Hacker News Reader

Comment by DoreenMichele | Hacker News Reader

I've tried curcumin. I wasn't impressed. It did little or nothing for me.

From what I am reading, this seems to be an approach that treats symptoms, not cause(s). I think it would be better to ask "What is causing the inflammation?"

Trying to control inflammation without knowing why it exists potentially makes things worse in the long run, even if it provides relief in the short run. This is the fundamental flaw with most medicines: We trade short-term gains for long-term costs, hand wave off the long terms costs and doctors get credit for "curing" your problem short term and wash their hands of long-term side effects, often chalking it up to the underlying condition for which you were nominally being treated.

View on HN

I frankly disagree that antiinflammatory drugs having "long term costs". I'd be very interested if you have a paper to back that claim up. A couple decades ago it was common for rheumatic patients to end up in wheelchairs. Today that's very uncommon. I agree that most antirheumatic drugs, and most drugs in general, treat the symptoms rather than provide an outright cure. But that's enough to drastically reduce disease severity and increase quality of life. Actual cures might be ideal but we are far from there research-wise - at least for most rheumatic conditions.

> The major side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Some 10% to 50% of patients are unable to tolerate treatment with NSAIDs because of side effects, including abdominal pain, diarrhea, and upset stomach. Approximately 15% of patients on long-term treatment with NSAIDs develop a peptic ulcer (ulceration of the stomach or duodenum). Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications, such as bleeding or perforation of the stomach.

This is for a lay audience, but it's not remotely controversial: https://www.medicinenet.com/nonsteroidal_anti-inflammatory_d...

Fair point, my statement was too general. NSAID indeed shouldn't be used willy nilly. The same goes for cortisone and long term use. My point should have specifically referred to biologicals such as anti-TNF and other anti-cytokine treatments.

Acute inflammation as the result of an injury isn't something that should be suppressed. We now understand that it should be allowed to persist as part of the healing process, so long as it isn't causing other serious problems.

Persistent, chronic inflammation is another thing altogether.

Wait, really? You're not supposed to ice or take NSAIDs after an injury?

Not doubting, just wondering when this changed and if other people have been following this advice.

Icing (and cold therapy in general) has been pretty thoroughly debunked now except for some very limited, specific scenarios. It might feel good, but there's no reliable evidence that it actually helps with long-term recovery or healing. "Good to Go" by Christie Aschwanden contains a great summary of icing (and other athletic recovery modalities).

https://wwnorton.com/books/9780393357714

NSAIDs can inhibit certain types of tissue healing. Some people eat them like candy because they're available OTC but the side effects can be significant.

https://journals.physiology.org/doi/full/10.1152/japplphysio...

https://academic.oup.com/ptj/article/97/8/807/3826991

Some more information that's a bit more accessible to the layperson - https://www.nytimes.com/2021/04/21/well/move/exercise-icing-...

TLDR, inflammation response is part of healing and icing limits that.

This take ignores the fact that frequently the underlying condition is known, it just doesn't have any cure known to science.

You've already been given the example of rheumatoid arthritis - another one is Crohn's, where "treating the symptoms" with anti-inflammatory treatments like infliximab or even just common-or-garden steroids vastly improves patient's quality of life. You can't tell these people to hold out until the researchers figure out how to cure the underlying condition, because that means consigning them to a life of painful intestinal scarring, blockages, fistulas, and ultimately surgery up to and including bowel resection.

You can't tell these people to hold out until the researchers figure out how to cure the underlying condition

Nowhere have I recommended this or implied this. At all.

Well, that is the implication I took away from your comment - I've re-read it, and I'm still getting that from the part where you talk about short-term gains and long-term costs.

Maybe it's just my different life experiences, but when I think about anti-inflammatory treatments I see the balancing of long-term gains versus long-term costs. Indeed the short-term effects of steroids are pretty awful!

But my comment isn't about individuals trying to manage their own health as best they can. It's about what kinds of questions researchers ideally should be asking.

Those are wholly different topics.

I think "I think it would be better to ask "What is causing the inflammation?" reads as if it is referring to the diagnostic process.

At any rate, I believe we need to be researching both anti-inflammatory treatments and treatments for the underlying causes: we have no way of knowing whether a treatment for one of these illnesses is 9 years away or 90, and in the meantime advances in anti-inflammatory treatments are providing real benefits.

Did you take it with something like piperine to enhance absorption?

No.

Then it might be worth another attempt.

My condition is well controlled. I'm fine.

I only answered your question for your edification. As a courtesy, on the assumption that you are seeking answers for yourself in an imperfect world where doctors aren't always as helpful as we would like.

Okay. Share experiential anecdotes online makes it an easier world to navigate. We don't always speak at this level of abstraction, but i think this is an implicit understanding among some subset of experience-sharers/recommenders.

e.g. Bottom line: I've generally seen many who have no response from curcumin without it paired with an absorption enhancer. This is information anyone reading may find helpful.

I haven't found turmeric effective as an anti-inflammatory. But it is an excellent blood cleanser and I've used it for that, without requiring any kind of enhancer to get what I needed out of it.

It's possible that it helps with brain fog for you because it's a blood cleanser, not because it's an anti-inflammatory. The blood brain barrier and separate lymph clearing system for the brain present challenges if your health is impacting brain function.

Understanding the exact reason it helps matters for trying to effectively make progress with your condition though misunderstanding the exact mechanism doesn't mean it won't work. It will just interfere with getting the most out of it and with finding effective substitutes.

Your observation that you need an absorption enhancer is often true for natural treatments. That's one of the chief things modern medicine does well -- delivers an effective dose in a simple to use form that requires minimal skill or comprehension from the patient.

Best of luck with your search for healing answers.

Reply on news.ycombinator.com