Posted on Dec 19, 2023, 2 p.m.
Dr. Joseph Maroon, as a practicing Neurosurgery for over 30 years, has devoted his professional career to researching and treating conditions that affect the brain, spine, muscles, joints, and nerves. He has personally seen the effects of severe inflammation associated with spinal disc disease, tumors, and chronic arthritic pain and deformities in his patients. Dr. Maroon firmly believes that one of the greatest scientific discoveries in the last 10 years is that excessive or chronic inflammation in our bodies is responsible for many of the chronic illnesses and diseases we face in our modern environment. A tremendous amount of scientific research sponsored by the National Institutes of Health, The American Heart Association, and University Research Centers has shown this critical link of excessive inflammation in our bodies to conditions such as Alzheimer’s Disease, Coronary artery disease, Heart Attacks, Stroke, Joint problems, and many more chronic conditions.
Per Dr. Maroon, “As a self-described fitness enthusiast and 8-time Ironman™ Triathlete, I have personally been afflicted with painful muscle and joint injuries and the need for powerful non-steroidal anti-inflammatories (NSAIDs), such as Vioxx, Celebrex, and Motrin, which can have serious side effects both in the short and long-term usage. My goal has always been to help my patients and recommend safe and effective products with little or no side effects. Such products must also be thoroughly tested and easy to take.”
Serious Side Effects Revealed
Despite their effectiveness in treating many forms of inflammation, NSAID drugs can have serious side effects. These complications were generally thought to be confined to the gastrointestinal (GI) tract. Stomach pain and in some cases, bleeding ulcers and the need for hospitalizations and blood transfusions can occur even with short-term use of these medications. Most physicians would counsel patients about these potential complications but with many of the NSAIDs are now available over the counter (OTC) subsequent complications have exploded.
Recent reports indicate annually in the US over 100,000 people are hospitalized and over 16,000 actually die from complications related to both steroids and NSAID medications. Additionally, despite their wide use for injury-related pain, NSAIDs can reduce tissue healing and in some cases lead to accelerated kidney failure in some people.
What Can We Do? Supplements
Some of the latest research indicates certain herbal supplements, including Curcumin, which is extracted from the spice turmeric, and Boswellia can be ideal for reducing inflammatory cytokines. Cytokines (see drawing) are inflammatory molecules produced by our body’s immune system. Cytokines are often linked to an inflammatory diet containing saturated fats, simple sugars, lack of physical activity, overuse of joints, or other tissue injury. Excessive amounts of cytokines over time can ultimately cause damage to healthy tissues in the body. See the list of conditions linked to excessive cytokine production below.
Supplements used to reduce Inflammation Response:
Curcumin is the active anti-inflammatory agent found in the spice turmeric. It has been shown to inhibit the activity of the 5-lipoxygenase and cyclooxygenase enzymes, blocking the production of pro-inflammatory eicosanoids (PG-2, LTB-4). A large double-blind study demonstrated that curcumin was as effective as a powerful anti-inflammatory drug in reducing pain, swelling, and stiffness in rheumatoid arthritis. It has also been shown to be effective in the treatment of postsurgical inflammation. Other studies indicate that curcumin can lower histamine levels and is a potent antioxidant.
Side effects are rare but can include heartburn and reflux. Curcumin inhibits the cyclooxygenase enzyme system, a known inflammatory pathway. Curcumin may reduce platelet aggregation and thus may potentiate the effects of certain anticoagulant drugs. Speak to your healthcare provider before taking it if you are on medications.
Boswellia possesses anti-inflammatory, anti-arthritic, and pain-relieving properties. In clinical studies, the gum resin of the Boswellia tree is better known as frankincense. Boswellia has been shown to improve symptoms in patients with osteoarthritis, and rheumatoid arthritis. Research indicates that boswellic acids inhibit the 5-lipoxygenase enzyme in white blood cells that is associated with the production of cytokines. Clinically, it has been used in the treatment of degenerative and inflammatory joint disorders. It reduces the total white blood cell count (a marker of inflammation) in inflamed joint fluid. It also inhibits leukocytes elastase which is released in rheumatoid arthritis. One recent study showed a statistically significant improvement in arthritis of the knee after 8 weeks of taking it three times a day. It improved function in the affected joints. Another study demonstrated a significant drop in pain severity and disability. The efficacy and tolerability of a combination of Boswellia-curcumin was shown to be superior to those of non-steroidal diclofenac for treating active osteoarthritis.
Diets low in excessive red meat, saturated fats, simple sugars, and overcooked food can suppress inflammatory factors in the body. Avoid excessive amounts of red meat, eggs, and wheat products all contain something called arachidonic acid. While some arachidonic acid is essential for your health, too much arachidonic acid in the diet will make your inflammation worse. Junk and processed foods often contain too much similar sugar. Excessive consumption of sugars and refined starchy carbohydrates like white flour can also aggravate inflammation. Another possible source of irritation is plants from the nightshade family.
Stay away from the starchier carbohydrates like pasta and white breads and you should avoid simple sugar too. Choose green leafy vegetables, green and brightly colored vegetables, and lots of fresh whole fruits. Berries are a great choice, especially blueberries and strawberries which are packed with anti-inflammatory phytochemicals and antioxidants. Apples and red onions are great sources of quercetin, which has strong anti-inflammatory properties. Green vegetables and whole fruits are also important as sources of dietary fiber. Oats and oatmeal contain beneficial fiber too.
Overall, a healthy anti-inflammatory lifestyle must include many of these better choices for diet, dietary supplements, and moderate regular exercise. We must avoid the too-easy choice of taking NSAIDs. For joint pain try lifestyle changes like daily stretches, yoga, and muscle conditioning. It’s not easy, but in the long run, most will find a longer and healthier life.
Common Diseases Related To Chronic Inflammation
Allergies-Inflammatory cytokines induce autoimmune reactions
Alzheimer’s Disease-Chronic inflammation destroys brain cells
Anemia-Inflammatory cytokines attack erythropoietin production
Aortic valve stenosis-Chronic inflammation damages heart valves
Arthritis-Inflammatory cytokines destroy joint cartilage and synovial fluid
Cancer-Chronic inflammation causes many cancers
Congestive heart failure-Chronic inflammation contributes to heart muscle wasting
Fibromyalgia-Inflammatory cytokines are elevated
Fibrosis-Inflammatory cytokines attack traumatized tissues
Heart attack-Chronic inflammation contributes to coronary atherosclerosis
Kidney failure-Inflammatory cytokines restrict circulation and damage nephrons
Lupus-Inflammatory cytokines induce an autoimmune attack
Pancreatitis-Inflammatory cytokines induce pancreatic cell injury
Psoriasis-Inflammatory cytokines induce dermatitis
Stroke-Chronic inflammation promoted thromboembolic events
Surgical complications-Inflammatory cytokines prevent healing
Article courtesy of Joseph Maroon, MD, FACS, among his accomplishments he is Senior Vice President of the A4M, board board-certified neurosurgeon, best best-selling author, keynote speaker, sports medicine expert, triathlete, and one of our medical editors. Dr Maroon is an expert and consultant in the areas of sports nutrition, concussion management, personal fitness, and brain and spinal problems, as well as being an internationally competing Ironman triathlete.
“I am glad to share with you what I have learned throughout my personal quest to overcome adversity to become an accomplished neurosurgeon, scientist, Ironman athlete, consultant, author, and advocate on healthy living and nutrition.” ~ Dr. Joseph Maroon.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement. These statements have not been evaluated by the Food and Drug Administration.
Content may be edited for style and length.
References/Sources/Materials provided by:
Acebo E, Raton JA, Sautua S, Eizaguirre X, Trébol, Pérez J: Allergic contact dermatitis from Boswellia serrata extract in a naturopathic cream. Am J Contact Dermat 51(2):91-92, 2004
Badria FA, El-Farahaty R, Shabana AA, Hawas SA, El-Batoty MF: Boswellia-curcumin preparation for treating knee osteoarthritis. Alternative & Complementary Therapies 8(6):341-348, 2002
Banno N, Toshihiro A, Yasukawa K, Tokuda H, Tabata K, Nakamura Y, et al: Anti-inflammatory activities of the triterpene acids from the resin of boswellia carteri J of Ethnopharmacol 107(2):249-253, 2006
Bengmark S: Curcumin, an atoxic antioxidant and natural NFkappaB, cyclooxygenase-2, lipooxygenase, and inducible nitric oxide synthase inhibitor: a shield against acute and chronic diseases. J Parenter Enteral Nutr 30(1):45-51, 2006
Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, Jolad SD, et al: Turmeric Extracts Containing Curcuminoids Prevent Experimental Rheumatoid Arthritis. J Nat Prod 69(3):351-355, 2006