Dear Dr. Roach: I just read your column about ulcerative colitis. Many years ago, I read about a possible relief: nicotine. I had a friend who was in dire straits for years, and he was ready to get a colostomy. He had not responded to all kinds of steroids and expensive meds. He was treated with nicotine patches, and in 48 hours he had relief. He wore a patch for at least a year. He moved years ago, but when I knew him, he looked at nicotine as a cure. Any thoughts?
Dear R. : I learned in medical school that ulcerative colitis could appear or flare after quitting smoking, and that studies were being done to look at nicotine as a treatment. Since then, nicotine has been more extensively studied but has not found a major role in the treatment of UC. It is used occasionally and even more occasionally successful in people who have not gotten relief with more-common treatments. The side effects of high doses cause many people to not tolerate it.
Dear Dr. Roach: Have you heard of Boswellia? Would you recommend it for arthritic pain?
Dear F.P: Boswellia, also called Indian frankincense, is an herb that has been used for millennia in India as an anti-inflammatory for relief of arthritis pain. I was able to find a well-done study from 2011 that showed significant benefit in reducing pain and improving function in people with osteoarthritis of the knee. The only side effects seen were minor headache and nausea. Other studies, all small and relatively short, confirmed these results.
Based on these small studies, it appears that Boswellia extract may have benefit in improving pain and function in people with osteoarthritis of the knee.
I found products that are labeled as having what the study medicine did (most commonly 100 mg once daily, containing at least 20 percent AKBA, the active ingredient).
However, let me emphasize that supplements are not subject to oversight by the U.S. Food and Drug Administration. In February 2015, the New York state attorney general’s office accused four major retailers of selling fraudulent and potentially dangerous herbal supplements under their store brands.
Of the products they tested, 78 percent did not contain any of the herbs on their labels, and some contained substances potentially dangerous to those with allergies (including wheat in products labeled “wheat- and gluten-free,” and powdered legumes, a potential risk for those with peanut allergies). These products were labeled “standardized” and “guaranteed.”
There may be good manufacturers, but with no way of independently testing their products, I cannot give a recommendation for a particular brand.
Email questions to ToYourGoodHealth@med.cornell.edu