Rheumatoid arthritis: Welcome relief from crippling pain and inflammation

Rheumatoid arthritis (RA) is an insidious disease that sets your body at war with itself. It causes your immune system to attack the tissues that line and cushion your joints, most commonly those in your hands and feet. Eventually, the cartilage, bone, and ligaments are destroyed, causing scar tissue to form within the affected joint.

In addition to the debilitating pain and inflammation this causes, RA may be accompanied by fatigue, weight loss, anaemia, anxiety and depression. Other symptoms include inflammation of the eyes, nodules or lumps under the skin, and a general feeling of malaise.

Symptoms tend to flare up from time to time, with periods of remission in between. Just what causes the immune system to malfunction, causing RA to develop, is still not clear, but many different factors, including genetic ones, may be involved.

Conventional treatments come with an unpleasant list of side effects

Your doctors first line of treatment for RA is likely to be non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or diclofenac. While these may help initially, they are likely to become less effective as the disease progresses, so more powerful drugs including corticosteroids (such as prednisolone) and immunosuppressants (such as methotrexate) are then prescribed.

Generally, the stronger the drug, the more severe are its potential side effects. For instance, RA patients who are treated with even low doses of prednisolone are at increased risk of coming down with pneumonia.
A newer class of drugs called TNF-blockers (which stop the production of an inflammatory substance called TNF-alpha) have been hailed as a breakthrough in RA treatment, but already they appear to be linked to skin problems and an inflammatory disorder of the blood vessels, called leukocytoclastic vasculitis (J Rheumatol 2004; 31: 1955-1958).

How the ocean is proving to be an excellent source of remedies for RA

The New Zealand green-lipped mussel has long been hailed as a natural treatment for arthritis, and a patented extract of this shellfish has recently been demonstrated in a clinical trial to have dramatic effects on RA symptoms (Adv Ther 2004; 21(3): 197-201). The supplement, called Lyprinol, contains a unique complex of fatty substances including sterols, sterol esters, triglycerides, free fatty acids and polar lipids.

 
In a 12-week study, involving 50 men and women with inflammatory RA, 62 per cent of those taking Lyprinol were able to reduce their dosage of conventional drugs and 38 per cent were regarded as symptom free by the end of the trial. The recommended dosage for Lyprinol is four capsules a day. Pregnant women and anyone with a shellfish allergy should avoid taking this supplement.

Another powerful weapon in the natural arsenal against the disease is the combination of omega-3 fatty acids found in fish oil. According to the results of at least 13 double-blind, placebo-controlled studies, omega-3 fatty acids can significantly reduce the symptoms of RA (J Rheumatol 2000; 27: 23432346).

Researchers have recently discovered that fish oil can significantly block the production of specific inflammatory chemicals, including C-reactive protein and soluble tumour necrosis factor receptor p55, that cause pain and swelling in the joints of RA sufferers (J Int Med Res 2004; 32(5): 443-54).

Unfortunately, not all fish oil supplements on the market are manufactured in a way that protects the stability of the omega-3 fatty acids (which are rapidly destroyed by heat and oxygen) and some can be contaminated with pollutants such as mercury. Ask a nutritional therapist or a specialist retailer of nutritional supplements for advice on the best brands to buy. A daily dose of 3 grams of fish oil is recommended.

Boswellia, Samento and Devils Claw provide an effective trio of healing herbs

A small Indian tree called Boswellia serrata is the source of a resin known as salai guggal, which has been used for thousands of years in traditional Ayurvedic medicine to treat arthritis and rheumatism. Research has identified boswellic acids as the active ingredients in Boswellia. When Indias Council for Scientific and Industrial Research was looking for anti-inflammatory herbs with beneficial effects on rheumatic diseases, they concluded that boswellic acids are more potent and less toxic than standard painkillers.

In a clinical trial involving 175 RA patients, 97 per cent reported moderate to excellent improvements in pain, joint swelling and morning stiffness after taking boswellic acids each day for three to four weeks. The improvements equalled those for patients taking the conventional drugs ketoprofen and phenylbutazone, but unlike the drug treatments, boswellic acids caused no undesirable side effects (Agents and Actions 1986; 18: 407-11). Take a daily supplement of Boswellia that provides 450mg to 600mg of boswellic acids.

Samento is a variety of cats claw (Uncaria tomentosa), a South American vine that gets its name from the sharp thorns on its stems. Samentos unique advantage over ordinary cats claw is that it does not contain substances called tetracyclic oxindole alkaloids (TOAs), which have been shown to block the beneficial actions of another group of related chemicals called pentacyclic oxindole alkaloids (POAs). It is the POAs that are credited with Samentos positive effects on auto-immune problems such as RA.

In a randomised, double-blind clinical trial involving 40 RA patients, those taking Samento experienced a 70 per cent reduction in the number of painful joints as well as significant reductions in pain intensity and the duration of morning stiffness (J Rheumatol 2002; 29(4): 678-681). Build up your dosage of Samento gradually, from one drop of extract daily in a cup of water to the maximum therapeutic dose of 25 drops twice a day. Take Samento on an empty stomach at least 30 minutes before meals and away from other supplements, for maximum absorption.

Another thorny herb that can benefit RA sufferers is devils claw (Harpagophytum procumbens). When researchers followed 89 patients with RA during a 2-month clinical trial, they found that the group given devils claw showed a significant decrease in pain intensity and improved mobility (Le Magazine 1992; 15: 27-30). Another double-blind study of 50 people with various types of arthritis found that just 10 days of treatment with devils claw provided significant pain relief (European Scientific Cooperative on Phytotherapy. Harpagophyti radix (devil's claw). Exeter, UK: ESCOP; 1996-1997). A typical dosage of devils claw is 750mg 3 times daily of a preparation standardized to contain 3 per cent iridoid glycosides.