toxicity

Woman takes 10x dose of turmeric, gets hospitalized for liver damage

A 57-year-old woman spent six days in the hospital for severe liver damage after taking daily megadoses of the popular herbal supplement turmeric, which she had seen touted on social media, according to NBC News.

The woman, Katie Mohan, told the outlet that she had seen a doctor on Instagram suggesting it was useful against inflammation and joint pain. So, she began taking turmeric capsules at a dose of 2,250 mg per day. According to the World Health Organization, an acceptable daily dose is up to 3 mg per kilogram of weight per day—for a 150-pound (68 kg) adult, that would be about 204 mg per day. Mohan was taking more than 10 times that amount.

A few weeks later, she developed stomach pain, nausea, fatigue, and dark urine. “I just did not feel well generally,” she said.

After seeing a news report about the possibility of toxicity from turmeric, she connected her symptoms to the pills and went to urgent care. Blood tests revealed her liver enzyme levels were 60 times higher than the normal limit, suggesting liver damage. She was admitted to a local hospital and then transferred to NYU Langone in New York City. Her hepatologist there, Nikolaos Pyrsopoulos, said she was “one step before full liver damage, liver failure, requiring liver transplant.”

Rare toxicity

Generally, turmeric—a golden-colored staple of curries—is not harmful, particularly in foods. But, as herbal supplements have gained popularity and doses have gotten larger, doctors have reported a rise in liver injuries from the spice. In fact, while rare overall, turmeric appears to have become the most common herbal cause of liver injuries in the US.

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Urgent questions

And it wasn’t just found in a few samples at each location—in Los Angeles, for instance, it was present in 56 percent of drug samples in September, and 32 percent in Philadelphia. It also wasn’t just found in trace amounts. In a study of 98 samples of BTMPS-tainted fentanyl, 63 percent of samples contained more BTMPS than fentanyl. Fourteen samples had BTMPS levels that were 10 times higher than the fentanyl content.

While it’s unclear why BTMPS, of all chemicals, has shown up in illicit drugs, researchers have some ideas. For one, BTMPS could simply be a cheap bulking agent that allows makers to dilute fentanyl and maximize profits. The substantial amounts of BTMPS in some samples lend weight to this hypothesis. But another possibility is that makers are using the UV-protection feature that the light stabilizer provides to extend the shelf life of drugs.

It’s also possible it’s simply an accidental contaminant, but researchers suspect that, given the rapid and widespread emergence, its addition is deliberate and likely early in the production process.

How BTMPS affects users is another big question. Animal studies suggest that BTMPS can interact with cell receptors in the heart and nervous system. This raises the possibility of cardiotoxic effects, like low blood pressure and cardiovascular collapse, as well as neurological toxicity, such as muscle weakness or dysfunction of the autonomic nervous system, which controls things like heart rate and breathing.

Anecdotal clinical reports link use of BTMPS to blurred vision, pink eye, ringing in the ears, and nausea. There are also reports of skin irritation and burning after injection, and, after smoking, throat irritation, coughing, and coughing up blood.

Researchers say clinical research on the component is now urgently needed, as well as more surveillance.

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