Like other forms of inflammatory arthritis, ankylosing spondylitis (AS) involves a number of different inflammatory “pathways” in the body — biological processes that play a role in the disease and its symptoms.
Regardless of the cause of the disease, any intervention that disrupts these processes — from taking prescribed medications to exercising to dietary changes — may reduce the burden of inflammatory health conditions. And so many people with AS are looking for lifestyle changes that may have this effect.
One dietary supplement that has gotten wide attention in recent years for all forms of inflammatory arthritis is turmeric. While the risks of trying turmeric for your AS are relatively low, it’s important to be aware of what your options are and what to expect from different forms of the supplement.
And if you decide to try turmeric, doing so in a methodical way can help you figure out whether it’s actually helping your AS symptoms. But as with any study involving a single person, you may see a benefit from turmeric simply because you’re looking for one — or you may find no benefit at all, even if it helps other people.
Here’s what you should consider before trying turmeric when you have AS.
How Might Turmeric Help AS?
Turmeric is derived from the rhizome (underground stem) of the plant of the same name. It’s available in different forms, including the fresh rhizome itself, a dried powder that’s often used in cooking, and a standardized extract that’s often taken as a dietary supplement.
The target ingredient that’s extracted for most dietary supplements made from turmeric is called curcumin. Curcumin is the most widely studied component of turmeric, and it’s known to interfere in several different inflammatory pathways throughout the body, according to Sheryl Mascarenhas, MD, a rheumatologist at the Ohio State University Wexner Medical Center in Columbus.
“Curcumin actually blocks some of the inflammatory pathways in rheumatoid arthritis and ankylosing spondylitis,” says Dr. Mascarenhas. One way it does this is by halting the effects of a protein called tumor necrosis factor (TNF). “A lot of the drugs we use for ankylosing spondylitis block this inflammatory pathway, as well,” Mascarenhas notes.
But curcumin is also known to block other inflammatory signals, as well — so its effects may be wide-ranging, and aren’t fully understood. Most of its potential effects on inflammatory arthritis also haven’t been studied specifically in the context of AS.
In fact, most studies of curcumin in arthritis have been small and limited in their conclusions. To make sense of multiple smaller studies, researchers sometimes pool their data together in what’s known as a meta-analysis, and one such analysis, published in August 2016 in the Journal of Medicinal Food, found that out of eight clinical trials of curcumin and other turmeric extracts in people with arthritis, four showed improvement in an index of overall arthritis symptom severity, while three showed improvement in an index of pain.
The results of the meta-analysis were promising enough for the researchers to conclude that the available evidence “supports the efficacy of turmeric extract (about 1,000 milligram [mg]/day of curcumin) in the treatment of arthritis,” while also calling for larger, better-designed studies to confirm this benefit.
Choosing to Take Turmeric
If you decide to start taking turmeric for your AS, Mascarenhas recommends first having a talk with your rheumatologist to discuss how much you’ll be taking and how you’ll evaluate its effects.
“It’s not really clear how much is an ideal dose, or how long someone should take turmeric,” she notes. But generally, she advises taking 500 mg of curcumin two to three times a day for those who wish to try it.
Some people probably shouldn’t take turmeric as a supplement, Mascarenhas says, including people with gallstone or bile duct problems. And there are risks and potential side effects associated with any supplement, although with turmeric, “we’re still trying to hash them out,” Mascarenhas notes. “I had one patient who developed itching.”
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Once you’re cleared by your doctor to take a turmeric supplement, you should initially evaluate it for about three months as a rule of thumb, Mascarenhas says. But there’s not much evidence to suggest how long it might take to see a benefit from turmeric, or how long you can safely take it.
As an alternative to taking a turmeric supplement, you can simply use the powdered or fresh turmeric more often in your cooking — but this won’t give you the same level of curcumin as a supplement. Still, “I’ve seen quite a few patients just cook with it and do really well,” says Mascarenhas. “It may help.”
Overall, a supplement tends to give you “more bang for your buck” based on curcumin levels — which you should definitely look at when comparing supplements. Mascarenhas doesn’t recommend any specific brand, but instead suggests doing some research or going with a brand that you trust.
If you decide to try turmeric, you’ll be in good company among people with AS and other forms of inflammatory arthritis, according to Mascarenhas. “Turmeric is probably one of the major supplements we see in our day-to-day practice,” she says, “where patients are coming in and noticing some improvement.”