OSTEOARTHRITIS
RHEUMATOID ARTHRITIS
NATURAL REMEDIES

Could these be the good ol' days of osteoarthritis? What seemed impossible 30 years ago -- actually replacing damaged joints -- is now not only possible, but a common practice, as researchers continue to develop lighter, more durable and more flexible materials. Imagine what lies down the road. Today's researchers are trying to stop OA before damage starts, working to improve diagnostic tools and develop treatments to forestall joint erosion. Even people whose joints are already damaged by OA can benefit from the knowledge generated by today's OA research, much of which has been funded by the Arthritis Foundation's research program. Find out where OA research is headed and how scientists may make life less painful in the future in "Next Steps."

While waiting for scientists to find a less painful future, some must consider disability. But of the approximately 1.5 million Americans who file for disability benefits every year, 65 percent are denied on their first try. Even people who aren't rejected often feel confused and overwhelmed by the process, which seems arcane at best and tortuous at worst. The system can seem designed specifically to batter their already fragile emotions, making a difficult situation even worse. There's no magic spell to make applying for disability benefits suddenly easy, but you can reduce your frustration -- and maybe even increase your chances of getting a fast approval -- by understanding the process before you apply. We'll help you navigate "The Disability Maze" step-by-step.

Rheumatoid arthritis is one of the most common autoimmune disorders

diseases caused by the immune system attacking the body’s own tissues.

Autoimmune reactions may be triggered by infection, tissue injury, or emotional trauma in people with a genetic predisposition to them.

Conventional medicine treats rheumatoid arthritis (and other autoimmune diseases) with steroids and other immunosuppressive medications, most of which are toxic when used long-term. Try to avoid these strong drugs if you can. Patients who are dependent on them are less likely to respond to natural treatments.

Lifestyle changes can moderate autoimmunity, and other strategies can help you control the symptoms of rheumatoid arthritis. Here are my basic recommendations:

Follow a low-protein, high carbohydrate diet; minimize consumption of foods of animal origin.
Eliminate milk and milk products including commercial foods made with milk.
Avoid all polyunsaturated vegetable oils, margarine, vegetable shortening and products made with partially hydrogenated oils of any kind.
Increase intake of omega-3 fatty acids by eating more cold water fish, walnuts or fresh ground flax seeds. You may also want to consider taking a fish oil supplement to help keep your protein intake low.
Get regular aerobic exercise (swimming is best for those with rheumatoid arthritis).
Practice relaxation techniques. In addition, visualization can help moderate autoimmune responses; psychotherapy can help you change emotional states that keep the immune system advertisement

balance.
Try hypnotherapy or guided imagery Look for a therapist willing to take on an autoimmune disease. Meditation and yoga can help, too.
Avoid health care practitioners who make you feel pessimistic about your condition.
Eliminate or reduce intake of coffee and tobacco as both have been liked to an increased risk for rheumatoid arthritis.

Here are specific recommendations for rheumatoid arthritis management:

One at a time, eliminate the following categories of food for two months: (1) all sugar except natural fruits; (2) all citrus fruits; (3) wheat, corn and soy. At the end of each trial period, restore the eliminated items to your diet. You may find that one or more has an influence on your arthritis symptoms.
For symptomatic treatment use aspirin and other over-the-counter anti-inflammatory drugs.
Take feverfew (Tanacetum parthenium) for its anti-inflammatory effect; one to two capsules twice a day
Use anti-inflammatory herbs Ginger and turmeric are particularly effective. I recommend Zyflamend, made by New Chapter Company, which includes both. You can continue to take these herbs indefinitely.
Experiment with traditional Chinese medicine, Ayurvedic medicine, homeopathy, Native American medicine, and healers.
Try long term fasting in a facility staffed by experienced health professionals. For additional information on fasting, check out www.dmoz.org.
Investigate apitherapy (bee-sting treatment); a local bee keeper should be able to advise you.

Naturopathic Treatment

The goal of benign prostatic hyperplasia (BPH) treatment is to reduce excessive cell growth by inhibiting the conversion of testosterone into the more potent hormone dihydrotestosterone (DHT) and by preventing estrogen from attaching to receptors in prostate tissue. From a naturopathic viewpoint, this is accomplished through nutrition and the use of supplements and herbs.

Nutrition

• Eat whole, fresh, unrefined, and unprocessed foods. Include fruits, vegetables, whole grains, soy, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, sardines, halibut, and mackerel). Eating organic food helps reduce exposure to hormones, pesticides, and herbicides.
• Avoid refined sugar and flour, dairy products, refined foods, fried foods, junk foods, hydrogenated oils, alcohol (particularly beer), and caffeine.
• Eliminate food sensitivities. Use an elimination and challenge diet to determine food sensitivities.
• Drink ½ of your body weight in ounces of water daily (e.g., if you weigh 150 lbs, drink 75 oz of water daily).

Supplements

The acupuncture points used will depend on the type of arthritis and where the symptoms are felt. Here are some examples. (Note: Acupuncture should be performed by an experienced and qualified therapist. Do not do this treatment yourself.)

If the arthritis is in the shoulder joints, points called the Large Intestine 15 and Triple Heater 14 might be used. (You can find this point by the little "dimples" that appear on the shoulder when you raise your arms straight out from the side of your body. )

If the arthritis afflicts the elbows, Large Intestine 11 (by the bend in the elbow) may be used. The Large Intestine 4, or "Joining of the Valleys" point on the hand may also be used. (To find this point, push your thumb against your forefinger. As you do, you'll notice a small mound of flesh popping up at the base of your thumb. The highest area on the mound is the point.)

If the arthritis is in the hip, Gall Bladder 30 (in the buttocks) may be used.

If the problem is in the knees, the "Eyes of the Knee" points are used. (If you put your fingers on the bottom of your kneecaps and slide them off, they'll fall into a little indentation right below the kneecap. The acupuncturist will place the needle there and direct it under the knee cap.)

If the arthritis is in the foot, the acupuncture point located on the spot where the toes meet the feet will be used.

For any arthritic problems with the face or head, Large Intestine 4 (the Joining of the Valleys point) is useful.

In cases of arthritis at the ankle, spine and jaw, local points beside the problem areas are used.\

A Study of Arthritis Drugs and Natural Alternatives in the Treatment of Arthritis, Osteoarthritis, Rheumatoid Arthritis, Bones, Joints and Cartilage Disorders

According to the Arthritis Foundation, roughly one-sixth of the total U.S. population, nearly forty million Americans, have arthritis. Approximately 80% of people over the age of 50 will experience arthritis in one of its many forms. Arthritis, however, is not exclusively a problem of the elderly. It can strike at any time and at any age. Under the age of 45, osteoarthritis is much more common in men. At age 55, it makes a dramatic shift, becoming much more common in women.

"Arthritis" has become the catchall term for over one hundred various diseases generally referred to as "rheumatic diseases". The American College of Rheumatologists list ten categories of rheumatic disease, including osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis, Systemic lupus erythematosus (SLE), tendinitis, bursitis, fibromyalgia and a number of bone and cartilage disorders. "Arthritis" is, in fact, a major symptoms of this larger group.

The term arthritis is said to be derived from Greek and means "inflammation of a joint." Symptoms include swelling, stiffness, tenderness, redness, loss of joint function, degradation, deformity and pain that have become the hallmark of the "rheumatic family of diseases." While not all forms of rheumatic diseases are referred to as "inflammatory", each, in its own way, involves inflammation to some extent and affects not only the joints and secondary tissues, but the body as a whole. Movement can be severely impaired and the associated pain can be episodic, unpredictable in duration and can even fade away for an undetermined period of time, only to "flare-up" when least expected.

Over time these continuing "flare-ups" can leave a myriad of problems. The affected joints may become deformed or bent into unnatural positions. Loss of mobility can range from limited to severe, with some joints literally frozen in place. Fleshy nodules can appear under the skin and calcification is common. The whole body can experience fatigue. Eyes may become dry and inflamed, lymph nodes swell, the appetite is reduced, and sores refuse to heal. Compression of nerves and blood vessels can cause pain and vascular insufficiency. Cartilage loses its integrity, causing uneven joints and bone rubbing.

In short, the cumulative effects of arthritis wear on us to the point that we reach for a "quick fix' readily offered by hundreds of commercials and advertisements that claim symptoms and pain can be eliminated by reaching for an ever stronger dose of the most recent arthritis medication.

Standard Treatments (NSAIDS)

The primary drugs used in the treatment of arthritis, particularly rheumatoid and osteoarthritis are nonsteroidal anti-inflammatory (NSAIDS) which include aspirin. In most cases, these drugs have proven to be of only limited value. They often suppress the symptoms, but accelerate factors that promote the disease itself NSAIDS have been shown to greatly in crease the already hyperpermeable gastrointestinal tract of those who suffer from rheumatoid arthritis. Best selling author, Dr. Michael Murray, in his book Arthritis, says, "The use of NSAIDS are a significant cause of serious gastrointestinal tract reactions, including ulcer hemorrhage and perforation, and lead to as many as 20,000 hospitalizations and 2,600 deaths each year"

Aspirin is often effective in relieving both the pain and inflammation of arthritis, how ever, since the therapeutic dose required is relatively high (2 to 4 grams per day), toxicity is quite common. Tinnitis (ringing in the ears) and gastric irritation are early manifestations of toxicity

Other NSAIDS include: Fenoprofen (Nalfon), Ibuprofen (Motrin, Advil, Nuprin), Indomethacin (Indocin, Indometh), Meclofenamate (Meclofen, Meclomen), Naproxen (Naprosyn), Piroxicam (Feldene), Sulindac (Clinoril) and Tolmetin (Tolectin).

Although these drugs have not been proven to be more effective than aspirin, they appear, in some cases, to be better tolerated. Generally, they are recommended for only short periods of time since prolonged use carries the risk of significant side effects.

Most side effects are the result of high doses that must be given in order to suppress the symptoms. The most common side effects of NSAIDS is damage to the intestinal tract and NSAID-induced peptic ulcer.' NSAIDS often cause allergic reactions, easy bleeding and bruising, ringing in the ears, fluid retention, heartburn, indigestion, abdominal cramps, gas, nausea, vomiting, diarrhea, constipation, urinary tract infection, rashes, headaches, depression, dizziness or fatigue, weight gain or loss.

When given in high doses over long peri ods of time, NSAIDS may cause kidney or liver damage.2

One serious side effect of aspirin and other NSAIDS that is often overlooked is the inhibition of cartilage repair and acceleration of cartilage destruction.3 Some clinical studies have shown that NSAIDS are associated with acceleration of osteoarthritis and increased joint destruction. The higher the dose and the longer the use of NSAIDS, the greater the joint destruction.4

There is increasing evidence that aspirin and other NSAIDS appear to suppress the symptoms, but accelerate the progression of osteoarthritis. If possible, the use of these drugs should be avoided or severely reduced.

Discontinuing any drug should be done gradually over a period of time and under the direction of your health care professional

Corticosteroids

A second class of commonly used drugs for arthritis are the corticosteroids. These include cortisone hormones and synthetic corticosteroids like prednisone and methylprednisone. While the synthetics have less extreme side effects, the long term use of synthetic corticosteroids, even at low doses, can cause serious, sometimes life- threatening problems. The lease serious of these side effects include the growth of facial hair, acne, fluid retention, weight gain, easy bruising, sleeplessness, muscle wasting and headaches. More serious side effects are stomach ulcers, inflammation of the pancreas, and the leaching of calcium from the bones (osteoporosis), which makes fracturing easier. These drugs suppress the immune response and, as a result, increase the risk of bacterial infections. They can promote narrowing of the blood vessels by fatty deposits and calcification (atherosclerosis). They can cause cataracts and glaucoma.5 Some studies indicate that they can suppress the normal functioning of the adrenal glands, suppressing the production of their natural hormones.

High doses of corticosteroids can spread previously limited infections to all parts of the body and can actually kill the living parts of bone, ultimately causing bone collapse.6

SAARDS & DMARDS

A third class of drugs are known by two names: Slow Acting Anti-Rheumatic Drugs or SAARDS, and Disease Modifying Anti- Rheumatic drugs or DMARDS. As the first name implies, these drugs take a long time to begin working, but eventually have an effect. They are used primarily in the treatment of inflammatory kinds of arthritis, especially rheumatoid arthritis, ankylosing spondylitis and arthritis associated with systemic lupus erythematosus.

The first group are antimalarials such as chloroquine (Aralen) and hydroxy-chloroquine (Plaquenil). Side effects include in digestion, nausea, vomiting, headaches, nervousness, diarrhea, abdominal cramps, psoriasis, ringing in the ear and blurred vision. Because the risk of eye damage is great, most doctors recommend an eye examination every six months.

D-penicillamine

More than twenty-five percent of people taking D-penicillamine (Cuprimine) quit within the first year due to its unwanted side effects. These include nausea, vomiting, diarrhea, rashes, kidney damage, blood abnormalities, drug-induced lupus and myasthenia gravis (where muscles gradually be come weaker and weaker). Anyone taking this drug is advised to have regular blood and urine tests to determine whether they should continue its use.

Sulfasalazine

50% of the patients who take sulfasalazine (Azulfidine) develop side effects within the first four (4) months of use. Side effects include rashes, nausea, vomiting, abdominal pain, headaches and blood and liver abnormalities. Patients are advised to have regular blood and liver tests.

Gold

The side effects of gold therapy are the reason most people quit taking it. Almost half of those treated with gold compounds experience diarrhea, indigestion, gas, nausea, abdominal pain, loss of appetite, ulcers in the mouth, rashes, itching, conjunctivitis, kidney problems, blood abnormalities and upper respiratory inflammation. Regular monitoring of blood and kidneys is advised.

Methotrexate

Methotrexate (Rheumatrex) seems to be the fastest acting of the SAARDS. Its side effects are nausea, loss of appetite, abdominal pain, rashes, anemia, ulcers, headaches, drowsiness, blurred vision, lung damage, fibrosis or cirrhosis of the liver, urinary tract irritation and kidney damage. Regular blood and liver tests are advised.

Cyclosporin

The majority of people who use cyclosporin (Sandimmune) report decreased kidney function and elevated blood pressure. Other reported side effects are headaches, gum swelling, tremors and convulsions. Regular blood and blood pressure tests are advised.

Azathioprine

Azathioprine (Imuran) is reported to produce slightly more side effects than other SAARDS. Side effects can include nausea, vomiting, diarrhea, bone marrow suppression and hepatitis. Long term use may increase the risk of cancer.

Summary of Arthritic Drugs
The prognosis is not bright for the long term use of most of these drugs. In most cases, their benefit is greatly outweighed by significant toxicity. Their use often produces significant side effects that can only be suppressed with additional drugs. Dr. Michael Murray, in his book Arthritis, states that "It is not uncommon for individuals with rheumatoid arthritis to be on 12 or more prescription drugs at one time."

Anyone who is considering using these or other arthritic drugs should ask their health care professional about their side effects. Your health care professional can also provide assistance in exploring natural alternatives without the side effects.

Standard treatment recommended for those who suffer from arthritis is estimated to be a $10 billion-a-year industry in the United States. "How successful have these traditional treatments been?" A group of English Rheumatologists conducted a study from 1964 to 1986 (22 years) of 112 rheumatoid arthritis patients who had received aggressive treatment at a center for rheumatoid diseases in Great Britain. At the end of the study, "over one-third of the patients were dead and more than half were either dead or severely disabled" At the ten year mark, participating physicians had been optimistic The patient's condition and function seemed to improve initially. After ten years of treatment, however, their condition declined considerably and joint destruction progressed. At the twenty year mark, nineteen percent of the patients were severely disabled. (Apparently none of the remaining patients showed any improvement.) The authors concluded that the concept that drugs induce a remission in patients is fallacious.7

Recent Information Regarding Natural Alternatives

During the past 16 years, many natural alternatives have been employed by those seeking relief from arthritis without long term side effects.

The following information is presented to help you become aware of alternative treatments and to act as a guide when working with your Health Care Professional or Advisor.

Glucosamine sulfate

More than a dozen controlled clinical trials in Europe and the UK have shown glucosamine sulfate to be as good or better than NSAIDS in treating arthritis. The studies report a positive impact on cartilage metabolism without adverse side effects.

Glucosamine is a naturally occurring simple sugar component which is the building block of larger complex sugars called glycosaminoglycans. Glycosaminoglycans form the gel-like ground substance found in connective tissue, mucous secretions and synovial fluid.

Glucosamine sulfate is the preferred form of glucosamine for therapeutic use. It is an effective means of providing glucosamine orally as a building block for the regeneration of cartilage and glycosaninoglycans lost during the progression of osteoarthritis.

Glucosamine sulfate plays an important role both in preserving the integrity of the tissue and in restoring this integrity after tissue injury, inflammation or degeneration.

An open field physician supervised study was carried out in Portugal to assess the effectiveness of oral glucosamine sulfate ad ministered to treat pain associated with arthritis. A total of 1201 patients received 500 mg. of glucosanine sulfate three times a day for 50 days. The results of the study showed that relief from pain, both at rest and during physical activity, improved steadily throughout the treatment period and continued for six to twelve weeks after the supplement was stopped. The clinical im provement was independent of gender, the age of the patient and the location of the arthritis. Oral glucosamine sulfate was well tolerated by 86% ofthe participating patients.8

Glucosamine sulfate

appears to be one of nature's best remedies for osteoarthritis, addressing the root of the problem plus relieving symptoms.

Chondroitin Sulfate

Chondroitin sulfate contains several molecules known as glycosaminoglycans (GAGS) or mucopolysaccharides. Chondroitin is composed of repeating units of glucosamine sulfate with attached sugar molecules. Because chondroitin is a larger molecule, it is often combined with an enzyme such as bromelain to help free its glucosamine and make it more absorbable.

Recent studies have shown that glucosamine sulfate and chondroitin sulfate, two naturally occurring substances normally present in the cartilage of the joints, out perform standard arthritis drugs in reducing long- term pain, joint tenderness and swelling.9

Chondroitin has also been shown to block or neutralize the enzyme that destroys cartilage. Using chondroitin in combination with glucosamine sulfate may provide synergistic benefits for halting the progression of osteoarthritis 10

Magnesium & Vitamin B6

Magnesium activates enzymes that help form new calcium crystals which, in turn, are necessary for vitamin D to convert to an active form. It also is a vital catalyst in enzyme activity, especially the activity of those enzymes involved in energy production. A deficiency of magnesium can interfere with the transmission of nerve and muscle impulses, causing irritability and nervousness.11

In addition, magnesium is necessary to pre vent the calcification of soft tissue.12 Recent research indicates that magnesium may help prevent osteoporosis and certain cardiovascular diseases.13 When magnesium is com bined with vitamin B6 (pyridoxine), it helps reduce and dissolve calcium phosphate and calcium oxalate kidney stones.14

Vitamin B6 effects both physical and mental health. Antidepressants, estrogen therapy, and oral contraceptives increase the need for vitamin B6. Cortisone drugs, often used by many arthritis suffers, block the adsorption of this vitamin by the body.15

Vitamin D

Vitamin D acts to increase the absorption, utilization and transport of calcium, and distributes calcium to the bones and teeth. It is necessary for growth, especially for the normal growth and development of bones.

It is also an important factor in the preven tion and treatment of osteoporosis and hypocalcemia, and enhances immunity, thyroid function and normal blood clotting.

Intestinal disorders and liver and gall blad der malfunctions interfere with the absorption of vitamin D. Some cholesterol lowering drugs, antacids, mineral oil and steroid hormones (cortisone) also interfere with the absorption of vitamin D. Supplementation is therefore advised.

Pantothenic Acid

Probably the least known of the B vitamins is pantothenic acid. It is used by the body's adrenal glands to manufacture steroid hormones. One such hormone, cortisone, is essential in times of physical stress.

Several researchers have pointed out that, because pantothenic acid is essential to the formulation of two important components of connective tissue, a deficiency of the vitamin would lead to a shortage of those substances.

Why is it possible to have a shortage of this important vitamin that is found in small amounts in most foods? The answer is simple. In the processing of most of our food, a major part of the pantothenic acid content is stripped away. In processing all purpose white flour, about half of the pantothenic acid content is lost. White rice has also lost half its pantothenic acid through milling. Losses of pantothenic acid in canning green vegetables average about 56%; in canning root vegetables, 46%; in canning peas and beans, 78%; in canning fruit juices, 50%. Losses to freezing are around 50% in all vegetables, though only about 7% is lost in fruits and juices (which are already naturally low in pantothenic acid). Losses in cooking any of these foods, run as high as 44% 16

How much do we really get in our diet? Most experts think we are getting about 50% of what we need and that additional supplementation is a good idea.

A 1966 study of people with rheumatoid arthritis showed abnormally high levels of pantothenic acid excreted in their urine. Later, studies by British researcher Dr. Annand confirmed that 20 of 26 patients with osteoarthritis showed significant im provement after 14 days of supplementation of pantothenic acid.17

Bromelain

Bromelain refers to a mixture of enzymes found in pineapple. Since its introduction as a medicinal agent in 1957, over two hundred scientific papers about its therapeutic applications have appeared in medical literature.

Various studies report that bromelain exerts a wide variety of beneficial effects, including the reduction of inflammation in cases of rheumatoid arthritis.18

Bromelain is a protease-containg enzyme, which may account for its anti-inflammatory effects which include the inhibition of pro inflammatory compounds. Bromelain has been shown to prevent swelling by activating compounds that break down fibrim.19 By decreasing fibrin, bromelain helps promote circulation and post-traumatic re-absorption of inflammatorily by-products.

This allows a speedier recovery time after injury.20

Bromelain also blocks the production of kinins.21 Kinins are compounds produced during inflammation that increase swelling and cause pain.

Bromelain is often combined in formulas with other anti-inflammatory ingredients such as curcumin to help enhance its absorption.

Conditions in which the clinical efficacy of bromelain has been documented, in addition to arthritis, include angina, bronchitis, athletic injury, bruises, maldigestion, menstrual cramps, pancreatic insufficiency, pneumonia, scleroderma, sinusitis, surgical trauma and thrombophlebitis.22

Yucca (Yucca glauca)

Native American Indians used the root of the yucca as a poultice on breaks and sprains and for rheumatism. Yucca contains a high content of steroid saponins which are precursors to cortisone and provide relief for symptoms of arthritis and rheumatism. Some researchers feel that yucca saponins improve the body's ability to produce its own cortisone by supplying materials needed for the hormone to be manufactured by the adrenal glands. Yucca is naturally rich in vi tamin A, B complex vitamins and contains some vitamin C. It is high in calcium, potassium, phosphorus, iron, manganese and copper. 23

Alfalfa (Medicago sativa) Fennel (Foeniculum valgare) Celery (Apium graveolens).

In many cases of osteoarthritis, plant based remedies can help address the underlying factors responsible for the degeneration.

Some plants that show great promise are those rich in substances known as phytoestrogens. These plant compounds have been shown to be capable of binding to estrogen receptors and cartilage cells, thereby preventing the bindings of the body's own estrogen to the receptor.24 Since there is a higher incidence of osteoarthritis in women, it suggests that estrogens may play a role in this disease. Further experimental studies have demonstrated that estrogen promotes osteoarthritis.25 Plants such as alfalfa, celery and fennel are all natural sources of phytoestrogens, and their regular consumption in the diet is encouraged. Other food sources of phytoestrogens include parsley, soy, nuts, whole grains and apples.

In traditional Chinese medicine, fennel is classed as an antispasmodic which helps regulate the chi (vital energy of the body) and remove congestion. In many Indian restaurants, one often finds a bowl of fennel seeds at the cash register. Diners are supposed to chew a few of these seeds to remove the effects of dietary sins, such as overeating, wrong food combining and eating excessive amounts of rich spicy foods. Because of its ability to influence the nerves, it works well as a painkiller26

Alfalfa's antirheumatic effect is probably due to its extremely high nutritive value which includes vitamins A, B, B6, B12, C, D, E, niacin, pantothenic acid, biotin, folic acid, minerals, proteins, saponins, amino acids, and trace elements. Alfalfa has proven to have a cholesterol lowering effect and it generally helps to improve over all health, vigor and vitality. Due to its saponin content, many believe it has some natural steroid properties. Although the treatment of arthritis is difficult at best, many herbalists feel that the use of alfalfa over the long term could significantly help many people deal with the ailment.

Hydrangea (Hydrangea arborecens)

Hydrangea is a remarkable herb. Its curative properties are second to no other plant.

It contains alkaloids that act like cortisone and is noted for its cleansing power. It helps prevent deposits in joints and is rich in minerals to help build joints. It is often recommended by herbalists for arthritis, gout and rheumatism.27

IJva Ursi (Arctostaphylus uva-ursi)

Uva ursi leaf is recognized by medical authorities as a diuretic, astringent and antiseptic. It also contains anesthetic principles capable of numbing pain. Today it is often recommended by herbalists as a tonic.

Cornsilk (Stigmata maidis)

Comsilk has long been used by physicians as a diuretic and for bladder complaints because it has a cleansing effect on urea as it circulates. It has been shown to be a valuable natural remedy in the treatment of renal and cystic inflammations.28 In China, the herb is also used to treat diabetes and hypertenion.29 In cases where edema is in dicated, most herbalists around the world agree that cornsilk directly reduces painful symptoms and swelling due to inflammatory conditions.30 Some herbalists feel that it may be useful in helping to decrease swelling associated with enlarged prostate.31

Ginger

Ginger is derived from the plant Zingiber officinale. Folk medicine has long touted ginger as an effective aid for proper digestion, and for relief of indigestion and nausea. Now scientists are discovering other potential uses including relief from the pain and inflammation of rheumatoid arthritis. Dr. Krishna C. Srivastva, of the Institute of Odense in Denmark, states that arthritis patients reported "significant relief" from pain after taking less than a tablespoon of ginger every day for three months.32

The Medical Tribune (30,18:16) reported one study of arthritis patients who took daily servings of ginger powder. All patients re ported that "they were able to move around better and had kss swelling and morning stiffness after eating the spice".33

Oriental Medicine attributes the stiffness, slowness and pain that results from rheumatic conditions to the entrance of cold and dampness in the body, an observation that is not lost to those who suffer from rheumatic symptoms that are intensified by inclement weather. The whole process of the joints losing their lubrication, function and warmth is seen as a "cooling of the body", referred to as atrophy in the West. Ginger is regarded as one of the classic remedies for these conditions and is used internally and externally.

Since ginger has been shown to protect the stomach against damage, it is an excellent ingredient in arthritic formulas to counter stomach problems resulting from the over use of aspirin and other NSAJDS.

Boswellin

The anti-inflammatory phytonutrient. Boswellia serrata (Indian Frankincense) is a large, branching deciduous tree that grows in the dry, hilly parts of India. The gum resin of Boswellin serrata, known in the vernacular, is "salai guggul", has been used in the Ayurvedic system of medicine for the treatment of rheumatism, respiratory and liver disorders. Boswellin 12R is a selectively fractionated principle obtained from the gummy exudate of the tree. In Ayurvedic medicine, the gum is described as being sweet, bitter, hot, antipyretic, antidysenteric and is attributed to lowering blood glucose levels.34 It has also been used to improve appetite and alleviate general weakness and debility.35 Each tree yields about one kilogram of resin per year.

The major use of this resin in contemporary medicine is as an antiarthritic and anti-inflammatory pharmacological agent.36 The anti-inflammatory and antiarthritic properties of the resin are attributed to the presence of B-boswellic acid and other related pentacyclic triterpene acids.37

There is positive evidence that boswellic acids reduce the synovial fluid leucocyte count and lower the elevated serum transaminase levels, as well as erythrocyte sedimentation rates.38 Inflammatory conditions such as rheumatoid arthritis are characterized by a marked increase in the above men- tioned parameters. Boswellic acids function as potent anti-inflammatory agents in rheumatic conditions, and are especially effective in shrinking inflamed tissues.39 This action is thought to be mediated through a vascular phenomenon. Boswellic acids improve blood supply to the joints and re store the integrity of blood vessels obliterated by spasm. They may, in turn, also open up collateral blood circulation to provide ad equate blood supply to the joints.40

One of the most remarkable qualities of boswellic acids is their absence of side effects which are all too often experienced by those who use the regularly prescribed NSAIDS (Non-Steroidal Anti-Inflammatory Drugs.)

Tumeric

(Standardized Extract - 95% Curcuma longa) Curcuma longa, also known as turmeric (pronounced too-muh-rik), is a member of the ginger family and has been highly esteemed by Indo European people for its golden yellow color and as a culinary spice.

Tumeric, best known as Haridra in San skrit, has been used in the Ayurvedic system of medicine for tens of centuries as an external tonic for the stomach, a blood purifler, for flatulence (gas) and dyspepsia (indigestion) and urinary tract diseases.41

The significance of tumeric in medicine changed considerably when it was discovered to have antioxidant properties due to its naturally occurring phenolic compounds. These phenolic compounds are collectively termed curcuminoids, since their principal ingredient is known as curcumin.

Continuing laboratory and clinical research has indicated that these curcuminoids and tumeric have antiinflammatory activity, which is comparable in strength to
steroidal drugs and nonsteroidal drugs such as indomethacin and phenylbutazone.42 In addition, curcuminoids inhibit enzymes (derived from arachidonic acid) which participate in the synthesis of inflammatory substances in the body.43 Curcuminoids have been shown to prevent the synthesis of several inflammatory prostaglandins and leukotrienes."

When the antiinflammatory properties of curcumin were tested in a double-blind clinical trial in patients with rheumatoid arthritis, curcumin produced significant improvement in all patients. The therapeutic effects were comparable to those obtained with phenylbutazone, a prescription drug known for its analgesic and anti-inflaxnmatory properties.45

White Willow Bark

Though weaker in its activity, white willow bark was the original source of salicin, the forerunner of aspirin. It is mentioned in ancient Egyptian, Assyrian and Greek manuscripts and was used to combat pain and fevers by physicians such as Galen, Hippocrates and Dioscorides.

Interestingly, salicin is converted through oxidation to salicylic acid within the body.46

Nutritional and Preventative Therapy

Nutritional therapy, as opposed to drugs, is the cornerstone of alternative treatment and prevention. The body's biochemistry is complicated (and endlessly fascinating). This is justification for seeking professional advise from a professional trained in the nutritional sciences and familiar with natural nutritional alternatives.

For best results (in the absence of a complete nutritional analysis), the following program of nutritional supplements is recommended for those seeking to mitigate the symptoms of arthritis or those practicing prevention.

Daily Recommendations:

1. A nutritional supplement contaming as many of the Natural Ingredients discussed in this paper as possible. Combined ingredients offer synergistic effects. (Amplified, larger than the sum of their parts.)

Recommended level: Take a supplement that delivers from 1000 to 1500 mg. of Glucosamine sulfate, combined with as many of the ingredients listed above as possible.

2. A High Grade Calcium Complex Supplement. When calcium is in short supply in the blood, the bodywithdraws it from the bones (where it belongs). Calcium Hydroxyapatite is recommended for its absorbability.

Recommended Level: 1000 to 1500 mg. per day.

3. Vitamin C Supplement. Dr.Richard A. Kunin, M.D. and Specialist in Orthomolecular Medicine
says, "It is well known that arthritis can be greatly relieved by giving adequate amounts of vitamin C. One of the most dramatic examples of vitamin C's therapeutic value in treating arthritis was Norman Cousins. Recovering from an arthritic condition called ankylosing spondylitis, Cousins persuaded his doctor to give him large, intravenous infusions of vitamin C (up to 35 grams per day). This, along with generous doses of laughter, cheerful surroundings and a good diet are all reported to have contributed to his recovery.

Recommended Level: Start with 1,000 milligrams of vitamin C (Ester C) per day. Gradually increase in 1000 milligram increments every few days until you find your therapeutic level. For most people, 2000 to 4000 milligrams of a high quality Ester C will be sufficient.

4. An Omega III Fatty Acid Supplement. These fatty acids, derived mainly from cold water fish such as salmon and mackerel, inhibit the inflammatory response. In addition, Omega III's help replace cholesterol levels in the body.
A good supplement should contain both EPA (eicosapentaenoic Acid) and DHA (decosahexaenoic acid). The mild anti-inflanimatory effects are possibly a result of increased PGE and PGE3 prostaglandins. In rheumatoid arthritis, EPA/DHA supplements have been shown to reduce joint stiffness and soreness and to improve flexibility.

Recommended Level: Take 3 softgel capsules per day for one week. Gradually increase to 6 per day.

Additional Recommendations

A Full Spectrum Multi Vitamin/Mineral Supplement
Natural Aloe Vera Juice ( 2 to 3 oz. per day)
A Green Food Supplement like Green Magic containing Spirulina
A Standardized Grape Seed Extract with Bioflavonoids
Natural Vitamin E Supplement (minimum of 400 lU)