The Base Anti-inflammatory Supplement Regimen

Chris Centeno, MD - I have what I call my “Base Anti-inflammatory Regimen”. What’s that and why should you care? Let’s dig in.

Inflamaging

As people get old like me, many get what’s called “inflammaging”. That’s the extra inflammation many people get as they age. In practice, what does this mean? All of that extra low-level inflammation tears up everything from arteries to nerves to organs.

How can you combat this low-level inflammation? Read on.

Low-Level Inflammation and Old Injuries

Can you feel inflammaging? Yep. The places on your body that have been damaged through the years and haven’t yet fully been fixed tend to get inflamed. For example, that old knee injury or that bad back from high school.

Can you fight inflammaging? Yes, there are a number of ways, but today we’ll talk about what I call a “Base Anti-inflammatory Regimen”.

A Base Anti-inflammatory Regimen

How can you control all of that old age inflammation? Many people do this with drugs like Motrin or other NSAID anti-inflammatories. However, this approach has serious risks like a dramatic increase in the risk for sudden death heart attack, and stroke. In addition, many patients get easily “addicted” to these medications. For example, it starts with taking this stuff to be able to work out, and then it becomes a daily habit to pop an NSAID pill just to function.

Instead of this, I use a “Base Anti-inflammatory Regimen”. This is a combination of supplements that are all anti-inflammatory or that help cartilage or both. Let’s dive in.

The Anti-inflammatory Supplements

Omega 3 (Fish Oil)

The research supports that the Omega 3 fatty acids in fish oil can help arthritis pain (1,2). How does that work? The Omega 3 fatty acids EPA and DHA, which are in fish oil, have a range of anti-inflammatory actions.

There are many inflammation pathways and two commonly talked about are the cyclooxygenase and the arachidonic acid (AA) pathways. The NSAID drugs like Motrin work on the first, but fish oil blocks the second AA pathway. Fish oil also has chemicals called resolvins, which help to resolve inflammation. EPA and DHA also alter gene expression within cells which leads to the production of anti-inflammatory chemicals.

How much should you take? The Regenexx Super Concentrated Omega 3 Fish Oil has 1,000mg of EPA and 500mg of DHA. This is two pills in the morning with breakfast or you can go higher and add two in the evening.

Curcumin

Curcumin is a component of the Turmeric root. It also can help arthritis pain (4-6). There are other inflammatory pathways than just the two I have described above. There’s one called LOX (lipoxygenase) and another called “NO” which is short for nitric oxide. Curcumin blocks both of these pathways.

How much should you take? The Regenexx Curcumin complex has 750mg of Tumeric extract with 95% curcuminoids and BioPerine. At that dose, it’s two capsules a day in the morning with breakfast. You can go higher to two caps twice a day.

The Next Level-Glucosamine and Chondroitin

If you’re still having issues after applying the basic supplements, then go up a level and add Glucosamine and Chondroitin. These are joint cartilage components that are as good as prescription Celebrex in reducing joint inflammation and pain (7). They also have been shown in some studies to help protect cartilage.

How much should you take? The Regenexx Stem Cell Support formula has 1,500mg of Glucosamine and 1,000mg of Chondroitin which is once a day in the morning with breakfast.

Occasional Use

If you get a breakthrough episode of pain due to a really bad day (a few times a year), then add in some occasional Tylenol. This is to handle issues that “break through” your anti-inflammatory supplements. However, be cautious here, as the goal is not to get addicted to Tylenol.

Chronic Issues

If you have chronic problem areas that aren’t addressed by this regimen, then those are spots that need to be treated. For me, that’s having my colleagues use platelet-rich plasma or bone marrow concentrate to help those areas through specific image-guided procedures targeting those spots.

The upshot? A base inflammation-fighting strategy using supplements is a great way to combat inflammaging and help stay off toxic NSAIDs. I do this every morning and it’s helped me stay active as I age.

______________________________

References:

(1) Hill CL, March LM, Aitken D, et al. Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose. Ann Rheum Dis. 2016;75(1):23-29. doi:10.1136/annrheumdis-2014-207169

(2) Suzuki Y, Fukushima M, Sakuraba K, Sawaki K, Sekigawa K. Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial. PLoS One. 2016;11(10):e0162769. Published 2016 Oct 4. doi:10.1371/journal.pone.0162769

(3) Calder PC. n-3 PUFA and inflammation: from membrane to nucleus and from bench to bedside [published online ahead of print, 2020 Jun 22]. Proc Nutr Soc. 2020;1-13. doi:10.1017/S0029665120007077

(4) Heidari-Beni M, Moravejolahkami AR, Gorgian P, Askari G, Tarrahi MJ, Bahreini-Esfahani N. Herbal formulation “turmeric extract, black pepper, and ginger” versus Naproxen for chronic knee osteoarthritis: A randomized, double-blind, controlled clinical trial. Phytother Res. 2020;34(8):2067-2073. doi:10.1002/ptr.6671

(5) Henrotin Y, Malaise M, Wittoek R, et al. Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo controlled three-arm study. Arthritis Res Ther. 2019;21(1):179. Published 2019 Jul 27. doi:10.1186/s13075-019-1960-5

(6) Panahi Y, Rahimnia AR, Sharafi M, Alishiri G, Saburi A, Sahebkar A. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res. 2014;28(11):1625-1631. doi:10.1002/ptr.5174

(7) Zeng C, Wei J, Li H, Wang YL, Xie DX, Yang T, Gao SG, Li YS, Luo W, Lei GH. Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee. Sci Rep. 2015 Nov 18;5:16827. doi: 10.1038/srep16827. PMID: 26576862; PMCID: PMC4649492.

Original Article: https://regenexx.com/blog/running-on-empty-fish-oil-and-my-ankle/

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