Hyaluronidase

Inflammatory Conditions and Ayurvedic Medicine

Inflammation is a very normal desired effect in the body. To rid the body of all its ill effects, our body creates inflammation under different situations like infections, toxic exposure, ischemia, trauma and many other conditions. As soon as it has done its share of work, the body produces anti-inflammatory processes to control the inflammation. In a normal, healthy person, this process is in perfect balance. However, where there is an imbalance, our body does not stop producing inflammation. This results in conditions such as arthritis, osteoarthritis, fibromyalgia, dermatitis, asthma, colitis, Crohn's disease and many others. All these lie under the control of mental, emotional, physical, nutritional, environmental and even spiritual conditions. Ayurveda is the science of balance and teaches how to create a balance by following mental, emotional, and spiritual balancing with the assistance of nutrition, yoga, meditation, breathing exercises, herbs and supplements according to our individual constitution (Prakriti) and pathology (Vikriti). Ayurvedic verses have made it very clear in this Sanskrit phrase, "Samdosha samagnishch samdhatumalkriya, prasanatmaindriyamna swasth itiyebhidhiyete" or a person who has balance in his physiology (Doshas), balanced digestive abilities (Agni), balanced tissues (Dhatus), balanced excretion (Malas) and the person whose soul, senses, and mind are content, is considered healthy. Technically speaking, inflammation represents a major source of oxidation or free radical damage and Ayurvedic medicine is blessed with an arsenal of wonderful herbs to control inflammations at different levels.

Boswellia Serrata for different inflammatory conditions

Boswellia, prized in the Middle East as Frankincense and brought by the wise men, grows in India, Northern Africa and the Middle East. Extract of Boswellia has been used to treat arthritis, asthma, ulcerative colitis, Crohn's disease, and skin conditions.

Osteoarthritis and Boswellia: In combination form with Ashwagandha, turmeric and zinc; studies have shown positive effects in the treatment of osteoarthritis. In a double blind placebo controlled study, patients showed a significant improvement in pain severity, and disability score. In an animal study, the dogs showed improvement in intermittent lameness, localized pain and stiff gait. All external factors that aggravate lameness, such as "lameness when moving" and "lameness after a long rest" diminished gradually. In another study, all patients receiving Boswellia treatment reported a decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling reduced considerably.

In my personal experience I have treated thousands of patients with a Boswellia preparation for osteoarthritis, rheumatoid arthritis and psoriatic arthritis. With a combination of the Panch Karma treatment, nutritional changes and yoga, we were able to take people off Prednisolone, Methotrexate and Enbrel treatment over a period of three to sixteen months.

Ulcerative colitis and Crohn's disease and Boswellia: Ulcerative colitis and Crohn's disease are both inflammatory diseases of the intestines. They are both dreaded and have high chances of becoming colon cancer. The standard medical treatment options involve lifelong commitments that come with their own share of side effects. In one study, patients receiving Boswellia preparation had an 82% remission as compared to 72% remission in a sulfasalazine group. Similarly, in Crohn's disease, the results were comparable to mesalazine: 44 patients were treated with Boswellia and 39 patients were treated with mesalazine, Boswellia extract proved to be just as effective as the pharmaceutical drug. In my clinic patients with ulcerative colitis and Crohn's disease have been able to go into remission with a combination of nutritional changes, yoga, breathing exercises and a Boswellia preparation.

Boswellia and Asthma: In a study done in 1998, 40 patients took 300 mg of Boswellia preparation three times a week for six weeks; 72% showed significant improvement whereas only 27% of patients after receiving a placebo, showed improvement. Typical doses of standardized extract of Boswellia serrata are 300-400 mg standardized for boswellic acid three times per day. Boswellia is quite safe in therapeutic doses. There were no pathological changes observed in animals; up to 1000mg/kg of body weight and LD 50 was at greater than 2g/kg of body weight.

Turmeric, A powerful Anti-inflammatory: Turmeric (Curcuma longa) is the source of spice that gives curries their signature yellow color and is used extensively in food, cosmetics, and religious ceremonies. It is also traditionally used in Ayurvedic and Chinese medicine. I believe turmeric to be the sole reason why Indians have less cancer compared to Americans. Current research has found turmeric to be a powerful antioxidant, anti-inflammatory, anticarcinogenic, antimicrobial and hepatoprotective. It has also shown wonderful results in cardiovascular and gastrointestinal diseases. The active principals in turmeric are the flavonoid curcuminoids along with various volatile oils, resins, proteins and sugars.

Potent Anti-inflammatory effect: Turmeric is a potent anti-inflammatory. Various laboratory studies have identified a number of different molecules involved in inflammation that are inhibited by curcumin. These molecules include phospholipase, lipoxygenase, cyclooxygenase 2 (Cox-2), leukotrienes, thromboxane, prostaglandins, nitric oxide, collagenase, elastase, hyaluronidase, monocyte chemoattractant protein-1 (MCP-1), interferon-inducible protein, tumor necrosis factor (TNF), and interleukin-12 (IL-12). Cox-2 inhibitors such as Celebrex and Vioxx have been number 1 sellers as nonsteroidal anti-inflammatory drugs. They have been touted to be gentle on the stomach, yet once someone starts using them, they discover that these drugs come with their own set of side effects. Recently, Vioxx showed an increase in heart disease, which is why it was recalled from the market. Turmeric on the other hand covers almost every aspect of inflammation and has a much broader spectrum than the current drug regimen available. It has all these benefits minus the side effects. In animal and in vivo studies, turmeric extract has been shown to decrease chronic and acute inflammation. This is the reason why turmeric milk is undoubtedly one of the most common recipes for trauma in India.

Furthermore, oral administration of curcuminoids in instances of acute inflammation was found to be as effective as cortisone or phenylbutazone. In animal studies, oral administration of the Turmeric extract reduced the inflammation of adjuvant induced arthritis. In monkeys, Turmeric extract inhibited the inflammation due to neutrophil aggregation.

Anti-inflammatory effects on skin diseases and wound regeneration of Turmeric

Traditionally, turmeric is not only employed as anti-inflammatory on skin conditions, but it has also been used as a skin color promoter. Turmeric extract applied to the skin topically has been shown to reduce inflammation, and irritation associated with inflammatory conditions and allergies. In acne conditions, a bacterium called Propionibacterium acnes plays a role in inducing inflammation and causing acne. Turmeric extract along with Neem extract and Rubia Cardifolia extract has been shown to stop the growth of Propionibacterium acnes. In other studies turmeric extract has been shown to regenerate skin and help repair wounds faster.

With all these benefits that turmeric has to offer, it makes perfect sense to use these herbs for skin rejuvenation. Traditionally, turmeric extract has been used in marriage ceremonies to enhance the charm of bride and bridegroom. Twenty-one years ago, I was married to my beautiful wife Rekha. After marriage, she developed a bad case of acne on her face. Her dermatologist prescribed antibiotics that provided limited help. I prepared a preparation of Turmeric and Neem extract and her face cleared up in two months and she did not get acne again. She got dermatitis on her whole body when she was pregnant with our second son Rishi and it was so bad that her skin was chapped, dry and very irritable. Turmeric extract came to the rescue once again and after consuming turmeric extract for two weeks all her rashes vanished completely. I have also given turmeric extract for surgical scars and they heal much faster.

Doses of turmeric: Typically 5-10 grams of turmeric is used per day. I prefer to use standardized extract in the doses of 500 mg to 2000 mg, two to three times per day.

Toxicity and side effects: No toxicity has been reported in acute or chronic administration of turmeric extract. Turmeric extract caused ulcer as evident in one rat study only at a very high dosage (100mg/kg of body weight).

Ashwagandha as potent anti-inflammatory

The word Ashwagandha comes from the Sanskrit words, Ashv meaning horse, and gandha meaning odor (from peculiar equine odor of this plant). Commonly known as winter cherry, this herb is regarded as a general tonic and is considered a Rasayana in Ayurvedic medicine. Rasayana are a special class of herbs and treatment that are rejuvenating and can be taken over long periods without causing any side effects. Ashwagandha contains steroidal alkaloids and steroidal lactones. Currently, 35 withanolides have been isolated from the plant. These withanolides serve as important hormone precursors that convert into human physiologic hormones as needed by the body. Ashwagandha exerts amphoteric properties, which means it can help regulate important physiologic processes. Whenever there are excessive hormones, it attaches itself to the cell membrane and nullifies the effect of the hormones, and whenever the hormone level is low, it helps to balance that hormone. In my opinion you get all the benefits of steroids with this plant without all the nasty side effects. I have used Ashwagandha in place of hormones and have seen amazing results.

The effectiveness of Ashwagandha in a variety of rheumatologic conditions may be, in part, due to its anti-inflammatory properties which have been studied by several authors. In animal studies, comparing the effectiveness of Ashwagandha and the prescription drug phenylbutazone in controlling inflammation, Ashwagandha was shown to be more effective. The Ashwagandha-treated group completely reduced the inflammatory proteins, whereas animals treated with phenylbutazone as well as the control groups had increased inflammatory proteins. Similar results were achieved in carrageenan-induced inflammation. In another study, Ashwagandha extract showed far superior (almost double) results when compared to the drug hydrocortisone to reduce inflammation. In another study on paw swelling with adjuvant induced arthritis, Ashwagandha caused significant reduction in the swelling and showed regeneration as observed by radiological studies. The reduction in swelling and regeneration was better than the drug hydrocortisone.

In another study, Ashwagandha root powder was given to 46 patients of rheumatoid arthritis with doses of 4, 6, or 9 grams for a period of 3-4 weeks. Pain and swelling disappeared completely in 14 patients, considerable improvement was noticed in 10 patients and 11 patients showed mild improvement.

The free radical mechanism is one of the mechanisms considered to contribute to many inflammatory diseases. Ashwagandha has demonstrated its powerful antioxidant action on the nervous system. Oral administration of Ashwagandha in animals has prevented lipid peroxidation. These effects were dose-related.

Immunomodulatory effects of Ashwagandha have also been studied in three myelosuppression models: cyclophosphamide, azathioprin and prednisolone. Significant increases in hemoglobin, red blood cell count, white cell count, and platelet count and body weight were observed in Ashwgandha treated mice.

Doses: A typical dose of the Ashwagandha root powder is 3-6 grams per day and 300-500 mg of standardized extract two to three times per day.

Side effects: Ashwagandha is generally considered safe even in higher doses.

Looking at the full profile of Ashwagandha; its negligible toxicity, along with its antioxidant, anti-stress, anti-inflammatory, immunomodulatory and rejuvenative properties, it makes perfect sense to utilize this herb in inflammatory conditions like osteoarthritis, rheumatoid arthritis, psoriatic arthritis, fibromyalgia, chronic fatigue syndrome, and other rheumatic conditions. I have chosen to give Ashwgandha wherever there is a need for steroids (like hydrocortisone or Prednisolone) or to people who already use these steroids and need to reduce the dosage. Ashwagandha has always come to the rescue with flying colors.

Ginger as powerful anti-inflammatory

Ginger is widely used as a spice in Asian cooking. It is commonly used in baked goods, beverages, candies, liqueurs and even perfumes. Ginger has been described as a medicinal plant in India and China for centuries. Charka (father of medicine) and Sushruta (father of surgery) have referred to its efficacy in many diseases. To the Arabic physician, ginger was known as "Zanjabil." The Greeks and Romans used it as a spice. In folk medicine it is considered a digestive and carminative, and an aid for stomach pain, diarrhea, nausea, rheumatism and toothache. Back in India, this spice was always Grandma's favorite for stomachaches, toothaches, headaches and joint pains. Pharmacologically, ginger is an antioxidant. It stops inflammation, inhibits prostaglandin, thromboxane, and leukotrienes synthesis, and is a potent blood thinner. It is also known to be choleretic, cardiotonic, digestive, carminative, antibiotic, thermogenic and it lowers cholesterol.

Ginger is an antioxidant: Ginger is a strong antioxidant, which is why it is used in preventing rancidity of meat products. It has been shown to prolong the shelf life of fresh, frozen and precooked meat. As an antioxidant, it helps prevent free radical damage and helps inflammation.

Ginger as an anti-inflammatory: Numerous ingredients in ginger have been shown to be potent inhibitors of inflammatory prostaglandin and leukotrienes. This may explain its use in inflammatory diseases such as rheumatoid arthritis, headaches and body aches. Ginger is also a powerful antioxidant and contains an enzyme "protease," which contains a powerful action towards inflammation as bromelain (from pineapple) and papain (from papaya). In an animal model study, ginger extract reduced the carrageenan-induced inflammation in rat's paw. Ginger also contains antihistaminic and anti-toxicity activities. Allergies and toxicity can many times trigger inflammation. In a study on seven patients with Rheumatoid arthritis, all the patients that were given ginger reported substantial improvement in pain relief, increased joint mobility, decreased swelling and morning stiffness. In another study with 28 patients with rheumatoid arthritis, 18 patients with osteoarthritis and 10 patients with muscular discomfort; powdered ginger was given in doses of 500-1000 mg per day for three months to two and a half years. Based on clinical observation, 75% of patients with rheumatoid arthritis, and osteoarthritis experienced relief in pain and swelling; 100% of the patients with muscular discomfort experienced relief in pain and swelling. Patients taking higher doses experienced faster results.

In another study by Srivastava and Mustafa, ginger was reported to be beneficial for migraine headaches.

Blood thinning effect of ginger: Ginger is a potent blood thinner. The blood thinning effect is due to its platelet aggregation inhibiting effect. It also inhibited thromboxane and prostaglandins and reduced platelet lipid peroxidation, which makes it one of the superior blood thinning agents.

Analgesic effect: Ginger has been shown to exhibit analgesic effects in experimental animals by inhibiting the release of substance P. This is a very similar action to capsaicin from cayenne or red pepper.

Antispasmodic action and anti-ulcer activity: Ginger increases intestinal motility and at the same time, has proven to be a powerful antispasmodic. This is why it is used as a gastrointestinal tonic. Ginger has also been shown to stop serotonin-induced diarrhea. Many patients taking selective serotonin reuptake inhibitors (SSRIs) like Prozac or Paxil suffer with the side effects of diarrhea. Ginger may come to their rescue. Time and time again, it has been shown to have anti-ulcer properties. It can prevent ulcers due to alcohol, indomethacin, aspirin and other common ulcerogenic compounds. Indomethacin and aspirin used as non-steroidal anti-inflammatory agents are known to cause ulcers. Almost 2000 people die every year from gastric bleeding due to these drugs. Ginger is a much safer alternative because of its valuable properties.

Dosage: Most of the research has been done with 1-2 grams of ginger powder, but in India the average intake is around 8-10 grams per day. Cooking the spice may also decompose the active ingredients in ginger. For anti-inflammatory purposes, take ginger 3-6 grams two to three times per day. Ginger has been combined in equal parts with long pepper and black pepper for digestive actions and the preparation is commonly called "Trikatu." Standardized extract of ginger doses is 100-200mg three times per day.

Toxicity: Ginger is quite safe in therapeutic doses. In experimental animals, the doses of 2.5 gram/kg were tolerated without any mortality. However, when the dose was increased to 3-3.5 gram/kg then there was 10-30% mortality. Some individuals taking 6 grams on empty stomach may get gastrointestinal upsets. Also ginger has blood-thinning activities. If you are on blood thinners like coumadin or taking aspirin, you may need to watch the ginger intake and limit it to 2 grams per day.

Guggul as powerful anti-inflammatory

Guggul is a highly valued botanical in Ayurvedic medicine and is used for a variety of diseases. While the West has made Guggul famous for lowering cholesterol; Ayurvedic medicine has always used this herb for inflammatory conditions like rheumatoid arthritis, osteoarthritis, psoriatic arthritis, nervous disorders, skin infections, urinary conditions (ex. Cystitis), and gonorrhea. It has also shown tremendous use in amenorrhea, menorrhagia, vaginal infections and endometritis. Guggul has been used in hayfever, laryngitis, bronchitis, and otitis media. An extremely famous Ayurvedic preparation called the "yograj guggul" is used for rheumatic conditions. There is also a special pharmacopoeia of guggul preparations: "triphala guggul," "kachnar guggul" and "chandraprabha vati" just to name few.

The guggul extract has shown significant anti-inflammatory actions in experimental models of inflammation. In rat paw edema and induced-adjuvant arthritis, guggul extract showed anti-inflammatory activity equal to phenylbutazone and ibuprofen and one-fifth as compared to hydrocortisone. In chronic inflammation model, it proved to be more effective than hydrocortisone, phenylbutazone and ibuprofen in reducing the severity of secondary lesions. This action is thought to be due to immune modulation and inhibition of delayed hypersensitivity reactions. In autoimmune disease such as rheumatoid arthritis, the immune system attacks its own tissue and makes lots of immune complexes which accumulate around the joint, causing inflammation and choking the blood supply to the joint and eventually leading to degeneration of joint. Guggul extract stops the formation of these immune complexes and stops the hypersensitivity reactions, thereby reducing the inflammation.

In a recent study done in Southern California, 30 male and female participants with osteoarthritis were treated with 500mg of guggul extract three times per day with food. Patients showed significant improvement in the 1-2 month follow ups and overall improvement in mood and pain were noticed as well. No side effects were observed during the trial.

I have personally treated several hundred patients with rheumatoid arthritis, osteoarthritis, psoriatic arthritis, polymyalgia rheumatica and fibromyalgia with great success by using nutritional modification, exercise, yoga, meditation, the Panch karma program, along with herbs such as Guggullip[TM], Boswelya plus[TM] and Trifal[TM]. I have been able to take people off Methotrexate, Enbrel and Prednisone between three to 16 months. Even though the patients show tremendous improvement, they are still advised to stick to their nutritional programs and routines for a lifetime of great health.

Doses: Guggul extract 300-500 mg three times per day with food.

I usually combine Guggul with other anti-inflammatory herbs like Ashwgandha, Turmeric, Boswellia serrata and Ginger.

Side Effects: Some literature has mentioned skin rash with guggul preparations. I have used Guggul-lip[TM] for the last 24 years without a single patient reporting skin rash. I believe it is due to a special carbohydrate in raw guggul and when it is not separated carefully it can cause skin rash. Special patented extraction method helps remove this harmful chemical from raw guggul. Other side effects reported were nausea, headache, eructation and hiccups. I have not seen these reactions in my patients either. Guggul may reduce the bioavailability of the drugs propranolol (Inderal) and diltiazem (Cardizem). This herb has a thyroid stimulating effect and may increase the effects of your thyroid medication. Guggul also inhibits platelet aggregation, which means that people on blood thinners may have to adjust the doses.

For more information about Dr. Virender Sodhi and the Ayurvedic Clinic, please visit www.ayurvedicscience.com. For the herbs listed above, please visit www.ayush.com

Disclaimer: This article is purely informative and should not replace the guidance of your physician. If you suffer from an illness, you should consult a physician before taking any herbs, vitamins, minerals or enzymes. Even at the peak of health, it is best to consult a qualified practitioner before taking any dietary supplement.

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by Dr. Virender Sodhi MD (Ayurved), ND

Phone: 425-453-8022

Email: drsodhi@ayurvedicscience.com * Website: www.ayurvedicscience.com

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