Introduction

Dr. Alex Jimenez, D.C., presents how anti-inflammatory botanicals and phytochemicals can reduce inflammatory cytokines that can cause pain-like issues in the body. We dive into how different pharmaceuticals could influence NF-kappaB and how chronic conditions can affect inflammation. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from inflammation, and its correlating symptoms can affect the musculoskeletal system. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

How Does The Body Deal With Inflammation

Dr. Alex Jimenez, D.C., presents: Our objectives are to look at the evidence for using selective phytochemicals and botanicals as anti-inflammatory and analgesic agents. Controlled studies have grown into mass numbers over the years, and we can feel more confident in some of their findings because a lot of these studies have been done with good-quality investigators and well-designed studies. And even though we get those studies published, the problem is that we rarely hear about them. The media needs to pick them up, and they usually don’t make it into the medical community despite their studies. If you compare that to when pharmaceutical research is done, you know it often makes the headlines and news. Let’s look at some of these botanicals and phytochemicals today.

In autoimmune conditions, pain is a huge issue in the body, and we also want to use its analgesic properties. And then, we have to identify the most appropriate phytochemicals and botanicals for specific inflammatory and pain conditions. So, before we jump into that, we want to review some of the mechanisms of the pharmaceuticals that are very commonly prescribed for inflammatory and autoimmune conditions. Even some of the newer biologics we’ve referred to a little bit, we want to look into them and, and look at how they work and some of their drawbacks, and then we’ll delve into these botanicals that are at our disposal. So it is important to remind anyone that all degenerative diseases have this pro-inflammatory state or inflammation as part of their underlying biochemical ideology. And that inflammation is a final common pathway for all these different dysfunctions. Diabetes, Alzheimer’s, atherosclerosis, cancer, and even some psychiatric disorders like schizophrenia and depression all have inflammation as one of their root causes. Now in this module, we’re focusing on the ones that are in the circles and these.

As you know, most chronic diseases are linked to excessive, persistent inflammation. We’ve pounded that point home well enough, as chronic inflammation occurs when the injury is ongoing or when a predisposed immune system just doesn’t shut off. It fails at counter-regulation and acute inflammation, which is beneficial; however, it can turn into a chronic inflammation if left untreated. Many chronic diseases have been associated with excessive or persistent inflammation. When it comes to chronic inflammation develops when an injury or traumatic event is ongoing, causing the muscles to tense up or when the immune system begins to attack the body when there are no pathogens that are affecting the body. And that the conventional pharmacological treatment focuses on specific pathways that are often really downstream in that inflammatory process, and from a functional medicine perspective, we want to look a bit more upstream to figure out what is the cause of chronic inflammation that is causing this many issues to this person and how anti-inflammatory botanicals and phytochemicals can dampen these inflammatory effects in the body.

How Do Pharmaceuticals Affect The Body?

Dr. Alex Jimenez, D.C., presents: One of the factors that can enhance inflammatory markers is pharmaceutical drugs. So, for example, pharmacologic controls like NSAIDs can inhibit the COX enzyme, while leukotriene inhibitors inhibit the LOX enzyme. DMARDs can affect various immune mechanisms that can influence the development of chronic inflammation. Biologics can inhibit multiple cytokines in the body, including the TNF-alpha and steroids, which can affect NF-kappaB and phospholipase-A2. So there are numerous ways to influence the inflammatory pathway and cause muscle and joint pain issues.

Pharmaceuticals are not the only factors that can cause inflammatory triggers to affect the body; it can be the food we eat or the environment that we live in that can trigger NF-kappaB, which disassociates from I-kappaB while going into the nucleus and binding to the DNA. That point leads to the transcription of many different genes. The body’s genes not only make DNA but can make RNA. When the body makes RNA, it is then biotransformed into DNA, leading to the turning of different inflammatory pathways. So when the pharmaceutical starts entering the body, it can inhibit the other cytokines and enzymes from turning on and cause chronic inflammation, thus causing the anti-inflammatory markers to dampen and causing the immune system to focus on the NF-kappaB.

NSAIDs

Dr. Alex Jimenez, D.C., presents: So let’s start looking at the non-steroidal anti-inflammatories or NSAIDs, which are ubiquitous as they are very common for many people to reach for when they are in pain. And the reason they use them is that they do work. NSAIDs inhibit cyclooxygenase enzymes and prevent those inflammatory prostaglandins, which cause inflammation and pain in the muscles or joints. Now paracetamol is on here, or acetaminophen is not technically an NSAID, but we will look at that separately.

But these NSAIDs, you know, aren’t without issues, as 70 million prescriptions for NSAIDs are written in the U.S. annually. And that over-the-counter uses included 30 billion doses of NSAIDs. That’s an enormous amount, and it’s no wonder most of us have taken them; we’re part of that 30 billion. However, that amount can lead to a leaky gut in our body system. We know their association with peptic ulcers and G.I. bleeding while inhibiting that resolving pathway, which is important to shut off the inflammatory response. So let’s look at DMARDs or disease-modifying anti-rheumatic agents. They’re the first-line therapy for rheumatoid arthritis. And one of the reasons they’re the first line of treatment is that they’re inexpensive but are slow acting and do decrease inflammation, but they don’t work very well to relieve pain directly.

So methotrexate is hydroxychloroquine, or Plaquenil is a very well-known one right now, especially with its use today. Still, methotrexate inhibits RNA and DNA synthesis, which has been used as a chemotherapy agent in cancer. And when it inhibits, it affects the dihydrofolate reductase, which is needed to make DNA and RNA; however, it also suppresses T and B-cell activation while inhibiting IL1 beta from binding to its receptors. So, unfortunately, even though they’re the first-line therapy, they come with several fairly severe side effects. But we keep talking about this idea of side effects; it’s no side effects. They’re the direct effects of the medication.

The Effects Of Pharmaceuticals

Dr. Alex Jimenez, D.C., presents: You know, they may be unwanted effects like rashes, stomach upset, liver, bone marrow, toxicity, congenital disabilities, and, of course, which we’ll see repeatedly. Any time that you shut down your immune system, you open yourself up for infections. So you become much more susceptible to infections. So, look at these biological DMARDs, which work as TNF-alpha blockers. These biological DMARDs work by curbing either T-cell activation or blocking TNF, which is the most common one, but they also can stop things like IL-six, deplete T-cells, and work in other ways. These biologics are called biologics because they’re actually monoclonal antibodies. And so these monoclonal antibodies, as antibodies do, they have very strong specific binding affinities.

And so, using antibodies as medications has been a great advance. Now, as we’re going to see, they may not be the ultimate solution for treating autoimmune disease, but they hold a lot of promise, especially when we need their specificity. So there are many chronic conditions that NSAIDs DMARDs or Biologic DMARDs that can mask inflammation and cause pain to the muscles and joints. Some of the chronic conditions include:

• Ankylosing-spondylitis
• Arthritis
• Crohn’s disease
• Endometriosis
• Psoriasis
• Rheumatoid Arthritis
• Osteoarthritis
• Fibromyalgia
• Lupus

Conclusion

Dr. Alex Jimenez, D.C., presents: These pharmaceuticals can reduce the pain that the person is experiencing with these conditions, but they are short-termed and only mask the issue until a person goes into treatment. When a person has an autoimmune or chronic disorder associated with inflammation, the cost of any medication is high. Even though good pharmaceuticals are important, we need to look at treatments that can examine the lesser-known or rarer conditions that can reduce the inflammatory effects that cause joint and muscle pain.  Incorporating anti-inflammatory botanicals and supplements like:

• Fish oil
• Curcumin
• Ginger extract
• Green Tea Extract
• Resveratrol

All have anti-inflammatory properties that can reduce inflammatory cytokines from the muscle and joints and combine with physical therapy. Physical therapy can allow the body to heal itself and will enable the individual to be pain-free naturally.

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