Gastrointestinal

Natural Anti-Inflammatory Options Open Up Possibilities for Improving Treatment Outcomes

natural anti-inflammatory

Inflammation is detrimental to many of the body’s tissues and is implicated in countless diseases and injuries ranging from the common flu to cancer. Emerging research has even linked systemic inflammation to unlikely conditions such as mood disorders and anxiety, expanding our understanding of the dangers posed by inflammatory responses. As more connections are discovered between inflammation and other health conditions, researchers are increasingly seeking to shed light on the mechanisms responsible.

Currently, clinicians often direct patients presenting with inflammation to over-the-counter compounds like non-steroidal anti-inflammatories (NSAIDs) which are proven to reduce inflammation safely. In more serious cases of inflammation that don’t respond to NSAIDs, doctors may prescribe corticosteroids, which can safely reduce inflammation temporarily. These medications are not effective in all applications, however. Additionally, corticosteroids present a number of side effects with significant health implications, making them generally unsuitable for long-term use. Due to the imperfect nature of these anti-inflammatory options, patients—especially those with severe chronic or systemic inflammation—are asking for more help than conventional compounds provide.

Research shows that this help is available and powerful. There are currently a number of natural anti-inflammatory compounds that have been proven safe and effective which may replace or augment conventional treatments. Thanks to recent studies investigating these anti-inflammatory treatments, researchers and clinicians now know more about their mechanisms of action and beneficial effects than they ever have before, allowing more patients to benefit from natural alternatives. Inflammation itself is difficult to fully address with any one compound, however. As such, it may be prudent to use natural anti-inflammatory options in combination to ensure that they are approaching the problem from multiple physiological angles.

Understanding Inflammation

Inflammation is a complex process, and scientists are still working to more deeply understand its full range of causes and effects. However, the working understanding of inflammation is fairly simple. When inflammation occurs, small blood vessels in the inflamed area dilate, allowing more blood to rush in. This increased blood flow causes the tissue to become warmer, and external tissues take on a reddened color. Excess plasma from the blood permeates into the inflamed tissues, which then become swollen as a result of their higher-than-normal liquid volume. The body uses the additional blood flow and increased volume to traffick white blood cells, platelets, and other cells responsible for tissue repair to the inflamed area so that the damage or external cause of the inflammation can be repaired.

As part of this process, white blood cells’ release an anti-pathogenic chemical package at the site of inflammation. Unfortunately, this often causes the healthy tissues at the inflamed site to be destroyed along with any pathogens and damaged tissues. The unintended destruction of healthy tissues makes inflammation a dangerous prospect, especially for sensitive organs like the intestines and brain. In these sensitive organs, runaway inflammation can easily mean death or permanent disability, which means that controlling inflammation must be a priority within medical practice. Additionally, the adverse effects of inflammation are now understood to be implicated in a broad range of health conditions and clinicians and researchers are reinterpreting many diseases in the context of their inflammatory symptoms in hopes of finding new ways to help patients. As such, anti-inflammatories are an important site of inquiry.

Pharmaceutical Anti-Inflammatories

Drugs that control inflammation include common chemicals like ibuprofen and aspirin, but these medications are not always effective to meaningful degree and may have undesirable or even dangerous side-effects. In particular, members of the most common class of anti-inflammatories, NSAIDs are associated with gastric ulcers, thinned blood, and internal bleeding in the colon. Most of these side effects only occur with extended periods of use, but some patients may experience them more easily than others. NSAIDs are also associated with slower muscle regrowth following traumatic injury.

One study published in the South African Journal of Medicine found that for patients with acute traumatic hamstring injuries, NSAIDs performed only 2% better than placebo in terms of pain relief, and negligibly better than placebo for inflammation reduction. These two effects were consistent from the day after the injury until a week later. Ultimately, however NSAIDs slowed the healing process and ultimately left the treatment group with more pain than the placebo group; a week after the initial injury and treatment with NSAIDs, the data showed that patients taking the NSAIDs had a median of 8.8 pain units out of 100 compared to those taking the placebo who experienced a median of 3.9 pain units. Additionally, the two groups exhibited similar reduction of swelling. Other studies have corroborated similar effects.

In contrast to NSAIDs, corticosteroids have a broader array of side effects but also a greater degree of efficacy in reducing inflammation. Unlike NSAIDs, corticosteroids cause veins to constrict, which means that they can act fast to stop acute inflammatory episodes more effectively. However, vasoconstriction can also produce a number of significant side effects and corticosteroids are linked to anxiety, depression, immunosuppression, hypertension, and slower wound healing as a result of reduced blood access to wound sites. Because of their wider and more dangerous side effect profile, corticosteroids are typically a second-line treatment that is only used once NSAIDs have failed to control inflammation. Once the patient is stabilized and inflammation is suppressed, doctors typically transfer patients back to an NSAIDs.

In addition to NSAIDs and corticosteroids, some patients turn to over-the-counter pain relievers such as acetaminophen (Tylenol, for example) in order to cope with the pain of inflammation. Although acetaminophen can provide temporary pain relief, it does not address the underlying inflammation. Furthermore, it can be toxic, causing profound liver damage and, in some cases, acute liver failure when taken in high doses. Overall, acetaminophen is acknowledged as the most common cause of liver injury, and risk is increased when taken in concert with alcohol use. It is critical that patients recognize the dangers of acetaminophen and focus their attention on seeking out safe anti-inflammatories that address the root cause of pain rather than potentially damaging pain relievers that simply mask it.

Finding the right anti-inflammatory, however can be a challenge. While most inflammation can be treated effectively with NSAIDs or corticosteroids, the drugs’ limitations have left a growing number of patients searching for natural remedies that can be used to supplement or replace pharmaceuticals. These natural anti-inflammatories include substances have long been renowned for their anti-inflammatory properties as well as innovative new supplements that are emerging to give patients more modern ways of coping with inflammation.

Fish Oil

Fish oil is a natural anti-inflammatory composed of omega-3 fatty acids. As a dietary supplement, these omega-3s inhibit the body’s ability to convert fatty acids like arachidonic acid to prostaglandin E2, which is highly proinflammatory. Because fish oil prevents the metabolic step necessary to generate proinflammatory molecules, the entire body experiences a lower level of inflammation. The ability of omega-3s to inhibit inflammation is so marked that some researchers have proposed using the blood concentrations of omega-3s as diagnostic indicators for the risk of coronary heart disease, which causes inflammation. Other researchers have proposed a link between consumption of fish oil and reduced chance of depression, Alzheimer’s disease, and stroke, all of which are associated with creating inflammation or being caused by inflammation.

Unlike pharmaceutical anti-inflammatories, fish oil is primarily preventative rather than reactive with regard to reducing inflammation, which means it cannot help patients during acute inflammation episodes.

Polyphenols

Humans have a long relationship with polyphenols, dating back to the prehistoric era of the Indus River Valley civilization. Since then, polyphenols have been renowned for their tissue-shrinking properties, which can help reduce chronic inflammation safely and effectively. Derived from plants like the green tea leaf, turmeric, and the pine tree, most polyphenols are confirmed to be bioactive, which makes them a natural area for scientists performing drug discovery.

Recently, polyphenols like turmeric have been tested as anti-inflammatories in the context of systemic inflammation, like in arthritis. One study found that daily administration of turmeric-derived compounds reduced inflammation caused by subsequent arthritic episodes by as much as 75% due to its inhibition of white blood cells’ secretion of damaging chemicals. On average, patients who used turmeric in a preventive capacity experienced a 68% reduction in joint inflammation, and scientists who replicated this experiment found an average of 65% inflammation reduction. However, the initial study also found that turmeric’s anti-inflammatory effect was heavily reduced and delayed when administered only after injuries. This means that like fish oil, turmeric is best used preventively and won’t have much of an impact when used to address an acute incident.

Aside from turmeric, other polyphenol-containing plants include the green tea leaf. The green tea leaf contains compounds that inhibit one of the body’s primary pro-inflammatory signaling molecules, the nuclear factor kappa light chain enhancer of activated B cells (NF-kB). Because cells that secrete NF-kB are prevented from modifying their protein production to generate other inflammatory molecules, inflammation is systemically reduced. These effects are under active study, but researchers state that green tea extract consumed in quantities as high as 400 mg per day is safe and effective.

Herbs like ginkgo biloba also contain polyphenols that exhibit anti-inflammatory effects. In particular, the polyphenol called quercetin has been associated with fewer aging-linked inflammatory markers when consumed daily by Japanese men. Furthermore, quercetin has also been associated with lower levels of LDL cholesterol, oxidative stress markers, a slightly longer lifespan, and lower blood pressure in patients with hypertension. These effects are especially pronounced in obese patients, who benefit more than patients of a healthy weight from quercetin supplementation. Like other polyphenols, quercetin is under active investigation by researchers who hope to exploit its medicinal effects.

Butyrate

Butyric acid is perhaps the newest and most promising natural anti-inflammatory compound. Also known as butyrate, butyric acid is a cellular signaling molecule produced in large volumes in the human gut and subsequently consumed by the gut microbiota for energy. Butyric acid is a potent anti-inflammatory because it inhibits secretion of the critical pro-inflammatory molecules IL-1B, TNF-a, and IL-6. These molecules are secreted by dying cells, creating inflammation that causes circulating white blood cells to clear any pathogens in their vicinity. Because butyric acid inhibits these signals from being secreted and causes proinflammatory t-cells to self-destruct, inflammation doesn’t occur. One study found that administration of butyric acid to cells in vitro reduced their secretion of certain proinflammatory molecules by more than 70%.

Historically, butyric acid’s anti-inflammatory effects were impossible to access due to to the compound’s inability to survive metabolism and produce systemic physiological effects. As a result, researchers have long sought a way to package butyric acid such that it could circulate everywhere in the body after oral administration and first pass metabolism. Thanks to recent breakthroughs in high bioavailability delivery systems, patients can now take butyric acid supplements to enjoy its potent anti-inflammatory benefits. Rather than losing most of the supplement to first-pass metabolism, bioavailability systems like erodible pill coatings or molecule-specific drug release triggers enable the supplement to get where it needs to go and remain there longer. Though butyric acid is under active research and many questions remain to be answered, its undeniable efficacy in vitro and safety profile in vivo make it an excellent choice for a natural anti-inflammatory.

Integrating Anti-Inflammatories in Treatment

Natural anti-inflammatories are becoming more understood by the day, and evolving knowledge brings new hope and expanded treatment options for patients seeking alternatives to conventional pharmaceutical therapies. However, patients who want to take advantage of natural anti-inflammatories must seek out the most appropriate and highest quality supplements in order to realize optimal benefits; many supplements have been tested in specific disease contexts, and patients should strive to find those that are proven effective for their needs. Natural anti-inflammatories are also often more effective when used in combination with each other and with traditional treatments. With this in mind, clinicians should tailor combination therapies to the specific needs of their patients to achieve the best treatment outcomes while minimizing side effects and promoting overall wellness.

Foundational Medicine Review is committed to bringing you research-based discussions of key issues related to a broad range of health issues, including gastrointestinal and neurological conditions. Join our mailing list to stay up to date with the latest findings.

Works Cited

Almekinders, LC. 1999. Anti-inflammatory treatment of muscular injuries in sport. An update of recent studies. Sports Med. 28(6):383-388. https://www.ncbi.nlm.nih.gov/pubmed/10623981

Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, et al. 2006. Turmeric extracts containing curcuminoids prevent experimental rheumatoid arthritis. J Nat Prod. 69:351–355. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533857/

Harris WS, Von Schacky C. 2004. The Omega-3 index: a new risk factor for death from coronary heart disease? Prev Med. 39:212–220. https://www.ncbi.nlm.nih.gov/pubmed/15208005/

Liu J, Wang F, Luo H, Liu A, Li K, et al. 2016. Protective effect of butyrate against ethanol-induced gastric ulcers in mice by promoting the anti-inflammatory, anti-oxidant and mucosal defense mechanisms. International Immunopharmacology. 30:179–187. http://www.sciencedirect.com/science/article/pii/S1567576915301867

Maroon JC, Bost JW, Maroon A. 2010. Natural anti-inflammatory agents for pain relief. Surg Neurol Int. 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011108/

Nishimuro H, Ohnishi H, Sato M, Ohnishi-Kameyama M, Matsunaga I, et al. 2015. Estimated daily intake and seasonal food sources of quercetin in Japan. Nutrients 7(4):2345-2358. https://www.ncbi.nlm.nih.gov/pubmed/25849945/

Reynolds JF, Noakes TD, Schwellnus MP, Windt A, Bowerbank P. 1995. Non-steroidal anti-inflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy. S Afr Med J. 85:517–522. https://www.ncbi.nlm.nih.gov/pubmed/7652633/

Saemann MD, Bohmig GA, Osterreicher CH, Burtscher H, Parolini O, et al. 2000. Anti-inflammatory effects of sodium butyrate on human monocytes: potent inhibition of IL-12 and up-regulation of IL-10 production. FASEB 14(15). https://www.fasebj.org/doi/abs/10.1096/fj.00-0359fje

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