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Arthritis pain remedies
have benefits and risks

"Physicians, patients, and the general public are confronted with an acute confusional state regarding the cardiovascular safety of medicines for arthritis." This is the first sentence in an editorial written by Dr. Eric Topol of the Cleveland Clinic Foundation for the Jan. 19 issue of the Journal of the American Medical Association. Topol points out that about half of those with arthritis also have cardiovascular disease, and argues that any arthritis drugs being tested for overall safety must consider cardiovascular risk as well.

Although drug manufacturers are required to conduct multimillion-dollar studies on thousands of people, unexpected surprises might still occur once a drug goes into widespread use. No drug is completely free of side effects.

Many people are looking for safer ways to deal with arthritis pain. The problem is that options such as herbal drug products have rarely undergone large studies on safety and effectiveness. Herbal drugs are not regulated like pharmaceutical drugs and do not include those detailed printed inserts that list all the potential problems thought to be possible, even if unlikely.

Dr. Kevin Gibson, a naturopathic physician in Honolulu, has found the herbal preparations listed below to be effective in helping some arthritic patients. Because these products normally do not come with "inserts," we have listed some cautions.

All inserts would state, "Do not exceed recommended dose" and "safety of use during pregnancy or lactation is unknown."

Boswellia serrata extract and boswellic acid: Possibly safe when used as directed. Safety of use beyond 12 weeks is unknown. Interactions with drugs, supplements, foods or lab tests unknown. Potential side effects: stomach pain, diarrhea, nausea, skin rash if used topically.

Picrorhiza kurroa: Possibly safe when used as directed. Safety of use beyond one year is unknown. Interactions with supplements, foods or lab tests unknown. Could interfere with immunosuppressant drugs. Potential side effects: vomiting, diarrhea, anorexia, itching, rash, giddiness. Might adversely affect autoimmune disorders.

Turmeric: Likely safe in amounts commonly used in foods. Possibly safe when used medicinally as directed. Interactions with foods or lab tests unknown. Avoid use with other supplements or drugs that have anticoagulant or antiplatelet actions (blood thinners). Generally well tolerated. Potential side effects: nausea and diarrhea.

Bromelain: Likely safe when used as directed. Avoid use with supplements or drugs that have anticoagulant or antiplatelet actions (blood thinners). Might increase absorption and blood levels of antibiotics; use together only with medical supervision. Do not take with foods containing uncooked potato or uncooked soybeans. Interactions with lab tests unknown. Do not use if allergic to pineapple.

To create your own product inserts, a good place to start is medlineplus.gov.

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