Liver injury from high-dose supplements
Concentrated curcumin supplements, especially those with piperine to boost absorption, have been linked to rare but serious liver injury. It happens unpredictably in a small number of people, possibly those with a particular gene variant, and cases got better when the supplement was stopped. The UK Committee on Toxicity reviewed the evidence and published its conclusion in December 2024.
The US Drug-Induced Liver Injury Network recorded 10 cases of liver injury linked to turmeric between 2004 and 2022, all after 2011. 5 people were admitted to hospital and 1 died of acute liver failure. Most cases involved supplements designed for high absorption.
2023ObservationalLiver Injury Associated with Turmeric, The American Journal of Medicine, Drug-Induced Liver Injury Network (DILIN) series
21 cases of acute liver inflammation possibly linked to curcumin-piperine supplements were reported in Italy between December 2018 and July 2019.
2024ObservationalCOT Statement COT/2024/07, citing Italian pharmacovigilance data
The UK Committee on Toxicity concluded there is reasonable evidence of a causal link between turmeric supplements and liver toxicity. The reaction is unpredictable and linked in many cases to the HLA-B*35:01 gene variant.
2024Regulator reviewUK Committee on Toxicity, Statement COT/2024/07 on the potential risk to human health of turmeric and curcumin supplements
Cases overwhelmingly involve concentrated curcumin extracts made for high absorption, including with piperine or tiny fat particles. About 10% of supplement cases with jaundice are fatal.
2023ObservationalNIH LiverTox, Turmeric entry, National Library of Medicine
Children can reach the daily limit
In 2014 European reviewers refined their estimate, because earlier figures suggested some children could go over the daily limit of 3mg per kg of body weight. Using real use levels, average intake in toddlers and children was below it, but the highest consumers in some countries reached or briefly went over it. Flavoured drinks and cakes were the main sources. Adults, teenagers and older people were below it in every scenario.
At the maximum permitted levels, estimated intake in children aged 1 to 10, at average and high levels, could go over the daily limit of 3mg per kg of body weight in some European countries.
2010Regulator reviewEFSA ANS Panel, Scientific Opinion on the re-evaluation of curcumin (E 100), EFSA Journal
Using real-world use levels, intake in the highest-consuming children and toddlers was at or near the limit in some surveys, mainly from flavoured drinks and cakes. Adults and teenagers were below it at all levels.
2014Regulator reviewEFSA, Refined exposure assessment for curcumin (E 100), EFSA Journal 12(10):3876
DNA and cancer tests
Lab tests have given mixed results: at high strengths, curcumin caused chromosome changes and DNA breaks in cells.
The international committee set a daily limit of 3mg per kg of body weight, based on a reproduction study.
2004Regulator reviewJECFA, WHO Food Additives Series 35, Monograph 840
Interactions with medicines
At supplement doses, curcumin can interact with some medicines. The best recorded is warfarin: curcumin may slow how the body clears it, raising blood levels and bleeding risk. Lab evidence also points to interactions with some chemotherapy and diabetes drugs and with medicines processed by certain liver enzymes. Most of this evidence is case reports and lab tests, not trials.
Curcumin may slow the clearance of warfarin, and at least one case of raised INR has been recorded in someone taking both. The Welsh Medicines Advice Service flags it as a clinically relevant interaction that needs monitoring.
ObservationalWelsh Medicines Advice Service, Turmeric: potential interactions
Curcumin mildly blocks the liver enzyme CYP3A4 and the transporter P-glycoprotein. Recorded interactions include 3.2 times higher blood levels of sulfasalazine and a case of tacrolimus toxicity after high turmeric intake.
ObservationalWelsh Medicines Advice Service, Turmeric: potential interactions
Linked to more type 2 diabetes in a large French study
The NutriNet-Santé study followed 108,723 French adults for about 8 years and tracked the colours in the packaged food they ate. People who ate the most curcumin (E100) were 49% more likely to develop type 2 diabetes than those who ate little or none. It is about curcumin added as a colour, not turmeric used in cooking. This is one observational study.
Among 108,723 French adults followed from 2009 to 2023, higher intake of curcumin as a food colour was linked to a 49% higher risk of type 2 diabetes (hazard ratio 1.49).
2026Observational study in peopleNutriNet-Santé cohort, Shah et al., Food Coloring Additives and Incidence of Type 2 Diabetes, Diabetes Care