Oct
03

How to reduce inflammation naturally

What do cancer, cardiovascular disease, autoimmune disease, and all chronic degenerative diseases have in common? Inflammation.

Most people associate inflammation with injuries that they can see, such as a twisted ankle, scraped knee, or a bee sting. These are all examples of obvious inflammation, easily identified with the naked eye, which occur as part of the healing process in response to an acute injury.

However, it is the inflammation we can’t see – the subtle low-grade chronic inflammation that happens at a cellular level – that can eventually overwhelm our pre-set defences, resulting in tissue damage and degeneration associated with chronic disease.

So what causes inflammation and how can we adjust our diet and lifestyle to avoid the ultimate consequences of uncontrolled inflammation?

Inflammation is at the root of so many diseases it is impossible to estimate the physical and economic impact it has on the Australian population. For example, two common conditions that have their foundations firmly planted in chronic inflammation are cancer and cardiovascular disease.

These two conditions alone are estimated to make up approximately 37 percent of the total disease and injury burden in Australia. This is just the tip of the iceberg; then there are autoimmune diseases, arthritis, allergies, neurodegenerative conditions, obesity and even depression which are also associated with inflammation, making it the leading cause of ill health.

What is inflammation?

The term inflammation comes from the Latin inflammo, which means ‘to ignite’. The process of inflammation was described in detail in one of the oldest recorded medical and scientific texts, De Medicia, written by the Roman scholar Aulus Cornelius Celsus (c. 25BC-c.50AD).

He described the various stages of inflammation as follows: dolor (“pain”), calor (“heat”), rubor (“redness”), and tumor (“swelling”). Later scholars added a final term, ‘functio laesa’, which translates to loss of function.

These observations still stand the test of time, however we now have a greater understanding of the cellular mechanisms involved.

Inflammation is the body’s first line of defence. When the body senses that there is an injury, a complex cascade of chemical messengers is released which triggers an immediate inflammatory response in order to neutralise, or ‘burn out’, any bacteria or pathogens present and flood the affected site with cells that will initiate the healing process.

Inflammation is part of our innate immunity, which means it is an inbuilt protective mechanism we were born with. It is not specific to any particular pathogen or bacteria, but more of a generalised protective response. The immune system cells are first on the scene and act as the foreman of the healing process, neutralising any existing threats and overseeing repair work. This is how the body should respond to any acute injury.

However, what happens when the threat is continual and the immune system is perpetually activated causing widespread, low-grade inflammation? This is where things go wrong and tissue degeneration and damage occur.

Cancer

Uncontrolled inflammation caused by chronic infection or irritation is well-recognised as a cause of cancer. For example, Helicobacter pylori, a common bacterial infection of the stomach, is also associated with gastric cancer, while viral hepatitis C is associated with the development of liver cancer. The chemicals in cigarette smoke lead to significant tissue irritation and inflammation, which ultimately causes cancer.

Chronic inflammation eventually damages the DNA of cells, and once rogue cells are established they are able to replicate themselves to the point that they create microscopic tumours. These tumours can then further harness the inflammatory process, using it to create new blood vessels which deliver nutrients and oxygen to fuel greater growth and replication.

Preventing cancer by managing inflammation has attracted significant attention from the scientific community. Several large trials, involving a total of 23,000 people, investigated the ability of aspirin (a common anti-inflammatory drug) to prevent strokes and heart attacks. Interestingly, data also examined the development of cancer in the trial participants and – astoundingly – there was a 34 percent reduction in all cancers and a 54 percent reduction in gastrointestinal cancers specifically.

Despite these amazing results, even the Cancer Council of Australia agrees, taking aspirin is not an ideal solution. Managing inflammation naturally through diet, lifestyle and nutritional supplementation is the best way to reduce inflammation and overall cancer risk.

Cardiovascular disease

Sadly, cardiovascular disease kills one person every 12 minutes in Australia and despite the advances in medical treatment it remains the leading cause of death. Inflammation influences every aspect of cardiovascular disease, not only in the initiation of vascular disease but also the triggering of clot formation.

The delicate cells lining the blood vessel walls are easily damaged by oxidative stress. As part of the healing process, a complex interaction between inflammation and small dense cholesterol molecules occurs at the site, which causes microscopic scarring and plaque formation. If this process continues unchecked, atherosclerosis develops and it is only a matter of time before a cardiovascular event, such as a heart attack, happens.

Smoking is a well-known cause of atherosclerosis, which is at least partly due to its ability to trigger widespread oxidative stress and inflammation.

Studies show that while aspirin may be useful for the prevention of stroke in women, its efficacy in preventing heart attack is still not proven and the Australian Heart Foundation recommends that lifestyle measures should be the main aim of preventative treatment.

Autoimmune diseases

There is a wide variety of autoimmune diseases, ranging from multiple sclerosis to coeliac disease, all of which have inflammation as a primary driver. These diverse conditions are caused by the immune system mistaking our own tissue for a foreign invader and launching an inflammatory attack to neutralise the ‘threat’.

While the exact cause of autoimmune disease is unknown, several contributing factors have been identified.

Chronic bacterial or viral infection may play a role based on the concept of ‘molecular mimicry’, where specific proteins of some pathogens are so similar to our own that the immune system becomes confused and starts to attack our own tissue.

Another theory is the complex interaction between the bacteria in the digestive tract (called the gut microbiome) and its interaction with the immune system. The modern diet can significantly disrupt the microbiome and cause inflammation of the gut lining. This damages the delicate pores in the gut lining and leads to the absorption of irritant substances, including bacterial by-products, from inside the gut into the circulation where the immune system reads it as a foreign invader. The subsequent inflammatory reaction launched by the immune system can cause significant damage.

Obesity

This may not be the first condition that springs to mind when we think about inflammation, but mounting evidence suggests that obesity, insulin resistance, and even type II diabetes may be related to inflammation.

Obesity is at epidemic proportions in Australia, with three out of five adults being overweight or obese. Even more worrying is that one out of every four children is overweight or obese, setting up our next generation for a life of ill health. According to the Australian government, these figures have risen by five percent since 1995 and show no signs of slowing.

While we know that the modern diet is fundamentally at the heart of the obesity epidemic, what we may not have considered is its effect on inflammation. The modern Western diet is based on processed foods that are high in refined carbohydrates, sugars and fats and flooded with chemical additives.

While the refined foods cause us to gain body fat (which in itself is inflammatory) the numerous chemical additives contribute to the systemic inflammation.

Insulin receptor sites on the cell wall are easily damaged by inflammation, which is thought to contribute to insulin resistance. Further to this is the effect of a highly processed diet on the gut microbiome causing inflammation.

So it seems it is a double-edged sword: once obesity is established, inflammation can perpetuate it, contributing to significant metabolic disruption.

Depression

This is a newcomer to the group of diseases driven by inflammation; however, emerging evidence is offering new insights into a complex condition that affects approximately 45 percent of Australians at some stage in their life.

A recent study has identified significant inflammation in the brains of depressed patients, using sophisticated PET scanning technology. They found that people with depression had a 30 percent increase in inflammation compared to healthy controls; they also found that the worse the depression, the greater the inflammation.

While this area of study is in its infancy, it offers some hope to people looking for answers.

What you can do to reduce inflammation

Diet

The typical Australian diet is very inflammatory, due to high intake of processed foods, refined carbohydrates, sugar, salt and fat, not to mention chemical additives and pesticides and herbicides used in farming. Even some of the ‘healthy’ choices found on our supermarket shelves can fit into this category.

The best way to ensure that you have an anti-inflammatory diet is to avoid the supermarket and buy most of your food fresh from the greengrocer, fishmonger, and local butcher.

A wholefood diet is arguably the single most effective step you can take to reduce inflammation. Not only is it high in valuable nutrients and low in irritating chemicals and additives, it also provides your body with the building blocks to fuel balanced immune responses, robust gut microbiome function, and effective elimination of toxins via healthy liver and gut function, all of which will help manage inflammation.

Vitamin D

This is a fat-soluble nutrient that helps us maintain bone strength and immune system health. Recently it has been shown to directly interact with the genes associated with inflammation and act as a powerful anti-inflammatory and pain reliever. Small amounts of vitamin D are found in fish, eggs and dairy.

Bioflavonoids

Vegetables are rich in a range of flavonoids that have significant anti-inflammatory effects. This group includes the powerful antioxidants found in berries and green tea, along with quercetin, rutin, and hesperidin, found in citrus fruit. A diet high in plant food should provide a wide range of flavonoids that will minimise inflammation; supplementing with bioflavonoids can also help.

Fish oil

Eicosapentaenoic acid (EPA), found in fish oil, acts to directly inhibit platelet aggregation and down-regulate the inflammatory cascade. Taking a high quality fish oil supplement daily can significantly reduce inflammation.

Turmeric

This is a potent anti-inflammatory herb which has been traditionally used to treat inflammatory conditions. Numerous studies and clinical trials have demonstrated that its active constituent, curcumin, is effective in both acute and chronic inflammation.

Boswellia

Found to reduce pain and inflammation in clinical trials, boswellia acts to significantly reduce inflammation without irritating the gut like pharmaceutical anti-inflammatories. Often included in formulas to treat arthritis.

Cat’s claw

A Peruvian vine traditionally used to treat arthritis and stomach complaints, cat’s claw has significant anti-inflammatory and pain-relieving properties.

Do’s and Don’ts

DO

  • Eat vegetables. Aim to have between six to nine serves of vegetables per day, buy organic where you can or soak and scrub them if they’re not.
  • Eat fruit. Enjoy a couple of pieces of fruit per day.
  • Eat deep-sea, oily fish such as wild-caught salmon, sardines or mackerel, at least three times per week.
  • Eat nuts and seeds – enjoy a handful a day.
  • Eat poultry. Choose organic, free-range poultry products.
  • Eat grass-fed, organic red meat sparingly – no more than a couple of times per week.
  • Eat whole grains. Choose small to moderate amounts of quinoa, buckwheat, amaranth, rice.
DON’T
  • Drink alcohol. Save it for special occasions only, as it’s very inflammatory.
  • Eat gluten. This is considered an inflammatory component of grains like wheat, barley and rye.
  • Eat too much sugar. It’s in nearly all processed foods, and nearly impossible to avoid if buying packaged foods.
  • Eat trans fats, which are found in fried food, potato crisps, margarine, bakery items, biscuits and many tinned and packaged foods.
  • Eat refined carbohydrates – this includes bread, biscuits, pastries and crackers.
  • Eat food additives. The range is endless, as they are found in almost all packaged and tinned foods.

Top 10 anti-inflammatory foods

  • Pineapple
  • Cherries
  • Ginger
  • Oily fish
  • Blueberries
  • Green tea
  • Garlic
  • Shiitake mushrooms
  • Papaya
  • Broccoli

If you suffer from inflammation or would like to reduce your risk of chronic disease see your health care practitioner today.

This article first appeared in Nature & Health magazine.
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Sep
09

Natural remedies for back pain

It’s hard to fathom the impact of back pain on your life unless you’ve experienced it. Tania Flack investigates what can go wrong, and how you can help.

Most people have had an aching back at some stage in their life, brought on by long hours at a desk or a heavy gym session. If you’re lucky, this type of back pain will ease in a day or two and soon be forgotten. However, when that pain becomes a dull roar which refuses to let up, we start to understand how chronic back pain can impact on your day-to-day life.

Of those Australians reporting back pain, nearly half experience difficulty with mobility, daily activities and self-care, which significantly impacts quality of life. And the financial impact of back pain on the Australian economy is staggering. It’s reported to cost approximately 1.2 billion dollars per year, split between hospital care, out-of-hospital appointments and prescription medications.

And that’s only a small part of the true costs, as many people manage back pain through modalities not reported in these statistics, like osteopathy, chiropractic, physiotherapy, acupuncture, or remedial massage.

Sadly, Australia seems to be leading the world in the impact of back pain on our society. Back pain ranks as the number one issue for Global Burden of Disease estimates in Australia, compared to sixth worldwide.

How can we treat back pain and what steps can we take to prevent it and avoid becoming part of the statistics?

What goes wrong

Muscle strain and tension

This is perhaps the most common type of back pain and most people will experience it at some stage. It often involves the neck and shoulder area or the lower back.

Stress is a common cause of muscle tension. When we are under stress, our fight-or-flight response launches a complex range of chemical and physical changes throughout the body, which are designed to help us get out of danger. Muscles tense up in preparation to fight off danger or flee. While this is useful if we are in physical danger, it can be problematic if we remain in this state for hours, which is often the case in the workplace.

Unrelenting muscle tension leads to muscle pain, strain, tension headaches, and fatigue.

Remedial massage, stretching and yoga are all effective treatments; however if this is an ongoing problem then meditation, mindfulness techniques, stress management and counselling can help you control stress and minimise muscle tension.

Another common cause of muscle strain is poor posture at work, especially if you sit all day. Inadequate lumbar support, incorrect placement of your computer screen or armrests set to the wrong height can all contribute to muscle strain. You should be able to adjust your workstation to suit your requirements. If you have repeated work-related muscle strain, speak to your employer and seek advice from your practitioner or an ergonomist who specialises in preventing work related postural injury.

Treatment options: Remedial massage, yoga, acupuncture, ergonomics, stress management.

Ligament or tendon strain

This type of injury is usually a direct result of over-stressing a joint, which can occur when lifting incorrectly. It can also be due to an accident: whiplash is a common example of this. The pain can be immediately obvious in some cases or may take up to 24 hours to become apparent, depending on the type and site of the injury.

The best first aid to apply is rest, ice and to limit movement until you see your practitioner. This helps to minimise inflammation and reduce pain.

Ligaments and tendons are avascular tissue, meaning they don’t have a blood supply, so this type of tissue can take some time to heal.

Treatment options: Physiotherapy, osteopathy. First aid: Rest, ice and limit movement. Arnica cream can reduce inflammation and speed healing.

Bulging disc

We have fibrous discs between each vertebra which help to cushion the spine against impact and protect the joints. These discs consist of a fibrous outer layer and a softer inner gel-like centre.

Like bones, discs are prone to degeneration with ageing and overuse, which can lead to herniation if the joint is put under undue pressure. When the disc herniates, the soft inner layer pushes through the outer layer of the disc and the resulting bulge can compress nerves in the spine. Often called a ‘slipped disc’, this type of back injury commonly occurs in the lumbar spine and sometimes in the neck.

It requires careful management and imaging , such as a CAT scan or MRI, to assess the degree of damage and help your practitioner formulate a treatment plan. This type of injury is often the cause of chronic back pain and severe cases may require surgery to relive pressure on the nerves.

Treatment options: Osteopathy, physiotherapy or chiropractic care. Imaging such as CAT scan or MRI is important and a medical consultation may be required.

Osteoarthritis

As we age, so do our vertebrae and over the course of our lives they are subjected to general wear and tear, which can lead to localised inflammation and osteoarthritic degeneration of the joint. This causes limited mobility and, in some cases, chronic back pain.

Maintaining strong bones is essential to help prevent osteoarthritis and having a whole-food diet rich vitamins and minerals will help maintain bone strength. A calcium supplement, along with glucosamine, chondroitin, vitamin D and K2, will support bone strength.

You can reduce inflammation by consuming oily fish such as salmon, mackerel, sardines and herring three times a week, and making sure you have lots of fresh green leafy vegetables in your diet. Avoiding foods known to promote inflammation – sugar, highly refined carbohydrates, preserved meats and fried foods – is also very important.

Herbal medicine, including turmeric, devil’s claw, cat’s claw, celery seed and ginger, can help relieve inflammation.

Treatment options: Nutritional medicine, herbal medicine, weight management, exercise and physiotherapy.

Sciatica

This describes the pain caused by compression and inflammation of the sciatic nerve, which exits the spine in the lower back and runs down the leg. This is a very important nerve and is involved in coordinating muscle movements when we walk.

This nerve can be compressed by a bulging disc in the lower back or can become compressed by the piriformis muscle, deep in the gluteal region.

Once this nerve is compressed, inflammation gets trapped between the nerve and the myelin sheath and swelling travels down the length of the nerve, causing the pain and weakness in the leg and foot which is typical of sciatic pain. This needs to be professionally assessed and treated as the two common causes of sciatic pain are managed very differently.

Treatment options: Great relief can be achieved by releasing the piriformis muscle along with the other deep muscles of the hips. Remedial therapists can achieve this while Pilates and yoga can help to prevent a relapse of piriformis-induced sciatica. If sciatic pain is due to a bulging disc, an osteopath, physiotherapist or chiropractor can help. X-rays and a medical consultation may also be required.

How to reduce your risk

Watch your weight

Being overweight is perhaps one of the biggest risk factors when it comes to back pain. Carrying extra weight burdens joints unnecessarily and is a leading cause of osteoarthritis, along with ageing. Excess weight around the middle shifts our centre of gravity and puts pressure on the lower back, increasing the risk of muscle strain or spinal injury.

Being overweight at the time of a back injury significantly slows the healing process. This is particularly important in the case of a herniated disk, especially if surgery is required. Being overweight at the time of injury can lead to a vicious cycle, because back pain prevents people from exercising, which leads to more weight gain, which ultimately leads to more back pain.

Luckily, weight management can be successfully achieved through diet alone for people who have limited mobility. Consulting with a nutritionist to formulate a dietary plan can be the first step to recovery and maintaining a healthy weight protects against future back injury.

Regular exercise

Poor core muscle strength shifts much of the weightbearing strain to the spine and can lead to greater wear and tear of the joints and an increased risk of injury. Achieving and maintaining strong abdominal muscles is one of the best way you can protect your back.

Walking, swimming, and taking part in sports that use a range of different muscles all help to strengthen the core and maintain flexibility Pilates and yoga are great ways to strengthen the body, reduce muscle pain, increase flexibility and retrain postural core muscles.

Other excellent activities include the Alexander technique and the Feldenkrais method: these both help people to reconnect with their body, become more aware of their posture, and strengthen and rebalance the core muscles. They are marvellous therapies for preventing and treating back injury and reducing chronic pain.

Occupational risks

Certain occupations carry greater risk of back injury. Any job that involves sitting for long hours, such as office work or truck/taxi driving, puts a great deal of pressure on the back and spine. If you sit all day you should schedule a break every hour, get up and walk to the water cooler or pull over and take a five minute break to stretch your legs. If your job involves heavy lifting or repeated bending, put measures in place to minimise back strain. If your work is straining your back, speak to your employer; sometimes only small changes are needed to make a big difference.

We should all be more aware of back health. Staying fit and active throughout life, and maintaining strong, flexible core muscles and a healthy weight can all considerably reduce your risk of back pain. And, if you are experiencing back pain, remember early intervention is the key to a fast recovery.

Best therapies for back pain

Remedial massage, Osteopathy, Acupuncture, Chiropractic care, Physiotherapy, Pilates, Yoga, Feldenkrais method, Alexander technique, Herbal medicine

Best nutrients for back pain

Turmeric, Ginger, Garlic, Oily fish, Shellfish, Flaxseed, Berries, Cherries, Leafy green vegetables, Cold-pressed virgin olive oil

Anti-inflammatory foods for pain

  • Magnesium, for muscle spasm – red meat, chicken, turkey, almonds, pecans, pistachios, sesame seeds, sunflower seeds, legumes
  • Essential fatty acids, for inflammation – deep sea oily fish, such as salmon, mackerel, sardines, herring and flaxseed
  • Vitamin C, for tissue strength – citrus fruit, blackberries, kiwifruit, red capsicum, strawberries, papaya, broccoli, rockmelon
  • Zinc, for would healing – oysters, red meat, Brazil nuts, almonds, cashews, walnut, pine nuts, sunflower seeds, parsley
  • Folate, for tissue repair – leafy green vegetables, carrot, celery, cabbage, chickpeas, hazelnuts, chicken livers, oranges
  • Calcium, for bone strength – dairy products, small fish with edible bones, like sardines and anchovies, tahini, crab, duck, sunflower seeds
  • Vitamin D, for bone health – dairy, egg yolk, herring, calamari; it is also synthesised from exposure to sunlight.

This article first appeared in Nature & Health magazine.
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Aug
26

Natural remedies for fibromyalgia

If you think unrelenting pain through your whole body sounds dreadful, well it is. Imagine waking every morning in pain – even walking hurts.
Your pain and exhaustion become overwhelming, and you lose your job.

Your friends and family can’t understand; you struggle to maintain relationships, and feel isolated and depressed. After many trips to doctors and specialists, you are finally diagnosed with fibromyalgia – and told there is little you can do but manage the pain and find a new way to live within the confines of your condition.

Sadly, this is a common story among fibromyalgia sufferers, compounded by a lack of understanding as to what causes the condition and no clear clues for a path forward. However, research is shedding light on it and natural medicine can help alleviate the symptoms.

What causes fibromyalgia?

Fibromyalgia is a chronic disease characterised by widespread pain and multiple tender points in muscles and soft tissues throughout the body, accompanied by stiffness and fatigue.

It affects between two and 10 percent of Australians, and is the second most common rheumatic condition, following osteoarthritis. It is seven times more likely to strike women than men, commonly between the ages of 35-55 years, although men and children can also develop it.

Initially viewed with scepticism by the medical fraternity, due to a lack of obvious and measurable biomarkers, it wasn’t until 1990 that diagnostic criteria were developed by the American College of Rheumatology. These were later expanded in 2010 to encompass a broader range of symptoms, including sleep disturbance, morning stiffness, cognitive problems, headaches, migraines, and depression.

There is much crossover between fibromyalgia and other clinical syndromes, including chronic fatigue syndrome, irritable bowel syndrome, restless leg syndrome and multiple chemical sensitivities, so even getting a diagnosis can be a long, frustrating experience.

Fibromyalgia is a complex condition and the exact cause is unknown, but abnormalities of cell signalling and neuroendocrine function have been identified and are being investigated. While we don’t have the full picture yet, it is generally thought that fibromyalgia can be triggered by infection, physical trauma, psychological stress, hormonal alterations, or possibly exposure to some drugs or chemicals.

People with fibromyalgia have abnormalities in the way the neurons of their central nervous system respond to pain signals. Neuroimaging studies demonstrate clear differences in the brain responses of fibromyalgia sufferers compared to normal controls. Neurotransmitter abnormalities have also been identified, including lower serotonin levels in the central nervous system, which may alter pain signalling. A decrease in dopamine signalling in the brain also plays a role.

In keeping with these findings, antidepressants are the standard medical treatment for fibromyalgia and can provide some relief of symptoms. Neuroendocrine deficiencies have also been identified as a possible contributing factor; so are changes in the function of the hypothalamus-pituitary-adrenal axis, which can lead to a lower secretion of adrenal hormones, blunted cortisol response, and lowered DHEA levels.

Fibromyalgia sufferers have demonstrated low adrenal function in studies, along with hyposecretion of adrenal androgens, including DHEA and testosterone. Chronic stress – either physical or emotional, or a traumatic event – impacts the delicate balance of the hypothalamus-pituitary-adrenal axis and can be associated with onset of fibromyalgia.

Most recently, research has focused on the role of the mitochondria, the energy-producing powerhouse in all cells. Fibromyalgia sufferers have decreased levels of coenzyme Q10 (a powerful antioxidant enzyme involved in mitochondrial energy production), and increased levels of oxidative stress and mitochondrial dysfunction. Exciting breakthroughs in the link between mitochondrial dysfunction and chronic fatigue syndrome (a closely linked condition) have started to emerge, so hopefully this research will have benefits for fibromyalgia sufferers in the future.

Leaky gut and thyroid

Between 30 and 70 percent of all fibromyalgia sufferers also experience irritable bowel syndrome, which has led researchers to try to identify a link.

While the cause of fibromyalgia is yet to be identified, there is a theory that dysbiosis (an imbalance of gut bacteria) causing an increase in the permeability of the gut lining (leaky gut) may be a contributing factor. Exposure to minute levels of bacterial endotoxins escaping the gut into the bloodstream is thought to trigger an inflammatory response in immune cells, which in turn alters cellular signalling, impacting pain perception, and causing depression and fatigue.

Poor diet, refined foods, sugar, alcohol, caffeine, some medications, herbicides and pesticides in foods, and stress all contribute to an unbalanced gut microbiome.

One study looking at the link between gut health and fibromyalgia found that 78 percent of all fibromyalgia patients tested positive for small intestinal bacterial overgrowth (SIBO), and when treated for this with antibiotics had significant improvements in gut symptoms, musculoskeletal pain and fatigue.

Other research examining the intestinal permeability of fibromyalgia sufferers has found that it is increased, compared to healthy controls.

Nutritional interventions designed to reduce symptoms of irritable bowel syndrome also significantly improve pain in fibromyalgia sufferers. Participants of one study ate a low-FODMAP (Fermentable Oligo-Di-Monosaccharides And Polyols) diet for four months, and were found to have significant reduction in overall pain scores and improvement in gut symptoms. The low FODMAP diet removes fermentable fibres from the diet, which reduces the total bacterial abundance in the digestive tract.

So these findings support the theory that levels of gut bacteria and the endotoxins they produce play a role in fibromyalgia.

Shifts in other hormones are also linked to fibromyalgia and evidence supports the hypothesis that fibromyalgia may, in part, be due to thyroid hormone resistance. Hypothyroidism is common in fibromyalgia sufferers; however, some people present with all the symptoms of thyroid disease but their blood results indicate normal thyroid function. This is thought to be due to thyroid resistance, which is a blunting of the cells’ responses to available hormone.

Several clinical trials have found that thyroid hormone replacement can significantly improve symptoms of fibromyalgia. Fibromyalgia sufferers displaying thyroid symptoms may benefit from supplemental iodine, selenium, zinc, and other cofactors to support thyroid hormone production, along with herbs like coleus and withania. A naturopath or nutritionist will be able to assess thyroid function, test for any nutritional deficiencies, and prescribe a tailored protocol if needed.

Nutritional medicine can help

SAMe: S-adenosylmethionine (SAMe) is an amino acid that has significant anti-inflammatory, painrelieving, and antidepressant activity in fibromyalgia. SAMe acts to down-regulate inflammation and has been shown to be as potent as non-steroidal anti-inflammatory medication in both animal studies and human clinical trials.

The antidepressant activity of SAMe is well-established, with many clinical trials finding that it provides equivalent antidepressant activity as standard pharmaceutical antidepressants, but without the side effects. A double-blind, placebo-controlled, randomised clinical trial has shown that even a relatively low dose of 200mg per day for 21 days reduces the number of tender trigger points and improves mood.

Acetyl-l carnitine: This antioxidant amino acid supports cell membrane health, mitochondrial activity, enhances energy production, and has significant neuroprotective properties. Clinical trials show that it alleviates depression in fibromyalgia sufferers, and a recent meta-analysis found that it has pain-reducing effects in peripheral neuropathy. One study involving over a hundred participants found that fibromyalgia sufferers given two 500mg of acetyl-l carnitine daily for 10 weeks had a significant reduction in musculoskeletal pain and depression.

Magnesium: This is essential for energy production in every cell in the body. Studies show that fibromyalgia sufferers have abnormal calcium and magnesium flow across the cell wall and low serum levels of magnesium. One study found that 300mg of magnesium citrate given daily for eight weeks significantly decreased the number of tender points, the level of tenderness, and depression scores. These results indicate that the combination of magnesium citrate with SAMe, which has been shown to have similar efficacy as standard antidepressants, may achieve similar results although no clinical trials have been done to date.

Coenzyme Q10 (CoQ10): This powerful antioxidant enzyme plays a critical role in mitochondrial function and energy production within the cell. Studies reveal that fibromyalgia patients often have deficiencies in CoQ10. One randomised, placebo-controlled, double-blind trial investigated the effects of 300mg of CoQ10 daily for 40 days in a group of 20 fibromyalgia patients. This produced significant reduction in pain, tender points, fatigue, and morning tiredness. Further investigation showed improvement in antioxidant enzyme activity, mitochondrial function, and inflammation. Another trial investigated the effects of a combination of 200mg of CoQ10 daily with 200mg of ginkgo biloba for 84 days. Ginkgo biloba is a powerful antioxidant herb that has a stimulatory effect on the microvasculature. Quality of life scores were monitored throughout the trial and 64 percent of participants reported improvement in symptoms.

Mind-body therapies

These are important management tools in any chronic painful condition, and fibromyalgia is no exception. Fibromyalgia sufferers can often feel that they are powerless to make changes in their health, due to their pain, which can lead to frustration, depression and isolation.

Partaking in gentle movement is an important part of learning to manage the symptoms of this debilitating condition, and several studies have identified benefit in meditation, mindfulness and other mind-body therapies, indicating that this type of intervention is an important addition to any fibromyalgia recovery program.

Qi Gong is a gentle movement therapy based on martial arts that uses physical poses, breathing techniques, and focused intention in order to promote the flow of qi or vital life force throughout the body. One randomised, controlled, cross-over study found that Qi Gong therapy over a course of seven weeks provided positive and reliable benefits and improved pain, psychological health and reduced distress.

Other studies have identified similar benefit from Tai Chi, which improves pain scores, sleep quality, physical and psychological function. Mindfulness-based meditation has been found to be effective for the depression and mood alterations associated with fibromyalgia; however, the movement-as-meditation therapies like Tai Chi and Qi Gong seem to have a broader range of benefits and are more successful in reducing pain.

6 steps to fibromyalgia recovery

Clean up your diet: Everything we eat has an impact on our body, and people with fibromyalgia need to take a ‘food as medicine’ approach to their diet and make every mouthful count. A predominantly plantbased, clean, wholefood diet is essential to help alkalise the system and keep your gut microbiome happy. Avoid processed foods, fried foods, sugar, caffeine, and alcohol.

Heal your gut: This is an important step towards recovery and diet should be your biggest focus here. However, pre- and probiotics, glucosamine, vitamin A, zinc, and bioflavonoids can help rebalance the gut and repair the gut wall. Herbs such as slippery elm, marshmallow and golden seal will also help. Speak to a professional about your gut health for proper assessment and treatment.

Dampen inflammation: A wholefoods diet is the best place to start. Eicosapentaenoic acid (EPA), a constituent from fish oils, can significantly reduce inflammation. Aim for a dose of 1.2g daily. Vitamin C and the bioflavonoids quercetin and rutin will also help. Herbs – turmeric, boswellia and cat’s claw – are also effective anti-inflammatories, but should be prescribed by a professional.

Control your stress: Being in pain is stressful and it’s vital that you take steps to manage stress as part of your recovery program. Managing stress reduces pain and protects against depression. Mindfulness techniques, meditation, Tai Chi and Qi Gong can be useful, as can the support of a psychologist specialising in chronic health conditions and pain management.

Keep moving: Even when muscle pain and fatigue limits activity, gentle movement can reduce stress, improve mood, release pain-reducing endorphins, and support healthy circulation and mobility.

Get specialised advice: Herbal medicine can be used to support recovery in fibromyalgia and may include herbs to support healthy adrenal and thyroid function, reduce pain, support mood, and promote restful sleep Herbal medicine needs to be prescribed on an individual basis by a trained professional, especially if you are taking other medicines, so speak to your naturopath or herbalist.

So the message is: don’t give up, but explore your options so you can find the perfect combination of support to help you on your path to recovery.

This article first appeared in Nature & Health magazine.
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Apr
01

Autoimmune disease: how to reduce your risk

Autoimmune disease is a silent epidemic that affects many Australians with numbers steadily growing each year. Tania Flack explains what goes wrong to cause autoimmune disease, and how you can reduce your risk.

Autoimmune diseases (AD) are a group of incredibly diverse conditions that have one important factor in common: they are all driven by a confused immune system that identifies the body’s own tissues as a foreign invader and launches a defensive inflammatory attack to try and neutralise the ‘threat’.

Unfortunately, when this occurs we become the victims because instead of protecting the body, the immune system can actually cause significant damage, and in extreme cases can become life-threatening. It really is sabotage from within.

Autoimmune disease is a silent epidemic that affects approximately five percent of Australians with numbers steadily growing each year. There are as many as 80 distinctly separate autoimmune diseases. Common ones include: rheumatoid arthritis (affecting the joints), multiple sclerosis (nervous system), Hashimoto’s or Graves disease (thyroid), type I diabetes (pancreas), and ulcerative colitis, Crohn’s and coeliac diseases (bowel).

Prognosis differs due to individual genetic and environmental factors. Tests which may be used to determine an autoimmune disorder include: C-reactive protein (CRP) (inflammation), erythrocyte sedimentation rate (ESR) (inflammation), antinuclear antibody test (ANA) (measures autoantibody levels and indicates an attack on the nuclei of the cells), specific autoantibody tests (identifies the types of tissue being damaged), and white cell count (assesses immune system function).

Autoimmune disease may go through cycles of exacerbation and remission, go into lengthy or permanent remission or continue on a destructive path.

What causes autoimmunity is one of modern medicine’s most intriguing questions. Although we know that the autoimmune process is triggered and perpetuated by a complex interaction between genes, environment, and hormones, we have few definitive answers; this makes treatment very difficult.

Modern medical treatment is aimed at attempting to control the symptoms and progression of the disease, modulate the immune system and limit tissue damage.

Natural medicine has a lot to offer people suffering from autoimmune disease; it can address some of the underlying drivers, reduce inflammation and modulate the immune system. In the hands of an experienced practitioner, natural medicines can be used in conjunction with medical treatment where necessary, to get the best results.

Pinpointing causes

While the exact cause of autoimmune disease is unknown, several potential contributing factors have been identified. Epidemiological data indicates that there has been an alarming increase in autoimmune diseases in the past three decades, particularly in the developed world; this may be due to:

The cleanliness factor

It seems our fixation with cleanliness and avoidance of germs can actually disadvantage the immune system. Playing in the dirt, romping with a family pet and having everyday exposure to germs from an early age seems to act as a protective measure, helping to train an immature immune system to properly identify what is our own tissue and what is foreign. It is far less common for people who grew up in non-industrialised countries to develop autoimmune disease. So let your kids get dirty and be exposed to everyday bugs, it may protect them in the future.

The leaky gut connection

Approximately 80 percent of our immune cells live just outside the gut wall, waiting in the wings like border control, to apprehend any potential foreign invaders. A perilously thin layer of epithelial cells separate the immune system from the trillions of bacterial cells living inside the gut. These bacteria are collectively referred to as the gut microbiome and they perform various important tasks, including helping us to breakdown food, producing nutrients, and maintaining the health of the bowel wall.
These bacteria are vital to our health, and in a well-balanced system the gut microbiome and the immune system exist harmoniously.

However, a modern diet may significantly interfere with the barrier between the two systems and this is where turf wars triggered by dietary factors can ultimately lead to major immune dysregulation. Tight gap junctions are the microscopic pores through which we absorb nutrients; they also act as a ‘doorway’ between the two systems. They are delicate structures and easily damaged by inflammatory, biological, and chemical insults.

Maintaining a healthy gut helps to strengthen the barriers between the gut microbiome and the immune system and decreases the risk of developing autoimmune disease.

Toxic triggers

Toxins damage the immune system and play a role in autoimmune disease, possibly due to their effect on the genes associated with inflammation. Environmental exposure to heavy metals, such as cadmium, mercury and lead, increases the risk of developing a range of autoimmune diseases, including multiple sclerosis.

Occupational exposure to common organic solvents (e.g. paints, glues, dyes, polymers, pharmaceuticals, printing inks) or pesticides used in farming also increases the risk of developing autoimmune disease. Avoiding these harmful chemicals and supporting detoxification will help to lessen the risk.

Bug wars

Some bacteria, viruses, parasites may actually trigger autoimmunity. This is thought to be due to a phenomenon called ‘molecular mimicry’, where the invading bug has specific proteins that are so similar to our own, the immune system becomes confused and starts attacking its own body tissue. For example, high levels of the inflammatory bacteria Prevotella copri are associated with the onset of rheumatoid arthritis.

Salmonella and other acute bacterial gut infections, such as Yersinia, Campylobacter and Shigella, are clearly associated with the onset of reactive arthritis. Several viruses are associated with the onset of autoimmune diseases, including Epstein Barr virus (multiple sclerosis) and enteroviruses (type I diabetes).

Hormones

There is a definite disparity between the sexes when it comes to autoimmune disease. Of the five to eight percent of the population with autoimmune disease, an estimated 78 percent of those are women. The discrepancy between the sexes is thought to be due to the complexity of hormones in women. Women are at greater risk of autoimmune flare-ups or developing autoimmune disease during times of hormonal change such as pregnancy and menopause.

Protect yourself

Perhaps the most exciting area of research into autoimmunity comes from our growing knowledge of how the bacteria in the digestive tract interact with the immune system and how diet may play a mediating role between the two systems. A recently released paper highlighted the effects of a modern diet on the immune system and identified common foods and additives that may contribute to autoimmune disease via their negative effect on the gut. Here’s what to avoid:

Gluten

Gliadin, found in gluten, may drive autoimmune disease by causing a leaky gut, which allows under-digested foods to be attacked by the immune system. This is found in grains such as wheat, barley and rye, and gets a bad wrap on many levels; not only is it the causative factor behind coeliac disease, it may be a key driver of autoimmune disease.

Gliadin, one of the components of gluten, opens the tight gap junctions in the digestive tract, contributing to a leaky gut. This allows the passage of under-digested foods, wastes and toxins from inside the lumen of the digestive tract out into the circulation where they are immediately set upon by the immune system.

Genetically, some people are more sensitive to gluten than others and more prone to develop coeliac disease. Interestingly, people genetically predisposed to coeliac disease seem to be more prone to other autoimmune diseases, particularly autoimmune thyroid diseases and type I diabetes. Due to its damaging affect on the gut membranes and its potential interaction with genes associated with autoimmune disease, avoiding gluten is vital.

Sugar

A lot has been written about the harmful effects of sugar in the diet and its connection with autoimmunity. Fructose, a type of sugar, has varying negative effects on the body; however, glucose – which has been lauded as a ‘preferred’ sugar – may actually contribute to the autoimmune disease cycle.

Glucose is absorbed mainly via the tight gap junctions in the digestive tract and can enhance gut permeability, which may contribute to leaky gut syndrome. When we eat a processed food it’s difficult to tell how much sugar we are consuming, so avoid processed foods and sugar.

Alcohol

This has also been shown to damage the tight gap junctions, which contribute to leaky gut and stress on the immune system. In susceptible people, alcohol may potentially play a role in the initiation and potentiation of autoimmune disease. Save alcohol for special occasions and avoid it altogether if you have an existing autoimmune disease.

Food additives

There are many that may irritate the immune system. Emulsifiers and surfactants are widely used in processed foods to ensure even consistency; think sauces, dressings, soy and nut milk, ice cream, pasta sauces, bread, chocolate, margarine. Both significantly impact tight gap junctions, breaking down the barrier between the gut and the immune system. Recently, a Japanese study has demonstrated a direct correlation between the annual sales of emulsifiers to the food and beverage industry and the rising rate of Crohn’s disease.

So despite the fact that there are still many unanswered questions about autoimmune disease, we have tools that can provide significant benefit to sufferers and, by using an integrative approach, we can provide the best outcome.

Your 10-point prevention plan

1. Go for whole: A wholefood diet can have profound effects on your health. Avoiding all processed foods reduces your intake of chemical additives that damage the immune system. Put some effort into developing a good relationship with your local suppliers, ask about the food you are buying and get a good understanding of where it is grown and how it is farmed – a little bit of knowledge can help you make good choices. Experiment with new recipes and expand your cooking repertoire.

2. Pick plants: Having a high vegetable intake will provide you with valuable nutrients to fuel your health, and natural prebiotic, probiotic, and dietary fibres to keep your gut microbiome happy. A high vegetable intake is anti-inflammatory and will also help to alkalise the body, which may relieve pain. Juicing is a great way to increase your intake. Aim for between 6-9 servings of vegetables and 2 pieces of fruit per day.

3. Go organic: This is definitely the way to go if you have an autoimmune disease; it is the fastest way to decrease your exposure to harmful pesticides and herbicides and reduce your toxic burden.

4. Love your guts: Adding fermented foods such as kefir, sauerkraut and kimchi provide beneficial bacteria to balance the microbiome. Resistant starches are a valuable source of fuel and support the health of gut bacteria; these can be found in potatoes, sweet potatoes, and rice that has been cooked, and then cooled. For best results these foods should be added to the diet slowly, starting with small amounts and building up over time.

5. Pump up your vitamin D: This is one of the most important nutrients for a healthy immune system. It has powerful anti-inflammatory effects and protects against the development of autoimmune diseases. You can get vitamin D from sun exposure and from certain foods, such as oily fish, eggs, and mushrooms. Some people have difficulty maintaining healthy vitamin D levels due to genetic variations, so supplementation is often needed. If you have an existing autoimmune condition, or you are at risk of developing one, you should aim to keep your vitamin D levels in a high healthy range, around 100 nmol/L. As vitamin D is a fat-soluble vitamin, you need to have your levels monitored by your health care provider.

6. Heal your gut: This is essential. Nutrients such as glucosamine, vitamin A, zinc and bioflavonoids will be useful for the repair of the gut wall, as will herbs like slippery elm, marshmallow, and licorice, although these should be prescribed by a professional if you are taking other medications.

7. Dampen inflammation: Eicosapentaenoic acid (EPA), a constituent from fish oils can significantly reduce the inflammation associated with autoimmune disease. Aim for a dose of 1.2 grams daily. Nutrients such as vitamin C and bioflavonoids like quercetin and rutin will help. Herbs such as turmeric, boswellia and cat’s claw are also effective anti-inflammatories.

8. Get specialised advice: There are several herbs which have an immunomodulating effect, and that can be used to control autoimmune disease, including polypodium and hermidesimus. These may not be suitable for every person and need to be prescribed by a professional, especially if you are taking other medications.

9. Control your stress: Sustained stress leads to disruption of adrenal hormones, including cortisol, which under normal circumstances helps us to ward off inflammation. Recent studies show that when cortisol is affected by sustained stress we are less able to modulate inflammation, which is one of the driving factors behind autoimmune disease. Managing stress also reduces pain and protects against depression: two vital survival skills for autoimmune disease. Mindfulness techniques, meditation, tai chi and gentle yoga can all be useful, as can the support of a psychologist specialising in stress management.

10. Keep moving: Exercise is an important part of keeping healthy and even when inflammation and fatigue limits activity, gentle movement can help to reduce stress, improve mood, release pain-reducing endorphins, and help support healthy circulation and mobility.


This article first appeared in Nature & Health magazine.
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Mar
25

Natural pain relief

We live in a fortunate age where we have easy access to pain-relieving pills; however, they do have side effects. Naturopath Tania Flack explores safer alternatives.

Popping a tablet for a headache or period pain is so commonplace we don’t really think about it; after all, pain medication is safe, right?

Common pain medication may be safe when taken as directed; however, they can have harmful effects on the body. For example, paracetamol directly depletes the action of glutathione in the liver and can cause liver damage when taken in high doses. Anti-inflammatory medications like ibuprofen can cause significant disruption to the delicate lining of the digestive tract, while stronger over-the-counter pain medications containing codeine are also often misused, some people may even develop a physical dependence, due to its opiate-like effects.

Pain comes in many guises: the continuous ache of arthritis, the low-grade throb of a dull headache, or the cramping pain that some women experience with their period.

Obviously the best way to address pain is to try to address its cause, but this can take time or may just not be possible, as in the case of chronic degenerative conditions.

Natural medicines can provide relief for acute pain and can be used to help manage chronic pain.

Sprains and strains

Whether it’s a twisted ankle, a sporting injury or you’ve knocked your shin on the car bumper bar, sprains, strains and bruises are common injuries that fall into the category of acute pain. First aid for these types of injuries should always start with rest, ice, compression, and elevation. These all minimise inflammation and pain and allow the body to begin the repair process. Ice numbs the pain, however never apply ice directly from the freezer to the skin – always wrap it in a damp cloth to prevent ice burn. Once this has been done use these options to reduce pain and speed healing.

Arnica: This herbal remedy has been used through the ages to treat swelling, bruising, and inflammation. Research shows that it selectively inhibits inflammatory mediators. It can be taken orally as a homeopathic or used in a topical cream applied directly to the bruise. Clinical trials show that using the homeopathic and topical preparations together significantly reduces pain.

Vitamin C and bioflavonoids: Vitamin C and bioflavonoids, such as quercetin and bromelain, are nutrients found in citrus fruit and pineapple. They have significant anti-inflammatory properties and, when taken together, help to mop up inflammation, reduce pain, and promote healing in soft tissue.

Backache

This is a common problem and can be due to postural imbalance, muscle strain or an underlying structural problem. If backache is a regular occurrence, it must be assessed by a practitioner specialising in spinal health.

Spinal care: Although it’s hard to group three distinctly different modalities together, it is safe to say that osteopathy, physiotherapy, and chiropractic care are all excellent therapies for backache. Gently manipulating the spine and mobilising soft tissues can be the fastest way to get relief. This type of care also provides the benefit of thorough assessment, which can prevent further pain and injury.

Massage: The healing touch of a remedial massage therapist can provide significant pain relief, particularly in the case of muscle tension. Massage relieves pain by increasing blood flow, reducing congestion in soft tissue, and releasing muscle tension.

Yoga and Pilates: While yoga and Pilates may not be the ideal therapy for acute back pain, there is no question that, under the supervision of a qualified instructor, both forms of movement can relieve chronic back pain and help to prevent recurrence.

Comfrey: Once known as ‘boneset’, comfrey has been traditionally used to ease pain and promote healing. It contains a compound that simultaneously stimulates tissue repair and decreases inflammation. Several clinical trials have investigated its effects: in one study, it was reported to be as effective as Voltaren (Diclofenac) gel for pain relief.

Headaches and migraines

Whether it’s the dull throb of a tension headache or the blinding pain of a migraine, headaches are a common reason why people reach for pain medication. Sufferers of regular headaches and migraines often have a high intake of painkillers, which over time may have a negative effect on their health. There are several effective natural remedies that can help to relieve and prevent headaches.

Magnesium: Sometimes described as ‘the miracle mineral’, this has significant benefits for headache sufferers. Changes in blood vessel diameter in the brain cause the throbbing associated with migraine and headache; magnesium helps to control this while relaxing the muscles around the head and neck. Magnesium deficiency contributes to headaches and migraines, and studies show that migraine sufferers have low brain levels of magnesium during an attack. Chronic migraine sufferers who take regular magnesium supplements can reduce the frequency of attacks by 41 percent.

Acupressure: This ancient technique uses gentle pressure applied to specific points, which stimulate the release of the body’s natural pain relieving neurochemicals, endorphins (see box “Acupressure points for headaches”). Studies show that regular acupressure provided better relief for headaches than regular muscle relaxant medication. Bonus: you can do it yourself at the onset of a headache to control symptoms.

Lavender: Who doesn’t love the scent of fresh lavender? Lavender essential oil has a soothing effect on the nervous system and is ideal for treating tension headaches. Studies confirm its analgesic and anti-inflammatory properties. A cloth dipped into cool water with a few drops of essential oil can be applied to the forehead to help relieve headaches.

Meditation: Meditation, mindfulness and relaxation techniques can be used by anyone to help control pain and are especially useful for treating and preventing headaches and migraine. Meditation alters our perception of pain and can significantly decrease stress hormones and inflammatory mediators that contribute to pain. Plus, once you learn you can meditate anywhere, so you’ll have a pain-relieving technique to employ at the first sign of a headache.

Toothache

Local anaesthetic is without a doubt a blessing when it comes to undergoing invasive dental procedures. However, that nagging pain that you may experience while waiting for your next dental appointment can be significantly relieved with some simple natural medicine strategies.

Ginger tea: This is one of the most effective pain-relieving and anti-inflammatory herbs we have, due to its effects on prostaglandin release. Gently swirl the warm tea around the mouth and across the affected area, and pain will slowly start to ease. Keep sipping the tea until pain is manageable. This is also an excellent treatment for the pain of a sore throat or sinus infection.

Clove oil: This old-fashioned remedy was once all that we had to relieve toothache and it still stands the test of time. Cloves contain eugenol, which has proven analgesic and antiseptic properties. A few drops of clove oil applied to the affected area can relieve pain. If you don’t have the oil handy, you could make clove tea. Lightly crush whole cloves and add hot water, allow it to steep for seven minutes, and then swirl gently around your mouth.

Nerve pain

Nerve pain can be excruciating, and doesn’t necessarily respond well to standard pain medication. Nerve pain usually follows a defined path across the body, be it the shooting pain down the legs caused by sciatica or the constant irritating pain around the side of the body or face caused by an attack of shingles.

St John’s wort: This herb is probably best known for its antidepressant effects; however its effects on the nervous system are more far-reaching. Specialised compounds in St John’s wort, namely hypericin and hyperforin, have been found to provide relief from nerve pain due to anti-inflammatory and direct analgesic effect on the nervous system, acting on opioid pathways. St John’s wort may interfere with the way some medications work so it should be professionally prescribed for the management of nerve pain.

Acupuncture: One of the oldest and most effective treatments known to man, acupuncture is suitable for many different types of pain, including nerve pain. Like acupressure, acupuncture stimulates the flow of qi, or life force, working to rebalance the body and change our perception of pain. It stimulates the release of endorphins and is so effective people have even used it to undergo minor medical procedures.

Period pain

This can be a common occurrence for some women, especially in teenage girls, perimenopausal women and any woman suffering from endometriosis.

Homeopathy: There are several excellent remedies: Caulophyllum is useful for spasmodic, labour-like pains; Cimicifuga is prescribed for sharp pain; Belladonna can be used for congested heavy pain, which starts before the period; and Pulsatilla and Sepia can help to regulate the cycle. A qualified practitioner will prescribe the most effective remedy.

Ease the ache

Arthritis affects 3.85 million Australians and is one of the leading causes of disability and chronic pain. Pain, inflammation, and joint degeneration caused by arthritis can lead to loss of mobility and a significant decrease in quality of life, so managing pain and inflammation is crucial. Natural medicine can be used alongside standard pain relief medication under professional supervision if needed.

Fish oils: Omega-3 essential fatty acids are renowned for their anti-inflammatory effects. Fish oils contain two main constituents, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). EPA is the major anti-inflammatory constituent and directly down-regulates inflammation. Fish oils have been shown in clinical trials to reduce pain, increase mobility and decrease the duration of morning stiffness associated with arthritis. While it is important to eat fresh fish, arthritis sufferers also need to supplement; Arthritis Australia recommends 2.7 grams of fish oil (containing both EPA and DHA) to manage the pain and inflammation of arthritis.

Turmeric: Considered a sacred spice throughout Asia, turmeric is used widely for culinary, medicinal and religious purposes, with good reason! The major therapeutic constituents, curcuminoids, have remarkable health benefits including potent anti-inflammatory and antioxidant effects. Animal studies confirm turmeric is more effective than some non-steroidal anti-inflammatory drugs and has direct anti-arthritic effects. Professionally prescribed, high dose turmeric supplements can be useful in managing arthritic pain. Adding turmeric to the daily diet will also down-regulate inflammation.

Anti-inflammatory herbs: There are a wealth of powerful anti-inflammatory and pain-relieving herbal medicines containing compounds that down-regulate inflammatory pathways in the body, so relieving pain and reducing joint damage. They include boswellia, cat’s claw, willow bark and devil’s claw. Herbal medicines should be professionally prescribed for the individual.

Tai chi: Moving is often the last thing arthritis sufferers feel like doing; pain, stiffness and joint restriction can cause them to avoid exercise. However, controlled movement can make a big impact on the level of pain experienced. Tai chi is a gentle form of exercise based on martial arts principles that involves flowing movements which stimulate the movement of qi, or life force, around the body. This promotes relaxation, stimulates blood flow, releases endorphins and helps maintain strength and flexibility. Regular tai chi has been shown to help manage chronic arthritis pain.

This article first appeared in Nature & Health magazine.
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