Note from Dr. Victor S. Sierpina: Please allow me to introduce Dr. Rob Slater, who upon finishing his Integrative and Behavioral Fellowship at the University of Texas Medical Branch, will be joining our faculty in July. Those wishing to schedule a consultation with him or to establish care with an integrative and holistic physician, call Family Medicine’s appointment desk. Dr. Slater has a wide range of expertise in Integrative Medicine especially in nutrition, integrative oncology, pain management, chronic fatigue, gastrointestinal issues, arthritis and more.

Arthritis is the most commonly reported condition in older adults, and involves inflammation and gradual degeneration of joints throughout the body. At first, the rubbery tissue between bones known as cartilage breaks down, and later, degeneration of the joint extends to the bones and surrounding soft tissues. Conventional treatment for arthritis typically starts with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), then steroid injections into the affected joint, followed by surgical replacement of the joint, or sometimes narcotic medications for people that cannot have surgery. Unfortunately, all of these treatments carry risks — fortunately, there are other options!

Many of the herbs and supplements used for arthritis have anti-inflammatory properties — but so do many foods! I recommend an anti-inflammatory diet to all of my patients with arthritis, which is a whole foods, plant-based diet that is rich in vegetables, fruits, whole grains and legumes (beans). This diet excludes processed and fast foods packed with unhealthy oils and added sugars, which fuel the inflammatory fire. Instead, I advise foods that are packed with healthy omega-3 fatty acids, such as cold-water fish (like salmon and sardines), flax, hemp, chia seeds and walnuts.

Omega-3s can also be taken in the form of supplements, such as fish oil. However, anti-inflammatory doses use 2,000 to 4,000mg of combined EPA/DHA a day, and most over-the-counter products only contain about 300mg of these omega-3s per capsule. To avoid taking 10 or more capsules a day, look for more concentrated omega-3 supplements.

Turmeric and ginger are two other fantastic food-based anti-inflammatories. The fresh roots or ground spices of turmeric and ginger can be used in cooking. Both can also be taken as supplements, with a usual dose of about 500mg twice a day. Many companies have formulated special types of the active ingredient of turmeric, called curcumin phytosome, that are better absorbed by the body. Interestingly, black pepper has been shown to naturally increase the absorption of turmeric.

Two other anti-inflammatory herbs that may be helpful for arthritis are Boswellia (Indian Frankincense) and Ashwagandha (Withania). These botanicals can be taken individually, but are often combined with other herbs. Avocado Soybean Unsaponifiables, Devil’s Claw and bromelain are other anti-inflammatory supplements used for arthritis.

Reducing inflammation is important in treating arthritis, but what about the degeneration of the joint? A promising class of supplements works differently, by providing the building blocks for healthy cartilage, which may reduce the breakdown of joints and slow the progression of arthritis. Glucosamine sulfate and chondroitin sulfate are two such supplements that appear to prevent the degeneration of joints when monitored with X-rays. MSM (Methylsulfonylmethane) is a supplement that appears to amplify the effects of glucosamine sulfate. Finally, SAMe (S-Adenosylmethionine) has also been shown in studies to reduce arthritis pain.

Dr. Rob Slater is an Integrative and Behavioral Medicine Fellow at the University of Texas Medical Branch.

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