Of Mice and Men...and Turmeric and Menopause

How rodent studies and weak science are driving the menopause supplement boom

PAVEL IARUNICHEV/Getty Images

Turmeric has been in the news, or rather, complications from turmeric supplements, as 57-year-old Katie Mohan told NBC News her story about turmeric-induced liver injury, which multiple news sites have since picked up. Ms. Mohan’s age is relevant given the highly targeted marketing of turmeric supplements to women for menopause-related symptoms. There has been a rise in liver injury associated with turmeric/curcumin supplements, and this appears to coincide with the introduction of products designed to enhance the absorption of turmeric or curcumin.^1-4 (Curcumin is a compound found in turmeric).

Readers of The Vajenda know that I have previously written about turmeric here. For those who are newer readers, welcome, and, I have a series on supplements (access here), where I explain issues with regulation and review products.

While some people may hear about supplements from their health care professional, the increasing commercialization of menopause appears to have spawned a growing number of menopause influencers and celebrities either endorsing specific menosupplements on social media, selling their own products, or partnering with companies to create/sell “curated” supplements. When these influencers have academic degrees, like MD or PhD, the consumer may think these products are backed by quality research and have been rigorously tested in the way that pharmaceuticals are tested, but in the United States, there is no testing required to bring a supplement to market (read more about that here).

When consumers investigate the webpages for many supplements there is typically a list of academic references, adding a veneer of scientific legitimacy. However, on closer inspection, these references often contain low-quality studies, irrelevant publications, or, quite frankly, garbage. Many consumers are unfamiliar with how to interpret scientific studies, and may trust the person with the academic credentials that this list of references represents robust science.

Two popular menopause/wellness influencers on social media who have reached minor celebrity status and who have legitimacy in the space courtesy of their academic degrees, Mary Claire Haver, M.D., and Stacy Sims, PhD, each promote a turmeric supplement. Given the rise of turmeric-related liver injury, I feel it is in the public’s interest to see the promoted science behind these products.

Dr. Mary Claire Haver - The ‘Pause Nutrition Turmeric Supplement

If a prospective buyer wants more information about turmeric, they are directed to the “ 'Pause Blog, Turmeric 101.” Here we find the following claims about curcumin, supported by several references:

Here’s the list of sources:

References 1, 4, 6, 7, and 8 are rodent studies, which are preclinical work and irrelevant when it comes to evaluating the efficacy and safety of a product for human women. Can you imagine the uproar if we approved vaccines or a new pharmaceutical for hot flashes based on rodent studies? There should be three phases or layers of human trials that happen after the rodents, but before a product is offered en masse to people.

Reference 2 is a review article about turmeric and ginger from 2011.⁵ There are more recent review articles in higher impact journals that conclude that we still don’t have good data to support using turmeric.^6-7 The problem with review articles is most of the studies of turmeric or curcumin have issues, so it’s possible to cherry pick and come up with a more positive review depending on the rigor of the approach. Regardless, Dr. Haver’s claim that curcumin has a role in ”a normal inflammatory response” is so vague it’s meaningless. It’s important to note that many supplements are marketed based on blood tests that are supposedly markers of health, as is done here with “markers of aging,” but what actually matters are meaningful health outcomes like a lower risk of high blood pressure or reduced rate of stroke. Biomarkers are smoke and mirrors.

Reference 3 is used to support Haver’s claim that curcumin can decrease hot flashes and is a randomized, blinded, clinical trial of curcumin vs. vitamin E vs. placebo over 8 weeks from Iran.⁸ The first two sentences in the introduction are nonsensical and should have been flagged before publication to clarify what the authors actually meant, which makes me concerned about the quality of the peer review. The Greene Climacteric Scale, a standard scale, was used to report changes in symptoms; regarding vasomotor symptoms (aka hot flashes and night sweats), all groups improved equally and there is no difference between the 26 women who took curcumin and the 28 who took placebo group. In addition, the women taking curcumin, vitamin E, and the placebo were all equally “extremely satisfied” with the outcome on the scale used in the study. The authors themselves conclude, “In other domains, significant improvement occurred in all groups compared to the baseline (except for the sexual domain); however, there was no significant difference between the curcumin and vitamin E groups with the placebo group.” I am not sure how anyone who read this study carefully and understood it would have used it to support turmeric/curcumin for hot flashes.

The next clinical trial is also from Iran and also compares curcumin and vitamin E with a placebo over eight weeks.⁹ According to Dr. Haver, this supports the use of turmeric for hot flashes as well as for “mood and a positive outlook on life.” The sample size is small (30 women took curcumin) and the groups differed in a significant way from each other–only 55% of the women who were given the placebo reported they were satisfied with their life at baseline versus 74% who took placebo. While the investigators report that the women who took curcumin had substantially fewer hot flashes/week at week 4 and 8 versus those who took a placebo, there was no difference in menopause symptoms between groups in the Greene Climacteric Scale, which includes questions about hot flashes. It’s problematic that the authors did not report out the component of the Greene Climacteric Scale that measures vasomotor symptoms to compare with with the self reported measurements for hot flashes. This should have been addressed in the discussion, but was not. Regarding mood, the authors conclude, “Curcumin and vitamin E had no significant effect on anxiety in postmenopausal women in the present study.” Not sure how this study can support Haver’s claim that turmeric has a benefit on mood or a positive outlook on life, and in my opinion it’s pretty sketchy to use it to support a benefit for hot flashes.

I did not bother to read the rat study supporting turmeric for improving “mood and a positive outlook on life,” because even if one can measure if a rat has a positive outlook on life, how would that apply to a woman?

There’s a reason the 2023 Menopause Society Position Statement on nonhormonal therapy for hot flashes doesn’t include turmeric or curcumin, the data just isn’t there.¹⁰

If a medical student submitted Dr. Haver’s blog to me as an assignment, I would fail them. It’s no surprise that the consumer watchdog group, Truth in Advertising, sent Dr. Haver a letter of concern in October 2024 about how she markets her supplements. You can find the letter here.

Dr. Sim’s Momentous Peri & Post Menopause Support Stack

Momentous has a Peri & Post Menopause Support Stack that is five supplements including turmeric and was “formulated with Dr. Sims.” Apparently, “research unequivocally supports each element” in their stack.

For those who don't know, Dr. Sims’ registered trademark is “Women are not small men,^®”

Surely, the science here will be robust. Unequivocal, in fact. After all, Momentous claims there are six credible reviews and studies to support this supplement stack of five products for peri and post menopausal women. Only one paper for turmeric is listed. Hope it’s a good one!

It’s a study done on men!

I shit you not, this pilot study of turmeric on 19 men aged 18-39 who followed “a muscle-damaging protocol” is apparently unequivocally “credible” to support the use of turmeric for “the unique needs of women during and after menopause.”

I’m not going down the antioxidant-muscle-soreness rabbit hole here, but most studies and a Cochrane review don’t support a clinically meaningful effect.¹¹

There are four other references for the “science” of turmeric on another page on the Momentous site. To be clear, Sims' name is not on this page, but if a consumer decides to poke around the website, they would find these references, which might make someone think, “Wow, there really is good science women!” Three of these are small studies are on men, and one is on rat prostates.

For fun, I looked up the reference for the Alpha GPC supplement in the Peri & Post Menopause Stack…it’s a study of seven men, mean age of 30.1 years, with two years of resistance training experience. I guess this unequivocally supports the use of this product for women ages 40 and up.

Irony is dead, killed by the supplement industry.

The Commercialization of Menopause

At this point, there will be someone on the interwebs who thinks I’m mean. Don’t complain that I’m mean, prove me wrong with science. Do you want to know what I think is mean? Promoting a turmeric supplement to vulnerable women in perimenopause and menopause that is six times the price of one from Costco, and the best references that can be dredged up, are, in my opinion, drinking game material.

Take a shot every time you read mice, rats, or men!

What is the risk of liver toxicity associated with turmeric/curcumin supplements? Who knows, understudied. Are particular people more vulnerable? Who knows. While LiverTox estimates the risk of liver toxicity might be in the 1 in 10,000 to 1 in 100,000 range, we don’t really know.¹ Now those numbers may seem small to you, but according to a recent study, an estimated 11,400,151 Americans took a turmeric/curcumin supplement within the previous 30 days; if the 1/100,000 is accurate then 114 people could be at risk of liver toxicity.¹² If there is is 1 in 10,000 risk, then it is 1,140 people. How many cases of liver toxicity are acceptable for a product with no robust evidence?

With 11 million Americans reportedly taking turmeric, and almost certainly more than half of them women, you can see why this product is appealing to sell for menopause–the market is already built in. I investigated a turmeric supplement to see what the profit margin might be, and I can get a turmeric supplement for about $7.27 a bottle. If I sell 8,333 bottles, which is the smallest number I can order, I net a profit of $195,302. It just takes a few emails to do this. The company that makes the product can design the label, bottle the product, store the inventory, and I can link it to a Shopify site for sales. With enough followers eager to follow my protocols, this could be like printing money.

I have no idea about the profit from a company like Momentous, but Altheletetech News reported that the “Utah-based brand tripled its revenue from 2022 and projects to double its revenue again this year.”

I also have no idea what kind of money people get from partnering with companies like Momentous. However, I have seen an email from a recruiter looking for partners for supplement brands, and they claimed that some medical doctors are making $20,000 a month for about 10 hours of work, where the work is helping to craft advertising messages that resonate with their followers and promotion on social media.

Some may ask why I didn’t notify Haver or Sims them before I published this article. I am not their unpaid research assistant. When I find minor errors or I question a reference used by a medical professional on social media, I contact the person personally out of professional courtesy for clarification. But commercializing menopause through products is an entirely different situation. I don’t tell pharmaceutical or consumer brand companies, like Vagisil, when I am going to write about their products, so why would I tell people who sell supplements, which are simply unregulated pharmaceuticals? If someone is selling a product or has verified one with their expertise, it is their responsibility to vet their references. If they stand by these references, well, you the reader can decide what you think about that.

I have two major concerns. One is when there is no good data to support any benefit for turmeric/curcumin use in human women for menopause, you the consumer are assuming all the risks with no proven benefits. We also don’t know if specific products or doses are a concern. It’s buyer beware. And while the risks may be small, if it’s your liver that is injured, then you may feel very differently about that risk.

The other is the commercialization of menopause via supplements and the false sense of security consumers get from products marketed by those with academic credentials and a list of references that, in the end, are just slick marketing of mostly irrelevant citations.

References

1. LiverTox, Turmeric https://www.ncbi.nlm.nih.gov/books/NBK548561/

2. Lombardi N, Crescioli G, Maggini V, et al. Acute liver injury following turmeric use in Tuscany: An analysis of the Italian Phytovigilance database and systematic review of case reports. Br J Clin Pharmacol. 2021; 87: 741–753. https://doi.org/10.1111/bcp.14460

3. Adverse effects associated with the consumption of food supplements containing turmeric, ANSES (the French Agency for Food, Environmental and Occupational Health & Safety) https://www.anses.fr/en/content/adverse-effects-associated-consumption-food-supplements-containing-turmeric

4. Australian Government Therapeutic Goods Administration, Medicines containing turmeric or curcumin - risk of liver injury, Safety Advisory. https://www.tga.gov.au/news/safety-alerts/medicines-containing-turmeric-or-curcumin-risk-liver-injury

5. Al-Suhaimi EA, Al-Riziza NA, Al-Essa RA. Physiological and therapeutical roles of ginger and turmeric on endocrine functions. Am J Chin Med. 2011;39(2):215-31. doi: 10.1142/S0192415X11008762. PMID: 21476200.

6. Kathryn M. Nelson, Jayme L. Dahlin, Jonathan Bisson, James Graham, Guido F. Pauli, and Michael A. Walters. The Essential Medicinal Chemistry of Curcumin Miniperspective. Journal of Medicinal Chemistry 2017 60 (5), 1620-1637 DOI: 10.1021/acs.jmedchem.6b00975

7. Liu S, Liu J, He L, Liu L, Cheng B, Zhou F, Cao D, He Y. A Comprehensive Review on the Benefits and Problems of Curcumin with Respect to Human Health. Molecules. 2022 Jul 8;27(14):4400. doi: 10.3390/molecules27144400. PMID: 35889273; PMCID: PMC9319031.

8. Farshbaf-Khalili A, Ostadrahimi A, Mirghafourvand M, Ataei-Almanghadim K, Dousti S, Iranshahi AM. Clinical Efficacy of Curcumin and Vitamin E on Inflammatory-Oxidative Stress Biomarkers and Primary Symptoms of Menopause in Healthy Postmenopausal Women: A Triple-Blind Randomized Controlled Trial. J Nutr Metab. 2022 Jun 9;2022:6339715. doi: 10.1155/2022/6339715. PMID: 35719707; PMCID: PMC9203212.

9. Ataei-Almanghadim K, Farshbaf-Khalili A, Ostadrahimi AR, Shaseb E, Mirghafourvand M. The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial. Complement Ther Med. 2020 Jan;48:102267. doi: 10.1016/j.ctim.2019.102267. Epub 2019 Nov 26. PMID: 31987231.

10. Shufelt, Chrisandra L. MD, MS, FACP, NCMP; Brown, Vivien MDCM, CCFP, FCFP, NCMP; Carpenter, Janet S. PhD, RN, FAAN; Chism, Lisa Astalos DNP, APRN, NCMP, FAANP; Faubion, Stephanie S. MD, MBA, FACP, NCMP, IF; Joffe, Hadine MD, MSc; Kling, Juliana M. MD, MPH, NCMP, FACP, IF; Soares, Claudio N. MD, PhD, FRCPC, MBA; Thurston, Rebecca C. PhD, FABMR. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause 30(6):p 573-590, June 2023. | DOI: 10.1097/GME.0000000000002200

11. Ranchordas MK, Rogerson D, Soltani H, Costello JT. Antioxidants for preventing and reducing muscle soreness after exercise: a Cochrane systematic review. Br J Sports Med. 2020 Jan;54(2):74-78. doi: 10.1136/bjsports-2018-099599. Epub 2018 Jul 27. PMID: 30054340.

12. Likhitsup A, Chen VL, Fontana RJ. Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults. JAMA Netw Open. 2024;7(8):e2425822. doi:10.1001/jamanetworkopen.2024.25822