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In the natural products industry, glucosamine and chondroitin are probably the most popular dietary supplement for the treatment of osteoarthritis. The emphasis here should be on osteoarthritis (OA), since there is no data indicating that these dietary supplements will be of benefit in the treatment of rheumatoid arthritis (RA). There are, however, dietary supplements which can be effective in the treatment of rheumatoid arthritis. Before discussing these supplements, let’s first take a closer look at RA. Arthritis is characterized by an inflammation and/or pain in a joint or joints of the body. Symptoms of chronic arthritis are pain, swelling, stiffness, and deformity of one or more joints.

Rheumatoid arthritis

The American College of Rheumatology reports that rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, swelling, and loss of function in the joints and inflammation in other body organs. Unlike OA, RA is an autoimmune disease where the body’s immune system attacks its own joint tissue. While the cause of RA remains unknown, recent studies show that certain people inherit a tendency to develop RA. RA affects about two million Americans.

In the case of RA, supplementation with certain natural ingredients may help the situation—often significantly. Following is a discussion of these natural ingredients.

Undenatured Collagen Type II
UC-II™ is a proprietary brand of undenatured type II collagen derived from chicken sternum cartilage and is particularly valuable for RA sufferers. Here’s why: Type II collagen administered orally works with the immune system to promote healthy joints by a process called oral tolerization. This process helps the body to differentiate between foreign invaders, such as bacteria, and elements that are good for the body, such as nutrients. The process of oral tolerization takes place in the small intestine where food is absorbed. Through a complex series of immunological events, patches of lymphoid tissue surrounding the small intestine screen incoming compounds and serve as a “switch” to turn the body’s immune response to foreign substances on or off, depending upon what that substance is. In the case of UCII, small amounts (typically 10 milligrams or less1 ) taken orally at bedtime have been shown to turn off the immune response targeted at the type II collagen present in bone joint cartilage.2,3

UC-II is supported by six human clinical studies, including research at Harvard University Medical School. Here is a review of three of those studies.

  • In a 90-day, double-blind, placebo-controlled, follow-up study on patients with severe rheumatoid arthritis, Harvard scientists found that 28 patients taking undenatured type II collagen showed significant improvement compared to the placebo group, while four patients recovered completely.4
  • In another double-blind, placebo-controlled trial, Harvard Medical School researchers showed that following treatment with undenatured type II collagen, 21 of 54 rheumatoid arthritis patients (39 percent) demonstrated significant improvement, while only 11 of 57 patients (19 percent) taking a placebo showed improvement.5
  • A human clinical study at Harvard Medical School showed that after three months of treatment with undenatured type II collagen, eight out of 10 patients with juvenile rheumatoid arthritis had a reduction in both swollen and tender joints. The average changes a 61 percent and 54 percent respective reduction in swollen and tender joint counts for the eight responders at the end of the study. Six patients had greater than a 33 percent reduction in both swelling and tender joint counts.6

Since UC-II is taken at bedtime, we also recommend the use of two herbs to be taken concurrently. These herbs not only help promote healthy sleep, but may also help reduce RA-associated pain.

Valerian root (Valeriana officinalis)
Valerian root extracts have been used for over 1,000 years for extract to relieve muscle spasms, as a mild sedative, treatment for insomnia, hysteria, nervous tension, fatigue, and menstrual cramps. Research data indicates a rational scientific basis for mild sedative qualities, and spasmolytic activity. Additional studies show mild painrelieving qualities.7 It is also used orally for muscle and joint pain8, as well as to treat neuralgia.9

California poppy (Eschscholtzia californica)
California poppy has been used historically to treat insomnia, the need for sedation, aches and pains, nervous conditions, childhood enuresis, and bladder disorders.10 Its sedating effects are in themselves potentially valuable for pain relief, since tension can exacerbate pain. This sedating effect was demonstrated in a double-blind, placebo-controlled study where a preparation containing fixed quantities of Hawthorn, California Poppy and magnesium proved safe and more effective than placebo in treating mild-to-moderate anxiety disorders.11 In one study, extracts of corydalis and California poppy inhibited a particular degradation process (dimerization) of certain pain-modulating peptides in the brain. This effect is thought to prolong the activity of these pain-relieving molecules.12

Omega 3 Fatty Acids
In a previous issue of HSR, we wrote an article about omega 3 fatty acids (O3FA). In that article we included a discussion of O3FA's value in the treatment of RA. Here is a brief review of that information.

Well-controlled clinical studies have clearly demonstrated that consumption of O3FA has resulted in an improvement in rheumatoid arthritis (RA) sufferers.13 As a matter of fact, a comprehensive review of medical literature by a board certified rheumatologist revealed that treatment with O3FA is associated with improvement in outcome measures in RA, and is able to help decrease the long-term requirements for nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen) in some circumstances. Furthermore, an expert workshop reviewing a comprehensive review of medical literature by a board certified rheumatologist revealed that treatment with O3FA is associated with improvement in outcome measures in RA, and is able to help decrease the long-term requirements for nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen) in some circumstances.14 Furthermore, an expert workshop reviewing the health effects of O3FA also concluded that these natural substances where able to help alleviate the symptoms of RA.15 It should be noted that these O3FA-related benefits were not limited to adult RA sufferers. A study conducted in the Czech Republic found that children with chronic juvenile arthritis were able to decrease their ibuprofen consumption by 17.3 percent over a period of five months when treated with a high-O3FA diet.16 Assuming that the O3FA product provides something in the 375 mg EPA and 250 mg DHA range, with 625 mg of total omega 3 fatty acids, an effective dose would be 1-2 capsules daily.

Conclusion
UC-II. may help reduce pain and promote healthy joints in those suffering from RA. Likewise, O3FA may help lessen RA symptoms. Finally, Valerian and California poppy may help promote sleep and pain relief for arthritis sufferers. The concurrent use of all of these natural substances may yield a better result than any one individually.

References

  1. Sieper J, Kary S, Sorensen H, Alten R, Eggens U, Huge W, Hiepe F, Kuhne A, Listing J, Ulbrich N, Braun J, Zink A, Mitchison NA. Oral Type II Collagen Treatment in Early Rheumatoid Arthritis. A Double-Blind, Placebo-Controlled, Randomized Trial. Arthritis and Rheumatism 1996; 39:41-51.
  2. UCII™ FAQ, 2004 InterHealth Nutraceuticals, Inc. Accessed October 14, 2004.
  3. Bagchi D, Misner B, Bagchi M, Kothari SC, Downs BW, Fafard RD, Pruess HG. Effects of Orally Administered Undenatured Type II Collagen Against Arthritic Inflammatory Diseases: A Mechanistic Exploration. International Journal References of Clinical Pharmacology Research 2002; 22:101–10.
  4. Trentham DE, Dynesius-Trentham RA, Orav EJ, Combitchi-D, Lorenzo C, Sewell KL, Hafler DA, Weiner HL. Effects of Oral Administration of Type II Collagen on Rheumatoid Arthritis. Science 1993; 261:1727–30.
  5. Barnett ML, Kremer JM, St Clair EW, Clegg DO, Furst D, Weisman M, Fletcher MJF, Chasan-Taber S, Finger E, Morales A, Le-CH, Trentham DE. Treatment of Rheumatoid Arthritis with Oral Type II Collagen. Results of a Multicenter, Double-Blind, Placebo-Controlled Trial. Arthritis and Rheumatism 1998; 41:290–7.
  6. Barnett ML Combitchi D, Trentham DE. A Pilot Trial of Oral Type II Collagen in the Treatment of Juvenile Rheumatoid Arthritis. Arthritis and Rheumatism 1996; 39:623–8.
  7. Foster S. Valerian. 1996 American Botanical Council. Accessed October15, 20004 from http://www.herbalgram.org/default.asp?c=valerian.
  8. Valerian monograph. Natural Medicines Comprehensive Database 2004. Accessed on October 15, 2004
  9. Mills S, Bone K. Principles and practice of phytotherapy. Edinburgh: Churchill Livingstone; 2000:581-9.
  10. Barker JE, Meletis CD. Naturopathic pain management. Alternative and Complementary Therapies 2004; 10(4):188–93.
  11. Hanus M.; Lafon J.; Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Current Medical Research and Opinion 2004; 20(1):63–71.
  12. Reimeier C, Schneider I, Schneider W, Schafer HL, Elstner EF. Effects of ethanolic extracts from Eschscholtzia californica and Corydalis cava on dimerization and oxidation of enkephalins. Arzneimittelforschung 1995;45:132–6.
  13. Alexander JW. Nutrition. 1998;14(7-8):627–33.
  14. Ariza-Ariza R, Mestanza-Peralta M, Cardiel MH, Semin Arthritis Rheum. 1998;27(6):366-70.
  15. de Deckere EA, et al. Eur J Clin Nutr. 1998;52(10):749–53.
  16. Vargova V, et al. Cas Lek Cesk. 1998;137(21):651–3.

Gene Bruno, MS, MHS

Gene Bruno is the Dean of Academics and Professor of Dietary Supplement Science for Huntington College of Health Sciences (a nationally accredited distance learning college offering diplomas and degrees in nutrition and other health science related subjects. Gene has two undergraduate Diplomas in Nutrition, a Bachelor’s in Nutrition, a Master’s in Nutrition, a Graduate Diploma in Herbal Medicine, and a Master’s in Herbal Medicine. As a 32 year veteran of the Dietary Supplement industry, Gene has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines, and peer-reviewed publications. Gene's latest book, A Guide to Complimentary Treatments for Diabetes, is available on Amazon.com, and other fine retailers.