Curcumin is known for its numerous pharmacological properties including, but not limited to, anti-inflammatory and antioxidant effects. Such properties have been shown to benefit a vast range of disease states, and increasing evidence highlights the ability of curcumin to also reduce muscle damage and pain, and enhance recovery and performance in active people via the management of exercise-induced inflammation and its many downstream effects.^1,2

The mechanical stress of muscle contractions during high intensity exercise is known to trigger an inflammatory response in the muscle tissue and the production of reactive oxygen species. The activation of transcription factors such as nuclear factor kappaB (NF-kB) contributes to muscle damage, increased muscle soreness and subsequent reductions in muscle strength.³ Such damage and impairment to muscle function may reduce an individuals’ ability to train, thus compromising overall athletic performance.

A randomised, single-blind, parallel design study evaluated the timing of curcumin ingestion to attenuate eccentric exercise-induced muscle soreness in men. Individuals were assigned to 180 mg/day of oral curcumin for either the 7 days before or the 4 days after exercise, or 180 mg/day of oral placebo for 4 days after exercise. Results showed that curcumin ingestion after exercise significantly improved range of motion and muscle soreness as compared to the control group (p<0.05), whereas curcumin ingestion before exercise did not affect changes in muscle damage markers.⁴

A double-blind, randomised-controlled crossover trial assessed the effect of 150 mg curcumin supplementation immediately following unaccustomed heavy eccentric exercise on selected markers of delayed onset muscle soreness (DOMS). At the end of the trial period, serum markers of muscle damage and inflammation (creatine kinase, alanine aminotransferase and aspartate aminotransferase) and levels of pain were significantly reduced, and total antioxidant capacity significantly higher in the curcumin group as compared to placebo (p<0.05).⁵

Curcumin has several mechanisms of actions relevant to the treatment of muscle symptoms, including the capacity to prevent and reduce delayed onset muscle soreness by blocking the nuclear factor inflammatory pathway, attenuation of muscular atrophy, enhancement of muscle fibre regeneration following injury, and analgesic and antioxidant effects. Curcumin can also increase the levels of cyclic adenosine monophosphate, which leads to an increase in the number of mitochondrial DNA duplicates in skeletal muscle cells.⁶

These findings highlight the need for practitioners to consider the beneficial role of curcumin in supporting muscle function and health, particularly in those patients just starting a new exercise regime or for those who are undertaking regular high intensity exercise.

Practitioners should consider the following treatment approaches:

• Prescribe between 150 mg-200 mg of curcumin per day
• The ideal time is following exercise rather than before, which has been shown to reduce muscle soreness
• To ensure optimal absorption and effectiveness, prescribe a practitioner-grade, highly bioavailable curcumin form such as a phospholipid complex.
• Also consider other factors such as vitamin D levels and supplement as indicated. Vitamin D has important direct effects on skeletal muscle and supplementation has been shown to increase muscle strength, reduced injury rates and improve athletic performance.7 Low levels of vitamin D may also be linked with higher levels of inflammatory markers.8
• Educate patients of the importance of consuming a diet rich in anti-inflammatory, antioxidant and nutrient dense whole-foods. Consumption of adequate dietary protein is also essential to support muscle repair and growth.

 

References

1. Basham, S.A., et al., Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. J Diet Suppl, 2019: p. 1-14.
2. Hewlings, S.J. and D.S. Kalman, Curcumin: A Review of Its' Effects on Human Health. Foods (Basel, Switzerland), 2017. 6(10): p. 92.
3. Garcia-Lopez, D., et al., Effects of eccentric exercise on NF-kappaB activation in blood mononuclear cells. Med Sci Sports Exerc, 2007. 39(4): p. 653-64.
4. Tanabe, Y., et al., Effective Timing of Curcumin Ingestion to Attenuate Eccentric Exercise-Induced Muscle Soreness in Men. J Nutr Sci Vitaminol (Tokyo), 2019. 65(1): p. 82-89.
5. Nakhostin-Roohi, B., et al., The Effect of Curcumin Supplementation on Selected Markers of Delayed Onset Muscle Soreness (DOMS). Annals of Applied Sport Science, 2016. 4(2): p. 25-31.
6. Sahebkar, A., et al., Curcumin: An effective adjunct in patients with statin-associated muscle symptoms? J Cachexia Sarcopenia Muscle, 2017. 8(1): p. 19-24.
7. Abrams, G.D., D. Feldman, and M.R. Safran, Effects of Vitamin D on Skeletal Muscle and Athletic Performance. J Am Acad Orthop Surg, 2018. 26(8): p. 278-285.
8. Yin, K. and D.K. Agrawal, Vitamin D and inflammatory diseases. J Inflamm Res, 2014. 7: p. 69-87.