When I climb out of bed each morning, that growing twinge of stiffness reminds me that I’m no longer a spring chicken. And I’m not alone. More than 70 per cent of us over 50 have some evidence of osteoarthritis (OA) in at least one of our joints. With another 1 per cent of the population suffering from rheumatoid arthritis (RA), it all adds up to a whole lot of sore, creaky joints.
In medical school we were taught that RA was inflammatory – due to an auto-immune illness – but that OA was merely the result of wear and tear on the joints. We were led to believe that there was just one solution to the joint damage seen with OA… or Degenerative Joint Disease as it’s sometimes called… and that, of course, is joint replacement.
MILLIONS risk joint replacement every year
And judging by the rising tide of joint replacements, most of my colleagues have bought into that thinking. In England and Wales there are approximately 160,000 total hip and knee replacement procedures performed each year… each one of these patients faces the dangers of surgery and post-surgical complications like blood clots from joint replacements. And they’re left with the long-term risks of having foreign metals in their bodies.
If joints aren’t replaced, OA pain is usually treated with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and Aleve. The reason they provide some relief is that – despite OA being labelled the wear-and-tear form of arthritis – inflammation does, in fact, play a role.
But when you understand just how these drugs work – and how they’re practically guaranteed to lead to damage to your gut – you’ll be clamouring for the same safe, natural alternatives I use with my own patients.
Inflammation’s vicious cycle
To understand what’s wrong with prescription and OTC anti-inflammatory medication like aspirin and ibuprofen, it’s important to first take a look at how inflammation occurs in our bodies.
A variety of factors including diet, injuries, infections, allergies, and toxins can set off warning signals in the body. We end up producing pro-inflammatory messenger proteins (called cytokines) and enzymes (particularly cyclooxygenase or COX) that actually eat away at the collagen in our joints.
It’s a vicious cycle that leads to even more inflammation and destruction of cellular tissue until, eventually, the joint space is largely obliterated.
In fact, this is the way that nearly all diseases progress; immune messengers are triggered by a variety of internal and external factors, which leads to inflammation and, eventually destruction of cells.
How common pain relievers attack your gut
Managing your levels of pro-inflammatory cytokines and enzymes is the key to reducing inflammation and controlling your arthritis pain.
In the case of OA, the cytokines that seem to do the most damage are called tumor necrosis factor alpha (TNF alpha) and interleukin one beta (IL-1b). Studies of the joint spaces of OA patients show elevated levels of both TNF alpha and IL-1b. It’s also been shown that reducing TNF alpha lowers inflammation, and lowering IL-1b reduces damage to cartilage.
Aspirin and NSAIDs work by tackling pro-inflammatory enzymes. They block the pathway by which COX enzymes (both COX-1 and COX-2) work – and since COX-2 causes inflammation, this can provide some relief.
But that reduced inflammation comes at a major price, because COX-1, which is also blocked by the majority of these medicines, is needed to protect your stomach lining. And so these medications can erode the stomach and cause ulcers and gastritis, even as they have a calming effect on the joints.
In an attempt to bypass the COX-1 issue, drug companies have produced a number of selective COX-2 inhibitor drugs over the years with some disastrous results. A number of these drugs have led to serious heart issues in users, and as a result most of them – including the well-known drugs Vioxx and Bextra – have been banned. But Celebrex, another COX-2 inhibitor, is still on the market.
But while the drug companies continue to toil away trying to create a drug that effectively inhibits COX-2 and the cytokines involved in inflammation (IL-1b and TNF alpha) – while not suppressing COX-1 – nature has already solved the problem. Certain plants are naturally anti-inflammatory, which means they can help relieve your pain without stomach damage or other side affects you get from prescription and OTC pain medications.
A recent article published in the journal Current Opinion in Pharmacology reviewed a number of natural substances and herbal extracts that have been proven to decrease the signals in the body that trigger and sustain painful inflammation.
The researchers listed 18 natural products that demonstrated impressive anti-arthritic activity. All of them (except the soy-derived protein Genistein) blocked COX-2.
All 18 blocked a substance called nuclear factor kappa-B (NF-kB) the signalling molecule that regulates the inflammatory process. And half of them blocked IL-1B as well. And, of course, these plant solutions manage to tamp down the inflammation without carrying the same harsh side effects that have been seen with drugs.
Top Four Arthritis Inflammation Busters
Of all the plant-based anti-inflammatories out there, there are four that I’ve seen work consistently well for arthritis symptoms. If you’re suffering from the aches and pains of arthritis these Top Four Arthritis Inflammation Busters could be the answer…
- Curcumin, which is extracted from the common kitchen herb turmeric, is a powerful natural anti-inflammatory. The herbal extract has literally hundreds of studies backing up its use for managing – and in some cases even helping to prevent – the symptoms of OA and RA.
There are even some studies showing that curcumin improves the function of the COX-2 inhibitor drug Celebrex, so that lower doses of the potentially dangerous drug can be used.
- Resveratrol, another powerful anti-inflammatory herbal extract, is readily found in grapes (including wine), berries and peanuts. Resveratrol has been proven to inhibit NF-kB, IL-1B, COX-2, and another inflammatory cytokine, Interleukin 6 (IL-6). By blocking these harmful substances resveratrol slows down the destruction of joint cartilage and can even help prevent OA before it ever begins.
In a recent study researchers combined curcumin and resveratrol into special nanocapsules. The combo was able to lower both joint inflammation and tissue destruction in an animal model, without the liver irritation that occurs with drugs.
- Boswellic acid, extracted from the Indian herb boswellia, has been used to treat OA and RA for over 30 years, and has accumulated an extensive amount of positive research over that time. It’s been shown to block NF-kB, COX-2 and another inflammatory enzyme 5-LOX.
In one randomised double-blind placebo-controlled study, 30 patients with OA of the knee were given boswellia extract or placebo for eight weeks, and then (after a period of time known as a ‘wash-out’) they were switched. The group receiving the active herbal medicine had a significant reduction in pain, they were able to walk greater distances and they had improved flexibility.
- Avocado-soybean unsaponifiables (ASU) is a remarkable substance created by combining extracts from both avocado and soybean oils. ASU is sold as a prescription product in Europe, under the name of Piascledine, and this is the form that has been used in most studies.
ASU has repeatedly been shown to suppress pro-inflammatory cytokines, and several clinical studies have found that it has a positive effect on OA. In one study, published in the journal Annals of the Rheumatic Diseases, 399 patients with hip OA were treated with 300 mg ASU or a placebo, and followed for three years.
X-rays showed a significantly better joint space width in the treated group than the placebo group. In other words the ASU had stopped the progression of the OA in its tracks, and with negligible side effects.
These four natural substances, and many others, have been proven safe and effective alternatives to the dangers of NSAIDs and other arthritis drugs. And just as importantly, they suggest that taking natural medicines can be a powerful way to prevent the aches and pains of arthritis from occurring in the first place, and that they may even be able to help prevent or delay a painful and risky joint replacement.
Dr. Glenn S. Rothfeld
Nutrition & Healing
Vol. 9, Issue 10, October 2015