Not Just Another Turmeric!

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Ingrid 2019

MediHerb Turmeric Forte has been available in the United States for the last several years and now finally available here in Canada! How is this formula different than the turmeric products you have been using up until now? Well according to Dr. Bob Scott ND “This is NOT just another turmeric product! Your patients will notice results within days and weeks like never before.” Dr Scott says “Turmeric Forte is a turbo-charged curcuminoid delivering FREE curcuminoids across the BBB, so think of this product as your best brain remedy!”

He would like to see all kids playing sports taking 1-2 OD as a preventive for TBI. Not only does this MediHerb product provide all three curcuminoids found in the spice, it is also up to 45% more bioavailable than regular curcumin. More importantly, it delivers up to 75% FREE curcuminoids into the plasma. It is the FREE curcuminoids that “turbo charge” the product. The FREE cucurminoids enter the BBB and all the other tissues. This results in full cell saturation within 1-2 hours of ingestion (at 4 per day dosage). Virtually every other quality curcumin product on the market has good absorption using pepper, nano or liposomal technology but the curcuminoids are still in the conjugated form so dosages required are much higher and effects are not as optimal.

Turmeric Forte provides 270mg of a proprietary blend of curcuminoids with 33% being the most active curcuminoid – curcumin. The suggested retail price for 60 caps is $42.50 and the maintenance dosage is 1-2 per day. Patient compliance is very high due to the quick response to their symptoms. Anecdotal comments from patients regarding headaches includes results within a few hours at 2 tabs per hour; for post stroke brain fag results can be seen within 2 weeks at 2 BID. For mild to moderate depression 2 tabs QID for 2 weeks may prevent the use of antidepressants.

There is no contraindication for breastfeeding and pregnancy. It is recommended not to take it with antiplatelet and anticoagulant drugs beyond the maintenance dosage of 1-2 per day (no more than 15 grams per day) and not to be taken with Talinolol (a beta blocker). It is also contraindicated in biliary tract obstruction.

Turmeric Forte will not replace the other MediHerb products that contain turmeric such as Boswellia Complex or Vitanox which do not contain the CGM form of curcuminoids, but can certainly be used to augment these formulas. Have your patients try it for one month and Turmeric Forte will speak for itself!

Kerry Bone’s lecture “Quenching the Internal Fire” has been summarized below to help shed light on the myriad of uses for Turmeric Forte in your practice:

Stress response led by Nrf2 pathways is the first stage of inflammation that then moves into para-inflammation where there is some upregulation up of the inflammatory response leading to chronic diseases. These chronic diseases include neurological, pulmonary, cardiac, autoimmune, arthritis, Alzheimer’s and diabetes type II.

NF kappa B drives many inflammatory responses but when it is chronically upregulated then it can drive chronic diseases as above but also obesity, Crohn’s disease, allergy, psoriasis and MS.

Many lifestyle choices increase NF-kappa B production such as alcohol, diet, smoking environmental toxins, viruses and bacteria. This also increases other inflammatory agents such as TNF, IL-1, IL-6, chemokines, MOS, MMP, COX2 and ICAM which all ultimately contribute to chronic diseases. Food choices such as fruits, legumes, vegetables spices like curcumin and exercise counteract these inflammatory responses.

When you extract curcumin from turmeric you just don’t get curcumin 95% you also get demethoxycurcumin and bisdemethoxycurcumin which are collectively known as curcuminoids. When it is made synthetically you don’t get the other two forms of curcumins you just get curcumin.

What is molecular promiscuity? It is the action of curcumin that it has a pleiotropic effect on many inflammatory pathways not just one. There have been thousands of papers published on curcuminoids and there are multiple pharmacological effects including anti-toxic, anti-oxidant, wound healing, anti-apoptotic and anti-angiogenic.

Example:
Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases
Ajaikumar B Kunnumakkara  17 September 2016

Herbal agents have network pharmacology where one agent effects many pathways such as curcumin. Each herb may have a mild influence across many targets due to this protein interaction network or PIN analysis. This was studied in the test tube by Dr. Gan Y Zheng et al (Acta Pharm SinB 2015 Nov 5(6) 590-595. PIN of curcumin with 482 nodes and 1688 interactions.)

Mechanisms of action of curcuminoids – up regulation or downregulation of the following:

Nuclear transcription factors such as down regulation of NF Kappa B, STAT and upregulation of Nrf2 factors. They also work through growth factors such as down regulation of VEGF and also down regulation through inflammatory cytokines such as TNF alpha and interleukin IL-1, IL-6.

Protein kinases MAPKs and Akt are downregulated.

(See Phytotherapist’s Perspective No 159 August 2017)

Curcumin has very poor bioavailability. Technologies have been developed to enhance absorption including adjuvant such as piperine and cyclodextrin, or enhanced lipid solubility using liposomes, micelles and phospholipid complexes to get through the gut wall, nanoparticles, chemical derivatives and natural biopolymers such as fenugreek (biopolymers of sugar molecules forming a soluble fiber).

The amount of black pepper required is 1 tsp or more to get a significant absorption of curcumin. Some physicians have seen allergies to black pepper result from these high dosages. Piperine suppresses cytochrome P450 enzymes in the liver so should not be used at the same time as many drugs that are also processed via cytochrome P450 enzymes. This is a safety issue. This is the reason MediHerb does not use piperine.

MediHerb makes a colloidal form of curcuminoids using fenugreek. Impregnating the curcumin into the soluble fiber of fenugreek called galactic mannosides, results in a slow release stable colloidal form – curcumin galactomannoside or CGM.

No chemical solvents are used except ethanol and water which is routinely used in herbal tinctures and extracts.

CGM human Studies:

Human studies in 50 people comparing 1000mg dose of CGM (40% curcuminoids) with straight curcuminoids. Showed 45X bioavailability uplift at a dose of 1000mg

At 250mg CGM, 100mg of curcuminoids showed a 24.8X bioavailability uplift.

CGM inhibits initial liver metabolism so that there are extraordinary high levels of the free form of curcuminoids rather than the conjugated form. CMG plasma half-life is extended 3 hours rather than one hour for straight curcuminoids.

Also the Cmax concentrations for both doses of CGM were above the threshold level of 100 nanomol/L resulting in key pharmacological activity. This was not reached in the non- enhanced straight curcuminoids. So the observed combination of strong bioavailability uplift with preservation of the free unconjugated forms was unique in this CGM form.

Kumar D Jacob D, Subash et al. J Funct Foods 2016 22: 578-587

In vivo study Krishnakumar IM, Abhilash Maliakel, Gopakumar G et al J Funct Food 2015;14 215-225 confirmed the increased bioavailability of CGM in comparison to unenhanced curcumin.

There was seen an increased distribution of free curcuminoids to heart, liver, kidney, spleen and in particular to the brain, 250 times that of unenhanced curcumin.

Do we have any clinical evidence that CGM works?

A small pilot study where people were given CGM 1000mg OD (containing about 391 mg of total curcuminoids), or unenhanced curcuminoid 951 mg OD or placebo over 30 days. There was significant improvement in quality of life only in the CGM group which was measured as reduced physical and mental fatigue and better concentration. In the unenhanced group there was a small benefit and no changes found in the placebo group.

There was an increase in the plasma anti-oxidant enzymes such as catalase, superoxide dismutase, glutathione peroxidase and glutathione in both curcuminoid groups. These are Nrf2 effects in both forms. But to get anti-inflammatory effects especially in the brain you need the enhanced form.

 There are more and more studies linking the immune system to mental health including the work of Dr. Ian Hickie Professor of the Sydney’s Brain and Mind Center. He states “what is driving the mental ill health is not so much a change in the brain but in the immune system.” Neuroinflammation has been linked to many complex brain disorders including imbalances in neurotransmitters.

 CGM has been studied to be effective for the following: arterial stiffness, depression, anxiety, optimizing insulin resistance, prediabetes and diabetes type 2, oral lichen planus, allergic rhinitis, lowers Lp(a), CRP, triglycerides and increases HDL’s and BDNF levels, improves microcirculation, endothelial function, pain management, PMS Takayasu arteritis, GI reflux, ulcerative colitis and other autoimmune diseases such as psoriasis and uveitis.

Summary:

CGM or curcumin galactomannoside found in Turmeric Forte is a significant breakthrough for natural therapists to use curcuminoids effectively. Because of curcuminoids promiscuity and the way non-resolving inflammation feeds most chronic disease processes the potential use of CGM are myriad but especially for neuroinflammation. Network pharmacological considerations suggest that we can achieve a high clinical potency with a minimal risk of side effects.

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