Arthritis and Food Allergy
Foods may play a role in making rheumatoid arthritis (RA) worse. Many patients report such an association, and a new study supports this claim. Researchers evaluated 14 RA patients and compared them with 20 controls. Intestinal secretions showed remarkably higher levels of food antibodies in the subjects than in the controls.
The most common offending foods were milk, eggs, pork, and codfish. Because antibodies to multiple foods were found in each subject, the researchers suggested that many small effects could add up to major symptoms. (Hvatum M, et al., The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis. Gut. 2006 Sep;55(9):1240-7.)
Avoid suspect foods and take supplements to help symptoms, such as vitamins C and E, SAMe, fish oil, borage oil, curcumin, and boswellia.
More arthritis info
Some people have suggested that foods from the nightshade family, such as potatoes, tomatoes, peppers, and eggplants might contribute to arthritis, this may not be true for most patients. However, some foods might increase inflammation, and others might reduce it.
Foods that contain land animal fat might increase inflammation because of the arachidonic acid that they contain (this is a non-essential fatty acid found in meat and poultry, as well as milk, and is a precursor of prostaglandin E2, which promotes inflammation). Trans fatty acids, from hydrogenated vegetable oils such as margarine and shortening, also increase inflammation. A diet high in fruits and vegetables is associated with reduced inflammation, but it is not clear which specific components are responsible.
The fish oil that you take and the vitamin C may both help to reduce inflammation and reduce arthritis pain. Olive oil and gamma-linolenic acid (from evening primrose or borage oils) enhance the anti-inflammatory effect of fish oil. Vitamin E (800-1200 IU daily) also lowers the markers of inflammation, such as CRP, by up to 50 percent.
A number of supplements also help reduce the inflammation or pain associated with arthritis. Curcumin, a turmeric extract (300-600 mg), ginger (250-750 mg), and boswellia (400-600 mg) can all help with arthritis. S-adenosyl methionine (SAMe) is beneficial in both osteoarthritis and rheumatoid arthritis (200-600 mg). Some combination of a healthy diet and these supplements should be helpful.
The herbal breakthrough easing pain and reversing arthritis
By Kerry Bone
When I first wrote about Boswellia almost 10 years ago, I focused on its role in rheumatoid arthritis (RA). Of course, rheumatoid arthritis is an autoimmune condition and is quite different from the more common form of the disease, osteoarthritis (OA). And Boswellia appeared to act on a type of inflammation specific to RA, so the thinking at the time was that this herb was only good for this form of arthritis. But over the past few years, researchers have discovered that Boswellia might just work for osteoarthritis after all.
In fact, several studies have shown that Boswellia not only relieves arthritis symptoms, but might actually change the course of OA, slowing its progression and possibly even reversing this chronic disease.
As effective as arthritis drugs—and a whole lot safer
The first trial, published in 2003, was a randomized, double blind, placebo-controlled, crossover study to assess the efficacy, safety, and tolerability of Boswellia extract in 30 patients with osteoarthritis of the knee. For eight weeks, 15 patients took 1,000 milligrams of Boswellia extract (containing 40 percent of the active compounds, called boswellic acids) while the other 15 took a placebo. Then the groups switched treatments for another eight weeks. While they were taking the Boswellia, all the patients reported a significant decrease in knee pain, increased knee flexibility, and increased walking distance.1 Except for minor gastrointestinal upset, there weren’t any side effects associated with the Boswellia.
But what’s most striking about this study trial is the substantial clinical benefit the researchers observed. For example, in the first eight-week treatment period, the pain index in the Boswellia group fell from 2.7 to 0.26, the loss of movement index was reduced from 2.8 to 0.30, and the swelling index went from 1.1 to zero.
The second trial was a randomized study that compared Boswellia with the drug valdecoxib, a selective COX-2 inhibitor.2 The patients received either 1,000 milligrams per day of Boswellia extract (again containing 40 percent boswellic acids) or 10 milligrams of valdecoxib per day for six months. Boswellia took longer to kick in than the drug, but by the end of the second month, patients in both groups reported comparable relief. And they continued to have equal effects for the remainder of the trial.
But what surprised the researchers was what happened one month after the patients discontinued both treatments. The patients who had been taking the drug were back to square one in terms of their arthritis pain. But even a full month after they stopped taking their treatment, the patients in the Boswellia group were still reporting major symptom and pain relief. In other words, the drug was just masking the symptoms, and while it worked faster than the Boswellia, it wore off just as quickly. The Boswellia was slower to take effect, but those effects were long-lasting, even after the patients stopped taking it. Which suggests that the Boswellia had actually improved the arthritis itself.
The third study was published just last year.3 In this trial, 75 patients with knee OA received either Boswellia extract (containing 100 or 250 mg of selected boswellic acids/day) or placebo for 90 days. The Boswellia offered statistically significant improvement in both pain and physical functioning. And the higher the dose, the faster it worked—in some cases in as little as seven days.
But apart from the fact that Boswellia was effective for OA, this trial provided two other useful pieces of information. First, it showed significant reductions in a substance called matrix metalloproteinase-3, which breaks down cartilage, making OA worse. Again, this suggests that Boswellia could slow down the progression of OA.
Second, this study showed that taking a larger amount of Boswellia early on—a loading dose—offers faster results. I often do this by starting my patients on double the long-term dose for a few weeks (the long term dose, as per the studies, should be about 1,000 mg of extract containing at least 400 mg of boswellic acids). Then, once their symptoms have started to improve, they can taper back to that long-term maintenance dose.
One other way to make Boswellia work even better is to take it with meals, especially a main meal that contains a reasonable amount of (healthy) fat. According to one study, dietary fat appears to make the boswellic acids four times more bioavailable than they are when Boswellia supplements are taken on their own.