Saturday, September 8, 2012

Curcumin for Diabetic Neuropathy

Recently I posted about the potential of curcumin, the antioxidant that is relatively abundant in turmeric, as a treatment for type 2 diabetes. I got a question about using curcumin for the most common long-term type 2 diabetes, diabetic neuropathy. Here's a reposting of a a comment I made on my other blog last year.

The bottom line of the current state of research is, curcumin seems like a good idea for treating diabetic neuropathy although the potential is yet to be proven. There is one subgroup of type 2 diabetics, however, who are especially likely to benefit.

The March-April 2010 edition of the Indian Journal of Pharmaceutical Sciences featured an article on the potential of curcumin, the prominent antioxidant in the curry spice turmeric, to treat a great variety of nerve disorders. "Curcumin demonstrates neuroprotective action" in "major depression, tardive dyskinesia, and diabetic neuropathy," authors of the paper stated, although "the mechanism of its neuroprotective action is not completely understood."

There is good evidence that curcumin is non-toxic. Curcumin is touted as antimicrobial, antiinflammatory, antihypertensive, antihyperlipidemic, antitumor, anticancer, antiphlogistic, antidiabetic, antipsoriasis, antithrombotic, and antihepatotoxic. Since it is a relatively small molecule, it enters the human bloodstream easily, and since it is a polar molecule (it has regions of relatively high positive and negative charge), it is easily absorbed by the brain. One of the peculiar characteristics of curcumin while it is still in turmeric is that it protects against radiation. It protects against radiation so well that any insects in bags of turmeric survive irradiation, and irradiating turmeric to make it shelf-stable actually accelerates its spoilage.

There are numerous theoretical reasons that curcumin should be helpful as a treatment for diabetic neuropathy. At the test-tube level, it protects astrocytes taken from brain tissue from destruction by free radicals. It seems to play a role in the regulatory evidence that control dopamine and serotonin levels.

The clinical evidence for curcumin as a treatment for diabetic neuropathy, unfortunately, does not yet exist. Panjab University in India did find that curcumin reduces insulin resistance in lab rats and increases sensitivity to pain (when the rats' paws were placed on a hot plate), but the study involved giving the rats insulin injections equivalent to 500 to 1,500 U a day in a human, half a vial to a vial and a half a day, vastly more than even the most insulin-resistant type 1 diabetic takes. And there's no way to know if these results with lab rats would translate even for the most insulin-resistant type 2 diabetics, who happen to take large amounts of insulin.

Moreover, while curcumin circulates in the body easily once it is absorbed from the digestive tract, it is very difficult for the body to absorb curcumin from the digestive tract. Curcumin bound to a phytosome is absorbed about twice as well as other forms of the supplement, but it's a little early to be recommending curcumin as more than optional treatment for type 2 diabetics. It won't hurt, but it's far from guaranteed to help for most diabetics.

Type 2 diabetics whose underlying problem is a condition called hemochromatosis (high iron levels), however, are a lot more likely to be helped by taking curcumin. Just don't use curcumin as your sole method of treatment for the disease. Work with a physician who has experience with the disease to create a comprehensive treatment plan.

Selected References:

Messner DJ, Sivam G, Kowdley KV. Curcumin reduces the toxic effects of iron loading in rat liver epithelial cells. Liver Int. 2009 Jan;29(1):63-72. Epub 2008 May 19.

Sharma S, Kulkarni SK, Agrewala JN, Chopra K. Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pharmacol. 2006;536:256–61.

Sharma S, Chopra K, Kulkarni SK. Effect of insulin and its combination with resveratrol or curcumin in attenuation of diabetic neuropathic pain: Participation of nitric oxide and TNF-alpha. Phytother Res. 2007;21:278–83.

You may also be interested in my article on Chinese herbal medicine for diabetes.

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