I don't endorse or recommend any of these treatments or remedies, and only present them here in order to give you a full spectrum of information. Many of these substances can have negative or deleterious effects. I do recommend and endorse choosing one's foods based on blood type as the most effective means of achieving remission.
by Lisa Purtell v19 Environmental Nutrition Feb '96 p1(2)
COPYRIGHT 1996 Environmental Nutrition Inc.
With over 50 million Americans suffering from arthritis and no cure in sight, alternative treatments such as nutrition offer seemingly harmless options to traditional therapies that come with a list of potentially serious side effects.
Although most experts scoff at the notion that diet can alter the course of arthritis, recent studies offer a glimmer of hope that diet may offer relief from rheumatoid arthritis, the second most common form of the disease. Rheumatoid arthritis begins when the body's immune system attacks its own joints, causing inflammation, impairing movement and sometimes disfiguring joints. (The most common form of arthritis, osteoarthritis, results from the breakdown of cartilage or soft cushion between joints.
Here's a look at recent advances in the nutrition-arthritis link: Omega-3 fatty acids from fish oils have long been touted for their ability to protect against heart disease. Some studies suggest they may also reduce the symptoms of arthritis, probably via their effect on prostaglandins, hormone-like substances that fight inflammation. In a study published last year, rheumatoid arthritis patients taking omega-3 fatty acid supplements reported a decrease in the number of tender joints and the duration of morning stiffness. Patients were able to discontinue anti-inflammatory medications, and symptoms were relieved for up to eight weeks after stopping the fish oil supplements. Independent, objective physician evaluations concurred. However, according to Jim Moody of the American College of Rheumatology (ACR), "The evidence for fish oils seems positive, but is not substantial enough to offer clinical benefit. Certainly, it is not known how safe it is to take fish oil supplements long term." ACR's recommendation? Get your omega-3's from eating fish, especially the dark, oily kind like salmon, sardines, anchovies, tuna, mackerel and bluefish.
Omega-6 fatty acids or gamma-linolenic acid (GLA), an essential fatty acid derived from plant seeds, seems to suppress the inflammation of arthritis. In one study, when patients were given GLA for six months, overall pain and joint tenderness diminished, whereas those in placebo groups experienced no improvement.
While GLA seems to pose no adverse effects, it is not approved as an effective therapy for arthritis. And even though GLA is available in preparations of borage seed oil and evening primrose oil at health food stores, the doses are usually far less than the 1.4 grams a day used in the study. Reseachers agree that more studies are needed to determine if smaller doses are as effective over the long-term.
Antioxidants are known to protect cell membranes from the ravages of free radicals. Since rheumatoid arthritis is a process of inflammation and damage to cells, could antioxidants offer the same protection to joint tissue? In one study where 1,419 adult men and women were followed for 20 years, a correlation was found between low blood levels of beta-carotene, vitamin E and selenium and the development of rheumatoid arthritis in a small subgroup of men. This suggests that inadequate intakes of these nutrients, particularly over a long period of time, may increase the risk of developing rheumatoid arthritis.
Although a single study based on only a few people is weak evidence, there is certainly no harm in increasing antioxidants in the diet. Top food sources of beta-carotene include broccoli, carrots, sweet potatoes, pumpkin and cantaloupe. Vitamin E is found in oils, nuts and wheat germ, while selenium is found in a wide variety of foods.
A vegetarian diet seems to improve arthritis symptoms, but it is not clear whether the elimination of meat or the addition of foods like fruits and vegetables is what relieves arthritis pain. Another possibility is that the switch to a meatless diet increases the amount of omega-3 fatty acids in the diet. Or perhaps more likely, say some arthritis experts, the so-called improvement may merely be reflecting the nature of the disease itself, in which flare-ups and remissions are common and unpredictable.
Food poisoning, such as that caused by Salmonella and Campylobactor, can be an unrecognized trigger for arthritis. One study found that 27 of 423 men with food poisoning developed a form of arthritis known as reactive arthritis. Symptoms in the previously healthy men lasted anywhere from a few months to five years. The best line of defense against reactive arthritis is to prevent food poisoning: Refrigerate food promptly, wash hands and utensils thoroughly after handling raw meat, chicken and fish, and cook ground meat to well-done. The Practical Approach. The line sometimes blurs between hope and reality. The American College of Rheumatology warns arthritis sufferers who are considering diet therapies: "Nutritional therapy for arthritis is experimental. Until more data is available, patients should continue to follow a balanced and healthy diet, be skeptical of miraculous claims, avoid elimination diets and fad practices."
Richard Panush, M.D., chairman for the Questionable Remedies Committee of the ACR, strongly opposes diet therapy. "For the most part, users will be disappointed with nutritional remedies as their benefit, at best, is modest."
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Better Nutrition for Today's Living August '94 p14(1)
COPYRIGHT 1994 Argus Press
Osteoarthritis (OA), or degenerative joint disease, which is the most common of all the rheumatic diseases, affects an estimated 16 million Americans. Rheumatoid arthritis (RA), a chronic inflammatory joint disease of unknown cause, affects over two million Americans, the majority of them women, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Md. OA affects cartilage, the protective material that covers the ends of bones, and causes it to fray, wear, and, in extreme cases, to disappear entirely, leaving a bone-to-bone joint resulting in excruciating pain. The disorder also causes stiffness and swelling of the joints. By age 65, approximately 75 percent of the population has X-ray evidence of OA in the hand, foot, knee and/or hip.
The primary target of RA, however, is the joint lining, or synovial membrane, which becomes inflamed and invades and damages nearby bone and cartilage. The resulting pain, stiffness and restricted movement can eventually destroy the joint. RA can also lead to inflammation of the blood vessels and the outer lining of the heart and lungs. Writing in Natural Alternatives to Over-the-Counter and Prescription Drugs, Michael T. Murray, N.D., recommends high-potency vitamin and mineral supplements, especially the antioxidants, for OA, along with glucosamine sulfate. For RA, he suggests the same vitamin and mineral supplements, along with eicosapentaenoic acid (EPA), bromelain, a mixture of enzymes found in pineapple, and curcumin, the yellow pigment in turmeric (Curcuma longa).
"Although curcumin has some direct anti-inflammatory effects, it is also thought to enhance the body's own anti-inflammatory mechanisms," Murray said. "Clinical studies have substantiated curcumin's anti-inflammatory effects, including a significant beneficial effect in RA."
"The gum resin exudate of Boswellia serrata is known as salai guggal in the vernacular and is used in the Ayurvedic system of medicine for the treatment of rheumatism/arthritis, obesity and various other disorders. A non-phenolic fraction obtained from its gum resin is reported to possess analgesic and psychopharmacological effects." One of the advantages of the herb, the researchers said, is that it is a new non-steriodal, anti-inflammatory and anti-arthritic substance which does not produce ulcers and other gastric complaints commonly associated with some anti-arthritic drugs.
In Indian Drugs in 1987, V.N. Gupia, et al. said that boswellic acids enhanced the blood supply to the joints of arthritic patients, and restored the integrity of blood vessels weakened by spasm. Equally important, the boswellic acids do not cause toxic side effects, they added.
The authors quoted a study by Pachnanda, et al. (1981, 1982), involving 175 patients with musculoskeletal rheumatism, including rheumatoid arthritis and ankylosing spondylitis, ranging from moderate to severe. The patients, both males and females, ranging in age from 10 to 50, had had the disorder for from one to six years. All had previously undergone conventional treatment.
In 122 out of the 175 patients, who were either bedridden or otherwise incapacitated, who also suffered from morning sickenss, showed an abatement of their symptoms from two to four weeks after boswellin treatment.
Seventeen of the 122 patients who were given a placebo had a recurrence of their symptoms within 10 days. Of the remaining 53 patients, 35 showed good results and the other 18 had no appreciable improvement within a week after initiating the treatment. No side effects were noted.
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byJames J. Gormley il v57 Better Nutrition for Today'sLiving Sept '95 p42
COPYRIGHT 1995 Argus Press
Although "For amber waves of barley" does not rhyme very well with "Above the fruited plain" in "America, the Beautiful" (1893/1911), its composer, Katherine Lee Bates, must have been looking at barley as she stood on the summit of Pike's Peak, in Colorado, and gazed out at the stunning expanse of fields that color the eastern plains of Colorado and thought the words: "For amber waves of grain."
It is believed that barley originated in Ethiopia or southern Asia about 5,000 B.C. and was being cultivated by the Swiss Lake Dwellers between 2,000 and 3,000 B.C., in Greco-Roman areas by 300 B.C., and in China by 200 B.C. These are rather ancient origins when we consider that barley-juice producers extract the juice from the leaves when the plant is very young, indeed -- when the barley is immature, or "green" -- hence "green barley."
Of all the reports on the beneficial effects of barley juice that have come out in the last 20 years, the most important for arthritis sufferers are those which suggest some compelling evidence, indeed -- that green barley juice (called "essence" by some) fights arthritis. Arthritis, which is characterized by inflammation and pain in the joints, has two forms which are the most common: osteoarthritis and rheumatoid arthritis.
Osteoarthritis is a degenerative joint disease "related to the wear and tear of aging and involves deterioration of the cartilage at the ends of the bones," which afflicts 15.8 million Americans, explain James F. Balch, M.D., and Phyllis A. Balch, C.N.C., in their Prescription for Natural Healing (1990). While osteoarthritis does not usually bring on serious disablement, rheumatoid arthritis -- which afflicts 2.1 million Americans -- often does.
The Balches tell us that rheumatoid arthritis attacks "the synovial membranes surrounding the lubricating fluid in the joints. The cartilage and tissues in and around the joints, and often the bone surfaces, are destroyed. The body replaces this damaged tissue with scar tissue, causing the spaces between the joints to become narrow, to develop folds, and to fuse together."
Traditionally, physicians have prescribed aspirin or any number of dangerous non-steroidal anti-inflammatory drugs (NSAIDs) for arthritis. But, as Julian Whitaker, M.D., reports in Young Again (1994), "these drugs can cause internal bleeding and block your body's ability to produce cartilage -- which eventually leads to even worse arthritis -- and their pain relief is often inadequate."
It is, now, generally accepted that various kinds of joint inflammation, "including some forms of rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and others, [...] have nutritional components and may improve when offending foods are eliminated from the diet," says Michael A. Klaper, M.D., in the May 1995 issue of Alive.
It is equally accepted that adding the right natural-food products can reduce many symptoms of arthritis and can slow, or even halt, the degeneration of cartilage -- one of several primary malefactors in the progression and symptoms of arthritis. Which brings us back to barley-juice.
In the early 1980s, animal-model trials conducted by a pioneer in green-barley-juice extraction and research, Yoshihide Hagiwara, M.D., revealed potent anti-inflammatory activity of barley-juice components, including the enzyme superoxide dismutase, chlorophyll, flavonoids, and the protein fractions P4-D1 and D1-G1.
In fact, barley-juice is "loaded with vitamins, proteins, minerals, and [...] chlorophyll," notes Whitaker in his newsletter Health & Healing: Tomorrow's Medicine Today.
Chlorophyll, the green lifeblood of plants, is a vital part of green barley juice. An important anti-inflammatory agent, chlorophyll is widely used as a breath freshener, body deodorizer and germicide. A number of studies on green barley also "show its effectiveness in fighting asthma, constipation, diabetes, [...] skin problems, obesity, anemia, impotence, high blood pressure, heart disease, cancer and kidney problems," Health Foods Business reported in October 1994. An important cereal grain, barley is part of the grass family, Gramineae, and is referred to by botanists as Hordeum vulgare. Important barley-producing U.S. states include Idaho, California and Minnesota; North Dakota alone produced 175 million bushels in 1986. Although our national colors might be red, white, and blue, our national diet should include a beautiful color --"barley- green."
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by James F. Scheer il v57 Better Nutritionfor Today's Living Feb '95 p72
COPYRIGHT 1995 Argus Press
A double-blind, placebo-controlled study of 52 rheumatoid arthritis patients was conducted by Jill Belch, M.D., of the department of rheumatology at Glasgow University Medical School.
Seventeen were given evening primrose oil, and 17 were administered a combination of evening primrose oil and fish oil. The remaining 18 were given a placebo. All patients were given six capsules every morning and evening.
Eighty-three percent of the primrose oil takers found marked pain relief so that they could either substantially reduce or quit the pain-killers. Ninety-four percent of those on the primrose-fish oil combination were able to reduce substantially or to eliminate the pain-killers. Just 34 percent of the placebo group were able to do this. Blech warns arthritis patients not to expect instant results with either the primrose oil or combination primrose/fish oil, because they may take up to several weeks to show their influence. Her study revealed that patients had been taking the supplements for from two to four months before improvement began to show.
Evening primrose oil has also notched a significant triumph in another area of pain -- that which troubles many pre-menopausal women, that is, premenstrual syndrome (PMS).
Abdominal bloating, depression, irritability, fluid retention, headaches, mood disorders, painful breasts, pelvic congestion, swollen ankles, weeping and, in certain instances, uncontrollable rage are the most frequent PMS symptoms.
Evening primrose oil proved effective in preventing severe symptoms of PMS in a pair of studies in Great Britain. M.G. Brush, M.D., of St. Thomas Hospital in London, one of the world's largest PMS clinics, administered evening primrose oil to 70 women who had been unable to get relief from one to two other therapies.
When they took two capsules of evening primrose oil three times daily, 67 percent of them were symptom-free. Twenty-two percent achieved partial relief, which adds up to 89 percent of treatment-resistant women gaining partial to total relief.
Evening primrose oil has also proved effective in reducing overweight and, therefore, the psychological and emotional pain that accompanies this condition. However, it only seems to work in patients who are more than 10 percent above their idea weight.
However, among the test subjects, more than 10 percent above their norm, 50 percent on an evening primrose oil supplement lost weight without changing their caloric intake.
Another area in which evening primrose oil proves helpful is in alcohol addiction -- particularly in decreasing alcohol's sabotaging effects. Alcohol puts the brakes on translating linoleic acid into GLA. When the patient drinks continuously for a long time, the levels of prostaglandin-E1 (PGE1) hit bottom and invite depression. Depression makes the person prone to continue drinking. Evening primrose oil relieves depression and, therefore, curbs the desire for additional drinking.
Excessive and continuous alcohol drinking cannot only deplete GLA, DHGLA and PGE1, but also damage the liver and kidneys. However, studies show that evening primrose oil can break or prevent the enzyme blockage that alcohol causes and guard both of these key organs. Evening primrose oil and certain other kinds of essential fatty acids contribute to the health and beauty of skin, hair and nails. Studies reveal that evening primrose oil is helpful in lowering the risk of heart attacks, in controlling the severe complications of diabetes, in managing hyperactivity and in slowing the aging process -- additional reasons why evening primrose oil is one of the most helpful products on the shelves of health food stores.
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(Longevity: The New Frontier) by Stephen Langer v3 Health News & Review Spring '93
COPYRIGHT 1993 Keats Publishing Inc.
To score a victory over arthritis, you must know all that it is possible to know about this cruel, stubborn, relentless enemy. And there is much to know about the degenerative disease that plagues 50 million Americans in almost 100 different form--mildly painful to excruciating. The majority of sufferers have either of the two most common types: osteoarthritis (most prevalent in older individuals)--wear and tear on the larger, weight-bearing joints, hips, knees or spine--or rheumatoid arthritis (which can afflict people of almost nay age)--inflammation of the synovium, a thin membrane envelope covering the joints, usually progressing to inflammation of other parts of the joints. In this disorder, only the small joints are generally affected, those of the knuckles and toes, but it can attack ankles, knees, wrists and the neck, even the hips or spine.
Vitamin C helps: Although some authorities maintain that nutrition has little to do with the quality of synovial fluid and the incidence of arthritis, two experts in this field, Drs. E. Abrams and J. Sandson, state in the Annals of Rheumatic Disease that synovial fluid is a thinner and more effective lubricant when blood levels of vitamin C are high. An earlier study reported in Geriatrics revealed that when individuals suffering from chronic arthritis received massive doses (4,000 mg) of ascorbic acid daily, they experienced less pain and had better appetite and a new feeling of well-being.
In an experiment at McKinley Hospital in Trenton, New Jersey most of 59 subject patients experienced an improvement of their arthritis symptoms and general health when given a combination of vitamin C and hesperidin, a bioflavonoid. When this supplement was withdrawn, symptoms returned and higher doses were required.
Dr. Fred Klenner, who has effected amazing therapies with ascorbic acid, states that vitamin C appears to rid arthritis patients of toxic heavy minerals which seem to contribute to their ailment. He says that individuals who take 10-20 grams of vitamin C daily, plus associated nutrients, will probably never be afflicted with arthritis. After many years of study, a distinguished British scientist, E.C. Barton Wright, D.Sc., F.R.I.C., F.I. Biology, published Arthritis: A Vitamin Deficiency Disease, a monograph making a strong case that adequate diet is a far better approach to preventing and treating arthritis than any existing drug therapy. He says evidence indicates that arthritis is brought on by a deficiency of pantothenic acid. Vitamin B6 (pyridoxine) has also scored against arthritis. Pyridoxine-deficient human subjects with painful joints similar to those in arthritis lost their soreness when given B6 supplements. Dr. John M. Ellis has had excellent success with 50 mg of B6 per day in treating osteoarthritis.
Administration of vitamin D, essential to the assimilation of calcium and phosphorus, has improved or deterred some forms of arthritis. Many individuals who live in northern states cannot get sufficient sunlight on their skin to interact with cholesterol there to form vitamin D. Fish liver oils are rich in vitamin D, and some brands are flavored.Calcium vs. stress.
Minerals are a must in the prevention and alleviation of arthritis. One of them is calcium. The pain of arthritis as well as its limitation of movement and, often, of work are forms of stress. Various kinds of stress make heavy demands on calcium. Another reason for assuring adequate calcium intake is that calcium purportedly lessens sensitivity to pain. The recommended daily intake is 800 mg.
One of the most neglected trace minerals in arthritis management is manganese, which helps keep zinc and copper in balance and often makes arthritics feel improved. Examination of 52 rheumatoid arthritics' hair samples by Dr. Charles Rudolph revealed that their most common trace element deficiency was manganese. Longevity authority Dr. Benjamin Frank stated that manganese is the most needed and valuable trace element for arthritis patients. The daily requirement has been estimated at 3 to 9 mg.
As with vitamins and minerals, an amino acid, histidine, appears to be deficient in rheumatic arthritics--roughly 28% below that of normal individuals, says Dr. Donald Gerber, associate professor of medicine at State University of New York Downstate Medical Center. Histidine-rich foods are brewer's yeast, egg whites, fish, peanut flour, soybean meal and wheat germ. DL phenylalanine, another amino acid, has proved useful in helping eliminate arthritis pain in a week or two when taken after meals three times a day.
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The University of California, Berkeley Wellness Letter March '95 p2(2) 77M1939
COPYRIGHT 1995 Health Letter Associates
As you swallow a mouthful of three-alarm chili, you may wonder if food that scorches your mucous membranes could possibly be good for you or your stomach lining. Why do you sometimes get heartburn after a spicy meal? Does very spicy food--as has been rumored--cause ulcers or cancer? Or as has also been claimed, does it help you lose weight, reduce blood cholesterol, thin the blood, warm you up in winter, and cool you off in summer?
The fruits of the genus Capsicum include sweet bell peppers as well as hot chili peppers. (Black pepper belongs to another family.) All contain capsaicin, the chemical that provides the "heat," but bell peppers contain little. As many as one-fourth of all people around the world eat hot peppers daily. Chilies may be the oldest known spice of all; they've turned up in archeological sites in Mexico dating to 7000 B.C., as wet. ancient Peru and Iraq. Native Americans burned hot peppers a. used the smoke to ward off invading Europeans, according to a recent review article by Geoffrey Cordell in The Annals of Pharmacotherapy. Deterrent use of hot pepper continues today in anti-dog and anti-mugger sprays. There are five types of capsaicin, with differing effects on the mouth. Capsaicin causes the watery eyes and runny nose, the sweating and burning, and the thirst you experience when eating the hot food. The chemical stimulates pain receptors all along the digestive tract. But capsaicin not only stimulates pain receptors, it also appears to block transmission of some pain signals. This might explain, in part, why people get accustomed to hot foods and can tolerate increasingly hotter dishes. Why do some like it hot? Nobody knows--some experts think it's our sense of adventure. Others suspect masochism. But few cuisines pass up hot peppers entirely. For one thing, hot peppers have an antibacterial effect, thus preserving food.
Chilies are rich in vitamin C: nine times more than in tomatoes, by weight. But you would have to munch half a chili pepper a day to get a significant amount. One health bonus: chilies help make up for the absence of fat and salt in food.
Health effects of capsaicin
Weight loss. Even though chilies can make you sweat, and may raise your metabolic rate briefly, there's no evidence they help you take off weight.
Indigestion, ulcers, hemorrhoids. It's never been demonstrated that chili consumption damages the stomach lining, causes ulcers or hemorrhoids, or interferes with the healing of ulcers or hemorrhoids. Of course, you may get heartburn or feel generally uncomfortable after a spicy meal, and this may result in a restless night. If this happens, you'll want to go back to milder foods, but it doesn't mean you've suffered permanent damage.
Cancer. A recent study claimed to find a link between high chili consumption and stomach cancer in Mexico, and another in Bombay suggested a link between high consumption of hot peppers and oral cancers. But some researchers think that chilies--perhaps because of their vitamin C and other antioxidants--might actually be protective against cancer.
Blood cholesterol, blood clotting. There's no scientific reason to think that chilies lower blood cholesterol. They may decrease clotting, however.
Warm you up, cool you down. Eating chilies creates a sensation of warmth, which makes curry sound tempting on a wintry night. But hot foods increase perspiration, which may be why they are particularly popular in hot climates.
Topical pain relief. Over-the-counter creams containing capsaicin can block pain perception and have been used successfully to treat the pain of rheumatoid arthritis, osteoarthritis, shingles, surgical wounds, and diabetic neuropathy. They work not only by interfering with the transmission of the pain impulse, but also as a counter-irritant, which is the way liniments work.
Tips for cooks
When handling hot peppers, it's a good idea to wear rubber or plastic gloves. Keep chilies away from cuts or abrasions, and never touch your face as you work; capsaicin is very painful to the eyes. To reduce the fire, discard the seeds and the spongy white ribs from the raw chili--that's where capsaicin is concentrated.
Cancer Biotechnology Weekly Jan 9 '95 p14(1)
COPYRIGHT 1995 Charles Henderson, Publisher
Professor Linda Bartoshuk's research into anesthetizing the tongue with the fiery compound from chilies (capsaicin) to block pain has led to a dramatic pain relief treatment for cancer patients. It utilizes a mixture of Betty Crocker taffy and cayenne pepper, according to a report in the current (January/February 1995) issue of The Sciences.
Bartoshuk and Yale colleague Ann Berger, of the oncology department, served the "hot taffy ... to nine cancer patients with mouth lesions," reports The Sciences. "On a pain scale from one to ten - ten being the worst ever experienced - a single dose of the candy reduced the patients' average pain from six to 1.5 for several hours. No other oral irritant exhibits capsaicin's pain-deadening power, a fact that Bartoshuk is currently reconfirming with a placebo study using black pepper."
"It is an incredible effect for a trivial intervention. It's easy on the patient, and it's cheap," Bartoshuk says. "What we have done with this approach to (oral) pain is simply more effective than anything that anyone else has done for these patients."
(adapted from Seminars in Arthritis and Rheumatism, 1994; 23,6, Supplement 3: 41-47) v9
The Back Letter Oct '94 p120(1)
COPYRIGHT 1994 Skol Corporation
Hot pepper cream shows promise as a treatment for the pain of fibromyalgia, according to a pilot study by Daniel J. McCarty, MD, and colleagues. Capsaicin, of course, is one of the compounds that gives chili peppers their bite and fragrance.
In a double-blind trial, 45 patients with primary fibromyalgia rubbed either .025% capsaicin cream or a placebo ointment into tender points on one side of the body four times per day for four weeks. The contralateral side of the body functioned as an untreated control. By the fourth week of the study, the patients who received capsaicin reported less tenderness on both the treated and untreated sides of the body, though there were no significant differences in analogue pain scale reports or in sleep quality. "A significant increase in grip strength was noted at week 2 for the capsaicin-treated patients," according to McCarty et al.
The only adverse effect reported by the subjects who received the capsaicin was stinging upon application of the cream. The discomfort generally abated over the course of the 4-week study.
Unfortunately, it is almost impossible to exclude the possibility of a placebo effect in trials involving capsaicin, since it both stings and has a distinctive fragrance. The researchers did analyze results separately in subjects who reported stinging and those who didn't, and they believe that the stinging did not bias the results. McCarty et al. plan a further study of fibromyalgia patients treated with a more potent formulation of capsaicin. To better gauge capsaicin's physical effects in the new study, they will exclude patients with serious psycho-pathology. (See Seminars in Arthritis and Rheumatism, 1994; 23(6), Supplement 3: 41-47.)
by Lawrence J. Pesko il v210 American Druggist Oct '94 p41(2)
COPYRIGHT 1994 Hearst Corporation
Capsaicin is the active ingredient in hot peppers of the Capsicum plant family. These fruits include Capsicum annum and Capsicum frutescens, which can contain from 0.1% to 1% capsaicin and capsaicinoids depending on the climate and soil of the area where the fruit is grown. Due to the widespread use of hot peppers in cooking, many people are familiar with its predominant pharmacological effect of burning and inflammation upon contact with mucous membranes.
It is interesting to note that capsicum fruits were one of the first plants to be domesticated in North and South America. The first detailed account of the spice was by Diego Alverez Chanca, a physician traveling with Christopher Columbus on his second voyage to the West Indies. In 1850, the Dublin Medical Press advocated that the use of one drop of hot pepper extract applied to cotton would provide instant remedy for toothache. It is of interest to note that capsaicin has a chemical structure that is similar to eugenol (the active principle in oil of cloves) that can also induce a long-lasting trigeminal local anesthesia. Recently, a commercially available form of capsaicin cream has been introduced in the U.S. for the temporary relief of neuralgia episodes of herpes zoster infections and in the treatment of diabetic neuropathy. Neuralgia is the pain associated with trauma or irritation to a peripheral nerve. It is characterized by burning, aching, or a sharp jabbing pain.
Capsaicin selectively stimulates and then blocks the chemosensitive unmyelinated sensory afferents from the skin and mucous membranes.[2,3] Capsaicin-induced desensitization has also been observed in cardiovascular, respiratory, and thermoregulatory systems.[4] Since capsaicin-sensitive nerve fibers contain substance P, which is released by capsaicin, it is presumed that many capsaicin effects are mediated by substance P.
Substance P is an undecapeptide that was originally discovered in 1931 in its role as a neurotransmitter of primary sensory afferent nociceptive fibers. Evidence is available suggesting that substance P is released from distal terminals of primary afferent fibers and may be involved in the inflammatory response associated with cutaneous injury and pain. The exact mechanism is unclear, but capsaicin appears not only to release substance P from these sensory fibers but also, after repeated application, to deplete the neuron of substance P. Clinically, patients using topical capsaicin often experience burning at the application site. This is reasoned to be due to the initial release of substance P from sensory neurons because the burning sensation usually dissipates as treatment is continued.
The initial clinical research with topical capsaicin has been in patients with postherpetic neuralgia. The first published open trial involved 14 patients with severe postherpetic neuralgia of greater that six months. Of the 12 patients completing the study, nine experienced significant relief of pain. Four of the patients discontinued opiate analgesics previously required to maintain pain relief while using capsaicin.
At a recent meeting in Dallas of the American Society of Clinical Oncology, Dr. Ann Berger from Yale University School of Medicine presented a study that evaluated the use of capsaicin troches in 12 cancer patients with oral mucositis. The patients' self-assessed pain levels before using the troches was between 3 and 10 on a 10-point pain-rating scale. After using the troches, patients reported that their pain was reduced to between 0 and 2.5 on the scale. Patients reported that the more they used the troches, the less intense the burning sensation from the troches. Berger reported that the patients discontinued use of the capsaicin after about three days of therapy because the mucositis had resolved.
The following formulation was presented by Berger and appeared in the June issue of Pharmacy Practice News.
Capsaicin Troches
Cayenne pepper 1/2 teaspoon Vinegar 2 tablespoons Water 2 tablespoons Butter 1/2 cup Molasses 1/4 cup Brown sugar 2 cups
Stir all the ingredients except for the cayenne pepper in a sauce pan over low heat until the sugar completely dissolves. Increase heat and begin to boil the mixture gently, stirring constantly until a candy thermometer registers 300 [degrees] F. Add the cayenne pepper and stir vigorously. Drop the mixture into a troche mold or by a teaspoon onto a buttered slab to form small patties. This mixture makes about a pound of troches.
Stability information is not available for this preparation.
Prevention Jan '94 p24(2)
COPYRIGHT 1994 Rodale Press Inc.
Scientist have squeezed yet another benefit out of the humble hot pepper. This time, capsaicin-- the active ingredient in that fiery vegetable-- has been found to help squelch the incessant itch of psoriasis. And less scratching may mean a shorter course for the outbreak.
Four times a day, 98 psoriasis sufferers rubbed a capsaicin cream on the flared-up areas, while 99 other sufferers used an inactive substances, or placebo. Six weeks later, itching was either eliminated or much better in 66 percent of those using capsaicin, compared with only 49 percent in the other group (Journal of the American Academy of Dermatology, September 1993).
"Capsaicin is another approach for helping psoriasis patients, especially those who are complaining of itching," says study author Charles N. Ellis, M.D., professor and associate chair of the department of dermatology at the University of Michigan Medical School. Capsaicin is believed to deplete the chemical in the body that's responsible for transmitting the "itch" signal to the brain. When capsaicin hits the skin, nerves release a flood of that transmitting chemical, called substance P. You feel relief after the initial deluge, researchers speculate, because the body is slow to replenish substance P.
While capsaicin can't cure psoriasis (nothing has yet been able to do that), erasing the itch may shorten the length of the bout, says Dr. Ellis. "By reducing the itching, we're reducing the amount of scratching that can stimulate psoriasis, making the condition easier to clear up," he says.
The cream can have a tingling or burning feel when first applied (not unlike what you feel on your hands when you cut hot peppers), but that sensation should weaken over time. Capsaicin cream, already used to treat other skin diseases, is available in drugstores (look for the lower-strength version), but should be used only under your dermatologist's supervision.
v19 HealthFacts August '94 p1(2)
COPYRIGHT 1994 Center for Medical Consumers Inc.
There is no successful treatment for osteoarthritis. The drugs prescribed to relieve symptoms and improve function do not stop the disease from progressing. Furthermore, their potential for serious side effects (see article at left) has prompted many people with arthritis to consider nonmedical therapies.
For guidance, albeit limited, they can look to a new review by David W. Puett, M.D., and Marie R. Griffin, M.D., M.P.H, of Vanderbilt University, Nashville, Tennessee (Annals of Internal Medicine, 15 July 1994). It is based on a computer search of all studies of nonmedical treatments for osteoarthritis published in the English-language medical literature from 1966 through 1993. Though the reviewers refer to these treatments as "nonmedical", many of them, for example, laser therapy, are administered in a medical setting. Nonmedical in this context refers to anything other than drugs and surgery.
Drs. Puett and Griffin set out to determine the efficacy of these therapies for the two areas in which osteoarthritis causes the most pain and dysfunction, the hip and the knee. All existing studies, however, address only the latter. Not surprisingly, the number of published trials of nonmedical therapies didn't come close to the number of studies that evaluated non steroidal anti-inflammatory drugs. Consequently, the helpful findings were sparse. Exercise reduces pain and improves function, but, incredibly, the optimal exercise regimen for people with osteoarthritis has yet to be determined.
The review turned up only two randomized controlled trials involving a popular "deep heat" treatment commonly administered before exercise in order to stretch tendons and relax muscles. Diathermy delivers heat either by high-frequency sound waves (ultrasound) or electro mechanical irradiation (microwave or short wave). In a four-week study, the exercise-only group experienced greater pain relief than those given short wave diathermy three times weekly before exercise.
Diathermy Doesn't Work
The other diathermy study, which lasted four to six weeks, found no difference between the people given ultrasound or sham ultrasound before exercising three times a week. "Available evidence suggests that this treatment provides no benefit in terms of pain reduction or improvement in function when added to an exercise program," concluded Drs. Puett and Griffin.
More promising are the topical application of capsaicin, and laser therapy. A low-energy laser is used to control pain from a variety of diseases, yet researchers have not been able to come up with an explanation for how it works.
Capsaicin, a topical cream with an active ingredient derived from red chili peppers, is sold over-the-counter under several names, including Zostrix, ToppSation, and Capsaicin. It's a counterirritant that produces warmth or a burning sensation when applied to the skin, but does not raise skin temperature or cause blistering. In an attempt to explain capsaicin's mechanism, Drs. Puett and Griffin theorize that it may "interfere with the production of substance P, a chemical mediator of pain from local sensory terminals to the central nervous system." For both treatments, the few existing studies showed benefits worthy of further research. In one well-designed study that administered either laser or a sham laser treatment on both sides of the knee twice daily for ten days, long-lasting pain relief was reported for participants who had received the real laser therapy. A similar result was shown in a study of people whose chronic pain was due to a variety of causes, but only eight participants had osteoarthritis.
Capsaicin was the subject of one well-designed study in which the participants applied either capsaicin or a placebo cream four times daily to the front, back, and sides of the knee. All had suffered moderate to very severe knee pain. The participants who had used the capsaicin cream improved significantly more than those who used the placebo cream.
The burning sensation noted by nearly half of those using capsaicin either decreased or disappeared with repeated use. This was the only study discovered by Drs. Puett and Griffin, which involved capsaicin or any other topical cream, excluding those containing nonsteroidal anti-inflammatory drugs.
The dosage used in the capsaicin study (0.025%) is similar to that in over-the-counter products. Other studies have shown capsaicin's efficacy in relieving the pain of post-herpetic neuralgia, diabetic neuropathy, and rheumatoid arthritis.
Other products involving the application of heat or cold have received no research attention, though they are commonly used. Last year, a survey of people with osteoarthritis and rheumatoid arthritis showed that 60% used topically applied heat or warm baths and 22% applied cold to painful areas.
As for transcutaneous electrical nerve stimulation (TENS) therapy, three studies explored this popular treatment, which is also used for other types of chronic pain, particularly that of the lower back. It involves a generator with wire leads, each with an electrode at the end. A conducting gel is put on the painful areas and the electrodes attached. When the unit is turned on, a low level of electricity, experienced as a tingling sensation, is applied to the painful sites. The study participants were instructed to self-administer TENS or a sham procedure for 30 to 60 minutes two to three times daily for two to six weeks, depending upon the study. All three published studies reported superior pain control for TENS, compared with results from the sham treatment. But, Drs. Puett and Griffin caution, "Strong placebo effects occurred in all three studies. Only one study used an objective measure of lower extremity function, but it had inadequate numbers to evaluate because of the many participants who dropped out (34%)." Improvement Similar to Drugs
In their conclusion, Drs. Puett and Griffin wrote, "The degree of improvement reported in several of these trials of nonmedical, noninvasive therapies is similar to that of non steroidal, anti-inflammatory drugs. Why are there so few trials of such promising alternative therapies? Studies of safety and efficacy are required of drug manufacturers before Food and Drug Administration (FDA) approval, but no such statutes exist for most alternative therapies. In contrast to drugs, there is often no clear financial sponsor of such studies of other interventions such as exercise."
The reviewers acknowledged that many of these nonmedical therapies are expensive, time-consuming, and require intensive patient contact. "However, the considerable risks associated with the use of non steroidal anti-inflammatory drugs are being recognized now in older populations. The risk of serious gastrointestinal side effects increases with non steroidal anti-inflammatory drug doses. Thus, alternatives to these drugs or interventions that will allow use of lower doses would be welcomed by physicians who treat this common problem." Financial support for this review came from the FDA and the U.S. Agency for Health Policy and Research.
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by Nathaniel Mead il v26 Natural Health Jan-Feb '96 p32
COPYRIGHT 1996 East West Partners
WHAT IT IS: Known also as bee sting therapy or bee venom therapy, Apitherapy is the systematic administration of honeybee stings in order to treat a variety of illnesses.
HEALING CLAIMS: Apitherapists nd patients cite recoveries from a wide range of chronic diseases, most notably, arthritis and autoimmune disorders, such as multiple sclerosis and lupus. Successful results have also been reported with asthma, chronic fatigue syndrome, and certain kinds of cancer.
THE EVIDENCE: Veteran apitherapist (and beekeeper) Charles Mraz of Middlebury, Vermont, says he has treated thousands of people over a sixty-year period, and that roughly 8o percent of them have either fully recovered from their ailments or significantly improved. Alternative Medicine Digest reported that more than 1,500 papers on the healing benefits of bee venom have been published in European and Asian scientific journals. Responding to the charge that no placebo-controlled human studies have been done on apitherapy, Bradford Weeks, M.D., former president of the American Apitherapy Society, points to studies conducted at the Walter Reed Medical Hospital, in which bee venom was injected into arthritic dogs. "The results have been consistently positive," Weeks asserts. "Clearly, belief is not the basis for the dog's improvement."
HOW IT WORKS: Supporters of apitheraphy mention several theories. One is that the stings activate powerful immune responses by the body. Another theory holds that bee venom stimulates the adrenal glands to produce cortisol, a hormone with anti-inflammatory properties.
A TYPICAL TREATMENT; methods vary, but typically a bee is placed on the skin with a pair of long tweezers. Dosages range from one or two stings every other day to twenty or even sixty stings per day.
LENGTH OF TREATMENT: People with mild forms of inflammatory illness tend to require only a few stings. More prolonged treatments are needed for more serious conditions, such as osteoarthritis (two to six weeks of regular stings) and rheumatoid arthritis (three to four months). Multiple sclerosis (MS), a more intractable degenerative disease, can require anywhere between one and two years of treatment (about four thousand stings a year).
PROPONENTS: About three hundred US. physicians practice apitherapy, either m their offices or outdoors. Christopher Kim, M.D., of the International Pain institute in Red Bank, New JCW has given more than two thousand parents roughly three million injections of bee venom.
SKEPTICS: most any doctor in the field of autoimmune disease is likely to doubt bee sting therapy The New York Times health columnist Jane Brody dubbed apitherapy a quack approach.
SAFETY: Two percent of the population are allergic to honeybee venom; for these people, apitherapy is dangerous. Anyone considering apitherapy should be tested first for potential allergies to bee venom.
WHAT IT FEELS LIKE: The sting produces a hot burning sensation that lasts about thirty to forty-five seconds. This discomfort is alleviated by placing an ice pack or can of frozen juice on the affected area.
COST: Most apitherapists are beekeepers (not M.D.s) and are not allowed to charge for their services. Doctors' fees will vary, but they run less than those for courses of anti-inflammatory drugs.
FINDING AN APITHERAPIST: The American Apitherapy Society (800-823-3460) will send a packet of information on apitherapy and list of apitherapists around the country. Nathaniel Mead lives in North Carolina and is a frequent contributor to Natural Health.
RELATED ARTICLE: "I Couldn't Wiggle My Toes."
Not long after learning she had multiple sclerosis in the spring of 1970, Patricia Wagner became confined to a wheelchair. "I was a breathing corpse," she recalls. "I had extremely poor vision, no hearing in my right ear, no feeling in my legs, I couldn't even wiggle my toes." With two years of her diagnosis, Wagner had become dependent on drugs. At any one time, she was taking ten different medications. For the next twenty years, she was hospitalized repeatedly. In the spring of 1991, in her third decade of fighting pain and debility, her doctor told her not to worry, that everyone eventually gets used to MS. But she didn't want to "get used to MS.; she wanted her life back. And so, in the summer of 1992, when a member of the American Apitherapy Society in Vermont told a mutual friend that bee venom--from a stringing bee--could help relieve symptoms of MS, Wagner decided that, however outlandish it sounded, it was worth a try. In her first session, a promising sign appeared--Wagner's entire left leg no longer felt ice cold, a sensation that had plauged her for years. The next day, the coldness had gone. Two weeks later her hearing had returned entirely.
Soon Wagner was taking around without a wheelchair. "Prior to this," she says, "I couldn't even get out of bed." At her next regular checkup, she says, her doctor could only stare in dumbfounded silence when she told him what she had done. Now sixty-five, Wagner says that her energy levels have increased and she no longer requires medication. -END-
InfoTrac * Health Reference Center Apr '93 - Apr '96
by Laurie Stoneham v2
Real Living with Multiple Sclerosis Sept '95 p10(3) TEXT / HEADINGS
COPYRIGHT 1995 Cobb Group
Bee venom therapy (BVT) is not an approved treatment for multiple sclerosis or for any other disease. Neither the U.S. Food and Drug Administration (FDA) nor the American Medical Association (AMA) recognize or approve its use. But a number of people with MS and other disorders, including arthritis and lupus, have tried using bee stings or extracted bee venom to treat their symptoms. Apitherapy enthusiasts--people who advocate the use of bees and bee products for health reasons-estimate there are between 5,000 and 10,000 people with MS using BVT to battle their disease. However, the actual number is unknown. In the next few pages, we'll look at the caution and concern expressed by physicians and researchers about the safety and effectiveness of bee venom therapies, as well as the enthusiasm of advocates. We'll also introduce you to a man with MS who feels he has benefitted from a regimen of regular stings.
"The Bee Lady" Pat Wagner, a person with MS and self-described "Bee Lady," is one of the best known advocates of the therapy. Her book, How Well Are You Willing to Bee, and the accompanying media coverage of her story have generated most of the interest in bee venom therapy among the MS community.
We spoke with Pat over the phone. Diagnosed with MS in 1970, Pat declined rapidly By 1992, she says the disease had turned her into "a breathing corpse." Then 41 years old, Pat couldn't see enough to tell whether a person was male or female; she was deaf in one ear, had no bladder or bowel control. "And I couldn't even think of wiggling a toe." She'll never forget February 24, 1992. That's the day her neurologist told her the medications she was on were no longer effective. He went on to tell her to expect little or no improvement in her condition. A month to the day later, on March 24,1992, her life and disease embarked on a dramatic new course. "That's the day I said B.S. to my M.S.!," Pat writes in her book. She has gone from being wheelchair-bound and bedridden to walking without assistance and leading a normal life-improvements she attributes to bee venom.
Although she now stings herself only occasionally, Pat tells us she has been placing extracted venom (diluted with saline solution) drops in her eyes. She claims that her vision has gone from 20/60 in the left eye and 20/400 in right eye, to 20/30 in both eyes. Beekeeper"s MS progresses
Not everyone reports positive results from bee stings, however. Ronald M. Davis, M.D., was diagnosed with MS in 1970, although he now knows his symptoms date back to the fall of 1960.
He started keeping bees around 1966. The general practice physician told us, "I was stung practically every time I worked the bees, which was several times a year. I was stung many times on each occasion, including on the face, arms, neck and hands." Despite this exposure to bee venom, Dr. Davis's MS progressed. Dr. Davis uses a walker or scooter to get around these days. Worth the risk? The most obvious known risk of exposing yourself intentionally to bee venom is suffering a fatal allergic reaction. However, the long-term impact of receiving large amounts of bee venom is not known. Even if there is no initial allergic reaction, sensitivity to the venom can and may develop over time.
We spoke with Stephen C. Reingold, Ph.D., Vice President for Research and Medical Programs for the National Multiple Sclerosis Society (NMSS), about a statement he issued in June 1993 cautioning against bee venom therapy Referring to recent media reports suggesting possible benefits, the statement concludes" ...it is impossible to separate claims from the potential for spontaneous changes in disease or from possible placebo effects that are not treatment related."
Dr. Reingold confirmed that the NMSS still does not endorse this approach, saying "It is an unproven therapy for MS without adequate scientific and clinical data, and it has potential dangers."
The hidden danger:
One of the dangers that is often overlooked is the one associated with not pursuing reasonable treatment, Dr. Reingold points out. "Individuals must always be certain to consult their physicians for appropriate medical care."
Peter Damiri, Public Relations Director for the Multiple Sclerosis Association of America (MSAA), echoes that sentiment: "The most important danger for people is to rely on false hope to treat their symptoms."
Doctors' advice:
Aaron Miller, M.D., is Director of the Division of Neurology at the Maimonides Medical Center in Brooklyn, New York, and chairman of the Real Living with Multiple Sclerosis Editorial Advisory Board. We asked him what he would advise a patient who was interested in pursuing bee venom therapy.
"I would advise against it because of the risks of allergic reaction, marked discomfort, and lack of scientific evidence supporting its efficacy," Dr. Miller said. "I would indicate to the patient that I believe it is worthy of scientific investigation, which is currently underway." We also spoke with Henry McFarland, M.D., Chief of the Neuroimmunology Branch of the National Institute of Neurological Disorders and Stroke of the National Institutes of Health in Bethesda, Maryland. He told us that he has about ten patients who have tried BVT. "About 50 percent of those patients didn't find it helpful and discontinued it," Dr. McFarland estimates, "while the other 50 percent find it very helpful." He continued, "I could treat ten patients with carrot juice, and five or six might get better. Without looking at the data critically and analyzing it very carefully, I might be able to say I had found a cure for MS. But what about the patients who didn't get better? Bottom line, until you have done a properly-controlled study, you won't know whether it works or not. And doing such a study with live bees would be very difficult," Dr. McFarland concluded. Clinical studies
No one knows exactly what bee venom does in the human body. Although scientists have researched sensitivity to bee stings, there has never been any kind of clinical data collected on the medicinal or therapeutic impact of honeybee venom. However, that may be changing. Two studies are currently underway. The NMSS has funded a study to see how mice with an animal model of MS, experimental allergic encephalomyelitis (EAE), react to injections of extracted bee venom. Fred Lublin, M.D., Professor and Acting Chairman of Neurology and Co-Director of the MS Center at Thomas Jefferson University in Philadelphia, is heading the research. He told us that experiments are currently underway, and that he hopes to have preliminary findings by the end of the year.
When asked what the net result of these findings would be, the neurologist explained, "It depends on what we see. If we see a positive effect on the mice, then perhaps it would be worthwhile studying bee venom in humans."
Another study is about to begin with the support of the MSAA. Dr. John Santilli, an immunologist in Bridgeport, Connecticut, will be working with consulting neurologist Dr. Jay Rosenberg of Kaiser Hospital in San Diego, California to identify what, if any, neurologic benefits bee venom produces in humans.
According to the MSAA Public Relations Director, Peter Damiri, a Phase I study following FDA guidelines is projected to begin in the fall of this year. The safety and toxicity of extracted bee venom will be studied for six to nine months. If all goes according to schedule, Damiri expects a Phase 11 trial to begin by late 1996.
RELATED ARTICLE: WARNING!
Bee stings and bee venom can cause fatal allergic reactions in susceptible individuals. Although physicians can test for sensitivity to bee venom, some people may develop the sensitivity over time. Therefore, even people who have been stung before could be at risk for a dangerous reaction to a subsequent sting.
Editor's Note: Many readers have phoned or written asking us to cover bee venom therapy and the people with MS who use it. Laurie Stoneham began her research by interviewing one of those readers, Gary Miller. Real Living with Multiple Sclerosis encourages readers to bear in mind that each person's MS takes a different course. Because MS has so many manifestations and, in relapsing/remitting MS, symptoms may come and go, no real conclusions can be drawn about the effect of treatments based on the experiences of a handful of people. As this article explains, scientific studies in animals and humans are only now beginning to look at the safety and effectiveness of bee venom therapy for MS. Until those studies are completed, people with MS and the experts who treat the disease can't know whether or not bee venom can be of value.