Rheumatoid Arthritis – herbal medicine / phytotherapy

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Herbal Medicine / Phytotherapy

A number of plant-based remedies have been shown to be beneficial to patients with Rheumatoid Arthritis, however some of them can interact adversely with prescription medications and so it is vital to tell your doctor which herbal supplements you are planning to take.


Peony root extract a traditional Chinese remedy for arthritis

Peony root extract a traditional Chinese remedy for arthritis


Rosehip

For many years there has been good press about Rosehip extract for patients suffering from osteoarthritis, but a 2007 German and Danish study proved its effectiveness in combating Rheumatoid Arthritis too.  Seventy-four patients participated in a six month trial of the compound LitoZin with just under half taking the preparation and the rest consuming a placebo.  There was a 20-25 per cent improvement among the trial group with a 40 per cent improvement in the number of joints causing pain. There was no improvement in the placebo group.  Rosehip is known to have anti-inflammatory properties. Further studies are underway.

Paeony Root

This extract has been widely used in Chinese medicine since 200BC. The most recent studies into its biological effectiveness for RA sufferers found that it actively prevents bone loss. A 2013 research group in China found that measurements of bone mineral density (BMD) after an extract of paeony root glucosides (TGP) had been given orally to rabbits who had antigen-induced arthritis for three months, were significantly improved compared to a control group. It appears that the compound suppresses some osteoporosis and prevents some bone loss.

Boswellic Acid

This is an anti-inflammatory  produced from the Frankincense tree. A recent study of H15, a special extract of gum resin of Boswellia Serrata, on 260 patients in different stages of RA found that the remedy was well tolerated and could be used with other conventional treatments (always advise your doctor of any remedies you are intending to try). The trial concluded that Boswellic Acid was particularly beneficial for patients in the early stages of the disease but had little effect during acute pain or flare up phases.

Thunder God Vine

The leaves and flowers of this Asian plant are highly toxic so any preparations must only be made from the root. Thunder God Vine root has been used for centuries as an anti-inflammatory but it can have unpleasant side effects (see Aggravating Factors section).  Although there have been a number of trials on the effectiveness of this herb, results have been inconsistent.  In some circles it has been hailed as a “herbal DMARD” and there have been some studies where it has been concluded that it worked better than sulfasalazine, or as well as methotrexate. A 2014 study of 207 RA patients found that patients who received 20mg of Thunder God Vine three times a day in addition to methotrexate enjoyed the best results.  A 2013 review of trials involving 733 patients found that the methodological quality of previous studies was poor, but that Thunder God Vine could be effective and further research under full clinical conditions could be useful.

Borage seed oil and Fish oils

A 2014 double-blind, randomised trial into marine and botanical oils found that borage seed oil plus fish oil works better for RA sufferers than either oil alone. After nine months of use patients displayed significant reductions in disease activity and this pattern was not affected by the different conventional medications various groups were using. These improvements were also evident at 18 months of usage in contrast to control groups. Trial patients were able to reduce their levels of both DMARD and TNF medications more than patients in the control group.

Oriental Bittersweet

This invasive woody vine of the Celastraceae family is also known as Chinese bittersweet, Asian bittersweet and Round-leaved bittersweet. Folk medicine has used its leaves as remedies for RA for centuries, but the plant’s berries are poisonous. A 2014 study looked at the ability of plant extracts to fight the invasion of fibroblast-like synoviocytes (FLS) in RA. It was found that Oriental Bittersweet inhibited the activity of FLSs especially when used in conjunction with TNF-ª medicines.

Chinese Bell Flower

This herbaceous perennial, whose root has anti-inflammatory properties, has been the subject of several  clinical trials. Platycodin D is a saponin isolated from the root of the Chinese Bell Flower that was used in a 2014 study on mice. Its use saw the level of malondialdehyde (MDA), which is an indicator of oxidative stress, reduced in a dose-dependent manner throughout the group given platycodin D. Also the production of IL-6 and TNF-ª, which are involved in rheumatoid arthritispathogenesis,  were surpressed by the treatment. From the trials it appears Chinese Bell Flower root extract has anti-inflammatory, antioxidative and immunomodulatory effects on RA.

Huo-Luo-Xiao-Ling Dan

Used for centuries in Chinese medicine to alleviate pain and inflammation, this herbal formula was studied in 2013 principally to see if it offered a viable option for patients who suffered adverse side effects to conventional RA drug therapy.  The scientists evaluated the efficiency of HLXL at combating bone and cartilage damage together with its ability to control inflammation. The compound scored well on all counts, so it was concluded that Huo-Luo-Xiao-Ling Dan offered a promising alternative treatment for RA sufferers.

Crude plant extracts

Many crude plant extracts from traditional medicine plants have been successfully used in the treatment of arthritis. In particular Cassia alata (Candlebrush) leaf extract was shown to protect against cartilage degredation. While the leaves of Urtica dioica (commonly known as the stinging nettle)  had arthritis inhibiting properties. Salacia reticulata worked as both an anti-inflammatory and at reducing skeletal tissue damage.

Ginger

Both as a rhizome extract and as the flavonoid compound 6-shogaol, ginger enjoys good clinical results in reducing disease incidence, joint swelling and cartilage destruction. Studies showed that ginger reduces some chemical substances, including leukotrienes, that cause inflammation, giving it an effect similar to Ibuprofen. It also contains salicylates which are changed into salicylic acid by the body, helping to ease pain. However, use of ginger can increase the risk of bleeding and should be employed with particular care if patients are already taking an anti-coagulant.

Green Tea

Dried leaves of the plant Camellia sinensis produce the black, green and white tea drunk around the world. All tea is known to boost the immune system and fight inflammation, however green and white teas are the least processed and so contain the highest polyphenol levels. A 2008 study of green tea showed that it gave protection against autoimmune arthritis by inducing changes in arthritis-related immune responses. Due to this it is thought to be a positive preventative measure for high risk individuals to embrace although further research is required. To keep polyphenol levels at their highest levels 7-8 cups of green tea need to be consumed throughout the day. However, like ginger, green tea can increase the risk of bleeding and should be avoided by those already taking an anti-coagulant or Warfarin.

Grapes

Resveratrol, a polyphenolic compound derived from grapes and also found in red wine, has been the subject of a number of recent studies which has confirmed its propensity to reduce cartilage and bone degeneration and have a significant anti-inflammatory effect.

References

Total glucosides of paeony prevents juxta-articular bone loss in experimental arthritis. BMC Complement Altern Med. 2013 Jul 21

Extracts of Tripterygium wilfordii Hook F in the Treatment of Rheumatoid Arthritis: A Systemic Review and Meta-Analysis of Randomised Controlled Trials. Evid Based Complement Alternat Med. Mar 2014.

Treatment of rheumatoid arthritis with marine and botanical oils: an 18-month, randomized, and double-blind trial. Evid Based Complement Alternat Med.Feb 2014. 

 Anti-invasive effects of Celastrus Orbiculatus extract on interleukin-1 beta and tumour necrosis factor-alpha combination-stimulated fibroblast-like synoviocytes. BMC Complement Altern Med. Feb 2014. 

 The Effects of Platycodin D, a Saponin Purified from Platycodi Radix, on Collagen-Induced DBA/1J Mouse Rheumatoid Arthritis. Evid Based Complement Alternat Med Jan 2014. 

 Chinese Herbal Formula Huo-Luo-Xiao-Ling Dan Protects against Bone Damage in Adjuvant Arthritis by Modulating the Mediators of Bone Remodeling. Evid Based Complement Alternat Med. May 2013. 

 Zingiber officinale: A Potential Plant against Rheumatoid Arthritis. Arthritus: May 2014.

Green tea protects rats against autoimmune arthritis by modulating disease-related immune events. Nutr. Nov 2008.

Anti-inflammatory effect of resveratrol on adjuvant arthritis rats with abnormal immunological function via the reduction of cyclooxygenase-2 and prostaglandin E2. Mol Med Rep. June 2014 

 

 

 

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