Herbs and inflammation
How ayurveda helps ease pain
By Virender Sodhi, MD (Ayurved), ND
Nobody likes to feel sick or sore, but inflammation is a very normal and desirable effect in the body. To rid itself of all of its ill effects, the body creates inflammation under different situations such as infections, toxic exposure, ischemia, trauma, and many other conditions.
As soon as inflammation has done its share of work, the body produces anti-inflammatory processes to control the inflammation. In a normal, healthy person, this process is in perfect balance.
However, when an imbalance exists, the body does not stop producing inflammation. This results in conditions such as arthritis, osteoarthritis, fibromyalgia, dermatitis, asthma, colitis, Crohn’s disease, and many others.
All these lie under the control of mental, emotional, physical, nutritional, environmental, and even spiritual conditions. Ayurvedic medicine has an arsenal of herbs to control inflammations at different levels.
Here are several herbs that can be useful to your patients:
• Boswellia serrata. Various studies have shown that boswellia, in combination form with ashwagandha, turmeric, and zinc, has positive effects in the treatment of osteoarthritis.
For example: In a double-blind placebo-control study, patients showed a significant improvement in pain-severity and disability scores. In an animal study, the dogs showed improvement in intermittent lameness, localized pain, and stiff gait. All external factors that aggravate lameness, such as “lameness when moving” and “lameness after a long rest” diminished gradually.
In another study, all patients receiving boswellia treatment reported a decrease in knee pain, increased knee flexion, and increased walking distance. The frequency of swelling was also reduced considerably.
• Turmeric. A number of laboratory studies have identified different molecules involved in inflammation that are inhibited by curcumin, the acidic coloring principle of turmeric. These molecules include phospholipase, lipoxygenase, cyclooxygenase 2 (Cox-2), leukotrienes, thromboxane, prostaglandins, nitric oxide, collagenase, elastase, hyaluronidase, monocyte chemoattractant protein-1 (MCP-1), interferon-inducible protein, tumor necrosis factor (TNF), and interleukin-12 (IL-12).
Cox-2 inhibitors such as Celebrex and Vioxx have been top sellers as non-steroidal anti-inflammatory drugs. Vioxx, however, showed an increase in heart disease and was recalled from the market.
Turmeric, on the other hand, covers almost every aspect of inflammation and has a much broader spectrum than the current drug regimen available. It provides all of the benefits, minus the frustrating side effects. In animal and in-vivo studies, turmeric extract has shown to decrease chronic and acute inflammation.
In instances of acute inflammation, oral administration of curcuminoids was found to be as effective as cortisone or phenylbutazone.
Turmeric comes in standardized extracts of 500 mg to 2,000 mg doses, taken two or three times per day. This herb has had no toxicity or side effects reported in acute or chronic administration.
• Ashwagandha. The effectiveness of ashwagandha in a variety of rheumatologic conditions may be due, in part, to its anti-inflammatory properties. In animal studies, comparing the effectiveness of ashwagandha and the prescription drug phenylbutazone to control inflammation, ashwagandha was shown to be more effective.
The ashwagandha-treated group completely reduced the inflammatory proteins, whereas animals treated with phenylbutazone and the control groups had increased inflammatory proteins.
In another study, ashwagandha extract showed far superior results in reducing inflammation, when compared to the drug hydrocortisone. And in another study on paw swelling with adjuvant-induced arthritis, ashwagandha caused significant reduction in the swelling and showed regeneration as observed by radiological studies.
The usual dose of this herb is 300 mg to 500 mg of standardized extract, two or three times per day. Ashwagandha is generally considered safe, even in higher doses. It may increase the effects of barbiturates. It is useful for patients who use hydrocortisone or Prednisolone and need to reduce the dosage or get off these drugs.
• Ginger. Numerous ingredients in ginger have shown to be potent inhibitors of inflammatory prostaglandin and leukotrienes. This may explain its use in inflammatory diseases such as rheumatoid arthritis, headaches and body aches.
Ginger is also a powerful antioxidant and contains an enzyme “protease” that contains a powerful action towards inflammation as bromelain and papain. In an animal model study, ginger extract reduced the carrageenan-induced inflammation in rat’s paw.
Ginger also contains antihistaminic and anti-toxicity activities. Allergies and toxicity can many times trigger inflammation. In a study on seven patients with rheumatoid arthritis, all the patients who were given ginger reported substantial improvement in pain relief, increased joint mobility, and decreased swelling and morning stiffness.
In another study with 28 patients with rheumatoid arthritis, 18 patients with osteoarthritis, and 10 patients with muscular discomfort; powdered ginger was given in doses of 500 mg to 1,000 mg per day for a period of three months to 2.5 years. Based on clinical observation, 75 percent of patients with rheumatoid arthritis and osteoarthritis experienced relief from pain and swelling, and 100 percent of the patients with muscular discomfort experienced relief from pain and swelling. Patients taking higher doses experienced faster results.
For anti-inflammatory purposes, patients should take 3 to 6 grams of ginger, two or three times per day. Ginger is quite safe in therapeutic doses. However, some individuals taking 6 grams of ginger on an empty stomach may get gastrointestinal upsets.
Because ginger has blood-thinning characteristics, patients who are on blood thinners such as coumadin or who take aspirin may need to limit their ginger intake 2 grams per day.
• Guggul. The guggul extract has shown significant anti-inflammatory ability in experimental models on inflammation.
In rat-paw edema and induced-adjuvant arthritis, guggul extract showed anti-inflammatory activity equal to phenylbutazone and ibuprofen and one-fifth the potentency of hydrocortisone.
In a chronic inflammation model, it proved to be more effective than hydrocortisone, phenylbutazone, and ibuprofen in reducing the severity of secondary lesions. This action is thought to be due to immune modulation and inhibition of delayed hypersensitivity reactions.
In autoimmune diseases such as rheumatoid arthritis, the immune system attacks its own tissue and makes immune complexes that accumulate around the joint, causing inflammation and choking the blood supply to the joint. This eventually leads to degeneration of the joint. Guggul extract stops the formation of these immune complexes and stops the hypersensitivity reactions, thereby reducing the inflammation.
In a recent study done in southern California, 30 male and female participants with osteo-arthritis were treated with 500 mg of guggul extract three times per day, taken with food. Patients showed significant improvement in the one- and two- month follow- ups, including overall improvement in mood and pain. No side effects were observed during the trial.
The usual dose of guggul is 300 mg to 500 mg three times per day, taken with food. This herb is usually combined with other anti-inflammatory herbs such as ashwgandha, turmeric, boswellia serrata, and ginger.
Guggul preparations may produce some side effects, including skin rash, nausea, headache, eructation, and hiccups.
Virender Sodhi, MD, (Ayurved) ND, CEO of Ayush Herbs, Inc., (www.ayush.com) was the first ayurvedic and naturopathic physician in the United States. He practices at the Ayurvedic Naturopathic Medical Clinic in Bellevue, Wash. He can be contacted at firstname.lastname@example.org.
Disclaimer: This article is purely informative and should not replace the guidance of a physician.