may have in vivo. The other cited study on curcumin concluded this: "The likely false activity of curcumin in vitro and in vivo has resulted in >120 clinical trials of curcuminoids against several diseases. No double-blinded, placebo controlled clinical trial of curcumin has been successful." --Zefr (talk) 18:45, 13 January 2017 (UTC)

The Cochrane review says:

The results of this systematic review suggest that curcumin may be a safe and effective therapy for maintenance of remission in ulcerative colitis when given as additional therapy with mesalamine or sulfasalazine. Further research is needed ... [my bold]

which is a fancy-pants way of saying there's no good evidence it works. That's what Wikipedia should be saying, to be plain about it. Alexbrn (talk) 18:53, 13 January 2017 (UTC)

That's actually pretty funny.Petergstrom (talk) 18:58, 13 January 2017 (UTC)

Curcumin found to be an MAOI (e.g. in mouse brain studies)

Curcumin is widely acknowledged to be an MAOI, and multiple studies, e.g. of mouse brains, have supported this. I added the following to the article's Pharmacodynamics section:

Curcumin is a reversible inhibitor of the MAO-A and MAO-B enzymes.

but it was reverted by Alexbrn with "Minor journal, not MEDLINE indexed; need good WP:MEDRS".

https://www.ncbi.nlm.nih.gov/pubmed/?term=curcumin+monoamine returns 30 results. Do any of these satisfy the criteria for inclusion? Thank you. --Dan Harkless (talk) 06:29, 29 March 2017 (UTC)

References

So if this is due, accepted knowledge, it should be easy to find a decent WP:MEDRS stating it. Alexbrn (talk) 06:38, 29 March 2017 (UTC)

It sticks to pretty much everything. Not a big deal or surprise that it sticks to MAOs. But yes we need good strong sources. Jytdog (talk) 06:46, 29 March 2017 (UTC)

"Pharmacodynamics"

Fancy greek for "what targets and pathways does this compound affect"? Initial studies that try to identify biological targets of compounds and work out pathways or structures that are perturbed that might cause some phenotype change, are indeed in vitro assays that are used in drug discovery and drug development. I changed the section header. Jytdog (talk) 18:49, 29 March 2017 (UTC)

Ok I'll ask

User: Rhode Island Red - in this dif you appeared to say that this edit by me was SYN. Maybe you meant that bit of content itself, but please explain. Thanks. Jytdog (talk) 23:28, 29 March 2017 (UTC)

The issue is that the source cited makes no statement similar to the one added to the WP article. Thus it failed verification. It looks as though the statement was cobbled together or gleaned from cherry-picking bits and pieces from the source, and that's WP:SYNTH -- the policy states "do not combine different parts of one source to reach or imply a conclusion not explicitly stated by the source." I'll add that the mere fact that some particular angle is being researched doesn't necessarily make it notable; strong evidence of efficacy is what's notable. It's also important to not muddle together basic research (in vivo/in vitro) with clinical research. Rhode Island Red (talk) 15:41, 30 March 2017 (UTC)

ah so it was the content. OK. Thanks. Jytdog (talk) 20:05, 30 March 2017 (UTC)

Alternative Medicine

I see a double standard to include a single death report and link IV curcumin as the causative agent. What is WP:MEDRS on this? Is it reasonable to include notable occurrences from news sources? If so we should be careful with causality. It may have been but it could have been a contaminated med or any other number of things. In any case if we can note death from curcumin, we might link to life's purportedly saved by curcumin as per such an article- http://www.dailymail.co.uk/health/article-4726136/How-curry-spice-helped-dying-woman-beat-cancer.html Chickpecking (talk) 00:04, 8 December 2017 (UTC)

Daily Mail is a reliable source for just about nothing. See WP:DAILYMAIL. Jytdog (talk) 00:06, 8 December 2017 (UTC)

Not at all my point- I don't want to add this or I would have already. I'm asking about the manner we document occurrences. If we must be careful drawing positive associations regarding curcumin and cancer, ought we also to be bound by the same when looking at adverse effects?Chickpecking (talk) 06:45, 9 December 2017 (UTC)

Stick to WP:MEDRS. Since the curcumin death has been documented by the FDA, all is well. Forbes alone would be insufficient. Alexbrn (talk) 06:48, 9 December 2017 (UTC)

Maybe we should stick to facts. per the FDA:

Two patients administered infusions of curcumin (a component of the spice turmeric) compounded with polyethylene glycol (PEG) 40 castor oil reportedly experienced immediate hypersensitivity reactions. The PEG 40 castor oil was a component of a curcumin emulsion product compounded by a pharmacy, ImprimisRx, located in Irvine, California. Hypersensitivity reactions to intravenous (IV) products containing polyethylene glycol castor oil have been reported in the literature and are the subject of warnings for a number of FDA-approved drugs. https://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/PharmacyCompounding/ucm570192.htm so instead of a reaction to curcumin, they think it was a reaction to something else in the infusion.Chickpecking (talk) 07:46, 9 December 2017 (UTC)

That's not what the source says. The precise biological mechanism isn't known but, explicitly, it could have been the PEG 40, or the curcumin, or something else ("some of the other ingredients in ImprimisRx’s product, including curcumin, also have been associated with hypersensitivity reactions when administered intravenously"). In any case, there is no doubt that the procedure itself - IV administration of a curcumin-based infusion - was the cause of death. Alexbrn (talk) 08:30, 9 December 2017 (UTC)

So there is unclarity of what did what, exactly my point. Might as well talk about the lady who ate gobs of tumeric and went into remission.Chickpecking (talk) 08:38, 9 December 2017 (UTC)

There is no lack of clarity. As the FDA says, the IV administration of an infused curcumin solution caused death. It is the quackery which is the point here. If they said turmeric caused a remission that would be noteworthy too. But of course they don't - that's the kind of thing we find instead in the Daily Mail or other appalling sources. Alexbrn (talk) 08:43, 9 December 2017 (UTC)

Shows your distinct bias. We can also find medical reports of cures elsewhere. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739749/ green tea and curcumin and more seem to have been at play here. My point is that if the one can stand, the other could too. To me, the death is a tragic case that we don't know what caused. The remission is an interesting case that we also don't have certainty about. Chickpecking (talk) 09:22, 9 December 2017 (UTC)

We do know what caused it: Kim Kelly ND injected Jade Erick with a curcumin emulsion and she died as a result. You have produced another unreliable source. To repeat, we need WP:MEDRS for this kind of content. If we stick to decent sourcing all shall be well. Alexbrn (talk) 09:38, 9 December 2017 (UTC)

poor logic. The emulsion was a mixture and the issue at hand is we don't have a causal link to curcumin. This is on the same footing as the case report, less so as there is probably a better causal link there.Chickpecking (talk) 09:51, 9 December 2017 (UTC)

You'd better take up your "logic" argument with the FDA. The woman died as a result of the procedure which was marketed as a curcumin altmed treatment – which is why it is due here in this article. We have an analysis of the event from the FDA which gives us a strong WP:MEDRS. A case report in contrast, is explicitly not reliable (see WP:MEDASSESS). That is the logic of the WP:PAGs, which is what counts here. Alexbrn (talk) 10:00, 9 December 2017 (UTC)

Sorry, I don't buy your take on the FDA's event report being on any higher ground than a medical case report- this is not laid out in WP:MEDRS. I have no issue with the FDA conclusions which do state it could have been any of several causes.Chickpecking (talk) 10:15, 9 December 2017 (UTC)

I disagree. The analysis by the FDA makes it a secondary source. The exact biological cause is clearly uncertain but from a medical practice perspective the cause is in no doubt: injection of the curcumin emulsion. Perhaps raise a query at WT:MED if you dispute that the FDA source is usable. Alexbrn (talk) 10:20, 9 December 2017 (UTC)

The cause and effect relationship between the curcumin infusion and the hypersensitivity reactions seems pretty unquestionable since it happened instantly during the infusion. There are two things about the FDA report that I found particularly remarkable: (1) the curcumin solution injected contained only 1-2% of the curcumin amount listed on the labeling; (2) the curcumin solution contained industrial grade PEG 40 castor oil. IMO, it probably was the PEG 40 CO (or its DEG byproduct) that was causitive.

But it doesn’t matter for our purposes which ingredient in the solution was causative. The curcumin infusion was used as a an unapproved therapy for eczema by this naturopath and it caused serious AEs (including one death). It highlights risks of naturopaths administering IV curcumin treatments, as well as the shoddiness of the compounding pharmacy that produced the IV formulation used in these cases. All in all, the event is really quite remarkable and clearly merits inclusion in the article. As a source in this case, the FDAs thorough report is rock solid. There are no similarly solid reports alleging any cures with curcumin, and surely none where the cause and effect relationship is as obvious as it was in the case of the hypersensitivity reactions.

It's not valid to argue that including the FDA report means that we have to drastically lower the bar and include some anecdotal case report where curcumin wasn’t even implicated as the therapeutic agent (the authors of the case study mentioned above implicated ECGC, not curcumin). So let’s not play the game of false equivalency. Rhode Island Red (talk) 15:43, 9 December 2017 (UTC)

Your first paragraph stays with the FDA's conclusions. It does matter which ingredient is causative, for the same reason it matters which addition, if any, to a cancer remission is causative in a case report. This might be more noteworthy on the PEG 40 page. Admittedly other case reports have a more persuasive temporal relation- sometimes as compelling as this death's relation to some ingredient. MD's also inject iv off label ingredients so adding in naturopath seems as immaterial as mentioning the location. Virtually every case report has a discussion of the literature. It is not that everything the FDA puts out is on the level of a case report but that an event report like this is on the level of a case report. Inherently these are equivalent. I am not saying include or not just that it sets a double standard- one with inherent bias- to include negative reports and not positive. It is virtually always easier to link a death to an event than a life saved.Chickpecking (talk) 20:13, 9 December 2017 (UTC)

Too promotional?

Hello, I plan to add more to this article, however the material was labeled as "too promotional". I have changed the text in order to better follow the guidelines. Please look at my sandbox, as that is what I plan to add later. If I still need to change things, please let me know. Msri20 (talk) 06:22, 9 December 2017 (UTC)Msri20

Please see WP:MEDRS. Our WP:Biomedical information should really be sourced to recent secondary material (e.g. systematic reviews or meta-analyses) in high-quality medical journals, or the views of major health organizations. Looking at your sources I'm seeing letters, primary research and poor-quality journals. I don't see anything immediately usable, except perhaps PMID 25373119. Be aware this is a topic for which WP:Discretionary sanctions apply so editing must be done with care. Alexbrn (talk) 06:34, 9 December 2017 (UTC)

Thanks for coming to talk, Mari20. It appears that you and some other people from your course didn't do, or weren't mindful of, the Education Project training on writing about health in Wikipedia. Please review that material and the message I left at your talk page carefully. Thanks. Jytdog (talk) 19:12, 9 December 2017 (UTC)