Origin: Oil from cold-water fish such as mackerel, salmon, herring, tuna, halibut and cod. Claims: Reduces inflammation and morning stiffness. Treats rheumatoid arthritis, lupus, psoriasis, depression and Raynaud’s phenomenon. Important for brain function and may inhibit RA development. What we know: Fish oil is an excellent source of omega-3 fatty acids (including EPA and DHA), which block inflammatory cytokines and prostaglandins; they are converted by the body into powerful anti-inflammatory chemicals called resolvins. Fish oil also lowers blood triglyceride (fats that circulate in the bloodstream), protecting against heart disease and reducing high blood pressure. Studies: EPA and DHA have been extensively studied for RA as well as dozens of other inflammatory conditions, including heart disease, depression, Raynaud's syndrome and lupus. A 2010 meta-analysis found that fish oil significantly decreased joint tenderness and stiffness in RA patients and reduced or eliminated NSAID use.
Preliminary studies indicate it may have a similar effect on osteoarthritis. A 2005 study of people with RA showed enhanced positive effects when fish oil supplements were used in combination with olive oil. Meta-analyses also have shown that fish oil improves depression when taken with conventional antidepressants and in one small study, it increased cold tolerance and time to vasospasm in Raynaud's. Dosage: Fish, capsules, softgels, chewable tablets or liquid. For general health, two 3-ounce servings of fish a week are recommended. However, it’s difficult to get a therapeutic dose of fish oil from food alone. To treat arthritis-related conditions, use fish oil capsules with at least 30 percent EPA/ DHA, the active ingredients. For lupus and psoriasis, 2 g EPA/DHA three times a day. For Raynaud’s phenomenon, 1 g four times a day. For RA and OA, up to 2.6 g, twice a day. For depression, 6.6 g daily. Due to potentially dangerous levels of mercury, women who are pregnant or hoping to conceive should avoid eating shark, swordfish, king mackerel and tilefish and should eat no more than 8 ounces of albacore tuna each month.
Fish oil supplements at normal doses are safe but more than 3000 mg (3 grams) a day increases bleeding risk; avoid taking with blood thinners such as warfarin (Coumadin). Some brands may contain toxic polychlorinated biphenyls (PCBs) or mercury. Look for brands that follow good manufacturing practices.Curcumin extract may be able to suppress biological mechanisms that spark inflammation in tendon diseases, according to new research. The research, published in the Journal of Biological Chemistry, reveals that curcumin, which is known as a for giving turmeric its bright yellow colour and its use as a food colouring ingredient, blocks important inflammatory pathways known to initiate tendinitis, preventing the initiation and promotion of inflammation in the tendons.The international team of researchers led by scientists at the University of Nottingham and Ludwig Maximilians University in Munich said that the spice extract could offer a new treatment hope for sufferers of the tendinitis“Our research is not suggesting that curry, turmeric or curcumin are cures for inflammatory conditions such as tendinitis and arthritis…
However, we believe that it could offer scientists an important new lead in the treatment of these painful conditions through nutrition,” said Dr Ali Mobasheri from the University of Nottingham, who co-led the research.“Further research into curcumin, and chemically-modified versions of it, should be the subject of future investigations and complementary therapies aimed at reducing the use of non-steroidal anti-inflammatory drugs, the only drugs currently available for the treatment of tendinitis and various forms of arthritis,” he added.Tendinitis is a form of tendon inflammation that causes pain and tenderness near to joints. It is particularly common in the shoulders, elbows, knees, hips, heels and wrists.The authors noted that as the global population ages, and inflammatory diseases become more prevalent, the incidence of tendinitis has increased. It is also linked to other arthritic and rheumatic diseases such as rheumatoid arthritis or metabolic diseases such as diabetes. Mobasheri and his colleagues explained that current treatments for tendinitis are restricted to the use of non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin or ibuprofen.
However, NSAIDS can be associated with undesired side effects including stomach ulcers, nausea, vomiting, heartburn, headache, diarrhoea, constipation, drowsiness and fatigue. Consequently, there is an acute need for new treatments with fewer debilitating side effect, said the authors.Curcumin has been associated with anti-inflammatory responses, and has been successfully used to treat inflammatory conditions in experimental research and in clinical trials.Recent studies in cell models have suggested that that curcumin is able to target specific inflammatory signalling pathways.Other research has linked curcumin to potential uses in treating arthritis and a range of rheumatic diseases, and potentially even as an agent to kill cancer cells.“However the potential for the treatment of tendinitis has not been explored,” said Mobasheri and his colleagues.The new study used a culture model of human tendon inflammation to study the anti-inflammatory effects of curcumin on tendon cells, to assess the effects of curcumin on the inflammatory and degenerative signalling pathways.
The research team found that curcumin inhibited interleukin-1beta-induced inflammation and cell death in the tendon cultures. “The anti-inflammatory effects of curcumin included down-regulation of gene products that mediate matrix degradation, prostanoid production, apoptosis, and stimulation of cell survival,” said the researchers.“These results demonstrate, for the first time, a potential role for curcumin in treating tendon inflammation,” they added. Source: Journal of Biological Chemistry Published online ahead of print, doi: doi:10.1074/jbc. “Curcumin Modulates Nuclear Factor κB (NF-κB)-mediated Inflammation in Human Tenocytes in Vitro”Authors: C. Buhrmann, A. Mobasheri, F. Busch, C. Aldinger, et alFor about seven or eight years, I’ve suffered from recurring tendinitis in multiple locations: both achilles heals, rotator cuff, neck, both quadriceps, and extensor (big toe). I’ve only received treatment from chiropractor who applied electric acupuncture to the affected site.
Inflammation has been a symptom of my tendinopathy–that’s how I know it is not tendinosis (on the difference, see: Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matters). Last Fall, I had my worst bout of tendinitis while visiting the Orkney Islands. On the top floor of the Orkney Museum, I took a little rest on a couch. When I stood up, I felt a shooting pain in my knee, which I later determined was quadriceps tendinitis. Because it is almost invariably a condition that manifests itself upon the occasion of using a tendon’s services, conventional wisdom treats tendinitis as a sports or repetitive use injury. At blame are overuse, lack of stretching, bad posture, or bad form. Aging also gets blamed (see Chronic Tendonitis Causes and Treatment), so it becomes part of the popular and circular understanding that if you have tendon problems it is a sign that you are getting old. This is a kind of bigotry of low expectations. When it comes to treatment, doctors prescribe rest, icing, non-steroidal anti-infammatory medications (NSAID), and steroids–and possibly surgery.
Prevention focuses on good posture, stretching, and prevention of overuse. It really makes one feel very old not being able to walk up and down stairs, get into the shower, or sleep normally. In my late 40s I reminded myself of my diabetic grandmother who went up and own stairs slowly and carefully. But Grandma Ruth was in her 70s. What was my problem? In 2011, I remember not being able to sleep because I couldn’t turn my head. I could barely bend my neck down to get in a car nor turn my head to look out back–not without pain. Last Fall, my Orkney Island quadriceps injury worsened to the point that even a slight bending of my left knee was extremely painful, and so I went to see my chiropractor. He required that I get an ultra sound, and for that I had to see my doctor who offered me a powerful NSAID, but I was happy with the over-the-counter Ibuprofen that I was taking. She said to take it round the clock. The ultrasound showed nothing conclusive, but by that time my knee was improving a little and my chiropractor decided he could treat it with electric acupuncture, which led to a recovery until I tried to use the tendon again, and the pain and inflammation revived.
I had at that point been on a low carbohydrate high fat diet for ten months, to the great improvement of my health. And so I decided that if I had been able to improve my health so much, then perhaps I could find a dietary solution to my tendinitis. So I began to search the internet for a solution, and I learned, not surprisingly, that a primary cause of tendinitis is the mouth. More specifically, I learned that it is what we put in our mouth, the food we eat or fail to eat, or indeed toxins we consume, that have a profound influence on the health of tendons. The most helpful website was that of the Tendonitis Expert, Joshua Tucker, who provides a specific list of dietary supplements to heal tendons. It was Tucker from whom I first learned of a condition called “Leviquin Tendinitis” One of the mechanisms is that Cipro depletes the body of magnesium which is necessary for mitochondrial health and when mitochondria become unhealthy, connective tissues become weak and are susceptible to damage.
I’d likely taken Cipro at least six times over the last decade coinciding with my devastating bouts of tendinitis. A few weeks earlier I had seen the amazing video by Dr. Terry Wahls, Minding your Mitochondria: So I began to eat organ meats and take the supplements that Tucker recommended: vitamins A, C, D, E. I also took CoQ10 (Ubiquinol) and R-Lipoic Acid (R-LA), for my mitochondria, and several fish oil capsules every day. I also began to skip breakfast, having only a high fat coffee in the mornings (called “intermittent fasting”). My bouts of tendinitis started to be further apart and less severe. Then in May, after Dr. Wahls book, The Wahls Protocol came out, because I still had recurring tendinitis (now with my right quadriceps), I decided to embrace her strictest regimen (Wahls Protocol Paleo Plus) to heal, if possible, the damage that Cipro had done. On her way to recovery from multiple sclerosis, Dr. Wahls became a specialist in functional medicine, which looks upon chronic disease as a single disease with multiple expressions, such as diabetes, cancer, and auto-immune diseases.
She writes, most poignantly: When chronic disease is the result of a deficiency, drugs aren’t going to solve the problem. As I’m sure you realize, multiple sclerosis is not a deficiency of the latest multiple-sclerosis-disease-modifying drug like Copaxone, just as fatigue is not a deficiency of wakefulness-promoting drugs like Provigil or even caffeine, and depression is not a deficiency of antidepressants like Prozac. No, these problems are not deficiencies of drugs, but they are triggered by deficiencies in your cells that lead to broken biochemistry and impaired signaling between your cells. When you look at chronic disease in this way, it’s obvious that you should treat the cellular deficiencies that cause diseases to develop in the first place instead of just treating the symptoms, which is what most conventional pharmaceutical treatments do. In this way of thinking, tendinitis is not due to lack of NSAIDs, surgery or steroid treatment: it is instead a result of toxins and nutritional deficiencies.