Dangers of Arthritis Medication : The NSAID

Many millions of Americans with bone and joint problems are “gobbling” aspirin and non-steroidal anti-inflammatory drugs (NSAID). This is occurring in a manner that presents a major public health concern. This concern is a direct consequence of the common side effects of these drugs. Common side effects of NSAID include stomach upset that can herald the onset of peptic ulcer and the precipitation of life threatening bleeding from the upper or lower digestive tract. In addition, liver and kidney prob lems are relatively common with NSAID use. Certain types of NSAID are associated with a risk of stroke or heart attack. Unfortunately, the side effects of NSAID are sometimes fatal, especially in the elderly, who represent the main target population who take these drugs, and to whom these drugs are often selectively marketed.

For these reasons, many people have sought alternative management strategies for bone and joint health, including the use of dietary supplements. While dietary supplements for bone and joint health are not drugs or considered substitutes for drugs (at law), many doctors and their patients are using dietary supplements to manage simple arthritis, especially osteoarthritis. This approach can occur only with statements that stress the use of “nutritional support for bone and joint structure and/or function.”

Supplements for Joint Health

Synergistic “joint” products use many natural agents in varying amounts to produce “additive benefits” for the nutritional support of joint function and mobility (synergistic formulation). Certain natural substances, such as glucosamine, have demonstrated nutritional benefits for joint structure and function, including the promotion of flexibility and the improvement of joint mobility during activity. Synergistic formulations have no rivals in terms of uniqueness and completeness of formulation, with overall nutritional versatility of various ingredients (Table 1).
• Glucosamine sulphate 2KCL
• Extract of Phellodendron Amurense
• Resveratrol
• Boron (Chelate/Fructoboron®)
In a proprietary natural composition of
• Barberry bark, Golden thread root, Fever few whole, Ginger root, Green tea extract 50%, Tulsi leaves, Hops flower, Oregano leaves, Rosemary leaves, Chinese Skullcap, whole Turmeric root, Nettle leaves, Boswellia serrata resin 60% extract, Devil’s claw root, White willow bark, Sea cucumber, whole hydrolyzed type II collagen, Methysulfonylmethane, Cetyl Myristoleate, Chondroitin Sulfate and green lipped mussel (Perna canaliculus).

Table 2. The ingredients of a synergistic joint supplement, used for nutritional support for joint function. This product is a classic example of synergistic formulation and is used as a teaching example. This approach starts to uncover complex
cascades of events that cause joint problems (Holt MD Labs). This formula contains herbs that may inhibit cyclo-oxygenase type 2 enzymes (COX-2 inhibitors).

Synergy in Joint Care

The joint formulation (Table 2.) has six potential, but different modes of potential action as a dietary supplement. This approach provides nutritional support for bone and joint health (Table 3). The formula contains full-dose, high-quality, low-sodium glucosamine. Glucosamine is a mainstay of joint nutrition that has been shown to have a clear benefit for the repair of cartilage in joints. Not only does glucosamine help repair cartilage in damaged joints, it promotes cartilage renewal and regeneration; and it may provide added advantages of improving lubrication within joints, by exerting beneficial effects on joint fluid. The formula also contains chondroitin which is another joint specific supplement that has variable, but demonstrable benefits in terms of improvement in joint mobility.

• Cartilage repair, renewal, regeneration and lubrication with glucosamine, cartilage
and chondroitin.
• Inhibition of leukotrienes with Boswellia – a body function.
• Antioxidant actions.
• Herbal system for potential inhibition of Cox-2 enzymes – a body function.
• Independent benefits of boron
• Immune support with collagen.

Table 3: The six potential beneficial actions of natural ingredients for joint health. These ingredients are present in formulae created by Holt MD Technologies and they are used as a teaching example. The above formulation strategy takes a lead over other beneficial joint supplements by employing the use of botanicals that have been used in traditional medical systems, as practiced in India and Asia. It utilizes the herb Boswellia serrata, which has been shown in laboratory experiments to antagonize or inhibit the production of substances (leukotrienes) that may promote inflammation in joints. This normal body function of the production of inflammatory substances (leukotrienes) is a key manner in which extracts of Boswellia provide nutritional support for joint structure and function. The proposed formula also contains the advantage of several antioxidants which can help minimize the oxidative stress that is put upon joints, as a consequence of “wear and tear” and other negative factors that cause oxidative tissue damage.

COX-2 Inhibition with Herbs: A Potential Action of Supplements

The most unique components of the proposed joint formula include a proprietary formula of herbal substances which are described variably in laboratory experiments to potentially inhibit COX-2 enzymes. COX-2 enzymes are produced as part of normal body function in the presence of inflammation; and they contribute to pain and disability that is experienced with inflammation, joint disorders, injuries, and arthritis.

There are a number of herbs which may inhibit COX-2 enzymes in the body. It is notable that the inhibition of COX-2 enzymes is the basic mode of action of popular and commonly used anti-arthritic medications that belong to the class of non-steroidal anti-inflammatory drugs (NSAID)(e.g., Vioxx® and Celebrex®). It is not possible to compare directly the herbal systems that may inhibit COX-2 enzymes with the drugs that inhibit these enzyme systems.

One important inhibitor of COX-2 enzyme systems that is found in the synergistic joint formula is the herb Phéllodendron amurense. Herbs or botanicals that have variable documentation of their ability to inhibit COX-2
enzyme systems include: Barberry bark, Goldenthread root, Feverfew Herb, Ginger Root, Green Tea extract, Polyphenols, Tulsi leaves, Hops flower, Oregano leaves, Rosemary leaves, Chinese Skullcap Herb, Turmeric root, Nettle leaves and Devil’s claw root. A proprietary, synergistic formulation of these herbs is used in dietary supplements (Holt MD Technologies).

More Potential Actions of Synergistic, Joint Formulae

The micronutrient “boron” that is present in the proposed formula has independent beneficial effects on joint health. Collagen contents in a joint supplement may provide indirect immune support for joint function. White willow bark is a tried and trusted herb used for nutritional support of joint function. Added to the completeness of the potential formula are sea cucumber, MSM, celadrine and New Zealand green lipped mussel (Perna canaliculus).

Nutritional Support for Joints Enters Mainstream Medicine

The benefits of dietary supplements for the promotion of bone and joint health have become a mainstay in medical practice of both alternative and conventional physicians. Many millions of people have used different nutritional ingredients, most often as glucosamine, for the nutritional support of their joint problems. Nutritional support for joint health may take several weeks to be maximally effective (up to 12 weeks). This means that individuals must be encouraged to continue taking dietary supplements for joint health for several weeks, before they conclude that they are not effective.

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