Natural Anti-Inflammatories

NSAIDs (non-steroidal anti-inflammatories) are frequently used to control inflammation and may be over the counter or prescription. Significant complications may be associated with such medications including: ulcers or other gastrointestinal hemorrhage (bleeding), heart attacks and stroke. Medical studies have evolved new drugs such as Vioxx, Bextra and Celebrex, often with increased risks or complications. Lesser known side-effects of NSAIDs include reduced healing (muscle, ligaments, tendons), negative effects on muscle tissue (increased necrosis/death), muscle weakness, delay of bruise healing, delayed muscle regeneration, and kidney side effects in athletes.

There are 3 main pathways involved in controlling inflammation: LOX (5-lipoxygenase), COX-2 and COX-1. Basically, these pathways involve inflammatory chemicals through the arachidonic acid pathway. Inflammation is controlled by decreasing the chemicals in this pathway. Some medications influence more than one pathway.

WHAT ARE THE NATURAL ALTERNATIVES? Article Medscape by Maroon, Bost, Borden, Lorenz and Ross is the source of this discussion with back up information from Natural Standard: Herb & supplement handbook by Basch and Ulbricht. CAUTION: do not substitute or start any supplementation program without consulting with your MD, DO, or pharmacist if on medications. Check with your DC to rule out any contraindications if not on medications. This article is for information purposes only and does not substitute for health care advice.

Natural medicines/herbs have been used in folk medicine to control inflammation and pain. Although concerns exist over quality and contaminants, many natural substances exist which reduce inflammation and pain effectively. Seeking pharmaceutical grade or standardized products will help alleviate such concerns.

Anti-inflammatory HERBS/SUPPLEMENTS:
1. Omega 3 EFAs (Fish Oil). The use of this product for musculoskeletal treatment can be traced back to the 18th century-good old Cod Liver Oil. The biggest problem with this product was rancidity (spoilage). Modern production techniques have fixed this problem. EPA and DHA are the active ingredients which have anti-inflammatory effects. The recommended dosage is 1.5 to 5 g of EPA and DHA/day with meals. Rare side effects include: belching and oily stools. May cause GI upset, slight alter blood sugar in diabetics, may deplete vitamin E, may increase vitamin A and D toxicity, may increase LDL (bad cholesterol) at certain levels, may elevate liver enzymes (rarely), may affect people who are bipolar or severely depressed, may rarely cause skin rashes. Contraindications: do not take if taking a blood thinner, herbs that thin the blood, or aspirin and other NSAIDs. Check with your heart doctor if taking a blood pressure medication or herbs that may lower BP as it may lower blood pressure. May add to triglyceride lowering effects of medications.
2. White Willow Bark. This is one of the oldest herbal remedies for pain and inflammation and has been using in ancient Egyptian, Roman, Green and Indian societies. The first record of its use was 3500 years ago. Aspirin was created from this herb with Bayer being the first to market it.. Salix alba (white willow) is most commonly used with properties similar to aspirin with effects comparable. The salacin is converted to salicylic acid by the liver and is considered to have less side effects than aspirin, although more costly. Contraindications: It should not be used with children and with patient having ulcers, liver disease, kidney disease or diabetes or any condition in which aspirin would be contraindicated. Dosage: usually 240 mg/day.
3. Curcumin (Tumeric): this yellowish colored spice is used in food flavoring and has been used by Ayurvedic and Chinese medicine as an anti-inflammatory, for digestive disorders and to enhance wound healing. It has been suggested as a treatment for colitis, arthritis, cancer and neurodegenerative disorders. Its centuries of use and recent studies show it works on the inflammatory pathways. Dosage: 400-600 mg, standardized powder 3 times a day. Side Effects: few but stomach upset and at high doses gastric ulcers. Comparable therapeutic effects to phenylbutazone.
4. Green Tea: long recognized as having cardiovascular and cancer preventative characteristics due to antioxidant properties.. Arthritic anti-inflammatory uses have been recognized more recently. It also inhibits chemicals that degrade cartilage (chondroprotective) Recommended dosage: 3-4 cups a day or 300 to 400 mg of extract. May irritate some peoples stomach lining and has a high caffeine content.
5. Pycnogenol (Maritime Pine Bark): been used since ancient times over 2000 years. Was mentioned by Hippocrates as an anti-inflammatory. It is considered helpful for wound healing, scurvy, ulcer healing and reducing vascular inflammation. It is one of the most potent anti-oxidants known. Research suggests it has the potential to counteract major cardiovascular risk factors for artery disease. It is 50 to 100 times more potent than vitamin E as an antioxidant. Studies show it helps reduce blood pressure and the risk of vein thrombosis. Dosage: 100-200 mg/day. Mild GI effects such as diarrhea and upset stomach have been noted. It should not be taken if on immunosuppressent or cortiocosteroid drugs since it enhances the immune system.
6. Boswellia Serrata (Frankincense): The resin has anti-inflammatory, anti-arthritic, and analgesic properties. Dosage: extract of 30-40% boswellic acids (300-500 mg two or three times a day) Well tolerated with some people experiencing: stomach discomfort, nausea, reflux, diarrhea. My Note: I have seen patients do as well on the combination of glucosamine sulfate, fish oils and bosewellic acids as they have on the prescription arthritic drugs like Celebrex, even with rheumatoid and osteoarthritis combined.
7. Cat's Claw (uncaria tomentosa): used as a treatment for arthritis, bursitis and intestinal disorders. Side effects are minimal but renal failure has been reported in lupus patients. Dosage: tea (1000mg root bark to 8 oz water) or extract, 20-60 mg.
8. Capsaicin (chili pepper): generally available as a topical roll on or cream. It may cause skin irritation in some people and burning. Do not use when sweating.