Turmeric Matrix For Rheumatoid Arthritis, Delayed Onset Muscle Soreness & More
Turmeric Matrix
Curcuminoids from turmeric are among the most popular nutraceuticals in use today. In fact, the global curcumin market size exceeded $70 million in 2020 and is expected to grow at a compound annual growth rate (CAGR) of 11 percent by 2027.1 The reason for the popularity of curcuminoids is likely due to the fact that they are highly efficacious, and supportive research is extensive. Nevertheless, not all curcuminoid products are created equal. One of the better forms of curcumin can be found in a turmeric matrix which has exceptionally good absorption. But before jumping into a discussion on this unique curcuminoid material, let’s review some background on turmeric and curcuminoids.
Turmeric/Curcuminoid Background and Bioavailability Issues
Turmeric is a member of the ginger family and has been used for as a traditional remedy in Chinese and Indian ayurvedic medicine as well as for condiment and flavoring purposes for more than 2,000 years, based on records dating back to 600 BCE.2 One textbook indicates that “the use of turmeric in Indian folk medicine is one of a veritable panacea, apparently efficacious for conditions that we would nowadays classify in the realm of infectious, inflammatory, metabolic and immunological diseases.”3
The medicinal part of turmeric is its rhizome, the underground stem which looks more like a root due to its thick appearance. Turmeric’s rhizome contains a variety of natural compounds, including naturally occurring curcuminoids such as curcumin (diferuloylmethane), demethoxycurcumin and bisdemethoxycurcumin.4
The limiting factor with turmeric is poor biovailability—with 40 percent to 75 percent of curcuminoids passing through the digestive tract unchanged in animal research.5
Due to its fast metabolic turnover in the liver and intestinal wall, blood concentrations of curcuminoids are low and tissue distribution is limited following oral dosing.6-14 Maximum plasma curcumin concentrations in humans, even upon intake of doses as high as 10 or 12 g curcumin, remain in the low nanomolar range (<160 nmol/L).15 Hence the value of a delivery system for curcuminoids.
Turmeric Matrix
A turmeric matrix (as Acumin-Cureit) was created to address the issue of poor curcumin bioavailability. This was accomplished using a proprietary Polar/Non Polar Sandwiching Technology (PNS), allowing for the hydrogen bonding interactions with curcuminoids, polar and non-polar compounds. Testing confirmed the presence of curcuminoids (curcumin, demethoxycurcumin and bismethoxycurcumin), lactones, sesquiterpenes and their derivatives derived from polar layer, aromatic turmerone, dihydroturmerone, turmeronol, curdione and bisacurone. In short, the presence of curcuminoids with high stability was verified with the matrix PNS formulation.16 Furthermore, the turmeric matrix demonstrated excellent absorptive properties. It is also worth noting that the technology is 100 percent turmeric derived (meaning no fillers, excipients or solubilizing agents).
Absorption
A randomized, open label, balanced, study17 was conducted to compare the absorption of curcuminoids from turmeric matrix (as Acumin-Cureit) to that of a standard curcumin 95 percent extract in 12 healthy adult subjects. This was a two period, two sequences and two treatment study. This means that a single oral dose of turmeric matrix and the curcumin 95 percent were each administered on two different days for the subjects, with the first and second dosages being separated by a wash out period of 14 days. Results were that the absorption of curcuminoids from turmeric matrix increased gradually in the successive hours after consumption, with a dramatic increase of in-blood curcumin levels obtained at fifth hour, and then gradual decrease thereafter. The absorption level of curcumin from turmeric matrix was more than 10 times that of standard curcumin 95 percent—and that was with the turmeric matrix providing 50 percent curcuminoids!
Another open-label parallel-arm study18 was conducted to assess and compare the bioavailability of curcuminoids from turmeric matrix (Acumin-Cureit) with two other commercially available formulations, namely, curcumin with volatile oil (volatile oil formulation) and curcumin with phospholipids and cellulose (phospholipid formulation) in healthy human adult male subjects (15 each group). Each formulation was administrated orally as a single 500-mg dose in capsule form, and blood samples were analyzed at various time intervals up to 24 hours. Results were that turmeric matrix was very well absorbed and resulted in a mean curcuminoids plasma Cmax of 170.14 ng/mL compared with 47.54 ng/mL and 69.63 ng/mL for the volatile oil and phospholipid formulations, respectively. The extent of absorption of total curcuminoids in the blood for the turmeric matrix was six times greater than volatile oil formulation and five times greater than phospholipids formulation. The results of this study indicate that curcuminoids in turmeric matrix exhibited greater bioavailability than the two other curcuminoid formulations.
In addition to its excellent bioavailability, turmeric matrix also has been shown in clinical studies to offer substantial benefits related to its anti-inflammatory properties.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune, chronic systemic inflammatory disorder. For centuries, curcuminoids have been used in ayurvedic medicine for the treatment of inflammatory conditions. This randomized, double-blind, placebo-controlled, three-arm, parallel-group study19 was conducted to evaluate the effect of curcuminoid matrix (as Acumin-Cureit) for their ability to improve the clinical symptoms of RA. Two different doses of curcuminoids were compared with that of a placebo in active RA patients. Twelve patients in each group received placebo, 250 or 500 mg of curcuminoids twice daily for 90 days. The responses of the patients were assessed using the American College of Rheumatology (ACR) response, visual analog scale (VAS), C-reactive protein (CRP), Disease Activity Score 28 (DAS28), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) values. RA patients who received curcuminoids at both low and high doses reported statistically significant changes in their clinical symptoms at the end of the study. These observations were confirmed by significant changes in ESR, CPR and RF values in patients receiving the study product compared to baseline and placebo. The results indicate that curcuminoid matrix (as Acumin-Cureit) act as an analgesic and anti-inflammatory agent for the management of RA at a dose as low as 250 mg twice daily as evidenced by significant improvement in the ESR, CRP, VAS, RF, DAS28 and ACR responses compared to placebo. Both doses of the study product were well tolerated and without side effects.
Delayed Onset Muscle Soreness
When people perform intense physical activity (e.g. working out in the gym), it may result in delayed onset muscle soreness (DOMS)—a multifactorial progression related to muscle pain, swelling, stiffness, tenderness, alter joint kinematics, muscle fiber disruption, decreased strength and power and acute tissue damage. A randomized, placebo-controlled, double-blind clinical study was conducted to assess the efficacy of curcuminoid matrix (as 500 mg Acumin-Cureit) compared to placebo in decreasing damage from inflammation and oxidative stress associated to severe muscle damage induced by eccentric continuous exercise (downhill treadmill running) in 30 subjects. Results were that curcuminoid matrix effectively managed DOMS due to its wide range of biological activities. Specifically, it significantly reduced DOMS, creatinine kinase (a measure of muscle damage) levels and increased VO2 max value (a measure of cardiorespiratory endurance) compared to placebo. Furthermore, the curcuminoids were found safe for administration. The consumption of curcuminoid matrix led to improve recovery and reduction of DOMS without any side effects due to the enhancement of bioavailable form of curcumin.
Sarcopenia
Sarcopenia is the progressive loss of skeletal muscles, which occurs as a result of aging. This randomized, placebo-controlled, double-blind clinical study20 involving 30 subjects evaluated the efficacy of curcuminoid matrix supplementation (as 500 mg Acumin-Cureit) in the management of sarcopenia by measuring the variables, such as hand grip strength, weight lift strength, time/distance before feeling tired after cycling, walking and climbing stairs, and Karnofsky performance scale index along with effects on general fitness, such as protein, urea, oxidative stress and hematology parameters. The results showed that curcuminoid matrix supplementation resulted in a significant increase of 1.43 percent (P < .001) in the handgrip strength compared with placebo. The weight-lifting capacity of subjects supplemented with curcuminoids showed an increase of 6.08 percent, whereas placebo showed a 4.54 percent decrease after the end of the study period. The results demonstrated that the curcuminoids tended to have a positive impact on distance covered before feeling tired as shown by an increase (P = .09) of 5.51 percent, compared with placebo group, which showed an increase of 2.29 percent. The time taken to walk the same distance was reduced in the curcuminoids group (1.15 percent), whereas in the placebo group, it was increased (2.02 percent). In conclusion, curcuminoid matrix (as Acumin-Cureit) played a significant role in the management of sarcopenia by anti-inflammatory action, increased hand grip strength, antifatigue effects and muscle protein management.
Oral Submucous Fibrosis
Oral submucous fibrosis (OSFM) is a chronic debilitating disease of the oral cavity characterized by inflammation and progressive fibrosis of the submucosal tissues, resulting in marked rigidity and an eventual inability to open the mouth. A double blinded, randomized and placebo-controlled trial21 was conducted to determine the efficacy of a nutraceutical formula in the management of OSFM, primarily improvement in mouth opening (interincisal distance) and secondarily changes in subjective oral burning symptoms. The nutraceutical formula included curcuminoid matrix (as Acumin-Cureit), combined with lycopene and piperine (as a bioavailability enhancer). A total of 50 eligible subjects (aged 18 to 66 years) with mild to moderate OSMF participated in the study. Results revealed that improvement in mouth opening and burning symptoms by the OSMF subjects when the nutraceutical formulation was used.
Conclusion
Curcuminoid matrix (as Acumin-Cureit) has been clinically demonstrated to provide five to 10 times greater absorption than other turmeric materials tested. In addition, human research has shown that it effectively acted as an analgesic and anti-inflammatory agent for the management of RA, improved recovery and reduction of DOMS, played a significant role in the management of sarcopenia, and helped improve symptoms of OSMF.
References:
1 Curcumin Market Size, By Application (Pharmaceutical, Food, Cosmetics), Industry Analysis Report, Regional Outlook, Application Development Potential, Covid-19 Impact Analysis, Price Trend, Competitive Market Share & Forecast, 2021 – 2027. Global Market Insights. Report ID: GM1788. Base Year: 2020. Retrieved January 12, 2022 from www.gminsights.com/industry-analysis/curcumin-market.
2 Curcuma longa (turmeric). Monograph. Altern Med Rev 2001;6 Suppl:S62-6.
3 Togni S, Appendino G. Curcumin and Joint Health: From Traditional Knowledge to Clinical Validation. In: Watson RR, Preedy VR (eds.) Bioactive Food as Dietary Interventions for Arthritis and Related Inflammatory Diseases. San Diego: Academic Press; 2013:67-81.
4 Blumenthal M (ed), et al. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council; 1998.
5 Luper S. A review of plants used in the treatment of liver disease: part two. Altern Med Rev. 1999;4:178-188.
6 Shoba G, Joy D, Joseph T, Majeed M, et al. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998;64:353–356.
7 Sharma RA, McLelland HR, Hill KA, Ireson CR, et al., Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer. Clin. Cancer Res. 2001;7:1894–1900.
8 Vareed SK, Kakarala M, Ruffin MT, Crowell JA, et al. Pharmacokinetics of curcumin conjugate metabolites in healthy human subjects. Cancer Epidemiol. Biomarkers Prev. 2008;17:1411–1417.
9 Cheng AL, Hsu CH, Lin JK, Hsu MM, et al. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001;21:2895–2900.
10 Lao CD, Ruffin MT, Normolle D, Heath DD, et al. Dose escalation of a curcuminoid formulation. BMC Complement. Alter. Med. 2006;6:10.
11 Garcea G, Berry DP, Jones DJ, Singh R, et al. Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences. Cancer Epidemiol. Biomarkers Prev. 2005;14:120–125.
12 Sharma RA, Euden SA, Platton SL, Cooke DN, et al. Phase I clinical trial of oral curcumin: biomarkers of systemic activity and compliance. Clin Cancer Res. 2004;10:6847–6854.
13 Carroll RE, Benya RV, Turgeon DK, Vareed S, et al. Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia. Cancer Prev. Res. (Phila) 2011;4:354–364.
14 Ringman JM, Frautschy S A, Teng E, Begum AN, et al. Oral curcumin for Alzheimer’s disease: tolerability and efficacy in a 24-week randomized, double blind, placebo-controlled study. Alzheimers Res. Ther. 2012;4:43.
15 Vareed SK, Kakarala M, Ruffin MT, Crowell JA, et al. Pharmacokinetics of curcumin conjugate metabolites in healthy human subjects. Cancer Epidemiol. Biomarkers Prev. 2008;17:1411–1417.
16 Amalraj A, Jude S, Varma K, et al. Preparation of a novel bioavailable curcuminoid formulation (Cureit™) using Polar-Nonpolar-Sandwich (PNS) technology and its characterization and applications. Mater Sci Eng C Mater Biol Appl. 2017 Jun 1;75:359-367.
17 Gopi S, George R, Thomas M, Jude S. A Pilot Cross-Over Study to Assess the Human Bio Availability of “Cureit” A Bio Available Curcumin in Complete Natural Matrix. Asian J Pharm. 2015; 03(11): 92-96.
18 Gopi S, Jacob J, Varma K, et al. Comparative Oral Absorption of Curcumin in a Natural Turmeric Matrix with Two Other Curcumin Formulations: An Open-label Parallel-arm Study. Phytother Res. 2017 Dec;31(12):1883-1891.
19 Amalraj A, Varma K, Jacob J, et al. A Novel Highly Bioavailable Curcumin Formulation Improves Symptoms and Diagnostic Indicators in Rheumatoid Arthritis Patients: A Randomized, Double-Blind, Placebo-Controlled, Two-Dose, Three-Arm, and Parallel-Group Study. J Med Food. 2017 Oct;20(10):1022-1030.
20 Varma K, Amalraj A, Divya C, Gopi S. The Efficacy of the Novel Bioavailable Curcumin (Cureit) in the Management of Sarcopenia in Healthy Elderly Subjects: A Randomized, Placebo-Controlled, Double-Blind Clinical Study. J Med Food. 2021 Jan;24(1):40-49.
21 Singh N, Amalraj A, Divya C, Gopi S. A Randomized, Multicentric, Placebo-controlled, Parallel, Double-blinded clinical trial to evaluate the efficacy of Svarnsaathi (A proprietary formulation enriched with bioavailable curcumin) in the treatment of Oral Submucous Fibrosis. Unpublished. 2019: 33 pgs.
Gene Bruno, MS, MHS, the dean of academics for Huntington College of Health Sciences, is a nutritionist, herbalist, writer and educator. For more than 30 years he has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines and peer-reviewed publications. He can be reached at gbruno@hchs.edu.
