Rheumatoid arthritis is an autoimmune disorder where our own immune system attacks the tissues of the joints.
The most commonly affected joints of the body by this type of arthritis are those of knees, ankles, feet, fingers and wrist. This arthritis also affects nerves, heart, lungs, eyes, mouth and other organs.
The attack of immune system on the tissues of the joints such as synovium (protective covering of the ends of the joint bones) causes swelling, stiffness and pain. It also results into difficulty in the mobility of the affected parts.
The cause of rheumatoid arthritis is not very clear but certain factors are known to trigger the development of this disease. These factors are infections, genetic inheritance, pollutants, certain chemicals (mineral oil, silica or insecticides), smoking etc.
Women are found to be at a greater risk of developing rheumatoid arthritis. In the individuals over 40 years of age, the risk is greater as well.
The common symptoms of this disease are morning stiffness, redness and swelling in the joints. The other symptoms that can be observed are fever, fatigue, weight loss, loss of appetite, numbness or tingling in skin, dry mouth, anaemia etc. Sometimes, formation of nodules can also be there.
Rheumatoid arthritis may lead to certain complications like the risk of developing osteoarthritis, infections, heart and lung problems or even leukemia.
The treatment is this disease mostly involves medications like NSAIDs (nonsteroidal anti-inflammatory drugs eg. ibuprofen), corticosteroids or DMARDs (Disease modifying anti-rheumatic drugs), in combination with physiotherapy or other physical exercises.
These drugs have many side-effects, which may sometimes be life-threatening. The side-effects include stomach irritation, heart problems, lung damage, kidney damage, infections in bone marrow, diabetes and many more.
Since the side-effects of the drugs used to treat rheumatoid arthritis often outweighs the benefits, alternative options are looked for which can be effective without causing additional problems.
Nature is the best source of such alternatives. Curcumin, a natural product obtained from the common spice turmeric has a potential against rheumatoid arthritis.
What is curcumin?
Curcumin, chemically known as diferuloylmethane is a polyphenolic compound obtained from the rhizome of the turmeric plant, Curcuma longa.
It is the most abundant and the most bioactive compound of turmeric. Its extract is also used as a dyeing agent for its yellow colour.
Curcumin possesses a large number of medicinal properties. It is known to have anti-inflammatory, antioxidant, anti-cancer, neuroprotective and many such activities.
These activities make it a therapeutic agent against many diseases such as cancer, diabetes, inflammatory diseases, neurological disorders etc.
6 Proven Benefits of Curcumin in Rheumatoid Arthritis
Curcumin with various properties like anti-inflammatory, antioxidant and pain-relieving, has immense potential against rheumatoid arthritis. It can benefit in the treatment as well as in the prevention of this disease.
1.Curcumin reduces inflammation
Inflammation is caused in the synovial tissue of the joints upon attack by the immune system. This is mediated by pro-inflammatory molecules called cytokines, for example TNF-α and interleukins (IL-1, IL-17 etc). These molecules result in the bone degradation by cartilage destruction.
The other types of molecules are also involved in the development of this disease such as, metabolites like prostaglandins (especially, E2) and enzymes like cyclooxygenase (COX-1 &COX-2).
Curcumin is a very effective anti-inflammatory compound. This property has been found useful in a number of inflammatory disorders, such as arthritis.
Curcumin is found to inhibit inflammation in the joints in the rheumatoid arthritis model. It prevents the gene expressions of the molecules that are involved in the inflammatory process, such as cytokines, prostaglandin E2, COX-2 etc.
In the synovial cells of rheumatoid arthritis patients as well, curcumin is found to inhibit the activity of various interleukins involved in the inflammatory process.
Curcumin’s anti-inflammatory action is also attributed to its ability to increase the activity of PPAR-γ. PPAR-γ is a factor involved in inhibiting the expression of pro-inflammatory molecules, especially cytokines.
What does it mean?
It means curcumin can be used to reduce the inflammation in the joints of rheumatoid arthritis patients. Curcumin inhibits various inflammatory molecules to achieve this.
2.Curcumin relieves pain
Pain is one of the most frequent symptoms observed by the rheumatoid arthritis patients. The release of inflammatory factors induces pain by activating the pain receptors in the joints.
Inflammation being the major cause of the pain in rheumatoid arthritis, its attenuation can be useful in treating the pain.
Curcumin is known to be a natural pain-relieving agent that carries out the action by its anti-inflammatory mechanism.
Meriva, a formulation of curcumin has significant analgesic action which is comparable to the analgesic drugs but safer. It reduces inflammation in the arthritic patients and thus controls the pain.
What does it mean?
It means curcumin consumption can relieve the pain experienced by the rheumatoid arthritis patients. Curcumin’s anti-inflammatory action helps in attenuating the pain.
3.Curcumin reduces the oxidative stress in synovium
The role of oxidative stress is very important in the development of rheumatoid arthritis. An increased production of reactive oxygen species (ROS) and a decreased innate antioxidant mechanism creates the oxidative stress.
This stress leads to an abnormal immune response in the synovial tissue that causes degradation of the joint cartilage and thus, causes the rheumatoid arthritis.
Curcumin is a natural antioxidant which scavenges the free radicals or ROS. It transfers electrons to prevent them from damaging various tissues like synovium and thus prevents the occurrence of various diseases.
It is known to reduce the oxidative stress markers in rheumatoid arthritis by its antioxidant action.
What does it mean?
It means curcumin intake can reduce the oxidative stress in the synovium of the joints. The antioxidant action of curcumin can prevent the progression of rheumatoid arthritis.
4.Curcumin prevents bone and cartilage loss
The pro-inflammatory cytokines like, TNF-α and interleukins, expressed in the bone tissues also lead to the degradation of bones and cartilage mediated by various signalling pathways like RANK pathway.
These molecules modulate the process of osteoclastogenesis (breaking of bones for repairing) and lead to bone erosion.
Curcumin can prevent the bone loss as well. It inhibits the signalling pathways like RANK, which in turn inhibits osteoclastogenesis in rheumatoid arthritis patients. This prevents the bone loss.
Curcumin also protects the cartilage cells from the damage induced by a pro-inflammatory molecule, interleukin-1β (IL-1β). It inhibits the activity of IL-1β and thus, prevents cartilage degradation.
What does it mean?
It means curcumin can prevent the bone and cartilage loss mediated by the pro-inflammatory molecules. It inhibits signalling pathways involved in the bone loss and cartilage degradation.
5.Curcumin has chemopreventive action in rheumatoid arthritis
The risk of developing cancer in the rheumatoid arthritis patients who were treated with DMARDs (disease modifying anti-rheumatic drugs) has increasingly been known. There are several reports of cancers of breast, lung, colon, lymphoma, skin etc.
These malignancies are linked to the altered immune responses and inflammatory responses caused by the pathogenesis of rheumatoid arthritis as well as the DMARDs treatment.
Curcumin is a well-known chemopreventive agent which prevents the development of a number of cancers induced by drugs, carcinogens or other factors.
The radical scavenging action and inhibition of inflammatory responses of curcumin helps in the prevention of cancer. It also induces death in malignant cells by interfering in various molecular pathways.
It is known to induce cell death in the synovial cells of rheumatoid arthritis patients. This prevents the hyperplasia or excessive division of cells which marks an initiation of malignancy.
Curcumin blocks the activity of T-lymphocytes (an immune cell) which helps in inhibiting proliferation and inflammatory responses that can lead to cancerous conditions.
Curcumin derivatives also show chemopreventive activity in rheumatoid arthritis model. This activity is a result of inhibition of various pro-inflammatory gene expressions.
What does it mean?
It means curcumin consumption can prevent the risk of developing cancer due to various aspects of rheumatoid arthritis. Curcumin’s anti-inflammatory, antioxidant and induction of cell death mechanisms helps in this.
6.Curcumin protects from the side-effects of the drugs used for rheumatoid arthritis treatment
The common drugs that are used for the treatment of rheumatoid arthritis are NSAIDs and DMARDs. These act against inflammation and modulate immune responses.
A major drawback of these drugs is that they pose serious side-effects to the patients. The side-effects range from nausea, headache to stomach ulcers, liver and kidney damage etc.
NSAIDs frequently induce nausea, peptic ulcers, gastrointestinal bleeding and other such side-effects.
Curcumin is known to have gastroprotective action against the side-effects induced by the NSAIDs. It reduces the inflammation and reactive oxygen species induced by the drug and prevents the damage to the gastrointestinal tract and thus prevents ulcer formation.
Methotrexate, a DMARD used in rheumatoid arthritis treatment causes severe side-effects to the liver by inducing oxidative stress.
Curcumin has been found to attenuate this oxidative stress and thus protects the liver from the damage.
What does it mean?
It means curcumin can be used along with the conventional drugs used for rheumatoid arthritis treatment to protect against the frequent side-effect of these drugs.
Dosage of Curcumin For Rheumatoid Arthritis
There is no specific dosage of curcumin prescribed for rheumatoid arthritis.
However, many studies utilize 500mg to 1000mg of curcumin daily in rheumatoid arthritis. These amounts of curcumin are effective against inflammation.
Meriva formulation of curcumin shows pain-relieving effect at a dose of 2000mg per day.
The most commonly used curcumin supplements are standardized 95% curcumin with bioprerine. Curcumin requires piperine or fats for better absorption by the body. (Read How to improve bioavailability of curcumin?)
Apart from this, there are many other curcumin supplements that help to enhance the bioavailabilty of curcumin. (Read 8 Popular curcumin supplement types)
Curcumin intake should be started with lower doses. The dose can be increased gradually over weeks. It is best taken after meals and it should not be taken along with other medications. A gap of 3-4 hour must be maintained.
Curcumin gel can be applied on the affected joints to reduce inflammation.
Turmeric is very safe for dietary use. Curcumin, in high doses is also found to be safe in most studies.
However, certain precautions must be taken pertaining to the consumption of curcumin. (Read Side effects & Precautions of Curcumin)
Turmeric and curcumin can cause allergy.It may result in fever, itchiness, skin rashes, vomiting etc.
Curcumin supplements can cause acid reflux, if taken in empty stomach, in sensitive individuals.
Gastric discomforts may be caused by a sudden high dose of curcumin. Curcumin intake should be started with small amounts and if gastric side-effects are observed then should be discontinued.
Curcumin interferes with drug metabolism. Taking it along with medications can reduce their effectiveness or may even lead to adverse effects. Therefore, a gap of 3-4 hours must be maintained in between.
Consultation of a medical practitioner is valuable in this regard.
Curcumin has blood thinning activity. If one is taking blood thinning medications or suffering from bleeding disorder, curcumin should be avoided as it may increase the risk of bleeding due to its blood thinning action. (Read Is turmeric a blood thinner?)
Curcumin should be discontinued prior to a surgery. The blood thinning activity of curcumin may slow down the blood clotting process, required for healing of a surgery wound. Therefore, its use should be discontinued at least 2 weeks before surgery and after that as well.
Curcumin supplements should be avoided by gallstone patients. (Read Is turmeric safe in gallstones?)
It should be ensured that curcumin supplement is uncontaminated. Curcumin supplements may be contaminated with heavy metals, harmful chemicals, fillers or additives. Such contamination can be dangerous for the body and may cause severe complications.
Curcumin supplements are best taken with bioavailability enhancers.Since curcumin is poorly absorbed by the body, it is best to take with certain agents like bioperine that increase its absorption in the body.
It is best to consult a medical practitioner prior to curcumin supplements use. If one has any apprehensions regarding the curcumin’s use, it is best to take advice of a medical practitioner to ensure the best results and prevent any adverse effects related to its use.
Curcumin is a highly beneficial compound for rheumatoid arthritis.
Its anti-inflammatory and antioxidant activities reduce the inflammation and pain related to the disease. Curcumin is also capable of preventing the cartilage and bone loss triggered by the abnormal immune response.
Moreover, curcumin has a chemopreventive action in rheumatoid arthritis which helps in prevention of the development of malignancies.
Additionally, curcumin protects from the side-effects of the common drugs used for the treatment of rheumatoid arthritis.
In conclusion, curcumin can be said to be a therapeutic natural compound of immense potential in the treatment of various aspects of the rheumatoid arthritis.