Devil`s Claw Leads In Herbals For Arthritis

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The most common buzzwords associated with herbal products are “natural,” “non-drug” and “safe.” You may also read that they are “legal” or even “approved” for use during competitions. While these claims are tempting, we prefer to zoom in on what really counts: Do they work'

“Legal,” as it applies to herbals, really means use of herbs won’t be detected. There are no breed organizations, show or race organizations that actually permit the use of herbals. In fact, in the strictest interpretation of no-foreign-substance rules, herbals would not be permitted. So, while you won’t get a drug-positive test using herbals as directed (high amounts of white willow could cause a drug-positive), you are not within the letter of the law either.

The terms natural, non-drug and safe are often used interchangeably when referring to herbals, but they are not synonymous and can be misleading. While undeniably natural (versus synthetically made), the active chemicals in herbals are as much real drugs as anything that comes from a pharmaceutical company. For example, autumn crocus is an herbal ingredient in arthritis remedies. It contains the same chemical, in the same form, as the human antigout medication colchicine. Black cohosh and white willow contain salicin, a close relative to salicylic acid (aspirin).

The safety of an herbal remedy, like a prescription drug, is directly related to the dose of the active chemical consumed. The main reason you are less likely to get into trouble with an herbal supplement is that they are much less potent drugs than most prescription items. The ones that do have extremely potent activity have already been purified and transformed into prescription or over-the-counter items, such as colchicine and aspirin. As a rule, because they are less potent, herbals do not have as many (if any) serious side effects, at least with short-term use (weeks to months). We could find no good information concerning potential side effects when herbals are used over a period of years. Some herbal preparations carry recommendations that you discontinue use at regular intervals. We strongly suggest you follow those recommendations.

Herbal Choices
On page 13, we list common ingredients in herbal remedies for arthritis. Most have a history of specific use in treating arthritis, and at least some clinical trials (usually European) support their use. The herbs included in equine arthritis products come from as close to home as native American lore (yucca) to as far afield as Ayurvedic medicine from India. A few have even been extensively studied to the point the active chemicals in the plants have been identified, purified and the mechanism of their action described. There is much less witchcraft and folklore involved in using herbals for arthritis than is commonly assumed.

Other ingredients fall into the general category of “cleansing herbs.” This common herbal-medicine term can be difficult to translate into traditional medical language or even everyday language. For example, a renal (kidney) cleansing herb might stimulate the production of urine or it might have a chemistry that is believed to cause increased secretion of metabolic waste in the urine. Herbs that purport to cleanse the liver usually stimulate the flow of bile. Still others may have the effect of increasing perspiration.

The general idea behind “cleansing herbs” is to encourage the horse’s body to clear itself of waste materials and toxins. Unfortunately, a fine line often exists between what is reasonably well documented either in a clinical trial or laboratory experiment and what is little more than speculation on the part of the manufacturer or herbal practitioner. In fact, it’s not uncommon for claims to make this leap within the same sentence.

We also found that some herbs, which might legitimately be tried to assist treatment of a human joint condition, are included in the mix for horses — but for conditions that horses do not have. Several of the ingredients are primarily indicated for arthritis caused by gout. Horses don’t get gout. The rationale for including them is their anti-inflammatory action. However, unless they are targeting a cell type or inflammatory chemical that is also involved in degenerative arthritis, they may not be as effective in horses.

On the other hand, many herbs that do have some documentation of effectiveness in degenerative arthritis also have an anti-inflammatory effect as a primary action. According to the classical description of degenerative arthritis, little inflammatory reaction is involved. While this may be true for advanced-stage degenerative arthritis in a horse (or human) that is not physically active, experience shows us that inflammatory components (e.g. synovitis) can be important contributors to pain in horses that are in active use and struggling with problem joints.

Dosages
“Correct” dosage is a big question with herbals, even when you look at the human literature. To start, there is a wide range in recommended dosages and much variability between products. Plus, products vary in potency between manufacturers and sometimes even from batch to batch with the same manufacturer. This is often because of variability between plants grown in different locations, on different soils, at different altitudes, or even under different weather conditions from year to year. If you read labels carefully, you will also see that some products contain only a specific portion of the plant (root, flowers, etc.) while others may use the entire plant.

Part of the solution to this problem is to use standardized extracts, which contain a specified/guaranteed amount (usually a percentage) of one or more of the herb’s active chemicals. This sounds like a good solution until you learn that not all herbs/botanicals have been studied extensively enough to know for certain what the active principle is or where it is located in the plant. Some experts also claim that standardized extracts may actually exclude some active and synergistic compounds that are present when the whole plant is used — and they may be right.

Serious manufacturers of high-quality whole-herb/plant products will establish a relationship with one supplier/grower to help minimize the natural variability that occurs in the chemical composition of plants grown under different conditions. However, in most cases, the best route is to use standardized products when available.

Our Findings
Before we could answer the question “Does it work'” we had to clearly define our expectations: Clear, consistent results within a reasonable period of time. Based on our field testing and research, if you are looking for an herbal arthritis remedy that will give your horse rapid relief of symptoms within hours to days (a non-drug drug!), the clear choice among the ingredients we tested is devil’s claw.

Devil’s claw is the common name of the plant Harpagophytum procumbens, which grows in the Kalahari Desert in Namibia. Its name comes from the fact that the fruit of the plant is in the form of huge, hooked claws — large enough to injure and trap cattle. The medicinal preparation is made from the secondary roots or tubers.

Devil’s claw has been studied in both standard laboratory models of inflammation and pain and in large clinical trials. Effectiveness in relieving arthritis symptoms is said to be just under 90% and equivalent to phenylbutazone in people. We also found it to have predictable analgesic effects, equivalent to about one gram of phenylbutazone (Bute-Less was more equivalent to 1.5 to 2 grams of bute), evident in less than 24 hours. Anti-inflammatory benefits were not as obvious (decreased heat, swelling). Interestingly, a study in mice also showed good analgesia but poor control of inflammation, while yet another study showed the effects are much more potent if it is injec ted rather than given orally.

Highly acidic environments can at least partially inactivate devil’s claw, so an added benefit is that devil’s claw is completely free of the damaging effects on the digestive tract and kidneys common with NSAIDs (non-steroidal anti-inflammatory drugs). In fact, it is said to be of benefit in treating disorders of the liver and bile flow.

We had the best results using Bute-Less, a standardized blend containing 7.4% devil’s claw (2% harpagoside content) and 7.4% yucca (12% saponin content). We found the most effective dose to be between 30 to 50 cc, depending on the severity of the condition and size of the horse. The base of this product contains sugar, honey and thickening agents, which made it extremely palatable in the feed (100% acceptance) or easy to administer by dose syringe, if you prefer.

We’re not sure how much the inclusion of the yucca extract contributed to the effectiveness of this product, but if you are looking for a substitute for phenylbutazone, this is the clear choice. Benefit obtained was rated as equivalent to 1.5 to 2 grams of phenylbutazone. The cost-to-benefit ratio of this product was also unbeatable.

Another standardized extract of devil’s claw, No-Bute (produced by a patented process — further details are proprietary) also proved of benefit to four out of five of our test horses. This is a pure devil’s claw product in a cider vinegar base. However, two of the five horses would not eat it when it was simply added to feed. We also found we needed the upper recommended dosage of 60 cc, sometimes up to 80 cc, to get a visible benefit. Maximal effect was rated as about the same as one gram of phenylbutazone, a common maintenance dose for horses with chronic arthritis.

Many of the multi-ingredient products we tested, including another liquid extract (Multi-Flex), also contained devil’s claw as a major ingredient, but these products did not provide the rapid, predictable relief of symptoms we obtained with the two products above. However, combination products use lower doses of the individual ingredients and are based on the principle that the various elements will work in synergy to eventually achieve an effect that is superior to that of any one ingredient. Most manufacturers counsel to allow three to four weeks for effects to be seen. Multi-ingredient herbals are a combination of herbs directed at arthritis specifically and herbs with reported general health benefits.

The most rapid-acting combination supplements were Joint Jolt (response in five days in one retired horse) and Multi-Flex (response in 10 days in one performance horse), with the Joint Jolt also showing mild-to-moderate benefit in two performance horses after two and three weeks. Overall response rate for the multi-ingredient products was 60 to 70%.

The character of the response was a little different from what we saw with Bute-Less and No Bute. The best way we can describe it is that the horses moved like horses on chondroitin do, which is more freely and relaxed although problem joints may still be easy to identify.

We stopped the multi-ingredient trials at the three- to four-week mark, since we did not feel we could confidently state that any improvement or deterioration beyond that time was in any way related to the supplements. Too much can go wrong (even something as simple as a twist in the field) to cause a horse to look worse, and arthritis cases often show periods of spontaneous improvement. We also believe that if you are going to derive any benefit there should be obvious signs of it by the four-week mark. Those horses that did improve may very well have gone on to do a little better yet if supplementation had been continued.

While multi-ingredient herbal products proved not to be quick fixes, they also are not intended to be. The Hilton Herbs manufacturer stated that in an eight-week trial in the United Kingdom, 65% of those horses (mean age 12) showed a favorable response to Multi-Flex. We found the best overall responses in older horses, probably because they stood the most to gain from the wider range of potential benefits. They won’t make your horse feel better overnight but are well worth trying if you are interested in long-term, steady improvements.

We had an interesting glimpse into the “cleansing” effect of multi-ingredient herbal products. Two horses given Phyto-Flex showed dramatic changes in the character of their sweat, going from thick and whitish, one with a peculiar odor, to clear and watery. These changes occurred at the same time as improved movement. The horse with “stinky” sweat also showed a dramatic improvement in overall attitude and in his appetite, which had been poor.

Yucca Trials
Yucca has a long heritage as an arthritis remedy, being used by native Americans both externally as a poultice and internally. Like the multi-ingredient herbal products, yucca does not promise overnight results. One reference stated it could take up to three months to see any effects. Many people who have experienced poor results using yucca were probably feeding too little.

We found an extremely broad diversity both in recommended dosages and strengths of the yucca products we tested. We had the best results with products that used a standardized extract (high saponin activity 10+%) and at generous dosages (three grams or more of the standardized 10% extract). Horses that responded to the standardized yucca extract did so within three to seven days. Response rate was 60%. Yucca feeding was continued for four weeks.

The apparent analgesic effect was not as marked and rapid as with devil’s claw, but this is because yucca does not have direct analgesic properties. We did see visible improvement in horses that had active heat and swelling. While we saw nothing miraculous (like you would get with an injection of corticosteroid or a high dose of phenylbutazone), yucca definitely did help. An added benefit of feeding yucca is a reduction in ammonia odor in the stall. Yucca blocks the enzyme urease, which breaks down naturally occuring urea in manure and urine into ammonia.

By far our best response was with Yucca Saponin powder (at a dose of three grams per day) and Yucca 24X Pellets (at the upper recommended dose of four ounces per day). Sun Gold 75% Pure Yucca and Desert Pure Yucca were also effective. However, we had to increase the dose of the Sun Gold 75% Pure Yucca to 1.5 to two tablespoons twice a day and use three scoops of Desert Pure Yucca instead of one to get as rapid a response. The manufacturer of Sun Gold 75% Pure Yucca reports an average wait of three weeks for results when using the one tablespoon twice-daily dose, in conjunction with adequate nutritional support.

Bottom Line
If you are looking to herbals as a substitute for bute, we obtained good responses at an unbeatable price with Bute-Less. It was rapidly effective with results equivalent to moderate amounts of phenylbutazone. We also liked high-dose yucca’s effect on heat and swelling. Yucca Saponin is the product of choice in this category.

We can’t recommend any multi-ingredient product over another as our trial did not extend beyond four weeks, and these are designed to provide benefits over the long term.

Herbals are no substitute for a correctly balanced diet, antioxidants, regular exercise and use of joint nutraceutical therapy (glucosamine, chondroitins, perna — see November 1997 and May 1999). Herbals, as with corticosteroids and NSAIDs, provide symptomatic relief. It’s best to think of them as drugs but without the side effects associated with traditional drug therapy.

Also With This Article
Click here to view "Arthritis Remedy Herbals Products."
Click here to view "Common Herbal Anti-Arthritis Ingredients."
Click here to view "Is Devil’s Claw Safe'"
Click here to view "Interpreting A Yucca Label."