Curcumin Supplements for Joint Pain: A “Curry” a Day?

It would take more than the scope of this article to delve into all of curcumin supposed and studied benefits in any appreciable detail, so as a brief synopsis here is a list of what benefits curcumin has a studied benefit toward:

In one study, curcumin resulted in a substantial decrease in inflammatory signs and improved movement around the joints.^[8]

• Reducing inflammation^[3,4]
• Reducing anti-oxidants^[4,5]
• Reducing pain marker^[6]
• Reducing effect of Osteoarthritis^[7]
• Increasing circulating levels of Nitric Oxide (improving blood flow and heart function)^[7]
• Potential suppressor of autoimmune diseases such as diabetes (type 1) and IBD^[8]

In this article, we will explore curcumin’s effects on providing joint support and relief.

Who will benefit?

After doing the research, it’s surprising that curcumin isn’t more frequently in the discussion for not only joint health, but overall health.

Because of the massive number of benefits, nearly anybody and everybody can benefit from Curcumin supplementation.

From those looking for pain relief from aching joints, to those looking to improve their health in general, there is really not much of a reason to not use Curcumin, so long as it’s within your budget and you get your doctor’s approval.

Note: this entire part is very long. If you don’t care about the science and research and just want to skip to the supplements, click here.

As it turns out, the primary reason curcumin was a popular ingredient in Ancient Chinese and Indian medicine is why it helps us today with joint relief. As opposed to other joint support ingredients which help in the remodelling process, curcumin is a potent anti-inflammatory which helps relieve the painful effects of inflamed joints and protect against potentially destructive behaviour of prolonged inflammation.^[1,2,4,5]

So before we dig any deeper, let’s take a look at what triggers inflammation, how inflammation begins and how it affects our joints.

What triggers inflammation

Curcumin alone resulted in a greater drop in inflammatory symptoms (pain and swelling) than [a certain NSAID].^[13]

Most of us are no strangers to joint pain. Whether it’s that dull ache in the shoulder during a bench press, an aching knee during a squat, or a sore hip when we walk, at one stage or another most of us will experience some form of joint pain.

In some cases it may pass in a matter of days, in other cases it may linger for weeks, months or years if left untreated.

In almost all cases, there is a degree of inflammation occurring at the joint which will affect our movement and cause pain.^[4,5]

Most joint-related issues fall under the category ‘chronic’ as the aches persist for weeks rather than hours or days and thus will be the focus of this article.^[4,5] The differences between acute (rapid occurring inflammation) and chronic (long term, low intensity but degenerative) will be covered in a later section.

How does inflammation occur?

Whenever something irritates our bodies, such as joint overuse, daily stress, and age, our bodies respond by directing white blood cells within nutrient dense blood to target the foreign substance in an attempt to remove it, stop the spread of the infection.^[7] These white blood cells release signalling molecules which contribute to the inflammatory response and thus begin the healing process.

These signalling molecules are known as cytokines and include the pro-inflammatory Interleukin-6, Interleukin-8, monocyte inflammatory protein-1, Tumour necrosis factor alpha and a host of others.^[7,9] It must be noted that inflammation is a necessary process for the defence of our bodies systems and if you have ever exercised, then you may be familiar with the stiffness that usually accompanies a workout which is a product of inflammation, however in some cases, it can work against us.^[10,11]

So briefly, a cytokine is a broad term for signalling proteins that affect the behaviour of another cell. In the context of inflammation, these cytokines include:

• Interleukins
• Tumour necrosis factor alpha
• Monocyte inflammatory protein-1

Acute VS Chronic Inflammation

Earlier we mentioned that there were two forms of inflammation – the “short term” kind and the “long-term” kind. We discuss both, but we’re really going to get into the one you care about most – the long-term kind (chronic inflammation!)

1. Acute Inflammation

   Acute, as its name suggests, has rapid onset, tends to be sorted out quickly by the white blood cells neutrophils and macrophages, is generally considered mild but often rears its ugly head by becoming very red, sore and hot. Examples of this form is the aftermath of a cut or a stubbed toe.^[7]

2. Chronic Inflammation

   On the other hand, Chronic takes weeks, months or years to subside, is mostly attended by monocytes/macrophages and lymphocytes, is generally quite severe and can be very subtle.^[7,10,11,12] Examples of this form are persistent injuries, arthritis or a chronic infection. With chronically inflamed joints, day to day function becomes extremely difficult and painful for the inflicted person.^[7,10]

   

   Inflammation is complicated, but your joint supplement doesn’t have to be with curcumin. Image courtesy BioCarta

   Chronic inflammation can be triggered in many various ways and instead of being beneficial like acute inflammation, it contributes to disease and age-related deterioration of the body.

   Aging, stress, obesity, prolonged joint injuries and other lifestyle factors increase the amounts of circulating pro-inflammatory cytokines and contribute to the constant inflammation many people have, but may be unaware of.^[7] The constant elevation of pro-inflammatory cytokines and prostaglandins also increase the levels of matrix metalloproteinases (MMPs) which destroy the cartilage around a joint.^[7]

   Matrix metalloproteinases (MMPs)

   It must be noted that MMPs, under normal functioning conditions, play a key role in many different cellular functions, including joint health. Joint remodelling requires at least two key events to take place, one is breakdown (make room for new components) and the other is synthesis of new structural components. In the case of MMPs, these play an important role in breakdown structural components.^[7] However in the case of chronic inflammation, MMPs are one of the primary causes of long term joint damage.

As this topic is very broad, we will focus specifically on chronic inflammations impacts at a joint.

So let’s get back to how Curcumin can help: brace yourself for science!

Curcumin performs its role of inflammation reduction through a series of different, yet interrelated pathways. These are:

1. Inhibition of Cytokine production^[7,12]
2. Down-regulating the activity of COX-2^[7] (The same pathway as COX-2 inhibitors such as Ibuprofen*)
3. Down-regulation of leukotrienes^[7,12]
4. Inhibition of inducible nitric oxide (iNOS)^[7,11]

* Note that because curcumin uses the same pathways as ibuprofen, it’s not recommended to take them together unless directed by a doctor. It could be used as a replacement for one of your ibuprofen doses, though. This is a situation where it’s best if you see your doctor — especially if you’ve been prescribed high-dose ibuprofen.

Let’s break down what each of these do and how Curcumin interacts with these pathways.

1. Cytokines

   

   Discussed below, Curcumin C3 Reduct is our preferred curcumin preparation for both cost and effectiveness.

   Cytokines are signalling proteins released by macrophages that initiate the inflammation process. It is overexpression of these cytokines which leads to prolonged inflammation that we are trying to limit.

   Curcumin suppresses cytokine production through activation and deactivation of other signalling proteins (activating ‘activating protein-1’ and deactivating NF-kB), which block inflammatory cytokine expression.

   The result again is reduced inflammation.^[1,7,10,12]

2. COX Enzymes

   COX are enzymes that produce prostaglandins. Prostaglandins promote inflammation and cause the cardinal signs of inflammation: pain, swelling, redness and heat and if in a joint, movement impairment.

   Curcumin down-regulates COX-2 expression through suppression of a protein known as nuclear factor kappa B. If nuclear factor kappaB cannot act on COX-2, then there would no inflammation.

   As discussed above, for people that do not like the idea of long term NSAID use; curcumin may be a viable alternative.^[1,7,8]

3. Leukotrienes

   Leukotrienes are inflammatory mediators whose presence typically produces histamines and prostaglandins which also promote inflammation. Curcumin down-regulates the LOX pathway which produces Leukotrienes through suppression of nuclear factor kappa B. As above, the result is reduced inflammation.^[1,7,9,12]

4. Macrophages and prostaglandins

   Macrophages and prostaglandins release nitric oxide which increases the diameter of the blood vessels allowing a greater movement of blood into the tissue creating the typical red look as well as increasing swelling in the area.

   Curcumin decreases the number of enzymes responsible for the production of nitric oxide thus reducing the swelling and redness of the inflamed site.^[1,7,10,12]

It may seem like a complicated mess, but most of the pathways are actually interconnected which make understanding them, much easier. Pathways one to three all rely on cytokine expression before they can occur, as curcumin reduces cytokine expression, these three pathways have a reduced effect.

So what does all this mean exactly? Putting it all together

Excessive inflammation encourages prolonged cytokine release; in particular tumour necrosis factor alpha and Interleukin 1B which interact with the enzymes COX-2. COX-2 produces prostaglandins and matrix metalloproteinases (MMP) which contribute to the increase in joint swelling, inflammation and bone erosion through osteoclast activation; Osteo meaning bone and clast meaning broken.

In people developing severe joint conditions, an increase in MMPs means an increase in joint re-absorption and a decrease in bone formation. The net effect is damaged joints.^[10,11]

Since Curcumin’s been around for so long, there are a few extremely successful studies worth pointing out:

• In one human study, supplementation of Curcumin in patients with crippling Rheumatoid Arthritis resulted in a substantial decrease in inflammatory signs and improved movement around the joints.^[8]
• In another study that assessed the efficacy of Curcumin alone or in combination with diclofenac (a type of NSAID) in people with active Rheumatoid Arthritis, they noted that Curcumin alone resulted in a greater drop in inflammatory symptoms (pain and swelling) than the diclofenac group.^[19]

• A study published in 2009 took 107 subjects with knee osteoarthritis and gave them either 800mg ibuprofen or 2g curcumin per day.

  Curcumin worked just as well as the drug — there were no significant differences between either group – both of them improved similarly!

Others have been cited throughout this write-up.

Point being…

The four mechanisms by which Curcumin works makes and the data surrounding its use in Arthritic patients makes it one of the best all round products currently available for joint pain management, joint degradation prevention and reduced joint inflammation.^[2]

Now it’s time to switch to “Buyer’s Guide” mode, because selecting the right curcumin product will make all of the difference in the world (unless you want to eat large spoonfuls of the raw stuff).

Curcumin does have one inherent downfall, but fortunately, it’s easily overcome: standard curcumin is not readily absorbed — it is rapidly metabolized through glucuronide.^[14,15]

This means that very little unprepared curcumin actually makes it into circulation — if taken in isolation.

This is where modern science and research saves the day and makes it more effective than ever before.

Making curcumin supplements actually work in reasonable doses

There are four main ways you can “activate” curcumin and make it more bioavailable to your system. We explain each one, and then show a PricePlow-powered price widget so you can compare prices:

• Curcumin C3 Reduct

  

  NutraBio’s Curcumin Brings Bioavailability and Digestion Support, and it’s of course third-party lab tested!

  The latest and greatest technology with Curcumin is discussed in our NutraBio Curcumin Advanced article, where we look at Sabinsa Corporation’s Curcumin C3 Reduct, which is standardized to a phenomenal 95% of tetrahydrocurcuminoids. It’s actually colorless, as the compounds demethoxycurcumin and bisdemethoxycurcumin specifically are the cascading antioxidants (and the major metabolites) of curcuminoids that your body produces when reacting with curcumin, and these are the compounds shown to have such great antioxidant potential!

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Curcumin Phytosome / Meriva



In terms of value, convenience, and efficacy, this is our choice in curcumin supplementation.

Meriva-500 is a patented Curcumin product that is Curcumin bound to phosphatidylcholine to improve absorption.^[17]

One animal study found that absorption was increased 20 fold over normal Curcumin and one 3 month study in patients with osteoporosis, inflammation markers decreased and mobility increased over the studies duration.^[14,17,18] The same 500mg dose was used during the trials. If using this complex, then a dose as small as 450mg has been shown to as effective as 4g of Curcumin.^[14,17,18]

This is our preferred method of curcumin supplementation, since it makes for reasonable, single-capsule serving sizes, and anecdotally, is what’s currently working best for us and is what prompted us to write this entire article.

This is also known as phytosome preparation — you may see products named “Curcumin Phytosome”.

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• Add Piperine (black pepper extract)

  

  Bioperine is the trusted, trademarked form of black pepper extract that promises 95% or greater piperine, which boosts curcumin bioavailability by as much as 2000%!

  The active component of Black Pepper, piperine, can be taken in conjunction with Curcumin to inhibit Glucuronidation and get Curcumin to where it is needed.^[16]

  When taken in conjunction with 20mg of Piperine, a dose of 2000mg is commonly seen for its effects.^[16]

  The study cited above showed that piperine increased bioavailability by 2000%!

  Below are some piperine-based curcumin supplements:

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  Note that you may see it called “BioPerine” — that is the most trusted tradenamed form of piperine, where they guarantee at least 95% piperine.^[21]

• Theracurmin

  Theracurmin is a preparation that reduces the size of the Curcumin molecule by 100x and increases its stability and then mixed with bio-enhancers to increase its absorption. This preparation increases absorption 27 fold in humans^[14,18]

  The biggest issue here is that these supplements are expensive, but they seem to garner the most efficacy and the highest reviews. So if you’re really struggling and aren’t afraid to spend, you can consider skipping right to this.

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Curcumin Dosage, how much is enough?

Give it time:

Most herbal supplements take time to exert effects – Curcumin is no exception. Processes take time to work within the body and so a little patience is warranted.

You have likely seen the PricePlow-powered price widgets above, which show you the best deals on supplements from over 40 stores. Using PricePlow, you can compare prices on Curcumin supplements and save. It’s recommended to stick with the products listed in the widgets above, however.

Click here to see our curcumin product category, where you can sign up for price drop alerts to get notified when there are deals on these products.

But once again, some of the products in our main curcumin category shown above may require a far greater dose than the C3 Reduct-, Bioperine-, Phytosome-, or Theracurmin-based products, so we still recommend sticking with those.

But we’re not done yet, because there’s even more you can do if you’re willing: