So I live in the EU where such supplements are supposedly safe. Article said that supplements that mix pepper and turmeric are dangerous. And the dose that was dangerous to the woman was 2000mg.
I looked on my table toward the bottle of turmeric my parents gifted me recently, saying they heard it was good and bought on a famous "health" store.
Bottle is: turmeric + pepper "designed for max absorption" and dose is 10000mg.
einarfd 6 hours ago [-]
That sounds crazy, are you sure you didn't misread the labeling?
When I checked the turmeric supplement I use. Which I buy in a reputable health food, and supplement chain in Norway.
It is 40mg of turmeric, which according to the article is well under the acceptable daily dose.
As far as I understand Norway follows the EU directives on this, but has some additional strictures as well. I wouldn't expect the difference to be this stark though.
Btw. the reason I use turmeric supplements is that I have a tendency to get persistent inflammation, and for me, the supplements seems to help with that. But if I didn't have this problem, I would not take it, and also, it isn't given that it works for you, even if it does for me.
orwin 2 hours ago [-]
Two points:
one, it's extremely likely that the article is incomplete and lack critical info like a presence of lead, or genetic predisposition.
Two: 10g is crazy. That's how you get kidney stones. Put so curcuma and black pepper in your meals. In EU, supplements (and recently, tea) are tested for heavy metal and plastic, and to see if the ingredient list is correct, but their effectiveness is not.
A_D_E_P_T 6 hours ago [-]
> Article said that supplements that mix pepper and turmeric are dangerous.
The article made it up. It's pure speculation. Hundreds of thousands of people take pepper+curcumin supplements and are totally fine.
What's likely the culprit here is an idiosyncratic immune response, or a heavy metal contaminated supplement. Of course, that's also speculative. Could be something she ate; could be that she didn't disclose a drinking problem.
The article reads like it has an axe to grind, tbh. "Oh no an unregulated racket!"
chilmers 6 hours ago [-]
From the linked NIH page on drug-induced liver toxicity:
“Importantly, means of increasing the bioavailability of curcumin were developed using piperine (black pepper) or lipid nanoparticle delivery methods to increase absorption. These high bioavailability forms of purified curcumin were subsequently linked to several cases of liver injury and mentioned as a possible cause of outbreaks of acute hepatitis with jaundice in Italy.”
My impression as an author with books on Amazon is that you get one review or rating for every 20-30 purchases, and there are two products with "200k people have purchased multiple times."
And that's to say nothing of people who have bought such products via other sources, like Wal-Mart, etc.
All that, and you have "several" cases? That's not a lot. You need much stronger evidence to support any assertion that the nature of the product is harmful. (As opposed to contamination or chance effects.) If anything, I'd say that purchase and utilization statistics support the notion that the product is not harmful.
simsla 3 hours ago [-]
Damage is usually done in aggregate. Leaded gasoline didn't have people dropping like flies, but still caused significant damage.
Although it seems this needs more research, I'd be wary dismissing it out of hand just because people haven't been having an acute reaction.
burnt-resistor 6 hours ago [-]
Secondarily, both contains oxalate in proportions of 1% of black pepper and 2% of turmeric by mass, which leads to the formation of kidney stones.
It's worse in the US because the FDA effectively "washes its hands" of anything deemed a "supplement". In general, the precautionary principle is difficult to find in America outside of FDA-approved procedures, medical devices, and medications. Food and supplements are desperately under-regulated.
perihelions 6 hours ago [-]
> "It's worse in the US because the FDA effectively "washes its hands" of anything deemed a "supplement""
The "natural" supplement industry lobbied for, and obtained, a law that makes them unregulatable.
> "The act was intended to exempt the dietary and herbal supplement industry from most FDA drug regulations, allowing them to be sold and marketed without scientific backing for their health and medical claims.[3]"
bell-cot 6 hours ago [-]
IIR, the FDA is legally forbidden from touching "supplements" - thanks to Congress, and the small army of supplement-industry lobbyists who tell Congress exactly what the law should say.
IAmBroom 49 minutes ago [-]
10000 mg is 1/3 ounce, or nearly a half teaspoon of flour. That's huge.
Thorrez 6 hours ago [-]
Are you talking about pills? Pills generally can only contain about 1000mg or a little more. Is the bottle suggesting you take 10 pills for a single dose?
speeder 3 hours ago [-]
The pills in the bottle look exactly the ones in the article, they are quite big.
6 hours ago [-]
kjuulh 6 hours ago [-]
I was working at a small farm-shop at some point, we sold smoothies of turmeric and ginger, we had to label it clearly, and restrict sale for pregnant woman, young kids and the elderly because large doses can be dangerous. As far as I recall both are a natural blood thinner.
Edit: in europe
kristofferc 6 hours ago [-]
That's 10 grams?? Does that even fit in a pill?
arcanemachiner 6 hours ago [-]
For turmeric, it's probably an extraction which is equivalent to 10g of raw herb.
lukan 6 hours ago [-]
"heard it was good and bought on a famous "health" store"
I heard it is good, not trusting generic "healthy wonder medicines" in general.
coldtea 5 hours ago [-]
I seriously doubt each pill/dose is 10 grams.
elric 6 hours ago [-]
Why would supplements supposedly be safe in the EU? They are not regulated as far as I know? They can be sold anywhere. They often contain all kinds of inflated claims..
loleufanboys 6 hours ago [-]
Not sure why this is downvoted, it's exactly correct. Supplements are entirely unregulated, and actually often not even sold as food/medicine "officially", but labeled as "collectible item". Light drugs are often sold this way too (kratom, HHC weed, etc).
coldtea 5 hours ago [-]
Health claims are regulated. Not as seriously as medicinal drugs, but at least as good as food (which is also way more regulated in the EU than the US), under https://eur-lex.europa.eu/eli/reg/2006/1924/oj/eng
squidbeak 5 hours ago [-]
No, this is flatly incorrect. The EU heavily regulates food supplements under Directive 2002/46/EC.
elric 5 hours ago [-]
So I took the trouble of reading the directive in question. It has a list of substances (like magnesium) which are covered by the directive. Turmeric is not on the list. Making it, unsurprisingly, unregulated.
coldtea 5 hours ago [-]
Thats "Vitamin and mineral substances which may be used in the manufacture of food supplements" which is a different instruction, for a different directive.
Mohan vowed: "I’ll never put another supplement in my body again."
Maybe just don't do such large doses?
6 hours ago [-]
NitpickLawyer 6 hours ago [-]
> Maybe just don't do such large doses?
Yeah. Isn't there a thing called water poisoning? Where your body sheds lots of things that it needs if you drink too much water? I'd wager a guess that if you drink >20 liters of water daily you'll be in some trouble...
literalAardvark 6 hours ago [-]
Iirc kidney rate is 0.8-1L per hour, so at 20L/day the person would be fairly likely to hit hyponatremia rather quickly.
Weasel words included because they're necessary... Health is complicated
rendall 6 hours ago [-]
I came here to say this. Of course she is understandably emotional after coming so close to a terrible death.
unnamed76ri 6 hours ago [-]
People will pay all kinds of money for supplements which have been denatured from their source (and therefore not as likely to be effective) instead of just eating fruits and vegetables.
redwood 5 hours ago [-]
Odd that the article doesn't mentioned that Turmeric is notorious for having lead added
Bender 3 hours ago [-]
I believe you are referring to Ayurvedic Medications mostly in India but the practice has spread to other regions. People that use Ayurvedic supplements have been doing so for thousands of years out of beliefs that heavy metals heal the body. Never use supplements someone made and distributed in zip-lock bags.
I personally will stick with supplements made by the same laboratories that make prescription drugs and get tested for heavy metals which are most of the popular supplements found on Amazon. The tests are labelled on the bottles.
elric 6 hours ago [-]
Turmeric is notorious for having lead added to it to brighten its colour.
energy123 6 hours ago [-]
That's a manageable risk if you buy from the small handful of reputable companies that do heavy metal testing like Life Extension or Natural Factors, who publish their COAs and have brand equity to protect.
The less manageable risk is the liver issue. The HLA-B*35:01 gene significantly increases the probability of it happening, and this gene can be screened for in theory. Periodic liver testing might be another way to manage the risk, to catch it before it's symptomatic.
HellsMaddy 6 hours ago [-]
Unless you buy on Amazon, in which case products from reputable brands are co-mingled with third-party FBA sellers' inventory, which may include counterfeits.
esperent 6 hours ago [-]
> According to the World Health Organization, an acceptable daily dose is up to 3 mg per kilogram of weight per day—for a 150-pound (68 kg) adult, that would be about 204 mg per day. Mohan was taking more than 10 times that amount
I think it's extremely likely that the majority of people in India and surrounding countries - so, hundreds of millions of people - far exceeds the WHO recommendation every day, and frequently eat as much as this woman did, in foods that also contain black pepper. I googled to make sure, and the top five or so links all said that Indians eat an average of 2-2.5g of turmeric per day.
So perhaps the issue was something else? For example:
- contamination
- taking it on an empty stomach rather than with food
- genetics
- liver damage from something else entirely
perihelions 6 hours ago [-]
You're conflating turmeric with the bioactive chemical component in turmeric, curcumin: the toxicology figures refer to the latter.
(To be fair, the Ars Technica article fails the reader by failing to use precise language, inviting dangerous misunderstandings).
esperent 5 hours ago [-]
I carefully read the article before commenting to check in case it was actually curcumin.
They clearly call it turmeric supplements, not curcumin, throughout the article. The main source given is this NBC article, which also clearly calls it turmeric supplements, not curcumin:
That's concordant with the "up to 3 mg per kilogram of weight" in Ars, which is phrased ambiguously, as if to refer to turmeric. The Ars editors are in the wrong.
esperent 1 hours ago [-]
Ok, so the WHO recommendation is for curcumin. That makes sense.However, the supplement this woman was taking is quite unambiguously referred to as turmeric in both articles.
At this point I'd say we should just write it off as terrible reporting and make a mental note that the quality of Ars Technica is taking a significant drop, if they're allowing these kind of errors in their articles.
mikae1 6 hours ago [-]
> contamination
Well, turmeric certainly has a history of “contamination”[1].
The 3mg per kg per day is of curcumin not turmeric itself. Looking up the content of curcumin in turmeric powder it seems to average around ~1-2% so 2-2.5g of turmeric per day would be 25-50mg of curcumin.
ReptileMan 6 hours ago [-]
Except the article didn't mention she was taking curcumin but turmeric. Sloppy journalism could also be a culprit.
perihelions 6 hours ago [-]
If a synthetic food additive were that hazardous at that small a multiple of the amounts used in food, it'd have been banned. This (curcumin) is an exemplar of that pervasive magical thinking in modern society, the naturalistic fallacy: the prior that there's some inherent qualitative difference between the class of things occurring naturally and the technological/synthetic.
It's perfectly legal to dye food yellow with turmeric.
Many synthetic dyes are illegal for food, dyes which (unlike turmeric) have never been shown to have caused actual harm. But which (like turmeric) are known to be toxic at some dose not used in any food product, some 10x or 100x or whatever high multiple.
Curcumin is known to be pharmacologically active; has lots of (poorly understood) biochemical effects, hits lots of targets. It's never been demonstrated to be medically useful. The unjustified assumption—the magical thinking—is that, being a natural plant substance, maybe some of these random effects, randomly twiddling with the biochemistry of a human body without understanding what you're doing, might be beneficial—so people deliberately ingest it. That's accepted. It's the opposite with synthetic chemicals: if one's biochemically active in some poorly-understood way, you assume that mystery activity is toxic—not beneficial.
(Tangentially, you should probably avoid turmeric regardless of any of this, because the modern supply chain is contaminated with heavy metals, which cause poisonings[0]).
It's exceptionally sensible in the context where hundreds of millions of children worldwide are clinically lead-poisoned, and contaminated turmeric is one of the leading causes of that.
In the Next on chubbyemu department of lack of moderation...
jmcgough 6 hours ago [-]
Presenting to the emergency department
burnt-resistor 6 hours ago [-]
And that intro music and video clips of someone holding their stomach.
Btw, he has a second channel on YT: @HemeReview
hkt 7 hours ago [-]
The dose makes the poison
collyw 6 hours ago [-]
[flagged]
elric 6 hours ago [-]
Yes. And much more so.
There are entire organizations dedicated to tracking side effects of medications. The leaflet with every medication contains a list of known adverse effects and their frequency (at least in the EU).
energy123 6 hours ago [-]
There are many more cases than just this one woman though. I can find dozens of case reports.
VMG 6 hours ago [-]
no, they get a lot more
markdown 6 hours ago [-]
> she began taking turmeric capsules at a dose of 2,250 mg per day.
That's a teaspoon. The average South-east asian eats close to that much in a day for their entire lives.
morsch 6 hours ago [-]
I think that's 2.2g curcumin. Powdered turmeric, the spice, contains approximately 3% curcumin by weight. So one teaspoon
turmeric sounds like it's pretty close to the RDA.
esperent 6 hours ago [-]
The article very clearly states that she was taking turmeric supplement, not curcumin.
magicalhippo 6 hours ago [-]
I just searched for tumeric black pepper extract and this[1] was the first product hits I got. It's called "Turmeric Curcumin with Black Pepper, 2250mg", and the bottle predominantly says "Turmeric" in a large font with the rest in a very small font.
The description states:
Each serving of Qunol Turmeric capsules' formulation contains 2250mg of curcumin with 95% curcuminoids. Other turmeric formulations may only contain 5% curcuminoids.
There's probably hundreds of brands of turmeric and black pepper though, it's a common supplement combination.
magicalhippo 3 hours ago [-]
The point was that there are capsules out there marketed as turmeic supplement which are almost pure curcumin, so it's not unlikely the article referred to them as turmeic capsules while they were technically curcumin capsules.
esperent 1 hours ago [-]
In that case, I'm very disappointed in the journalist who wrote this piece, and it's significantly lowered my opinion of Ars Technica that they allowed it to be published in this state.
markdown 6 hours ago [-]
I quoted them verbatim.
morsch 5 hours ago [-]
Yeah? So? I still think she took 2.2g curcumin, not turmeric.
noselasd 5 hours ago [-]
That's unlikely, the turmeric used in asian cuisine contains about 3-5% curcumin while what's commonly sold as "turmeric" capsules/supplement often contain > 90%. Some may contain less but are mixed in with piperine that significantly boosts its effects/toxicity
I looked on my table toward the bottle of turmeric my parents gifted me recently, saying they heard it was good and bought on a famous "health" store.
Bottle is: turmeric + pepper "designed for max absorption" and dose is 10000mg.
When I checked the turmeric supplement I use. Which I buy in a reputable health food, and supplement chain in Norway. It is 40mg of turmeric, which according to the article is well under the acceptable daily dose. As far as I understand Norway follows the EU directives on this, but has some additional strictures as well. I wouldn't expect the difference to be this stark though.
Btw. the reason I use turmeric supplements is that I have a tendency to get persistent inflammation, and for me, the supplements seems to help with that. But if I didn't have this problem, I would not take it, and also, it isn't given that it works for you, even if it does for me.
one, it's extremely likely that the article is incomplete and lack critical info like a presence of lead, or genetic predisposition.
Two: 10g is crazy. That's how you get kidney stones. Put so curcuma and black pepper in your meals. In EU, supplements (and recently, tea) are tested for heavy metal and plastic, and to see if the ingredient list is correct, but their effectiveness is not.
The article made it up. It's pure speculation. Hundreds of thousands of people take pepper+curcumin supplements and are totally fine.
What's likely the culprit here is an idiosyncratic immune response, or a heavy metal contaminated supplement. Of course, that's also speculative. Could be something she ate; could be that she didn't disclose a drinking problem.
The article reads like it has an axe to grind, tbh. "Oh no an unregulated racket!"
“Importantly, means of increasing the bioavailability of curcumin were developed using piperine (black pepper) or lipid nanoparticle delivery methods to increase absorption. These high bioavailability forms of purified curcumin were subsequently linked to several cases of liver injury and mentioned as a possible cause of outbreaks of acute hepatitis with jaundice in Italy.”
https://www.ncbi.nlm.nih.gov/books/NBK548561/
So no, the article didn’t make it up. In fact, you made up the claim that they made it up. Seems like you are the one with an axe to grind.
See, e.g.: https://i.ibb.co/Qvbdjqf7/amazon-curcumin.png
My impression as an author with books on Amazon is that you get one review or rating for every 20-30 purchases, and there are two products with "200k people have purchased multiple times."
And that's to say nothing of people who have bought such products via other sources, like Wal-Mart, etc.
All that, and you have "several" cases? That's not a lot. You need much stronger evidence to support any assertion that the nature of the product is harmful. (As opposed to contamination or chance effects.) If anything, I'd say that purchase and utilization statistics support the notion that the product is not harmful.
Although it seems this needs more research, I'd be wary dismissing it out of hand just because people haven't been having an acute reaction.
It's worse in the US because the FDA effectively "washes its hands" of anything deemed a "supplement". In general, the precautionary principle is difficult to find in America outside of FDA-approved procedures, medical devices, and medications. Food and supplements are desperately under-regulated.
The "natural" supplement industry lobbied for, and obtained, a law that makes them unregulatable.
https://en.wikipedia.org/wiki/Dietary_Supplement_Health_and_... ("Dietary Supplement Health and Education Act of 1994")
> "The act was intended to exempt the dietary and herbal supplement industry from most FDA drug regulations, allowing them to be sold and marketed without scientific backing for their health and medical claims.[3]"
Edit: in europe
I heard it is good, not trusting generic "healthy wonder medicines" in general.
See Article 6 and on: https://eur-lex.europa.eu/eli/reg/2006/1924/oj/eng
https://peixeverde.pt/wp-content/uploads/2023/01/curcumega-8...
Pretty sure that is a mg, not an μg
Yeah. Isn't there a thing called water poisoning? Where your body sheds lots of things that it needs if you drink too much water? I'd wager a guess that if you drink >20 liters of water daily you'll be in some trouble...
Weasel words included because they're necessary... Health is complicated
I personally will stick with supplements made by the same laboratories that make prescription drugs and get tested for heavy metals which are most of the popular supplements found on Amazon. The tests are labelled on the bottles.
The less manageable risk is the liver issue. The HLA-B*35:01 gene significantly increases the probability of it happening, and this gene can be screened for in theory. Periodic liver testing might be another way to manage the risk, to catch it before it's symptomatic.
I think it's extremely likely that the majority of people in India and surrounding countries - so, hundreds of millions of people - far exceeds the WHO recommendation every day, and frequently eat as much as this woman did, in foods that also contain black pepper. I googled to make sure, and the top five or so links all said that Indians eat an average of 2-2.5g of turmeric per day.
So perhaps the issue was something else? For example:
- contamination
- taking it on an empty stomach rather than with food
- genetics
- liver damage from something else entirely
(To be fair, the Ars Technica article fails the reader by failing to use precise language, inviting dangerous misunderstandings).
They clearly call it turmeric supplements, not curcumin, throughout the article. The main source given is this NBC article, which also clearly calls it turmeric supplements, not curcumin:
https://www.nbcnews.com/health/health-news/liver-damage-turm...
So why do you think it's actually curcumin?
https://apps.who.int/food-additives-contaminants-jecfa-datab... ("...ADI of 0–3 mg/kg of body weight for curcumin...")
That's concordant with the "up to 3 mg per kilogram of weight" in Ars, which is phrased ambiguously, as if to refer to turmeric. The Ars editors are in the wrong.
At this point I'd say we should just write it off as terrible reporting and make a mental note that the quality of Ars Technica is taking a significant drop, if they're allowing these kind of errors in their articles.
Well, turmeric certainly has a history of “contamination”[1].
[1] https://www.npr.org/sections/goats-and-soda/2024/09/23/nx-s1...
It's perfectly legal to dye food yellow with turmeric.
Many synthetic dyes are illegal for food, dyes which (unlike turmeric) have never been shown to have caused actual harm. But which (like turmeric) are known to be toxic at some dose not used in any food product, some 10x or 100x or whatever high multiple.
Curcumin is known to be pharmacologically active; has lots of (poorly understood) biochemical effects, hits lots of targets. It's never been demonstrated to be medically useful. The unjustified assumption—the magical thinking—is that, being a natural plant substance, maybe some of these random effects, randomly twiddling with the biochemistry of a human body without understanding what you're doing, might be beneficial—so people deliberately ingest it. That's accepted. It's the opposite with synthetic chemicals: if one's biochemically active in some poorly-understood way, you assume that mystery activity is toxic—not beneficial.
(Tangentially, you should probably avoid turmeric regardless of any of this, because the modern supply chain is contaminated with heavy metals, which cause poisonings[0]).
[0] https://www.consumerreports.org/health/food-safety/your-herb... ("Your Herbs and Spices Might Contain Arsenic, Cadmium, and Lead")
That doesn't make sense in any context.
Are you a bot?
It's exceptionally sensible in the context where hundreds of millions of children worldwide are clinically lead-poisoned, and contaminated turmeric is one of the leading causes of that.
https://www.npr.org/sections/goats-and-soda/2024/09/23/nx-s1...
> "Are you a bot?"
Kindly read the forum rules.
Btw, he has a second channel on YT: @HemeReview
There are entire organizations dedicated to tracking side effects of medications. The leaflet with every medication contains a list of known adverse effects and their frequency (at least in the EU).
That's a teaspoon. The average South-east asian eats close to that much in a day for their entire lives.
The description states:
Each serving of Qunol Turmeric capsules' formulation contains 2250mg of curcumin with 95% curcuminoids. Other turmeric formulations may only contain 5% curcuminoids.
[1]: https://www.qunol.com/products/turmeric-2250