Researchers have found that the volatile oils in curcumin could be key in treating dyspepsia, which is characterised by recurring symptoms of an upset stomach that have no obvious causes. Sufferers may feel bloating, pain, tightness, nausea, and heartburn. They are often given omeprazole as treatment. However, omeprazole has long term side effects on health, which include gut microbiome imbalance and impairment of calcium absorption, leading to osteoporosis later in life.
On the other hand, curcumin was found to be just as effective in treating dyspepsia with no adverse side effects.
Curcumin, an active ingredient in turmeric, is currently being used to treat dyspepsia in certain Southeast Asian regions. However, there is uncertainty about its efficacy, so Thailand does not recognise it as a medical drug for treating the condition. To study the potential of curcumin in treating dyspepsia, the researchers conducted a randomised controlled trial.
From 2019 to 2021, 151 patients between the ages of 38 to 62 completed the study. They were divided into three groups – Group 1 took curcumin alone, Group 2 took omeprazole alone, and Group 3 took curcumin and omeprazole.
The medications were carefully packaged into two different sizes: large capsules containing 250 mg of curcumin or placebo, and small capsules containing 20 mg of omeprazole or placebo. To ensure consistent dosing, each participant was provided with specific instructions to take two large capsules four times a day, along with one small capsule once a day, for a total duration of 28 days.
Dyspepsia symptoms on days 28 and 56 were assessed using the Severity of Dyspepsia Assessment (SODA) score after the participants completed a questionnaire that assessed pain intensity, non-pain symptoms, and satisfaction.
The researchers found that both curcumin and omeprazole could adequately treat dyspepsia with no side effects.
Volatile oils key to treatment efficacy
“We actually found higher levels of volatile oils than curcuminoids in the curcumin that we used for the trial,” said Associate Professor Krit Pongpirul from the Faculty of Medicine in Chulalongkorn University.
Most curcumin extracts in the market contain 90% curcuminoids, but the product by Prof Krit and his team contains less than 2% curcuminoids. After consulting with experts in traditional medicine, Prof Krit concluded that the volatile oils in curcumin could play a key role in treating dyspepsia.
Western medicine is focussed on extracting curcuminoids from turmeric, but all other ingredients, including the volatile oils, are usually stripped away during this process. The western concept is to get the highest possible concentration of curcuminoids from turmeric so that an optimal amount can be absorbed into the bloodstream with the objective of reducing inflammation.
But Prof Krit and his team adopts what he calls an “Asian approach” and plans to promote this curcumin treatment under the brand name ThaiCureMin.
A potential to alter the gut microbiome
“You can call it a crude extract. It has several ingredients and is a holistic, ancient approach to treating dyspepsia. I would say it’s natural, has a low-dose of curcuminoids, and we do not want it to be absorbed into the bloodstream. We’re not focussed on the anti-inflammatory effects. Rather, we want it to sit in the bowel in its natural form so that it aids digestion,” said Prof Krit, who emphasised that ThaiCureMin is not like the conventional extracts that contain a high percentage of an active ingredient.
There are plans to conduct further trials in the US and within Thailand to further understand the role of volatile oils in curcumin, and to explore the possibility that curcumin could be classified as a prebiotic.
“We’re trying to ensure product quality and to provide stronger evidence for how ThaiCureMin works. We believe that it could work as a prebiotic, which can modify the gut microbiome and get to the root cause of dyspepsia. The volatile oils could have an effect through the microbiome modification mechanisms. So we will check the gut microbiome before and after consumption of this product as well,” said Prof Krit.
ThaiCureMin is a collaboration with the country’s Government Pharmaceutical Organization (GPO), which subsidised the study and provided placebo drugs for use in the research. The research was also funded by the Ministry of Health’s Department of Thai Traditional and Alternative Medicine.
Distribution plans
When asked about the availability of ThaiCureMin, Prof Krit said that it is not commercially available yet. He plans to launch ThaiCureMin as a drug that is recognised by the Royal College of Medicine in Thailand so that can be used as a medicine like proton pump inhibitors and prokinetic drugs, two of the most common treatment options for dyspepsia.
ThaiCureMin is based on a product by the GPO, but these curcumin capsules are not concentrated extracts of curcuminoids and are produced as supplements. The GPO capsules are thus subject to looser regulations and are not obliged to ensure consistency in the amount of ingredients within each batch.
“They’re simply processed to make it a little more concentrated than when you eat fresh turmeric. To ensure consistency and quality for ThaiCureMin, we have to come up with the same drug at a much better quality that’s acceptable by the US and European markets. We are negotiating with the farmers, selecting the best species in Thailand. We are also enhancing traceability by getting a serial number for each turmeric plant. You must be able to trace back to the exact turmeric plant for the ingredients in the pill that you're taking,” said Prof Krit.
As the GPO is not ready to launch their curcumin pills commercially, Prof Krit is negotiating with a private manufacturer to produce ThaiCureMin on a large scale for export.
“We’ve got lots of western patients who fly all the way to Bangkok for this product,” said Prof Krit, who credits the publication of their findings in the BMJ Journal for opening up opportunities in the US.
For this reason and due to regulatory issues, he plans to concentrate on the US and Thai markets first before considering expansion to other regions.
“Some countries require evidence that it works for their specific population. But others, like the US, only look at the quality and reliability of your research findings. Since we have published our work in the BMJ Journal, I believe the US FDA has already given us the green light,” said Prof Krit, who is currently collaborating with George Washington University.
“There are plans to replicate my study in the States, and I plan to observe US expats in Thailand as well so that we can prove the product’s efficacy not just for the Thai population, but also for the US population.”
Source: BMJ Evidence-Based Medicine
DOI: http://dx.doi.org/10.1136/bmjebm-2022-112231
“Curcumin and proton pump inhibitors for functional dyspepsia: a randomised, double blind controlled trial”
Authors: Pradermchai Kongkam, Wichittra Khongkha et al.
