A recent letter appearing in Dr. Paul Donohue's nationally syndicated newspaper column "Good Health" reads,

"Dear Dr. Donohue: I have had rheumatoid arthritis for more than 30 years and recently developed a stomach ulcer. I am no longer able to take aspirin or NSAIDs [nonsteroidal anti-inflammatory drugs including lbuprofen, Advil, Motrin, Clinoril, Naprosyn, Indocin, Nuprin, Nalfon, Feldene, Ansaid, Bufferin, Rufin and Tolectin]. I am told to take Tylenol, but this is not satisfactory. Any suggestions? -- M.T.

Dr. Donohue's reply,

"Dear M.T: You are truly between a rock and a hard place. Aspirin and the nonsteroidal anti-inflammatories such as ibuprofen and indomethacin make up a most popular group of arthritis-control drugs. Unfortunately, your stomach ulcer makes such drugs off-limits."

And what kind of substitute drugs does Dr. Donohue suggest?

"There are other medicines to try, even with the ulcer, such as Arthropan [an aspirin containing substitute] or Trilisate [another aspirin derivative]. Or, you can try enteric-coated aspirin..... And your doctor has further choices, including gold, penicillamine or methotrexate [so-called second-line drugs recommended when NSAIDs no longer work well, usually advocated in the hope of preventing all-too-frequent irreversible joint damage & deformity]."

What can M.T. and other ulcer-prone chronic pain sufferers expect from these "substitute" drugs?"

"No one can guarantee that substitute drugs won't cause an ulcer flare. As is sometimes the case, you might have to weigh the side effect risk against the pain of nontreatment."

"The pain of nontreatment" suggested by Dr. Donohue and unfortunately by many of his physician colleagues is a non-option. It's extremely revealing that once NSAIDs and second line drugs have been tried and failed, conventional allopathic medicine has no legitimate, science-based alternative therapies to recommend. Their option appears to be, "Suffer with chronic debilitating pain or take conventional NSAIDS."

It is estimated there are 40 million arthritic pain sufferers in the United States, most of whom are on aspirin or aspirin substitutes. NSAIDs as a group are one of the most commonly prescribed collection of drugs worldwide. An estimated 10 million victims of arthritis are currently taking large doses of NSAIDs on a daily basis (many of whom are on multiple drugs - 4 to 12 drugs simultaneously is not uncommon, often prescribed to counteract familiar side-effects of conventional NSAIDS).

Over the last decade or two a number of healing herbs have been researched, mostly in the medical and scientific communities of Europe and Asia, demonstrating an unexpected ability to improve the symptoms of different arthritics on a level equal to NSAIDs (nonsteroidal anti-inflammatory drugs) - but with no toxic side effects! One such standardized herbal extract nicely and thoroughly presented in this booklet is Boswellia serrata.

The major use of Boswellia serrata in contemporary medicine is as an anti-arthritic and anti-inflammatory plant-derived extract. Its anti-inflammatory actions, supported by solid science, are indicated in clinical medicine for the treatment of rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis, soft tissue rheumatism, gout, low back pain, myositis and fibrositis, and are attributed primarily to the presence of boswellic acids (These acids have been carefully identified and standardized in the Boswellin® product, a production step necessary in order to assure the health consumer that, in fact, the active ingredients are in each tablet, capsule or powder). The therapeutic action of a standardized Boswellia serrata includes: reduction of joint swelling, restoration and improvement of blood supply to inflamed joints, pain relief, increased mobility, amelioration of morning stiffness, steroid-sparing effect and general improvement in the quality of life.

Boswellia serrata extract, while demonstrably effective in the treatment of different chronic inflammatory conditions, produces none of the common side-effects associated with conventional NSAIDs and second-line drugs! There are no reports of GI ulceration, no GI bleeding, no GI perforation and no kidney disease. The absence of NSAID-related toxicity is the result of its unique site of action: namely, the blocking of the enzyme lipoxygenase and the resulting decrease of pro-inflammatory leukotrienes. On the other hand Boswellia serrata extract does not affect cyclo-oxygenase and the synthesis of Prostaglandins.

Many safe and effective natural alternatives are now within our reach. As a consequence, no one in chronic pain need any longer face the singular choice of long-term NSAID medications as the only pain remedy. There are times, or course, when potent drugs may be necessary. But my experience as a physician and investigator compels me to recommend that potent pain medications, especially for people over the age of 60, should be used as a last resort, and as sparingly as possible. By educating yourself, either as a health professional or a victim of chronic pain, about the remarkable world of proven natural alternatives, including Boswellia serrata in this fine booklet, millions of people will to discover the benefits afforded them through safe, time-tested, natural remedies."


James Braly, M.D.
Boca Raton, Florida
February, 1996