Natural Pain Relievers

Before you take that pill for your aches and pains, take note: more people die each year of bleeding ulcers caused by non-steroidal anti-inflammatories (NSAIDS) than from cocaine abuse.

NSAIDS are one of the seven most-commonly prescribed drugs in North America. These include Aspirin, Celebrex, ibuprofen (Advil, Motrin) and Naproxen.

Mrs. Rogers, 55, complained of joint pain and wanted to stop taking ibuprofen, which she was taking every day in increasing dosages. I agreed with her concerns of the side-effects of these medications. The most common is damage to the intestinal tract, including ulcers and bleeding ulcers. Her MD had prescribed Celebrex, a fairly new anti-inflammatory with supposedly fewer side-effects. This is turning out not to be true in practice, and Mrs. Rogers wanted to try something natural before trying it.

I explained that these NSAID anti-inflammatories, while inhibiting pain, actually increase joint and gastric damage. These drugs also fail to inactivate cartilage-destroying enzymes (collagenase and phosholipase) that are released when the cartilage is damaged. NSAIDS will control pain and swelling, but these enzymes will continue to damage the joint and inhibit rebuilding of cartilage. NSAIDS will also decrease folic acid and therefore increase homocysteine levels, which are associated with an increased risk of heart disease and stroke. They also deplete vitamin C and sulphur, both of which are necessary for cartilage creation.

The first things I always instruct patients to do are:

1. Omit foods that cause inflammation namely the nightshade foods (i.e., tomatoes, eggplant, potatoes and peppers)


2. Stop drinking coffee and pop


3. Take a good mineral supplement including at least 1,000 milligrams of a good quality calcium and 600 mg of magnesium sulphate in a capsule form


4. Drink at least eight to 10 glasses of pure water every day


5. Take a good quality essential fat such as flax oil or fish oils one tablespoon per day.

I'm frequently delighted that this simple program works so well for many people. Mrs. Rogers needed additional support, so I recommended a combination of glucosamine, MSM and devil's claw.

Glucosamine Sulphate

This popular supplement is derived from chitin, the exoskeleton of shrimp, lobster and crabs. The body manufactures the simple molecule glucosamine and stimulates the manufacture of glycosaminoglycans, which are the key component of cartilage.

Glucosamine also promotes the incorporation of sulphur into cartilage; therefore, the sulphate form is the best source of glucosamine rather than the hydrochloride form or NAG (N-acetyl-glucosamine). Glucosamine has been studied since the 1970s, and finally some MDs recommend it first for the treatment of arthritis because the research is overwhelmingly positive it's 10 to 30 times more safe than NSAIDS!

Glucosamine stimulates cartilage synthesis and repair, protects the joint against further destruction, has a powerful therapeutic effect in the treatment of osteoarthritis and inhibits collagen-destroying enzymes. One study indicates that the longer you take it, the better. After three years, patients continue to experience improvement of their symptoms, so continued use is recommended. People with sulphur allergies need not be concerned, as what they are allergic to is sulphite found in food additives and drugs. The sulphate form is naturally occurring in high concentrations in human blood and is an essential mineral.

MSM (methyl sulfonyl methane)

This is an inexpensive way of ingesting sulphur into the body. It is important for cartilage synthesis and repair. Sulphate molecules are important for liver detoxification (in fact, five of the 10 phase-2 detox liver enzymes depend on sulphur-containing amino acids), as well as formation of glycosaminoglycans, including chondroitin sulfate.

I find in clinical practice the dosage of MSM can vary widely. Some do well with 3,000 mg per day while others do better with double that amount. There is no toxicity with MSM. I prescribed for Mrs. Rogers 1,500 mg glucosamine and 1,700 mg MSM. These are often prescribed together along with chondroitin, if necessary, which helps absorption.

Devil's Claw

A South African plant, devil's claw (Harpagophytum procumbens) promotes flexibility, acts as an anti-inflammatory by inhibiting pro-inflammatory eicosanoids, and relieves pain. It has been shown to benefit patients with osteoarthritis of the knee and hip and those with chronic back pain. In one study, six capsules containing 435 mg of devil's claw taken daily worked just as well in treating symptoms of osteoarthritis of the knee and hip than NSAIDS and was superior in the lack of side-effects noted. Look for standardized harpagoside products. For Mrs. Rogers, I prescribed 400 mg per day.

After three months on the above program, Mrs. Rogers was able to eliminate the use of ibuprofen. She also lost a few pounds avoiding all those potatoes she had been eating previously, and her energy improved along with her mental clarity!

Say No to NSAIDs

Health Canada issued two warnings earlier this year about the safety of two particular NSAIDS, Vioxx and Celebrex (go to hc-sc.gc.ca and see "2002 health warnings").

For Vioxx: "...a risk of gastrointestinal toxicity associated with the use of Vioxx exists, although it is less than half that of another NSAID drug, naproxen" (April 19). Health Canada also says serious stomach problems such as bleeding can occur in rare cases, especially in the elderly."

For Celebrex: "the risk of ulcer complications (gastrointestinal bleeding, perforation and obstruction) in patients taking Celebrex and low-dose ASA (Aspirin or other ASA brands) was four times that of patients taking Celebrex alone" (May 23).

Both Vioxx and Celebrex warnings urge patients who experience gastrointestinal toxicity such as stomach pain and blood in stools as well as swelling of the legs (fluid retention), shortness of breath, weakness, fatigue, excessive weight gain or chest pain while on these drugs to see their physicians at once.