ConsumerLab.com Answers
Question:
Are supplements which claim increased absorption or improved bioavailability telling the truth? Is it worth paying more for these? Are there concerns?
Answer:
It is true that some supplements contain special ingredients, or enhancers, which can improve the absorption or bioavailability (amount of ingredient circulating in your blood) of certain supplements, such as CoQ10, curcumin, milk thistle, green tea, grape seed, ginkgo, and resveratrol. Enhancers typically act in the gut to either improve solubility or reduce the amount of enzymatic breakdown which occurs there. By allowing you to absorb more active ingredient, the supplement may be more potent, meaning that a smaller dose may be used. At the same time, enhancers may increase the absorption or otherwise interact with other supplements or drugs which you take, so it is important to use caution.
The four main types of enhancers currently found in supplements are emulsifying agents, like lecithin; self-emulsifying systems, which involve an oil; phytosomes made from phosphatidylcholine; and enzyme inhibitors, like black pepper extract. Liposomes and nanoparticles have also shown promise for improving absorption. Pros and cons of these enhancers, and the types of ingredients with which they may be useful, are discussed below (and in many of ConsumerLab.com's Product Reviews). See the full answer >> >>
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Question:
I've heard that curcumin is a MAO inhibitor. Is this true, and does that mean it is not safe to take if you eat amine-rich foods like cheese and dark chocolate?
Answer:
It is true that curcumin can act as a MAO inhibitor, but this has only be demonstrated in animals when given intravenously at high doses. There are no studies on curcumin's effect on MAO inhibition in people taking oral supplements -- which have significantly lower absorption and tend to be taken in much lower doses. There are, however, certain supplements and drugs which should not be taken when using curcumin and turmeric. For more information about this, see the Concerns and Cautions section of the Turmeric/Curcumin Supplements Review>> Also see the Encyclopedia article about Curcumin>>
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Question:
I read that turmeric may be a GI irritant. I have GI problems and wonder if I should avoid turmeric and curcumin?
Answer:
Although curcumin (from turmeric) has been shown in clinical studies to improve symptoms of indigestion and ulcerative colitis, it is true that it a small percentage of people may experience nausea, diarrhea and mild stomach distress, especially when taking high doses for prolonged periods of time. This and other concerns are discussed in the Turmeric and Curcumin Supplements Review, which includes details about dose, side-effects, tips for taking curcumin and turmeric supplements, as well as ConsumerLab.com’s tests of products. Also see the article about on Turmeric in our Encyclopedia.
Be aware that curcumin and turmeric should be avoided by people with gallstones or gallbladder disease, as these can stimulate the gallbladder.
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Question:
After taking a curcumin supplement, I started getting chronic diarrhea which went away when I stopped taking it. Can curcumin supplements cause diarrhea?
Answer:
Yes, unfortunately diarrhea is one of the reported side-effects of curcumin supplements. The risk of diarrhea may increase with higher doses of curcumin (900 mg/day or more) or when taken for one month or longer (Sharma, Clin Cancer Res 2004). For more information, including other potential side-effects of curcumin, evidence for use, and our tests of curcumin supplements, see the Curcumin Supplements Review >>
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Question:
I recently read that turmeric is only effective if it is combined with black pepper. Is this true?
Answer:
Black pepper is not necessary for turmeric to be effective, but it can be helpful. Black pepper contains a compound, piperine, which inhibits the metabolic breakdown of turmeric compounds in the gut and the liver. This allows higher levels of turmeric compounds to remain in the body (i.e., it increases its bioavailability), which may increase the effects of turmeric. Keep in mind that this can also affect the breakdown of other compounds, including certain drugs. You can get more details about this in the Turmeric (Curcumin) Supplements Review.
Be aware that the biggest problem with turmeric is making sure that its compounds are absorbed from the gut. You will absorb little if turmeric is not taken with along with fats or oils, which is why it's best to take turmeric and curcumin with a meal containing fats or oils. Black pepper does not help with absorption. Special formulations of turmeric and curcumin supplements have been developed to increase absorption and bioavailability of turmeric compounds. Details about these are also found Turmeric (Curcumin) Supplements Review, noted above.
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Question:
Is Theracurmin better absorbed than other curcumin formulas - and can it really help lower my blood pressure?
Answer:
Theracurmin™ is a branded form of curcumin that has been reduced in particle size to form "nanoparticles" which are then microencapsulated. Studies of its absorption and effect on blood pressure have been conducted and are discussed, along with information about other forms of curcumin such as BCM-95, Meriva, and CurcuWin, in the Turmeric and Curcumin Supplements Review >>
ConsumerLab.com Answers
Question:
Is Rhodiola rosea effective for depression and does it have other uses? Will ConsumerLab.com be testing these supplements?
Answer:
Evidence from small studies (including one recently supported by the National Institutes of Health) suggests that extracts made from Rhodiola rosea (also known as roseroot) may have a modest benefit in depression. It is not as effective as anti-depressant medication but poses less risk of side-effects. There is some preliminary evidence it may also be modestly helpful for people with mild anxiety. Support for some of its other proposed uses - such as fighting fatigue and improving mental acuity - has not been well established. For more about Rhodiola rosea, including the type and dosage used to treat depression, see the full answer >>
ConsumerLab.com has tested popular R. rosea supplements for quality and purity. See the results (including our top picks among Approved products), plus more about the evidence for these and other uses, such as reducing fatigue and improving athletic performance, in the Rhodiola Rosea Supplements Review.
For information about other supplements used for depression, see the Depression article in the Encyclopedia on our site, as well as our product reviews of St. John's Wort Supplements, Fish Oil Supplements, SAMe Supplements and Turmeric/Curcumin Supplements.
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Question:
I take ubiquinol to replenish CoQ10 depleted by my statin. I also take curcumin (from turmeric). Since they both manage free radicals, do I need to take the curcumin?
Answer:
Although both curcumin and ubiquinol (the activate form of CoQ10) have antioxidant properties, they have very different effects in the body, as is the case with other antioxidants, such as vitamin E and vitamin C. So taking one will not achieve all the things accomplished by the other.
CoQ10 is used for energy production within cells, and levels in the body can be lowered by statin drugs. Some, but not all, evidence suggests taking CoQ10 may help reduce certain side effects of statin drugs, such as muscle pain. Curcumin, on the other hand, has anti-inflammatory effects, which may be helpful for conditions such as arthritis or muscle-soreness after exercise, but it is not known to increase energy production in cells, or reduce statin-related muscle pain.
For more about what each of these ingredients do, plus our tests of popular products, see the CoQ10 and Ubiquinol Supplements Review and the Turmeric and Curcumin Supplements Review >>
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Question:
Do any supplements help with nerve pain, like sciatica or diabetic neuropathy?
Answer:
Several supplements have been shown to be helpful for nerve pain caused by conditions such as sciatica or diabetic neuropathy. These include fish oil, curcumin, alpha-lipoic acid (ALA) and GLA, and benfotiamine. Read the full answer for details and dosage >>
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Question:
How does turmeric spice compare to turmeric (curcumin) in supplements? I sprinkle it on my foods and wonder if that's equivalent to taking a supplement.
Answer:
Turmeric spice is ground (dried) turmeric herb — specifically the root/rhizome, sold as a powder. Consuming between ½ to 1 teaspoon of turmeric powder (about 2.5 to 5 grams) with food has been found to have certain digestive and cognitive benefits.
Most clinical studies, however, have not used turmeric powder, but turmeric extract. Only about 3% of the weight of turmeric powder is curcumin and "curcuminoid" compounds -- which are believed to be important to turmeric's effects. In turmeric extracts, the concentration of these is often increased to as high as 95%.
Therefore, it is not unusual for a capsule containing half of a gram of turmeric extract to provide 400 mg of curcuminoids, while the same amount of turmeric powder (ground herb -- just like the spice) might provide only about 15 mg. In fact, in 2013, ConsumerLab.com found that capsules of turmeric "herb" (not extract) from a well-known supplement brand contained only 3 mg of curcuminoids per capsule. Many brands of turmeric supplements contain a combination of extract and herb, and the ratio will greatly affect the amount of curcuminoids you get, so be sure to check the amounts of curcuminoids in popular supplements in ConsumerLab.com's Review of Turmeric and Curcumin Supplements and Spices >>.
One advantage of using turmeric spice, as opposed to a supplement, is that you are more likely to consume it with fats or oils from your food. This will enhance absorption of curcuminoids in the turmeric, as they are lipophilic (they attach to fats). You should take turmeric supplements with meals for the same reason and/or choose a supplement which includes a bioavailability enhancer (as discussed in detail in the Review). (Be aware, however, that some curcumin may be lost due to heat and chemical changes when cooking foods spiced with turmeric.)
Another way that turmeric extracts differ from turmeric powders is that extracts are less likely to be contaminated with heavy metals, such as lead, and do not contain the filth (insect parts and rodent hairs) normally found to varying degrees in the powders. In the Review, you'll also see our tests of levels of filth and heavy metals in popular turmeric spices for cooking, plus the dosage of herb or extract used in treating conditions such as ulcerative colitis, uveitis, arthritis, psoriasis, diabetes, depression, and cognitive function.
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Question:
Which supplements can help to lower blood pressure?
Answer:
There are many supplements, including fish oil, curcumin, certain probiotics, cinnamon and others, which may lower blood pressure. However, if you already take medication to lower blood pressure, always consult your physician before using these supplements, as they may lower your blood pressure too much, or interfere in some other way with your current medication. Be aware that a number of supplements can increase blood pressure. Sign in to see the full answer >>
See the Encyclopedia article about Hypertension for more information.
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Question:
Can curcumin help prevent or improve symptoms of Alzheimer's disease?
Answer:
Laboratory and animals studies have shown that curcumin inhibits several biological and chemical processes in brain cells associated with the development of Alzheimer's disease, and may act similarly to some drugs currently used to treat symptoms (Aricept, Razadyne). And, in animal models of the disease, oral supplementation with curcumin has shown some benefit. However, the few studies that have been conducted in people with Alzheimer's disease have found little benefit (although it may improve cognitive function in healthy older adults). For more details, (as well as our tests and comparisons of products) see the Turmeric and Curcumin Supplements and Spices Review >>
See the Encyclopedia articles about Turmeric and Alzheimer's Disease.
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Question:
What is phytosomal curcumin? Does it have better absorption than other curcumin formulations?
Answer:
As discussed in the Curcumin Supplements Review, only a limited percentage of curcumin taken orally will be absorbed into the blood. Phytosomal formulations, such as Meriva, which combine curcumin with phosphatidylcholine (a natural surfactant that dissolves in both water and oil), can help to improve bioavailability compared to regular curcumin. Other formulations, such as BMC-95, CurcuWin, Theracurmin, and black pepper extract (Bioperine) may also improve bioavailability. More details about these and how they compare, are found in the Bioavailability section of the Turmeric and Curcumin Supplements Review >>
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Question:
I use a brand of curcumin and the most recent bottle contained capsules a few shades lighter than what I am accustomed to taking. Is this color change an issue to be concerned about?
Answer:
Variation in the color of turmeric and curcumin can occur, even from bottle-to-bottle for the same product. This is not necessarily a problem, as explained in the "What to Consider When Buying and Using" section of the Turmeric and Curcumin Supplements and Spices Review. Most importantly, the product should provide the expected amount of curcuminoid compounds (not all do!)— which is what ConsumerLab.com has measured and published (see the "What CL Found" and "Test Results by Product" sections of the Review).
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Question:
How should curcumin dose be adjusted if using formulations with enhanced bioavailability such as Meriva, BCM-95, CurcuWin, Theracurmin, Bioperine, and C3?
Answer:
If you're taking curcumin with just water (and not with foods containing fats or oils), these formulations can greatly increase the absorption and/or bioavailability of curcumin and other curcuminoid compounds, which will affect the dose you need to take. Find out more about each of these formulations and their suggested dosage in the "Absorption and Bioavailability" section of the Turmeric/Curcumin Review >>
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Question:
Is it true that taking turmeric/curcumin with food can reduce iron absorption from food?
Answer:
First, it's important to know that you're usually better off taking turmeric and curcumin with food because the fats and oils in foods significantly enhance the absorption of key compounds — curcuminoids. However, these same compounds can bind to iron and may reduce its availability — which should be of concern to people who are anemic or have low iron stores. The concern is greater with curcumin than with turmeric spice as discussed in the "Cautions and Concerns" section of the Turmeric and Curcumin Supplements and Spices Review >>
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Question:
How does regular black pepper compare with black pepper extract used in supplements? Will sprinkling it on food with turmeric help increase the bioavailability of curcumin compounds from turmeric?
Answer:
Black pepper contains piperine, a compound which has been shown to increase the bioavailability of curcumin — a key anti-inflammatory compound in turmeric. Piperine appears to do this inhibiting an enzyme that breaks down curcumin in the body. Piperine may similarly increase the bioavailability of certain supplement ingredients, such as CoQ10, as well as drugs (as discussed in the Concerns and Cautions in the Turmeric Supplements Review).
While regular black pepper (used as a spice in foods) contains a much smaller percentage of piperine than black pepper extracts, which are highly concentrated (such as Bioperine) — it is possible to get enough piperine from regular black pepper to significantly increase the bioavailability of turmeric in food. Sign in to see the full answer >>
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Question:
Is it safe to take Bioperine (which contains piperine from black pepper)?
Answer:
Piperine (from black pepper) can enhance the absorption or bioavailability of certain compounds, such as curcumin from turmeric. Bioperine is a branded extract of black pepper which is 95% piperine and is commonly included in curcumin supplements, but is also sold separately. Be aware that piperine can interact with many medications and may also have anti-platelet effects. In addition, it may cause gastrointestinal side-effects and, potentially, bleeding, at somewhat higher than suggested doses. See the "Concerns and Cautions" for black pepper extract within the Turmeric/Curcumin Supplements Review.
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Question:
Do turmeric and curcumin supplements contain significant amounts of oxalates? Can this increase my risk of kidney stones?
Answer:
Yes, turmeric can contain a significant amount of oxalate, which can form calcium oxalate kidney stones (the most common type of kidney stone). However, some curcumin products (which are derived from turmeric) are believed to contain very little, if any, oxalates. For details, see the "Concerns and Cautions" section of Turmeric/Curcumin Supplements Review >>
See the Encyclopedia article about Kidney Stones for information about other supplements which may be helpful or harmful.
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Question:
I take 1000 mg of a high-absorption curcumin extract. It seems to be working, but would it be safe to take a larger dose?
Answer:
Although as much as 8,000 mg of curcuminoids (mostly curcumin) daily from a formulation that was not enhanced for absorption/bioavailability has been taken safely for as long as 18 months, a dose this high may not be safe with a "high absorption" curcumin. In addition, keep in mind that there are potential side effects and drug interactions with turmeric/curcumin that may increase with higher doses. For more details, sign in and see the full answer >>
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Question:
Is it safe to take curcumin or turmeric supplements for a long period of time?
Answer:
Formal, long-term safety studies have not been conducted with curcumin or turmeric supplements, although smaller efficacy studies have not shown toxicity with fairly high doses. Side-effects, however, can occur. Keep in mind that bioavailability enhancers found in some curcumin supplements can interfere with certain medications and medical conditions. For more details, see the "Concerns and Cautions" section of the Curcumin and Turmeric Supplements and Spices Review >>
ConsumerLab.com Answers
Question:
Which supplements can help lower or control my blood sugar?
Answer:
Many different supplements may help lower or control blood sugar in people with prediabetes or type 2 diabetes who experience hyperglycemia (when blood glucose rises higher than normal). These supplements are discussed below. More details about each, including dosage, drug interactions, potential side effects, and ConsumerLab.com's reviews of products on the market, can be found by clicking on the links.
Due to the seriousness of hyperglycemia, it is important to consult with your physician regarding use of these supplements.
Cinnamon supplements may modestly improve blood sugar in people with type 2 diabetes whose blood sugar is not well controlled with medication. In addition, one small study found that a branded cinnamon extract reduced fasting blood sugar by an average of about 10 mg/dL in prediabetic men and women with metabolic syndrome. Keep in mind, however, that only certain varieties of cinnamon have been shown to have this effect, and long-term safety studies have not been conducted.
Curcumin (from turmeric) may improve blood sugar levels, according to preliminary studies, and one study found curcumin to dramatically lower the chances of prediabetes in middle-aged, slightly overweight men and women with somewhat higher than normal blood sugar levels.
Alpha lipoic acid may improve insulin sensitivity and blood sugar control in people with type 2 diabetes, although it may only slightly reduce levels of glycosylated hemoglobin (HbA1c).
Chromium picolinate may help some people with type 2 diabetes decrease fasting blood glucose levels as well as levels of insulin and glycosylated hemoglobin (HbA1c). However, be aware that high doses may worsen insulin sensitivity in healthy people who are not obese or diabetic.
Having adequate blood levels of vitamin D may reduce the risk of insulin resistance in people who are obese. There is some evidence that a certain blood level of vitamin D is needed for normal glucose metabolism in women who are overweight and obese (but not diabetic), but it is not clear whether any further benefit is gained with higher blood levels.
In healthy people, consuming a moderate amount of olive oil with a meal has been shown to reduce increases in blood sugar after the meal compared to the same meal consumed with corn oil. In people with type 1 or type 2 diabetes, olive oil may improve glucose metabolism.
Increasing dietary fiber, especially insoluble fiber from cereal and grains, is associated with a reduced risk of diabetes and has been shown to reduce fasting blood glucose and modestly lower HbA1c in people with type 2 diabetes (Martin, J Nutr 2008; Post,J Am Board Fam Med 2012). In people with type 1 diabetes, 50 grams of dietary fiber per day has been shown to significantly improve blood sugar control and reduce hypoglycemic events (Giacco, Diabetes Care 2000). The American Dietetic Association states that "diets providing 30 to 50 g fiber per day from whole food sources consistently produce lower serum glucose levels compared to a low-fiber diet. Fiber supplements providing doses of 10 to 29 g/day may have some benefit in terms of glycemic control." (Slavin, J Am Diet Assoc 2008). Although ConsumerLab.com has not tested fiber products, we have produced a webinar about that provides more information.
Ginseng, both American and Korean Red ginseng (from Panax ginseng), may reduce blood sugar levels in people with diabetes, according to preliminary research.
Drinking whey protein before a high glycemic meal may help to lessen increases in blood sugar after the meal in people with well-controlled type 2 diabetes.
Silymarin, a component of milk thistle, may decrease blood sugar and hemoglobin A1c in people with type 2 diabetes, and reduce insulin resistance in people with coexisting diabetes and alcoholic cirrhosis.
Inulin, a type of prebiotic, may improve measures of blood sugar control in women with type 2 diabetes, although it did not improve blood sugar levels or insulin resistance in a study of prediabetic men and women.
Berberine (a compound found in plants such as barberry, Oregon grape and goldenseal) may reduce blood sugar levels in people with metabolic syndrome or type 2 diabetes, according to a few small studies.
Fenugreek may help to lower blood sugar, according to preliminary studies, and one study found fenugreek extract to significantly improve some measures of blood sugar control and insulin response in people with type 2 diabetes.
D-ribose, often promoted for energy or sports performance, may also lower blood sugar levels (Fenstad, Internet J Nutr Wellness 2007).
Gymnema sylvestre may decrease average blood sugar levels in people with type 1 or type 2 diabetes, according to two small, preliminary studies using 400 mg of a standardized extract (GS4 from Sabinsa, standardized to 25% gymnemic acid) for six months or more (Baskaran, J Ethnopharmacol 1990; Shanmugasundaram, J Ethnopharmacol 1990).
White mulberry (Moruns alba or Morus indica) has been traditionally used in Asia to help treat type 2 diabetes, and there is some preliminary evidence to support this use. Mulberry leaf extract (species not given) may lessen increases in blood sugar after ingestion of table sugar in healthy people and people with type 2 diabetes (Mudra, Diabetes Care 2007). Among people with type 2 diabetes, taking 1 gram of powdered white mulberry leaf three times daily (after breakfast, lunch and dinner) for four weeks was found to lower fasting blood sugar by 27%, while taking 5 mg of the anti-diabetes drug glibenclamide lowered fasting blood sugar by only 8% (Andallu, Clin Chim Acta 2001).
There is mixed evidence as to whether CoQ10 may lower blood sugar. To be safe, people with diabetes or who take medication to lower blood sugar should consult a physician before using.
Preliminary evidence suggests certain other supplements, including aloe, ashwagandha, ginkgo, green coffee bean extract, glucosamine, black cohosh, rhodiola, reishi mushroom and tart cherry juice may lower blood sugar. While there is not enough clinical research to support the use of these supplements for this purpose, it's important to keep this in mind, as they could enhance the blood sugar lowering effect of other supplements or medications you may be taking.
There are a few supplements which may worsen blood sugar control or insulin sensitivity in certain people: excessive amounts of niacin may elevate blood sugar levels, and prescription digestive enzymes may cause an increase or decrease in blood sugar levels in people with exocrine pancreatic insufficiency. CLA (conjugated linoleic acid), a popular supplement for slimming, may worsen blood sugar control in diabetics and in obese people without diabetes.
Although fish oil does not appear to adversely affect blood sugar levels in people with diabetes, one study reported that a large daily dose of krill oil (providing a modest amount of EPA and DHA) reduced insulin sensitivity in overweight, middle-aged men by about 27% -- which could potentially increase the risk of diabetes.
Also note that high doses of vitamin C may increase blood sugar or interfere with certain blood sugar tests.
ConsumerLab.com Answers
Question:
I've heard it's best to take fat-soluble supplements, like CoQ10, curcumin, and vitamin D, with fats or oils to increase absorption. Would taking them with a fish oil capsule be enough?
Answer:
The amount of fat in a fish oil supplement is only about 1 gram. While that might help a little, studies which have shown increased absorption of fat-soluble vitamins have involved taking them with foods or meals containing fats. Most meals provide at least 5 grams of fat (the amount of fat in a single egg, for instance), while a tuna wrap with mayo can have 40 grams.
In the case of vitamin D, taking it with a meal has increased absorption by 32% to 57% compared to taking it with just water. The bigger (and fattier) the meal, the better — at least for absorption!
Of course, you can also purchase special formulations of some fat-soluble vitamins and other supplements which enhance their absorption — in some cases, even more than taking them with fats. These are described in our reviews of CoQ10, curcumin and vitamin D. Other supplement ingredients which are fat soluble and are best absorbed with fats are vitamin A, vitamin E, and vitamin K, as well as astaxanthin and boswellia (and its key component AKBA).
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Question:
Which supplements help to improve energy and decrease fatigue?
Answer:
Getting adequate sleep, eating a healthy, well-balanced diet, and regular exercise are the best ways to maintain your energy. However, we all have times when we could benefit from an energy boost. (If you are frequently tired, be sure to consult your physician about potential causes, as discussed below).
Certain supplements may help increase energy and decrease fatigue.
CoQ10, which plays a role in energy production in cells, has been shown to decrease fatigue in people with conditions such as heart failure and Gulf War Illness. One small study suggested it may increase self-assessed "vitality" in older adults. (Be aware that taking CoQ10 in the evening can cause insomnia in some people).
Curcumin (from turmeric) has been shown to reduce fatigue in older men and women using a particular branded formula.
Ashwagandha may reduce fatigue in middle-aged adults with moderate to severe anxiety.
Cocoa flavanols may help reduce self-reported mental fatigue in healthy adults, according to one study.
Ginseng is a popular ingredient in supplements promoted for increasing energy and vitality. Although there is little evidence to support this effect in healthy people, there is some evidence it may increase energy in people with cancer-related fatigue.
Carnitine may help reduce fatigue in older men with symptoms of sexual dysfunction, depression and fatigue.
B vitamins are involved in the metabolism of food to release energy, and deficiency in vitamin B-12 is known to cause fatigue. However, if you already get an adequate amount of the B vitamins in your diet and are not deficient in them, supplementing with additional amounts of B vitamins is not known to improve performance. Be aware that energy drinks often contain much higher doses of B vitamins than needed — sometimes amounts above tolerable limits. Energy drinks also commonly contain significant amounts of caffeine or ingredients which naturally contain caffeine such as guarana and cola nut. Although caffeine does not actually provide energy, it acts as a stimulant and can reduce fatigue. Be aware that energy drinks can increase blood pressure, and stroke and liver injury have been reported in people consuming certain energy drinks.
Energy bars, or nutrition bars, can be a good source of real energy (calories), especially if you are on the go and haven't had a chance to eat a real meal, and also provide vitamins and minerals. It's important to choose carefully as some are high in sugar, or contain sugar substitutes that may upset your stomach. Some also contain caffeine.
Supplements that provide iodine, such as kelp supplements and potassium iodide, are often promoted to increase energy. However, there is little evidence for this effect unless they are being used to treat hypothyroidism due to iodine deficiency.
Rhodiola rosea and maca supplements are sometimes promoted to increase energy or reduce fatigue, however, there is not enough evidence to support these supplements for this use.
Iron deficiency can cause fatigue. Consequently, correcting iron deficiency with iron supplementation can reduce related fatigue. Interestingly, iron supplementation has even been shown to reduce fatigue in women who are not anemic but have ferritin levels in the lower end of normal range.
If your fatigue is caused by difficulty sleeping, melatonin or other supplements for sleep may be helpful. (Note that taking high-dose vitamin D may reduce your body's natural production of melatonin).
Be aware that St. John's wort can cause fatigue when you take it, or if you abruptly stop taking it.
Because there are many possible causes of fatigue, it's important to consult with your doctor if you feel tired frequently.
See the Encyclopedia article about Fatigue for more information.
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Question:
Which supplements help for osteoarthritis of the hip?
Answer:
Several supplements may modestly reduce pain or improve other symptoms of hip osteoarthritis, which is inflammation caused by damage or "wearing away" of cartilage in the hip. Use the links below for more information.
SAMe supplements have been shown to reduce joint pain, stiffness, and inflammation associated with osteoarthritis of the hip, and may be as effective as many of the leading anti-inflammatory drugs.
Ginger may modestly reduce pain and disability in people with hip osteoarthritis.
A branded enzyme supplement containing bromelain, trypsin and other ingredients, Wobenzyme, was found in one clinical study to reduced pain and stiffness, and improved function in men and women with hip osteoarthritis just as well as a prescription non-steroidal anti-inflammatory drug.
One small study found that, compared to fish oil, a formula containing green-lipped mussel oil (a omega-3 fatty acids EPA + DHA), olive oil and vitamin E (Omega XL) reduced pain and improved physical function in men and women with osteoarthritis of the hip. However, there are no studies comparing this formula with a placebo for hip osteoarthritis. (Although there is evidence that fish oil supplements may help to reduce pain due to rheumatoid arthritis, there is not enough evidence to suggest its helpful for osteoarthritis of the hip. )
There is some evidence that collagen hydrolysate may reduce pain associated with hip osteoarthritis.
Tart cherry juice has been found to reduce markers of inflammation, but not pain, in people with osteoarthritis, although the type (knee or hip) was not specified.
Glucosamine and chondroitin are popular supplements for joint health and some early clinical research suggested a benefit, however, more recent and larger clinical studies have tended to show little or no benefit for osteoarthritis of the hip.
There is mixed/preliminary evidence that other supplements, such as white willow, rosehip, cat's claw, devil's claw and avocado/soybean unsaponifiables may be beneficial for hip osteoarthritis. These are discussed in the Encyclopedia article about Osteoarthritis.
Supplements such as curcumin, boswellia, MSM and ashwagandha, which have shown some promise for helping with knee osteoarthritis do not appear to have been studied in well-controlled clinical trials for hip osteoarthritis.
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Question:
Which supplements can cause diarrhea?
Answer:
There are a number of supplements which can cause diarrhea. Discussed below are some of the most common culprits. Diarrhea can also be caused by certain medications, illness and infection, and certain health conditions, such as irritable bowel syndrome (IBS) and lactose intolerance -- so be sure to consult with your physician if you experience severe or chronic diarrhea.
Supplements with a laxative effect:
Magnesium supplements can cause diarrhea and, in fact, are often taken for their laxative effect. However, if you are taking magnesium for other reasons, and want to avoid this effect, certain forms of magnesium are less likely to cause diarrhea. Taking your magnesium supplement with food can also reduce the occurrence of diarrhea.
Aloe supplements containing latex are also known for their laxative effect. If you are taking aloe for a different purpose, be sure to choose a product labeled as aloe gel or vera leaf juice which has been processed to remove the latex.
Be aware that many weight loss supplements contain herbs with laxative properties, such as cascara, frangula, rhubarb root and senna, so be sure to carefully read the label if you are taking a supplement for weight management or "cleansing", such as certain acai supplements and drinks.
Certain types of fiber can also have a laxative effect, but do not necessarily cause diarrhea — some forms of fiber, in fact, may be helpful for diarrhea associated with IBS.
Other common supplements that can cause diarrhea:
Fish oil and other supplements containing omega-3 fatty acids, or a combination of omega-3 and omega-6 fatty acids, such as flaxseed oil and borage oil, can cause diarrhea. Taking smaller doses throughout the day, rather than a single, large dose, may help reduce this effect.
Taking large doses of vitamin C can cause diarrhea. Other supplements which can cause diarrhea when taken in high doses include ashwagandha, NAC (N-acetyl-cysteine), lysine, iodine and kelp supplements which contain iodine, D-limonene, and yacon syrup.
Other supplements which can cause diarrhea include curcumin/turmeric, St. John's wort, berberine, creatine, 5-HTP, nattokinase, chlorella, modified citrus pectin (MCP), and beta-sitosterol, a common ingredient in cholesterol-lowering supplements and prostate supplements.
Unexpected sources:
An often-over-looked cause of diarrhea from supplements can be from added sugar substitutes such as sorbitol. Sorbitol can be found in protein and nutrition bars (ConsumerLab.com lists amounts of sugar alcohols (such as sorbitol and mannitol) in popular bars in its Review) and some protein powders and drinks and meal replacement and weight management meals and shakes. These chemicals can also be found in certain zinc lozenges and some B12 supplements, especially dissolvable tablets, liquids and sprays, although occasionally in regular tablets as well.
ConsumerLab.com Answers
Question:
What are the effects of curcumin on the liver?
Answer:
Some short-term studies suggest that moderate doses of curcumin may be helpful for people with certain liver conditions such as non-alcoholic fatty liver disease (NAFLD). However, it's not known how the liver may be affected by long-term curcumin/turmeric supplementation, especially at higher doses. For details, see information about NAFLD in the Turmeric/Curcumin Supplements Review.
Be aware that curcumin can stimulate the gall bladder and worsen pain during stone passage in people with gallbladder disease, as noted in the Concerns and Cautions section of the Turmeric/Curcumin Supplements Review.
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Question:
What are the side effects of curcumin and turmeric?
Answer:
Turmeric/curcumin supplements are generally safe, but gastrointestinal side effects may occur with higher doses and they can cause problems for people with gallbladder disease, kidney stones, or those taking blood-thinning, blood-sugar-lowering, or immunosuppressant medications. Curcumin may also inhibit iron absorption. Be aware that black pepper extract (piperine) often added to curcumin to increase bioavailability also interacts with a number of medications. For more details about dose, side effects, and drug interactions, see the Concerns and Cautions section of Curcumin and Turmeric Supplements Review (The Review includes our tests and comparisons as well as Top Picks among curcumin and turmeric products).
ConsumerLab.com Answers
Question:
I heard that Theracurmin, a form of curcumin, was shown to help with memory, but it's expensive. Does Theracurmin really improve memory and is it worth it?
Answer:
Curcumin has shown some short-term beneficial effects on cognition (thinking and memory). Longer-term studies have generally shown mixed results, although an 18-month study done with Theracurmin (an enhanced bioavailability formula) showed modest improvements in short-term memory, verbal memory, and attention compared to placebo. Be aware that those taking Theracurmin were nearly twice as likely to report gastrointestinal side effects as those taking placebo. Brain scans suggested other possible benefits of Theracurmin, although the value of those findings is unclear. More details about this are found in the Memory, Cognition, and Alzheimer's Disease section of our Turmeric and Curcumin Supplements and Spices Review.
Due to poor bioavailability of curcumin (particularly if not taken with a meal containing fats), many formulas have been developed to enhance curcumin absorption and overall bioavailability. A study of Theracurmin found it to raise blood levels of curcumin much better than regular curcumin powder. However, participants in the study took the products with water, which would greatly limit absorption of regular curcumin powder. If the products had been taken with a fat-containing meal, it's possible that the difference would not have been dramatic. More about this is found in the Absorption and Bioavailability section of the Turmeric and Cumin Supplements and Spices Review, which also discusses and compares curcumin formulas such as BCM-95, Meriva, and CurcuWin, as well as Bioperine — an ingredient often added to curcumin formulas to increase bioavailability. Also see our Top Picks among curcumin supplements in the Review.
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Product Reviews Turmeric and Curcumin Supplements and Spices Review |
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Posted: 4/1/17 Last Update: 8/8/18
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Choosing the Best Turmeric/Curcumin SupplementCL Identifies Best Turmeric/Curcumin Supplements and Spices
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Turmeric and its key compound, curcumin, may be helpful in treating inflammation and conditions such as depression, diabetes, and indigestion. However, supplements on the market vary widely in the amounts of key curcumin compounds they contain, and some formulations may be better absorbed than others.
Which are the best turmeric and curcumin supplements, and which don't measure up? To find out, ConsumerLab.com purchased and tested many popular turmeric/curcumin supplements. The tests showed that two products contained only about 50% of the curcumin compounds which CL expected based on their labels.
Supplements which passed testing were then compared on cost (ranging from 20 cents to over $8.00 for equal amounts of curcumin compounds), and ConsumerLab.com then arrived at its Top Picks Among Supplements.
Bottles of ground turmeric spice were also tested for possible contamination with heavy metals (lead, cadmium and arsenic) and filth. Three turmeric spices failed for filth — each having numbers of insect parts ConsumerLab considers unacceptable. Those that passed were then compared on cost and ConsumerLab.com chose its Top Pick Among Spices.
You must be a member to get the full test results along with ConsumerLab.com's recommendations and quality ratings for turmeric and curcumin products. You will get results for 11 turmeric/curcumin supplements selected for testing by ConsumerLab.com as well as for eight others which passed the same testing in CL's voluntary Quality Certification Program. You will also get results for five popular turmeric spices used for cooking.
In this comprehensive report about turmeric and curcumin supplements and spices you'll learn:
- Which turmeric and curcumin products failed testing, which passed, and which are CL's Top Picks
- How turmeric and curcumin products compare on ingredients, quality, and price
- How the bioavailability of curcumin may be enhanced with ingredients such as black pepper extract (Bioperine), CurcuWin, Meriva and BMC-95... and how to increase absorption of curcumin even without an enhanced formula!
- Dosing for specific uses of turmeric and curcumin, including rheumatoid arthritis, osteoarthritis, depression, ulcerative colitis and proctitis, uveitis, psoriasis, blood sugar control, and cancer
- Safety and side effects of turmeric and curcumin supplements
- Cautions and potential drug interactions with turmeric, curcumin and black pepper extract
Learn More About Turmeric and Curcumin SupplementsQuestion:
Are supplements which claim increased absorption or improved bioavailability telling the truth? Is it worth paying more for these? Are there concerns? Get the answer >>
Question:
I've heard that curcumin is a MAO inhibitor. Is this true, and does that mean it is not safe to take if you eat amine-rich foods like cheese and dark chocolate? Get the answer >>
Question:
I read that turmeric may be a GI irritant. I have GI problems and wonder if I should avoid turmeric and curcumin? Get the answer >>
Question:
After taking a curcumin supplement, I started getting chronic diarrhea which went away when I stopped taking it. Can curcumin supplements cause diarrhea? Get the answer >>
Question:
I recently read that turmeric is only effective if it is combined with black pepper. Is this true? Get the answer >>
Question:
Is Theracurmin better absorbed than other curcumin formulas - and can it really help lower my blood pressure? Get the answer >>
Question:
Is Rhodiola rosea effective for depression and does it have other uses? Will ConsumerLab.com be testing these supplements? Get the answer >>
Question:
I take ubiquinol to replenish CoQ10 depleted by my statin. I also take curcumin (from turmeric). Since they both manage free radicals, do I need to take the curcumin? Get the answer >>
Question:
Do any supplements help with nerve pain, like sciatica or diabetic neuropathy? Get the answer >>
Question:
How does turmeric spice compare to turmeric (curcumin) in supplements? I sprinkle it on my foods and wonder if that's equivalent to taking a supplement. Get the answer >>
Question:
Which supplements can help to lower blood pressure? Get the answer >>
Question:
Can curcumin help prevent or improve symptoms of Alzheimer's disease? Get the answer >>
Question:
What is phytosomal curcumin? Does it have better absorption than other curcumin formulations? Get the answer >>
Question:
I use a brand of curcumin and the most recent bottle contained capsules a few shades lighter than what I am accustomed to taking. Is this color change an issue to be concerned about? Get the answer >>
Question:
How should curcumin dose be adjusted if using formulations with enhanced bioavailability such as Meriva, BCM-95, CurcuWin, Theracurmin, Bioperine, and C3? Get the answer >>
Question:
Are there drug interactions with curcumin or turmeric? Get the answer >>
Question:
Is it true that taking turmeric/curcumin with food can reduce iron absorption from food? Get the answer >>
Question:
How does regular black pepper compare with black pepper extract used in supplements? Will sprinkling it on food with turmeric help increase the bioavailability of curcumin compounds from turmeric? Get the answer >>
Question:
Is it safe to take Bioperine (which contains piperine from black pepper)? Get the answer >>
Question:
Which supplements can help with indigestion and/or heartburn? Get the answer >>
Question:
Do turmeric and curcumin supplements contain significant amounts of oxalates? Can this increase my risk of kidney stones? Get the answer >>
Question:
I take 1000 mg of a high-absorption curcumin extract. It seems to be working, but would it be safe to take a larger dose? Get the answer >>
Question:
Is it safe to take curcumin or turmeric supplements for a long period of time? Get the answer >>
Question:
Which supplements can help lower or control my blood sugar? Get the answer >>
Question:
I've heard it's best to take fat-soluble supplements, like CoQ10, curcumin, and vitamin D, with fats or oils to increase absorption. Would taking them with a fish oil capsule be enough? Get the answer >>
Question:
Which supplements help to improve energy and decrease fatigue? Get the answer >>
Question:
Which supplements help for osteoarthritis of the hip? Get the answer >>
Question:
Which supplements can cause diarrhea? Get the answer >>
Question:
What are the effects of curcumin on the liver? Get the answer >>
Question:
What are the side effects of curcumin and turmeric? Get the answer >>
Question:
I read that aging lowers the body's capacity to produce vitamin D. Even regular sun exposure will not suffice and one may have to take a vitamin D3 supplement during old age to meet our body's regular requirements. Please comment on this. Get the answer >>
Question:
I heard that Theracurmin, a form of curcumin, was shown to help with memory, but it's expensive. Does Theracurmin really improve memory and is it worth it? Get the answer >>
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Update:
(4/14/17): ConsumerLab.com was contacted by an attorney representing one of the companies with a product that was designated "Not Approved" in this Review. The attorney demanded that information about the product be removed from the Review, asserting that CL "misunderstood" the product and that its methods were "flawed." CL disagrees with these assertions. Information about the product remains in the Review. For more information, see the Update posted near the top of the full Review.
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