Related Terms

• Amomoum curcuma, anlatone (constituent), ar-turmerone, CUR, Curcuma, Curcuma aromatica, Curcuma aromatica salisbury, Curcuma domestica, Curcuma domestica valet, Curcuma longa, Curcuma longa Linn, Curcuma longa rhizoma, curcuma oil, curcumin, curcuminoids, diferuloylmethane, essential phospholipids, essentiale, EPL, E zhu, Gelbwurzel (German), gurkemeje (Danish), haldi, Haridra (Sanskrit), Indian saffron, Indian yellow root, jiang huang (Mandarin Chinese), kunir, kunyit, Kurkumawurzelstock (German), kyoo (Japanese), lipostabil, Number Ten (NT), Olena, phosphatidylcholine, polyenyl-phosphatidyl choline, polyunsaturated phosphatidylcholine, PPC, radix zedoaria longa, resveratrol, rhizome de curcuma, safran des Indes (French), sesquiterpenoids, shati, Sterpur P-30 Granulat, tumerone, turmeric, turmeric oil, turmeric root, turmerone (constituent), Ukon (Japanese), yellowroot, zedoary, Zingiberaceae (family), zingiberene, Zitterwurzel (German).

Background

• Meriva-SR® is a patented time-release dietary supplement that combines curcumin and phosphatidylcholine. The product is manufactured by Thorne Research, Inc.

• Curcumin is a constituent of turmeric (Curcuma longa). The root of turmeric has long been used in traditional Asian medicine to treat upset stomach, arthritis pain, and fatigue. Laboratory and animal research suggests that turmeric and curcumin may have anti-inflammatory, antioxidant, and anticancer properties. Early human evidence, although poor quality, suggests possible effectiveness in managing indigestion, high cholesterol, and scabies when used on the skin.

• Thorne Research, Inc., claims that Meriva-SR® may offer various health benefits, such as supporting joint health and cardiovascular function, and helping to maintain the body's normal inflammatory response. However, due to a lack of well-designed studies, evidence-based conclusions cannot be made regarding the use of turmeric or curcumin for any specific indication.

• In general, evidence from human and animal studies suggests that curcumin is poorly absorbed into the bloodstream. To improve the absorption, Thorne Research, Inc., combined the curcumin extract with phytosomes, which are plant extracts bound to phosphatidylcholine, an essential component of human cells that is present in almost all cells within the body. The highest concentrations of phosphatidylcholine are found in the brain, heart, liver, and kidneys. Phosphatidylcholine can be made by the body or consumed from foods or supplements isolated from either egg yolk or soybeans.

• When taken by mouth, phosphatidylcholine appears to be very well absorbed, according to human research.

• Results from animal research suggest that curcumin bound with phosphatidylcholine C had five times higher levels in the blood and higher levels in the liver and other tissues, except the gastrointestinal tract, than curcumin that was not bound with phosphatidylcholine.

• Phosphatidylcholine is most commonly used to treat liver conditions. There is evidence of some benefit in the treatment of chronic hepatitis, but further large-scale trials are needed to confirm these early findings. There is also some early evidence to suggest that a slow-release preparation of phosphatidylcholine may be beneficial in the treatment of chronic ulcerative colitis.

• Injectable phosphatidylcholine has been used to try to break down localized fat deposits as an alternative to liposuction. However, there is a lack of high-quality evidence to support this use of phosphatidylcholine.

Theory/Evidence

• Meriva-SR®: Currently, there is a lack of well-designed human studies conducted by third-party researchers to test the safety and effectiveness of Meriva-SR®. However, the manufacturer states that several studies have shown curcumin to have protective effects in the liver, suggesting its use in protecting the liver from harmful environmental toxins, such as over-the-counter medications like acetaminophen.

• Turmeric/curcumin: It has been suggested that curcumin, the active ingredient in Meriva-SR®, may have beneficial effects for various medical conditions. However, supportive evidence from available human studies is unclear or conflicting.

• Antioxidant: In clinical research, a specific component of turmeric (NCB-02) had positive effects on endothelial function and its biomarkers in patients with type 2 diabetes. More well-designed human studies are needed before a conclusion can be made.

• Blood clot prevention: Early research suggests that turmeric may prevent the formation of blood clots. More research is needed to determine if turmeric is effective for this condition.

• Cancer: Several early animal and laboratory studies report that curcumin may have anticancer effects against colon, skin, and breast cancer. The specific way in which turmeric or curcumin exhibits anticancer properties may be due to its antioxidant activity, its prevention of new blood vessel growth, or its direct effects on cancer cells. More research is needed to determine the potential role turmeric or curcumin has in preventing or treating human cancers.

• Cognitive function: Curcumin has been shown to have antioxidant and anti-inflammatory properties and to reduce burden due to plaque buildup in laboratory studies. However, there is currently not enough evidence to suggest the use of curcumin for cognitive performance.

• Dyspepsia (indigestion): Turmeric has been traditionally used to treat stomach problems such as indigestion. Some early evidence suggests that turmeric may offer some relief from these stomach problems. However, at high doses or with extended use, turmeric may actually irritate or upset the stomach. More human studies in this area are needed before a conclusion can be made.

• Gallstone prevention/bile flow stimulant: Early studies report that curcumin may decrease the occurrence of gallstones. Human studies are lacking in this area, and more research is needed before a conclusion can be made.

• High cholesterol:Early studies suggest that turmeric may lower levels of "bad" cholesterol and total cholesterol in the blood. Well-designed human studies are needed before a conclusion can be made.

• HIV/AIDS:Several laboratory studies suggest that curcumin may have activity against HIV. However, reliable human studies are lacking in this area.

• Inflammation: Laboratory and animal studies show anti-inflammatory activity of turmeric and curcumin. Reliable human research is lacking.

• Irritable bowel syndrome (IBS): Early studies suggest that Curcuma xanthorriza may have beneficial effects on IBS compared to placebo. More studies are needed to verify these findings.

• Liver protection: Early research suggests that turmeric may have a protective effect on the liver. More research is needed before any conclusions can be made.

• Oral leukoplakia: Results from laboratory and animal studies suggest that turmeric may have anticancer effects. Human studies are needed before a conclusion can be made.

• Osteoarthritis: Historically, turmeric has been used to treat rheumatic conditions. Laboratory and animal studies show anti-inflammatory activity of turmeric and curcumin, which may be beneficial in people with osteoarthritis. More human research is needed.

• Peptic ulcer disease (stomach ulcer): Turmeric has been used historically to treat stomach ulcers. At high doses or extended use, however, turmeric may actually irritate or upset the stomach. Currently, there is not enough human evidence to make a conclusion.

• Rheumatoid arthritis: Turmeric has been used historically to treat rheumatic conditions, and based on animal research, it may reduce inflammation. More research is needed before a conclusion can be made.

• Scabies: Historically, turmeric has been used on the skin to treat long-lasting skin ulcers and scabies. It has also been used in combination with the leaves of the herb Azadirachta indica ADR, or "neem." More research is needed.

• Uveitis (eye inflammation): Laboratory and animal studies suggest that turmeric and curcumin may have anti-inflammatory activity. Poorly designed human research suggests a possible benefit of curcumin in the treatment of uveitis. Reliable human research is needed before a conclusion can be made.

• Viral infection: Early evidence suggests that turmeric may help treat viral infections. More research is needed before a conclusion can be made.

• Phosphatidylcholine: Currently, there is not enough well-designed human research to determine if phosphatidylcholine is an effective treatment for any medical condition.

• Acute alcoholic hepatitis: Based on available data, it is unclear if phosphatidylcholine is an effective therapy for acute alcoholic hepatitis.

• Chronic active ulcerative colitis: According to human research, phosphatidylcholine is involved in the formation of a protective surface that plays a key role in mucosal defense. Increasing the phosphatidylcholine concentration within the colonic mucus may improve intestinal barrier function and decrease inflammatory activity in ulcerative colitis. However, additional research is needed to confirm these early findings.

• Chronic hepatitis B: In a large human study involving patients with hepatitis B and C, no beneficial effects were seen in the subgroup of patients with hepatitis B. Further exploration of the effects of phosphatidylcholine in this subgroup is needed to fully clarify the possible beneficial effects of phosphatidylcholine in this patient group.

• Chronic hepatitis C:In a human study of patients with chronic hepatitis B and C, treatment with phosphatidylcholine in the subgroup of patients with chronic hepatitis C was associated with an increased response rate compared with placebo. Overall, the results appear promising in this trial. However, more research is needed to confirm the results of this trial.

• Acute viral hepatitis: Early human evidence does not support the use of phosphatidylcholine in the treatment of acute viral hepatitis. Additional research is warranted.

• Fulminant and subacute liver failure:Based on available human evidence, it is unclear if phosphatidylcholine is an effective treatment for liver failure. Additional research is needed.

• HBsAG-negative chronic active hepatitis: A small human study showed promising results with the use of phosphatidylcholine. However, it is unclear whether or not the results translated into clinical benefit.

• Hyperlipoproteinemia (high blood cholesterol and triglycerides):Although early research results are promising, additional studies are needed to determine if phosphatidylcholine is an effective therapy for hyperlipoproteinemia.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

• According to the manufacturer, Meriva-SR® does not contain wheat; gluten; corn; yeast; egg; dairy products or lactose; palmitic acid; magnesium; calcium; vegetable stearates; or artificial colors, sweeteners, or flavors. Meriva-SR® contains phytosome, a soy derivative, but there are no other soy-based ingredients in Meriva-SR®.

• One capsule of Meriva-SR® contains 250 milligrams of curcumin phytosomes (Curcuma longa extract/phosphatidylcholine complex).

• The manufacturer recommends taking one Meriva-SR® capsule three times daily or as otherwise directed by a healthcare practitioner.

• Children and pregnant or lactating women should avoid using Meriva-SR® due to a lack of safety information for this product.

Safety

• General: Patients with known allergies to ingredients in Meriva-SR® (curcumin) should avoid using the product. Children and pregnant or breast-feeding women should also avoid using Meriva-SR® due to a lack of safety information for this product. Use cautiously in people with allergies to plants in the Curcuma genus or to turmeric or any of its constituents (including curcumin), yellow food colorings, or plants in the Zingiberaceae (ginger) family.

• Meriva-SR®: According to the manufacturer, Meriva-SR® is not recommended in those with a history of hypersensitivity to any of its ingredients, which include curcumin phytosomes. Meriva-SR® does not contain wheat; gluten; corn; yeast; egg; dairy products or lactose; palmitic acid; magnesium; calcium; vegetable stearates; or artificial colors, sweeteners, or flavors. Meriva-SR® contains phytosome, a soy derivative, but there are no other soy-based ingredients in Meriva-SR®.

• According to the manufacturer, animal research suggests that curcumin may reduce the effectiveness of cyclophosphamide. Research also suggests that curcumin may decrease camptothecin-induced death of cultured breast cancer cells. Curcumin may also interfere with the absorption and effectiveness of the chemotherapy drug irinotecan, which is used to treat colon cancer. The use of curcumin along with these agents should be avoided.

• According to the manufacturer, there is no known toxicity or problems from curcumin intake during pregnancy. However, the manufacturer recommends consulting a healthcare practitioner before using this product. There is a lack of safety studies evaluating these claims.

• Turmeric/curcumin: Based on historical use, turmeric is generally considered safe when used in amounts commonly found in foods.

• Based on animal studies, turmeric may interfere with the way the body processes certain drugs that use the liver's cytochrome P450 enzyme system. As a result, the blood levels of these drugs may increase and cause increased effects or potentially serious adverse reactions. Patients using medications or supplements should check the package inserts and speak with their healthcare professionals or pharmacists about possible interactions.

• Turmeric may cause an upset stomach, especially in high doses or if taken over a long period of time. Heartburn has been reported in patients being treated for stomach ulcers. Since turmeric is sometimes used for the treatment of heartburn or ulcers, caution may be needed in some patients. Nausea and diarrhea have also been reported.

• Based on laboratory and animal studies, turmeric may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking agents that may increase the risk of bleeding. Dosing adjustments may be needed. Turmeric should be stopped before scheduled surgery.

• Limited animal studies suggest that curcumin may increase liver function enzymes. However, available human studies suggest that turmeric may not affect liver function enzymes. Turmeric or curcumin may cause gallbladder squeezing (contraction) and may not be advised in patients with gallstones. Turmeric may increase the risk of kidney stone formation in people prone to kidney stones.

• In animal studies, hair loss (alopecia) has been reported.

• In theory, turmeric may weaken the immune system and should be used cautiously in patients with immune system deficiencies.

• Turmeric may lower blood pressure levels and may have an additive effect if taken with agents that also lower blood pressure.

• People with diabetes or low blood sugar levels or those taking antidiabetic agents should use turmeric cautiously.

• Historically, turmeric has been considered safe when used as a spice in foods during pregnancy and breast-feeding. However, turmeric has been found to cause uterine stimulation and stimulate menstrual flow. Therefore, caution is warranted during pregnancy. Animal studies have not found that turmeric taken by mouth to cause abnormal fetal development.

• Phosphatidylcholine: Based on historical use and available research, phosphatidylcholine appears to be safe when taken by mouth at recommended doses for up to one year.

• Reported side effects include fatigue, flulike symptoms, limb pain, exanthema, fever, headache, swelling, increased liver enzymes and jaundice (yellowing of the skin and eyes), itching, burning and redness at the injection site, and nausea and vomiting.

• Phosphatidylcholine supplementation is not recommended in pregnant or breast-feeding women due to lack of sufficient data. Phosphatidylcholine is present in human milk.

Author Information

• This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Ireson C, Orr S, Jones DJ, et al. Characterization of metabolites of the chemopreventive agent curcumin in human and rat hepatocytes and in the rat in vivo, and evaluation of their ability to inhibit phorbol ester-induced prostaglandin E2 production. Cancer Res. 2001 Feb 1;61(3):1058-64. View Abstract

2. Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phophatidylcholine. Cancer Chemother Pharmacol (2007) 60:171-177.

3. Meriva Online. www.merivaonline.com

4. Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com

5. [No authors listed] Phosphatidylcholine. Altern Med Rev. 2002 Apr;7(2):150-154. View Abstract

6. Thorne Research. www.thorne.com