Tag Archives: NSAID

Arthritis Supplement Super Arthgold Recalled

image Nano Well-being Health, Inc., has issued a voluntary recall for Super Arthgold (500 mg) . Super Arthgold is  a dietary supplement marketed for joint pain and arthritis. The U.S. Food and Drug Administration (FDA) has found that it contained undeclared drug ingredients, making it an unapproved new drug.

The ingredients that have been found in this supplement, but are not listed on the label are two prescription NSAIDs indomethacin, and diclofenac. The muscle relaxant chlorzoxazone was also found in these supplements.

According to a press release issued by the FDA:

“Use of this product containing undeclared drug ingredients has a reasonable probability of resulting in fatal adverse events in consumers and patients with underlying illnesses, including known allergy to the hidden ingredients, cardiac, gastrointestinal, hepatic [liver], and renal [kidney] conditions as well as patients who recently [have] undergone cardiac bypass graft surgery.”

Before taking any supplement it’s always a good idea to consult your physician. In this case, because the drugs were not listed on the label, there is risk of accidental overdose  or higher risk of adverse side effects for those already taking NSAIDs.



Rheumatoid Arthritis (RA): Which Treatment Option is Best?


Over the past several months I have received comments that I think need to be addressed in a much longer format than a comment response.  The comments are related to treatment options for rheumatoid arthritis and which treatment is best.

We are fortunate enough to have many options available to us today to manage our rheumatoid arthritis (RA).   Traditional medicine offers everything from NSAIDs (Non Steroidal Anti-Inflammatory Drug) like Advil and  DMARD s(Disease Modifying Antirheumatic Drugs) such as Plaquenil, Arava, Methotrexate, Gold, and Cyclosporine to biologics like Remicade, Enbrel and Humira. There is a growing trend toward alternative medicine as a  solution to  deal with this disease.  Each option has its benefits, risks and side effects.

NSAIDs are a class of drug that are used primarily to treat inflammation and mild to moderate pain.  These medications vary in potency and  include the brand names Advil, Motrin, Naproxen, Anaprox and Celebrex.  Between 10% to 50% of patients are unable to tolerate NSAIDs because of their side effects. These side effects include upset stomach, stomach pain, and diarrhea.  About 15% of people on long term NSAID treatment develop ulcers of the stomach and/or the duodenum.

DMARDs cover a variety of different of drugs.  Anti-malarial drugs such as Plaquenil (Hydroxycloroquine) are considered a DMARD and were initially used to treat malaria. It was discovered to help  arthritis when patients noticed an improvement in their arthritis symptoms while taking plaquenil for malaria.  Plaquenil effects the immune system but doctors do not know how it works for rheumatoid arthritis. Arava (leflunomide) interferes with genes in developing immune cells. When taking Arava, liver monitoring for toxicity is required.  You should not take this drug if you are planning to get pregnant or are currently pregnant because of birth defects. The most common side effects for patients taking Arava are rash, nausea, hair loss, liver enzyme elevation and anemia. Methotrexate is a chemotherapy drug that initially was used to treat acute leukemia.  Methotrexate (MTX) has become the gold standard for treatment of rheumatoid arthritis (RA).  Methotrexate interferes with the growth of cells in the bone marrow.  The most common side effects from methotrexate include stomach upset, hair loss, diarrhea, and  mouth sores.  Folic acid is given while taking this medication to reduce the side effects.  Liver function monitoring is necessary to watch for toxicity. Methotrexate should also not be taken if you are pregnant or planning to get pregnant. Injectable Gold has been shown to improve symptoms of rheumatoid arthritis however toxicity is common and constant monitoring in necessary.  Side effects include rash, diarrhea, conjunctivitis and marrow suppression. Cyclosporine is a medication that is used primarily for the prevention of rejection of transplanted organs.  It is effective for the treatment of rheumatoid arthritis because it stops an overactive immune system from attacking the joints. Side effects can be severe and include hypertension, kidney problems, headache, nausea and diarrhea.

Biologic response modifiers (biologics) are the latest treatment option for rheumatoid arthritis pain and inflammation.  They work by blocking the tumor necrosis factors(TNF) components of the immune system.  People with RA have too much TNF in their bodies and it overwhelms the immune systems response to inflammation. Biologics such as Enbrel, Remicade and Humira are genetically engineered proteins that binds to and deactivates the TNF molecules before they can do damage.  The risks in taking this class of drug include serious infection including sepsis and tuberculosis, nervous system diseases such as multiple scholosis, allergic reactions, lymphoma and congestive heart failure.  Because these drugs are fairly new their long term side effects are not known.

There has been much debate on the effectiveness of complimentary and alternative treatments options for rheumatoid arthritis.  These treatments include GLA (Gamma Linolenic Acid), DHA (Docosahexaenoic Acid, Tai Chi, herbal supplements and acupuncture. There are many more complimentary and alternative treatment options that will be discussed in future posts.

GLA (Gamma-linolenic Acid) is an essential fatty acid found primarily in plant oils. It is found in borage  oil and black currant seed. In preliminary testing it has shown to reduce morning stiffness and swelling however studies have been small to date and additional research would provide more information. DHA (Docosahexaenoic Acid) is an omega 3 fatty acid found in cold water fish. Several studies have shown that DHA reduces inflammation but not the progression of the disease. The movements of Tai Chi improve strength, flexibility and balance. There is no indication that Tai Chi effects the progression of rheumatoid arthritis. Acupuncture in thought to stimulate the release of chemicals called endorphins that block pain. Acupuncture is very effective in treating chronic pain like that in rheumatoid arthritis. The list of supplements as an alternative solution to conventional medicine for the treatment of rheumatoid arthritis include vitamin E, MSM, copper, manganese, vitamin C, selenium, zinc, bromelain, ginger, turmeric and boswellia.  These alternatives have proven to help in inflammation and in some cases joint damage.

The benefits of using conventional medicine for the treatment of rheumatoid arthritis are that knowledgeable doctors using this method are readily available and the medications work for many people. These medications have significantly improved the lives of many with rheumatoid arthritis. The downside to this treatment option is the side effects can vary from mild to severe and some long term effects are not even known.

The benefits to choosing an alternative medical solution for the treatment of rheumatoid arthritis is that the side effects to these treatment are few and are less damaging to the body.  The disadvantage to complimentary and alternative treatments are that finding a qualified medical professional that can help guide you through all the options available can be a challenge and there is debate on whether or not they can help with joint damage.

Ultimately the choice for a treatment option is a personal one.  What matters is what works for you. Everyone has their own body chemistry.  What works for one person may not work for another. The advantage that we have today is that we have options, many options, and if something is not working for us we can try in another direction until we find our own solution. It is not up to me or anyone else to decide what is best for you and your body.  Trust yourself to figure out what is best for you.

The Importance of Omega-3 Fatty Acids in RA Diet

omega3s1There has been much research that indicates that a diet rich in omega-3 fatty acids can reduce joint inflammation in people with rheumatoid arthritis(RA).  Omega-3 fatty acids decrease morning stiffness and decrease the amount of NSAIDs( Non Steroidal Anti-Inflammatory Drug such as ibuprofen, or naproxen) needed for RA patients.

Omega-3 fatty acids are found naturally in fish such as trout, salmon, mackerel, tuna and halibut as well as flax seeds, flax seed oil, walnuts, walnut oil, canola oil, pumpkins seeds,  pumpkin seed oil and soybeans (edamame). Whole flax seeds are available in ground form in special packaging so that the compounds in the flax seed stay active. Flax seeds and flax seed oil need to be kept refrigerated.

Omega-3 fatty acids can be taken in the form of fish oil capsules.  I wish I had know the following before I tried the supplements, but fish oil can cause bloating, belching, flatulence, and diarrhea.  Just thinking about the supplements brings me back to that awful day that I tried them.  Let’s just say that they did not agree with my delicate sensibilities and leave it at that.

It is important to note that fish oil supplements may contain heavy metals (including mercury) and other potentially harmful contaminants.  Make sure that you purchase the supliment  from a trusted source that certifies that their products are free of heavy metals.

You should consult your physician before taking a supplement of any kind because it may interfere with other medications you may be taking.

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