Lifestyle Choices

GLA

The amount of GLA required to have this effect is quite high. I recommend 200-300mg GLA per day, reducing to 150mg after three months if inflammation reduces and symptoms stay stable. Only 9-10 per cent of the oil in evening primrose oil is GLA so that means you need to take 3000mg of evening primrose oil, or six 500mg capsules per day. Borage oil contains a higher proportion of GLA and you can get single capsules which provide 250mg of GLA. One of these a day is an essential part of an anti-inflammatory strategy. Supplementing GLA has been shown to be more effective when the co-factor vitamins and minerals (vitamin B6, zinc, B3 and vitamin C) are also supplied.

OMEGA 3 FATS

Even more important for reducing inflammation than GLA are the Omega 3 fats found in oily fish, particularly herring, mackerel, salmon and tuna. These fats are derived from an essential oil called linolenic acid, which is found in small amounts in some nuts and seeds. The richest source is flax seed, and its oil.

Studies have also confirmed that supplementing these fish oils can help reduce pain and inflammation. In one study, 17 patients with arthritis were given 1.8g of EPA a day. After 12 weeks they had significantly less stiffness and tenderness of joints. The improvement didn’t last when the patients stopped taking the EPA supplements.

These positive results were confirmed by another study in which rheumatoid arthritis patients on NSAID medication were given ten fish oil capsules daily and compared with people on NSAIDs alone. After six weeks there was a significant reduction in the number of painful joints in those taking fish oil, compared to those simply on NSAIDs. When the NSAID medication was withdrawn this improvement vanished, and reduction in pain on the fish oils alone was similar to that on NSAIDs alone. In other words fish oils were as effective as taking NSAIDs.

This strongly suggests that taking in a large enough amount of fish oil is anti-inflammatory — probably due to its EPA and DHA content — and may be as effective as NSAID medication in some cases, without the side-effects.

Curcumin

The bright yellow pigment of the spice turmeric contains the active compound curcumin which has a variety of powerful anti-inflammatory actions — trials in which it was given to arthritic patients have shown it to be similarly effective to the anti-inflammatory drugs, without the side-effects. Like the NSAIDs, it blocks the formation of the pro-inflammatory prostaglandins (PGE2), as well as leukotrienes, another type of inflammatory mediator. It is a powerful antioxidant and has been shown to promote detoxification. Curcumin is highly recommended for easing pain and inflammation in both osteoarthritis and rheumatoid arthritis as well as in post-operative inflammation. An effective dose is 500mg, one to three times a day.

Boswellia

Boswellia serrata, also known as Indian frankincense, is proving to be a very powerful natural anti-inflammatory agent, used mainly for arthritis, without the side-effects of current drugs. The boswellic acid contained within the herb achieves comparative anti-inflammatory effects without the associated gut problems experienced with anti-inflammatory and painkilling drugs such as aspirin. Boswellic acid appears to reduce joint swelling, restores and improves blood supply to inflamed joints, provides pain relief and improves morning stiffness.

In one study where patients initially received boswellic acid, and then later a placebo, arthritic symptoms significantly lessened whilst taking the Boswellia, but then returned with a vengeance when the treatment was switched over to placebo. Other studies with arthritic patients have shown significant relief after four weeks supplementing 600mg of boswellic acid.

Preparations are available in tablet and cream form — the ideal dose is 200-400mg, one to three times a day; the creams are especially useful in the treatment of localised inflammation.

Ashwagandha

Ashwagandha is a promising natural remedy that has been used for hundreds of years as part of the Ayurvedic medicine tradition in India. The active ingredients in this powerful natural anti-inflammatory herb are `withanolides’. These also appear to have anti-cancer properties. In animal studies ashwagandha has proven highly effective against arthritis. In one study animals with arthritis were given either ashwagandha, hydrocortisone or placebo. While hydrocortisone produced a 44 per cent reduction in symptoms, ashwagandha produced an 89 per cent reduction in symptoms, making it substantially more effective than cortisone.

Although this remedy has a good track record in Ayurvedic medicine it has only recently come to the attention of conventional medicine and human trials are awaited with interest. The therapeutic dose depends on the concentration of withanolides. Try 300mg twice a day of the root, providing 1.5 per cent withanolides.

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