Rheumatoid Arthristis

“According to the World Health Organization, 80% of the Earth’s inhabitants…rely upon… traditional medicine[s]…for their primary health-care needs, in part due to high cost of Western pharmaceuticals. Medicines derived from plants have played a pivotal role in the health care of both ancient and modern cultures. One of the prime sources of plant-derived medicines is spices.”

Turmeric is one such spice, known around the world by different names, my favorite of which is probably zard-choobag. Turmeric is the dried powdered root stalks of the turmeric plant—a member of the ginger family—from which the orange-yellow pigment curcumin can be extracted. The spice turmeric is what makes curry powder yellow, and curcumin is what makes turmeric yellow. The molecule even looks cool. I always thought it kind of looked like a crab.

Anyways, in recent years, more than 5,000 articles have been published in the medical literature about curcumin. Many sport impressive-looking diagrams suggesting curcumin can benefit a multitude of conditions via a dizzying array of mechanisms.

Curcumin was first isolated more than a century ago, but out of the thousands of experiments, just a handful in the 20th century were clinical studies involving actual human participants. But, since the turn of the century, more than 50 clinical trials have been done, testing curcumin against a variety of human diseases, with 84 more clinical trials on the way. But most of the 5,000 were just in vitro lab studies, which I’ve resisted covering until they moved more out of the petri dish and into the person. But, this study got my attention.

“Rheumatoid arthritis…is a chronic systemic inflammatory disorder that…causes progressive destruction of the cartilage and bone” of joints. “The long-term prognosis of RA is poor with as much as 80% of patients affected becoming disabled” with a “reduction [of years] in life expectancy.” There’s lots of drugs one can take, but unfortunately, they’re often associated with severe side effects, including blood loss, and bone loss, and bone marrow suppression, and toxicity to the liver and eyes. There’s got to be a better way.

Well, the efficacy of curcumin was first demonstrated over thirty years ago. A double-blind crossover study; curcumin versus phenylbutazone, a powerful anti-inflammatory they use in race horses. Both drugs showed significant improvement in morning stiffness, walking time, joint swelling, with the complete absence of any side effects in the curcumin group—which is more than can be said for phenylbutazone, which was pulled from the market three years later for wiping out some people’s immune systems, and their lives.

Here’s the latest. “Forty-five patients diagnosed with [rheumatoid arthritis] were randomized into three groups”—curcumin, the standard of care drug, or both. The primary endpoint was a reduction in disease activity, as well as a reduction in joint tenderness and swelling. All three groups got better, but interestingly, the curcumin groups showed the highest percentage of improvement—significantly better than those in the drug group.

“The findings…are significant, and demonstrate that curcumin alone was not only safe and effective, but was surprisingly more effective in alleviating pain compared” to the leading drug of choice—all without any apparent adverse side effects. In fact, curcumin appeared protective, given that there were more adverse reactions in the drug group than the combined drug and curcumin group. In contrast to the nonsteroidal anti-inflammatory drugs, curcumin has no gastrointestinal side effects, and may even protect the lining of the stomach.

Y. Henrotin, A. L. Clutterbuck, D. Allaway, E. M. Lodwig, P. Harris, M. Mathy-Hartert, M. Shakibaei, A. Mobasheri. Biological actions of curcumin on articular chondrocytes. Osteoarthr. Cartil. 2010 18(2):141 – 149.

S. K. Yadav, A. K. Sah, R. K. Jha, P. Sah, D. K. Shah. Turmeric (curcumin) remedies gastroprotective action. Pharmacogn Rev. 2013 7(13):42 – 46.

B. Chandran, A. Goel. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 26(11):1719 – 1725.

P. Anand, C. Sundaram, S. Jhurani, A. B. Kunnumakkara, B. B. Aggarwal. Curcumin and cancer: An old-age disease with an age-old solution. Cancer Lett. 2008 267(1):133 – 164.

A. Shehzad, J. Lee, Y. S. Lee. Curcumin in various cancers. Biofactors. 2013 39(1):56 – 68.

S. Saha, A. Adhikary, P. Bhattacharyya, T. Das, G. Sa. Death by design: Where curcumin sensitizes drug-resistant tumours. Anticancer Res. 2012 32(7):2567 – 2584.

A. Goel, A. B. Kunnumakkara, B. B. Aggarwal. Curcumin as Curecumin: From kitchen to clinic. Biochem. Pharmacol. 2008 75(4):787 – 809.

R. A. Sharma, A. J. Gescher, W. P. Steward. Curcumin: The story so far. Eur. J. Cancer 2005 41(13):1955 – 1968.

S. C. Gupta, S. Patchva, B. B. Aggarwal. Therapeutic roles of curcumin: Lessons learned from clinical trials. AAPS J. 2013 15(1):195 – 218.

S. Shishodia. Molecular mechanisms of curcumin action: Gene expression. Biofactors. 2013 39(1):37 – 55.

S. C. Gupta, G. Kismali, B. B. Aggarwal. Curcumin, a component of turmeric: From farm to pharmacy. Biofactors. 2013 39(1):2 – 13.

S. Shishodia, G. Sethi, B. B. Aggarwal. Curcumin: Getting back to the roots. Ann. N.Y. Acad. Sci. 2005 1056(NA):206 – 217

S. Salvioli, E. Sikora, E. L. Cooper, C. Franceschi. Curcumin in cell death processes: A challenge for CAM of age-related pathologies. Evid Based Complement Alternat Med. 2007 4(2):181 – 190.

M. S. Baliga, N. Joseph, M. V. Venkataranganna, A. Saxena, V. Ponemone, R. Fayad. Curcumin, an active component of turmeric in the prevention and treatment of ulcerative colitis: Preclinical and clinical observations. Food Funct. 2012 3(11):1109 – 1117.

A. Shehzad, G. Rehman, Y. S. Lee. Curcumin in inflammatory diseases. Biofactors. 2013 39(1):69 – 77.

J. H. Kim, S. C. Gupta, B. Park, V. R. Yadav, B. B. Aggarwal. Turmeric (Curcuma longa) inhibits inflammatory nuclear factor (NF)-κB and NF-κB-regulated gene products and induces death receptors leading to suppressed proliferation, induced chemosensitization, and suppressed osteoclastogenesis. Mol Nutr Food Res. 2012 56(3):454 – 465.

B. B. Aggarwal, W. Yuan, S. Li, S. C. Gupta. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Mol Nutr Food Res. 2013 57(9):1529 – 1542.

W. H. Inman. Study of fatal bone marrow depression with special reference to phenylbutazone and oxyphenbutazone. Br Med J. 1977 1(6075):1500 – 1505.

L. Baum, C. W. K. Lam, S. K.-K. Cheung, T. Kwok, V. Lui, J. Tsoh, L. Lam, V. Leung, E. Hui, C. Ng, J. Woo, H. F. K. Chiu, W. B. Goggins, B. C.-Y. Zee, K. F. Cheng, C. Y. S. Fong, A. Wong, H. Mok, M. S. S. Chow, P. C. Ho, S. P. Ip, C. S. Ho, X. W. Yu, C. Y. L. Lai, M.-H. Chan, S. Szeto, I. H. S. Chan, V. Mok. Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer disease. J Clin Psychopharmacol. 2008 28(1):110 – 113.

S. Bengmark, M. D. Mesa, A. Gil. Plant-derived health: The effects of turmeric and curcuminoids. Nutr Hosp. 2009 24(3):273 – 281.

S. D. Deodhar, R. Sethi, R. C. Srimal. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J. Med. Res. 1980 71:632 – 634.

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