Possible hepatotoxicity with oral turmeric- or curcuminoid-containing NHPs

Health Canada’s review of safety information for turmeric- or curcuminoid-containing Natural Health Products (NHPs) has revealed a possible link with the risk of hepatotoxicity. Occasionally, it can progress to more severe complications, including liver failure.The safety review was triggered by rare cases of hepatotoxicity with oral turmeric- or curcuminoid-containing health products reported to international regulatory authorities and in published scientific literature. Turmeric mainly comes from the rhizome of the Curcuma longa plant, which is native to Asia and belongs to the ginger family. Curcuminoids, such as curcumin, are the active compounds in turmeric. They are extracted from the rhizome and used in NHPs. Curcuminoids have antioxidant effects and other potential health benefits.Health Canada’s safety review included information provided by foreign regulatory agencies, as well as from searches of the Canada Vigilance database, the World Health Organization’s adverse drug reaction database and the scientific literature.Twelve Canadian cases of hepatotoxicity in patients using either turmeric- or curcuminoid-containing NHPs orally were included in the review. All 12 cases had insufficient clinical information and/or the presence of confounders, such as underlying medical conditions and use of other medications and NHPs that are known to affect the liver, which limited further assessment. However, a link to the use of the product could not be ruled out.Health Canada also reviewed over 60 international case reports of hepatotoxicity in persons using turmeric- or curcuminoid-containing health products orally. Three deaths were reported and two of these were attributed to hepatotoxicity linked with the oral turmeric- or curcuminoid-containing health product.Although cases of hepatotoxicity are rare and the underlying cause is often unclear, Health Canada determined that the reports reviewed suggest a possible link between the use of oral turmeric or curcuminoids and the risk of hepatotoxicity under conditions similar to how these products are used in Canada.The risk of hepatotoxicity associated with turmeric- or curcuminoid-containing NHPs appears to be idiosyncratic (i.e., not dependent on dose or duration of use, and unpredictable in onset with risk factors not fully known). In most cases, the hepatotoxicity was reversible once use of the product was stopped.No safety concerns have been identified for turmeric when it is used as a culinary spice and consumed in food in typical dietary amounts, or when used topically or as a colouring agent in NHPs. Therefore, Health Canada’s safety review does not apply to turmeric or curcuminoids consumed as foods, applied topically or used as colouring agents.Turmeric- and curcuminoid-containing NHPs are authorized in Canada to help relieve joint pain and inflammation, and as a source of antioxidants. Turmeric and curcuminoids can also be used in herbal products to help with digestion or protect the liver, or in traditional Chinese medicines.More than 3,000 turmeric- or curcuminoid-containing NHPs for oral use are authorized by Health Canada. They are available in various dosage forms (capsules, tablets, powders and liquids), preparations, and in combination with various ingredients. Most of these products are not authorized for use by individuals under 18 years of age. They are also not recommended for use by individuals with biliary disorders (gallbladder and/or bile ducts).Health Canada concluded that their review found a possible link between the oral use of either turmeric- or curcuminoid-containing NHPs and the risk of hepatotoxicity. As a result, Health Canada will update the monographs for turmeric and curcuminoids to include the risk of hepatotoxicity. Licence holders will also be required to update the risk information on product labels for all licensed turmeric- or curcuminoid-containing NHPs to:Add information about the warning signs and symptoms of hepatotoxicity, including yellowing of the eyes or skin, dark urine, nausea, vomiting and stomach painAdvise consumers to stop using these products and consult a healthcare professionals if symptoms occur, andAdvise consumers to consult a healthcare professional before using any of these products if they have a liver disorder or are taking medications.Health Canada plans to inform healthcare professionals and consumers about these updates through a Health Product InfoWatch communication and a social media campaign. Note that international regulators in Australia, Italy and France have also implemented a number of regulatory actions, such as label updates for oral turmeric- or curcuminoid-containing health products to include the risk of hepatotoxicity and safety alerts to inform consumers of the risk.Reference:Government of Canada. Summary safety review - turmeric and curcuminoids for oral use - assessing the potential risk of hepatotoxicity. October 3, 2025. (accessed October 7, 2025).

Possible hepatotoxicity with oral turmeric- or curcuminoid-containing NHPs

Register for free access or login.

Related Topics

Business Topic