Arthritis is classified by a group of diseases referring to joint pain or disorders.
It is the leading cause of disability in people all over the world.
Nearly 100 types of arthritis and related conditions have been observed in humans to date. It is more prevalent in women and older people.
Cartilage is a firm but flexible tissue in our joints that provide them with cushion and support. It absorbs shock and protects our joints from injury.
The most common manifestation of cartilage is in the form of cartilage destruction.
This causes wear and tear in the joint, pain and inflammation. This normal wear and tear are known as osteoarthritis.
Rheumatoid arthritis, on the other hand, is an autoimmune inflammatory condition.
It reduces the formation of synovial fluid that lubricates the joint and decreases mobility.
It is a more serious condition than osteoarthritis as it can cause complete destruction of both bone and cartilage.
There are various other kinds of arthritis such as arthritis caused by infectious agents such as Shigella and Salmonella or metabolic arthritis such as gout.
Most common symptoms of arthritis are pain, swelling, stiffness, loss of mobility, stiffness, difficulty in carrying out day to day tasks, etc.
There are various causes of arthritis, but the most common ones are injury, genetic factors, immune disorders or a combination of several of these factors. Various risk factors include sex, age, overweight, etc.
Since arthritis is a chronic disorder, there is no definite treatment for it but it can be managed through proper physical exercise and maintaining a healthy body.
It has been observed that licorice can help improving arthritis. It acts as an analgesic and an anti-inflammatory agent. Let’s understand this magical plant root better.
What is Licorice?
Licorice is the root of the plant Glycyrhhiza glabra and can be sweet. Licorice plant is native to Southern Europe and parts of Asia.
It has been used for ages for treating a variety of conditions ranging from the common cold to liver diseases. It helps get rid of phlegm and heal sore throats.
It is also used in the treatment of peptic ulcers, eczema, indigestion, weight loss, etc.
Licorice products are made from peeled and unpeeled, dried root. It is available as teas, capsules and licorice extract.
It has been observed that the active compounds in licorice help in managing arthritis due to its anti-inflammatory and immunomodulatory properties.
Proven Benefits of Licorice for Arthritis
Licorice benefits in arthritis in many ways. Licorice extract suppresses the expression of pro-inflammatory markers. effective adjuvant or alternative for nonsteroidal anti-inflammatory drugs, with little to no side effects. Licorice also acts as an immunomodulatory agent, thus benefiting in arthritis.
1) Licorice acts as an anti-inflammatory agent
The aggregated effects such as joint degradation, immune response and chronic inflammation in arthritis lead to a more serious inflammatory condition.
A study was conducted to analyze the effects of active compounds present in licorice as anti-inflammatory agents.
Glycyrrhizic acid, liquiritin, and liquiritigenin were analyzed for their effects on inflammation markers in our body.
It was observed that these three compounds inhibit the elevation of pro-inflammatory markers such as nitric oxide, interleukin, etc.
There was a significant reduction in inflammation due to suppression of these inflammatory mediators.
The result suggests that these bioactive compounds present in licorice extract can prove to be very useful in the treatment of inflammation-related disorders and diseases.
It has been observed that six flavonoids separated from licorice have anti-oxidant and anti-inflammatory properties.
These flavonoids were obtained and isolated from the natural plant and were tested by antioxidant and anti-inflammatory assays.
Two out of six compounds were observed to possess anti-inflammatory qualities.
They inhibited the production of nitric oxide, interleukin, and prostaglandins, all of which play crucial roles in pro-inflammatory mechanisms.
The contents of the six compounds were government approved and caused no significant side effects.
Thus, flavonoids extracted from licorice play a crucial role in reducing inflammation.
A study was conducted to assess the anti-inflammatory properties of four licorice extracts.
Extract of raw licorice obtained from ethanol and water showed the maximum anti-inflammatory properties and significantly suppressed nitric oxide and prostaglandin production.
It has been observed that the expression of NF-kappaB factor is increased in several types of chronic inflammations and leads to the enhanced production of proinflammatory gene products.
It was observed that the treatment of different cells with licorice extract inhibited NF-kappaB pathway.
Hence, licorice has a potential role in the suppression of NF-kappaB expression and reducing inflammatory responses in patients who have arthritis.
An animal study was conducted to observe the effects of licorice and roasted licorice extracts on acute inflammation and collagen-induced arthritis.
It was seen that roasted licorice extract possessed greater activity than normal licorice extract in inhibiting inflammation.
Oral administrations of these extracts reduced arthritis score, swelling and even reduced the levels of proinflammatory cytokines in joints.
Thus, licorice extract and roasted licorice extracts have benefits in protecting against both acute and chronic inflammatory conditions, including rheumatoid arthritis.
What does this mean? Licorice extract suppresses the expression of pro-inflammatory markers such as nitric oxide, interleukin, prostaglandins, and NF-kappaB. The active compounds and flavonoids present in licorice help in the treatment of chronic inflammatory conditions such as rheumatoid arthritis.
2) Licorice can be used as an effective alternative to NSAIDs
NSAIDs are known as Non-Steroidal Anti-inflammatory Drugs. They are the most common form of pain relievers in this world.
These drugs help in reducing pain and inflammation.
The most popular types are aspirin and ibuprofen.
Painkilling action of NSAIDs includes reducing the direct effect of inflammation on pain-nerve simulation and sensitivity and also decreasing the indirect heat and swelling.
These reduce or inhibit the production of prostaglandin and possess anti-clotting properties.
Even though NSAIDs show efficiency in reducing pain and inflammation, they have unwanted side effects.
These side effects include stomach pain, ulcers, increased bleeding, headaches, nausea, hypertension, drug interactions, etc. Therefore, these are not the ideal therapeutic agents.
Active compounds of licorice such as glycyrrhizin (GL) and glycyrrhetinic (GA) acid help in the treatment of rheumatoid arthritis based on cyclooxygenase pathway.
It has been observed that cyclooxygenase/thromboxane pathway’s auto-regulatory feedback loop is critical in the pathogenesis of rheumatoid arthritis.
But, thromboxane is neither the target of nonsteroidal drugs nor the target of disease modifying drugs.
Therefore, the limitations and side effects of these drugs might be due to the lack of effects on thromboxane pathway.
On the other hand, glycyrrhetinic acid and glycyrrhizin are capable of targeting this cyclooxygenase pathway and thus, can be used as add on therapy for rheumatoid arthritis.
The results suggest that the active compounds of licorice, glycyrrhizin, and glycyrrhetinic acid not only potentiate therapeutic effects but also reduce the side effects and usage of nonsteroidal anti-inflammatory drugs by targeting the cyclooxygenase pathway.
A study compared the anti-inflammatory effects of anti-arthritic herbal medicines with ibuprofen, a NSAID.
It was observed that natural licorice extract showed significant anti-inflammatory response as compared to the artificial drug ibuprofen.
Therefore, natural interventions such as licorice are most suitable for suppressing lipopolysaccharide induced inflammation as compared to NSAIDs.
Natural therapeutic agents have little to no side effects as compared to artificial NSAIDs.
What does this mean? Licorice contains active compounds like glycyrrhizin and glycyrrhetinic acids which target the key pathways required for proliferation of rheumatoid arthritis and therefore help in the management of the disease and reduction of inflammation. Therefore, licorice can be used as an effective adjuvant or alternative for nonsteroidal anti-inflammatory drugs, with little to no side effects.
3) Licorice acts as an immunomodulatory agent
In autoimmune diseases such as rheumatoid arthritis, the body’s immune system starts acting against itself and classifies “good” cells as “bad” cells.
Due to this, the immune system that was meant to protect our body from foreign invaders starts attacking the body and harms the healthy tissue.
Licorice extract helps in immunomodulation in our body and also shows antimicrobial activity.
These properties help in the management of arthritis, especially rheumatoid arthritis which is linked directly to the immune system.
Regulatory T cells perform a critical role in controlling immune responses and in preventing autoimmunity. Thus, increase in T cells in vivo can have broad implications for autoimmune and inflammatory diseases.
Licorice can promote regulatory T cell induction both in vivo and in vitro due to the presence of isoliquiritigenin and naringenin.
It also enhanced the immune suppression of regulatory T cells, which can be helpful in the prevention and treatment of autoimmune diseases.
Thus, the underlying mechanism of historically and widely used natural medicine licorice could be the induction of regulatory T cells.
Studies have shown that the immunomodulatory properties of licorice are also because of its active component glycyrretinic acid.
Various assays were used to map the immunological characteristics of licorice extract.
It was observed that Licorice extract blocked the activity of T cells.
It blocks various immune pathways and channels which are probably the reason for its immunomodulatory and anti-inflammatory effects.
What does this mean? Licorice contains active compounds such as naringenin, glycyrrhetinic acid, etc. which are responsible for immunomodulatory properties of the herb. Induction of T cells and immunosuppression help in managing autoimmune diseases like rheumatoid arthritis and are the main effects shown by these components.
Dosage of Licorice for arthritis
In traditional Chinese medicine, the recommended dosage of licorice is 8-15g for regular health protein and 100g for disease states.
The acceptable daily intake for glycyrrhizin is advised to be 0.2 mg/kg/day.
The dosage of Deglyccyrhizinated (without glycyrrhizin) can be up to 1800 mg daily for four weeks without any toxicity in humans.
For dried root consumption, 1-5 g licorice root can be used three times per day. A 1:5 ratio of licorice tincture can be taken in doses of 2-5 mL three times per day.
There is no recommended dosage for licorice; therefore it is advised to consult a health practitioner before using.
It is strongly suggested that licorice should not be consumed for more than a week without a prescription.
Precautions
It has been observed that licorice consumption can cause side effects in certain individuals.
Side effects include headaches, fatigue, high blood pressure,
swelling, etc.
High doses have been linked with stronger side effects such as muscle pain and numbness in limbs.
It is advised that people with heart diseases, cancer, hypertension, diabetes, and kidney diseases should not take licorice. Pregnant and breastfeeding women should also refrain from licorice usage.
Licorice may also interact with certain diabetes, diuretic, laxative and anti-depressant drugs.
Consult a health practitioner before use and do not use for more than 4-6 weeks
Conclusion
Licorice is a natural medicinal herb that has been used for ages in ancient medicine to treat various conditions.
It contains many active compounds which help in the management of arthritic conditions.
The active compounds present in licorice block various pathways and mechanisms responsible for inflammation and thus show anti-inflammatory activity.
This helps in reducing inflammation caused by inflammatory arthritis.
Licorice shows significant immunomodulatory effects which help in strengthening the immune system and managing autoimmune diseases like rheumatoid arthritis.
Glycyrrhizic acid, liquirtin, etc. interact with various mechanisms to show therapeutic effects and reduce the dependence on NSAIDs.
Thus, licorice is an effective natural therapeutic agent and can be used as an adjuvant or alternative for arthritic drugs with minimum side effects.