Antioxidants are substances that destroy dangerous free radicals in the body which often cause inflammation. As such, they can be considered as anti-inflammatories which also includes such vitamins as A, E, and C.
Inflammation, found in some forms of arthritis, depletes the joints of vitamin E. Studies have shown that, by taking 400-600 mg per day, there was a reduction in the symptoms of osteoarthritis. (Note that a mixed form of Vitamin E containing alpha, beta, delta, gamma tocopherols and tocotrienols is seven times better than taking the popular form of d-alpha tocopherol).
Another antioxidant is Pycnogenol, a botanical supplement derived from the extract of the bark of maritime pine. There are many antioxidants from which to choose found in a variety of natural foods. Those who eat high levels of antioxidants show a much slower rate of joint deterioration, particularly in the knees.
B vitamins consist of several within the family (see Vitamins at a Glance). B5 (pantothenic acid, aids in tissue repair. Those with rheumatoid arthritis often show a deficiency of this vitamin and others in the family. Since B vitamins are water-soluble, they are depleted every day and more often when under stress.
Some nutrition-oriented doctors are now prescribing as much as 1000 mg of B5 to help with morning stiffness, general disability, and pain. Another, B6, helps reduce swelling and joint stiffness. It is also required by several other nutrients for assimilation into the body. B3 (niacin), can help increase joint mobility, improve muscle strength, and reduce fatigue; but high doses are required.
NOTE: If one B vitamin is taken without the others, it could cause a deficiency of in one or more of the others. Therefore, it is recommended that a good multiple B formula be taken along with any isolated others. B vitamins have proven to help arthritic patients even when very small amounts when included in multi-vitamin and mineral supplements.
Boron is an important trace mineral needed for bone and joint maintenance. (Minerals as a whole are often deficient in those with arthritis as well as other conditions. For more information of the necessity of all minerals, see Minerals at a Glance). Vital for the structure of plants, boron was not shown to be crucial for humans until the early 1940s. We now know that boron is essential in the metabolism of both calcium and magnesium in the body – both of which contribute greatly to bone health. There is a suggested link between boron deficiency and arthritis. Boron can be found in almost all fruits and vegetables as it is taken up from the soil into the plant. However, the boron content of the plant is dependent on what is available in the soil. Generally, a diet rich in raw fruits and vegetables supply enough of this nutrient. Boron does appear to have analgesic effects, but it has been poorly investigated so its mechanism is not well understood. It is said that 3-9 mg per day is a safe dose and that 6 mg of boron per day, taken for two months, may help relieve the symptoms of osteoarthritis. However, since boron can increase estrogen levels, it is recommended that supplements should be limited to 3 mg per day. High doses of 500 mg per day causes nausea and vomiting, as well as affecting estrogen levels. Besides, that much is very rarely needed by the body.
Boswellia (also known as Frankincense) is an anti-inflammatory herb used in treating arthritic pain. The resin collected, called guggul, has traditionally been used in Ayurvedic medicine for treating such chronic inflammatory states as ulcers and arthritis as well as for controlling cholesterol levels. It has been only in recent years that any studies have been done on its effectiveness. Although it appears to have anti-inflammatory effects on the body, it does not have any direct analgesic effects. However, there is a significant reduction in pain through the decrease in inflammation. Although it is widely used for rheumatoid arthritis, it can also be a valuable supplement in the treatment of osteoarthritis.
Calcium helps maintain bone density and reduces the risk of further loss. However, it is not the amount of calcium taken that is important, but how much is absorbed into the body. Therefore, it is especially important to use a form that is easy to absorb. (See Minerals at a Glance)
Capsicum is one of the most widely used spices in the world. It has been used in Central and South America for thousands of years to increase circulation and aid digestion and it even stops bleeding! It is now becoming widely known for its analgesic and anti-inflammatory effects. Shown to act through a specific receptor on pain fibers (the VR1 receptor), capsicum decreases the production and action of substance-P, which is a chemical released from nerve fibers in response to pain. It mediates an inflammatory response by causing blood vessel dilation and the release of histamine from mast cells. At first, capsicum actually increases the release of substance-P, which can be felt as a burning sensation. Later, substance-P production greatly decreases, reducing the overall pain and inflammation response. It was originally thought that capsicum affected only those fibers that conduct the pain message from the skin to the CNS. However, it is now believed to have a wider effect on all sensory nerves, playing a central role in the spinal cord where substance-P acts as a neurotransmitter for pain stimuli. Most forms of capsicum are administered via a cream and applied topically over the arthritic or painful areas. The skin is supplied with many small nerve branches that lead back to the main ‘trunks’ of the nerve. When capsicum is applied to a nerve branch, substance-P is depleted simultaneously in all connecting branches and, hence, has an effect on the joint. Daily use is likely needed over a period of a couple of weeks before enough is built up in the system to cause a major reduction in pain.
Chondroitin sulfate, in conjunction with glucosamine, has shown to restore joint function. Since vitamin B6 is needed to help the absorption of both chondroitin and glucosamine, it is advised that it be added as well.
Curcumin (turmeric) is another herbal plant effective against arthritic symptoms. It is a member of the ginger family and, thus, has the same anti-inflammatory effects. It has been used for centuries in India to treat inflammation and pain, as well as aiding in the digestive process. Its anti-inflammatory effects have been compared to hydrocortisone and phenylbutazone. It is thought that curcumin inhibits the breakdown and metabolism of cortisone by the liver. This would increase the amount of circulating cortisone in the body and prolong its effect. Curcumin appears to be less active in experimental animals without adrenal glands, indicating that the herb may also work by stimulating the release of adrenal corticosteroids. Further studies support a role for curcumin in priming cortisone receptors. (See many more health benefits of curcumin in Nature’s Pharmacy: Evidence-based Alternatives to Drugs)
DMSO (dimethyl sulfoxide) is a bi-product of the wood industry, and first introduced for therapeutic use in 1963. During the 1970s, DMSO was extensively prescribed in Russia to rheumatic patients. It is now widely used worldwide as a treatment for musculoskeletal inflammation. DMSO is not found in the diet and must be taken in supplemental form. Oral absorption of DMSO is excellent, and its metabolism is well established. When it is ingested, about 15% of DMSO is converted into MSM, one of its active components. It increases the moisture-retaining and shock-absorbing qualities of cartilage in a joint and increases free radical scavenging. In doing so, it decreases inflammation while providing building materials for collagen repair. DMSO acts as an antioxidant by neutralizing oxidized molecules in the body, particularly the joints. This ultimately has an effect on pain and inflammation in both inflammatory and non-inflammatory types of arthritis. It has also proven effective when applied topically, with effects lasting up to six hours. It is most effective when the concentration ranges from 70%-90%. Anything higher, the efficacy actually starts to decrease. The only side effect known is that it may leave a garlic taste in the mouth.
Essential Fatty Acids (omega oils) are, as the name suggests, essential and have shown to produce modest improvements in joint pain and stiffness by keeping the joints “lubricated” with the “good” fats. However, because of the modern diet, most people are 70%-80% deficient. Symptoms of such deficiency are fatigue, dry skin and hair, acne, constipation, depression, bloating, and arthritis. EFAs are composed of the following:
- Omega 3s, which are broken down into three groups: alpha-linoleic acid (found in flax seeds, hempseeds, walnuts, and dark green leaves); stearidonic acids (found in blackcurrants); and eicosapentaenoic acids (found in cold-water fish like salmon, mackerel, sardines, and trout).
- Omega 6s, which are also broken down into three groups: linoleic acids (LA) (found in the seeds of hemp, safflower, sunflower, soybeans, pumpkin, and sesame); gamma-linolenic acids (GLA) (found in the oils of borage seed, evening primrose, and blackcurrant seeds); and arachidonic acids (found in meats and other animal products – which cause inflammation). GLA converts to a prostaglandin called E1, known to have anti-inflammatory effects.
- Omega 7 and 9s, also known as oleic acids, are widely abundant in olives, almonds, avocados, peanuts, cashews, and macadamia oils. Omega 7s are found in coconut and palm oils and sea buckthorn. However, these fatty acids do not play a crucial role in the treatment of osteoarthritis but they are important for skin and mucus membranes.
The role of EFAs in the body is crucial in determining which prostaglandins will be produced. Prostaglandins are hormone-like substances important in the regulation of many bodily functions including blood pressure, pain, inflammation, swelling, allergic reactions, blood clotting, and much more.
The inflammation of arthritis is mediated by such chemicals as prostaglandins and leukotrienes. The body produces ‘good’ prostaglandins that have important functions including moderate inflammation. The role of EFAs is to limit the availability of arachidonic acid (found in animal products), which promotes the synthesis of ‘bad’ prostaglandins involved in excessive inflammation production.
Omega 3 and 6 EFAs lead to the production of the more beneficial prostaglandins. Clinical evidence for the use of EFAs in reducing the inflammation of arthritis is growing showing that they significantly reduce pain and inflammation in the joint.
EFAs also help to improve the good/bad ratio of cholesterol, soften skin and hair, and regulate bowel movements. The ideal ratio of omega 6 to omega 3 EFAs is about 3:1 or 4:1. It is important to note that grocery store oils and salad dressings contain only omega 6 oils – and usually well-processed at that. Thus the ideal balance is tremendously important to offset the average consumption being 15:1.
By increasing the good fats (listed above), many disorders, including arthritis, will be greatly reduced. Many of these cold-pressed oils are excellent used salad dressings, added to fruit drinks and blended well, or simply taken on their own.
Ginger root has been used in traditional Chinese medicine for thousands of years to help decrease pain and inflammation. There are well over 1,300 species belonging to the Zingiberaceae family, but the most commonly used ones are Zingiber officinale and Alpinia galanga (Greater Galanga), which is a Siamese type of ginger. Ginger contains several hundred active ingredients, but the most recognized ones are a group of active constituents called oleoresins. Ginger not only aids in the digestive process, but also has the ability to inhibit the prostaglandin enzymes that cause inflammation. Ginger does not cause the gastric irritation that pharmaceutical anti-inflammatories do. In fact, ginger helps the digestion and nausea.
Globe artichoke helps to break down uric acid crystals, especially in the cases of gout, as well as assisting both the gallbladder and liver to clean and recycle products. By adding lemon to the artichoke, the lemon will directly stimulate the detoxification processes within the liver.
Glucosamine sulfate is naturally produced by the body and contains a building block needed for joint cartilage repair. However, it may also be taken in supplement form with a maximum absorption rate reaching about 90%. It has been used since the 1800s when it was isolated from chitin, a component in the exoskeleton of crustaceans, insects, and spiders. Thankfully today, there are plant-based forms. Symptoms are lessened as damaged joints are repaired when this supplement is taken. (see more separately above)
Magnesium is essential for the maintenance of healthy bones and works in conjunction with calcium. It is recommended that a minimum of half as much magnesium as calcium be taken. Often, a full 1:1 ratio of calcium to magnesium is required.
Manganese, an antioxidant and trace mineral, is important for the synthesis of cartilage components. Although a deficiency may go unnoticed, it will contribute to osteoarthritis.
Milk thistle is a liver protector and detoxifier. It is widely used to help the liver clear out toxic buildup that starts the disease process. Taking milk thistle helps the liver function better which, in turn, will help ease the symptoms of arthritis as well as other diseases.
MSM (methylsulfonylmethane) is a naturally occurring sulfur-containing compound used as a structural building material for cartilage. It contains about 34% sulfur, and is a derivative of DMSO (dimethyl sulfoxide), another form of arthritis supplementation. However, when DMSO enters the body, only about 15% is converted into MSM, which is the active molecule. MSM is also found in many foods ,including fruit, alfalfa, corn, tomatoes; but the richest source is breast milk. Unfortunately, MSM is very volatile, and its therapeutic effects are lost when the food is cooked, processed, or stored.
SAM-e (S-adenosylmethionine) is a substance formed by combining the essential amino acid methionine with ATP (adenosyl-triphosphate), which is the body’s major form of energy storage. It is essentially three phosphate molecules attached together that form a bond. When this bond is broken, it leaves a di-phosphate and a single phosphate, releasing energy. This is the energy that the body uses for muscle contractions, nerve impulse conductions, heart beats, or antibody creations. ATP is required for every reaction in the body and is the molecule that combines with an amino acid to form SAM-e. This combination has been proven to increase the manufacture of certain cartilage components called proteoglycans. The blood levels of these proteoglycans rise following supplementation with SAM-e. Just as with glucosamine and chondroitin sulfates, SAM-e also has a beneficial effect on cartilage. Its role is also that of restoration, indirectly reducing inflammation by reducing the destructive process. Several studies have indicated that when patients consumed 1200 mg of SAM-e per day (400 mg 3 times a day), there was a significant reduction in pain, stiffness, and other arthritic symptoms and rivaled that of several different NSAIDs. However, the price of the supplement is the main deterrent, often causing people to bypass it entirely or to take a smaller dose. Not only does SAM-e help keep the joints healthy and strong by providing building materials to replace worn down cartilage, but it also helps indirectly to decrease the pain and inflammation of a joint through this repair. SAM-e does have one side effect. It appears to have anti-depressant properties and may elevate mood in those depressed because of chronic pain. Therefore, if pharmaceutical anti-depressants are being taken at the same time, SAM-e may interfere with the efficacy of the drug.
Selenium is an antioxidant mineral found lacking in those with rheumatoid arthritis. People with this condition seem to have an abnormality in their metabolism, affecting the absorption of several nutrients including this mineral as well as others. When taken with vitamin E, the effects of selenium are enhanced.
Slippery Elm, Marshmallow, and Cabbage are all demulcent, emollient herbs that help to soothe irritated and inflamed mucous membranes, especially in the digestive tract. They can help minimize the effects of regular arthritis medications.
Sulfur is needed to form connective tissue and to increase the production of SAM-e (s-adenosylmethione), glutathione, and N-acetylcysteine, all of which influence the joint and cartilage structure. However, too much can be destructive.
Vitamin C, an antioxidant, is another nutrient found lacking in those with arthritis, particularly rheumatoid arthritis. It is a free-radical scavenger that is also necessary for cartilage and bone formation. Vitamin C with bioflavonoids also helps to strengthen collagen, the cell-binding protein found in bones. Collagen cannot be synthesized without vitamin C present in the body. It is a vital nutrient for those taking aspirin as the drug causes a deficiency of this nutrient. Recommended doses range from 1000 to 6000 mg per day. Taking vitamin C and E together helps to reduce inflammation and speed the healing of joints. Since vitamin C is eliminated quickly from the body, including the timed-release forms, it is advisable to take several smaller doses throughout the day than one large dose.
Vitamin D is essential for the formation, growth, and maintenance of bones and necessary for the absorption of calcium. Vitamin D and calcium work wonders in helping to reduce the effects of osteoarthritis, in particular.
Willow (Salix) has one of the longest uses in medicinal history for the treatment of fevers and inflammations. It has provided the foundation for many of the anti-inflammatory drugs used today. There are several species of willow, all of which belong to the family Salicaeae. Despite the fact that the Crack Willow (S. fragilis) and the Purple Osier Willow (S. purpurea) contain the highest concentration of salicin (10% and 8% respectively), it is the white and black willows most commonly used in North America. They have only slightly less than 1% concentration of salicin. The bark of young branches is particularly rich in medicinal substances, but it is salicin’s anti-inflammatory effects that are most sought. Ironically, salicin’s effects are rather weak, requiring metabolism in the gastro-intestinal tract and liver to reach its final form, salicylic acid (ASA or aspirin). This conversion takes time. Therefore, willow has a slower onset of action than salicylic acid itself, but its therapeutic effect lasts longer and with significantly fewer side effects than that of the isolated form used in pharmaceuticals.
Zinc is a vital healing mineral required by every cell in the body. It is also important for the absorption and assimilation of many nutrients. It is a vital co-factor involved in over 200 different enzyme reactions, as well as assisting in the production of several hormones. It is needed for cross-linking and regeneration of connective tissue in cartilage. Zinc metabolism is altered in those with arthritis, particularly rheumatoid arthritis, leaving a deficiency in the body. Zinc has been used in the treatment of RA, where serum levels have been found to be low. Supplementation results in a slight decrease in pain and inflammation. Zinc is well-known for its wound healing properties and its positive effects on the immune system, especially during colds and flu. The mineral is found abundantly in muscle tissue and plays an important role in its health and maintenance. An antioxidant, it helps to increase the function of the enzyme superoxide dismutase (SOD) which subsequently causes a reduction in free radical attacks on cellular structures and, therefore, decreases inflammation. Since zinc is involved in so many enzyme reactions helping to assimilate other nutrients, its success in the area of muscle repair stands to reason as nutrients are better able to help the body repair itself. However, high doses of zinc can interfere with copper absorption and vice versa. It is recommended that for every 30 mg of zinc, 2 mg of copper should be added to the diet, but not at the same time. Zinc can be found in such foods as pumpkin seeds, almonds, ginger root, rye bread, oysters, and shell fish.
Herbs for Arthritis
RA (rheumatoid arthritis)
- Boswellia has anti-inflammatory properties and may help build cartilage.
- Burdock root, devil’s claw, horsetail, sarsaparilla, and white willow also are useful anti-inflammatories.
- Ginger is a cooking spice that aids in digestion and also has anti-inflammatory properties.
- Turmeric (Curcumin) is a cooking spice that has anti-inflammatory properties and protects against free radicals.
- Yucca roots have anti-inflammatory properties. They are boiled in water and made into a tea.
- Boswellia has unique anti-inflammatory properties, working in a similar manner to nonsteroidal anti-inflammatory drugs (NSAIDs).
- Burdock may be used to deep cleanse tissues.
- Chinese angelica, licorice, false unicorn root, black cohosh, wild yam, and sage contain compounds similar to estrogen, but are less powerful than synthetic hormones, consequently producing fewer side effects.
- Comfrey can be helpful in repairing damaged bones.
- Herbs rich in calcium include parsley, nettle, dandelion leaf, and horsetail.
- Horsetail is believed to have the effect of strengthening connective tissue. It is rich in silica, which helps harden bones.
- Nettle also helps the body to get rid of harmful excess acids.
- White Willow has anti-inflammatory and analgesic effects.