Natural vs Orthodox Anti-inflammatories

If you’ve read the previous blog on inflammation, you’ll understand a bit more about why and how inflammation happens and the associated symptoms that come with it, whether for good or bad!

This blog aims to explore some of the more ‘peddled’ natural and orthodox anti-inflammatories, and look at whether they work for diabetes or other inflammatory linked disorders and diseases or for local musculo-skeletal inflammation such as low back and shoulder minor injuries.

*This is by no means an exhaustive guide, just an introduction to get you thinking and questioning the hearsay out there.

The ‘Natural’ remedies

Curcumin (active ingredient of Turmeric, family of ginger)

The active anti-inflammatory ingredient within turmeric is called Curcumin, and there have been many trials to work out whether it truly is an anti-inflammatory we could use to benefit us.
Results of curcumin trials and reviews show that while there does seem to be a promising and potential anti-inflammatory effect on the body, which could help prevention against inflammatory diseases such as cancer, diabetes and cardiovascular disease, these are largely inconclusive and result in some inefficient testing.
Further to this, our gut lining is unable to absorb curcumin well, but taking it with Piperine can help with the absorbency. Though with such a small amount entering our system, it’s unclear whether it can be of benefit. That said, do also note that some test tube studies found that very high doses of Curcumin can cause DNA damage and supress the immune system.

Some studies have reported that there is no medicinal property in taking either turmeric or curcumin as a supplement or in the diet for an anti-inflammatory aid. There can also be interactions with other medications if you take high doses of turmeric, so do check first before taking any supplements alongside your medications. While this sounds all very negative, trials are ongoing as there is still promise shown from this well-renowned spice extract as a potential anti-inflammatory product, so watch this space. So I’ll still be adding turmeric to my cooking as usual!

There are also a whole host of other ailments that curcumin have a possible beneficial impact on, for further details check out this great website; https://examine.com/supplements/curcumin/

While I’ve not gone into ginger in this write-up, curcumin is from the ginger family and also one of the ‘supplements’ thought to be anti-inflammatory.

Pineapple (Bromelain)

Pineapples are commonly eaten as a delicious fruit but also as a digestive aid. Pineapple is actually an irritant, you’ll know this if you’ve eaten a lot of it in one sitting; it actually takes off a layer of the skin in the mouth which can be sore temporarily! Bromelain is the active ingredient in pineapple that is thought to be anti-inflammatory and this is more concentrated in the stalk of the pineapple, which you wouldn’t ordinarily eat! There are some claims that Bromelain could be beneficial for cancer prevention, osteoarthritis and cardiovascular diseases.

There is some limited evidence for bromelain as an anti-inflammatory, but this is not conclusive and studies continue. But that said, there have been no real side effects shown in high doses (unless you’re eating large amounts of pineapple and get a very sore mouth!), BUT it can interact with anti-biotics (check with GP if you take Bromelain), it can act as a blood thinner which can actually enhance some anti-biotics or cause other effects.

With lots of claims of anti-inflammatory foods, eating the whole pure fruit will allow your body to digest the nutritious ingredients and have a range of health benefits for you, so no reason not to start adding a bit more fruit into your diet daily or continuing to, ranging them and varying to get lots of different wide-reaching benefits, as well as the possible anti-inflammatory side-effects that improve with a healthier lifestyle.

Omega 3 fatty acids

Including fatty acids to your diet in the form of omega 3, has shown anti-inflammatory properties in some studies. These can take the form of oily fish, cod liver oil capsules, roasted soya beans, walnuts, flaxseeds amongst other sources.

While some research is fairly confident in the benefits of taking omega 3 fatty acids against inflammation, there is still no distinct overriding evidence to say that by taking high potency fish oils in capsule form, that this directly reduces inflammation to prevent inflammatory diseases. You’re probably better placed to include omega 3 fatty acid into your diet for their general health benefits and any possible inflammation reduction could be a welcome side effect of this healthy diet.

Eating Sugar

There is thought to be a link between high and consistent levels of sugar consumption in the diet, particularly ‘added sugars’, leading to low grade inflammation that we see in disorders such as diabetes, cancer and cardiovascular disease.

With regard to more local inflammation from sprains and injuries, the effect of excessive sugar in the diet is inconclusive, but with lots of research on global systemic health and sugar consumption it is worth considering your own sugar consumption daily and seeing whether you can change certain things for the long term. This article below from Arthritis.org lists food that are associated with rise in inflammation (sugar, refined carbs, omega 6 fatty acids in excess, saturated and transfats, alcohol, MSG, gluten (found in wheat barley and rye) and casein (found in dairy products), aspartame (artificial sweetner) ;

https://www.arthritis.org/living-with-arthritis/arthritis-diet/foods-to-avoid-limit/food-ingredients-and-inflammation.php

Reducing levels of chronic stress

Stress has been linked with all sorts of health issues and a rise or sustained level of inflammation. Chronic levels of inflammation as associated with poor health and have shown links with cancer, diabetes and cardiovascular diseases.

Everyone has their own coping strategies for dealing with unhelpful stress and anxiety and we all unwind in various ways to suit our mood and preferences, and so finding something that works to de-stress you, is as important as deciding to try to reduce your stress levels in the first place. Here are some examples to get you feeling more grounded, present and happier; talking to friends, regular socialising, get outside, singing, playing an instrument, enjoyable exercise whether it’s a walk, jog or dance around the living room, going to the spa, having a bath, get creative, travel, self-massage and gentle stretching, tai chi (also see the above benefits from tai chi as an anti-inflammatory!).

Some people may benefit from getting extra help if you are struggling to cope day to day with the stresses of life. A Cognitive Behavioural Therapy course can be life changing, speak with your GP about this. Sometimes our body is telling us to just stop for a minute and re-evaluate.

The old school RICE routine (rest, ice, compression, elevation)

Rest- no longer thought to help in reduction of inflammation, movement is the way forward. Clearly this depends on the severity of injury and where it is etc. As soon as you can safely move the joint, get the circulation going and get onto weight bearing exercise, the better. Better still, movement and manipulation by an osteopath or other qualified manual therapist, complement the first stages of recovery very well, this helps you to get the fullest safe range of movement in the injured area without aggravating the joint/injury sight, with the added benefits of improved circulation and flexibility.

Ice –icing an injury such as ankle sprain is based largely on anecdotal experience, it gives a temporary analgesic state which can help relieve pain temporarily, though should not be used just before movement and exercise as it will disguise pain signals to warn of further damage. Icing is still largely used, it’s not proven as beneficial above another method of anti-inflammatory.

Exercise & movement- As above, mobilisation, movement, local osteopathic treatment can help improve recovery speed, getting you back to work, reduce pain and swelling. Some of the processes thought involved in reducing inflammation and pain with ‘safe’ exercise, are increased cortisol and adrenalin. Really interestingly, one study lists a 12 week Tai Chi programme as increasing T-cell circulation, which are a major source of the anti-inflammatory cytokine IL-10.

The only potential negative notes on mobilisation and exercise as an anti-inflammatory, are firstly; the risk of worsening the injury, and so great care and seeking the right information to suit your injury and recovery is very important. Secondly, more with elite athletes, exercise may be immunosuppressive, and as consequence leading increased susceptibility to common infections.

Elevation and compression- there is insufficient evidence from trials and inconclusive research to suggest that these methods are better than other methods for sprained ankle.

Orthodox Medication

NSAIDS

NSAIDs stand for non-steroidal anti-inflammatory medication, these medications include ibuprofen and Naproxen which are widely used to reduce inflammation. These work by blocking COX (cyclo-oxygenase) enzymes, which help make prostaglandins.

Prostaglandins are made at sites of injury or damage, causing pain and inflammation. By blocking COX enzymes, fewer prostaglandins are produced therefore reducing further inflammation and pain.

COX inhibitors like ibuprofen and Naproxen can work well for acute inflammation or arthritic flare ups, be sure to check any medical interactions and whether you’re suitable to take these. They do not always work, it depends whether it is prostaglandins that are the mechanism for your pain and inflammation.

These medications are not designed to be taken long term.
While anti-inflammatory medications can help prevent further pain and inflammation, they do not cure the underlying irritant, they just mask it temporarily. Remember that inflammation is supposed to occur in line with healing, it’s the overreaction when swelling becomes too painful and swollen beyond what’s needed from the protection and healing processes.

Steroid medication

We refer to ‘steroid medications’ a lot, but they come under different names in medicine; steroids are naturally occurring hormones in our body, it is ‘corticosteroids’ which are the man-made steroid that replicates the action of cortisol, which are anti-inflammatory in the body, Prednisolone for example is a corticosteroid.

Cortisol reduces the immune response which helps reduce the production of inflammation; corticosteroids work by stopping or slowing the immune system from triggering inflammation. Turning down your immune system means that you may suffer more frequently from infections. Taking high doses of corticosteroids for 3 months or more, can lead to reduction in bone density amongst other undesirable side effects.

Cortisone can be injected at the site of inflammation, common sites include the shoulder, back and elbow. It supresses inflammation for a temporary period of time, it can last days to months. Too many cortisone injections can cause tissue damage and so they have to be spaced out over time, or may not be suitable for you depending on your health and the context.

While some patients get great temporarily relief from Cortisone injections, they do not always relieve your pain, as again, it depends on the mechanism of pain and whether it is directly related to the inflammation.

Reference links for further reading:
Curcumin;
https://examine.com/supplements/curcumin/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/

Forget what you’ve heard: Turmeric seems to have zero medicinal properties


Bromelain;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529416/
https://abreathofreason.com/tag/bromelain/
Fatty acids;
https://www.ncbi.nlm.nih.gov/pubmed/12480795
https://www.health.harvard.edu/staying-healthy/do-fish-oil-supplements-reduce-inflammation
RICE;
http://thischangedmypractice.com/move-an-injury-not-rice/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/
Exercise and movement
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/
http://www.hivdent.org/_Medical_/2011/nri_3041_sep11_v2_FINAL_CORRECTED_PROOF1.pdf
Sugar
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868080/
https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation