Arthritis: Osteoarthritis Herbal Support Program
By Geoff D'Arcy, Lic. Ac., D.O.M.
Supplementation Program:
Joint-Ease Formula: 2 capsules, 3 times daily.
Glucosamine: 1 capsule, 3 times daily.
Inflam-Ease Forumla: 2 capsules, 3 times daily for "flare-ups" of inflammation.
Osteoarthritis, often called the "wear and tear" arthritis, is the most prevalent form of arthritis. Common to nearly all vertebrates, including those long-extinct giants, the dinosaurs, it is a chronic disease in which the cartilage breaks down. Cartilage is a slippery tissue that covers the ends of bones in a joint, allowing the bones to glide over one another. It also absorbs energy from the shock of physical movement. When cartilage in a joint deteriorates, osteoarthritis occurs.
How is osteoarthritis diagnosed? No single test can pinpoint the disease. Most doctors use a combination of patient history and examination, along with x-rays to diagnose the disease and rule out other causes for the symptoms. As the cartilage in a joint deteriorates, the bones begin to rub together, causing pain, swelling, and loss of motion of the joint. The joint may begin to lose shape. Small bone spurs called osteophytes may grow on the edges of the joint. Inflammation may or may not be present. Pain may flare up on use or through environmental changes such as "cold, damp" weather. In Traditional Chinese Medicine, arthritis is viewed as caused by obstruction of the energy channels and restriction of blood flow, reducing the body's ability to ease inflammation. These symptoms almost always begin gradually, taking years until the pain is severe.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Even though they are commonly prescribed, the physical cost of years of pain management with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can be severe, even fatal! The New England Journal of Medicine reports that “anti-inflammatory drugs (prescription and over-the-counter, which include Advil®, Motrin®, Aleve®, Ordus®, Aspirin, and over 20 others) alone cause over 16,500 deaths and over 103,000 hospitalizations per year in the US,” according to a review article published in the New England Journal of Medicine.(1) Everything from stomach bleeding to intestinal damage to liver failure can result from the long-term use and interactions with what are known as NSAIDS, or Non-Steroidal Anti-Inflammatory Drugs. Fortunately, herbs and glucosamine are not only safe and effective means of easing the joint discomfort of arthritis, but glucosamine can help to rebuild the cartilage. Rather than just focusing on treating the symptoms and covering up the pain, it is more sensible to get to the root of the problem and pay attention to the body.
Facts
40 million Americans (one in six) have arthritis. About 6 million Americans (2.5 percent of the U.S. population) are self diagnosed. By the year 2020, the Centers for Disease Control projects that arthritis will increase to 59.4 million Americans. Women are affected by arthritis more than men. At least 26 million women of all ages have arthritis. Arthritis is the number one cause of disability in America. It limits for about 7 million Americans. The estimated annual cost of arthritis to the economy is $65 billion in medical care and indirect costs such as lost wages Osteoarthritis is the most common form of arthritis, affecting an estimated 20.7 million Americans. Almost every person over the age of 75 has OA in at least one joint Osteoarthritis affects an estimated 20.7 million Americans. Almost everyone over the age of 75 is affected in at least one joint. Before age 45, more men have it, while after age 45, osteoarthritis is more common in women. OA is responsible for more than 7 million physician visits per year.
Formulas
Joint-Ease Formula: Supports joint health and ease of movement. This formula may help both varieties, especially when symptoms are aggravated by cold, damp weather. In Traditional Chinese Medicine, "bi" syndromes are obstructions in the flow of energy that cause pain and swelling. This formula, used for thousands of years, contains herbs for joint inflammation and has analgesic and circulation-promoting properties. Pubescent angelica is included for acute or chronic pain obstruction. Large gentian has recently been discovered to contain gentianine, a powerful anti-inflammatory agent. Turmeric contains curcumin, a powerful antioxidant shown to prevent free-radical damage of the joints to a greater extent than both Vitamin E and Vitamin C; it mobilizes the body's own anti-inflammatory system. Bromelain, a mixture of enzymes from pineapple, therapeutically breaks down fibrin which walls off inflamed areas, obstructing blood flow and tissue drainage.
Glucosamine: Contain a synergistic combination of glucosamine sulfate and chondroitin sulfate. Glucosamine sulfate is a well-absorbed source of glucosamine, an important precursor for the synthesis and maintenance of connective tissues. Chondroitin sulfate also supports formation of connective tissues, primarily joint cartilage, and helps protect existing cartilage. These ingredients are grerst to support the body’s connective tissues, such as tendons, ligaments, bone, and cartilage. Research has shown great promise for glucosamine to help act as a shock absorber of bone against bone.
Two long-anticipated major clinical studies have recently found that Glucosamine and Chondroitin Sulfate, work even better than common pain killers. The "GAIT" Glucosamine/Chondroitin Arthritis Intervention Trial - Glucosamine Effectiveness (13 Universities - United States Study) reports “Combination of glucosamine and chondroitin sulfate is effective in treating moderate to severe knee pain due to osteoarthritis.”
Under the direction of the NIH (National Institutes of Health), one of the world’s foremost medical research centers, 13 highly prestigious research universities in the United States performed this randomized, double-blind, placebo controlled, parallel assignment, efficacy study on over 1,500 osteoarthritis sufferers. The Glucosamine and Chondroitin combination was found to significantly reduce pain compared to placebo AND Celebrex® (celecoxib), using the WOMAC Pain Index (Western Ontario and McMaster Osteoarthritis Index).
An independent Hospital based European study (known as the GUIDE study) released its results. They too, showed the extraordinary benefits of glucosamine. The Glucosamine Unum-in-Die (Once a Day) Efficacy (GUIDE) Trial - Joint Discomfort (13 Hospitals - European Study) Found: “Glucosamine sulfate…might be the preferred symptomatic medication in knee osteoarthritis.” Dr Herrero-Beaumont of the Fundacíón Jiménez Díaz in Madrid, found glucosamine sulfate to be more effective than the over-the-counter painkiller acetaminophen for joint discomfort in a multicenter, randomized, placebo- and reference-controlled, double-blind study.
Inflam-Ease Formula: Bromelain is a potent anti-inflammatory enzyme. Scientific evidence shows that bromelain (a proteolytic enzyme of pineapple) breaks down fibrin, a substance that builds up around inflamed areas, blocking blood supply. It has been shown to actually digest inflammatory compounds. Bromelain quenches inflammation at its source - the molecules that create it - and it is also effective in inhibiting prostaglandins. In an extensive five-year study of more than 200 people experiencing inflammation as a result of surgery, traumatic injuries and wounds, 75 percent of the study participants had good to excellent improvement with bromelain, a much higher rate than that afforded by drugs. Most of the people in this study were discharged from the hospital in only eight days - half the usual amount of time. They also experienced no side effects. The results of several other studies showed that this enzyme also reduces inflammation resulting from arthritis or sports injuries.
Turmeric has an active ingredient curcumin, which inhibits several inflammatory compounds including nitric oxide, interleukin -1, tumor necrosis factor, lipoxygenase and cyclooxygenase. Curcumin has antioxidant free radical quenching properties. These have unique anti-inflammatory properties with therapeutic action comparable to aspirin, but with important advantages in that curcuminoids prevent the synthesis of thromboxanes, causing redness, swelling and pain, and do not affect prostacyclins, important in the prevention of vascular thrombosis. The anti-inflammatory mechanisms of curcumin compare to those of the non-steroidal anti-inflammatory drug, phenylbutazone, but with no side effects. It has been proven to alleviate the symptoms of osteoarthritis, rheumatoid arthritis, stomach pains and intestinal spasm.
Dietary Guidelines: Substitute red meats with fish and white meat; use soy based alternatives, decrease the number of eggs per week, use egg beaters or tofu, use low fat dairy products, substitute vegetable oils for butter, lard and other saturated fats, eat fruits and vegetables daily and cut down on all refined sugar and flour products, use no or low salt, and drink herbal teas, green tea, or vegetable juices instead of soft drinks and coffee. Eat more cold water fish and take 1 tablespoon of flaxseed oil daily.· Salmon, mackerel, herring, halibut are good sources of omega-3 fatty acids. Flaxseed oil is a good source of alpha linolenic acid, an omega03 oil that the body can convert to eicosapentaenoic acid (EPA). Eat 5 or more servings of a combination of vegetables and fruits. Numerous studies show that a diet high in carotene rich and flavonoid rich fruits and vegetables reduces the risk of heart disease and strokes. Green leafy vegetables, yellow-orange colored fruits and vegetables, such as carrots, apricots, mangoes, yams and squash. Red and purple vegetables and fruits such as tomatoes, red cabbage, berries, and plums. Legumes, grains and seeds are rich sources of carotenoids. Good sources of flavonoids include: citrus fruits, berries, onions, parsley, legumes, green tea and red wine. Increase the intake of fiber and complex carbohydrates by eating 6 or more servings per day of whole grain breads, cereals, and legumes.
Stress: Relaxation, yoga, breathing exercises, meditation, all can help and should be pursued. A simple relaxation technique of 20 minutes a day progressively sweeping the mind through the body head to toe can help relax the tone of the nervous system. This helps take the body out of the "fight or flight response." This allows for less chance of spasming that often contributes to inflammation of the myofascia. Check out our Stress Relief Program.
Exercise: Should be little and often, with gentle stretching before hand.
References:
NSAID’s
Wolfe MM, et. al. NEJM 1999;340(24):1888-99
Bromelain Enzyme
Baumuller, M. "Enzyme zur wiederherstellung nach sprunggelenkdistorsionen." Z. Allg. Med., 1992; 68: 61.
Blonstein, J.L. "Oral enzyme tablets in the treatment of boxing injuries." The Practitioner, 1967; 198: 547.
Boyne, P.S. & Medhurt, H. "Oral anti-inflammatory enzyme therapy in injuries in professional footballers." April 1967, 198: 543.
Bucci, L.R. Nutrition Applied to Injury Rehabilitation and Sports Medicine, Boca Raton: CRC Press, 1995. p. 170.
Hiss, W.F. "Enzyme in der sport- und unfallmedi-zin." Continuing Education Seminars, 1979. Muller-Hepburn, W. "Anwendung von enzymen in der sportmedizin." Forum d. Prakt. Arztes, 1970,18.
Worschhauser, S. "Konservative therapie der sportverletungen. Enzympraparate fur therapie undprophylaxe." Aligemeinmedizin, 1990; 19: 173.
Klein, G., et al. "Phlogenzym in der behand-lung der periarthropathia humerosacapularis tendopathica simplex." Arzt + Praxis, 1997; 781: 879-885.
Turmeric
Arora RB et al., "Anti-inflammatory studies on Curcuma longa," L Ind J Med Res. 59: 1289. 1971.2.
Ammon HPT et al., "Mechanism of anti-inflammatory actions of curcumin and boswellic acids," J Ethnophamacology. 38: 113. 1993
Myrrh
Al-Harbi, M.M., et al., "Gastric antiulcer and cytoprotective effect of Commiphora molmol in rats," J Ethnopharmacol (1997), 55(2):141-50
Andersson, M., et al., "Minor components with smooth muscle relaxing properties from scented myrrh (Commiphora guidotti)," Planta Med (1997), 63(3):251-54
Atta, A.H, and A. Alkofahi, "Anti-nociceptive and anti-inflammatory effects of some Jordanian medicinal plant extracts," J Ethnopharmacol (1998), 60(2):117-24
Eucommia
Li Y, Kamo S, Metori K, Koike K, Che QM, Takahashi, "The promoting effects of geniposidic acid and aucubin in Eucommia ulmoides Oliver leaves on collagen synthesis," S Biol Pharm Bull 2000 Jan;23(1):54-
Li Y, Sato T, Metori K, Koike K, Che QM, Takahashi, "The promoting effects of geniposidic acid and aucubin in Eucommia ulmoides Oliver leaves on collagen synthesis," Biol Pharm Bull 1998 Dec;21(12):1306-103.S. Biochemistry Laboratory, College of Pharmacy, Nihon University, Chiba, Japan