Arthritis: The Botanical Solution Notes

More recent research (Asquith et al. 2014) found at least 85 percent of AS cases involved a microbial infection within the gut.
Further research (Kang et al. 2015) has established that anti-HLA-B27 antibodies will bind more prevalently with Klebsiella pneumoniae, and anti- Klebsiella antibodies bind with collagen in joints. The combination creates a perfect storm for ankylosing spondylitis. For this reason, about 9 out of 10 people with ankylosing spondylitis have the HLA-B27 genetic allotype
In one review of multiple studies from the rheumatology department of a Turkish hospital (Ogrendik 2009), it was found that people with chronic infections of oral anaerobic bacteria—the kind that infects the gums, such as Porphyromonas gingivalis, Tannerella forsynthensis, and Prevotella intermedia—were more likely to have RA. Furthermore, antibodies from these bacteria were found in greater levels within the synovial fluid of RA patients.
The fluid was taken prior to knee replacement, and frozen until being analyzed. After full analysis of the cell lines, the IgM antibodies were examined for potential links to prior viruses. Eleven of the fifty patients—22%—had IgM antibodies to the measles virus. The presence of antibodies among the synovial fluid cells indicates that there was at some point, an active viral infection within or around their synovial fluids. The authors indicated that this certainly indicated a clear viral link to their RA
Estrogen balance has also been linked to arthritis—in both rheumatoid arthritis and osteoarthritis
researchers now estimate that genetic factors may influence about 50- 60% of all rheumatoid arthritis cases
For example, a study from the University of Western Ontario’s Clinical Neurological Science Department (Ebers et al. 1996) reviewed the research on twins and autoimmune complexes such as multiple sclerosis. They also conducted a genome search of 100 sibling pairs, looking for MS gene markers. Their research on multiple sclerosis concluded that while monozygotic twins showed higher concordance levels (matching pathologies) than dizygotic twins and siblings (25-30% versus 4%), they found that “environmental factors strongly influenced observed geographical differences.” They also concluded, “Studies of candidate genes have been largely unrewarding.”
Studies more specific to arthritis have revealed a range of only 12-15% concordance between monozygotic twins for rheumatoid arthritis
A 2003 report from University of North Carolina’s Department of Rheumatology and Immunology (Dooley and Hogan) discussed these factors in more detail, concluding that, “Rather than disease-specific genes for individual autoimmune disorders, there may be “autoimmunity genes” that increase the risk for development of autoimmune disorders in families. Autoimmune disorders may result from multiple interactions of genes and environmental factors.”
In 2008, the Immunosciences Lab in California released a study (Vojdani) that tested the fluids of 420 patients with a variety of autoimmunetype disorders. These were screened with 96 different antibodies for a variety of different infectious and protein-type antibodies. A significant number of the autoimmune-patients tested positive to one or multiple autoantibodies. This leads to a thesis that some autoimmunity is related to a derangement of the immune system from previous infections, and/or the immune system has been overloaded with too many toxins
A significant amount of research over the past decade has confirmed that a disproportionate amount of arachidonic acid in the diet will produce increased levels of inflammation (Calder 2008 and many others) due to an oversupply of these messengers.
The western diet had no reduction in pain and swelling. The placebo (no DHA oil) group in the low arachidonic acid group had a 14% reduction in pain and swelling. The DHA supplemented-western diet group had 11% reduction in joint pain and 22% reduction in joint swelling. The DHA supplementation, low-arachidonic acid group had a reduction in joint pain of 28%, and a reduction in joint swelling of 34%.
The study revealed that people consuming more than 200 milligrams a day of vitamin C were one-third less likely to experience a worsening of their osteoarthritis. Dr. Timothy McAlidon, a professor at the University suggested that the reduction in free radicals by the antioxidant vitamin C was the likely mechanism. He also commented that, “Vitamin C may also help generate collagen, which enhances the body’s ability to repair damage to the cartilage.”
Vitamin D has also been shown to slow down the progression and pain of osteoarthritis
Fifty-five people with rheumatoid arthritis followed either a vegetarian diet or an omnivorous diet for one year. After three months and one year, the 27 people in the vegetarian group improved significantly in “all clinical variables and most laboratory variables” when compared to the 26 people in the omnivore group. This same effect was found in a previous study at the University of Oslo with 53 RA patients (Kjeldsen-Krash et al. 1994). This group was studied for two years, and it was found that the vegetarian group sustained their improvements over the entire two-year period
Acetaminophen can also cause stomach bleeding and gastric upset. A recent study (Beasley et al. 2008) has also showed acetaminophen can increase asthma, eczema and conjunctivitis in young children.
Usually this is prescribed to a patient after other arthritis drugs have failed to offer pain relief. Meta data research (reviews of multiple studies) has shown that HA injection may provide some temporary pain relief, but these effects often do not last longer than six months (
A 2015 study from Italy’s Ch-Pe University (Belcaro et al.) tested 66 patients with osteoarthritis. They gave 32 patients a boswellia extract while another 34 patients were given conventional treatment. After 12 weeks of taking the boswellia extract, pain and walking distances were significantly improved compared to the control group.
Many other studies have concluded similar findings. A meta-study from the UK’s Peninsula Medical School and the Universities of Exeter and Plymouth published in the British Medical Journal (Ernst 2008) reviewed 47 clinical studies on boswellia. Seven met their control criteria, including rheumatoid arthritis research. The researchers concluded: “B. serrata extracts were clinically effective.”
In one double-blind, randomized and placebo-controlled study (Sengupta et al. 2008), 75 osteoarthritis patients were given either 100 mg of boswellia extract, 250 mg of boswellia extract, or a placebo for 90 days. Of the 70 patients that completed the study, patients who took either dosage of boswellia had significantly lower pain scores and mobility throughout the trial. Furthermore, levels of metalloproteinase-3—the enzyme matrix thought to be present during the cartilage breakdown process—were significantly lower among the boswellia treatment group
In two other studies, boswellic acids extracted from boswellia were found to have significant anti-inflammatory action. The trials revealed that boswellia inhibited the LOX enzyme (5-lipoxygenase) and thus reduced leukotriene production (Singh et al. 2008; Ammon 2006).
Another study (Takada et al. 2006) showed that boswellic acids inhibited cytokines and suppressed cell invasion through NFkappaB inhibition. This enhances the immune system’s ability to stop cell mutation and suppress osteoclast (deranged bone cells) production
In an in vivo study by researchers from the University of Maryland’s School of Medicine (Fan et al. 2005), boswellia extract illustrated “significant anti-arthritic and anti-inflammation effects.” The report also concluded that, “these effects may be mediated via the suppression of proinflammatory cytokines.”
In an in vitro study also from the University of Maryland’s School of Medicine (Chevrier et al. 2005), boswellia extract proved to inhibit Th1 cytokines while potentiating Th2 cytokines. This illustrated boswellia’s ability to modulate the immune system in the face of inflammation.
In a study of 29 dogs with degenerative osteoarthritis, boswellia extract significantly reduced osteoarthritis severity and significantly increased mobility in 71% of the 24 dogs that completed the study (Reichling et al. 2004).
In a randomized, placebo-controlled, double-blind study from India’s Indira Medical College (Kimmatkar et al. 2004), 30 patients with osteoarthritis of the knee were given either boswellia extract or a placebo. The boswellia-treated patients had significantly less swelling of the knee, decreased knee pain, increased knee flexion and increased walking distance at the end of the study
Boswellia extracts also illustrate significant inhibition against microorganisms. In one study (Schillaci et al. 2008), Staphylococcus epidermidis, Staphylococcus aureus, and Candida albicans were effectively inhibited by boswellia extracts.
The patients were tested with biopsy and for inflammatory factors relating to prostaglandins among the stomach and esophagus. They were also tested for arthritic pain levels before and after the treatment period, using the visual analogue scale (or VAS)—which measures pain in combination with mobility. The researchers found that both groups had a similar reduction in pain, but the group taking the ginger did not suffer from the various effects typical of NSAID medication—including increased levels of stomach mucosa prostaglandins PGE1, PGE2 and PGF2alpha. These prostaglandin increases directly relate to an increased risk of ulceration, as the stomach mucosal membrane loses its protective abilities with NSAID use
In 2014, researchers from Italy (Riso et al.) determined that broccoli will cut inflammation within hours. And eating broccoli for just ten days will cut the body’s inflammation in more than half. Other studies find it prevents and repairs DNA damage and may even curb osteoarthritis. And a more recent study shows that DNA damage is reduced just 24 hours after eating broccoli. In this 2014 study, researchers from Italy’s University of Milan fed 250 grams (one portion) of steamed broccoli to a group of ten young smokers. Then they tested the subjects three hours after the meal, six hours after the meal and 24 hours after. They found that the broccoli significantly increased their blood levels of vitamin C, beta-carotene and folate immediately. And within six hours, their glutathione S-transferase levels significantly increased. Glutathione S-transferase is an enzyme produced in the liver that clears toxins out of the blood and tissues. Then 24 hours after eating the broccoli, the researchers found that DNA damage due to free radicals was significantly reduced, by some 18%, in many of the subjects. In a related study (Riso et al. 2013) some of the same researchers from the University of Milan gave 250 grams of broccoli to a group of young smokers for ten days. Before and after the study the researchers collected blood from the subjects and conducted an extensive analysis of the blood. They measured the subjects’ various immune cell status, including C-reactive protein (CRP) levels, tumor necrosis factor alpha (TNF-α) levels, interleukin 6 (IL-6) and adiponectin. They also analyzed levels of folate and lutein in the blood. After the 10-day broccoli-enriched diet the subjects were re-tested and the researchers found that their CRP levels went down by 48%. This is a significant drop in CRP levels, indicating the smokers’ inflammatory levels went down by over a half. The researchers also found that circulating levels of lutein and folate went up as well. The drop in CRP levels was found independent of lutein and folate levels, and the researchers found that lycopene increases also accompanied a drop in IL6 levels—indicating a relationship between lycopene and inflammation factors—as other studies have confirmed. This study confirms an earlier study done at the same university in 2010 (Riso et al.). In this study the researchers tested 27 young smokers who were otherwise healthy, and gave them either 250 grams of steamed broccoli per day or a control diet. In this study the researchers tested mRNA and DNA enzyme levels—which relate directly to the repair of DNA. They also measured DNA strand breaks within the blood. In this study, the researchers found that those eating the broccoli had 41% drop in strand breaks of DNA, and other changes in enzyme levels associated with DNA protection.
In a new study out of Italy’s Catholic University, researchers (Crescente et al. 2009) found that both resveratrol and quercetin inhibited arachidonic acid-induced platelet aggregation
Research has supported the observation that increased GLA oil consumption can reduce inflammation in arthritis. In a double-blind, randomized and placebo-controlled study of 37 patients with rheumatoid arthritis from the University of Pennsylvania (Leventhal et al. 1993), supplementation with 1.4 grams per day of GLA reduced tender joint scores by 45% and swollen joint scores by 41%. The placebo group showed no improvement. Other studies have shown similar results (Brzeski et al. 1991; Horrobin 1989).
study of six women performed at England’s University of Southampton (Burdge et al. 2002) published in 2002 in the British Journal of Nutrition showed a conversion rate of 36% from ALA to omega-3 fatty acids (EPA, DHA and other omega-3). A follow-up study of men at Southhampton showed ALA conversion to EPA and other n-3 fatty acids occurred at an average of 16%.
Research has illustrated that like fish oils, DHA algal oils have illustrated significant therapeutic and anti-inflammatory effects. One study (Arterburn et al. 2007) measured pro-inflammatory arachidonic acid levels after a dosage of algal DHA. It was found that arachidonic acid levels decreased by 20% following a dose of 100 milligrams. In this randomized open-label study (Arterburn et al. 2008), researchers gave 32 healthy men and women either algal DHA oil or cooked salmon for two weeks. After the two weeks, plasma levels of circulating DHA were bioequivalent.
In a study by researchers from The Netherlands’ Wageningen University Toxicology Research Center (van Beelan et al. 2007), all three species of commercially produced algal oil showed equivalency with fish oil in their inhibition of cancer cell growth. Another study (Lloyd-Still et al. 2007) of twenty cystic fibrosis patients concluded that 50 milligrams of algal DHA was readily absorbed, maintained DHA bioavailability immediately, and increased circulating DHA levels by four to five times
In a study by researchers from the University of Guelph in Ontario (Tulk and Robinson 2009), eight middle-aged men with metabolic disorder were tested for the inflammatory effects resulting from changing their fat consumption ratio between omega-3 and omega-6. The men were divided into two groups. One group ate a high saturated fat diet with a ratio of 20:1, omega-6 to omega-3, and the other group ate a diet with a ratio of 2:1 (high omega-3 diet). Both groups were tested before and after the diet change. Testing after the diet change showed that the group with the high omega-3 diet had lower inflammatory markers.
Before and after the 30 months, the researchers examined each of the women using X-rays and joint-space narrowing measurements according to the diagnostic criteria of the American College of Rheumatology. In other words, their examinations included both X-ray measurements and physical examinations. At the end of the study, the researchers found those who lost either 11 pounds or more—or more than 5 percent of their body weight—had a significantly lower incidence of osteoarthritis
A 2013 study from Wake Forest University Medical School (Messier et al.) studied 454 men and women with osteoarthritis who were 55 years old or older. They were all overweight and obese, and had a body mass index that ranged from 27 to 41, but 360 of them had BMIs greater than 30. They also had very painful knee osteoarthritis. The study lasted for 18 months. The participants were divided into three groups. One group underwent an intensive weight loss diet-only plan. Another group did the weight loss diet plus exercise. A third group only did the exercise. After the 18-months, the researchers found that the diet-only group lost an average of 8.9 kilos (about 20 pounds)—9.5 percent of their body weight from the beginning of the study. The diet-plus-exercise group lost 10.6 kilos (about 23.5 pounds)—11.4 percent of their beginning weight. The exercise-only group lost an average of 1.8 kilos (about 4 pounds)— or 2 percent of their original body weight. This of course allowed the researchers to compare the effects of weight loss versus exercise. And whether it is the weight loss or the exercise to lose the weight that reduces osteoarthritis. The researchers found that those in the diet-only group had significantly lower knee force compression compared to the exercise group. The levels averaged 2487 N for the diet-only group, versus 2687 N for the exercise-only group. In comparison, the diet-only group had a reduced knee joint load by 10 percent (265 N), while the exercise-only group’s knee joint load decreased by five percent (148 N). And the diet-plus-exercise group’s knee joint load decreased by 9 percent (200 N). So the diet-only group’s knee joint load was the lowest. Inflammation levels—measured by IL-6 levels—were the same between the diet-only group and the diet-plus-exercise groups—at 2.7 pg/mL. These levels were lower than the exercise group, at 3.1 pg/mL. However, the diet-plus-exercise group experienced less pain—at level 3.6—than both the diet-only and the exercise-only groups. These had 4.8 and 4.7 levels for pain, respectively. The diet-plus-exercise group also had better quality of life scores compared to the other two groups. In terms of mobility, the diet-plus-exercise also won out. The diet-plusexercise group walked faster and further for the six-minute test. The exerciseonly group also walked more than the diet-only group. Yes, mobility and pain were more improved in the two groups that exercised. And diet plus exercise resulted in the least amount of pain and the greatest mobility. But the researchers found clear evidence that weight loss was the greatest factor in reducing overall symptoms of osteoarthritis
The researchers found the patients who took the probiotics had “moderate” response in terms of swollen joints and symptom scores. But the significant response came in the form of modulating IL-10, IL-12 and TNFalpha scores. This means boosting immunity and reducing inflammation factors.
Other studies have found that a combination of bromelain and papain have had the same anti-inflammatory effects of the NSAID drug diclofenac for the treatment of osteoarthritis

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