***This 3 part article series is from a deep-dive video I made on chronic pain, inflammation, common pain meds and curcumin. Click here to watch the DEEP DIVE video (49 min) or click here to watch the shorter (6 min) video***
Image Source: www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61854-5/fulltext
It’s generally agreed that the most influential American medical document of the last 100+ years was the Flexner Report of 1910. At the turn of the 20th century there was a major push toward medical school reform in the United States. By 1904 the American Medical Association had created a permanent Council of Medical Education that surveyed and rated the nation's schools. A few years later, Abraham Flexner was commissioned by the Carnegie Foundation, in partnership with the likes of John D Rockefeller and JP Morgan, to visit all 148 medical schools in the U.S., to evaluate the condition of medical training. [1-2]
In 1910 Flexner released his report, which called for widespread reform, including the shutting down of some 100 medical schools (in the 20 years that followed his report, the number of medical schools in the U.S. went from 148 to 76). While much of Flexner’s calls for medical education reform were timely, he was clearly biased toward a laboratory-based approach that favored patentable pharmaceutical medication, expensive diagnostic procedures and surgical interventions. The de facto result of Flexner’s Report included the elevation of the conventional, allopathic, biomedical approach to healthcare, the suppression of the alternative, integrative, holistic and biopsychosocial approach to healthcare, and led to the pharmaceutical and medical device industries co-opting much of the medical school curricula (which continues to this day). [1-2]
Image Source: http://coachmikeblogs.com/the-undereducated-authority-on-nutrition-dont-fall-for-the-lab-coat/
The continuing influence of the Flexner Report and the ideologies it supported is partly why physicians in the U.S. only receive, on average, around 20 hours of formal nutritional education in medical school. Similarly, European medical students only receive about 24 hours of guided instruction on nutrition. And when you understand that nutrition is the primary influencer of gut health, and that gut health and the microbiome are linked to 90% of all disease, the oversight here is staggering. [3-5]
Image Source: www.goodrx.com/blog/prescription-drug-advertising-regulation-united-states/
But perhaps the educational oversight with nutrition and a smart holistic approach isn’t surprising when we consider the clout of the pharmaceutical, medical device and conventional healthcare industries. Of the 195 countries in the world only TWO allow direct-to-consumer advertisements for pharmaceuticals- New Zealand and the United States. 
Image Source: www.statista.com/statistics/257364/top-lobbying-industries-in-the-us/
It’s also important to understand that the pharmaceutical industry is the most powerful political lobbying group in America. From 1998-2019 the pharmaceutical industry spent 4.2 billion dollars lobbying congress; the insurance industry, the second most powerful lobbying group, spent 2.8 billion during that same time period. In 2018 the pharmaceutical lobby spent almost twice as much money ($280 million) as the second most powerful industry. [7-8]
Now to me, lobbying seems a little like legalized bribery. But I’m not a legal or political expert.
And maybe all of this wouldn’t be SUCH a huge problem if most pharmaceutical medication worked by correcting the root cause driving disease. Sadly, most drugs “work” by suppressing or interfering with a natural, normal process in the body -- which may temporarily alleviate a symptom -- but it doesn’t address the root cause driving dysfunction, as is the case with the pain medications I just discussed.
Image Source: www.pbs.org/newshour/health/americans-spend-much-pharmaceuticals
So what do you get when you combine medical school education that’s biased toward medications and surgeries with DTC drug advertising, plus the unbelievably powerful pharmaceutical lobby in Washington DC PLUS drugs that don’t safely and effectively correct the root issues driving pain and disease?
The natural result of all of this is an over-medicated population, an opioid catastrophe, a bunch of mis-educated healthcare professionals, incredibly wealthy pharmaceutical executives and an on-going health crisis due to unresolved health issues.
…so all that’s part of the problem. Let’s talk about some SOLUTIONS to chronic pain and inflammation. Let’s talk about turmeric and curcumin…
Image Source: https://newsnetwork.mayoclinic.org/discussion/home-remedies-are-there-health-benefits-of-turmeric/
Turmeric is actually a flowering plant, genus species name Curcuma longa, and is a member of the ginger family. Turmeric is native to Southeast Asia and the Indian Subcontinent, and it’s been used as a culinary spice and medicinal agent for thousands of years. It’s the roots (or rhizomes) that are primarily used, both in cooking and as a nutritional supplement. The rhizomes are used fresh or more commonly are boiled in water and dried, after which they are ground into a deep orange-yellow powder. Turmeric powder is commonly used as a flavoring agent in many Asian cuisines, especially for curries. By itself turmeric’s taste has been described as warm, bitter, earthy, and black pepper and mustard-like. 
Turmeric contains numerous curcuminoids- polyphenol compounds that tend to have a pronounced therapeutic effect. The most popular curcuminoid is curcumin, but others include demethoxycurcumin and bisdemethoxycurcumin. Regular turmeric powder only contains 1.5-8% curcumin, whereas standardized turmeric extracts often contain 95% curcuminoids, the majority of which (75-85%) is curcumin. Although the therapeutic use of curcumin was recorded as early as the mid-1700s, the first modern scientific journal article referring to its use in human disease was published in 1937 by Oppenheimer. The seminal paper on curcumin and human health was published in the scientific journal Nature in 1949, some 70 years ago. 
Image Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/
A 2012 review of the scientific literature found that curcumin positively impacts patients with various pro-inflammatory diseases, including cardiovascular disease, cancer, arthritis, gastrointestinal diseases (Crohn’s disease, ulcerative colitis, irritable bowel disease, peptic and gastric ulcer, gastric inflammation), psoriasis (and other skin conditions), diabetes, renal conditions, AIDS and liver diseases. Studies have shown curcumin safe at doses as high as 12 grams a day over 3 months. Curcumin is generally poorly absorbed, but certain natural substances can greatly increase absorption. For instance, piperine, a black pepper extract, increased the bioavailability of curcumin by a whopping 2,000%! 
A 2016 meta-analysis of 8 randomized controlled trials found curcuminoids were able to significantly reduce pain and were safe and well tolerated in all evaluated RCTs. The meta-analysis found that curcuminoids have an analgesic effect for postsurgical pain, osteoarthritis, fibromyalgia, gout and rheumatoid arthritis. 
A different 2016 meta-analysis of RCTs provided scientific evidence supporting the efficacy of turmeric extract, equivalent to about 1000 mg/day of curcumin, for the treatment of arthritis. 
Image Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/
A 2017 review of scientific data found turmeric and curcumin benefit oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety and high cholesterol. The review reiterated that, when combined with piperine from black pepper, bioavailability increases by 2000%. Here the data supported the use of 2g/day of curcumin for pain relief, and as a potential alternative to NSAIDS. 
… but how does curcumin work exactly?? Well, as a multimodal substance it works on a few levels…
To start, curcumin works through antibacterial, antifungal and antiviral effects. As various pathogenic bacteria, fungi and viral infections help drive cellular and tissue damage which leads to inflammation and pain, substances that effective kill and/or disable pathogens help address one of the root causes of disease. 
Image Source: www.everydayhealth.com/rheumatoid-arthritis/diet/gut-health-ra-diet-tips/
Curcumin also supports intestinal health, both in the small and large intestines. Curcumin is hepatoprotective and has regenerative and stimulating effects on the liver. Curcumin also helps stimulate bile, which plays a crucial role in detox processes, fatty acid metabolism and gut microbiome health.
Interventions to improve intestinal and liver functioning can’t be overstated. The intestines are where the majority of essential nutrients are absorbed, where 70% of the immune system is located, and where 90% of the neurotransmitter serotonin and 50% of the neurotransmitter dopamine are produced.
As far as the liver is concerned, it’s the primary filtration organ for the blood, plays a critical role in hormonal health, is the site where triglycerides are converted to ketones, stores a large amount of back up glycogen, and plays a major role in digestion of fatty acids and gut microbiome health. 
Curcumin also acts as an antioxidant in the body, where it’s a potent free radical (ROS) scavenger, helping to reduce oxidative stress in large part by increasing glutathione levels as well as SOD (superoxide dismutase) and catalase activities, all of which help inhibit lipid peroxidation. Note that it’s often oxidized LDL that’s found in vascular plaque, so this has implications for CVD as well. 
Image Source: www.semanticscholar.org/paper/Curcumin%3A-a-novel-therapeutic-for-burn-pain-and-Cheppudira-Fowler/ebeff097aeaf2b3796f6039dbede1ad917c00405/figure/2
Curcumin exerts some of its therapeutic effects by regulating and modifying cell signaling. Nuclear Factor Kappa B or NF-kB is a protein complex found in almost all animal cell types. NF-kB helps control DNA transcription, inflammatory cytokine production and cell survival. Curcumin helps modify and regulate aberrant NF-kB signaling. This works to reduce inflammatory cytokines such as interleukin/IL-1, IL-6, IL-8, TNFa (tumor necrosis factor-alpha) and TGFb (transforming growth factor-beta). Ingesting bioavailable curcumin in therapeutic amounts helps drives down other inflammatory markers including Cox-2 enzyme levels. 
The positive effects of curcumin can be objectively measured using various lab tests that measure systemic inflammation such as CRP, Erythrocyte Sedimentation Rate (ESR) and homocysteine. Curcumin may even have the power to turn a positive Rheumatoid Factor or Antinuclear Antibody test result to a negative reading.
Image Source: https://bioaegistherapeutics.com/innate-immunity/
While in today’s video we’re focusing mostly on curcumin’s effect on inflammation and pain, there is also a large body of clinical evidence to support its safe and effective use for several common conditions, including cancer and Alzheimer’s…
With cancer, curcumin induces programmed cell death in malignant cancer cells, in large part through damage to cancer cell’s mitochondria. Curcumin helps reduces the growth of new blood vessels in tumors. Curcumin helps blocks tumor growth and metastases. And finally curcumin helps activate the nuclear vitamin D receptor, which is associated with improved gut health and immune functioning. 
With Alzheimer’s, curcumin promotes neurological health by increasing the omega 3 metabolite DHA. Curcumin also stimulates neurogenesis (or the creation of new brain cells) as well as neural plasticity and repair. Curcumin helps reduce amyloid plaque. And finally, curcumin is neuroprotective against quinolinic acid-induced degeneration. 
Image Source: www.connectchristianchurch.org/ministries/worship-ministry/messages/what-does-the-bible-say-about-the-bible/
So that’s an overview of just some of the clinical data on curcumin’s health effects. Since of one my main health approach principles is a biblical approach, I thought it’d be interesting to see what the bible says about today’s topic. And while turmeric isn’t specifically mentioned in scripture, the medicinal value of many herbs are discussed (ex. saffron, cinnamon, cumin, and others). Interesting, to me at least, the bible does mention inflammation a few times, including in Deuteronomy 28 and Psalm 38…
The LORD will strike you with wasting disease, with fever and inflammation, with scorching heat and drought, with blight and mildew, which will plague you until you perish. ~Deut. 28:22 (NIV)
Deuteronomy was written by Moses around 1400 BC after the nation of Israel had wandered around in the wilderness for nearly 40 years. In the latter parts of Deuteronomy, Moses details the blessings that come from widespread obedience to God’s ways and the curses that come from disobedience. Deuteronomy 28, as you can see, is all about the curses, and hints that the people were well aware of the association between inflammation and disease.
My back is filled with searing pain; there is no health in my body. ~Psalm 38:7 NIV
For my loins are full of inflammation, and there is no soundness in my flesh. ~Psalm 38:7 NKJV
For my insides are full of burning pain, and there is no soundness in my body. ~Psalm 38:7 CSB
For my waist is filled with burning. There is no soundness in my flesh. ~Psalm 38:7 WEB
Psalm 38 was written by the ancient Israelite king David around 950 BC. This is a psalm of grief, where David laments his sin and the adverse health consequences of it. Interesting to me is that, while various English translations mention different areas of the body (back, loins, insides, waist), all translations ascribe the pain and inflammation to the midsection of his body, where the small and large intestines are located.
I don’t want to get into a deep theological discussion here. We do live in a fallen world, and disease, pain and early death can happen even to those who are living right (biblical examples that come immediately to mind include Job and Jesus). That said, the bible does clearly teach that, on a general level, increases in sin and ignorance are linked to increases in pain, disease and death. We see this in such places as Romans 6:23 “the wages of sin is death” and Hosea 4:6 “my people perish for lack of knowledge.”
… so that’s a little of what the bible says on inflammation. Next let’s talk about curcumin supplements…
[CLICK HERE TO READ PART 3 OF 3]
1 www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61854-5/fulltext (includes image of 1910 Flexner Report)
2 https://history.library.ucsf.edu/flexner_report.html (details on Flexner Report of 1910)
3 www.ncbi.nlm.nih.gov/pmc/articles/PMC4042309/ (2010; US docs only receive 20 hours formal nutrition education during med school)
4 www.nature.com/articles/ejcn201475 (2014; European docs only receive 24 hours formal nutrition education during med school)
5 https://worldmicrobiomeday.com/resources/ (90% of all disease linked back to gut microbiome in some way)
6 www.goodrx.com/blog/prescription-drug-advertising-regulation-united-states/ (2019 article on New Zealand & US being only 2 countries to allow DTC advertising for pharma drugs)
7 www.opensecrets.org/lobby/top.php?indexType=i (industries that spent the most $ lobbying congress, 1998-2019)
8 www.opensecrets.org/news/2019/01/lobbying-spending-reaches-3-4-billion-in-18/ (2018 lobbying $ was highest in 8 yrs; pharma spent >$280 million, followed by insurance >$150 million)
9 www.britannica.com/plant/turmeric (general info on turmeric)
10 www.ncbi.nlm.nih.gov/pmc/articles/PMC5429333/ (2016 scientific journal article on turmeric, curcumin, it’s history and beneficial effects on human health, including for cancer, CVD, neurological & inflammatory diseases)
11 www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/ (2012 review of clinical literature on benefits of curcumin for human health)
12 https://academic.oup.com/painmedicine/article/17/6/1192/2240744 (2016 meta-analysis of 8 RCTs found curcuminoids safe and effective to reduce multi types of pain)
13 www.ncbi.nlm.nih.gov/pmc/articles/PMC5003001/ (2016 meta-analysis of RCTs found 1g/day curcumin effective for arthritis)
14 www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/ (2017 scientific review of the clinical data for curcumin)