[1]

姜黃會「傷肝」

早在 10 多年前，日本肝臟學(xué)會就開展了對各種民間藥物及健康食品所誘發(fā)的「藥物性肝功能損害」的調(diào)查。

所謂藥物性肝損害，顧名思義就是服用藥物或含有藥物成分的食物導(dǎo)致的肝臟損害。而這項調(diào)查的結(jié)果可能讓太多人震驚：

導(dǎo)致藥物性肝損的原因很多，但其中名列第一的就是——姜黃。（如下圖）

統(tǒng)計顯示，誘發(fā)藥物性肝損的食物 / 藥物 69 類 117 種當(dāng)中，姜黃占比竟然高達(dá) 24.8%，接近四分之一，這是一個非常高的比例。

這項調(diào)查中還報告了 3 例死亡事件，其中一例是姜黃所導(dǎo)致的爆發(fā)性急性肝炎致全身多臟器衰竭而死。

受到這項調(diào)查的影響，日本肝膽科醫(yī)生形成了普遍共識：

姜黃是一種需要當(dāng)心的東西。

姜黃補(bǔ)充劑里還有其他「傷肝成分」

之所以要警惕姜黃類補(bǔ)充劑，還有一個原因是——姜黃類補(bǔ)充劑常含有較多的鐵。

很多人知道補(bǔ)鐵可以預(yù)防缺鐵性貧血，但凡事都有個度，如果攝入的鐵過多，就會損傷肝細(xì)胞，甚至提高肝硬化、肝癌的風(fēng)險。

其實都不用說如此嚴(yán)重的情況，很多服用姜黃補(bǔ)充劑的脂肪肝患者去驗血之后就會發(fā)現(xiàn)鐵超標(biāo)，這是值得警惕的。

上述內(nèi)容來自【1】

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【不良反應(yīng)與副作用】毒理學(xué)研究表明，姜黃有一定的致畸變作用，可能與姜黃根素有關(guān)。動物試驗表明，長期服用姜黃制劑可以使子宮內(nèi)膜萎縮、解體，睪丸重量以及睪酮明顯下降。臨床中暫無此類不良反應(yīng)的報道，但有報道稱，服用姜黃煎劑后可以使血壓升高。

上述內(nèi)容來自【2】

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Hormonal alterations: Studies have shown that curcumin is capable of modulating the function of hormonal systems in the body. ?In cases of abnormally high estrogen (such as among those with Endometriosis), curcumin has been shown to reduce estradiol production and secretion. ?Therefore, it is possible that when taken at high doses and/or by certain users, decreases in the production of certain hormones may be unfavorable and lead to an array of side effects. ?If you notice major fluctuations in hormone levels after supplementing with curcumin, it may be more than just a coincidence – curcumin could be the culprit.[3]

Source: http://www.ncbi.nlm.nih.gov/pubmed/24639774
Hot flashes: Along with facial flushing and feverish feelings, some people experience hot flashes from curcumin supplementation. ?Hot flashes are characterized by brief, yet sudden, flash of heat throughout the body and/or in a specific region of the body. ?If you perceive intermittent temperature increases throughout your body, but don’t have a fever, you may be experiencing hot flashes as a result of curcumin supplementation. ?In some cases, hot flashes may occur during the first few days of supplementing and then subside after a week or two as the body adapts to supplementation.[3]

Itchiness: In the event that you were allergic to curcumin and/or a concomitant ingredient within a curcumin supplement, you may feel itchy. ?Those that are allergic to curcumin will likely become itchy on the very first day (or two) of supplementation. ?This itching may vary in its intensity from mild to severe, but usually occurs throughout the entire body. ?Some users may report greater severity of itchiness in certain bodily regions. ?In many cases, the itchiness is also accompanied by a skin rash (spots, blotches, etc.).[3]

Low blood sugar: If you have diabetes, you may notice irregularities in your blood sugar after supplementing with curcumin. ?It is believed that curcumin could lower levels of blood sugar, possibly causing hypoglycemia. ?Some speculate that curcumin may also act synergistically with other medications to reduce blood sugar, thereby amplifying preexisting blood sugar reduction (from those medications). ?Although a significant reduction in blood glucose from curcumin supplementation is unlikely, it may occur in certain users – especially among those with diabetes.[3]

Low testosterone: There is some speculation that curcumin could slightly reduce the production of androgens within men. ?In other words, curcumin supplements may reduce testosterone levels, which in turn may be an unwanted effect. ?Furthermore, some evidence suggests that curcumin supplementation may alter functionality of the male reproductive system and may decrease sperm motility.[3]

Nausea: Clinical studies note that individuals supplementing with 3.6 to 8 grams of curcumin per day for a 4-month period experienced mild nausea as a side effect. ?That said, 3.6 to 8 grams of curcumin per day is considered a relatively high dosage for supplementation. ?If you are on a high dose regimen of curcumin supplementation and notice the onset of mild nausea, you could simply reduce the dosage until the nausea subsides.

面部潮紅和發(fā)燒，發(fā)癢、低血糖、睪丸激素水平低、每天3.6~8g是比較高的劑量。

上述內(nèi)容來自【3】

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Liver and Gallbladder Problem
The liver and the gallbladder, two of the most significant organ of the digestive system, may be poisoned by excess intake of Curcumin. According to the Linus Pauling Institute at Oregon State University, it may cause the gallbladder to contract, sometimes called the gallbladder squeezing. Curcumin increases the flow of bile produced by the liver. It provokes the gallstone problem by washing out the gallstone out of the gallbladder and causes obstruction in the bile duct. It now results to a gallbladder attack and it happens due to increase in the flow of bile from the liver.(肝臟和膽囊是消化系統(tǒng)最重要的兩個器官，過量攝入姜黃素可能會導(dǎo)致中毒。根據(jù)俄勒岡州立大學(xué)萊納斯·鮑林研究所的研究，它可能導(dǎo)致膽囊收縮，有時稱為膽囊擠壓。姜黃素增加肝臟產(chǎn)生的膽汁流量。它通過沖洗膽囊中的膽石引起膽結(jié)石問題，并導(dǎo)致膽管阻塞。現(xiàn)在它導(dǎo)致膽囊病發(fā)作，發(fā)生的原因是來自肝臟的膽汁流量增加)

上述內(nèi)容來自【4】

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“A relatively high number of reports suggests that curcumin may cause toxicity under speci?c conditions. In 1976 Goodpasture and Arrighi found that turmeric caused a doseand time-dependent induction of chromosome aberrations in several mammalian cell lines; these alterations were observedat concentrations of 10 lg mL-1. .1Accumulating data have demonstrated since then that curcumin can induce DNA damage and chromosomal alterations both in vitro and in vivo at concentrations similar to those reported to exert bene?cial effect.2–10[4]

For instance, curcumin concentrations of 2.5 and 5 lg/mL?were shown to induce DNA damage to both the mitochondrial and nuclear genomes in cells.8 .These reports raise concern about curcumin safety, as the induction of DNA alterations is a common event in carcinogenesis.”[4]

(可能會導(dǎo)致DNA損傷)

Pregnancy and breastfeeding – It is advised that you consult with your doctor if you are considering taking turmeric when pregnant or breastfeeding. Turmeric is likely to be safe when taken in small doses, such as the typical dosage added to food (roughly 1.4 grams). But, if you are taking turmeric for medicinal purposes during pregnancy, then this is not advised as turmeric may stimulate your uterus and result in miscarriage. There is no substantial evidence that notes the side effects of turmeric and breastfeeding, however, some experts may advise against the use of it until the substance is further explored in women who are breastfeeding.（婦女咨詢醫(yī)生，1.4g以內(nèi)添加到食物中是安全的）

8. Contractions
Though there isn’t any real evidence that it would be harmful – turmeric is forbidden in pregnancy and breastfeeding.

In fact, scientists say that consuming turmeric as a spice during pregnancy is totally harmless.

However, there’s a reason why the supplements aren’t allowed in pregnancy.

The reason why: In a higher dose, turmeric was proved to stimulate uterine contractions.

During pregnancy, this would be extremely dangerous because it would mean risking the baby’s life.

So if you experience joint pain at that time, it’s best to talk to your doctor instead of taking any supplement.

When it comes to breastfeeding – there aren’t many reports or information. Scientists don’t know yet if turmeric would pass through breast milk, and this means it’s better to stay away from it.(懷孕期間不得服用姜黃，必須遵醫(yī)囑)[6]

Curcumin is being recognized and used worldwide in many different forms for multiple potential health benefits. For example, in India, turmeric—containing curcumin—has been used in curries; in Japan, it is served in tea; in Thailand, it is used in cosmetics; in China, it is used as a colorant; in Korea, it is served in drinks; in Malaysia, it is used as an antiseptic; in Pakistan, it is used as an anti-inflammatory agent; and in the United States, it is used in mustard sauce, cheese, butter, and chips, as a preservative and a coloring agent, in addition to capsules and powder forms. Curcumin is available in several forms including capsules, tablets, ointments, energy drinks, soaps, and cosmetics [2]. Curcuminoids have been approved by the US Food and Drug Administration (FDA) as “Generally Recognized As Safe” (GRAS) [2], and good tolerability and safety profiles have been shown by clinical trials, even at doses between 4000 and 8000 mg/day [18] and of doses up to 12,000 mg/day of 95% concentration of three curcuminoids: curcumin, bisdemethoxycurcumin, and demethoxycurcumin [19].(4-8g之間基本是安全劑量，上述內(nèi)容來自【7】)

piperine is the major active component of black pepper and, when combined in a complex with curcumin, has been shown to increase bioavailability by 2000%（姜黃和黑椒一起服用,查了其他資料，準(zhǔn)確的應(yīng)該是胡椒堿black pepper extract）

3. Avoid if suffering from gallstones or gallbladder obstruction
Studies report that low dose curcumin can cause gallbladder contraction in humans. (Read Is it safe to take turmeric if suffering from gallstones?) 40 mg curcumin can bring about 50% gallbladder contraction.

Now this action of curcumin is beneficial in preventing gallstone formation. However if already suffering from gallstones or bile duct obstruction, a contraction of this sort can cause severe pain.

Therefore it is advised to avoid curcumin supplements in gallstone or gallbladder obstruction.

4. Use turmeric with caution in case of gout or kidney stones
Now, this precaution does not stand for curcumin supplements, but its mention is noteworthy. Turmeric as a spice is high in oxalates and hence it should be avoided in case of gout or if one is susceptible to developing kidney stones.

However, curcumin supplements are extracted and purified to a level that oxalates are minimal and non toxic.

Therefore for therapeutic purposes in case of kidney stones and gout, it is advisable to take curcumin supplements over turmeric as a spice.

For more details on this read: Does Turmeric Cause Kidney Stones? Is it safe to take Turmeric In Gout?（

如果患有膽結(jié)石或膽囊阻塞，請避免

研究報告稱，低劑量姜黃素可導(dǎo)致人類膽囊收縮。（如果患有膽結(jié)石，服用姜黃安全嗎？）40毫克姜黃素可以使膽囊收縮50%。

現(xiàn)在姜黃素的這種作用有利于防止膽結(jié)石的形成。然而，如果已經(jīng)患有膽結(jié)石或膽管阻塞，這種收縮會引起劇烈疼痛。

因此，建議避免在膽結(jié)石或膽囊梗阻時補(bǔ)充姜黃素。

4痛風(fēng)或腎結(jié)石時小心使用姜黃

現(xiàn)在，這一預(yù)防措施并不代表姜黃素補(bǔ)充劑，但值得一提的是。姜黃作為一種香料含有大量的草酸，因此在痛風(fēng)或容易患腎結(jié)石的情況下應(yīng)避免使用。

然而，姜黃素補(bǔ)充劑被提取和純化到草酸鹽含量最低且無毒的水平。

因此，對于腎結(jié)石和痛風(fēng)的治療目的，建議服用姜黃素補(bǔ)充劑，而不是姜黃作為香料。

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Reference:

【1】姜黃號稱解酒又護(hù)肝，真相卻是可能傷肝！_姜黃素

【2】中藥姜黃的副作用與禁忌_姜黃的危害與不良反應(yīng)_養(yǎng)生之家

【3】Curcumin Side Effects & Adverse Reactions (List) - Mental Health Daily

【4】Curcumin Side Effects

【5】What are the side effects of Turmeric (Curcumin)?

【6】Top 9 Side Effects Of Turmeric & Curcumin Supplements - Cure My Joint Pain

【7】姜黃號稱解酒又護(hù)肝，真相卻是可能傷肝！

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