Devil’s Claw 

Introduction:

Devil’s Claw (Harpagophytum procumbens) is a plant indigenous to Africa.  Natives of that continent have used its dried roots in their medical formulations for many years to treat a variety of conditions, including pregnancy pains, sores, fever, liver problems, indigestion, and arthritis. The plant’s name comes from the shape of its fruits. Supporters suggest that it possesses anti-inflammatory properties because of its high concentration of the iridoid glycosides Harpogoside and Beta-Sitosterol, which suppress Cyclo-Oxygenase 2 by their effect on NF-Kappa B. Devil’s Claw thus putatively decreases the mediators involved in active inflammation while sparing those the body creates constitutively, yielding a theoretically more physiologic effect.

Evidence:

Studies demonstrate some effect for Devil’s Claw in relieving symptoms of rheumatoid arthritis, although there is a need for further studies in order to truly determine the efficacy of this product. A 1976 study with 122 patients comparing it to phenylbutazone shows some symptomatic relief and decrease in inflammation. Patients taking the supplement for 21 days in 1992 show less anti-inflammatory effect than those taking standard medicines.  Recent critics of this study suggest that the three week time period is insufficient to fully evaluate the treatment. A recent French trial comparing it to standard treatments for osteoarthritis shows fewer side effects and similar efficacy in reducing symptoms. Other trials for conditions such as back pain suggest efficacy in decreasing pain when compared to placebo.

Dosage:

750 mg three times per day is a standard dose for relief of rheumatoid arthritis. Available formulations include capsule, tincture, powder, liquid, and tea. No single formulation appears superior to any other, but look for the standard 3% concentration of iridoid glycosides. Buy this agent from a company you trust, as it is not monitored by the FDA.  When using this product, as with any medical supplement, always communicate with your physician. 

Side Effects:

The herb is generally well tolerated at pharmacologic doses. Some patients report upset stomach, ringing in the ears, and headache. Others note a decrease in appetite or change in taste. These effects are usually minor. Some patients on anticoagulation while taking Devil’s Claw have increased bleeding problems, and it should certainly be avoided in these settings and in people at risk for bleeding, such as those with ulcers or open wounds. Avoid this herb during pregnancy and breastfeeding along with any others not proven safe in these settings. We do not know the effects of long term ingestion of this agent.  Devil’s Claw may also interact with a variety of other medications.  Always discuss the potential benefits and risks of Devil’s Claw and any supplement with your physician before trying it.  

Authors:    Sanjiv Bajaj, A.B., University of Alabama-Birmingham School of Medicine, Birmingham, AL

       Neil Chaterjee, M.D., New York-Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY

Articles:

Huang TH, Tran VH, Duke RK, Tan S, Chrubasik S, Roufogalis BD, Duke CC. “Harpagoside suppresses lipopolysaccharide-induced iNOS and COX-2 expression through inhibition of NF-kappaB activation.” J Ethnopharmacol. 2005 Sep 30.

Soeken KL. “Selected CAM therapies for arthritis-related pain: the evidence from systematic reviews.” Clin J Pain. 2004 Jan-Feb;20(1):13-8.

Chrubasik S, Pollak S, Black A. “Effectiveness of devil’s claw for osteoarthritis.” Rheumatology (Oxford). 2002 Nov;41(11):1332-3.

Wegener T. “Degenerative diseases of the musculoskeletal system--overview of current clinical studies of Devil's Claw (Harpagophyti radix).” Wien Med Wochenschr. 2002;152(15-16):389-92.