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, curminoids, diferuloylmethane, E zhu, enhansa, Gelbwurzel (German), gurkemeje (Danish), haldi, Haridra (Sanskrit), Indian saffron, Indian yellow root, jiang huang (Mandarin Chinese), kunir, kunyit, Kurkumawurzelstock (German), kyoo (Japanese), NT, number ten, Olena, radix zedoaria longa, resveratrol, rhizome de curcuma, safran des Indes (French), sesquiterpenoids, shati, turmeric, turmeric oil, turmeric root, turmerone (constituent), Ukon (Japanese), yellowroot, zedoary, Zingiberaceae (family), zingiberene, Zitterwurzel (German).

Background

• Enhansa®, manufactured by Lee Silsby Compounding Pharmacy, is a dietary supplement that contains enhanced-absorption curcumin as the active ingredient. It is available as capsules or a powder and is designed to be taken once or twice daily.

• Curcumin, the compound responsible for the bright yellow color of turmeric (Curcuma longa), is believed to be the principal pharmacological agent.

• In general, evidence from human and animal studies suggests that curcumin may be poorly absorbed into the bloodstream. The manufacturer claims that Enhansa® may be 7-8 times more absorbable than standard curcumin extracts.

• The manufacturer also claims that curcumin may help treat autism spectrum disorders (ASDs) because it reduces the levels of inflammatory markers and other chemicals usually elevated in such diseases. According to the manufacturer, curcumin may increase levels of glutathione, which may be decreased in people with autism or other developmental disorders.

• A clinical trial published in 2011 found that Enhansa® may improve language, reduce developmental delay issues, increase appetite, calm mood, increase immunologic activity, and significantly elevate blood glutathione levels in individuals with autism spectrum disorder and other cognitive, metabolic, immune, and gastrointestinal problems. However, larger-scale studies are necessary to further evaluate these findings.

Theory/Evidence

• Enhansa®: There is currently a lack of third-party research testing safety and effectiveness of Enhansa®. Human and animal evidence suggests that curcumin may be poorly absorbed into the bloodstream.

• The manufacturer claims that Enhansa® may be 7-8 times more absorbable than standard curcumin extracts. However, studies supporting this claim are not identified on the Lee Silsby website, and it is unclear where the information was obtained from.

• The manufacturer claims that curcumin increases glutathione within the cells; reduces inflammatory markers linked to autism; improves liver detoxification; chelates lead and cadmium and protects against mercury toxicity; and acts as an antiviral, antifungal, potential PPAR-gamma agonist, and NF-kappa-B inhibitor.

• A clinical trial of 22 subjects with autism spectrum disorder and other cognitive, metabolic, immune, and gastrointestinal problems found that Enhansa® may improve language, reduce developmental delay issues, increase appetite, calm mood, increase immunologic activity, and significantly elevate blood glutathione levels. Potential side effects may include emotional changes, anxiety, changes in stools, low-grade fevers, rashes, itching and sensitivity to sun exposure. There was one reported drop-out due to IgA nephropathy (kidney disease) symptoms.

• According to the study, Enhansa® is absorbed better when taken with food. The study also suggested taking two even daily doses to help to minimize side effects and ensure even distribution.

• This study was partially funded by the Lee Silsby Compounding Pharmacy, the manufacturer of Enhansa®. Larger-scale, well-designed studies are necessary before firm conclusions can be made.

• Turmeric/curcumin: It has been suggested that curcumin, the active ingredient in Enhansa®, 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 lab 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 research suggests 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 lab 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.

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, Enhansa® is specific carbohydrate diet (SCD) legal and does not contain gluten, casein, soy, sugar, yeast, corn, or egg.

• Enhansa® is available as 150-milligram or 600-milligram capsules or as a powder (small scoop equals 75 milligrams, and a large scoop equals 300 milligrams).

• The manufacturer recommends starting with a low dose of Enhansa® and gradually increasing the dose over several weeks. The manufacturer recommends starting at 150 milligrams daily for one week, followed by 300 milligrams daily for one week (taken in two divided doses), followed by 450 milligrams daily the third week (taken in two divided doses) and stopping at 600 milligrams daily (in two divided doses). Any dose higher than 600 milligrams should be discussed with a healthcare provider.

• Specific dosing for people with liver or kidney disease is not discussed on the manufacturer website and should be discussed with a healthcare provider.

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

Safety

• General: Patients with known allergies to ingredients in Enhansa® (curcumin) should avoid using the product. Children and pregnant or breast-feeding women should also avoid using Enhansa® 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.

• According to the manufacturer, Enhansa® is specific carbohydrate diet (SCD) legal, gluten-free, casein-free, soy-free, sugar-free, yeast-free, corn-free, and egg-free.

• Enhansa®: According to the manufacturer, individuals taking Enhansa® may experience flulike symptoms, rashes, regression, and reactions related to the death of yeast and viruses. These flulike symptoms may last for several weeks, depending on the user's health status, and may reappear at dose adjustments. According to the manufacturer, treatment should not be discontinued if these side effects appear as they are part of the treatment process. However, there is a lack of available research to support this claim.

• According to a clinical trial published in 2011, potential side effects may include emotional changes, anxiety, changes in stools, low-grade fevers, rashes, itching and sensitivity to sun exposure.

• Children and pregnant or breast-feeding women should not use Enhansa® due to lack of safety data.

• 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 causes abnormal fetal development.

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.

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2. Aggarwal BB, Kunnumakkara AB, Harikumar KB, et al. Potential of spice-derived phytochemicals for cancer prevention. Planta Med 2008 Oct;74(13):1560-9. View Abstract

3. Deodhar SD, Sethi R, Srimal RC. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632-34. View Abstract

4. Lee Silsby Compounding Pharmacy Web site. Enhansa® product information. www.leesilsby.com

5. López-Lázaro M. Anticancer and carcinogenic properties of curcumin: considerations for its clinical development as a cancer chemopreventive and chemotherapeutic agent. Mol Nutr Food Res 2008 Jun;52 Suppl 1:S103-27. View Abstract

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

7. Polasa K, Naidu AN, Ravindranath I, Krishnaswamy K. Inhibition of B(a)P induced strand breaks in presence of curcumin. Mutat Res 2004 Feb; 557(2): 203-13. View Abstract

8. Prusty BK, Das BC. Constitutive activation of transcription factor AP-1 in cervical cancer and suppression of human papillomavirus (HPV) transcription and AP-1 activity in HeLa cells by curcumin. Int J Cancer 3-1-2005;113(6):951-60. View Abstract

9. Strimpakos AS, Sharma RA. Curcumin: preventive and therapeutic properties in laboratory studies and clinical trials. Antioxid Redox Signal 2008 Mar;10(3):511-45. View Abstract

10. Taher MM, Lammering G, Hershey C, et al. Curcumin inhibits ultraviolet light induced human immunodeficiency virus gene expression. Mol Cell Biochem 2003;254(1-2):289-97. View Abstract

11. Usharani P, Mateen AA, Naidu MU, et al. Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week study. Drugs R D 2008;9(4):243-50. View Abstract