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The Wild Rose is Hip for Osteoarthritis
Wild Dog Rose Flower (Rosa canina) http://en.wikipedia.org/wiki/Rose “Hearts starve as well as bodies; Give us bread, but give us roses.” (James Oppenheim, “Bread and Roses”)1 Once more the beautiful Wild Rose (Rosa canina), a humble member of the Rose species so beloved by all around the world and one of oldest medicinal plants in history and folklore, comes to the rescue of our seriously ailing world. A Whiff of Rose History and Medicine The rose is believed to have first been cultivated by the Persians and Chinese and is said to have been planted in Nebuchadnezzar II’s Hanging Gardens of Babylon2 – a city, according to historian Herodotus 450BC, that “In addition to its size …surpasses in splendour any city in the known world.” Fact or fantasy? We do not know. The gardens may only have existed in the minds of Greek poets and historians, 2A but the pillaging of artefacts and then devastation of Iraq may preclude any future archaeological find. It’s best to hold on to the dream. It has also been suggested that Alexander the Great brought the Apothecary’s rose (Rosa gallica) from Persia to Greece where ‘honey of roses’ was used to heal wounds. These days Rose hip seed oil (Rosa canina) and (Rosa rubiginosa) are used for the same purpose and to avoid scarring. However, according to Pliny, Alexander did find “among the spoils of Darius, the King of Persia, a casket for perfumes, enriched with precious stones and pearls”, but “covered as he was with the dust of battle, deemed it beneath a warrior to make use of unguents” - he actually instructed that the casket be used to house the poetic works of Homer.3A Without falsely ‘romancing the rose’ it is firmly fixed in history. Certainly, in the 1st- Century AD Pliny the Elder recorded no less than 32 different medicinal uses for roses. Being a native to ancient Persia and other parts of Asia Minor, Persians are credited with the discovery of Rose Otto and its production in the 10th century. Its natural solar distillation, separating the rose essential oil from petals floating in water in an enclosed garden, is alleged to have been observed and copied by Avicenna, the famous Arab physician. However, it is also proposed that it is likely both the ancient Egyptians and Hebrews had discovered this secret of natural solar distillation long before. Egyptian Queen Cleopatra is held to have used rose water, which is still a remedial cosmetic lotion today and is the natural by-product of rose oil distillation. In one form or another roses found their place around the globe in societies’ cuisine, medicine and worship, as well as a re-emergence in cosmetics. Candied rose petals that currently adorn cakes and chocolates were first used for Roman banquets. The Emperor Nero liked rose petals to descend upon his feasting guests knee deep – he was none too bothered if the odd one was suffocated by them! In Rome the use of roses became so important that orchards and vineyards were cleared to accommodate the rose industry.3 Rose petals were used in wine, latterly in brandy in the rose-growing area of Bulgaria, subsequent to ancient merchants having brought rose bushes to Bulgaria and Turkey. The architectural form of the religious rose can be found discreetly ensconced in places of worship e.g. the stained glass ‘rose window’ of York Cathedral, England. The enigmatic rose is even hidden in our Law ‘sub rosa’, meaning ‘carried out secretly’. During the medieval period the rose was grown mainly for its medicinal properties, but later in the 19th-Century when the essential oil of roses was re-discovered the fragrant rose became best known for its use in perfumery. Although the Apothecary’s rose is still used for potpourris, teas, lotions and cosmetics, it is the fruit of the rose, ‘rose hips’, that has proved to be a highly curative remedy in modern times. In the 20th- Century both the wild Dog Rose (Rosa canina) and ‘Rosa Mustique’ (R. rubiginosa) rosehip seed oils have been used for both remedial and cosmetic skin products.
Dog Rose Hips (Rosa canina) Location: South slopes of Mt. Spilnik, Zagora above Planinsko polje (Notranjska, Slovenia) Photo: Copyright © Dr. Amadej Trnkoczy Rose hips, dried ‘shells’ powdered, were once used for treating scurvy via the ascorbic, citric and malic acids content. Later on the ‘hips’ provided much needed rose hip syrup and juice, a high-yield concentrate of potent vitamin C supplement, for babies in WWII. This was important to infants who no longer had access to orange juice. Natural rose hips provide, weight for weight, about eight times the amount of vitamin C of oranges and up to 100 times that of oranges in concentrated extracts. From the 19th-Century onwards science has revealed that rose hips contain much more than4 vitamin C (ascorbic acid). They also contain vitamin E (tocopherols), vitamin B3 (niacin), vitamin K (a group of 2-methilo-naphtahoqinone derivatives) 5 and vitamin P (bioflavonoids),6 vitamin A (carotenoid), vitamin D (ergosterol), pectin, sterine (phytosterols), as well as minerals calcium, iron, phosphorus, potassium, sodium and other traces. In fact, researchers last year found rose hips contain more novel natural products, e.g. proanthocyanidin glycosides with antioxidant effects. No matter for how long it has been known and experienced that rose hips contain anti-inflammatory properties, it is only in the past three years that Danish researchers have found a ‘galactolipid’,8A (2S)-1,2-di-O-[(9Z,12Z,15Z)-octadeca-9,12,15-trienoyl]-3-O-beta-d-galactopyranosyl glycerol (1) isolated from dried and milled fruits (rose hips) of the wild Dog Rose (Rosa canina), which they believe may explain the clinically observed anti-inflammatory properties of rose hip herbal remedies.8 Earlier French research had revealed that the antioxidant effects of rose hip extract (R. canina) are not only due to vitamin C, but also to polyphenolics9 - research suggests that polyphenols are powerful antioxidants and proven anti-carcinogenics. Scientific interest is fired when these findings combine with German research of five years ago entitled: ‘Value of complementary medicine exemplified by rose-hips’10 which found laboratory experiments showed that rose hip extract inhibits lipid oxidation [‘in vitro’] and rose hip treated patients suffering from osteoarthritis reported that physical symptoms declined. Furthermore, data from a randomized controlled trial indicated not only that pain significantly declined but also flexion of the hip improved in the study’s active group. Is it any wonder that anti-inflammatory properties of rose hip are useful as a natural treatment in patients with osteoarthritis. In 2004, Danish researchers carried out a double-blind, placebo-controlled, crossover study on the effect of Hyben Vital®, a herbal remedy made from a subtype of Rosa canina, which had been reported to have anti-inflammatory properties on the symptoms, such as pain and stiffness, and reduction of inflammation on 112 osteoarthritis patients who received treatment with either 5g. daily of Hyben Vital® or an identical placebo for 3 months, followed immediately by the alternative treatment.11 General wellbeing, including mood, sleep quality and energy were also assessed and recorded in a personal diary. When patients, on the basis of reduction in joint pain, were divided into responders and non-responders, the first 3 months of active treatment showed a response rate of 66% for the Rosehip remedy, compared to that of placebo 36%. No major side effects occurred in either group. The data indicated that Hyben Vital® reduced the symptoms of osteoarthritis, and the marked differences in the responses of the two groups was interpreted as indicating a strong ‘carryover’ effect of the standardized remedy. A study to evaluate the safety and efficacy of standardized LitoZen® and Hyben Vital® rose-hip powder {Hyben Vital International, Lagneland, Denmark) on knee and hip joint mobility, pain, and ‘activities of daily living’ (ADLs) in patients with osteoarthritis has been carried out12 and not found wanting, except for exhortations for ‘more research’. The ‘good news’ is that Danish researchers’ most recent study involving 94 persons using LitoZen® 13 showed that rose hip resulted in a significant reduction of pain, stiffness, disability, and global severity of the disease in 82% of the patients after the first three weeks of treatment!14 What is more, and very important, patients also took half as many traditional pain-killers such as Ibuprofen and Paracetamol, which can cause serious side-effects including stomach ulcers, bleeding, heartburn and nausea, if used over a prolonged period. We already know that rose hip oil has been used for eons to heal open wounds and that rose hip seed oil (Rosa aff. Rubiginosa L.) heals topical ulcers,15 so all that forceful anecdotal one time considered roseate history, has since proven to be scientifically correct in modern times, and makes this remedy an excellent safe candidate to aid osteoarthritic sufferers. The LitoZen® study was presented at the Osteoarthritis Research Society International World Congress in Boston, Massachusetts 8th December 2005.16 Why this sudden rush on Rose hip supplement as an osteoarthritic remedy? “Pain associated with osteoarthritis is commonly treated in conventional medicine with non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroids. However, the prolonged use of these drugs is associated with undesirable side effects. Although conventional drugs called cyclooxygenase-2 (COX-2) inhibitors (enzymes involved in the synthesis of pro-inflammatory cytokines) have previously shown promising analgesic and anti-inflammatory activities, they have recently shown to produce serious side effects in some patients. And, these drugs are relatively expensive. Thus, there is a growing demand for safe, effective, low cost treatments for Osteoarthritis.”17 The present development of the rose hip supplement aptly arrives bang in the centre of recent research finding that gluscosamine brought around only 40% pain relief and took up to 12 weeks for patients to notice an improvement. The review by the WHO (World Health Organization) Collaborating Center for Public Health Aspects of Rheumatic Diseases, Liege, Belgium on glucosamine, currently the most popular supplement for knee, hip and hand joint pain, states: “Since some discrepancies have been described between the results of studies performed with a patent-protected formulation of glucosamine sulfate distributed as a drug and those having used glucosamine preparations purchased from global suppliers, packaged, and sold over-the-counter as nutritional supplements (not regulated as drugs and with some potential issues concerning the reliability of their content), caution should be used when extrapolating conclusive results obtained with prescription drugs to over-the-counter or food supplements.”18 However, the more pressing findings of a review study by researchers in New Zealand that the drug Celebrex, belonging to the class of drugs Cox-2 inhibitors, which is manufactured by Pfizer Inc. and is commonly used to treat arthritis pain, has been found to more than double the risk of a heart attack and is a good raison d'être to speedily find alternatives and/or complementary arthritis treatments.19 The selection of research papers that were reviewed will of course be strongly contested by Pfizer’s, but it makes finding and using alternative treatment(s) for arthritic diseases with lesser or ‘no risk’, offering decreasing use of conventional drugs with side-effects of paramount importance. LitoZen® is not “a rose by any other name’, it’s the real thing and really ‘hip’, or to update the jargon - it’s really ‘cool’! A Bit about Arthritis Arthritis, which unfortunately is a very common condition, refers to inflammation of the joints making them painful, stiff and swollen, and in severe cases can significantly restrict mobility. In 2003 it was estimated to afflict around seven million people in the UK, with and nine million sufferers of arthritis and other joint-pain conditions come 2006.20 & 21 The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is not a single disease but comes in about 200 different forms, the exact cause of which is unknown. It manifests in the breakdown of protective tissue (cartilage) in the joints resulting in inflammation from bone friction usually affecting fingers, knees, hips and spine, but may also affect the wrists, elbows, shoulders and ankles. Rheumatoid arthritis is an auto-immune disease whereby the immune system, which function is to act against infections, malfunctions and conversely attacks the tissues of the body itself. The condition is caused by inflammation of the lining (synovium) of the joints, but can also affect other parts of the body, including blood, lungs and the heart. Again the exact cause is unclear, although genetic factors play a role in some cases, but not all. It may also be triggered by an infection. Affected joints feel tender, stiff and swollen and symptoms can last for an extended period of time, or may flare up in phases. In severe cases it can lead to serious joint damage and disability.22 COMMENT: The message should have got across by now that prevention and treatment of chronic debilitating diseases such as arthritis require more than palliative treatment. A combination of lifestyle, diet and exercise accompanying herbs and other supplements is usually required for improvement of joint health and to avoid further joint deterioration. It has been widely thought for some time that eating a varied and balanced diet, as well as beneficial exercise, can help to reduce the symptoms of arthritis. As far back as 1983, it was proposed that “individualized dietary manipulations might be beneficial for selected patients with rheumatic disease.”23 Those with arthritis may be told to cut down on red meat, avoid alcohol and coffee, but suggested changes to diet may fall upon deaf ears. Clearly, there is now quite a bit of scientific proof that high level ‘red meat’ consumption is an inflammatory risk factor for the disease.24 An American review, last year, illuminated the dietary link to rheumatic disorders: “A prospective study suggests that higher intakes of meat and total protein as well as lower intakes of fruit, vegetables, and vitamin C are associated with an increased risk of inflammatory polyarthritis or rheumatoid arthritis. Several studies suggest that the Mediterranean-type diet or its main components may have protective effects on the development or severity of rheumatoid arthritis. A recent prospective study investigated several purported dietary factors for gout and confirmed some of the long-standing suspicions (red meats, seafood, beer, and liquor), exonerated others (total protein, wine, and purine-rich vegetables), and also identified potentially new protective factors (dairy products). Recent double-blind, randomized, placebo-controlled studies suggest that antioxidant vitamins (vitamin E, vitamin C, beta-carotene, and retinol) do not halt the progression of symptomatic knee osteoarthritis, as was previously suggested.” So there you have it. From a preventive view-point, the study, which covered the dietary habits of 25,000 people between the ages of 45-75 by the University of Manchester showed people who ate meat every day had double risk of developing the disease compared to those who ate meat less, perhaps twice a week. With around 387,000 rheumatoid arthritis sufferers in the UK, a few alterations to the daily and weekly diet is a worthwhile consideration. There are other risk factors at play such as genetic susceptibility, smoking, low intake of Vitamin C that gang up against staying arthritic-free. And, ‘red meat’ in itself is not dangerous to health or ‘off the menu’, but should be eaten in moderation as part of a balanced healthy diet. However, for people with arthritis a low-fat, high-fibre diet is deemed vital to maintaining good general health. Post Script: For those interested in the production of rose hips, it may appeal to read the Domestication of wild roses for fruit production by Madeleine Uggla.26 References:
2A. ‘The Hanging Gardens of Babylon’, Diodorus Siculus from “7 Wonders of the World” - http://www.indiavilas.com/indiainfo/indiainfo.asp?m=7wgarden
3A. ‘The Natural History’ by Pliny, translated with copious notes and illustrations by the late John Bostock, M.D., F.R.S. and H.T. Riley, Esq., B.A., late Scholar of Clare Hall, Cambridge. Pub. By Henry G. Bohn, York Street, Covent Garden, London, 1855. Book VII, Chapter: ‘Men of remarkable genius’ [Refer to Book VII, 107-109 in Loeb edition].
7A. Proanthocyanidins [also called procyanidins]: Flavonoids (plant pigments responsible for many of the health benefits of many fruits and medicinal plants).
8A. Galactolipid: e.g. Cerebroside: Any of various lipid compounds containing glucose or galactose and glucose, and found in the brain and other nerve tissue, especially the myelin sheath. Also called galactolipid, galactolipin. “Case: Dog Rose Hip” http://64.233.179.104/search?q=cache:A36Iw8FxezMJ:www.plantertilsundhed.dk/f/f1/UCAA_UK.pdf+Rosehip+galacto+lipid&hl=en&gl=uk&ct=clnk&cd=1
Rossnagel K, Willich SN. Institut fur Sozialmedizin und Epidemiologie, Universitatsklinikum Charite, Humboldt-Universitat zu Berlin. Gesundheitswesen 2001 Jun; 63(6):412-6.
‘Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption.’ Pattison DJ, et al. Uv. of Manchester, Manchester, England, UK. Comment in: Arthritis Rheum. 2004 Dec; 50(12): 3745-7 – Arthritis Rheum. 2004 Dec; 50(12):3804-12.
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