Sesame

Alireza Askari et al. (2024) · Frontiers in pharmacology

This randomized trial with 86 completing patients compared a traditional Persian medicine remedy — basil leaf oil blended with sesame oil — against a standard drugstore treatment, diclofenac gel, for knee osteoarthritis pain. Basil has been recommended for joint pain in Persian medical texts since Avicenna and Rhazes, roughly a thousand years ago, and this was the first study to directly test it head-to-head against a modern pharmaceutical. One hundred adults with knee osteoarthritis were randomly assigned to rub either the basil-sesame oil blend or 1% diclofenac gel onto their knees three times a day for 4 weeks; everyone could also take an as-needed pain pill if they needed more relief. Researchers tracked pain and stiffness using a standard osteoarthritis questionnaire (WOMAC), a 0-100 pain scale, how far patients could bend their knee, and how fast they could walk. Both treatments worked about equally well: there was no meaningful difference between the herbal oil and the diclofenac gel on any measure at 2 or 4 weeks, and both groups showed significant improvement in pain, stiffness and function compared to when they started. One interesting difference: people using diclofenac gel needed noticeably more rescue pain medication by the fourth week, while basil-oil users' need for extra medication stayed about the same — a pattern that could suggest diclofenac's effect wearing off faster. Importantly, nobody using the basil oil reported any side effects at all. These findings suggest this centuries-old herbal remedy may relieve knee osteoarthritis pain about as well as a standard anti-inflammatory gel, with an excellent safety record. That said, there was no "fake treatment" (placebo) group, so it's not fully clear how much of the improvement came from the oils themselves versus the natural ups and downs of the condition, and because sesame oil may have its own joint-protecting effects, the specific contribution of basil can't be pinned down. Larger studies with a placebo group and longer follow-up are needed before this becomes a routine recommendation.

Zhiyong Long et al. (2023) · Frontiers in immunology

Whether the plant compounds often discussed for rheumatoid arthritis — turmeric, green tea, pomegranate, garlic — actually do anything is the question this meta-analysis set out to answer. This review gathered every randomized trial it could find on the question: 47 trials, nearly 3,900 people, fifteen different plant polyphenols, from Iran, China, Korea, Egypt, Japan, Brazil, India and the United States. The clearest picture came from two of them. The first is total glucosides of paeony, an extract of Chinese peony root that is a licensed prescription medicine in China. Twenty-three trials tested it — always added to standard RA drugs like methotrexate, never instead of them. Disease activity scores came down, and so did CRP, ESR and rheumatoid factor, the blood markers doctors track. The most interesting result: people taking it reported *fewer* side effects than people on the standard drugs alone. That fits how it is used clinically — it appears to soften the toll the conventional drugs take on the liver and stomach. The second is curcumin, the yellow compound in turmeric. Five trials, and the same direction: lower disease activity, lower inflammatory markers, no extra side effects. Green tea polyphenols looked promising across two trials. Saffron did not show a clear effect. Everything else — pomegranate, garlic, resveratrol, sesame, cinnamon, ginger, kudzu, cranberry, olive oil, quercetin — rests on one or two small trials apiece, which is encouraging but not yet evidence that bears weight. The honest caveat, which the authors state plainly themselves: the trials disagreed with each other a great deal, most were small, and when the researchers sliced the data by dose and duration some of the headline benefits faded. Nearly all of these were add-on studies. Nobody tested a polyphenol against methotrexate, so the evidence says nothing about replacing a prescribed medication. What it does support is turmeric and peony extract as the best-evidenced candidates, studied as additions to existing treatment rather than replacements for it.