Assessing Literature using the PRISMA statement: NSIADS vs. Curcuma Longa

Excluding aspirin, chronic use of NSAIDs is cardiotoxic and nephrotoxic (Curiel & Katz, 2013).  It’s a safe bet that all of us, irrespective of our chosen field, will interact with many clients who use NSAIDs chronically.  Therefore, it is relevant to have an awareness of the literature surrounding the  methods of managing subjective pain that are included to our modalities.

One traditional phytotherapeutic intervention for pain management is turmeric.   From the perspective of western herbalism the assertion that turmeric is effective at pain management is uncontroversial.  The more important question as a clinical herbalist would be, is turmeric safe?  Safety is a critical area where it is incumbent on herbalists to stay appraised of all of current research. 

One summary source on turmeric is a narrative review by Kamala Krishnaswamy MD (Krishnaswamy, 2008).  This review offers persuasive arguments for turmeric’s many uses and indications.  I am including it in case any of you haven’t been part of a discussion of the varied therapeutic properties of turmeric.  Unfortunately, due to its unsystematic nature its validity is low, and since it does not contain a discussion on the safety of turmeric it cannot serve as relevant source on the question of turmeric safety.

A relevant and valid summary source on turmeric is a systematic review entitled “The Safety and Anti-Inflammatory Activity of Curcuimin” (Chainani-Wu, 2003).  This systematic review’s goal was to use electronic searches to compile the literature on turmeric safety.  It did not provide numeric analysis of the findings, but by avoiding this it was able to discuss both in-vitro and both human and animal in-vivo studies in the qualitative synthesis.

Another summary source on turmeric is a meta-analysis entitled “Zingiberaceae extracts for pain: a systematic review and meta-analysis” (Lakhan, Ford, & Tepper, 2015).  In the context of PRISMA, this paper’s reporting is valid with key discussions in each of the typical main sections of a published paper.  Attention is given to the search and selection in the methods section and the results section includes a forest plot.  One key limitation to this paper is that it is not looking exclusively at turmeric, but the entire zingiberaceae family.  The paper is also hampered by a small sample size of relevant papers although the selection criteria which leads to this small sampling is robust and justified.   

In conclusion, all the publications discussed are relevant to the discussion of turmeric as an herbal intervention. But the Systematic Review by Chianani-Wu is valid, generalizable, and relevant to our initial question as to the safety of turmeric as an intervention.

References:

Chainani-Wu, N. (2003). Safety and Anti-Inflammatory Activity of Curcumin: A Component of Tumeric (Curcuma longa). Journal of Alternative & Complementary Medicine, 9(1), 161–168. http://doi.org/10.1089/107555303321223035

http://www.ncbi.nlm.nih.gov/pubmed/12676044

Curiel, R. V., & Katz, J. D. (2013). Mitigating the Cardiovascular and Renal Effects of NSAIDs. Pain Medicine, 14(suppl 1), S23–S28. http://doi.org/10.1111/pme.12275

http://www.ncbi.nlm.nih.gov/pubmed/24255997

Krishnaswamy, K. (2008). Traditional Indian spices and their health significance. Asia Pacific Journal of Clinical Nutrition, 17 Suppl 1, 265–268.

http://www.ncbi.nlm.nih.gov/pubmed/18296352

Lakhan, S. E., Ford, C. T., & Tepper, D. (2015). Zingiberaceae extracts for pain: a systematic review and meta-analysis. Nutrition Journal, 14, 50. http://doi.org/10.1186/s12937-015-0038-8

http://www.ncbi.nlm.nih.gov/pubmed/25972154