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Medscape

Spice-Med Interactions: What Every Clinician Needs to Know

Spices have been valued for centuries in Ayurvedic and Chinese medicine because of their healing properties. In small amounts used for cooking, cinnamon, turmeric, and ginger are generally safe and may provide health benefits, depending on their quality and preparation methods. However, at higher therapeutic doses, they can interact with medications or cause side effects; therefore, long-term use should be monitored by a healthcare professional. Cinnamon Cinnamon spice is extracted from the bark of various species of the cinnamon tree, and essential cinnamon oil is obtained from the bark or leaves. Active constituents include cinnamaldehyde, eugenol, and coumarin. Cinnamon provides antioxidant, anti-inflammatory, antimicrobial, antiviral, antihypertensive, blood sugar-regulating, and antitumor properties, which may reduce the risk for heart disease and improve brain function. Traditionally, it has also aided digestion and fought infections. Combined with lysozyme, essential oils from Cinnamomum verum and clove ( Syzygium aromaticum ) have been shown to reduce the minimum inhibitory concentrations of gentamicin and imipenem against multidrug-resistant Pseudomonas aeruginosa and Klebsiella pneumoniae , thereby enhancing antibiotic efficacy and modifying resistance. Its use in patients with breast cancer could be promising, but further studies are needed. However, an in vitro study showed that cinnamaldehyde activates receptors that increase the excretion of certain drugs, potentially reducing their effectiveness. The cheaper Asian cassia cinnamon contains larger amounts of coumarin than the more expensive Ceylon cinnamon; in high doses, coumarin can damage the liver and, in combination with anticoagulants, can increase the risk for bleeding. Interactions may occur with painkillers, antidepressants, chemotherapeutic agents, and antidiabetic drugs. Reported side effects include gastrointestinal symptoms, headaches, and skin reactions, such as dermatitis or worsening rosacea. Turmeric Turmeric contains the curcuminoid curcumin, the yellow component of curry powder, masala, and golden milk, prized for its anti-inflammatory and antioxidant properties and, at therapeutic doses, its anticarcinogenic and analgesic effects. Other compounds may also contribute to the observed cognitive benefits. Caution is advised when extrapolating scientific results from laboratory and animal experiments to humans, particularly because the amounts used in these studies are impractical compared with concentrated curcuminoid curcumin extracts. Curcumin interacts with liver enzymes and may affect antidepressants, antihypertensives, chemotherapeutic agents, and certain antibiotics. Its blood-thinning, blood sugar-lowering, and blood pressure-reducing properties can potentiate the effects of anticoagulants, antidiabetics, insulin, and antihypertensives. Concurrent intake of iron-rich foods can reduce curcumin's bioavailability. To ensure adequate absorption, curcumin should be consumed with fats and piperine-rich black or long pepper, as well as with chili, lemon, ginger, honey, or even cinnamon and nutmeg. The preparation methods are crucial: Cooked roots may offer stronger DNA-protective effects, roasting in ghee may benefit the gut microbiome and compound uptake, and oxidation should be avoided. At therapeutic concentrations, curcumin is contraindicated in gallstones, cholestasis, bleeding disorders or anticoagulation, and during pregnancy and breastfeeding. Ginger Ginger is known for its anti-inflammatory, immune-boosting, and antiemetic effects. Some studies suggest blood sugar- and blood lipid-lowering properties, but the extent of interactions with antidiabetic drugs and possible side effects — similar to those of sulfonylureas — requires further research. Ginger is already included in combination products for the treatment of diabetes. Its active constituents, such as gingerol, have blood-thinning effects when consumed regularly, chronically, or in concentrated form, and can increase bleeding risk when taken with anticoagulants. Higher doses can cause gastrointestinal side effects such as mucosal irritation, bloating, and heartburn. Conclusion Laboratory studies have indicated potential drug interactions for these spices, but the findings mainly involve high doses rather than typical culinary use. Caution is advised before starting such supplements, particularly in patients taking anticoagulants, antidiabetics, or chemotherapeutic agents. For most people, these spices are considered safe and combine taste with potential health benefits.