NATURAL TREATMENTS FOR ARTHRITISIndra Leibowitz Pharmacist Naturopath

Agenda• Types of Arthritis• Traditional Western Medications• Plant-based Herbals• Glucosamine/ Chondroitin• GLA• Products show and tell• Questions

Treatment Modalities Arthritis• NSAIDS• Analgesics• DMARDS (Disease-modifying anti-rheumatic drugs, for

RA)• Corticosteroids• TNF inhibitors• Intra-articular hylands and synovial fluid substitutes

White Willow Bark• It works like aspirin• Anti-inflammatory• Can “thin” the blood, prevent clots• Side effects: Nausea, stomach pain, tinnitis, kidney and

liver toxicity, Reye’s syndrome

White Willow Bark• Salix alba• Underside of leaves are white and hairy• Main ingredients in salicin• Isolated by French pharmacist in 1828• Salicin can convert to salicylic acid

Nettle Leaves

• Yellow rhizomes and stolons• Stinging and non-sting hairs• Containing vitamin A, folate, calcium, proteins, iron • Flavor similar to spinach• Used in Germany for BPH and arthritis

Nettle Leaves• Anti-inflammatory components • Block production of prostaglandins • Active compounds reduce TNF-alpha and IL-1B• Inhibits at the genetic level to reduce compounds in

synovial fluid• Comparable to Enbrel• Bodybuilders use it to increase free testosterone

Boswellia Serrata • Known as Indian Frankincese• Used in Ayurveda• Boswellic acids contain anti- inflammatory compounds• Boswellic active compound called AKBA• Inhibits 5-lipoxygenase

Boswellia Serrata • Research team including MD from Arthritis Foundation

have done studies • Double-blind, placebo-controlled study for OA • Pain and physical ability before study and 7, 30, 60, 90

days after• 250mg Boswellia reduced pain, increased joint function,

reduced levels of cartilage-degrading enzyme MMP-3• Side effects: Stomach upset, skin rashes

Bromelain• Anti-inflammatory found in pineapples• Studies in Germany show improvement with knee

osteoarthritis, decreased swelling after torn ligaments • German Commission E dose is 80-320mg two-three times

daily• Arthritis dose is 500-2000mg daily• Destroyed by heat

Bromelain• 1-8 pineapples/day!• Bromelain can increase glucosamine absorption by up to

90%• Many drug interactions!• Caution: Antibiotics, Sedatives, Blood thinners

Glucosamine/Chondroitin/MSM• Many manufacturers• 1500mg glucosamine/ 1200mg chondroitin• Does not work for everyone• MSM useful at higher elevations only (High altitude

climbers) where lack of oxygen

Gamma Linolenic Acid (GLA)• Found in seeds and oils of plants • Essential fatty acids • Most concentrated one is Borage oil• Others include evening primrose, blackcurrant seed oil• Benefits seen after 6 months and doses of 1.4g/day of

GLA

Omega-3 Fatty Acids• Body can’t make itself, so get from diet • Food sources are salmon, tuna, trout, nuts seeds, cooking

oils• Form leukotrienes which stop inflammation• Most useful in rheumatoid arthritis

Tips to Get Omaga-3 in Diet • Eat salmon and tuna• Use canola oil instead of corn oil• Corn oil contains Omega-6 which promotes inflammation

vs canola oil which has Omega-3• Omega-3 Supplements in capsules

Examples of GLA sources Borage Seeds Evening Primrose

Spices, Foods and Arthritis • Tumeric and garlic both antioxidants and anti-

inflammatories • Studies in 1980 India 1200mg curcumin decrased joint

swelling and stiffness comparable to rx phenylbutazone, but study flawed no placebo group

• Green tea-antioxidant polphenols neutralize free radicals • Cayenne• Chili Pepper ( Capsicum) topical

Herbs, Teas Poultices, Creams • Need correct concentrations to be effective (ie/

glucosamine)• Creams such as capsaicin have limited use • Teas minimal effect • Medications may interfere with absorption

THANK YOU!Questions

And Show and tell