Positive Health Online

Last month I wrote about pain and inflammation, triggered by the body's response to tissue damage, with the release of prostaglandins, histamine, leukotrienes, cytokines, free radicals, serotonin, interleukin, insulin, thromboxanes, prostacyclins and lymphokines.

Drug treatments can bring relief, but have side effects. Natural remedies work in the same way, but without side effects. I explored some of these, discussing the role of allergens, eating the right foods and the importance of essential fatty acids and supplementation. This month I focus on the analgesic and anti-inflammatory properties of herbs and phytonutrients.

Boswellia serrata (NO Burseraceae)

Boswellia serrata is a deciduous tree, which grows in India, known as Indian frankincense or olibanum. The active principles, obtained from the gum resin, a fraction of which is called salai guggal, prevents formation of leukotrienes, and has benefits in rheumatoid arthritis, osteoarthritis, soft tissue rheumatism, low back pain, myositis and fibrositis. The therapeutic action includes reduction in joint swelling, increased mobility and alleviation of morning stiffness. Unlike aspirin, a non-steroidal anti-inflammatory drug which produces side effects of gastrointestinal ulceration, bleeding, perforation and kidney disease, Boswellia serrata has no side effects and is even safe to use during pregnancy.[1] The non-acidic oil fraction of the gum resin, salai guggal, has analgesic and sedative effects, which work in a similar way to morphine. A supplement of 200-400mg daily can be taken and a cream made from Boswellia serrata may be used in localized situations.

Turmeric (Curcuma longa)

Turmeric has been used for centuries in Ayurvedic medicine. Most people recognize turmeric as the yellow colour found in curry powder; however, it has great importance as a medicinal herb due to the presence of curcuminoids (phenolic compounds) called curcumin, dimethoxycurcumin and bisdimethoxycurcumin. 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.[2] Turmerin, another active component of turmeric, has potent antioxidant effects and may contribute to anti-inflammatory action, as it scavenges hydroxyl and superoxide radicals and inhibits production of lipid peroxides, which fuel the inflammatory response. The anti-inflammatory mechanisms of curcumin compare to those of the non-steroidal anti-inflammatory drug, phenylbutazone, but with no side effects. Dosages of 500mg 1-3 x daily can alleviate the symptoms of osteoarthritis, rheumatoid arthritis, stomach pains and intestinal spasm.[3]

Cayenne Pepper (Capsicum frutescens)

The active component of Cayenne pepper is capsaicin. Topical application stimulates and blocks small pain fibres by depleting them of the neurotransmitter substance P that mediates pain impulses.[4] Cream made from 0.025%-0.075% capsaicin applied 4 x daily may help peripheral neuropathic pain, post-herpetic neuralgia, trigeminal neuralgia, psoriasis and fibromyalgia.[5] It is also useful for diabetic neuropathy, cluster headaches, earache, osteo- and rheumatoid arthritis. Capsaicin is a powerful pain reliever; Dr CS Dyer suggests that "if cayenne pepper had been given in all cases where whisky had been taken for relief, many of those who are now dead would be alive today".[6]

Quercetin

Quercetin, a naturally occurring flavonoid is found in black tea, onions, broccoli, squash, red grapes and citrus fruit. It has anti-inflammatory and anti-allergic activity due to its inhibition of histamine and leukotrienes, which are responsible for vasoconstriction and bronchoconstriction in asthma, hayfever and gout. Quercetin helps in psoriasis, rheumatoid arthritis, lupus, atopic dermatitis and ulcerative colitis and benefits diabetes by inhibition of aldose reductase, which converts blood glucose to sorbitol, implicated in diabetic cataracts, neuropathy and retinopathy. It also enhances insulin secretion, protects pancreatic beta cells from free radical damage and inhibits platelet aggregation. Quercetin can be used with bromelain to potentiate anti-inflammatory activity[7] and has potent antioxidant and vitamin C-sparing actions. Dosages of quercetin range from 200-400mg 3 x daily and should be taken 20 minutes before meals.

Ginger (Zingiber officinale)

Ginger has been used traditionally for thousands of years for healing purposes within the Eastern Ayurvedic and Chinese Medicine Systems. Ginger inhibits the synthesis of pro-inflammatory prostaglandins, thromboxanes and leukotrienes, has antioxidant properties, and has pain relieving effects as a result of its ability to inhibit the release of substance P, in a similar way to capsaicin. The pungent principles (oleoresin) are thought to be the most pharmacologically active components of ginger. It is useful in treating stomach ache, rheumatism, gastrointestinal problems, arthritis, toothache and migraine.[8-9] However, it is important to note that it is contraindicated in kidney disease. Half an inch of fresh ginger can be taken daily in the diet and supplement doses vary between 500-2000mg daily.

There are numerous other herbs and phytonutrients which alleviate pain and inflammation, amongst which are bromelain, echinacea, angelica, peppermint, Aloe vera and feverfew. However, there is not one specific natural remedy that will suit everyone and a natural health practitioner will be able to help you to choose the best solutions for your symptoms. More importantly he/she will identify the underlying causes of your condition, and produce an individualized plan of action with quality recommendations to help your body to heal.

References

1. Singh GB and Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent. Agents and Actions. 18(3/4): 407-11. 1986.
2. Arora RB et al. Anti-inflammatory studies on Curcuma longa. L Ind J Med Res. 59: 1289. 1971.
3. Ammon HPT et al. Mechanism of anti-inflammatory actions of curcumin and boswellic acids. J Ethnophamacology. 38: 113. 1993.
4. Cordell GA and Araujo OE. Capsaicin: Identification, nomenclature and Pharmacotherapy. Ann Pharmacother. 27: 330-6. 1993.
5. Werbach Melvyn and Murray Michael. Botanical Influences on Illness. Third Line Press Inc. ISBN 1 891710 00 1. p497-99. 2000.
6. Bartram Thomas. Bartram's Encyclopedia of Herbal Medicine. Robinson Publishers. ISBN 1 85487 586 8. p103. 1998.
7. Tarayre JP and Lauressergues H. Advantages of a combination of proteolytic enzymes, flavonoids and ascorbic acid in comparison with non-steroid anti-inflammatory agents. Arzneim-Forsch. 27: 1144-49. 1977.
8. Srivastava KC and Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypothesis. 39: 342-48. 1992.
9. Mustafa T and Srivastava KC. Ginger (Zingiber officinale) in migraine headaches. J Ethnopharmacol. 29: 267-73. 1990.