Are There Any Benefits and What Are the Risks?
Summary
We have extensively studied whether black pepper (piperine) should be added to turmeric/curcumin products. While most manufacturers of turmeric supplements state that adding piperine increases curcumin levels in the bloodstream, this does not necessarily mean improved bioavailability or efficacy at the gut level. Or even that it is safe.
Curcumin, turmeric's active ingredient, interacts with gut bacteria to produce beneficial metabolites when processed naturally through the intestines. Adding black pepper or its extract, piperine, disrupts this natural process, leading to higher curcumin levels in the blood but potentially reducing its overall efficacy and causing liver damage due to unnatural absorption.
There are also serious concerns about the quality and safety of commercially available piperine, often sourced from China with uncertain purity. The American Turmeric Company recommends consuming turmeric with fats or oils or with food and using fermented turmeric products to enhance absorption naturally without using black pepper or piperine.
Introduction
Turmeric contains many beneficial compounds, which is why it has been used for medicinal purposes for thousands of years. One of the main ingredients in turmeric is curcumin (or, more correctly, the curcuminoids). These compounds provide turmeric's anti-inflammatory effect. Researchers are learning that controlling inflammation is the key to relief from pain and even inhibiting the spread of cancer cells.
Whether black pepper/piperine should be added to turmeric or curcumin-based products is fraught with confusion and controversy. Our only goal here is to provide you with the scientific information that is available so you will be more informed about the subject and can then make your own decision
There is an interesting “modern-day” phenomenon taking place which is being driven by the internet. The current emphasis on adding piperine had its origins in two places. First, initial studies showed that even when high doses of curcumin were given to test subjects, there were very low levels of curcumin found in the bloodstream. This led the researchers to the conclusion that curcumin was not being absorbed efficiently by the body. They suggested adding black pepper or an extract of black pepper known as piperine would solve the problem. We will discuss this in greater detail below.
Health Supplement Marketers Jumped On The “Piperine” Bandwagon Because It Made Their Products Seem Novel And It Gave Them “Authority Bias”
The second origin of the “black pepper/piperine” fad originated in the marketing world. Once marketers heard about adding piperine to their turmeric/curcumin product, they saw it as a marketing advantage to say that their product was “special” because they offered
something that no one else did. This is known as an “appeal to novelty”, where it is assumed that something is better simply because it is new or different. They may have had some initial marketing advantage, but it soon seemed everyone who sold turmeric/curcumin products had jumped on that bandwagon, and their advantage was gone.
“Authority Bias”, which occurs when a person or entity appears to have expertise or authority, soon came into play as blog and podcast creators picked up the theme by saying, “And, of course, you know you must add black pepper to your turmeric/curcumin, or it won’t be absorbed.”
Now, let’s take a look at the facts. The basic premise is that researchers discovered that after turmeric/curcumin is ingested, a check for its presence in the bloodstream found a very low concentration. That finding is correct. It is also correct that black pepper did increase the presence of curcumin in the bloodstream and, hence, its bioavailability.
Looking for the Wrong Thing in the Wrong Place
It is our position and belief, based on much research, that this activity greatly reduces the efficacy of curcumin. The reason is that they misunderstood – or, in the rush to exert “authority bias,” have ignored - what happens to curcumin once it is in the gut. This is where the claim comes from that says, “Our curcumin is 2000X more bioavailable because we add piperine to it”. Having more curcumin in the bloodstream is one thing, but that DOES NOT
mean it is more bioavailable. It means that the piperine has tricked the gut and the liver into NOT processing the curcumin as it normally would be but instead lets it enter the blood stream in an unprocessed state. Have you wondered why turmeric/curcumin has been used for thousands of years with great, documented results, and now, all of a sudden, our bodies can’t process it, and we must rely on stopping the liver from doing its normal job?
To understand what is happening, you need to know that turmeric and curcumin contain Type 3 starches, which resist digestion in the small intestine and pass into the large intestine. As these starches reach the large intestine, they are broken down by gut bacteria into various metabolites. These metabolites can be absorbed into the bloodstream from the intestines. Once absorbed, they are distributed throughout the body, where they can exert systemic effects. For example, one of the resulting metabolites (tetrahydro curcumin) has been noted for its strong antioxidant properties, which can help protect cells from oxidative stress. Other significant health benefits of these metabolites include anti-inflammatory
and antioxidant effects, improved gut and metabolic health, neuroprotection, anticancer potential, immune system support, and cardiovascular health. These benefits highlight the importance of curcumin and its interaction with the gut microbiota in promoting overall health.
But adding black pepper/piperine to turmeric/curcumin suppresses certain metabolic enzymes used by the gut microbes, preventing the action described above from taking place as nature intended. That is why when curcumin is forced to bypass its natural pathway through the intestines, it is “short-circuited” and allowed to enter the bloodstream unprocessed. That means that higher concentrations in the bloodstream mean less curcumin in the gut to do the job it was intended to do.
Study Finds Correlation Between Taking Turmeric with Piperine and Liver Injury
A study published in August of 2023 by the Thomas Jefferson Hospital in Philadelphia found cases of hepatocellular liver injury, which is an inflammation of the liver cells, in patients consuming turmeric/curcumin and piperine. The problem was caused by the fact that by suppressing the natural function of the liver, curcumin in very high amounts was being pulled into the liver from the digestive tract and was causing liver damage. So not only was the curcumin not being broken down into beneficial compounds known as
metabolites, it had the potential to cause damage to the now-defenseless liver.
So why is turmeric/curcumin so efficacious in treating certain human conditions if it is so badly absorbed? The scientific study (1) below explains the answer to that question.
“The new working hypothesis that could explain the curative role of curcumin, despite its limited availability, is that curcumin acts indirectly on the brain, affecting the “gut-brain–microflora axis”, a complex two-way system in which the gut microbiome and its composition, are factors that preserve and determine brain health. It is, therefore, suspected that curcumin and its metabolites have a direct regulatory effect on gut microflora and vice versa, which may explain the paradox between curcumin’s poor bioavailability and its commonly reported therapeutic effects. Curcumin and its metabolites can have health benefits by eliminating intestinal microflora dysbiosis. In addition, curcumin undergoes enzymatic modifications by bacteria, forming pharmacologically more active metabolites than their parent, curcumin. In this review, we summarize a number of studies that highlight the interaction between curcumin and gut microbiota and vice versa, and we consider the possibility of microbiome-targeted therapies using curcumin, particularly in disease entities currently without causal treatment”.
In the journal Medical News Today (June 28, 2024), (2) researchers stated that they had "identified a risk associated with taking turmeric and black pepper supplements together". (2)
This is the reason we DO NOT add anything (such as black pepper or piperine) to our turmeric/curcumin products. It is also the reason that we recommend that you take it with food or a smoothie or a Golden Latte.
Sources:
(1) "Mutual Two-Way Interactions of Curcumin and Gut Microbiota", Internal Journal
of Molecular Studies, Feb. 2020.. Link here.
(2) "Turmeric and black pepper supplements linked to liver injury in some people", Medical News Today (June 28, 2024) Link here.