Natural Solutions for Inflammation

Introduction

There is an old saying that makes great sense in this day and age – NEVER TAKE A DRUG THAT PRODUCES SIDE EFFECTS MORE SEVERE THAN THE DISEASE! That is certainly the case when we look at drugs used to deal with inflammation and especially those taken for the most common form of arthritis – osteoarthritis. No one has ever died from osteoarthritis, but serious adverse side effects (including death) can occur with conventional drugs used for this condition. Not just Vioxx and Celebrex, but even aspirin, ibuprofen, and acetaminophen can produce serious side effects. In fact, statistics indicate that more people in the United States die each year from taking nonsteroidal anti-inflammatory drugs than die from AIDS.

Fortunately, results from clinical trials have shown nature offers some very effective alternatives to these drugs in the treatment of osteoarthritis such as glucosamine sulfate, MSM, and the natural matrix of special cetylated, esterifed fatty acids (Celadrin™).

Though osteoarthritis is the most common reason why people take anti-inflammatory drugs, it is not the only reason. Inflammation is an underlying feature of virtually every disease process. Inflammation may be acute and obvious such as that seen in rheumatoid arthritis, allergies, and infections, or it may be subtle and chronic as seen in atherosclerosis, cancer, and Alzheimer’s disease.

What exactly is inflammation?

The term inflammation when used in a medical context refers to a localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes loss of function. The key feature here is “protective.” Inflammation is designed to protect us against infecting organisms. During inflammation white blood cells rush to the area to destroy harmful microorganisms and dead cells, preventing the spread of the irritation and permitting the injured tissue to repair itself.

The problem with inflammation occurs when it is not protecting us from danger, but actually producing harmful effects. The damaging effects of inflammation are most apparent in inflammatory diseases caused by abnormal immune responses. Seemingly unrelated disorders such as asthma, multiple sclerosis, inflammatory bowel diseases, psoriasis, and rheumatoid arthritis all have common inflammatory elements that underlie the disease process.

The inflammatory milieu

Inflammation is a fairly non-descript general term. So, too is saying that compound X exerts “anti-inflammatory action.” There are several key cites of anti-inflammatory action, but simply qualifying a compound as an anti-inflammatory has little meaning. Providing an in-depth review of all of the natural anti-inflammatory agents is beyond the scope of this brief article. So, let’s limit the discussion to the following categories: antioxidants; modulators of eicosanoid (prostaglandin) metabolism; and proteolytic enzymes. The point I want to make here is that during the inflammatory process, there are a number of interrelated cascading events that create the clinical features seen in an inflammatory condition. In one condition, one facet of inflammation may be more prominent than another facet seen in another condition. In other words, there are no simple answers or a single magical bullet for all inflammatory conditions.

Antioxidants and inflammation

Antioxidant compounds are important anti-inflammatory agents as during the inflammatory milieu the area affected is bathed in an environment full of pro-oxidants and free radicals. When antioxidant status is low, it leads to greater perpetuation of the inflammatory response. Antioxidants quell the inflammatory fire, but they are generally only protective and exert little direct anti-inflammatory action. In other words think of antioxidants as acting in protecting our cells from damage the way that a moat protects a castle. A moat does not disarm the enemy, it just makes it more difficult to attack the castle.

The antioxidant system in the human body is a beautiful orchestra that requires all of the interrelated instruments. Vitamins C and E, zinc, selenium, and flavonoids are particularly important against inflammation. In addition, the flavonoids exert many other effects beneficial against inflammation making flavonoid-rich extracts like grape seed and pine bark extracts quite useful in inflammatory conditions.

Modulators of eicosanoid metabolism

Eicosanoids include compounds known as prostaglandins and leukotrienes. These compounds are derived from essential fatty acids stored in our cell membranes. To reduce the production of eicosanoids that stimulate inflammation (1) reduce the level of arachidonic acid by reducing the intake of meat and animal products; and (2) increase the level the beneficial omega-3 fatty acids EPA and DHA. Supplementation of fish oils concentrated for EPA and DHA at a dosage of 1.8 g EPA and 1.2 g DHA has been shown to be extremely effective in reducing inflammation and producing positive clinical changes in many inflammatory diseases in numerous double-blind trials. In fact, supplementation of omega-3 fatty acids is absolutely essential in any inflammatory state, whether it be acute or chronic.

In addition to altering eicosanoid metabolism with fish oils, there are a number of natural products that act on key enzymes (namely cyclooxygenase 1 and 2) that produce inflammatory eicosanoids. Perhaps the most important natural compound in this category is curcumin – the yellow pigment of turmeric (Curcuma longa). But, this action is not curcumin’s only anti-inflammatory effect. In fact, curcumin exhibits the widest range of anti-inflammatory actions of any known substance.

• Potent antioxidant action
• Inhibition of leukotriene formation
• Inhibition of platelet aggregation
• Promotion of the breakdown of fibrin, thereby reducing swelling
• Inhibition of white blood cell response to various stimuli involved in the inflammatory process
• Stabilization of intracellular membranes in white blood cells
• Direct inhibition of various chemical mediators of inflammation

Cetylated, esterifed fatty acids (i.e., Celadrin®) have also been shown to impact eicosanoid metabolism. Its main action appears to be its ability to enhance cell membrane health and integrity. As a result it halts the production of inflammatory prostaglandins. It also reduces the production of the negative immune factors like IL-6 that play a central role in inflammation. For more information on Celadrin® see my newsletter 03:05:2005 Celadrin for Inflammation.

Proteolytic enzymes

Proteolytic enzymes (or proteases) refer to the various enzymes that digest (break down into smaller units) protein. These enzymes include the pancreatic proteases chymotrypsin and trypsin, bromelain (pineapple enzyme), papain (papaya enzyme), fungal proteases, and Serratia peptidase (the “silk worm” enzyme). Preparations of proteolytic enzymes have been shown to be useful in a wide range of inflammatory situations.

The benefits in some inflammatory conditions appears to be related to helping the body breakdown immune complexes formed between antibodies produced by the immune system and the compounds they bind to (antigens). Conditions associated with high levels of immune complexes in the blood are often referred to as “autoimmune diseases” and include such diseases as rheumatoid arthritis, lupus, scleroderma, and multiple sclerosis. Higher levels of circulating immune complexes are also seen in ulcerative colitis, Crohn's disease, and AIDS.

Final Comments

This article is meant to achieve a simple goal, I wanted to stress that inflammation is a very complicated process that has many different facets. In severe inflammatory disease, a very comprehensive approach utilizing an assortment of natural medicines with different anti-inflammatory actions is required. For recommendations for specific inflammatory conditions please visit my Conditions Center.