These are my top six:
Curcumin, the active ingredient in the yellow curry spice turmeric, works as well as anti-inflammatory drugs, but without the side effects. Like NSAIDs, it blocks the formation of the pro-inflammatory prostaglandins (PGE2), as well as leukotrienes. In fact, it turns out to be what everyone hoped drugs like Vioxx would be (a mild 5-Lox and Cox-2 inhibitor that not does not affect Cox-1) and has been used for its medicinal properties in Ayurveda (Indian traditional medicine), for hundreds of years. There is no evidence of any downsides, even in high doses of 8g a day. Olives contain two potent painkillers The first is hydroxytyrosol - a very powerful antioxidant with anti-inflammatory effects. This is a ‘polyphenol’.
Another key ingredient is oleocanthal which is chemically related to ibuprofen, though has none of the negative side effects. This is the ingredient that gives olive oil a throaty bite, like a slight sting at the back of the mouth, just as ibuprofen does. In 2005 researchers at the Monell Chemical Senses Center and University of the Sciences in the US found that oleocanthal was a potent anti-inflammatory painkiller which partially inhibits the activity of the cox-1 and cox-2 enzymes. [G. K. Beauchamp et al., ‘Phytochemistry: ibuprofen-like activity in extra-virgin olive oil’, Nature, vol. 437 (7055), 2005, pp. 45-6]
Like turmeric, olive extract decreases levels of pro-inflammatory substances. Studies on olive pulp extract have shown that it reduces levels of two inflammatory messengers called TNF-alpha and interleukin-8. In fact one study with mice found that the extract reduced TNF-alpha levels by 95%. Some of the newest pain-killing drugs work by reducing TNF-alpha. [C. M. Bitler et al., ‘Hydrolyzed olive vegetation water in mice has anti-inflammatory activity’, Journal of Nutrition, vol. 135 (6), 2005, pp. 1475-9] An extract of hops is an anti-inflammatory An extract from hops, called isooxygene, is one of the most potent natural COX-2 inhibitors and one of the most effective natural painkillers of all. It works just as well as painkilling drugs.
In one study two tablets of ibuprofen inhibited COX-2 by 62 per cent, whereas isooxygene from hops achieved a 56 per cent inhibition. Not only is it almost as effective as ibuprofen but it also doesn’t have the gut-related side effects of anti-inflammatory drugs. This is because ibuprofen also inhibits COX-1 (the so called ‘good’ COX, because it produces prostacyclin, which protects the gut lining), whereas the hop extract does not. Quercitin – a red onion a day Many plant foods contain flavonoid compounds, which are known to inhibit inflammation [M. Lindahl and C. Tagesson, ‘Flavonoids as phospholipase A2 inhibitors: importance of their structure for selective inhibition of group II phospholipase A2’, Inflammation, vol. 21(3), 1997, pp. 347–56]. One of the most potent is quercitin. One red onion, or a cup of berries, or three servings of greens provides about 10mg of quercitin. Other good sources of quercitin include red wine, tea, grapefruit, broccoli, squash, red grapes, cranberries and citrus fruits. This is one reason why vegetarian diets have proven highly effective in reducing pain and inflammation. However, taking fifty times this amount, 500mg a day, quercitin becomes a potent anti-inflammatory inhibiting the production of the pro-inflammatory prostaglandins (type 2) and also inhibiting the release of histamine, which is involved in inflammatory reactions.
Glucosamine works better with MSM. Glucosamine is proven to slow progression of osteoarthritis of the knee. Good quality evidence shows it works as well as ibuprofen but with less side-effects. In four high-quality 2005 studies that gave glucosamine sulphate versus NSAIDs, the glucosamine worked better in two, and was equivalent to the NSAIDs in the other two. Although there is evidence that chondroitin works, the research does not show that it works better than glucosamine. Most of the research has been done using glucosamine sulphate, but the most absorbable form is glucosamine hydrochloride. Promising results are reported for pain relief and relief from arthritis in people taking daily supplements supplying 1 to 3g of one of the most effective sources of sulphur, methylsulfonylmethane (MSM).
A combination of both glucosamine and MSM is particularly effective. EPA rich Omega 3 reduces joint pain There’s no question about the benefits of upping your intake of omega 3s. A meta-analysis [Goldberg R., Pain, May 2007] of 17 randomized, controlled trials assessing the pain relieving effects of omega-3 PUFAs in patients with rheumatoid arthritis or joint pain found that supplementation with EPA rich Omega 3 fats for 3-4 months reduces patient reported joint pain intensity (by 26%), minutes of morning stiffness (by 43%), number of painful and/or tender joints (by 29%), and NSAID consumption (by 40%).
Putting it all together: The real magic comes when you take all these together. In practical terms this means both eating more of all these foods on a daily basis and supplementing 2 EPA rich omega 3 fish oil capsules, aiming for 1,000mg of EPA and day and combination supplements of the other natural remedies discussed above. You need at least 1 gram of glucosamine to make a difference and almost as much MSM. With the right combination formula containing most of the above you’ll probably need 2 a day to maintain freedom from pain, 4 a day if you are in pain and 6 a day for acute pain. If you’d like to know more details about the exact doses, and the research, read my book Say No to Arthritis.
Ed is a case in point. He first started getting joint pain in his mid-thirties. After an accident in which he tore a ligament, he needed surgery, which revealed that the cartilage in his knee was severely damaged. The damaged cartilage was surgically removed. A few years later the same thing happened to his other knee. A few years on, he needed a second operation on the first knee! Now, in his mid-forties he was suffering from severe arthritis, with ever-increasing pain. There was little improvement in the first two months, but by the third month his knees were feeling a whole lot better.
By six months he was virtually pain-free. “I used to have constant pain in my knees and joints, could not play golf or walk more than 10 minutes without resting my legs. Since following your advice my discomfort has decreased 95-100%. It is a different life when you can travel and play golf every day. I never would have believed my pain could be reduced by such a large degree, and no return no matter how much activity.” Let me know what has worked for you or any questions you have.