S2895 Hepatotoxicity of Turmeric as a Popular Anti-Inflammatory Supplement: A Systematic Review

Introduction: Turmeric is derived from Curcuma longa, a member of the ginger family and contains curcumin as one of its active components. It has gained popularity in recent years for its promoted anti-inflammatory and antioxidant effects, with a wide variety of benefits advertised in popular culture. With the increased use of turmeric as an herbal supplement, documented reports of turmeric-associated hepatoxicity have been increasing in recent years. Methods: A systematic review was conducted using Pubmed, Scopus, and ScienceDirect from January 2010 and March 2025 that described turmeric-associated liver injury. According to PRISMA guidelines, 2 reviewers completed the initial title and abstract screening, full-text review, and data extraction. A total of 33 studies were included in the study. Results: There have been increasing reports of turmeric-associated liver injury in recent years. Duration of onset of hepatocellular injury ranged from 3 weeks up to 4 months. A hepatocellular pattern was the predominant pattern of liver injury, with rare instances of auto-immune hepatitis noted. Complete resolution of liver injury was noted in nearly all reported cases following discontinuation of turmeric supplementation and usually occurring within 1-3 months following cessation. There are a few reported cases requiring steroid therapy for treatment and one case of death associated with turmeric-associated liver injury. The high resolution rate suggests that the liver injury is generally reversible; however, the duration of time until resolution and use of steroids show the varying extent of liver injury which may occur. The included studies generally involved turmeric in concentrated forms found in commercial supplements, as opposed to turmeric used as an ingredient as part of a balanced diet. There is not clear evidence of a dose-dependent relationship between turmeric and liver injury as dosages and formulations varied between studies and in some studies, dosages were not reported. Conclusion: While turmeric has been known for its anti-inflammatory properties, the increased availability of commercial turmeric supplements has been marked by an increase in reported liver injury. Increased awareness of the possible hepatocellular adverse effects related to turmeric use is essential, especially as herbal supplements become more widespread. Use of herbal supplements, including turmeric, should be considered in patients with liver injury, especially in patients with no other known risk factors.