When Plants Harm: A Real Case of Turmeric-Induced Liver Injury
understanding risk, pharmacology, and what this case teaches us about safe, responsible herbalism.
A recent news story caught my attention. A woman was hospitalized with liver damage after taking high-dose turmeric supplements for wrist pain. She had seen turmeric promoted online as a natural way to reduce inflammation.
But instead of relief, she developed jaundice, dark urine, and liver enzyme levels that were sixty times higher than normal.
She came very close to needing a liver transplant.
These are the kinds of headlines that stir fear. And understandably so. Liver injury is serious. But as herbalists, these stories should also push us to think critically. What exactly went wrong? Was it the turmeric itself? The dose? The form? Or was it the absence of guidance?
Too often, herbs are treated like harmless wellness add-ons. But the reality is more nuanced. Turmeric is not just a colorful spice or trendy capsule. It is a potent medicinal plant with a long history, a complex chemistry, and a wide range of actions in the body.
This isn’t about blaming the individual.
It’s also not about blindly defending the herb.
It’s about understanding how traditional medicines are being pulled out of context and sold as quick-fix solutions without the education that should go with them.
A Quick Look at the Case
Katie Mohan, a 57-year-old woman from New Jersey, began taking turmeric capsules after seeing them promoted online as a natural remedy for wrist pain and inflammation. But instead of relief, she began to feel increasingly unwell. Her urine darkened. Her skin took on a yellow tint. Something wasn’t right.
After a visit to urgent care, lab results showed her liver enzymes were sixty times above normal. She was hospitalized, then transferred to NYU Langone, where she spent six days on IV treatment. Her doctors shared that she had come dangerously close to needing a liver transplant.
Katie had been taking 2,250 mg of turmeric extract daily. That’s more than double what’s typically considered a safe upper limit for curcumin extracts, depending on the product. She hadn’t been warned. Like many, she believed “natural” meant safe. No practitioner was involved. No one had helped her determine whether this dose was appropriate. She simply followed what she saw online.
This isn’t an isolated case. According to the National Library of Medicine, turmeric is now one of the leading causes of herb-related liver injury in the United States.
You can read the full article from NBC News here.
Why This Matters for Herbalists
These are the kinds of headlines that shape public perception of herbal medicine. And they can be frustrating—because on one hand, they serve as important warnings. But on the other, they often strip herbs of their context and reduce complex stories to simple conclusions like “turmeric is dangerous” or “supplements can’t be trusted.”
The reality is more nuanced. Turmeric isn’t inherently harmful. But like any powerful plant, it has to be used properly. Dose matters. Preparation matters. So does the individual taking it.
As herbalists, this is where we come in. We can offer the clarity and education that are often missing from the supplement aisle. That starts with going back to the plant itself.
A Closer Look at Turmeric: Tradition, Modern Hype, and What’s Actually Inside
Before we get into what went wrong in the liver injury case, it’s worth stepping back and taking a closer look at the plant itself. What is turmeric, really? Why has it been used in medicine for thousands of years, and how did it become one of the most talked-about supplements in the wellness world?
From Kitchen Spice to Capsule
Turmeric has a long and sacred history in many traditional medicine systems. In Ayurveda, it was used to support digestion, soothe inflammation, clear the skin, and protect the liver. It was applied to wounds, infused into food, and prepared with ghee and warming spices to help the body absorb its benefits. Unani and traditional East and Southeast Asian medicine systems also used turmeric as both food and medicine, woven into daily life through ritual and routine.
Its golden color wasn’t just symbolic. It was medicinal. Turmeric wasn’t viewed as a supplement or a quick fix. It was part of a much larger framework of healing.
Today, that picture looks a bit different. Curcumin, the compound most commonly extracted from turmeric, is now sold around the world in capsules, powders, drinks, skincare, and more.
In India, turmeric is still used in curries. In Japan, it’s brewed into tea. In Malaysia, it’s applied as an antiseptic. In Korea, you’ll find it in functional drinks. In Thailand, it’s added to beauty products. In Pakistan, it’s used to reduce inflammation. And in the United States, turmeric shows up in mustard, cheese, and chips…and now in concentrated capsules that promise everything from joint relief to brain support.
Curcumin has been classified as “Generally Recognized As Safe” (GRAS) by the FDA, and some studies have shown that even very high doses—up to 8,000 or even 12,000 mg of concentrated curcuminoids—can be tolerated under clinical supervision. But that doesn’t mean those doses are safe or appropriate for everyday use. What we tolerate short term isn’t always what’s wise to take long term, especially without context or practitioner support.
Curcumin Isn’t the Whole Story
Turmeric (pronounced tur-mer-ik) comes from the rhizome of Curcuma longa, a plant in the ginger family native to India and now cultivated throughout Southern Asia and Central America. It has been used for thousands of years in traditional systems like Ayurveda and Unani for everything from liver support and wound healing to digestion and inflammation.
In modern wellness spaces, though, turmeric is often reduced to just one compound: curcumin.
Curcumin, along with its relatives demethoxycurcumin and bisdemethoxycurcumin, makes up only about 1 to 6 percent of the dried rhizome. These are collectively referred to as curcuminoids, and while they do have notable antioxidant and anti-inflammatory actions, they are not the whole picture.
In fact, many supplement labels use “curcumin” interchangeably with “turmeric,” which can be misleading.
Turmeric is far more chemically complex. In addition to curcuminoids, it contains:
Essential oils like turmerone, zingiberene, and ar-turmerone, which contribute to antimicrobial and anti-inflammatory effects. These compounds may also offer synergy when the whole rhizome is used, rather than isolated extracts.
Starches, proteins, fiber, vitamins, and minerals that influence both its traditional uses and how it’s absorbed in the body.
Other polyphenols and terpenes, especially in fresh or minimally processed turmeric.
Many of turmeric’s proposed effects—such as antioxidant support, liver protection, and even antitumor activity—are now being explored in research. But findings are mixed. Outcomes vary widely due to inconsistent supplement quality, differing curcuminoid concentrations, and turmeric’s naturally low bioavailability when taken alone.
That’s why many products include piperine (from black pepper) or use lipid-based delivery systems to improve absorption. However, these additions can also change how turmeric behaves in the body, sometimes in unpredictable ways.
So, while curcumin may be the most researched component, it's only one part of a much broader plant profile.
If we want to use turmeric as true medicine, we need to understand the whole plant not just the compound that made it famous.
Revered Doesn’t Mean Risk-Free
In traditional medicine, turmeric wasn’t taken as a daily pill. It was mixed with food, warmed in milk, or prepared in teas alongside other herbs. It was used thoughtfully, seasonally, and often in small, consistent amounts.
Today’s supplements are different. High-dose extracts are often taken every day, long-term, and without much thought to bioavailability or liver metabolism. These concentrated forms can behave more like pharmaceuticals than culinary herbs. Curcumin is processed by the liver, and when that system becomes overwhelmed—whether because of dose, duration, or underlying health conditions—side effects can appear.
Turmeric is not a dangerous plant. But it is potent. And like any potent herb, it deserves respect. Context matters. Dose matters. And the form in which we take it changes how it acts in the body.
Mechanism of Injury
So, what’s actually going on here? How can a plant like turmeric, used for centuries in both food and medicine, end up causing liver damage in certain people?
This type of reaction appears to be what we call idiosyncratic.
That means it doesn’t happen to everyone, and it’s not always related to how much was taken. Instead, it’s likely tied to how an individual’s immune system responds. These are the kinds of reactions that are hard to predict, and they often involve genetic susceptibility.
Recent research has found a strong connection between turmeric-induced liver injury and a specific genetic marker known as HLA-B*35:01. More than 70 percent of people who experienced this kind of liver damage carried that gene, compared to only 10 to 15 percent of people in control groups. This suggests that turmeric may trigger the immune system in people with this marker in a way that causes liver inflammation.
One theory is that curcumin, or one of its breakdown products, may bind to the surface of liver cells and alter how they appear to the immune system. This could cause T cells to mistakenly see those liver cells as harmful, setting off an immune response that leads to damage.
Interestingly, the same genetic marker has been linked to liver reactions from other herbs that contain high levels of polyphenols, such as green tea, Garcinia cambogia, and fo-ti (Polygonum multiflorum).
Proposed mechanism of EGCG-induced liver injury (DILI, or Drug-Induced Liver Injury) in individuals with the HLA-B35:01 gene variant. This same gene has been linked to turmeric-induced liver injury, suggesting a shared immune-mediated pathway among certain polyphenol-rich herbs.
While these herbs can offer real benefits, they also carry risks for certain individuals, especially in extract form or when combined with other stressors like medications or existing liver strain.
This doesn’t mean turmeric is inherently dangerous. It means we need to respect its potency and remember that even widely used herbs can affect people differently depending on their genetics, health status, and how the herb is prepared and taken.
How to Use Turmeric Safely
Turmeric has a long-standing reputation as a safe and beneficial plant. It’s been used in food, in medicine, and in ceremony across cultures for centuries. But like all powerful herbs, the details matter. The dose, the preparation, the person taking it, and the context in which it’s used all determine whether it brings healing or harm.
Understanding Safe Doses
Curcumin, the main active compound extracted from turmeric, has been evaluated by both the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and the European Food Safety Authority (EFSA). Both organizations have set the acceptable daily intake (ADI) for curcumin at 0 to 3 milligrams per kilogram of body weight. For a 150-pound adult, that works out to about 200 milligrams per day.
Compare that to the dose reported in the liver injury case. The woman at the center of that story was taking 2,250 milligrams per day of a curcumin extract. That’s more than ten times the upper limit of what is considered safe by international food safety bodies. She wasn’t taking turmeric in food. She wasn’t guided by a practitioner. She saw something marketed online and followed the suggestion without knowing how it might affect her body.
This is why herbal safety education matters. Natural does not mean risk-free. And when you’re working with an extract that concentrates a single compound from a whole plant, you are not dealing with the same chemistry or actions as the traditional preparation.
There’s been a growing movement to reclaim herbalism by calling it “the original medicine.” And that’s true. But if we are going to use that language, we have to treat it accordingly.
hat means understanding the pharmacognosy of the herb, the study of how plant constituents act in the body, as well as the pharmacokinetics (how it's absorbed, distributed, and metabolized) and pharmacodynamics (what it actually does once it’s there). You can’t treat herbs like medicine without taking the time to understand them at that level.
Herbalism is a clinical skill. It’s a trade that requires study, respect, and nuance. If we ignore that, we risk outcomes like the one we’re seeing in this case. And we risk having stricter laws and regulations imposed that could limit access for everyone.
What the Research Tells Us About Safety
Clinical trials have consistently shown that curcumin is generally well tolerated in humans. Doses between 500 milligrams and 12 grams have been studied in both short- and long-term settings. Reported side effects include nausea, diarrhea, headache, rash, abdominal discomfort, and yellow-colored stool. Most of these effects were mild and self-resolving.
In longer-term studies lasting one to four months, some participants showed mild increases in liver enzymes such as alkaline phosphatase and lactate dehydrogenase. These lab changes didn’t always lead to symptoms but do remind us that even widely used herbs can impact organ systems when used at therapeutic doses.
Across clinical trials, the most commonly reported adverse effects included indigestion, bloating, dizziness, restlessness, itching, and gastrointestinal discomfort. No participants required medication to manage these effects, and many formulations were shown to be beneficial—particularly for joint pain, muscle soreness, and inflammation—without serious safety concerns.
Not All Curcumin Is Created Equal
One of the challenges in evaluating curcumin safety is that not all products are the same. Some studies used water-dispersible turmeric extracts, others used curcuminoid-essential oil complexes, and some used nanomicelle or bio-optimized forms that significantly increase absorption.
Formulations that enhance bioavailability can deliver more curcumin to the bloodstream with lower doses. This can be helpful, but it also increases the potential for adverse effects in people who are sensitive or already managing liver or kidney issues. It is essential to understand what form you're taking, how much actual curcumin it contains, and whether it has added piperine (black pepper extract), which can amplify both benefits and risks.
For example, water-dispersible turmeric extracts have been shown to improve muscle soreness at doses as low as 250 milligrams per day. Nanomicelle forms can be effective in even smaller amounts. The takeaway is that more is not always better—especially when you are using a formulation designed to push absorption higher than what the body might naturally process.
Curcuma longa
Acknowledging the Controversies
While curcumin is often seen as a therapeutic golden child, not all researchers are convinced. A paper titled "The Dark Side of Curcumin" raised concerns about its potential to cause DNA damage, disrupt mitochondria, and interfere with liver detox enzymes at high doses. Some researchers have argued that curcumin may not be suitable as a lead compound in drug development due to its chemical instability, low bioavailability, and potential to interfere with multiple cell signaling pathways in unpredictable ways.
It’s also been flagged as a “PAINS” (pan-assay interference) compound, which refers to substances that produce false-positive results in drug screening due to their chemical reactivity.
However, these critiques have been met with strong rebuttals from the scientific community. In 2015, the Curcumin Resource Database (CRDB) was created to catalog over 9,000 published studies, hundreds of patents, and nearly 200 identified molecular targets. Curcumin may not be a flawless drug candidate, but that does not erase the clinical value it has demonstrated in real-world applications particularly when used thoughtfully and within appropriate contexts.
The Bottom Line
Turmeric is not something to be afraid of. But it is not something to take casually either. It is a powerful plant that deserves to be understood for what it is—not just promoted for what it might do.
If you are considering using turmeric or curcumin as a supplement, especially in extract form, here are a few basic guidelines:
Work within recommended dosing ranges (typically 150 to 500 milligrams of curcumin daily) unless advised otherwise by a qualified practitioner.
Be cautious with high-bioavailability formulations, especially those containing piperine.
Pay attention to signs of digestive distress, skin irritation, or changes in liver enzymes if you are taking it regularly.
Choose whole-root preparations or food-based forms when using turmeric long term.
Always consider the full health picture, including medications, liver health, and genetic predispositions.
This is where trained herbalists come in. Our role is to understand both the tradition and the science, and to help people navigate this kind of decision-making with confidence and care.
Herbalism Is Medicine. Treat It That Way.
To reiterate what we’ve explored throughout this piece, turmeric is not inherently dangerous. The harm comes from how it’s used, how it’s marketed, and how often it’s taken without any real understanding of its complexity. When you take a powerful herb out of context and treat it casually, you risk not only individual safety but the credibility and future of herbal practice as a whole.
If we’re going to call herbalism the “original medicine,” then we need to treat it like medicine. That means understanding not just the plants, but also the people we’re working with. It means being well-versed in anatomy, physiology, pathophysiology, and pharmacology. It means asking how a plant is metabolized, how it’s eliminated, what cells it interacts with, and what phytoconstituents are driving its actions.
Practicing herbalism recklessly—or without serious, informed consideration—puts us all at risk. Cases like this one get turned into headlines. Headlines become fuel for regulation. And when laws are passed in response to preventable harm, they don’t just impact the person who made the mistake. They impact everyone trying to do this work responsibly.
This might be an unpopular opinion, but it needs to be said. If you are practicing herbalism without a strong foundation in the body sciences, it’s time to pause and fill in those gaps. Don’t rely on surface-level education that stops at “Chamomile is good for anxiety.” Ask why. What is the plant doing in the body? How does it modulate neurotransmission, and through which compounds? What pathways does it influence? What risks does it carry for certain populations?
As herbalists, we are working with human bodies. And we owe it to our clients, our communities, and our lineage of practice to do so with care, clarity, and competence.
Herbalism is a clinical craft. It is not just a spiritual path, not just a lifestyle trend, and not just a collection of folk remedies. It requires study. It demands discernment. And if we want to keep it accessible, we have to protect its integrity.
Turmeric is powerful. Most herbs are. That’s why they work. But with that power comes responsibility. Let’s rise to meet it.
If you found this piece helpful, insightful, or worth sharing, I’d love for you to leave a comment, like the post, or give it a restack so others can find it too. And if you’ve been learning from this space and want access to deeper resources, consider becoming a paid subscriber. It helps keep this work going and supports thoughtful, nuanced herbal education rooted in both tradition and science.
Until next time,
— Agy | The Buffalo Herbalist
Bibliography
Concerns over rise in supplement-induced liver injuries. (2025, July 9). [Video]. NBC News. https://www.nbcnews.com/health/health-news/liver-damage-turmeric-supplement-woman-hospitalized-rcna217578
Safety and Efficacy of Turmeric (Curcuma longa) Extract and Curcumin Supplements in Musculoskeletal Health: A Systematic Review and Meta-Analysis. (2023, September 1). PubMed. https://pubmed.ncbi.nlm.nih.gov/37574203/
Hewlings, S., & Kalman, D. (2017). Curcumin: A review of its Effects on Human health. Foods, 6(10), 92. https://doi.org/10.3390/foods6100092
National Institute of Diabetes and Digestive and Kidney Diseases. (2025, June 16). Turmeric. LiverTox - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK548561/
Sharifi-Rad, J., Rayess, Y. E., Rizk, A. A., Sadaka, C., Zgheib, R., Zam, W., Sestito, S., Rapposelli, S., Neffe-Skocińska, K., Zielińska, D., Salehi, B., Setzer, W. N., Dosoky, N. S., Taheri, Y., Beyrouthy, M. E., Martorell, M., Ostrander, E. A., Suleria, H. a. R., Cho, W. C., . . . Martins, N. (2020). Turmeric and its major compound curcumin on Health: Bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.01021
This is why I don’t recommend supplements, even though it’s a huge part of natural health promotion. You don’t know what you’re getting. Consuming the plant as a whole in teas, foods and even tinctures provides the benefits of all the compounds working synergistically. Isolating the compounds for supplements basically turns it into a drug. I have read about green tea supplements with high amounts of EGCG causing liver damage. I’d rather drink a cup of matcha or put it in a smoothie. The best way to use plants medicinally is in your daily habits, as you mentioned the “Asian medicine systems also used turmeric as both food and medicine, woven into daily life through ritual and routine.” Here in the U.S. everything has to be made a commodity.
Thank you so much for this! Here I am making herbal remedies like a happy hippie and checked the turmeric I take for my rheumatoid arthritis. If I had been taking all three capsules as recommending I would have been on the 2250mg product!Great callout.