Targeted Natural Therapeutics
Data is minimal regarding the effect of many dietary supplements in polymyalgia rheumatica; perhaps because few research dollars are being directed at natural remedies for this condition. Because of significant side effects associated with drugs prescribed for polymyalgia rheumatica, however, Life Extension suggests patients do everything possible to reduce their use of these drugs, including pursuing natural remedies proven to reduce inflammatory cytokine levels.
Calcium and vitamin D. Calcium is important to maintain adequate serum calcium so bone demineralization can be prevented. Vitamin D or a vitamin D analog is necessary for the body to absorb and utilize calcium. Studies have shown that vitamin D analogs (alfacalcidol or calcitriol) are readily converted to active form in the body (Reginster 2005; Richy 2005).
Vitamin K. Vitamin K consists of vitamins K1 and K2; vitamin K3 is a synthetic form (Bern 2004). Maintaining adequate vitamin K levels is crucial for bone mineralization, blood clotting, cell growth, and blood vessel health (Bern 2004). Vitamin K1 (phylloquinone) has anti-inflammatory effects, while synthetic vitamin K3 does not (Eichbaum 1979).
N-acetylcysteine. N-acetylcysteine (NAC) is a well-known antioxidant that also helps regulate production of inflammatory cytokines. In one study, NAC modulated IL-6 production through an NF-kappa B mechanism (Shibanuma 1994).
Plant extracts. A number of plant extracts have also been shown to decrease NF-kappa B, including stinging nettle extract (Riehemann 1999); helenalin from arnica flowers (Lyss 1997); a spiroketal compound found in chamomile and Plagius flosculosus (Calzado 2005); oleandrin from oleander (Manna 2000); resveratrol from grapes and other fruits (Manna 2000); 1’-acetoxychavicol acetate (ACA) from Languas galanga (Ichikawa 2005); curcumin (Jobin 1999); ergolide from Inula britannica (Whan 2001); rocaglamides extracted from Aglaia (Baumann 2002); and tetrandrine from Han-Fang Chi, a Chinese herb used to treat rheumatic disorders (Ho 2004).
Fish oils. The inclusion of omega-3 fish oils in the diet has shown to help with autoimmune and inflammatory diseases (Kelley 2001; Simopoulos 1999, 2002) by suppressing synthesis of TNF-α (Endres 1989). Vitamin E and fish oil in mice have decreased pro-inflammatory cytokines, including IL-6 and TNF-α (Venkatraman 1999). Omega-3 fish oils have been useful in patients with a variety of inflammatory diseases, including rheumatoid arthritis and atherosclerosis (Simopoulos 1999). Studies in humans with rheumatoid arthritis suggest fish oil and vitamin E decrease inflammation (Tidow-Kebritchi 2001). Moreover, fish oil supplementation has shown anti-inflammatory effects (resulting in decreased use of anti-inflammatory drugs) for patients with a variety of other chronic inflammatory diseases (Simopoulos 2002).
Vitamins C and E. Vitamin E is an antioxidant with anti-inflammatory actions. The alpha-tocopherol form of vitamin E can decrease inflammation that contributes to atherosclerosis. Alpha-tocopherol supplementation has been shown to decrease C-reactive protein levels (Singh 2005). Vitamin C is an antioxidant (Das 1989) that also has anti-inflammatory properties and blocks NF-kappa B activation by TNF-α (Bowie 2000).
Methylsulfonylmethane. Sulfur is a mineral found in several amino acids, the building blocks of all proteins in the body. Methylsulfonylmethane (MSM), a natural metabolite of dimethyl sulfoxide (Richmond 1986), is used as a dietary supplement by many people. MSM is naturally found in fruits, vegetables, grains, and animals (cow’s milk is a rich source) (Parcell 2002; Richmond 1986). MSM has been studied in patients with a variety of conditions, including arthritis, allergies, and fibromyalgia, among others. MSM appears to have little or no toxicity (Horvath 2002).
Studies have shown that MSM can decrease pain and increase mobility in patients with osteoarthritis (Kim 2006).Curcumin and ginger. Curcumin, a well-known antioxidant and anti-inflammatory, has been shown to reduce NF-kappa B in a wide variety of conditions, including autoimmune diseases and cancer (Yadav 2005). Ginger has also been documented to reduce multiple inflammatory chemicals, including NF-kappa B and many others, and to be effective against a variety of inflammatory diseases, including autoimmune diseases characterized by an elevation of NF-kappa B (Aggarwal 2004).