The substances which cause inflammation and pain are called ‘inflammatory mediators’ – body chemicals such as prostaglandins, leukotrienes and oxidants. Prostaglandins and leukotrienes are made from one of the omega-6 fats, arachidonic acid, which is abundant in meat and milk. Too much of these foods in your diet can lead to over production of the inflammatory prostaglandins and leukotrienes. Although inflammation can be an important protective mechanism, too many inflammatory mediators create pain.
The most common medical treatment for inflammation is anti-inflammatory drugs which are effective symptom suppressors, providing pain relief, but do nothing to address the causes of the inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) work by blocking the production of the body’s inflammatory mediators, and while they are mostly very effective, they are not without side-effects, especially in the gut. Prescriptions for NSAIDS cost the NHS about £250 million per year. Extraordinarily, this class of drug is responsible for more deaths than any other. When used long term, NSAIDS such as aspirin and ibruprofen can cause gastrointestinal bleeding and can put a strain on the liver.
Recent studies have also shown that new anti-inflammatory drugs which inhibit important enzymes can double, or in some cases quadruple, a person’s chance of a heart attack. Despite this danger, the average person takes in excess of 300 doses of these painkillers a year! That’s six a week.
Effective solutions without side effects
Luckily, there are a number of natural anti-inflammatory agents, some of which have been proven to be as effective as drugs, without the side-effects. One of the most popular is fish oils. Fish oils do not lubricate your joints, as is often believed. What they actually do is reduce pain and inflammation. They are converted in the body into beneficial anti-inflammatory prostaglandins, which counteract the inflammatory substances NSAID drugs are used to suppress.
Good research now shows conclusively that fish oil supplementation can reduce the inflammation of arthritis. A case in point is a study in 2002 which found that 86% of patients with arthritis who took cod liver oil prior to knee replacement surgery had no or reduced levels of enzymes which cause cartilage damage, compared to just 26 per cent of patients who took a placebo. An effective amount to take is the equivalent of 1000mg combined omega 3s EPA and DPA a day, which means two to three of most fish oil capsules. Talking of fats, there’s a special blend of fatty acids called Celadrin that has proven highly effective at reducing arthritic pain in recent trails.[3,4] It comes as a cream or in capsules. Like so many natural remedies, it seems to work on many different fronts, but certainly helps damaged cells in inflamed joints to heal more quickly.
Glucosamine: One of the best known non-drug treatments for joint pain is glucosamine. Glucosamine is an essential part of the building material for joints and the cellular ‘glue’ that holds the entire body together, although joint cartilage contains the highest concentration. The mechanism by which glucosamine appears to stop or reverse joint degeneration is by providing the body with the materials needed to build and repair cartilage. A study of individuals with osteoarthritis of the knee found that participants taking 1500mg of glucosamine sulphate daily had a similar reduction in symptoms to those taking 1200mg of ibuprofen daily. However, the glucosamine group tolerated their medicine much better.
In addition, several studies have shown that glucosamine is equally as good as NSAIDS for easing arthritic pain and inflammation, and there are less of the stomach-irritating side effects associated with NSAIDs. Glucosamine hydrochloride appears better tolerated than the sulphate form – aim for 1000 to 2000mg a day. It works especially well when combined with MSM (see below).
MSM: MSM, which stands for methylsulfonylmethane, is a source of the essential mineral sulphur. Sulphur is involved in a multitude of key body functions including pain control, detoxification and tissue building. Extraordinary results have been reported for pain relief in those with arthritis who took MSM. One study at UCLA School of Medicine in California found that on 2250mg of MSM a day, patients with arthritis had an 80 per cent improvement in pain within six weeks, compared with 20 per cent in those who had taken dummy pills. MSM is available both as a balm and in capsules. The therapeutic dose appears to be 1500-3000mg a day.
Some people experience a worsening of symptoms in the first ten days, then improvement.
Curcumin: The bright yellow pigment of the turmeric spice contains the active compound curcumin, which has a variety of powerful anti-inflammatory actions. Trials in which it was given to arthritic patients have shown it to be similarly effective to anti-inflammatory drugs, without the side-effects. On top of this, it’s a potent antioxidant. Interestingly, the most recent review of turmeric in the Journal of Clinical Immunology states that curcumin at low doses can also enhance antibody responses. This suggests that curcumin's reported beneficial effects in arthritis, allergies, asthma, atherosclerosis, heart disease, diabetes, Alzheimer's and cancer might be due in part to its ability to modulate the immune system. The only downside it that it stains everything so take care when using in cooking! Turmeric gives a great flavour in curries, stir-fries or add a teaspoon when cooking rice. You need about 500mg, one to three times a day (the equivalent of one heaped teaspoon or one capsule three times a day).
Boswellia: Frankincense may be the ultimate gift for an arthritic friend. Boswellia serrata, also known as Indian Frankincense, is proving to be a very powerful natural anti-inflammatory agent, without the side-effects of current drugs. In one study where patients initially received boswellic acid, and then later a placebo, arthritic symptoms significantly reduced while taking the Boswellia, but then returned with a vengeance when the treatment was switched over to placebo.
Boswellic acid appears to reduce joint swelling, restores and improves blood supply to inflamed joints, provides pain relief, increases mobility, improves morning stiffness and prevents or slows the breakdown of the components of cartilage. It works in a different way to turmeric and other ‘COX2 inhibitors’ (substances which block a particular inflammatory mediator) which is why I like to use a combination of boswellia and a potent COX2 inhibitor such as curcumin or the hop extract IsoOxygene. Preparations of boswellia are available in tablet and cream form – the ideal dose is 200 to 400mg, one to three times a day; the creams are especially useful in the treatment of localised inflammation.
Hops: Hops are not just an ingredient in beer, but one of the most effective natural pain killers of all. The hop extract IsoOxygene is one of the most potent natural COX2 inhibitors. A recent study compared the effects of IsoOxygene to Ibuprofen: two tablets of Ibuprofen inhibited COX2 by 62 per cent, while IsoOxygene achieved a 56 per cent inhibition. Not only is it almost as effective, it doesn’t have the associated gut problems or other side-effects of anti-inflammatory drugs. You need about 500mg to 1500mg a day.
Olive extract: Olives contain an extract called Hydroxytyrosol which has powerful anti-inflammatory effects. The active ingredient is a polyphenol, which has an antioxidant content over ten times greater than vitamin C. Olives also contain a compound called oleocanthal which is chemically related to ibuprofen, although again has none of the negative side effects. In 2005 researchers at the Monell Chemical Senses Center and University of the Sciences in the US found that oleocanthal was a potent anti-inflammatory painkiller. Like boswellia and turmeric, olive extract decreases the levels of pro-inflammatory substances. In fact one study found that the extract reduced a marker of inflammation by approximately 40 per cent.
When the extract was combined with glucosamine, this increased to a huge 87 per cent. While eating olives will give you a small amount of the extract, taking a supplement of concentrated olive extract is a guaranteed way of getting enough. You need 40 to 100mg of olivenol a day.
Antioxidants: Antioxidant nutrients help reduce inflammation, so if you’re arthritic or experience a lot of pain, eat plenty of fruit (especially berries) and vegetables, or consider supplementing with an antioxidant formula. A study in 2005 involving over 25,000 people showed that a low intake of the vitamin antioxidants found in fruit and veg significantly increased the risk of arthritis. Quercitin is one of the most abundant anti-oxidants found in onions, broccoli, squash, red grapes and citrus foods. It works with vitamins C and E to protect against free-radical damage. It also has an anti-inflammatory effect by inhibiting the enzymes that produce pro-inflammatory prostaglandins.
A trial in which people with rheumatoid arthritis were treated with a vegan diet high in antioxidants including quercetin found they had decreased joint stiffness and pain as well as an improvement in self-reported health. Quercitin also inhibits the release of histamine, which is involved in inflammatory reactions. Take 500mg per day, between meals.
Ashwagandha: Ashwagandha is a promising natural remedy that has been used for hundreds of years as part of Ayurvedic medicine in India. The active ingredients in this powerful anti-inflammatory herb are ‘withanolides’. In animal studies, Ashwaganda has proven highly effective against arthritis. In one study, animals with arthritis were given either Ashwaganda, hydrocortisone or placebo. While hydrocortisone produced a 44 per cent reduction in symptoms Ashwagandha produced an 89 per cent reduction in symptoms, making it substantially more effective.
Although it has a good track record in Ayurvedic medicine, it has only recently come to Western medical attention and human trials are awaited with interest. The therapeutic dose depends on the concentration of withanolides. Try 300mg twice a day of the root, providing 1.5 per cent withanolides.
Ginger: Ginger is another effective anti-inflammatory favoured by Ayurvedic medicine. Twentieth century technology has demonstrated that ginger inhibits the synthesis of pro-inflammatory prostaglandins and thromboxanes, another type of inflammatory mediator. It also has antioxidant properties and contains an enzyme that may have a similar action to bromelain (see below). Supplementing ginger in one study reduced the pain and swelling of three quarters of the participants with rheumatoid and osteoarthritis, while all patients with muscular discomfort experienced relief from pain.
Taking a supplement of 500-2000mg of ginger a day is ideal. Otherwise, incorporate a half inch slice of fresh ginger into your daily diet.
Bromelain: Bromelain is a collection of enzymes found in pineapples. Since it was first used in 1957, it has been shown to have a wide variety of medicinal properties – including the reduction of inflammation in rheumatoid arthritis. There are several mechanisms by which bromelain is believed to help. Firstly, it inhibits pro-inflammatory compounds and blocks the production of kinins, compounds which increase swelling and cause pain. Secondly, it helps reduce swelling by breaking down fibrin – a mesh that forms around an inflamed area, blocking off the blood supply and impairing tissue drainage. Bromelain can be taken in supplement form – 250-750mg a day in between meals.
Combination supplements: The easiest way to supplement all these natural anti-inflammatory agents is in various combined herbal formulas. Since their effect is probably synergistic, this may prove more effective than just taking one ingredient alone and also requires lower doses. These can also be found in creams which can be applied locally, reducing pain and swelling in specific joints.
Nature Does it Better Than Drugs
In summary, there are natural ways to reduce inflammation without drugs that are as effective, if not more so, than conventional pain-killers with fewer side-effects. However, the real answer to inflammation must involve tackling its underlying causes, rather than just treating the symptoms. It is also important to supplement nutrients which support the rebuilding of damaged joints. This new approach to conquering inflammation is complex, like the problem itself, and is best achieved by working with a nutritional therapist who can run the necessary tests and advise you on diet and supplements for each stage of reprogramming your body. This approach is based on an understanding that inflammation and pain are the body’s ways of saying ‘Help’ and that current diet and lifestyle factors have exceeded the body’s capacity to adapt. Click here to find a nutritional therapist in your area. Click here to read about natural ways to tackle arthritis.
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