Search

Self Care Pharmacy Blog

Archive for the ‘Herbal Products/Natural Supplements’ Category

 

The Truth about Calcium That May Leave Supplement Companies in Pandemonium

Monday, November 9th, 2015

By: Caleb Tang

Calcium is an essential mineral and contributor to bone health that helps keep bones strong. In fact, 99% of the body’s calcium is found in bon
e.1 The human body is continually removing calcium from bone so that it can be used to aid in blood clots, muscle movement, and nerve messaging. Dietary calcium actually replenishes these losses and prevents bones from becoming weak. So why wouldn’t increasing the amount of calcium intake positively affect bone health? Imagine that your car is low on gas. Wouldn’t it obviously make sense to go to the nearest gas station and fill up your tank? In the case of bone health, the answer is not that cut and dry. Yes, calcium is an important factor, but increasing intake alone will not directly improve bone health.7

800px-500_mg_calcium_supplements_with_vitamin_DJust three weeks ago, the New York Times published an article titled, “Calcium Doesn’t Improve Bone Density, Analysis Finds”. This surprising claim was made by Nicholas Bakalar of the New York Times. He based his claim on two articles published by the British Medical Journal (BMJ) just this summer. The results from articles review made a bold claim that completely defies common household knowledge.  Aside from the fact that the two BMJ articles came to the same conclusion, the two were eerily related. Both were published on the same day (September 29, 2015) and both were associated with the University of Auckland and the University of Otago in New Zealand.

It seems illogical that increasing consumption of a crucial mineral for bone strength would not actually improve bone strength. The apparent paradox lies within biology and culture.9 It is important to realize that one simple dietary change will not affect bone strength. Consuming more calcium means nothing if the body doesn’t absorb it.1,6 Vitamin D increases calcium absorption from the small intestine, into the bloodstream, and finally to the bones. Other factors that positively affect bone health are as follows: weight-bearing exercise, tobacco avoidance, moderate alcohol intake.1

The effectiveness of calcium supplementation on bone mineral density varies according to two factors:  dietary calcium intake and stage of life.8,9 Compared to Western cultures, Asian cultures do not commonly incorporate high-calcium level foods (such as milk, cheese and other dairy products) into the everyday diet.10-12 A study in elderly Thai women found that calcium supplementation of at least 500mg/day for 2 years resulted in noticeable changes in BMD (bone marrow density) at several skeletal study points. The study’s conclusion was this: “Calcium supplementation might be crucial in people who have low calcium intake at baseline”.9 In cases like these, supplementation may be needed, but the first choice is to consume calcium from foods.8

Another important factor that plays a role in the effectiveness of calcium supplementation is the stage in life of the patient, especially if that patient is a woman. Elderly postmenopausal women experience loss of “beneficial effects of estrogen on the stimulation of intestinal calcium absorption and reduction of renal calcium excretion as well as an increase in bone turnover rate.”9 In this case, vitamin D calcium supplementation would actually help to prevent early postmenopausal bone loss.6,9

The human body surely requires at least some calcium, but currently, there is no reliable method to determine an optimal amount of daily calcium intake based on criteria such as age, gender, height, and weight.4 Even in a study where the mean calcium intake was well above the daily recommended amount (1,200mg/day), hip fractures were still evident.4 This seemingly counterintuitive finding begs that further studies explain why meeting or even exceeding a healthy limit will produce a high incidence of hip fractures.

In light of these recent scientific findings, one shouldn’t rely on calcium supplements to prevent BMD complications. Furthermore, patients who currently have osteoporosis or a high risk of fracture should never replace prescription medication with calcium supplementation. Until further evidence surfaces, people of all ages hoping to prevent later development of osteoporosis should continue to strive for a balanced diet containing adequate protein, fruits, vegetables, calcium, and vitamin D.8 Would you still consider taking a calcium supplement for the insignificant increase in bone strength it provides?

References:

  1. National Osteoporosis Foundation. Clinician’s guide to prevention and treatment of osteoporosis. Washington, DC: National Osteoporosis Foundation, 2010;1–56.
  2. Bolland MJ, Leung W, Tai V, et al. Calcium intake and risk of fracture: Systematic review.BMJ. 2015;351. doi: 10.1136/bmj.h4580.
  3. Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: Systematic review and meta-analysis.BMJ. 2015;351. doi: 10.1136/bmj.h4183.
  4. Cho K, Cederholm T, Lökk J. Calcium intake in elderly patients with hip fractures.Food & Nutrition Research. 2008;52:1-5.
  5. Cosman F, de Beur ,S.J., LeBoff MS, et al. Clinician’s guide to prevention and treatment of osteoporosis.Osteoporos Int. 2014;25(10):2359-2381.
  6. Kärkkäinen M, Tuppurainen M, Salovaara K, et al. Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65-71 years: A 3-year randomized population-based trial (OSTPRE-FPS).Osteoporos Int. 2010;21(12):2047-2055.
  7. Kling, Juliana M.Clarke, Bart L.Sandhu,Nicole P. Osteoporosis prevention, screening, and treatment: A review.Journal of Women’s Health (15409996). 2014;23(7):563-572.
  8. Nieves JW. Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D.Osteoporos Int. 2013;24(3):771-786.
  9. Rajatanavin R, Chailurkit L, Saetung S, Thakkinstian A, Nimitphong H. The efficacy of calcium supplementation alone in elderly thai women over a 2-year period: A randomized controlled trial.Osteoporosis Int. 2013;24(11):2871.
  10. Kim HS, Kim JS, Kim NS, Kim JH, Lee BK (2007) Association of vitamin D receptor polymorphism with calcaneal broadband ultrasound attenuation in Korean postmenopausal women with low calcium intake. Br J Nutr 98:878–881
  11. Lau EM, Woo J, Lam V, Hong A (2001) Milk supplementation of the diet of postmenopausal Chinese women on a low calcium intake retards bone loss. J Bone Miner Res 16:1704–1709
  12. 12. Chee WS, Suriah AR, Zaitun Y, Chan SP, Yap SL, Chan YM (2002) Dietary calcium intake in postmenopausal Malaysian women: comparison between the food frequency questionnaire and three-day food records. Asia Pac J Clin Nutr 11:142–146

Darker Isn’t Always Better

Thursday, October 29th, 2015

By: Maame Debrah-Pinamang, PharmD Student

ChocolateFor years, the scientific world has been shouting to the masses about the benefits of eating dark chocolate. The health benefits of dark chocolate have been extensively studied to provide us with the knowledge that habitual consumption of dark chocolate will lead to lower risk of cardiovascular disease, raise your high density lipoprotein levels (good cholesterol), as well as provide antioxidant properties to keep you looking younger, longer.1 Evidence such as this has led people to choose dark chocolate over regular milk chocolate. What if that’s not necessarily the case? Recently, there was an article stating that milk chocolate provides the same benefits of dark chocolate, as well as an increase in research on what the health benefits of dark chocolate come from, and whether the heart benefits that dark chocolate has is present in other types of chocolate.2 Besides color and taste, there is very little difference between dark and milk chocolate. Different companies include different levels of sugar and cocoa powder in their formulations, although the FDA sets standards for what cocoa levels constitute each type of chocolate. In order to be considered milk chocolate, the piece of chocolate must not contain less than 10% chocolate liquor, and at least 12% milk ingredients. For dark chocolate, the required amount of chocolate liquor is greater than or equal to 35%.3

A recent study analyzed the chocolate consumption of over 20,000 people for a period of 11 years, on average. Participants consumed a median of 4.6 grams (about 1.25 individual squares on a standard bar of Hershey’s chocolate) of chocolate per day, and had their cardiovascular health assessed.4 The data used in the first study looked at the effects on HDL and LDL with the participants self-reporting their consumption of chocolate. Participants that consumed a higher amount of chocolate had an increase in cardiovascular health, a lower body mass index (BMI), as well as lower blood pressure. However, the self-reporting of chocolate consumption leads to errors in reporting and inconsistent measurements. The study also failed to report the specific type of chocolate the participants consumed, making it difficult to pinpoint the exact cause of the reduced health risks. In order to produce a more reliable study, the researchers should have produced a specified amount of chocolate to each participant as well as recording the specific kind of chocolate.

Of the more common types of chocolate, dark chocolate is more extensively studied for the benefits that it may provide, but that kind of chocolate may be irrelevant. In a similarly conducted study in Japan, researchers gave participants 13, 19.5, and 26 grams of chocolate per day.5 Similar to the first study, those who ate more chocolate saw a greater increase in cardiovascular health. Those who ate at least 13 grams of chocolate per day found approximately 3.23 mmol/L decrease in LDL cholesterol. Some limitations of the study was that the study participants were given cocoa powder, which is not readily available to most people, as well as the cocoa powder being added to hot water, and not taken as a piece of chocolate that is easily available to all people.

In order to gain all the heart benefits of chocolate, each person should attempt to get approximately 1.5 grams of chocolate per day. Although a consistent consumption of chocolate could provide an increase in heart health, the benefits may not apply to everyone. Different health conditions may not allow for self-care with chocolate consumption. Given the results of the research, it is inconclusive that the impact of dark chocolate on heart health is greater than milk chocolate. The studies performed in the articles allow a safe assumption that either kind of chocolate would provide the same benefits.  The health benefits stemming from cocoa powder and not from the color of the chocolate allow for a greater range of chocolate that will provide heart healthy benefits. The recommended daily amount of chocolate from The Cleveland Clinic Wellness is 1.5 to 3 ounces to ensure maximum heart benefits from chocolate (Godiva sells chocolate in 1.5 ounce size).6 The small amount of chocolate provides us with right correct amount of chocolate to ensure heart health, without the excess sugar that comes with eating too much chocolate. Although it is important to take self-care measures to reduce your risk of heart disease, do not rely solely on chocolate as your cardiologist. Before beginning any self-care regimens, contact your primary care provider to ensure that the measures you are starting are safe and the best options for your needs.

 

References

  1. Kwok, C. S. et al. Habitual Chocolate Consumption and Risk of Cardiovascular Disease Among Healthy Men and Women. British Medical Journal. 2015.
  2. Wanjek, Christopher. “Even Milk Chocolate is Good for you, According to new Study” Huffington Post. June 16, 2015. Accessed October 14, 2015.
  3. Hershey’s. Types of Chocolate. Available at: http://web.archive.org/web/20090126124820/http://hersheys.com/nutrition/chocolate.asp Accessed October 28, 2015.
  4. Smit, H. J., Gaffan, E. A., Rogers, P.J. Methylxanthines are the psycho-o Kondo. pharmacologically active constituents of chocolate. 2004; (176)3-4:412-19.
  5. Baba, S, et al. Plasma LDL and HDL Cholesterol and Oxidized LDL Concentrations Are Altered in Normo- and Hypercholesterolemic Humans after Intake of Different Levels of Cocoa Powder. The Journal of Nutrition. 2007;137(6): 1436-1441.
  6. Cleveland Clinic Wellness. Eating Chocolate can be Healthy. Available at: http://www.clevelandclinicwellness.com/Promos/Pages/Chocolate.aspx#. Accessed October 28, 2015.

Sugar and Spice

Wednesday, October 28th, 2015

By: Micah Bernard800px-Ground_cinnamon

Cinnamon. What comes to mind when you hear that word? Cinnamon buns, cinnamon glazed apples, snickerdoodles? It’s no secret that cinnamon and sugar are a great pair! But is there more to the relationship between sugar and cinnamon than just the great taste?

People with pre­diabetes or type 2 diabetes must be very careful to manage blood sugar levels. This can be achieved by following a special diet, losing weight, exercising, and taking medications such as metformin. Now there is a common spice that is being investigated as a supplement to help control blood sugar. In 2013, NPR published an article stating that cinnamon can help lower blood sugar.1 But is this claim backed up by science? Researchers in the last few years have been studying the impact of cinnamon on the management of blood sugar and have had promising results.
In 2003, researchers sought to determine if cinnamon could improve blood glucose levels in people with type 2 diabetes.2 In this study of 60 people with type 2 diabetes ranging in age from 45 to 58, subjects took either a placebo or one of three amounts of cinnamon: 1, 3, or 6 grams each day. After 40 days, the results showed that cinnamon in any of the three doses helps lower blood glucose levels 18­-29%, while no significant changes were reported in the placebo groups.

Another study in 2006 of 79 diabetic patients looked at whether cinnamon extract helps improve glycemic control in patients with type 2 diabetes.3 Each person either received a capsule of 3 grams of cinnamon or a placebo three times a day for 4 months. The results showed that the reduction in fasting blood glucose levels in the patients receiving cinnamon (10.3%), was significantly greater than in the control group, who had a reduction of only 3.4%. However, no significant differences were seen in hemoglobin A1c, which is an indicator of average blood sugar levels over the past three months.

A recent study that ran statistical tests on data from ten randomized controlled trials studying cinnamon’s effect on blood glucose found that cinnamon decreased fasting blood glucose levels by 24.59 mg/dl.4 There was no significant difference in the patients’ hemoglobin A1c. The study was unable to determine what the optimal dose of cinnamon or duration of treatment; this is an area where further research is needed.

How does cinnamon do it? Researchers do not fully know how cinnamon works, but they believe it may increase the body’s levels of and sensitivity to insulin, the hormone that helps your cells take sugar out of the blood stream, thereby lowering blood sugar levels.5 In addition, cinnamon may slow the emptying of the stomach, so there is less of a spike of sugar in the bloodstream.6 There is debate among researchers about what dose of cinnamon should be used to manage blood sugar.

As with any supplement, it is important to check with your doctor before adding cinnamon to your diet. If, after talking to your doctor, you decide to see if cinnamon works for you, it is important to choose the right kind of cinnamon. Cinnamon comes in two varieties, Cassia and Ceylon. Cassia is the more common type found in many supermarkets, however in higher doses, such as those used to control blood sugar, coumarin isolates (not to be confused with the blood thinner Coumadin) found in cinnamon can cause liver damage.1 The Ceylon variety of cinnamon has only trace amounts coumarin isolates, making it safer for the liver.7 So, if you plan to supplement your blood sugar management with cinnamon, ask a pharmacist to help you correctly select the Ceylon variety.

While researchers still do not fully agree on the effectiveness of cinnamon as a supplement for controlling blood sugar in type 2 diabetics and pre­diabetics, many recent studies show promising results. The effects of cinnamon may not be enough to replace a drug intended to control blood sugar, but those with pre­diabetes or diabetes may find it a useful supplement to help manage their condition.

What are your thoughts on using a natural supplement to manage a health condition?

Sources:

1. Aubrey A. Cinnamon Can Help Lower Blood Sugar, But One Variety May Be Best. NPR 2013. Accessed October 15, 2015.
2. Khan A, Safdar M, Ali khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. 2003;26(12):3215­8.
3. Mang B, Wolters M, Schmitt B, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 2006;36(5):340­4.
4. Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta­analysis. Ann Fam Med. 2013;11(5):452­9.
5. Kaiser C. Cinnamon’s Effect in Diabetes Uncertain. Cinnamon’s Ef ect in Diabetes Uncertain 2013. Accessed 2015.
6. Hlebowicz J, Darwiche G, Björgell O, Almér LO. Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr. 2007;85(6):1552­6.
7. Johannes L. Little Bit of Spice for Health, but Which One? WSJ 2013. Accessed 2015.

A Natural Approach to Preventing Gestational Diabetes

Monday, October 26th, 2015
image courtesy of freedigitalphotos.net

By Katie Woodward, PharmD Student

You are having a new baby! Congratulations! You’ve probably already had several opportunities to answer that age-old question, “What gender are you hoping for?” And it is likely you responded with something like, “I don’t care as long as my baby is healthy!” Thanks to new scientific research, your chances of delivering a healthy baby are constantly improving.

We are going to play a quick game of “Bad News/Good News.” The bad news: gestational diabetes may cause complications in your pregnancy. Several factors may put you at risk of developing gestational diabetes. If diabetes runs in your family, if you are overweight, not very active, or over the age of 40 you are at risk of developing gestational diabetes.1 Gestational diabetes can cause jaundice, high birth weight, trauma during birth, increase necessity for C-section, and increase likelihood of obesity or diabetes in the child.1,2 Gestational diabetes also puts a new mother at risk of developing Type 2 Diabetes, which can require insulin injections and other treatments to control.

Now, for the good news: new research has demonstrated that myo-inositol is a supplement you can take which significantly decreases your chances of developing gestational diabetes, even if you are at high-risk.3 For those already diagnosed with gestational diabetes, taking a myo-inositol supplement can help decrease your need for insulin, make you more likely to carry the baby to term, and decrease your infant’s chances of developing hypoglycemia.3 Standard treatment for gestational diabetes requires the patient to check blood sugar levels in the morning and after meals, which can require several needle sticks per day as well as the purchase of a glucometer, test strips, and lancets.4 Insulin injections are also used to help control the blood sugar in up to 20% of women with gestational diabetes.4

A research study published in the Journal of Maternal-Fetal and Neonatal Medicine was designed as a prospective, double-blind, randomized controlled clinical trial which compared a placebo group to a group of mothers who supplemented with myo-inositol twice daily.3 The myo-inositol group had significantly better outcomes including lower maternal BMI, longer gestation at the time of delivery, and decreased abnormal oral glucose tolerance test results. The oral glucose tolerance test is the standard screening measure for gestational diabetes.  One limitation was that the study was relatively small. Some of the data may have been statistically significant if there had been more women involved in the study; for instance, the myo-inositol group had a lower incidence of neonatal hypoglycemia, but the data was not quite strong enough to be statistically significant. Another interesting statistic is that 21% of women in the placebo group required insulin therapy, while only 3% of women in the myo-inositol group required insulin therapy. While larger studies may be needed to validate this data, this study demonstrated that at least 50% of women who take myo-inositol may benefit from the treatment.3 Since the current standard of care for prevention of gestation diabetes is diet change and monitoring blood sugar, myo-inositol may be an easy and beneficial way to minimize complications from gestational diabetes.  It also has a promising potential to minimize the requirement of insulin injections.

Since it is a compound naturally found in both your body and your baby’s body, you can safely consume myo-inositol supplements.5 The product may be a little bit difficult to find in grocery stores, but it can be found in combination products or ordered online. According to research, the supplement is best if taken 2000 mg twice daily (make sure you separate the doses by at least six hours.)One product can be purchased from Fairhaven Health6 where you can get a 60-day supply for less than $20.* Myo-inositol is often combined with another compound called D-chiro inositol, which has also been demonstrated to assist with gestational diabetes.7 The combination product is called Ovasitol and it can be purchased online from Theralogix Nutritional Science Company, but it must be ordered online and can cost up to $1 per day ($90 for a 90 day supply.)8 Another product to consider is called Sensitol, and it contains D-chrio inositol, myo-inositol, and alpha lipoic acid. The product can be ordered online and a thirty day supply is $52.9

Gestational diabetes can have some scary consequences for you and your baby. Based on the evidence, I would recommend that any mother who has increased risk of gestational diabetes should discuss supplementation with myo-inositol with their medical provider.   It could help prevent or minimize problems associated with gestational diabetes. Myo-inositol may be expensive and may not be easily accessible to all; since it is commonly used as a preventative supplement, do you think that pregnant women at high risk for developing gestational diabetes should consider it as an option?

*The manufacturer suggests that the drug be taken four times daily, but in studies, the 2000 mg dose was only recommended twice daily.3 Also, this will help decrease the cost of the drug.

**Note: The Cochrane Collaboration is working on a new study to further describe the dosing and efficacy of myo-inositol as a treatment/ prevention method for gestational diabetes and it should be released soon.

References

  1. Available at: http://www.cdc.gov/diabetes/pdfs/library/diabetesreportcard2014. Accessed October 14, 2015.
  2. Brown J. Myo-inositol for preventing gestational diabetes. Cochrane Database Of Systematic Reviews [serial online]. February 2, 2015;(2)Available from: Cochrane Database of Systematic Reviews, Ipswich, MA. Accessed October 11, 2015.
  3. Matarrelli B, Vitacolonna E, Celentano C, et al. Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. The Journal Of Maternal-Fetal & Neonatal Medicine: The Official Journal Of The European Association Of Perinatal Medicine, The Federation Of Asia And Oceania Perinatal Societies, The International Society Of Perinatal Obstetricians [serial online]. July 2013;26(10):967-972. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed October 11, 2015
  4. Available at: http://www.mayoclinic.org/diseases-conditions/gestational-diabetes/basics/treatment/con-20014854. Accessed October 21, 2015.
  5. D’Anna R, Scilipoti A, Di Benedetto A, et al. myo-Inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care [serial online]. April 2013;36(4):854-857. Available from: MEDLINE, Ipswich, MA. Accessed October 11, 2015.
  6. Available at: http://www.fairhavenhealth.com/myo-inositol.html?cmp=bing&kw=myo-inositol&utm_source=BingShopping&utm_medium=CSE&utm_campaign=myo-inositol. Accessed October 14, 2015.
  7. Costantino D, Guaraldi C. [Role of D-chiro-inositol in glucidic metabolism alterations during pregnancy]. Minerva Ginecol. 2014;66(3):281-91.
  8. Available at: http://www.theralogix.com/index.cfm?fa=products.ovasitol.default&dvsn=reprohealth. Accessed October 14, 2015.
  9. Available at: http://catalog.designsforhealth.com/Sensitol?quantity=1. Accessed October 21, 2015.

Magnesium and physical activity – does it make a difference?

Monday, December 1st, 2014

By Matthew Johnson, Pharm.D. Student.

Magnesium is a mineral involved in many bodily functions such as muscle and nerve regulation, blood sugar control, energy production, and the making of proteins.Recommended Dietary Allowance (RDA) is the average daily amount needed to meet the body’s needs of a dietary substance for most healthy people.The RDA for magnesium varies by age and gender. For women 19-30 years old it is 310 mg (men 400 mg). For women aged 31 years and older the value is 320 mg (420 mg for males). A deficiency of magnesium can result in seizures, abnormal heart rhythms, low blood calcium and potassium levels, and muscle contractions/cramps. Furthermore, magnesium deficiency has been linked to both lower physical activity and exercise ability.2  This is even more important for the elderly population because of the impact the aging process has on physical activity.Specifically, the aging population is at greater risk for magnesium deficiency than young people due to low dietary intake, reduced absorption, and a greater amount excreted in stools and urine. It is important to note, however, that excessive magnesium intake from supplements may cause diarrhea, abdominal pain, and/or cramping. Furthermore, intake of amounts greater than 5000mg per day can lead to magnesium toxicity and death. 4

The current standard of care for improving physical activity is sufficient aerobic and muscle-strengthening activities.5  The Center for Disease Control and Prevention recommends for adults 65 years and older to do muscle-strengthening activities that work all of the major groups of muscles (hips, back, shoulders, arms, legs, chest and abdomen) on two or more days per week. Muscle-strengthening activities include lifting weights, resistance band usage, push-ups, sit-ups, yoga, and gardening activities such as digging or shoveling. The CDC also recommends that all adults 18 years and older get either 5 hours of moderate-intensity aerobic activity or 2 hours and 30 minutes of vigorous-intensity aerobic activity. Moderate activity is a 5 or 6 on a 10-point scale in which 0 is defined as sitting and 10 is full effort activity. Vigorous activity is a 7 or 8 on this same scale.

A study recently published in the American Journal of Clinical Nutrition looked at the effects of oral magnesium supplementation on physical performance.3  This study only involved healthy elderly women that were involved in a weekly exercise program. There were two groups of healthy women in the study: one group received oral magnesium supplements of 900mg magnesium oxide/day for 12 weeks while the second group did not receive supplements or any other differences in treatment. The purpose of the study was to see if magnesium supplementation would improve physical performance. Short Physical Performance Battery (SPPB) tests were used in part to examine physical performance. A SPPB test involves checking lower limb activities such as walking and balance. The study found better physical performance in the group taking the magnesium supplements. There were no harmful effects seen in either of the groups. One major factor that limited the results of the study was that it only included healthy elderly women that exercised and so the same results may or may not occur in populations such as adolescents, men, or people that do not exercise. A different study published earlier this year in the Journal of Sports Sciences supports the findings that magnesium supplementation can improve physical performance.6

For individuals seeking to improve physical activity, it appears that magnesium supplements in the appropriate RDA range can be taken to boost physical activity performance.  Have you tried magnesium supplements before? If so, what form did you take and did you notice any differences after taking them?

Sources:

  1. S. Department of Health & Human Services, Nation Institutes of Health, Office of Dietary Supplements. Magnesium Fact Sheet for Health Professionals. http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ Reviewed November 04, 2013. Accessed October 2014.
  2. Lukaski HC. Magnesium, zinc, and chromium nutriture and physical activity. Am J Clin Nutr. 2000;72(suppl):585S–93S.
  3. Nicola V, Berton L, Carraro S, et al. Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program:a randomized controlled trial. Am J Clin Nutr. 2014; 100: 974-981.
  4. Kutsal E, Aydemir C, Eldes N, et al. Severe hypermagnesemia as a result of excessive cathartic ingestion in a child without renal failure. Pediatr Emerg Care. 2007;23:570-572.
  5. Center for Disease Control and Prevention. Physical activity: How much physical activity do older adults needs? http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html. Updated June 17, 2014. Accessed November 2, 2014.
  6. Setaro L, Santos-Silva P, Colli C, et al. Magnesium status and the physical performance of volleyball players: effects of magnesium supplementation. Journal Of Sports Sciences[serial online]. March 2014;32(5):438-445. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 12, 2014.

Melting Away the Pounds: The Cold Facts

Monday, November 17th, 2014

By: Sara Hill, PharmD Student

As the holidays rapidly approach, more and more people start to think about losing weight for their family functions or maintaining their current weight throughout a food-laden season. However, despite the urge to snap up the first weight loss supplement that we hear advertised, we have to remember the importance of evaluating each product to decide if it is our best option. One supplement that fits that description is Garcinia cambogia, a growingly popular herbal supplement that Dr. Oz and others believe to be a good choice to help us lose weight.

In June, a journal called Phytotherapy Research published a study that researched Garcinia cambogia to determine how effective it truly is. (In case you are wondering, phytotherapy is the use of plants and plant products for medicinal purposes.) The researchers wanted to see if Garcinia cambogia made a difference in several health values, including weight, body mass index (BMI), waist-hip ratio, and percentage of fat mass in the body. The study involved two groups of women whose BMI values were greater than 25 (BMI >25 is considered obese). The first group of women was given Garcinia cambogia for 60 days and put on a diet that reduced their calorie intake. The second group of women was given a placebo and put on a diet that reduced their calorie intake in the same way as the first group of women. After 60 days, the researchers compared the health values of the women who had taken the supplement and those who hadn’t. Although the study identified that G. cambogia helped to lower the women’s triglycerides (a cholesterol marker), the weight, BMI, waist-hip ratio, and percentage of fat mass was not significantly different between the two groups of women.1 Although the study provided useful information, it did not account for ways that different groups of people gain and lose weight. Men and women gain weight differently, as do young people and elderly people. Furthermore, the study only accounts for the lifestyle and diet of a particular geographic location. The diet the researchers chose may not be reasonable for women (or men) in other parts of the world.

This study only contributes to a growing collection of studies examining Garcinia cambogia. Several studies have been conducted on the benefits of taking G. cambogia, but they do not always come to the same conclusion. Studies published in the late 90’s found that G. cambogia did not cause significant weight loss.2 However, studies from 2000 and 2004 shows that G. cambogia actually does lead to weight loss.2

Our decision to take or not to take Garcinia cambogia involves several things. First, we have to know that G. camgobia has not been proven save, although no studies have seen any harmful effects­­3. However, G. cambogia has been on the market before as a part of other weight loss supplements that caused safety concerns. It was one of the key ingredients in several versions of Hydroxycut that were removed from the market because of safety concerns. Furthermore, multiple cases of liver damage have led to concerns that G. cambogia is poisonous to the liver. Yet another case reported that G. cambogia interacts with some prescription medications (like antidepressants) and causes harmful levels of certain compounds in the body. Finally, we must remember that no one has conducted an extensive safety study on G. cambogia to identify the risks that go along with taking it. Without being fully aware how likely we are to be harmed, we cannot compare the risks and benefits and therefore make a fully educated decision.

Second, we have to know if G. cambogia is effective. As we have already discussed, the studies that tested how effective the supplement is do not agree with each other. One possible explanation suggests that some forms of G. cambogia work better because your body can absorb it better than the other forms. When more of the supplement makes it into your body, it can actually have its full effect. The scientists who proposed this reasoning recommend looking for bottles that list G. cambogia in the potassium and calcium salt forms instead of simply one or the other, or a completely different salt altogether. (Please note that the term “salt” here does not refer to standard table salt but to the chemical structure that allows the compound to get into your body. You should look for a product like this one that lists calcium and potassium as the salt forms.) The scientists who evaluated the calcium/potassium form of G. cambogia found positive results, indicating that G. cambogia does lead to significant weight loss.

Finally, our decision to take G. cambogia should include a comparison to standard weight loss methods. Our primary study compared women taking G. cambogia to women not taking it, but both groups of women decreased the number of calories in their diet, and both groups of women lost weight. The standard weight loss methods of diet and exercise should always be our first approach (although they are certainly difficult to accomplish during the holidays). By focusing on eating healthier foods (fewer fatty and fried foods, fewer carbs, and less sugar) in appropriate quantities and spending more time being physically active, you may find that additional weight loss techniques are no longer needed. Supplements like G. cambogia should only become an option once you’ve tried these other weight loss techniques and should be used carefully to meet your specific physical needs.

Because weight loss is often such a pressing concern, we are usually tempted to choose what seems to be the easiest, fastest option. However, due to the concerns presented above, G. cambogia does not seem like the best option. Until further tests examine the safety of the supplement as well as the effectiveness of the particular salt forms, you are probably better off staying away from it.

But what do you think? Would you feel comfortable taking Garcinia cambogia to supplement your weight loss efforts? Would you expect it to be effective?

Works Cited:

  1. Vasques, C.A.R.; Schneider, R.; Klein-Junior, L.C.; Falavigna, A.; Piazza, I.; Rossetto, S. Hypolipemic Effect of Garcinia cambogia in Obese Women. Phytotherapy Research. 2014;28(6):887-891.
  1. Downs, B.W.; Bagchi, M.; Subbaraju, G.V.; Shara, M.A.; Preuss, H.G.; Bagchi, D. Bioefficacy of a novel calcium-potassium salt of (-)-hydroxycitric acid. Mutat Res 2005;579: 149-162.
  1. Chuah, L.O.; Yeap, S.K.; Ho, W.Y; Beh, B.K.; Alitheen, N.B. In Vitro and In Vivo Toxicity of Garcinia or Hydroxycitric Acid: A Review. Evidence-Based Complementary and Alternative Medicine. 2012;1155(10) 12 pages.

Revealing the “Dark” Side of Chocolate

Friday, November 14th, 2014

By: Ruth Choi, PharmD Student

 

For centuries, cocoa has been consumed for its pleasurable taste as well as for its health benefits. Today, research attempts to explain how cocoa may be beneficial to our overall health, specifically cardiovascular health. Chocolate- Guilty Pleasure or Healthy Supplement is a review paper that was recently published in The Journal of Clinical Hypertension. In the paper, Latham et al discuss major studies done with cocoa to determine how cocoa acts in the body to produce cardiovascular benefits and whether it can be consumed as a dietary supplement.

The unique diet and health of the Kuna Indians initially sparked research on dark chocolate consumption and cardiovascular health. From the San Blas Islands of Panama, Kuna Indians consume about four 8-ounce cups of unprocessed cocoa drinks per day and have exceptionally low rates of hypertension and cardiovascular disease (CVD) even to old age.1 For instance, the mean blood pressure (BP) was 110/70 mm Hg in the elderly over 65 years.1 Cocoa comes from the Theobroma cacao tree, and a major component of it is flavanol. One of the proposed mechanisms is flavanols are responsible for improving blood flow by stimulating the endothelium of blood vessels to produce more nitric oxide (NO) and increase vasodilation.1 Improving blood flow subsequently reduces CVD risk factors such as hypertension, platelet dysfunction, insulin resistance, and hypercholesterolemia.1. Heiss et al researched the effects of cocoa intake in smokers and found that drinking cocoa high in flavanols (176-185 mg) increased NO levels and reversed endothelial dysfunction.2 One way the body naturally produces NO is through insulin stimulation. Insulin resistance occurs in individuals who do not respond to insulin’s action on blood vessels to produce NO. In a study done by Grassi et al, flavanol-rich dark chocolate proved to decrease BP and insulin resistance and improved blood flow in hypertensive patients.3

Cholesterol also plays a significant role in cardiovascular health. Dark chocolate is thought to increase HDL-C levels, which is the good cholesterol. In a 3-week study done on healthy subjects, Mursu et al found that consuming either 75 g of dark chocolate or flavanol-rich dark chocolate daily increased HDL-C levels by 11.4% and 13.7%, respectively.4 On the contrary, some studies will argue that it is actually theobromines in cocoa that help increase HDL-C levels.1 Further research is needed to determine whether flavanols or theobromines increase HDL-C levels.

Many recent studies show the benefits of cocoa intake on cardiovascular health. Due to its delectable taste, relative safety, and low cost, cocoa-rich dark chocolate is being considered as a health supplement. Major hindrances to its use, however, are the caloric intake and limitations of many of the studies.1 Due to its high caloric, saturated fat, and sugar content, chocolate needs to be consumed with caution, especially in obese patients. Though less palatable, people could consume cocoa-based products with less sugar or saturated fat. Latham et al explain the limitations that are apparent in all of the studies that were reviewed.1 One of the major limitations is the variability in flavanol content in all the studies making it difficult to interpret and compare the results. It also hinders making effective dosage recommendations for patients. Another limitation is the small sample sizes in all the studies making it difficult to generalize the results to a larger, more diverse population. The short duration of the studies is another limitation because it is unknown whether cocoa intake would produce these same results if given long term. Therefore, further research is needed until we can recommend dark chocolate as a health supplement. Nonetheless, one thing you can take away from the research is that you don’t have to feel guilty anymore about eating ‘healthy’ dark chocolate in moderation as part of your dietary lifestyle changes to prevent and treat CVD risk factors.

The Dietary Approaches to Stop Hypertension (DASH) diet recommended by the National Heart, Lung, and Blood institute (NHLBI) consists of eating a diet rich in fruits, vegetables, and low-fat dairy products to improve BP.5 Many supplements also exist that have been significantly proven to have antihypertensive effects. What sounds better, chocolate or veggies?

References:

 

  1. Latham L, Hensen Z, Minor D. Chocolate—Guilty pleasure or healthy supplement? JCH. 2014;16(2): 101. http://onlinelibrary.wiley.com/doi/10.1111/jch.12223/full. Published February 2014. Accessed October 29, 2014.

 

  1. Heiss C, Dejam A, Kleinbongard P, Schewe T, Sies H, Kelm M. Vascular effects of cocoa rich in flavan-3-ols. JAMA. 2003;290(8): 1030. http://jama.jamanetwork.com/article.aspx ?arti cleid=197170. Published August 27, 2003. Accessed October 29, 2014.

 

  1. Grassi D, Necozione S, Lippi C, et al. Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives. HYP. 2005:46(2): 398. http://hyper.ah ajournals.org/content/46/2/398.full.pdf+html. Published July 18, 2005. Accessed October 29, 2014.

 

  1. Mursu J, Voutilainen S, Nurmi T, et al. Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. FRBM. 2004:37(9): 1351. http://www.sciencedirect.com/science/ article/pii/S0891584904004551. Published November 1, 2004. Accessed October 29, 2014.
  2. What Is the DASH Eating Plan? National Heart, Lung, and Blood Institute. Available from: http://www.nhlbi.nih.gov/health/health-topics/topics/dash/

 

 

Can You Drink Your Way to Good Health?

Friday, November 14th, 2014

by Rachel Wilcox, PharmD student

Red wine is often thought to be a good source of antioxidants and is associated with heart health.1 Resveratrol is an antioxidant found in a variety of sources, including red wine, nuts, berries and dark chocolate.2 Antioxidants are believed to be important in either preventing or reducing heart disease, cancer, the effects of aging and increasing the body’s resistance to stress.3,4 Resveratrol acts to rid the body of harmful toxins and some evidence shows that resveratrol may play a role in slowing progression of cancer.2 One current popular antioxidant is Vitamin C, which is found in orange juice and has a daily-recommended intake of 90mg for adult males and 75mg for adult females.5 Although evidence of resveratrol’s benefits may not be as concrete as Vitamin C, resveratrol is gaining popularity in the public eye. In fact, some consumers in the US are going beyond just drinking wine for the supposed benefits of resveratrol and are spending about $30 million dollars each year on resveratrol supplements.1,6 A major problem concerning resveratrol is that there is no FDA approved recommendation for daily intake and current studies provide conflicting evidence about the benefits of this antioxidant.7

A recent article from CNN cites an observational study that investigated the effects of resveratrol on health outcomes such as heart disease, inflammation, cancer and mortality in 783 patients who were 65 years of age or older. 1,6 This study found that resveratrol in red wine was not associated with anti-cancer properties, reducing inflammation or improving heart disease.6 The researchers did note that a limitation of their study was in their sample size. Increasing the amount of patients studied might allow the researchers to find an association between resveratrol and health outcomes.6

There is conflicting evidence for the benefits of resveratrol. Some scientific studies found that resveratrol improved health outcomes while other studies found no benefit. One study looked at the relationship between resveratrol and its effect on protecting a second heart attack in humans. The study describes that resveratrol did thin the blood, which is important for prevention of secondary heart attacks.3 Resveratrol also possesses anti-cancer properties but this study only looked at resveratrol effects in rats and mice.2 On the other hand, several studies show that resveratrol does not live up to the hype. One study showed that resveratrol was only responsible for about less than 5% of the antioxidant activity in wine.4 In fact, their research shows that there was no significant difference in terms of antioxidant benefit between red wine and wine with 10 times the amount of resveratrol added.4 This information brings up an important question. If wine consumption may not provide enough resveratrol to see benefits, should resveratrol supplements be recommended instead? The bottom line answer is probably not. A recent publication from Harvard Medical School explains some of the concerns with resveratrol supplements. One major concern is that there is no safe and effective dose established for these supplements.7 Long-term safety is also an issue since studies have not evaluated what effects resveratrol has on the human body over time.7

Since there is so much conflicting evidence about the benefits of resveratrol and whether moderate portions of wine will even provide the needed amount of resveratrol, I would not recommend drinking wine solely for antioxidant effects of resveratrol. It is also important to weigh the potential benefits of drinking alcohol against any negative consequences. The U.S. health department guidelines strongly recommend that women do not consume more than 1 alcoholic drink per day, and that men consume no more than 2 alcoholic drinks a day.8 Overconsumption of wine and other alcohol can cause liver damage as lead to other serious health issues. Remembering to consume alcohol responsibly and within the recommended guidelines is important to reduce the chances of negative consequences. While alcohol consumption does have drawbacks, it is important to note wine contains many other antioxidants that may be beneficial. I encourage wine enthusiasts and other curious individuals to do more research on different types of antioxidants wine provides and the associated health benefits. One study did find that the health benefits of wine were attributed to many different antioxidant compounds rather than a single compound.4 I also do not recommend taking resveratrol supplements because there may be more effective products on the market with stronger scientific evidence to support the use, such as Vitamin C. What do you think, would you consider taking a resveratrol supplement? What antioxidant supplements have you tried and why?

References

  1. Hudson W. Antioxidant in red wine has no benefit at low doses. CNN. http://thechart.blogs.cnn.com/2014/05/12/antioxidant-in-red-wine-has-no-benefit-at-low-doses/. Accessed October 1, 2014.
  1. Murtaza G, Latif U, Najam-Ul-Haq M, et al. Resveratrol: An active natural compound in red wines for health. Journal of Food & Drug Analysis. 2013;21(1):1-12. Accessed October 2, 2014
  1. Das DK, Mukherjee S, Ray D. Resveratrol and red wine, healthy heart and longevity. Heart Fail Rev. 2010;15(5):467-477. Accessed October 1, 2014.
  1. Xiang LM, Xiao LY, Wang YH, Li HF, Huang ZB, He XJ. Health benefits of wine: Don’t expect resveratrol too much. Food Chem. 2014;156:258-263. Accessed October 2, 2014
  1. Office of Dietary Supplements. Vitamin C. National Institute of Health. http://ods.od.nih.gov/factsheets/VitaminC-Consumer. Updated June 24, 2011. Accessed October 21, 2014.
  1. Semba R, Ferrucci L, Andres-Lacueva C, et al. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Internal Medicine [serial online]. July 2014;174(7):1077-1084. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed October 1, 2014.
  1. Can drinking wine really promote longevity? recent evidence shows the antioxidant resveratrol in wine does not offer a health boost. Harv Health Lett. 2014;39(11):5-5. Accessed October 2, 2014.
  2. Center for Disease Control and Prevention. Alcohol and Public Health. Center for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm#standDrink. Updated March 14, 2014. Accessed November 9, 2014.

 

Tried everything for your headache?

Wednesday, November 5th, 2014

By Neal Fox, PharmD Student

One problem with treating headaches is that we don’t know exactly how they happen. Therefore, it is hard to know how to keep them from happening or even stop them once they start. When people have to deal with a headache on their own, they go to the pharmacy and buy something. They can take acetaminophen, ibuprofen, naproxen, or aspirin, which can potentially cause side effects if used too much. These drugs can also upset the stomach. For worse headaches prescription drugs are used, many of which have bad side effects and can be expensive. Melatonin can prevent and treat different types of headaches with few side effects and low cost.1,2 People who often get migraine headaches tend to not have enough melatonin inside of them.3 To fix this, melatonin can be taken as a pill.

A paper from India in September 2014, titled “Melatonin: functions and ligands”, detailed much about melatonin and all of the possible medical uses for it. Melatonin is created by the pineal gland, a part of the brain. Melatonin is related to sleep and it has been used to help people sleep better. There are many other things that melatonin can help with such as swelling, pain, and free radicals. This means that it could be involved in treating more diseases in the future.2 Right now, there is good evidence to support the use of melatonin for headaches. Using melatonin is very different from what Americas normally do. We use medications with unpleasant side effects that often work only in 50% of people who take them.4 Due to the research on melatonin being performed overseas, its benefits may not be well-known in America.

Around the world, scientists are looking at melatonin and headaches, and there are many studies supporting the use of melatonin in migraines as well.3 In a recent article from Turkey by researchers Karadas and Odabasi, 23 people were given 3 mg of melatonin before bed. This study found that, when taking melatonin, people had migraines less often. Plus, the migraines that they did have, hurt less. Because of this, the people taking melatonin needed to use other drugs less.5 Miano et al. found that melatonin 3 mg at bedtime was effective in reducing headache attacks in 22 children ages 6-16. However, 7 of the children reported no improvement.6 Melatonin has been used in other kinds of headaches, such as cluster headache. Cluster headache is a type of headache with really bad pain on one side of the head for a short time. This type also tends to mess up the body’s internal clock in different ways. Leone et al found that 10 mg of melatonin worked very well for half of people but another study by Pringsheim et al used only 2 mg and did not see any benefit.1,7 Finally, another type of headache called hemicrania continua (HC) is normally treated with a drug called Indomethacin, which has side effects including headache. HC is a type of headache that lasts for a long time and is usually on one-side of the head but not very bad. However, at times this headache can become much worse and the severe pain can last for hours or days.  Melatonin has been used to help people with HC and has been very successful.8,9 Finally, a Dutch group treating sleep patients found that 78.6% of them had a decrease in headaches with melatonin. However, 13.8% of patients who didn’t have headaches before, got them while on melatonin.10

We don’t know exactly how melatonin works for headache. A possibility suggested by some experts is all about the internal sleep clock that we have and melatonin’s effect on that. The research that has been done so far shows good things about melatonin. We know that it is highly safe and inexpensive. The only reported side effects of melatonin are that it can make people really sleepy and might cause headaches in some people with sleep disorders.10 If you think melatonin may be beneficial to you, talk with your doctor and make an informed decision together. Melatonin may not work for everyone, because of the complexity of headaches and the different kinds. But if it could work, is it worth it to try?

Kaitie’s Story

Since I was thirteen, I used to get terrible headaches 3-5 times a week. I started taking melatonin (3 mg before bed) in April of 2013 and have only had about 10 major headaches since then (currently October 2014). The main issue I have had with taking melatonin regularly is that it can be more difficult to get out of bed due to drowsiness; but this usually subsides within 30 minutes of actually getting up. I would definitely recommend trying melatonin for prevention of frequent headaches.

Have you tried everything for your headache? Are you willing to try melatonin?

 

References:

  1. Pringsheim T, Magnoux E, Dobson CF, Hamel E, Aubé M. Melatonin as adjunctive therapy in the prophylaxis of cluster headache: A pilot study. Headache. 2002;42(8):787-792.
  2. Singh M, Jadhav HR. Melatonin: Functions and ligands. Drug Discov Today. 2014;19(9):1410-1418.
  3. Vogler B, Rapoport AM, Tepper SJ, Sheftell F, Bigal ME. Role of melatonin in the pathophysiology of migraine: Implications for treatment. CNS Drugs. 2006;20(5):343.
  4. Peres M, Masruha M, Rapoport A. Melatonin therapy for headache disorders. Drug Development Research (USA). 2007;68:329-334.
  5. KARADAS Ö, ODABASI Z. Migrende melatonin proflaksisinin etkinligine yönelik açik uçlu klinik çalisma: Ön rapor. Archives of Neuropsychiatry / Noropsikiatri Arsivi. 2012;49(1):44-47.
  6. Miano S, Parisi P, Pelliccia A, Luchetti A, Paolino MC, Villa MP. Melatonin to prevent migraine or tension-type headache in children. Neurol Sci. 2008;29(4):285-287.
  7. Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G. Melatonin versus placebo in the prophylaxis of cluster headache: A double-blind pilot study with parallel groups. Cephalalgia. 1996;16(7):494-496.
  8. Hollingworth M, Young T, M. Melatonin responsive hemicrania continua in which indomethacin was associated with contralateral headache. Headache. 2014;54(5):916-919.
  9. Rozen TD. Melatonin responsive hemicrania continua. Headache. 2006;46(7):1203-1204.
  10. Rovers J, Smits M, Duffy JF. Headache and sleep: Also assess circadian rhythm sleep disorders. Headache. 2014;54(1):175-177.

Can Ginger Cure Rheumatoid Arthritis?

Tuesday, November 4th, 2014

by R. Brandon Kime, PharmD Candidate

Rheumatoid arthritis is a disease that causes the breakdown of joints throughout the body due to the body’s immune system attacking these tissues. As the joints degrade, they become less able to support and lubricate the bones that they attach. Eventually, the bones can rub together, causing erosion of the bone and possibly deformity of the joint. This entire process results in a considerable amount pain for those affected, as well as difficulties in day-to-day functioning. Unlike other types of arthritis, rheumatoid arthritis can occur in people of all ages. Rheumatoid arthritis is usually treated by prescription drugs that decrease inflammation or decrease immune system activity. Some of these drugs may have significant side effects, including increased chance for infection for those that suppress the immune system, or increased chance for ulcers and bleeding for anti-inflammatory drugs. Physical therapy may also be used to increase joint flexibility and decrease stress and degradation of the joints. One European study estimated the total cost of rheumatoid arthritis in the US as 42 billion euros,1 or over 53 billion dollars.

Plants have been used since ancient times for medicinal purposes,2 and traditional medicine is growing acceptance in developed countries.3  An article written by Al-Nahain and colleagues evaluated the potential of the ginger plant (Zingiber officinale) in treating rheumatoid arthritis.4 The root of the ginger plant is most often used in food because of its unique taste, but it also has several medicinal properties that have been observed. Ginger has been well-studied for its anti-inflammatory effects (it is similar in action to aspirin or ibuprofen).5,6 The plant contains many drug-like compounds that may be useful in either treating rheumatoid arthritis outright or developing new anti-inflammatory drugs.2 One study tested both ginger extract as well as several chemicals isolated from ginger in an animal model of rheumatoid arthritis and found ginger to have “profound antiarthritic efficacy.”7 This means that ginger is capable of treating arthritis on multiple levels. While ginger may have potential in treating arthritis, it would not be without disadvantages. There is a lack of precise dosing information for this application of ginger. Furthermore, since it is considered a dietary supplement insurance companies would be unlikely to cover it.

While “cure” is far too strong of a word at this time, what does all this mean for those struggling with rheumatoid arthritis? First, it gives them a potential option when standard therapies do not work well enough to treat their symptoms. Individuals suffering from the disease can talk to their doctors and discuss whether using or adding a ginger supplement to their regimen could be beneficial in treating their symptoms. Second, it gives them hope for future research to find more effective treatments for rheumatoid arthritis. The Al-Nahain article is optimistic that further research into the chemical functions of ginger components, “may make it possible to stop further progress or even reverse the damage caused by [rheumatoid arthritis].”2 Finally, if new research into ginger prompts further research into the benefits of other substances marketed as dietary supplements, I think that is good for the world of healthcare as a whole. Selecting healthcare products should be based on evidence rather than advertising. I would recommend that consumers become proactive in discovering the benefits of both mainstream and alternative treatments. In this way, consumers can make more informed decisions and progress can be made in treating various diseases.

Has anyone you have known taken a ginger supplement for their rheumatoid arthritis? How well did his or her treatment work?

References

  1. Lundkvist J, Kastäng F, Kobelt G. The burden of rheumatoid arthritis and access to treatment: Health burden and costs. The European Journal of Health Economics. 2008;8(, Supplement 2: The Burden of Rheumatoid Arthritis and Patient Access to Treatment):S49-S60.
  2. Phillipson JD. Phytochemistry and medicinal plants. Phytochemistry. 2001;56(3):237-243.
  3. World Health Organization. WHO traditional medicine strategy 2002-2005. 2002.
  4. Al-Nahain A, Jahan R, Rahmatullah M. Zingiber officinale: A potential plant against rheumatoid arthritis. Arthritis. 2014;2014:8.
  5. Grzanna R, Lindmark L, Frondoza CG. Ginger-an herbal medicinal product with broad anti-inflammatory actions. Journal of medicinal food. 2005;8(2):125-132.
  6. Mascolo N, Jain R, Jain SC, Capasso F. Ethnopharmacologic investigation of ginger (zingiber officinale). J Ethnopharmacol. 1989;27(1–2):129-140.
  7. Funk JL, Frye JB, Oyarzo JN, Timmermann BN. Comparative effects of two gingerol-containing zingiber officinale extracts on experimental rheumatoid arthritis⊥. J Nat Prod. 2009;72(3):403-407.