First the pain and arthritis drug rofecoxib
(Vioxx) was pulled from the market due to an increased risk for
heart attack and stroke. Next came news that another COX-2 inhibitor,
the anti-inflammatory drug valdecoxib (Bextra), can double the risk
for heart attack and stroke. Then headlines focused on celecoxib
(Celebrex) and the warning that it could increase risk for heart
attack. Another arthritis drug -- infliximab (Remicade) -- is on
cancer-causing alert. And now, there are warnings of the heart risks
connected to the over-the-counter drug naproxen. What's an
arthritis sufferer to do?
A growing number of arthritis sufferers are
seeking relief through alternative approaches. According to the
Arthritis Foundation, 64% of Arthritis Today readers have used a
dietary supplement in the past six months, as compared with 49%
of the general population. (Order a free copy of Arthritis Today's
Supplement Guide at www.arthritis.org. With their trust shattered,
arthritis sufferers now are looking beyond conventional drugs for
solutions. To learn about natural alternatives, I consulted Mark A.
Stengler, ND, a naturopathic physician in private practice in California
and author of The Natural Physician's Healing Remedies (Bottom Line Books).
He told me that dietary supplements often can provide effective pain relief,
and sometimes even more benefits, such as reduced joint inflammation.
REVIEWING YOUR OPTIONS: DIETARY SUPPLEMENTS
Dr. Stengler recommends a variety of supplements
for the relief of arthritis pain and inflammation. Since you may have to
mix and match remedies to find the combination that meets your individual
needs -- and because even supplements can have side effects -- it is best
to consult a naturopathic physician for evaluation and guidance. You can
find one in your area at www.naturopathic.org.
Among Dr. Stengler's recommendations are...
Boswellia (Boswellia serrata), which comes from the
Boswellia serrata tree that grows in the dry hills of India. It can ease
pain and improve function in people with arthritis. Take 1,200 to 1,500 mg
of a standardized extract containing 60% to 65% boswellic acids two to
three times daily.
Bromelain, an enzyme found in pineapples, has a
natural anti-inflammatory effect. Take 500 mg three times daily between
meals. Dr. Stengler suggests products standardized to 2,000 MCU
(milk clotting units) per 1,000 mg or 1,200 GDU (gelatin dissolving units)
per 1,000 mg. Check the label.
Cayenne (Capsicum annuum) cream works by depleting
the nerves of substance P, a neurotransmitter that transmits pain messages.
For symptomatic relief, apply a cream standardized to 0.025% to 0.075%
capsaicin to the affected area two to four times daily. This old standby
is one of today's recent medical discoveries. Ben-Gay, which contains
capsaicin, is another option.
Cetyl myristoleate (CMO) is an oil commonly found
in fish and dairy butter. Preliminary studies have shown promise for
treating arthritis. Take 540 mg daily.
Devil's claw (Harpagophytum procumbens) improved
knee and hip pain when taken in combination with NSAIDs in a recent study.
Take 1,500 to 2,500 mg of the standardized powdered herb in capsule or
tablet form daily, or use 1 millimeter (ml) to 2 ml of the tincture three
times a day. Do not take devil's claw or NSAIDs if you have a history of
gallstones, heartburn or ulcers.
Evening primrose, black currant and borage oils
contain the essential fatty acid gamma linolenic acid (GLA), which
reduces joint inflammation. Adding good oils like these to your body --
and eliminating your intake of bad ones such as saturated oils -- can help
you feel better overall. Take up to 2.8 g of GLA daily.
Fish oils contain a direct source of the omega-3
fatty acids that reduce joint inflammation and promote joint lubrication.
Dr. Stengler recommends a daily dose of at least 1.8 mg of DHA and 1.2 mg
of EPA. Be patient -- improvement may take up to 12 weeks.
Ginger (Zingiber officinale) is a popular choice for
inflammation and pain relief. Pour boiling water over the grated root
to make a tea, or add fresh ginger to your meals. If you want a stronger
remedy, take 1 g to 2 g of the dried powder in capsule form two or three
times daily, or use 1 ml to 2 ml of the tincture three times daily.
Glucosamine sulfate from the tissues of shellfish and
chondroitin sulfate from animal cartilage are good basic supplements for
those with arthritis. Taken for four to eight weeks, they help decrease
pain and inflammation. Recent evidence from two European studies suggests
that glucosamine even may halt or reverse disease progression, and some
people taking it may be able to reduce their use of NSAIDs. (See Daily
Health News, May 17, 2004.) Dr. Stengler recommends 1,500 mg daily of
glucosamine and up to 1,200 mg daily of chondroitin.
MSM (Methylsulfonylmethane) -- organic sulfur --
has natural anti-inflammatory benefits because sulfur is an integral
component of cartilage. Take 2,000 mg to 8,000 mg daily. Reduce dosage
if diarrhea occurs.
SAM-e (S-adenosylmethionine) is an excellent
supplement to reduce the symptoms of arthritis. A naturally occurring
substance in the cells of the body that activates chemical reactions,
it is required for methylation reactions, meaning that it makes available
a carbon-hydrogen molecule for crucial chemical reactions to take place.
In regard to the joints, SAM-e's methylation helps prevent the loss of
water in cartilage, which keeps the joint more flexible. Take 600 mg to
1,200 mg daily for two months, followed by 400 mg to 800 mg daily as a
maintenance dosage.
Caution: Many arthritis supplements (including
devil's claw, fish oil, GLA oils and ginger) thin the blood, which means
you may be at a higher risk for bleeding if you also are taking NSAIDs
(such as ibuprofen), blood-thinning medications or other dietary supplements
that slow clotting, or if you have a blood-clotting disorder.
PAIN RELIEF: THE SAFE AND NATURAL WAY
Of course, dietary supplements are just the tip
of the iceberg when it comes to natural treatments for the relief of
arthritis pain and inflammation. Other options you may wish to explore
are diet, exercise, physical therapy, stress management, massage therapy,
acupuncture, acupressure and yoga. Rest assured that, as drugs with toxic
side effects are removed from the market, there are still plenty of safe
and natural alternatives that can make arthritis easier to live with.
Sources...
Mark A. Stengler, ND, naturopathic physician in private
practice at La Jolla Whole Health Clinic in La Jolla, California, associate
clinical professor at Bastyr University in Kenmore, Washington, and National
College of Naturopathic Medicine in Portland, Oregon. He is author of 16 books,
including The Natural Physician's Healing Remedies (Bottom Line Books) and
Prescription for Natural Cures (Wiley).
