New research on some ‘old’ ingredients have revealed some potential opportunities for innovation in the joint care space.
Wormwood, an ingredient in absinthe, has been used by many cultures around the world as part of folk remedies. In a study published in Clinical Rheumatology in 2016, an extract of wormwood (Artemesia annua) at a dosage of 150 mg daily improved measures of pain based on the WOMAC scale.1
New delivery forms of capsaicinoids are interesting, especially those which are highly potent. For example, capsaicinoids from ghost pepper (Capsicum chinense) are antagonist of the pain pathway TRPV1, but not always the most fun to swallow or apply topically. By encapsulating them in nanolipid vesicles, a new application and potential was uncovered in a 2016 human pilot trial.2
Combinations of clinically proven ingredients are being increasingly evaluated for potential synergy. A combination of methylsulfonylmethane (MSM) and boswellia (Boswellia serrata) gum extract outperformed glucosamine for osteoarthritis pain.3
One of the main challenges with clinical studies on supplements for pain is the long duration. Few people want to wait 8 weeks for a noticeable effect, but regardless, that is the typical duration of arthritis studies on supplements. A combination of Ayurvedic ingredients recently outperformed ibuprofen, with improvements reports within only 60 minutes after a single acute dose in a clinical model for acute pain.4 This is the kind of fast-acting effect in greater demand.
The connections between immune function and pain are becoming increasingly clear. Mushrooms are known for their ability to support healthy immune regulation, and they may support inflammatory pathways in immune dysregulation. For example, reishi (Ganoderma lucidum) fruiting body was shown in a 2016 study to improve physical exercise performance and flexibility in people with fibromyalgia.5 In a separate study, a pollen extract along with a saw palmetto (Serenoa repens) fruit oil both reduced measures of pain in subjects with inflammatory prostatitis.6
Alkalinizing agents such as mineral salts have been on the radar for some time with regards to detoxification and cleansing, but with little evidence from randomized controlled trials for pain. An alkaline powder containing mineral salts reduced osteoarthritis and raised urinary pH in a recent RCT.7
Look for more studies on non-conventional supplements to support pathways underlying pain and inflammation.
Blake Ebersole has led a number of botanical quality initiatives and formed collaborations with dozens of universities and research centers. As president of NaturPro Scientific, Ebersole established quality compliance and product development services for supplements and ingredients such as ID Verified™. Follow him on Twitter at @NaturalBlake.
- Stebbings S et al. “A pilot randomized, placebo-controlled clinical trial to investigate the efficacy and safety of an extract of Artemisia annua administered over 12 weeks, for managing pain, stiffness, and functional limitation associated with osteoarthritis of the hip and knee." Clin Rheumatol. 2016 Jul;35(7):1829-36. DOI: 10.1007/s10067-015-3110-z.
- Sarwa K et al. “Topical Analgesic Nanolipid Vesicles Formulation of Capsaicinoids Extract of Bhut Jolokia (Capsicum chinense Jacq): Pharmacodynamic Evaluation in Rat Models and Acceptability studies in Human Volunteers." Curr Drug Deliv. 2016;13(8):1325-1338.
- Notarnicola A et al. “Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial." Int J Immunopathol Pharmacol. 2016 Mar;29(1):140-6. DOI: 10.1177/0394632015622215.
- Girandola RN, Srivastava S, Loullis CC. “A clinical trial comparing Lanconone® with ibuprofen for rapid relief in acute joint pain." Trials. 2016 Apr 6;17:189. DOI: 10.1186/s13063-016-1268-6.
- Collado Mateo D et al. “GANODERMA LUCIDUM IMPROVES PHYSICAL FITNESS IN WOMEN WITH FIBROMYALGIA." Nutr Hosp. 2015 Nov 1;32(5):2126-35. DOI: 10.3305/nh.2015.32.5.9601.
- Iwamura H et al. “Eviprostat has an identical effect compared to pollen extract (Cernilton) in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized, prospective study." BMC Urol. 2015 Dec 7;15:120. DOI: 10.1186/s12894-015-0115-5.
- van Velden DP et al. “Non-allopathic adjuvant management of osteoarthritis by alkalinisation of the diet." Afr J Prim Health Care Fam Med. 2015 Apr 21;7(1). DOI: 10.4102/phcfm.v7i1.780.