Photo: Maria Orlova

Does turmeric thicken or thin blood?

Yes, turmeric is a blood thinner. Though the researchers had found no published reports of patients bleeding from taking turmeric, it could increase the risk, especially if paired with another anticoagulating drug. They concluded that patients should “avoid concomitant use.”

nytimes.com - He Was on Blood Thinners and Supplements. Could He Still Have ...

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Why Bleeding?

Now that the patient was stable, the issue on Bailey’s mind was why he bled in the first place. Sure, he was on a very effective blood thinner, but he’d been taking that for years without bleeding. He hadn’t fallen and hit his head. And none of the tests suggested he had an infection or a weakness in the blood vessels in the brain that would make bleeding more likely. Later that morning, the patient’s partner brought in all his medications and supplements. But there was one that was not on the list from the E.R.: turmeric. He started taking it earlier that week, he told the doctor. It’s from India — it’s completely natural.

Supplemental Information

Bailey, like most doctors, didn’t know much about supplements. And she didn’t know anything about turmeric, beyond the fact that it was a yellow spice sometimes used in curries. Could it have contributed in some way to his bleeding? It was his only new medication. She posed the question to her team on rounds. Stephen Rappaport, a young pharmacist who saw patients with the I.C.U. team, was immediately interested. He didn’t know much about turmeric either, but he would certainly look into it. As the team discussed other issues involved in this man’s care, Rappaport fired off an email to the University of Illinois at Chicago Drug Information Group, a subscription research service for pharmacists, asking about any effect turmeric might have on blood clotting. Their response came back a few hours later. Yes, turmeric is a blood thinner. Though the researchers had found no published reports of patients bleeding from taking turmeric, it could increase the risk, especially if paired with another anticoagulating drug. They concluded that patients should “avoid concomitant use.” In prescribing a medication like the blood thinner this patient was taking, doctors must weigh the benefit of reducing the blood’s ability to clot against the potential damage of unstoppable bleeding. For this patient, the math seemed straightforward. He’d already had a couple of strokes, and he was at high risk of having a third if nothing was done, so he was given the blood thinner. But this brain bleed made the doctors wonder if the math had now changed. The patient’s risk of having another stroke was quite high, but so was his risk of bleeding again — unless the turmeric had played a role. If that were the case, and it was a big if, then simply not taking the turmeric would be enough to balance the risk-benefit equation.

Spice of Life

Few published studies show how supplements act in the human body in controlled trials. Unlike drug makers, supplement makers are not required to test what their products actually do. Turmeric’s blood-thinning effect is not generally an issue when eaten, as it contains only a tiny amount of its anticoagulant ingredient, curcumin. A half-teaspoon of the turmeric on your spice shelf contains only 50 milligrams of curcumin. But the capsules of turmeric sold as a supplement are almost all curcumin. Each dose contains 1000-2000 mg. of the drug. Many sites on the internet that discuss turmeric mention this fact and suggest not combining it with medications or other supplements that have an anticoagulant effect, but this patient hadn’t seen the warning.

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Do you need black pepper to absorb turmeric?

consumerlab.com - How to Take Turmeric How & Curcumin - ConsumerLab.com

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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