Mechanism of Action

Many clinical trials set out to determine the efficacy of this supplement have focused on its active ingredient, curcumin, rather than turmeric itself. However, it has a very limited medical profile in terms of ability within the body due to its hydrophobic nature and having a low bioavailability after being taken orally. Since this herb is used in hopes to target different therapies, it has different actions in the body to reflect that. For example, to have its antiinflammatory effect, curcumin has been shown to interfere with the eicosanoid pathway and further the signaling molecules that play a role in the immune response and local inflammation. It has also proven to inhibit the expression of growth and metastases promoting genes as well as regulate enzymes that control tumor growth in trials for cancer treatment.

Safety & Warnings

While there is not much toxicology data and there have not been many safety reasons for concern, there are a few warnings regarding certain groups and health conditions that have been advised to avoid taking turmeric supplements. One of which being women who are pregnant and lactating due to stimulation of menstrual flow and of the uterus. Also, patients with gallstones, bile duct obstruction, or passage obstruction should be cautious with turmeric and curcumin.

R eferences

Turmeric. Lexi-Drugs. Lexicomp. Wolters https://online.lexi.com

Kluwer Health, Inc. Riverwoods, IL.

Accessed February 20, 2023.

Kuttan, R., Sudheeran, P. C., & Josph, C. D. (1987). Turmeric and curcumin as topical agents in cancer therapy. Tumori Journal, 73(1), 29-31.

Hay, E., Lucariello, A., Contieri, M., Esposito, T., De Luca, A., Guerra, G., & Perna, A.(2019). Therapeutic effects of turmeric in several diseases: An overview. Chemico-biological interactions, 310, 108729.

Adverse & Side Effects

This herbal supplement has very few adverse and side effects. Even when taken at relatively high doses, such as in a cancer trial, very few systemic repercussions were found. However, it has been found that dyspepsia, or recurring stomach upset symptoms, and itchy skin on some areas of the body has been correlated to taking turmeric. In rare cases, contact dermatitis and anaphylaxis have occurred, but compared to other drugs and oral supplements, turmeric has a favorable side effect profile.

Interactions

Due to the way this herb is metabolized and broken down in the body, it does interact with a few different kinds of medications. If taken together, it may increase and enhance the adverse and toxic effects of those agents. Turmeric potentially interacts with antiplatelet agents, anticoagulants, non-steroidal antiinflammatory drugs, salicylates, thrombolytic agents, and a few others.

Turmeric and Curcumin as Topical Agents in Cancer Therapy

A study conducted at the Amala Cancer Research Centre in Thrissur, India set out to prove the medicinal use of one of their most popular cooking spices, turmeric, as a topical ointment in treating cancerous lesions. They evaluated sixty-two patients, all with locally recurring ulcerating tumors that smelled, itched, and were painful either in the oral cavity, breast, skin, vulva, or random site. Every patient had tried and failed to respond to treatments such as radiotherapy, surgery, or chemotherapy. After applying the ointment with its respective dose of curcumin three times a day and receiving weekly evaluations, most of the patients experienced positive responses in their lesions such as the reduction of smell, itching, exudate, lesion size, and overall pain. While this study was published in 1985 and many more tests have been done to further examine this herb’s role as a medicinal agent, it was the beginning of a movement for curcumin in cancer therapy.

Would I Consider Turmeric for Myself?

I have been fortunate enough at this point in my life to not have any underlying health conditions that may require the intervention of a supplement such as turmeric. However, if at some point I needed medicical care and being in the position I am as a future pharmacist, I am honestly not sure if turmeric and curcumin would be the first product I would turn to.

~ E Ronk

Alyssa

Gouty

Public Health major Spring 2023

Scientific name/Common name(s)

Scientific name: Valeriana Officinalis

Common name(s): Valerian, Valerian Root, Garden Heliotrope, All-heal

History:

Origin: Asia, Europe

Historically valerian was promoted as a therapeutic herb dating back as far as the time of ancient Greece and Rome. Valerian was used to treat nervousness, trembling, headaches, and heart palpitations in the 16th century. Following this time, in the 19th century, Valerian was rediscovered as a stimulant, defying what it had previously been used to treat. It was later promoted for the treatment of stress, anxiety, hyperactivity, sleep difficulties, and other distress disorders.

Common Uses:

Sedative

• Insomnia

• Nervous tension

How it works in the body:

It is still not well understood how valerian works in the body. Researchers have identified the following active compounds that may be responsible for its impact on the human brain and body.

• Iridoids – valepotriates

• Essential oils – valerenic acid, valeric acid

• Lignans

• Flavonoids

• GABA (at low levels)

Available (dosage) forms:

• Tea

• Tincture

• Fluid extract

• Capsulated, dry powered extract

Typical dosing/serving:

Valerian is recommended 1 to 2 hours before bedtime, or up to 3 times throughout the day with the last dose near bedtime.

• Tea: Pour 1 cup of boiling water over 1 teaspoon (2 to 3 g) of dried root, steep 5 to 10 minutes.

• Tincture (1:5): 1 to 1 ½ to 1 tsp (1 to 2 mL)

• Fluid extract (1:1): ½ to 1 tsp (1 to 2 mL)

• Dry powdered extract (4:1): 250 to 600 mg

Effectiveness:

Clinical data for treating sleep disorders is inconclusive, but valerian may offer some therapeutic benefits for sleep disorders and associated common symptoms.

Safety/Warnings/Toxicities:

Avoid taking valerian if the following apply to you as it may be unsafe or toxic.

• Pregnant or breast feeding

• Children under 3

• Liver disease

Adverse/side effects:

• Driving

• Operating dangerous machinery

Few adverse effects are attributed to valerian. Reports from clinical studies listed several common side effects.

• Headache

• Upset stomach

• Feelings of uneasiness

• Heart rate changes

Interactions (food/drug):

• Insomnia

• Drowsiness

• Dry mouth

• Vivid dreams

Effects felt by valerian may be enhanced or cause adverse reactions if taken with other sedative medications, herbs, or dietary supplements with sedative properties and other depressants.

• Benzodiazepines o Xanax®, Valium®, Ativan®, and Halcion®

• Barbiturates or central nervous system (CNS) depressants o Phenobarbital, morphine, and propofol

Summary of ONE article/study:

• Dietary supplements o St. John’s wort, kava, and melatonin

• Alcohol

• Narcotics

Valerian Root in Treating Sleep Problems and Associated Disorders – A Systematic Review and Meta-Analysis

The prevalence of sleep problems commonly coupled with many other symptoms, including anxiety, encouraged the analysis of valerian to understand its effects. This study had a goal to provide updated data as well as address inconsistencies commonly found in other studies analyzing the effects of valerian on sleep disorders and their associated comorbidities. The results suggested that various outcomes were potentially due to “variable quality of herbal extracts.” Further evidence suggested that valerian did offer therapeutic benefits and could be a safe herb to promote sleep and associated symptoms. The overall effects are limited due to the inconsistent active constituents and further quality control processes need revision.

Personal/Professional opinion:

After reviewing various research and published articles on the oral supplement Valerian, it appears to be a relatively safe supplement for people to consume. Using valerian for a short amount of time, up to 28 days, has been found in studies to create no difficulties in most adults. Studies on long-term use have not been performed. Generally, valerian appears to be safe if utilized in moderation. ~ A Gouty